ObjectiveTo evaluate the prognostic value of osteopontin (OPN) in patients with liver cancer by using meta-analysis.MethodsWe searched PubMed, Embase, Web of science, Wanfang database, Chinese Science and Technology Academic Journal, Chinese Journal Full-text Database, and Chinese Biomedical Literature Database to identify relevant articles from their inception to October 31, 2018. A meta-analysis was carried out by using the STATA 12.0 software.ResultsA total of 13 studies were included in this meta-analysis, including 2 171 liver cancer cases. The pooled data of studies showed that OPN expression level was negatively associated with overall survival time (HR=1.58, 95% CI was (1.37, 1.79), P<0.001) and disease free survival time (HR=1.67, 95% CI was (1.39, 1.96), P<0.001). High expression of OPN for patients with liver cancer had shorter overall survival time and disease-free survival time compared with those of low expression of OPN.ConclusionCurrent evidence shows that high expression of OPN is closely related to poor prognosis of patients with liver cancer.
ObjectiveTo compare the effectiveness and safety of laparoscopic cholecystectomy (LC) plus laparoscopic common bile duct exploration (LCBDE) with LC plus endoscopic retrograde cholangiopancreatography (ERCP) for patients with concomitant cholelithiasis and choledocholithiasis by using meta-analysis.MethodsWe searched PubMed, Cochrane Library、EMBASE, Chinese Biomedical Literature Database, Chinese Science and Technology Academic Journal, Chinese Journal Full-text Database and Wanfang database to identify relevant articles from their inception to 31 October 2018. A meta-analysis was carried out using the RevMan 5.3 software.ResultsA total of 13 RCTs were included in this meta-analysis, 747 cases received LC+LCBDE and 761 cases underwent LC+ERCP. The meta-analysis results showed that no significant difference between the LC+LCBDE group and the LC+ERCP group in terms of common bile duct (CBD) stone clearance rate [RR=0.99, 95%CI (0.95, 1.02), P=0.87] and overall complications [RR=0.94, 95%CI (0.72, 1.22), P=0.64]. The LC+LCBDE group had higher rate of postoperative bile leakage rate [RR=3.87, 95%CI (2.01, 7.42), P<0.000 1] than that LC+ERCP group. However, the LC+LCBDE group had lower rate of postoperative pancreatitis [RR=0.28, 95%CI (0.14, 0.55), P=0.002] than that LC+ERCP group.ConclusionsBoth LC+LCBDE and LC+ERCP are equivalent in CBD stone clearance rate and overall complications, LC+LCBDE is associated with a higher postoperative bile leakage rate and lower rate of postoperative pancreatitis, appropriate treatment should be selected according to the individual patient’s condition.
目的 探讨改良区域神经阻滞麻醉在腹股沟疝无张力修补术中的优势和应用价值。方法 回顾性总结和分析2008年2月至2010年3月期间张掖医学高等专科学校附属医院运用改良区域神经阻滞麻醉行腹股沟疝无张力修补59例患者的临床资料。结果 59例患者按照神经阻滞麻醉效果分级标准，Ⅰ级52例，Ⅱ级6例， Ⅲ级1例。7例Ⅱ、Ⅲ级患者在分离腹膜前间隙内侧时自诉疼痛，经静脉给予杜非合剂2 ml后完成手术，但均未更改麻醉方式。术后无皮疹、皮下硬结、精索水肿、阴囊血肿、尿潴留、切口感染等并发症发生。结论 改良区域神经阻滞麻醉下行腹股沟疝无张力修补术效果好、安全性高、操作简单、费用低。
ObjectiveTo explore the effect of using a stent graft to treat a Stanford type A aortic dissection with the ascending aorta in the cavity.MethodA retrospective review was made of the clinical data of a patient with Stanford type A aortic dissection admitted to Zhangye People’s Hospital Affiliated to Hexi University in December 2016.ResultsAfter the patient underwent general anesthesia aortic dissection and stent graft treatment, the dissection fracture completely disappeared. After 2 years of follow-up, the patient’s pseudocavity hematoma was completely absorbed. The operative time was 30 min and the blood loss was about 5 mL. There were no complications such as avulsion of dissection, internal leakage, cerebral infarction, myocardial infarction, nervous system, and other complications occurred.ConclusionFor Stanford type A aortic dissection with a tear located in the ascending aorta, intracavitary treatment with coated stent is feasible for ascending aortic dissection with good vascular conditions and tear location through accurate preoperative assessment.