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Effectiveness and safety of splenectomy for gastric carcinoma:A meta-analysis

World Journal of Gastroenterology 2009年第42期15卷 5352-5359页

作者： kun yang xin-zu chen jian-kun hu bo zhang zhi-xin chen jia-ping chen Department of Gastrointestinal Surgery West China Hospital Sichuan University No. 37 Guo Xue Xiang Chengdu 610041 Sichuan Province China

AIM： To evaluate the impact of splenectomy on longterm survival, postoperative morbidity and mortality of patients with gastric cancer by performing a metaanalysis METHODS： A search of electronic databases to identify randomized controlled trials in The Cochrane Library trials register, Mediine, CBMdisc （Chinese Biomedical Database） and J-STAGE, etc was performed. Data was extracted from the studies by 2 independent reviewers. Outcome measures were survival, postoperative morbidity and mortality and operation-related events. The meta-analyses were performed by RevMan 4.3. RESULTS： Three studies comprising 466 patients were available for analysis, with 231 patients treated by gastrectomy plus splenectomy. Splenectomy could not increase the 5-year overall survival rate [RR = 1.17, 95% confidence interval （CI） 0.97-1.41]. The postoperative morbidity （RR = 1.76, 95% CI 0.82-3.80） or mortality （RR = 1.58, 95% CI 0.45-5.50） did not suggest any significant differences between the 2 groups. No significant differences were noted in terms of number of harvested lymph nodes, operation time, length of hospital stay and reoperation rate. Subgroup analyses showed splenectomy did not increase the survival rate for proximal and whole gastric cancer. No obvious differences were observed between the 2 groups when stratified by stage. Sensitivity analyses indicated no significant differences regarding the survival rates （P 〉 0.05）. CONCLUSION： Splenectomy did not show a beneficial effect on survival rates compared to splenic preservation. Routinely performing splenectomy should not be recommended.

关键词： Gastric cancer Splenectomy Survival rate Morbidity Operative surgical procedure Postoperative period Treatment outcome

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Cost-effectiveness analysis of chemotherapy for advancedgastric cancer in China

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World Journal of Gastroenterology 2008年第17期14卷 2715-2722页

作者： xin-zu chen kun jiang jian-kun hu bo zhang Hong-Feng Gou kun yang zhi-xin chen jia-ping chen Department of Gastrointestinal Surgery and Multidisciplinary Treatment Team of Gastrointestinal TumorsWest China Hospital Sichuan University Chengdu 610041Sichuan Province China Department of Integrated Western and TraditionalChinese Medicine West China Hospital Sichuan UniversityChengdu 610041 Sichuan Province China Department of Oncology West China HospitalSichuan University Chengdu 610041 Sichuan Province China

AIM： To assess the economics of various chemotherapeutic regimens for advanced gastric cancer （AGC）, and to select the best cost-effective regimen for the common Chinese patients. METHODS： Data source used in this study was the Chinese Biomedical Disk Database. Patients were diagnosed as AGC and any regimen was eligible. Outcome measures included median survival time （MST） and percentage of complete and partial response （CR＋PR）. Economic statistics was per capita direct medical cost （DMC） of a single cycle. TreeAge Pro Healthcare 2007 software was used to carry out costeffectiveness and incremental cost-effectiveness analysis. Sensitivity analyses were applied by altering willingness- to-pay and annual discount rate, and also re-analyzed by excluding the studies with apparent heterogeneity. RESULTS： Seven retrospective economics studies on 760 patients were included. S-fluorouracil-based regimens were universal, and also some new agents were involved, such as docetaxel, paclitaxel, andoxaliplatin. By processing analysis, we could recommend etoposide, leucovorin and 5-fluorouracil （ELF） regimen as preference, with a DMC/MST ratio of 2543 RBM/11.7 mo and a DMC/CR＋PR ratio of 2543 RMB/53.3%. Uraciltegafur, etoposide and cisplatin （FEP） or 5-fluorouracil, adrimycin/epirubin and mitomycin （FAM） regimens could be regarded as optional first-line chemotherapy for AGC in common Chinese patients. With no regard for willingness-to-pay, the docetaxel, cisplatin and 5-fluorouracil （DCF） regimen could be chosen as either a first- or a second-line chemotherapy, with a DMC/CR＋PR ratio of 9979 RMB/56.3%. CONCLUSION： 5-fluorouracial regimens are still considered the mainstream for AGC, while new agents such as taxanes are optional. More randomized clinical trials are required before any mandatory recommendation of certain regimens for patients with AGC in China is made.

