ObjectiveTo investigate the risk factors of hepatoduodenal lymph node (HDLN) metastasis in patients with advanced gastric cancer and its effect on prognosis. MethodsClinical datas of patients with advanced gastric cancer who underwent D2 radical gastrectomy for gastric cancer and HDLN dissection between Jan 2011 and Nov 2013 in department of general surgery of Ankang Central Hospital were retrospectively reviewed. Multivariate logistic regression analysis was performed to identify the independent risk factors associated with HDLN metastasis. Survival curves were performed to compare the survival rate of patients with or without HDLN metastasis and of patients with HDLN metastasis or with other lymph node metastasis. A Cox proportional hazards model was used for the multivariate analysis of risk factors for death in advanced gastric cancer. ResultsThe incidence of HDLN metastasis was 10.7% in patients with advanced gastric cancer. Multivariate logistic regression analyses revealed that the middle or lower stomach cancer (OR=6.014, P=0.002) and stage T3 or T4 (OR=5.133, P=0.021) were independent risk factors for HDLN metastasis. The 2-year overall survival (OS) rate was 36.7% in patients with HDLN metastasis. It was lower in patients with HDLN metastasis compared with those without (P=0.002). Limited to node-positive patients, patients with HDLN metastasis demonstrated decreased 2-year OS rate compared with node-positive patients without HDLN metastasis (P=0.027). Cox proportional hazard analysis identified poorly differentiated or undifferentiated cancer, stage of T3 or T4, and HDLN metastasis were independent poor prognostic factors in the patients with advanced gastric cancer (P < 0.05). ConclusionsCancer located in the middle or lower stomach, and stage T3 or T4 were independent risk factors for HDLN metastasis in patients with advanced gastric cancer. HDLN metastasis demonstrated a poor prognosis.
ObjectiveTo investigate the rule of lymph node metastasis in early gastric cancer (EGC) so as to provide a reasonable treatment. MethodsWe retrospectively analyzed the clinical data of 118 EGC patients who had been treated from January 2006 to December 2012,and a total of 8 potential factors associated with occurrence of EGC were evaluated by univariate analysis and multivariate logistic regression analysis. ResultsThe univariate analysis showed that ulcer,tumor size,depth of invasion and lymphatic involvement were correlated with lymph node metastasis (P<0.05).Multivariate logistic regression analysis showed that presence of an ulcer (OR=2.872),tumor of 3.0 cm or larger than that (OR=2.351),tumor invasion into the submucous layer (OR=3.461) and invasion into the lymphatic tubes (OR=1.784) were found to be independent risk factors. ConclusionLymph node metastasis of EGC is correlated with many factors,so EGC treatment choice should be made reasonably based on strict screening to exclude various risk factors before taking surgery.
ObjectiveTo explore the clinical efficacy and security of early enteral nutrition (EN) on patients with gastric cancer after radical operation. MethodsSeventy cases who treated in Affiliated Hospital of Inner Mongolia Medical University from Dec. 2008 to Apr. 2013 were randomly divided into EN group (n=35) and parenteral nutrition (PN) group (n=35), analysis and comparison of nutrition indicators and recovery indicators between 2 groups were performed. ResultsThere were no significant differences on levels of count of white blood cell (WBC), serum albumin (ALB), prealbumin (PA), and transferring (TRF) before operation between the 2 groups (P > 0.05). On 3 and 7 days after operation, the levels of ALB, PA, and TRF were all higher in EN group (P < 0.05) besides level of count of WBC. In addition, hospital stay and hospitalization cost were both lower in EN group (P < 0.05), but there was no significant difference on postoperative exhaust time and complication incidence (P > 0.05). ConclusionsEN is a safe, effective, and economical method of nutritional supplements, and it is a preferred method of nutritional support for patients with advanced gastric cancer after operation at prophase, which is worthy to apply widely in clinical.
ObjectiveTo explore the dynamic expression changes of neuronal growth and differentiation-associated miR-124a and miR-9 in the process of epileptogenesis. MethodsEstablish the lithium-pilocarpine induced status epilepticus (SE) rat model. Animal behavior change induced by SE as well as in the period of chronic epilepsy was observed by naked-eye or video-recording. Major time points for the study were chosen at 1d, 7d, 14d and 28d post-SE, on which the post-SE rats were decapitated and their hippocampal specimens were obtained. Total RNA from each specimen was extracted and qPCR was exploited to detect miR-124a and miR-9 expression in the specimens. Statistical analysis was used to show the dynamic expressional changes of miR-124a and miR-9 in rat hippocampus at 1d, 7d, 14d and 28d post-SE during the process of epileptogenesis. ResultsCompared with normal rats, the expression level of miR-124a in rat hippocampus did not show a significant difference at 1d post-SE, but it had shown markedly differences at 7d, 14d and 28d post-SE(P < 0.05), with a declining trend. Compared with normal rats, the expression level of miR-9 had demonstrated significant differences at 1d, 7d, 14d and 28d post-SE(P < 0.05)with a generally increasing trend, although there was slight fluctuation of expressional up-regulation at 7d post-SE. ConclusionNeuronal growth and differentiation-associated miR-124a and miR-9 had shown dynamic changes of down-regulation or up-regulation in the process of epileptogenesis. It can be suspected that miR-124a and miR-9 take part in hippocampal neurogenesis post-SE and be involved in epileptogenesis process.
ObjectiveImpaired breathing during and following seizures is an important cause of sudden unexpected death in epilepsy (SUDEP), but the network mechanisms by which seizures impair breathing have not been thoroughly investigated. Progress would be greatly facilitated by a model in which breathing could be investigated during seizures in a controlled setting. MethodRecent work with an acute Long-Evans rat model of limbic seizures has demonstrated that depression of brainstem arousal systems may be critical for impaired consciousness during and after seizures. We now utilize the same rat model to investigate breathing during partial seizures with secondary generalization. ResultBreathing is markedly impaired during seizures(P < 0.05;n=21), and that the severity of breathing impairment is strongly correlated with the extent of seizure propagation (Pearson R=-0.73;P < 0.001;n=30). ConclusionSeizure propagation could increase the severity of breathing impairment caused by seizures. Based on these results, we suggest that this animal model would help us to improve understanding of pathways involved in impairment of breathing caused by seizures and this is an important initial step in addressing this significant cause of SUDEP in people living with epilepsy.