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Features of synchronous and metachronous dual primary gastric and colorectal cancer

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World Journal of Gastrointestinal Oncology 2023年第11期15卷 1864-1873页

作者： Yi-Jia Lin hua-xian chen Feng-xiang Zhang xian-Sheng Hu Hai-Juan huang Jian-hua Lu Ye-Zi cheng Jun-Sheng Peng Lei Lian Department of General Surgery(Gastrointestinal Surgery) The Sixth Affiliated HospitalSun Yat-sen UniversityGuangzhou 510655Guangdong ProvinceChina Department of General Surgery(Colorectal Surgery) The Sixth Affiliated HospitalSun Yat-sen UniversityGuangzhou 510655Guangdong ProvinceChina Follow-up office The Sixth Affiliated HospitalSun Yat-sen UniversityGuangzhou 510655Guangdong ProvinceChina

BACKGROUND Studies evaluating the characteristics of dual primary gastric and colorectal cancer(CRC)(DPGCC)are limited.AIM To analyze the clinicopathologic characteristics and prognosis of synchronous and metachronous cancers in patients with DPGCC.METHODS From October 2010 to August 2021,patients with DPGCC were retrospectively reviewed.The patients with DPGCC were divided into two groups(synchronous and metachronous).We compared the overall survival(OS)between the groups using Kaplan-Meier survival methods.Univariate and multivariate analyses were performed using Cox’s proportional hazards model to identify the independent prognostic factors for OS.RESULTS Of the 76 patients with DPGCC,46 and 30 had synchronous and metachronous cancers,respectively.The proportion of unresectable CRC in patients with synchronous cancers was higher than that in patients with metachronous cancers(28.3%vs 3.3%,P=0.015).The majority of the second primary cancers had occurred within 5 years.Kaplan-Meier survival analysis showed that the patients with metachronous cancers had a better prognosis than patients with synchronous cancers(P=0.010).The patients who had undergone gastrectomy(P<0.001)or CRC resection(P<0.001)had a better prognosis than those who had not.In the multivariate analysis,synchronous cancer[hazard ratio(HR)=6.8,95%confidence interval(95%CI):2.0-22.7,(P=0.002)]and stage III-IV gastric cancer(GC)[HR=10.0,95%CI:3.4-29.5,(P<0.001)]were risk prognostic factor for OS,while patients who underwent gastrectomy was a protective prognostic factor for OS[HR=0.2,95%CI:0.1-0.6,P=0.002].CONCLUSION Regular surveillance for metachronous cancer is necessary during postoperative follow-up.Surgical resection is the mainstay of therapy to improve the prognosis of DPGCC.The prognosis appears to be influenced by the stage of GC rather than the stage of CRC.Patients with synchronous cancer have a worse prognosis,and its treatment strategy is worth further exploration.

关键词： Synchronous Metachronous Prognosis Gastric cancer Colorectal cancer

Stapled transperineal repair for low-and mid-level rectovaginal fistulas:A 5-year experience and comparison with sutured repair

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World Journal of Gastroenterology 2021年第14期27卷 1451-1464页

作者： Qian Zhou Zhi-Min Liu hua-xian chen Dong-Lin Ren Hong-cheng Lin Department of Coloproctology The Sixth Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510655Guangdong ProvinceChina Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases The Sixth Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510655Guangdong ProvinceChina Guangdong Institute of Gastroenterology The Sixth Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510655Guangdong ProvinceChina

