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Prognostic impact of metastatic lymph node ratio in advanced gastric cancer from cardia and fundus

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World Journal of Gastroenterology 2008年第27期14卷 4383-4388页

作者： chang-ming huang Bi-Juan Lin Hui-Shan Lu Xiang-Fu Zhang Ping Li Jian-Wei Xie Department of Oncology Affiliated Union Hospital of Fujian Medical University Fuzhou 350001 Fujian Province China

AIM: To investigate the prognostic impact of the metastatic lymph node ratio (MLR) in advanced gastric cancer from the cardia and fundus. METHODS: Two hundred and thirty-six patients with gastric cancer from the cardia and fundus who underwent D2 curative resection were analyzed ret- rospectively. The correlations between MLR and the total lymph nodes, positive nodes and the total lymph nodes were analyzed respectively. The influence of MLR on the survival time of patients was determined with univariate Kaplan-Meier survival analysis and mul- tivariate Cox proportional hazard model analysis. And the multiple linear regression was used to identify the relation between MLR and the 5-year survival rate of the patients. RESULTS: The MLR did not correlate with the total lymph nodes resected (r = -0.093, P = 0.057). The 5-year overall survival rate of the whole cohort was 37.5%. Kaplan-Meier survival analysis identified that the following eight factors influenced the survival time of the patients postoperatively: gender (χ2 = 4.26, P = 0.0389), tumor size (χ2 = 18.48, P < 0.001), Borrmann type (χ2 = 7.41, P = 0.0065), histological grade (χ2 = 5.07, P = 0.0243), pT category (χ2 = 49.42, P < 0.001), pN category (χ2 = 87.7, P < 0.001), total number of re- trieved lymph nodes (χ2 = 8.22, P = 0.0042) and MLR (χ2 = 34.3, P < 0.001). Cox proportional hazard model showed that tumor size (χ2 = 7.985, P = 0.018), pTcategory (χ2 = 30.82, P < 0.001) and MLR (χ2 = 69.39, P < 0.001) independently influenced the prognosis. A linear correlation between MLR and the 5-year survival was statistically significant based on the multiple lin- ear regression (β = -0.63, P < 0.001). Hypothetically, the 5-year survival would surpass 50% when MLR was lower than 10%. CONCLUSION: The MLR is an independent prognostic factor for patients with advanced gastric cancer from the cardia and fundus. The decrease of MLR due to adequate number of total resected lymph nodes can improve the survival.

关键词： Lymph node metastasis Metastatic lymph node ratio Lymphadenectomy Prognosis

Effect of lymphadenectomy extent on advanced gastric cancer located in the cardia and fundus

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World Journal of Gastroenterology 2008年第26期14卷 4216-4221页

作者： chang-ming huang Bi-Juan Lin Hui-Shan Lu Xiang-Fu Zhang Ping Li Jian-Wei Xie Department of Oncology Affiliated-Union Hospital of Fujian Medical University Fuzh-ou350001 Fujian Province China

AIM： To analyze the prognostic impact of lymphade-nectomy extent in advanced gastric cancer located in the cardia and fundus. METHODS： Two hundred and thirty-six patients with advanced gastric cancer located in the cardia and fundus who underwent D2 curative resection were analyzed retrospectively. Relationships between the numbers of lymph nodes （LNs） dissected and survival was analyzed among different clinical stage subgroups. RESULTS： The 5-year overall survival rate of the entire cohort was 37.5%. Multivariate prognostic variables were total LNs dissected （P 〈 0.0001; or number of negative LNs examined, P 〈 0.0001）, number of positive LNs （P 〈 0.0001）, T category （P 〈 0.0001） and tumor size （P = 0.015）. The greatest survival differences were observed at cutoff values of 20 LNs resected for stage Ⅱ（p = 0.0136）, 25 for stage Ⅲ（P 〈 0.0001）, 30 for stage Ⅳ（P = 0.0002）, and 15 for all patients （P = 0.0024）. Based on the statistically assumed linearity as best fit, linear regression showed a significant survival enhancement based on increasing negative LNs for patients of stages Ⅲ （P = 0.013） and Ⅳ（P = 0.035）. CONCLUSION： To improve the long-term survival of patients with advanced gastric cancer located in the cardia and fundus, removing at least 20 LNs for stage Ⅱ,25 LNs for stage Ⅲ, and 30 LNs for stage N patients during D2 radical dissection is recommended.

关键词： Stomach neoplasms Lymph node meta-stasis Surgery Lymphadenectomy Prognosis

A Load Service System with Reputation Proof in P2P Networks

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Journal of Computer and Communications 2015年第4期3卷 30-39页

作者： ming-chang huang Department of Business Information Systems & Operations Management University of North Carolina at Charlotte Charlotte USA

In this paper, a new system design for load services in computer networks with a new reputation system is constructed. The use of the reputation system is to address the free-rider problem. Database systems are used by directory agents to save information provided by load-server agents. Protocols are built for how a host finds available servers for load service or load transfer, especially when a host moves to a new region. Detailed procedures include how a directory agent builds its database, how a load-server agent provides services, and how a load-client agent receives its desired services. The system uses the fuzzy logic control method to transfer loads for load balancing, instead of the method of a fixed threshold level. For an ad-hoc (wireless) computer network framework, this new system structure is aimed to provide efficient ways for hosts to communicate with one another and to access resources in the system. This will also help the users of networks locate resources in a most effective and secure manner.

