Objective Based on the PSQ-18 scale, to evaluate the effects of disease classification early warning system (DCEWS) on operation quality of health examination center (HEC). Methods By means of the comparable and retrospective cohort study methods, using “PSQ-18” of American Rand Corporation as a tool, taking the date when HEC implemented DCEWS as node, and adopting statistic software for random sampling, it was divided into two groups: the traditional group (before implementing DCEWS, n=475) and the early warning group (after implementing DCEWS, n=473). The PSQ-18 scale scores of both groups were analyzed so as to assess the effects of DCEWS on HEC. Results Such factors as sex, age, education level and family average monthly income had certain effects on the score of PSQ-18, but there was no significant difference between the two groups (Pgt;0.05); in the following 4 dimensions as the ways of interpersonal communication, degree of doctor-patient communication, convenience degree and the overall satisfaction of patients, the PSQ-18 scores of the traditional group and the early warning group were 4.0±0.92/4.2±0.97, 3.8±0.94/4.0±0.96, 4.4±0.60/4.6±0.6, 4.2±0.87/4.4±0.94, respectively, with significant differences (all Plt;0.05). Conclusion The implementation of “Disease classification early waning system” can significantly increase the “patient satisfaction” of health examinees, and can significantly improve the operation quality of health examination center.
Objective To compare the combination of Xiao Chai Hu Tang and interferon versus the simple interferon for the management of chronic hepatitis B (CHB) in terms of clinical therapeutic effect and safety. Methods Such databases as PubMed, CBM disc, CNKI, VIP, Japana Centra Revuo Medicina were searched to include the randomized control trials (RCTs) of treating chronic hepatitis B by using Xiao Chai Hu Tang plus interferon as the treatment group and the interferon as the control group. The quality of the inclusive methodology was evaluated by two reviewers independently. RevMan5.0.24 software was employed for meta-analyses. Results Seven RCTs involving 668 patients were included and all of them were classified as Grade C methodologically. The results of meta-analyses demonstrated: compared with the simple interferon treatment, adding Xiao Chai Hu Tang to interferon was able to significantly increase the HBV-DNA negative conversion ratio (RR=1.44, 95%CI 1.18 to 1.76, P=0.000 4) and the HBeAg negative conversion ratio (RR=1.54, 95%CI 1.21 to 1.94, P=0.000 4); when the intervention duration was more than 12 weeks, the ALT normalization rate was improved significantly (24 weeks: RR=1.39, 95%CI 1.17 to 1.66, P=0.000 2; 12 weeks: RR=1.79, 95%CI 1.23 to 2.61, P=0.002) and the incidence of flu-like symptoms induced by interferon was significantly reduced (liver-protection treatment: RR=0.54, 95%CI 0.40 to 0.73, Plt;0.000 1; Non-liver-protection treatment: RR=0.75, 95%CI 0.59 to 0.95, P=0.02). The funnel plot was asymmetric, indicating publication bias. Conclusion Although Xiao Chai Hu Tang maybe has certain potential supplementary benefits to interferon for the management of CHB. The results of the above meta-analyses should be interpreted prudently because there exit disparities in domestic and international trails with the shortage of double blind or multi-centered clinical trials with high quality. The current evidence provides no way to compare the combination of Xiao Chai Hu Tang plus interferon with the simple interferon for the treatment of CHB and no accurate conclusion in terms of clinical therapeutic effects and safety.
ObjectivesTo develop an orthotopic xenografts model that can dynamically observe the growth of rectal cancer and lymphatic metastasis, and to preliminarily explore the feasibility of monitoring the growth and metastasis of rectal cancer by in vivo imaging system.MethodsAn orthotopic xenografts model was developed in nude mouse by rectal submucosal injection of red fluorescent protein-labeled human colorectal adenocarcinoma cell line HCT 116. Then, the fluorescence signal from cancer cells was collected at different time points by means of in vivo imaging system, and the growth and metastasis of cancer cells in the rectum of nude mice was observed in real time. Finally, the model was evaluated by pathology.ResultsFifty visualized nude mouse models of orthotopic implantation and lymphatic metastasis were successfully constructed. At 2-7 weeks after implantation, the fluorescent protein of tumor were observed in all nude mouse with in vivo imaging system. After the orthotopic implantation, the volume of the transplanted tumor grew with the extension of time, and the integrated density expanded gradually. The number of caudal mesenteric lymph node metastases, para-aortic lymph node metastases, liver metastases and lung metastases increased time-dependent. The results of histological study was consistent with depending on lymph nodes to express fluorescent proteins to determine metastasis.ConclusionsIt is reliable and feasible to visualize the orthotopic implantation and lymphatic metastasis model of nude mice. The in vivo imaging system is simple and effective for real-time, non-invasive and dynamic observation of the growth of orthotopic xenografts and lymphatic metastasis in nude mice.
