老年小肾癌患者的随访

研究背景:对于老年患者合并多发性系统疾病预期寿命较短患者,积极的随访带来的益处在于避免手术的风险.但是积极随访对于肿瘤的治疗意义尚需讨论.     

Plasma monocyte chemotactic protein-1 remains elevated after minimally invasive colorectal cancer resection

AIM: To investigate plasma Monocyte Chemotactic Protein-1 levels preoperatively in colorectal cancer (CRC) and benign patients and postoperatively after CRC resection.METHODS: A plasma bank was screened for minimally invasive colorectal cancer resection (MICR) for CRC and benign disease (BEN) patients for whom preoperative, early postoperative, and 1 or more late postoperative samples (postoperative day 7-27) were available. Monocyte chemotactic protein-1 (MCP-1) levels (pg/mL) were determined via enzyme linked immuno-absorbent assay.RESULTS: One hundred and two CRC and 86 BEN patients were studied. The CRC patient’s median preoperative MCP-1 level (283.1, CI: 256.0, 294.3) was higher than the BEN group level (227.5, CI: 200.2, 245.2; P = 0.0004). Vs CRC preoperative levels, elevated MCP-1 plasma levels were found on postoperative day 1 (446.3, CI: 418.0, 520.1), postoperative day 3 (342.7, CI: 320.4, 377.4), postoperative day 7-13 (326.5, CI: 299.4, 354.1), postoperative day 14-20 (361.6, CI: 287.8, 407.9), and postoperative day 21-27 (318.1, CI: 287.2, 371.6; P < 0.001 for all).CONCLUSION: Preoperative MCP-1 levels were higher in CRC patients (vs BEN). After MICR for CRC, MCP-1 levels were elevated for 1 mo and may promote angiogenesis, cancer recurrence and metastasis.     

Toward standardization of care: The feeding readiness assessment after congenital cardiac surgery

Background

Feeding practices after neonatal and congenital heart surgery are complicated and variable, which may be associated with prolonged hospitalization length of stay (LOS). Systematic assessment of feeding skills after cardiac surgery may earlier identify those likely to have protracted feeding difficulties, which may promote standardization of care.

Methods

Neonates and infants ≤3 months old admitted for their first cardiac surgery were retrospectively identified during a 1‐year period at a single center. A systematic feeding readiness assessment (FRA) was utilized to score infant feeding skills. FRA scores were assigned immediately prior to surgery and 1, 2, and 3 weeks after surgery. FRA scores were analyzed individually and in combination as predictors of gastrostomy tube (GT) placement prior to hospital discharge by logistic regression.

Results

Eighty‐six patients met inclusion criteria and 69 patients had complete data to be included in the final model. The mean age of admit was five days and 51% were male. Forty‐six percent had single ventricle physiology. Twenty‐nine (42%) underwent GT placement. The model containing both immediate presurgical and 1‐week postoperative FRA scores was of highest utility in predicting discharge with GT (intercept odds = 10.9, P = .0002; sensitivity 69%, specificity 93%, AUC 0.913). The false positive rate was 7.5%.

Conclusions

In this analysis, systematic and standardized measurements of feeding readiness employed immediately before and one week after congenital cardiac surgery predicted need for GT placement prior to hospital discharge. The FRA score may be used to risk stratify patients based on likelihood of prolonged feeding difficulties, which may further improve standardization of care.     

The relationship between volatile sulphur compounds, tongue coating and periodontal disease

Abstract:  The purpose of the present study was to observe the casual levels of volatile sulphur compounds (VSC) in volunteers with different clinical scores of tongue coating, periodontal pockets depth and Gingival Bleeding Index. Seventy-two subjects who attended for the first time at the dental clinic of the University were randomly selected for intra-oral and periodontal examinations. Systemic and dental histories were also obtained. The subjects were unaware of all procedures. The level of VSC was assessed by using a portable sulphide monitor (Halimeter^®; Interscan Co., Chatsworth, CA, USA). High tongue coating levels were related with more VSC counts (multivariate anova , P  = 0.01). No statistically significant relation (multiple linear regression, P  > 0.05) was observed among the VSC levels considering age, bleeding and periodontal pockets sites (depth >4 mm). We concluded that the tongue coating was one of the main factors influencing the VSC levels.