BACKGROUND Currently,rectovaginal fistula(RVF)continues to be a surgical challenge worldwide,with a relatively low healing rate.Unclosed intermittent suture and poor suture materials may be the main reasons for this.AIM To evaluate the efficacy and safety of stapled transperineal repair in treating RVF.METHODS This was a retrospective cohort study conducted in the Coloproctology Department of The Sixth Affiliated Hospital of Sun Yat-sen University(Guangzhou,China).Adult patients presenting with RVF who were surgically managed by perineal repair between May 2015 and May 2020 were included.Among the 82 total patients,37 underwent repair with direct suturing and 45 underwent repair with stapling.Patient demographic data,Wexner faecal incontinence score,and operative data were analyzed.Recurrence rate and associated risk factors were assessed.RESULTS The direct suture and stapled repair groups showed similar clinical characteristics for aetiology,surgical history,fistula features,and perioperative Wexner score.The stapled repair group did not show superior results over the suture repair group in regard to operative time,blood loss,and hospital stay.However,the stapled repair group showed better postoperative Wexner score(1.04±1.89 vs 2.73±3.75,P=0.021),less intercourse pain(1/45 vs 17/37,P=0.045),and lower recurrence rate(6/45 vs 17/37,P=0.001).There was no protective effect from previous repair history,smaller diameter of fistula(10)were risk factors for fistula recurrence.Furthermore,stapled repair gave better efficacy in treating complex RVFs(i.e.,multiple transperineal repair history,mid-level fistula position,and poor control of defecation).CONCLUSION Stapled transperineal repair is advantageous for management of RVF,providing a high primary healing rate and low recurrence rate.

关键词： Rectovaginal fistula Surgical repair Transperineal approach Stapled technique Recurrence

起源于肛门直肠的Fournier坏疽患者的临床结局:重点关注会阴区未受感染的坏疽

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Gastroenterology Report 2019年第3期7卷 212-217,I0003页

作者： Hong-cheng Lin Zu-Qing chen hua-xian chen Qiu-Lan He Zhi-Min Liu Zhi-Yang Zhou Rong Shi Dong-Lin Ren Department of Coloproctology The Sixth Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdong 510655China Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases GuangzhouGuangdong 510655China Guangdong Institute of Gastroenterology GuangzhouGuangdong 510655China Department of Colorectal Surgery People’s Hospital Affiliated to Fujian University of Traditional ChineseFuzhouFujian 350004China Department of Anaesthesiology The First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdong 510080China Department of Radiology the Sixth Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdong 510655China

背景:Fournier坏疽(FG)是一种发生于外生殖器和会阴部的真菌感染。本研究旨在探讨源自肛门直肠、继发于肛瘘和肛周脓肿的FG的临床特征。方法:回顾性收集2013年5月至2017年4月间中山大学附属第六医院和福建中医药大学附属人民医院收治的F... 详细信息

背景:Fournier坏疽(FG)是一种发生于外生殖器和会阴部的真菌感染。本研究旨在探讨源自肛门直肠、继发于肛瘘和肛周脓肿的FG的临床特征。方法:回顾性收集2013年5月至2017年4月间中山大学附属第六医院和福建中医药大学附属人民医院收治的FG病例,对其临床特征及治疗结局进行分析。结果:60例FG患者纳入研究。最常见的病原微生物是大肠杆菌。影像学和手术探查证实,分别有52例和59例患者病变累及生殖区和直肠周围,但有7例(12%)患者会阴区未被感染。早期彻底清创和应用广谱抗生素治疗效果满意,患者病死率为1.7%。10例患者进行了保护性结肠造口术。无一例患者行睾丸切除术或尿道转流术。结论:原发于肛门直肠区域的FG病情进展迅速,致死率高。肛门直肠的病变可不经会阴组织而直接感染生殖区。要获得满意的治疗效果,必须对坏死组织进行积极的外科清创,但保护性结肠造口则不是必需的。

关键词： Fournier’s gangrene perianal abscess anal fistula protective colostomy

Efficacy and safety of minimally invasive laparoscopic surgery under general anesthesia for ovarian cancer

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World Journal of Clinical Cases 2024年第9期12卷 1569-1577页

作者： xian Qin chen chen Yang Liu xian-Hong hua Jia-Yi Li Meng-Jie Liang Fang Wu Department of Anesthesiology The First People's Hospital of Jiangxia DistrictWuhan 430200Hubei ProvinceChina Department of Obstetrics and Gynecology The First People's Hospital of Jiangxia DistrictWuhan 430200Hubei ProvinceChina

