ObjectiveTo explore the effects of intraoperative lymphatic chemotherapy (LC) on immune functions of patients after esophageal carcinoma resection. MethodsPatients who underwent intraoperative LC during esophageal carcinoma resection in the Department of Thoracic Surgery of West China Hospital from March to October,2013 were prospectively included in this study, and patients who underwent esophageal carcinoma resection without intraoperative LC during the same period were also included as the control group. All the patients were divided into a pacitaxel LC group,a fluorouracil LC group,and a control group without LC. A total of 37 patients were included in this study including 25 male and 12 female patients with their age of 42-76 (61.89±7.95) years. There were 15 patients in the pacitaxel LC group,15 patients in the fluorouracil LC group,and 7 patients in the control group. Representative indexes of humoral immunity and cellular immunity in peripheral blood of all the patients were examined preoperatively and on the third and seventh postoperative day, and then compared among the 3 groups. ResultsAll the immune indexes of the 3 groups decreased after surgery to different extent. There was no statistical difference in preoperative and postoperative difference of immunoglobulin concentration between LC groups and the control group (P>0.05). CD8+ T cell count recovered more rapidly after surgery in LC groups than the control group. CD3+ T cells recovered most rapidly after surgery in the fluorouracil LC group. ConclusionLC is beneficial for the recovery of cytotoxic effects of T lymphocytes but may not promote humoral immunity for patients after esophageal carcinoma resection.
Lymphatic metastasis of esophageal cancer is one of the main ways of esophageal cancer metastasis and it is as well one of the most important factors influencing the prognosis of esophageal cancer patients. Compared to intravenous administration of chemotherapy, local chemotherapy has the less toxicity and less systemic side effects. Nano carbon is a safe and effective carrier for intraoperative lymphatic chemotherapy. It plays an important role in tracing and targeting lymph node during the lymphatic chemotherapy. Lymphatic chemotherapy can induce tumor into necrosis and apoptosis. For esophageal cancer, lymphatic chemotherapy is also to be proved to improve the rate of lymph node dissection and the number of metastatic lymph nodes, decrease tumor size, improve the quality of life and survival rate. In conclusion, lymphatic chemotherapy can be considered an assistant therapy to eliminate the tumor cell in lymph nodes and micrometastatic foci. In this review, the metastatic characteristic of esophageal cancer, the significance, mechanism and application of lymphatic chemotherapy carried by nano carbon are summarized.
ObjectiveThe purpose of this study was to offer new suggestions for current clinician training under the guidance of the Healthy China 2030 policy by investigating the patients’ needs.MethodsThis study surveyed adult outpatients from West China Hospital of Sichuan University between March and July, 2019 and February and May, 2020 by self-constructed questionnaires to investigate the expectation and requirements of outpatients towards medical professionals.ResultsA total of 430 questionnaires were distributed, and 402 of them (93.5%) were collected and included in this study. All questionnaire respondents expected that medical graduates should have outstanding expertise and ethical standard. The majority valued qualities such as physical and mental health (90.05%), a bachelor’s degree or higher (73.88%), knowledge on disease control and prevention (61.69%), knowledge on health care (91.29%), ability to continuously update current knowledge (70.65%), and excellent communication (71.14%) and teamwork (62.44%) skills. In addition, most patients expected that new health care providers to possess humanitarianism and professional dedication relevant traits, and could improve diagnoses and treatments via research activities. Patients’ demand for abilities such as disease control and prevention, health care, and integrative cooperation between traditional Chinese medicine and modern medicine significantly increased after the COVID-19 pandemic (P<0.05).ConclusionsNowadays, to provide health care services which meet the needs of the public, clinicians are expected to have qualities such as outstanding expertise, humanity, research and knowledge-updating skills, disease control and prevention, health care management, and capability to take the advantages of traditional Chinese medicine and modern medicine.
Objective To assess the impact of earthquake magnitude scale on injury characteristics of patients admitted to an earthquake rescue hospital，and provide references for rescue strategy formulation and medical resourceallocation. Methods We retrospectively analyzed clinical data of patients injured in 2008 “5 • 12” Wenchuan earthquakeand 2013 “4 • 20” Lushan earthquake who were admitted to West China Hospital of Sichuan University. Patient gender，age，time of admission，mechanisms，types and severity of injury and their prognosis were compared between the 2 groups.Results A total of 1 856 patients who were injured in Wenchuan earthquake，including 974 male and 882 female patients with their age of 45.8±22.7 years，and 316 patients who were injured in Lushan earthquake，including 174 male and 142 female patients with their age of 43.0±23.1 years，were enrolled in our study. No significant difference was found in genderor age between these 2 groups （P＞0.05）. Peak time of admission of Wenchuan earthquake patients was significantlylater than that of Lushan earthquake patients，and transfer duration of Wenchuan earthquake patients was significantly longerthan that of Lushan earthquake patients. The percentage of patients with crash injury of heavy objects or buried trauma ofWenchuan earthquake patients was significantly higher than that of Lushan earthquake patients. Injury severity and in-hospitalmortality of Wenchuan earthquake patients were significantly higher than those of Lushan earthquake patients. The proportionof patients with chest or cerebral injury of Lushan earthquake patients was significantly higher than that of Wenchuanearthquake patients. Conclusions Earthquake magnitude scale has a significant influence on mechanisms，types andseverity of injury of patients injured in earthquakes，as well as their timely transfer，management and prognosis. In earthquakeswith a comparatively lower magnitude scale，more thoracic surgeons and neurosurgeons are needed to ensure timelymanagement for patients with chest or cerebral injury.