关键词： Advanced gastric cancer Chemotherapy 5-fluorouracil Taxanes Cost-effectiveness

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The Large Sky Area Multi-Object Fiber Spectroscopic Telescope (LAMOST)

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Research in Astronomy and Astrophysics 2012年第9期12卷 1197-1242页

作者： Xiang-Qun Cui Yong-Heng Zhao Yao-Quan Chu Guo-ping Li Qi Li Li-ping zhang Hong-Jun Su Zheng-Qiu Yao Ya-Nan Wang Xiao-Zheng xing xin-Nan Li Yong-Tian Zhu Gang Wang bo-Zhong Gu A-Li Luo xin-Qi Xu Zhen-Chao zhang Gen-Rong Liu Hao-Tong zhang De-hua yang Shu-Yun Cao Hai-Yuan chen jian-Jun chen kun-xin chen Ying chen jia-Ru Chu Lei Feng Xue-Fei Gong Yong-hui Hou Hong-Zhuan hu Ning-Sheng hu Zhong-Wen hu Lei jia Fang-hua jiang Xiang jiang Zi-bo jiang Ge Jin Ai-hua Li Yan Li Ye-ping Li Guan-QunLiu zhi-Gang Liu huo-Ming Shi Zheng-Hong Tang Qing-Sheng Tao Xiang-Yan Yuan Chao Zhai Jing zhang Yan-Xia zhang Yong zhang Ming Zhao Fang Zhou Guo-hua Zhou Jie Zhu Si-cheng Zou National Astronomical Observatories Chinese Academy of Sciences Beijing 100012 China yzhao @ *** Nanjing Institute of Astronomical Optics and Technology National Astronomical ObservatoriesChinese Academy of Sciences Nanjing 210042 China University of Science and Tecfinologyof China Hefei 230026 China Shanghai Astronomical Observatory Chinese Academy of Sciences Shanghai 200030 China Institute of Architecture Design and Research Chinese Academy of Sciences Beijing 100190China

The Large Sky Area Multi-Object Fiber Spectroscopic Telescope (LAMOST, also called the Guo Shou Jing Telescope) is a special reflecting Schmidt telescope. LAMOST’s special design allows both a large aperture (effective aperture of 3.6 m–4.9 m) and a wide field of view (FOV) (5°). It has an innovative active reflecting Schmidt configuration which continuously changes the mirror’s surface that adjusts during the observation process and combines thin deformable mirror active optics with segmented active optics. Its primary mirror (6.67m×6.05 m) and active Schmidt mirror (5.74m×4.40 m) are both segmented, and composed of 37 and 24 hexagonal sub-mirrors respectively. By using a parallel controllable fiber positioning technique, the focal surface of 1.75 m in diameter can accommodate 4000 optical fibers. Also, LAMOST has 16 spectrographs with 32 CCD cameras. LAMOST will be the telescope with the highest rate of spectral acquisition. As a national large scientific project, the LAMOST project was formally proposed in 1996, and approved by the Chinese government in 1997. The construction started in 2001, was completed in 2008 and passed the official acceptance in June 2009. The LAMOST pilot survey was started in October 2011 and the spectroscopic survey will launch in September 2012. Up to now, LAMOST has released more than 480 000 spectra of objects. LAMOST will make an important contribution to the study of the large-scale structure of the Universe, structure and evolution of the Galaxy, and cross-identification of multiwaveband properties in celestial objects.