BACKGROUND Ovarian cancer is one of the most common malignant tumors in female reproductive system in the world,and the choice of its treatment is very important for the survival rate and prognosis of patients.Traditional open surgery is the main treatment for ovarian cancer,but it has the disadvantages of big trauma and slow recovery.With the continuous development of minimally invasive technology,minimally invasive laparoscopic surgery under general anesthesia has been gradually applied to the treatment of ovarian cancer because of its advantages of less trauma and quick recovery.However,the efficacy and safety of minimally invasive laparoscopic surgery under general anesthesia in the treatment of ovarian cancer are still controversial.AIM To explore the efficacy and safety of general anesthesia minimally invasive surgery in the treatment of ovarian cancer.METHODS The clinical data of 90 patients with early ovarian cancer in our hospital were analyzed retrospectively.According to the different surgical treatment methods,patients were divided into study group and control group(45 cases in each group).The study group received minimally invasive laparoscopic surgery under general anesthesia for ovarian cancer,while the control group received traditional open surgery for ovarian cancer.The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30),clinical efficacy and safety of the two groups were compared.RESULTS The intraoperative blood loss,length of hospital stay,postoperative gas evacuation time,and postoperative EORTC QLQ-C30 score of the study group were significantly better than those of the control group(P<0.05).The incidence of postoperative complications in the study group was significantly lower than in the control group(P<0.05).The two groups had no significant differences in the preoperative adrenocorticotropic hormone(ACTH),androstenedione(AD),cortisol(Cor),cluster of differentiation 3 positive(CD3+),and cluster of differentiation 4 positive(CD4+)indexes(

关键词： Early-stage ovarian cancer Efficacy Minimally invasive Laparoscopy Safety Surgery

肠道Cajal细胞数量对行吻合器经肛直肠切除术(STARR)的梗阻性排便综合征患者的预后和预测价值

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Gastroenterology Report 2018年第4期6卷 270-276,I0001,I0002页

作者： Hong-cheng Lin hua-xian chen Liang huang Ya-Xi Zhu Qian Zhou Juan Li Yu-Jie Xu Dong-Lin Ren Jian-Ping Wang Department of Colorectal Surgery The Sixth Affiliated Hospital of Sun Yat-sen UniversityGuangzhou510655 GuangdongChina Guangdong Institute of Gastroenterology Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor DiseasesGuangzhou510655 GuangdongChina Department of Pathology The Sixth Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdongChina

目的:本研究旨在评估吻合器经肛直肠切除术(STARR)治疗梗阻性排便综合征(ODS)的功能学结果,并探讨肠道Cajal细胞(ICC)数量与STARR手术疗效的关系。方法:将50例行STARR手术的ODS患者的全层直肠标本,采用免疫组化方法检测直肠样本中的ICC... 详细信息

目的:本研究旨在评估吻合器经肛直肠切除术(STARR)治疗梗阻性排便综合征(ODS)的功能学结果,并探讨肠道Cajal细胞(ICC)数量与STARR手术疗效的关系。方法:将50例行STARR手术的ODS患者的全层直肠标本,采用免疫组化方法检测直肠样本中的ICC细胞数量,并取20例来自直肠癌癌旁组织的直肠样本作为对照。收集排粪造影和直肠测压的功能学参数。结果:无论是在黏膜下层表面(SM)、肌纤维(IM)还是环形肌与纵形肌的肌间隙(MY)中,与对照标本相比,ODS直肠标本中的ICC细胞数量均显著减少(均P<0.05)。术前克利夫兰便秘评分(CCS)为24.2˘64.1,术后1、2、3、4和5年CCS评分均显著下降(均P<0.05)。术后3年,58.3%(28/48)的患者疗效满意(CCA≤10)。单因素分析显示,术前需手辅助排便(P=0.017)、ICC-MY细胞数量减少(P=0.067)、直肠感觉阈值增加(P=0.073)的ODS患者,术后功能学结果不良。多因素分析证实,ICC-MY细胞数量减少是术后不良功能学结果的独立预测因素(OR=0.097,95%CI:0.012-0.766)。结论:STARR手术治疗ODS总体疗效满意,但随时间推移,肛门功能会有所恶化。直肠标本中ICC细胞数量减少的患者术后肛门功能不良,提示术前对直肠进行全层组织学评估或可预测STARR手术的功能学结局.