关键词： Load Service Peer-to-Peer Network Directory Agent Load-Server Agent Load-Client Agent Reputation System

huang's three-step maneuver for laparoscopic spleen-preserving No.10 lymph node dissection for advanced proximal gastric cancer

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Chinese Journal of Cancer Research 2014年第2期26卷 208-210页

作者： chang-ming huang Qi-Yue Chen Jian-Xian Lin Chao-Hui Zheng Ping Li Jian-Wei Xie Department of Gastric Surgery Fujian Medical University Union Hospital

Due to the complexity of the splenic hilar vessels, their anatomical variation and the narrow and deep space, as well as the bleeding-prone splenic parenchyma and the difficulty to manage splenic or vascular bleeding at the splenic hilum,the procedure remains challenging and technically demanding procedure for the performance of laparoscopic pancreas- and spleen-preserving splenic hilar lymph nodes dissection. Based on our experiences, we gradually explored a set of procednral operation steps called ＂huang＇s three-step maneuver＂. In this paper, we not only provide the concrete operation steps for the surgeon, but we also provide our recommended technique of pulling and exposure for assistants. This new maneuver simplifies the complicated procedure and improves the efficiency of laparoscopic spleen-preserving splenic hilar lymphadenectomy, making it easier to master and allowing for its widespread adoption.

关键词： Stomach neoplasms spleen preservation laparoscopy lymph node dissection

Study on the sulfinatodehalogenation of BrCF_2CF_2R

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Chinese Journal of Chemistry 1997年第5期15卷 472-474页

作者： HU, Qiao-Sheng HU, chang-ming huang, Wei-YuanShanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai 200032, China Shanghai Institute of Organic Chemistry Chinese Academy of Sciences Shanghai 200032 China

Sodium dithionite initiated sulfinatodehalogenation of BrCF2CF2R is studied.

关键词： Sulfinatodehalogenation fluorinated alkyl bromide fluorinated sulfinates fluorinated sultene

Apply Service Oriented Architecture and Web 2.0 Application in Web Services

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通讯和计算机（中英文版） 2015年第2期12卷 45-48页

作者： ming-chang huang Department of Business Information Systems & Operation Management University of North Carolina at Charlotte Charlotte NC

Prognostic impact of dissected lymph node count on patients with node-negative gastric cancer

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World Journal of Gastroenterology 2009年第31期15卷 3926-3930页

作者： chang-ming huang Jian-Xian Lin Chao-Hui Zheng Ping Li Jian-Wei Xie Bi-Juan Lin Hui-Shan Lu Department of Ontology Affiliated Union Hospital Fujian Medical University No. 29 Xinquan Road Fuzhou 350001 Fujian Province China

AIM:To investigate the long-term effect of the number of resected lymph nodes (LNs) on the prognosis of patients with node-negative gastric ***: Clinical data of 211 patients with gastric cancer, without nodal involvement, were analyzed retrospectively after D2 radical operation. We analyzed the relationship between the number of resected LNs with the 5-year survival, the recurrence rate and the post-operative complication ***: The 5-year survival of the entire cohort was 82.2%. The total number of dissected LNs was one of the independent prognostic factors. Among patients with comparable depth of invasion, the larger the number of resected LNs, the better the survival (P0.01). The post-operative complication rate was 10.9% and was not signif icantly correlated with the number of dissected LNs (P>0.05).CONCLUSION: For node-negative gastric cancer, sufficient number of dissected LNs is recommended during D2 lymphadenectomy, to improve the long-term survival and reduce the recurrence. Suitable increments of the dissected LN count would not increase the post-operative complication rate.

关键词： Stomach neoplasms Lymph nodes Gastrectomy Lymphadenectomy Prognosis

Role of 3DCT in laparoscopic total gastrectomy with spleen-preserving splenic lymph node dissection

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World Journal of Gastroenterology 2014年第16期20卷 4797-4805页

作者： Jia-Bin Wang chang-ming huang Chao-Hui Zheng Ping Li Jian-Wei Xie Jian-Xian Lin Jun Lu Department of Gastric Surgery Fujian Medical University Union Hospital

AIM: To investigate whether computed tomography with 3D imaging (3DCT) can reduce the risks associated with laparoscopic surgery.

关键词： Stomach neoplasms Spleen preservation Laparoscopy Lymph node dissection Computed tomography angiography with three-dimensional imaging

Comparision of modified and conventional delta-shaped gastroduodenostomy in totally laparoscopic surgery

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World Journal of Gastroenterology 2014年第30期20卷 10478-10485页

作者： chang-ming huang Mi Lin Jian-Xian Lin Chao-Hui Zheng Ping Li Jian-Wei Xie Jia-Bin Wang Jun Lu Department of Gastric Surgery Fujian Medical University Union Hospital

AIM: To evaluate the safety and feasibility of a modified delta-shaped gastroduodenostomy (DSG) in totally laparoscopic distal gastrectomy (TLDG).

关键词： Stomach neoplasms Totally laparoscopic surgery Digestive tract reconstruction Modified anastomosis Treatment outcome