Objective To systematically review the impacts of general anesthesia using sevoflurane versus propofol on the incidence of emergence agitation in pediatric patients. Methods Such databases as PubMed, EMbase, Web of Science, The Cochrane Library (Issue 4, 2012), CNKI, CBM, WanFang Data and VIP were electronically searched from inception to December 2012, for comprehensively collecting randomized controlled trials (RCTs) on the impacts of general anesthesia using sevoflurane versus propofol on the incidence of emergence agitation in pediatric patients. References of included studies were also retrieved. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.1 software. Results A total of 9 RCTs involving 692 children were included, of which, six were pooled in the meta-analysis. The results of meta-analysis showed that: a) after anesthesia induction using sevoflurane, intravenous propofol maintenance was associated with a lower incidence of emergence agitation compared with sevoflurane maintenance (RR=0.57, 95%CI 0.39 to 0.84, P=0.004); and b) patients anesthetized with total intravenous propofol had a lower incidence of emergence agitation compared with total inhalation of sevoflurane (RR=0.16, 95%CI 0.06 to 0.39, Plt;0.000 1). Conclusion The incidence of emergence agitation after general anesthesia using sevoflurane is higher than that using propofol. Due to the limited quantity and quality, the application of sevoflurane should be chosen based on full consideration into patients’ conditions in clinic.
ObjectiveTo systematically review efficacy and safety of docetaxel chemotherapy combine with 3-dimensional conformal radiation therapy (3D-CRT) in treatment of esophageal cancer.MethodsDatabases including PubMed, EMbase, The Cochrane Library, Web of Science, CNKI and WanFang Data were searched from inception to February 2017 to collect randomized controlled trials (RCTs) and quasi-randomized control trials (qRCTs) about docetaxel chemotherapy combine with 3D-CRT in treatment of esophageal cancer. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by using Stata 12.0 software.ResultsA total of 17 RCTs involving 1 353 patients were included. The results of meta-analysis showed that, compared with the radiotherapy alone, the docetaxel chemotherapy combine with 3D-CRT could improve effective rate (OR=1.25, 95%CI 1.07 to 1.47, P=0.003), 3-year survival rate (OR=1.91, 95%CI 1.19 to 3.06, P=0.006), but there were no significant differences in 1-year survival rate (OR=1.28, 95%CI 0.95 to 1.72, P=0.105), hematologic toxicities (OR=1.13, 95%CI 0.85 to 1.49, P=0.389) and gastrointestinal reactions (OR=1.19, 95%CI 0.90 to 1.57, P=0.181).ConclusionsCompared with radiotherapy alone, docetaxel chemotherapy combine with 3D-CRT can improve the effective rate, 3-year survival rate, but not increase the incidences of adverse effects. Due to limited quantity and quality of the included studies, more high quality studies are needed to verify above conclusion.
Objective To evaluate the effect of fast track surgery (FTS) after esophageal cancer surgery. Methods The randomized controlled trial (RCT) and observational studies about FTS for esophageal cancer in PubMed、EMbase、The Cochrane Library、Web of Science、CBM、CNKI and WanFang databases were searched up to May 2017. Then the studies were screened according to the inclusion and exclusion criteria by two researchers. Data were analyzed by Stata12.0 software. Results Totally 13 RCTs and 5 observational studies with 2 447 patients were eligible for analysis. Compared with the control group, incidence of postoperative complications (OR=0.53, 95%CI 0.40 to 0.71, P<0.05) significantly reduced in the FTS group, but there was no significant difference between the two groups in readmission rate (OR=1.21, 95%CI 0.83 to 1.76, P=0.313) and 30 d mortality rate (OR=0.72, 95%CI 0.43 to 1.20, P=0.207). Conclusion FTS can safely and effectively accelerate the recovery of patients with esophageal cancer and it owns important clinical values.
ObjectiveTo explore the possible factors which influence the survival time of elderly patients with esophageal cancer.MethodsWe retrospectively analyzed the data of patients with esophageal cancer treated in the First Hospital of Lanzhou University, Gansu Province Tumor Hospital from January 2012 to October 2016. Kaplan-Meier method was used to estimate and analyze the single factor, survival curve with log-rank test. The Cox regression model was used for multivariate prognostic analysis．ResultsAccording to the inclusion and exclusion criteria, 302 patients were eventually collected, including 231 males and 71 females, with an average age of 66.0±6.0 years. The univariate analysis showed that age, tumor stage, tumor site, Karnosfsky performance satus (KPS) score, and treatment were prognostic factors (P<0.05). Multivariate analysis showed that the patient age and treatment were independent factors for overall survival (OS) and progress-free survival (PFS) (P<0.05). The OS and PFS of the patients with age≤70 years were better than those of the patients more than 70 years. Chemotherapy alone and surgery alone was better for survival situation than radiotherapy alone.ConclusionAge and treatment are independent prognostic factors in survival time of the elderly patients with esophageal cancer.