关键词：直肠切除术吻合器感觉阈值排粪造影肌间隙肛门功能手辅助单因素分析

Track correlation algorithm based on CNN-LSTM for swarm targets

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Journal of Systems Engineering and Electronics 2024年第2期35卷 417-429页

作者： chen Jinyang WANG Xuhua chen xian Research Institute for National Defense Engineering Academy of Military SciencesLuoyang 471023China Information Engineering University Zhengzhou 450001China School of Computer Science and Technology Xidian UniversityXi’an 710071China

The rapid development of unmanned aerial vehicle(UAV) swarm, a new type of aerial threat target, has brought great pressure to the air defense early warning system. At present, most of the track correlation algorithms only use part of the target location, speed, and other information for correlation.In this paper, the artificial neural network method is used to establish the corresponding intelligent track correlation model and method according to the characteristics of swarm targets.Precisely, a route correlation method based on convolutional neural networks (CNN) and long short-term memory (LSTM)Neural network is designed. In this model, the CNN is used to extract the formation characteristics of UAV swarm and the spatial position characteristics of single UAV track in the formation,while the LSTM is used to extract the time characteristics of UAV swarm. Experimental results show that compared with the traditional algorithms, the algorithm based on CNN-LSTM neural network can make full use of multiple feature information of the target, and has better robustness and accuracy for swarm targets.

关键词： track correlation correlation accuracy rate swarm target convolutional neural network(CNN) long short-term memory(LSTM)neural network

Strengthening Mechanism and Microstructure of Deformable Ti Particles Reinforced AZ91 Composite

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Acta Metallurgica Sinica(English Letters) 2022年第12期35卷 1935-1945页

作者： Biao Tang Jian-Bo Li Jun-Liu Ye huan Luo Yi-Tao Wang Bo Guan Yang-Fan Lu xian-hua chen Kai-Hong Zheng Fu-Sheng Pan School of Materials Science and Engineering Chongqing UniversityChongqing 400044China International Joint Laboratory for Light Alloys(MOE) School of Materials Science and EngineeringChongqing UniversityChongqing 400044China Institute of New Materials Guangdong Academy of SciencesGuangzhou 510650China

In this study,the deformable titanium(Ti)particles reinforced AZ91 composite was successfully prepared by powder metallurgy and subsequent extrusion.The mechanical properties and microstructural evolution of pure AZ91 and 5 Ti/AZ91 composite were studied.The yield strength,ultimate tensile strength,and elongation of 5 Ti/AZ91 composite are measured to be 212 MPa,323 MPa,and 10.1%,respectively.Microstructure analysis revealed that Ti particles are elongated along the extrusion direction,forming a discontinuous strip Ti particles,fine precipitated Mg_(17)Al_(12) phase inhibits dynamic recrystallization(DRX)behavior through Zener pinning effect and hinders the growth of matrix grains,resulting in refiner grains of 5 Ti/AZ91 composite.Heterogeneous deformed Ti particles and magnesium(Mg)matrix to generate additional heterogeneous deformation-induced(HDI)strengthening.Heterogeneous deformation-induced strengthening mainly contributed to the increment of yield strength for 5 Ti/AZ91 composite.

关键词： Magnesium matrix composites Tiparticles Recrystallization Mechanical properties Heterogeneous deformation

Glibenclamide pretreatment attenuates early hematoma expansion of warfarin-associated intracerebral hemorrhage in rats by alleviating perihematomal blood-brain barrier dysfunction

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Chinese Neurosurgical Journal 2024年第1期10卷 8-19页

作者： Zongwei Zeng Liang Liang Zhou Feng Peiwen Guo Xiaoke Hao Jishu xian hua Feng Yujie chen Zhi chen Department of Neurosurgery and State Key Laboratory of Trauma Burn and Combined InjurySouthwest HospitalThird Military Medical University(Army Medical University)Chongqing 400038China Department of Neurosurgery The 945Th Hospital of PLAYaanSichuan Province 625099China Department of Rehabilitation Southwest HospitalThird Military Medical University(Army Medical University)Chongqing 400038China Chongqing Key Laboratory of Precision Neuromedicine and Neuroregeneration Southwest HospitalThird Military Medical University(Army Medical University)Chongqing 400038China Chongqing Clinical Research Center for Neurosurgery Southwest HospitalThird Military Medical University(Army Medical University)Chongqing 400038China