ObjectiveTo compare the short-term outcome of 3-port and 5-port laparoscopic assisted radical resection for middle and high rectal cancer.MethodsWe retrospectively analyzed the clinical characteristics of 67 patients with middle and high rectal cancer who were treated in the Gastrointestinal Ward of Center of General Surgery in General Hospital of Western Theater Command of the Chinese People’s Liberation Army from January 2018 to December 2018. The operative, pathological, recent postoperative related indicators, and follow-up results of the two groups were compared and analyzed.ResultsAmong all the enrolled patients, 33 cases received 3-port laparoscopic surgery (3-port group) and 34 cases received 5-port laparoscopic surgery (5-port group). The total length of incision and the pain score of the Visual Analog Scale (VAS) on the 3rd postoperative day of the 3-port group were significantly better than those of the 5-port group (P<0.05). Peripheral incisal margins were negative in both two groups. However, there were no statistically significant differences in indicators such as operative time, intraoperative blood loss, operative conversion rate, hospitalization expenses, length of the distal margins, number of positive lymph nodes, number of lymph nodes harvested, time to the first flatus, time to the first ambulation, time to urinary catheter removal, time to drainage tube removal, time to the first oral intake, postoperative hospital stay, and postoperative complication rate (P>0.05). Thirty cases of the 3-port group were followed up for 12–24 months (median of 19 months), as well as 29 cases of 5-port group were followed up for 12–24 months (median of 19.5 months). There were no significant differences on the incidences of intestinal obstruction, local recurrence, distant metastasis, and death between the two groups (P>0.05).ConclusionCompared with the conventional 5-port laparoscopic surgery, the 3-port laparoscopic surgery could shorten the total length of incision and reduce the surgical trauma, suggesting that it is safe and effective.
Objective To investigate the correlation between the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic immune inflammation index (SII) and clinicopathological characteristics and prognosis in patients with gastrointestinal stromal tumor (GIST). Methods The clinicopathological data and blood routine results of 101 patients with GIST who were treated surgically in the General Hospital Western Theater Command PLA from December 2014 to December 2018 were collected retrospectively, samples were obtained to calculate NLR, PLR and SII. The optimal cutoff value of NLR, PLR and SII were evaluated by receiver operating characteristic (ROC) curve. The Chi-square test and t-test were used to analyze the relationship between NLR, PLR, SII and clinicopathological characteristics of GIST. The Kaplan-Meier plots and the log-rank test were used to analyze the influence factors affecting the recurrence-free survival (RFS) of patients with GIST. Multivariate Cox regression analyses was used to identify the independent influence factors affecting the RFS of patients with GIST. Results The preoperative peripheral blood NLR, PLR and SII of patients with GIST were correlated with the tumor site, tumor diameter and modified NIH risk stratification (P<0.05), but not with the mitotic count of tumor cells (P>0.05). Kaplan-Meier plots and log-rank test showed that NLR, PLR, SII, surgical method, tumor site, tumor diameter, mitosis rate and modified NIH risk stratification were the influential factors of RFS in with GIST. The multivariate Cox regression analysis revealed that postoperative whether to accept regular imatinib adjuvant therapy (HR=32.876, P<0.001), modified NIH risk stratification (HR=129.182, P<0.001), and PLR (HR=5.719, P=0.028) were independent influence factors affecting the RFS of patients with GIST. Conclusions Preoperative peripheral blood PLR, NLR, and SII are correlated with clinicopathological characteristics such as the tumor location, tumor diameter and modified NIH risk stratification, and are the influencing factors of postoperative RFS in patients with GIST. PLR is an independent predictor of RFS in patients with GIST.