Recurrent esophageal carcinoma after esophagectomy with three-field lymph node dissection

To evaluate the effect of the extended lymphadenectomy for thoracic esophageal carcinoma, the pattern of recurrence in the 50 patients with pT3 tumors who underwent esophagectomy with cervical, mediastinal, and abdominal lymph node dissection (3-F) (group A) was compared with that of 100 patients at pT3 who underwent esophagectomy without upper mediastinal and cervical lymphadenectomy (2-F) (group B). The cumulative 5-year survival rate for 115 patients who underwent 3-F was 50.9%. Cumulative 5-year survival rates for patients in groups A and B were 36.8% and 22.0%, respectively. The survival curve for group A was significantly better than group B (P = 0.02332). Lymphatic recurrence was noted less frequently in group A (8/23) than in group B (31/49) (χ² = 5.1149), whereas the rate of hematogenous recurrence was similar. Extension of the field of lymph node dissection reduced the lymph node recurrence in patients with thoracic esophageal carcinoma, which may have positively affected patient survival. © 1996 Wiley-Liss, Inc.     

Long-term benefits of aggressive treatment for primary colorectal cancer

The long-term follow up of 128 colorectal cancer patients is reported. Seventy-nine percent (101/128) of the patients had curative resections: 70 patients had radical lymphadenectomies with wide removal of tumor-adjacent nodes, and 31 patients had standard resections. The 5-year overall survival rates for Dukes' stage B and C patients and for all rectosigmoid cancer patients significantly favored radical resection (60% vs. 38%, 57% vs. 29%, respectively, P < 0.05). Tumor-free survival rates were also higher after radical lymphadenectomy but did not reach statistical significance. Eleven percent (14/128) of the patients required multiorgan resections, and/or preoperative radiation to render fixed cancers resectable, and these patients had a 10-year tumor-free survival rate of 45%, compared to zero % 5-year survival for the 27 patients who underwent palliative procedures (P < 0.01). These results confirm that many colorectal cancer patients will be cured with aggressive treatment and they support the need for a controlled trial for evaluation of lymphadenectomy for this disease. © 1996 Wiley-Liss, Inc.     

Extended criteria for liver transplantation in hepatocellular carcinoma. A retrospective,multicentric validation study in Belgium

BackgroundRecent studies indicate that a group of patients with cirrhosis receiving a liver transplantation for hepatocellular cancer (HCC) beyond the Milan Criteria (MC) can achieve a similar outcome compared to patients within these criteria. This study aims to investigate the value of the Asan critera (AC), up-to-7 criteria (UT7), French alpha-foetoprotein (AFP) model and Metroticket 2.0 (MT2.0) model compared to the MC.Methods526 patients transplanted for non-metastatic HCC were analyzed. Patient groups within and beyond MC and extended criteria were determined according to radiological assessment and AFP value at listing.ResultsOverall survival (OS) and recurrence (RR) rates were similar between patients within MC and all extended criteria. Five-year OS within MC was 71.3% compared to 70.9% for AC, 71.4% for UT7, 69.7% for AFP-model and 71.0% for MT2.0 criteria. Five-year RR within MC was 12.3% compared to 13.5% for AC, 13.0% for UT7, 14.3% for AFP-model and 13.2% for MT2.0 criteria. Patients beyond MC but within the extended criteria had tendency towards higher recurrence.ConclusionsAll validated extended criteria (AC, UT7, AFP-model and MT2.0) could be proposed as alternatives to the MC with similar outcome. Prospective data are awaited to assess recurrence beyond MC.     

护士延时下班对日周性疲劳及满意度影响的研究

目的探讨临床护士不同程度的延时下班对日周性疲劳及工作满意度的影响,为科学合理配置人力提供依据。方法通过整群抽样,调查了浙江省杭州市3所三等甲级医院479名临床护士的延时下班程度、日周性作业疲劳程度、护士工作满意度。结果工作前,各组疲劳度与工作满意度差异均无意义(P>0.05);一个工作日结束时,两两比较得出:按时下班组(编号1组)与延时下班<1 h组(编号2组),疲劳度与工作满意度差异均无意义(P>0.05);延时下班1~2 h组(编号3组)与第1、2组比较,疲劳度与工作满意度差异均有显著性意义(P<0.01);延时下班>2 h组(编号4组)与第1、2组比较,疲劳度与工作满意度差异均有显著性意义(P<0.01),与第3组比较,疲劳度与工作满意度差异均无统计学意义(P>0.05)。结论延时下班不足1 h,对护士日周性疲劳度与工作满意度影响不明显;延时下班1 h以上,则显著影响日周性疲劳度与工作满意度。     

延伸护理方案对不同民族地区糖尿病患者自我行为改变的效果

目的：探讨延伸护理方案对不同民族地区糖尿病患者自我行为改变的效果。方法选取我院收治的40例汉族糖尿病患者作为A组,同时选取40例回族糖尿病患者作为B组。对所有患者均行延伸护理方案,并于3个月后观察对比两组自我行为改善效果以及护理结束后血糖水平达标率。结果 A组和B组护理前饮食、运动、足部护理、血糖监测和遵医嘱用药等评分相近,护理后两组各项评分均明显升高,且A组远高于B组(P=0.000);A组护理结束时血糖水平达标率为35.00%,B组为32.50%,前者较后者稍高,但是差异不具有统计学意义( P=1.000)。结论采用延伸护理方案后,汉族糖尿病患者自我行为改善效果较回族糖尿病患者更加显著,但是二者护理结束后血糖水平达标率相近,值得在各民族地区推广使用。     

基于内模自适应估计器的VEP信号提取新方法

本文基于确定信号和扰动和内模建立了两种视觉诱发脑电（VEP）和自发脑电（EEG）混合信号的组合状态空间模型，基于时域参数模型提出了采用迭代型推广卡尔曼滤波算法来实现VEP信号的自适应估计，最后通过临床实际应用比较分析了两种建模方法的滤波性能。