Background Hematoma expansion is a determinant of poor outcome of intracerebral hemorrhage but occurs frequently,especially in warfarin-associated intracerebral hemorrhage(W-ICH).In the present study,we employ the warfarin-associated intracerebral hemorrhage(W-ICH)rat model,to explore the efficacy and potential mechanism of glibenclamide pretreatment on hematoma expansion after intracerebral hemorrhage,hoping to provide proof of concept that glibenclamide in stroke primary and secondary prevention is also potentially beneficial for intracerebral hemorrhage patients at early stage.Methods In the present study,we tested whether glibenclamide,a common hypoglycemic drug,could attenuate hematoma expansion in a rat model of W-ICH.Hematoma expansion was evaluated using magnetic resonance imaging;brain injury was evaluated by brain edema and neuronal death;and functional outcome was evaluated by neurological scores.Then blood-brain barrier integrity was assessed using Evans blue extravasation and tight junction-related protein.Results The data indicated that glibenclamide pretreatment significantly attenuated hematoma expansion at 24 h after W-ICH,thus mitigating brain edema and neuronal death and promoting neurological function recovery,which may benefit from alleviating blood-brain barrier disruption by suppressing matrix metallopeptidase-9.Conclusions The results indicate that glibenclamide pretreatment in stroke primary and secondary prevention might be a promising therapy for hematoma expansion at the early stage of W-ICH.

关键词： Intracerebral hemorrhage Warfarin Glibenclamide Hematoma expansion Blood-brain barrier Matrix metallopeptidase-9

Clinical effect of laparoscopic radical resection of colorectal cancer based on propensity score matching

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World Journal of Gastrointestinal Surgery 2024年第1期16卷 124-133页

作者： Yang Liu xian-Xue Wang Yu-Lin Li Wen-Tao He Hong Li hua chen Department of General Surgery Changde HospitalXiangya School of MedicineCentral South University(The First People’s Hospital of Changde City)Changde 415000Hunan ProvinceChina Department of Anesthesiology Changde HospitalXiangya School of MedicineCentral South University(The First People’s Hospital of Changde City)Changde 415000Hunan ProvinceChina

BACKGROUND The incidence of colorectal cancer(CRC)is increasing annually.Laparoscopic radical resection of CRC is a minimally invasive procedure preferred in clinical practice.AIM To investigate the clinical effect of laparoscopic radical resection of CRC on the basis of propensity score matching(PSM).METHODS The clinical data of 100 patients who received inpatient treatment for CRC at Changde Hospital,xiangya School of Medicine,Central South University(The First People’s Hospital of Changde City)were analyzed retrospectively.The control group included patients who underwent open surgery(n=43),and those who underwent laparoscopic surgery formed the observation group(n=57).The baseline information of both groups was equipoised using 1×1 PSM.Differences in the perioperative parameters,inflammatory response,immune function,degree of pain,and physical status between the groups were analyzed.RESULTS Thirty patients from both groups were successfully matched.After PSM,baseline data showed no statistically significant differences between the groups:(1)Periop-erative parameters:The observation group had a longer surgery time,less intra-operative blood loss,earlier first ambulation and first anal exhaust times,and shorter gastric tube indwelling time than the control group;(2)Inflammatory response:24 h after surgery,the levels of interleukin-6(IL-6),C-reactive protein(CRP),and tumor necrosis factor-α(TNF-α)between groups were higher than preoperatively.IL-6,CRP,and TNF-αlevels in the observation group were lower than in the control group;(3)Immune function:At 24 h after surgery,counts of CD4-positive T-lymphocytes(CD4+)and CD4+/CD8-positive T-lymphocytes(CD8+)in both groups were lower than those before surgery,whereas CD8+was higher than that before surgery.At 24 h after surgery,both CD4+counts and CD4+/CD8+in the observation group were higher than those in the control group,whereas CD8+counts were lower;(4)Degree of pain:The visual analog scale scores in the observation group were lower than those in the control group at

关键词： Colorectal cancer Laparoscopic Open surgery Inflammatory reaction Immune function Propensity score