关键词： techniques: wide field telescope - active optics - multi fiber - spectroscopy survey - data reduction

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急性肠梗阻的病因学和病死率:705例回顾分析(英文)

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中西医结合学报 2008年第10期6卷 1010-1016页

作者：陈心足魏涛姜坤杨昆张波陈志新陈佳平胡建昆四川大学华西医院普外科胃肠肿瘤多学科协作项目组四川成都610041 四川大学华西医院中西医结合科四川成都610041

目的:总结急性肠梗阻的病因学类型和总体病死率,探索手术治疗前合理的保守治疗时间。方法:回顾性分析了华西医院1995年至2002年的住院病人病历,分类统计各类病因,并分析病死率与手术前保守治疗间期的相关性。结果:共纳入705例急性肠梗... 详细信息

目的:总结急性肠梗阻的病因学类型和总体病死率,探索手术治疗前合理的保守治疗时间。方法:回顾性分析了华西医院1995年至2002年的住院病人病历,分类统计各类病因,并分析病死率与手术前保守治疗间期的相关性。结果:共纳入705例急性肠梗阻病例,其中71.1%病变部位在小肠,82.6%为单纯性肠梗阻。最常见病因为粘连(62.0%),肿瘤次之(23.7%)。56.7%的病例接受外科治疗。总体病死率为1.6%,其中保守治疗组为1.3%,外科治疗组为1.7%。肠坏死发生率随保守治疗间期延长而增高,当绞窄发生超过24 h即可能死亡。结论:与西方相似,在中国同样有病因向粘连性转移的流行病学趋势。基于四川大学华西医院经验,近半数的单纯性肠梗阻病例可经保守治疗缓解。保守治疗延长且无缓解趋势的单纯性肠梗阻,或绞窄发生第一个24 h内的病例应接受外科治疗。

关键词：肠梗阻病因学预后病死率

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管状胃在食管胃结合部腺癌手术中的应用

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四川大学学报（医学版） 2012年第4期43卷 625-627,638页

作者：陈秀峰杨弘鑫陈海宁张波陈志新胡建昆陈佳平四川大学华西医院胃肠外科中心成都610041

目的评价管状胃在Ⅱ、Ⅲ型食管胃结合部腺癌的经腹近端胃切除手术中应用的临床效果。方法将2009年10月至2010年12月期间确诊为Ⅱ、Ⅲ型食管胃结合部腺癌的72例患者分为两组,完成近端胃切除后,传统组(38例)行传统食管-残胃吻合,管状胃组... 详细信息

目的评价管状胃在Ⅱ、Ⅲ型食管胃结合部腺癌的经腹近端胃切除手术中应用的临床效果。方法将2009年10月至2010年12月期间确诊为Ⅱ、Ⅲ型食管胃结合部腺癌的72例患者分为两组,完成近端胃切除后,传统组(38例)行传统食管-残胃吻合,管状胃组(34例)则行食管-管状残胃吻合。结果两组患者的基本资料及临床病理特征差异均无统计学意义(P>0.05)。传统组术后出现胃食管返流症状的患者有12例(31.6%),而管状胃组中仅有4例(11.8%)(P=0.043)。术后经胃镜检查发现患有返流性食管炎的患者在传统组中有9例(23.7%),管状胃组中有2例(5.9%)(P=0.036)。结论近端胃切除后食管-管状胃吻合,可以减少术后胃食管返流的发生,值得临床推广。

关键词：食管胃结合部腺癌经腹手术近端胃切除管状胃并发症

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The first data release(DR1) of the LAMOST regular survey

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Research in Astronomy and Astrophysics 2015年第8期15卷 1095-1124页

作者： A-Li Luo Yong-Heng Zhao Gang Zhao Li-Cai Deng Xiao-Wei Liu Yi-Peng Jing Gang Wang Hao-Tong zhang jian-Rong Shi Xiang-Qun Cui Yao-Quan Chu Guo-ping Li Zhong-Rui Bai Yue Wu Yan Cai Shu-Yun Cao Zi-huang Cao Jeffrey L.Carlin Hai-Yuan chen jian-Jun chen kun-xin chen Li chen Xue-Lei chen Xiao-Yan chen Ying chen Norbert Christlieb jia-Ru Chu chen-Zhou Cui Yi-Qiao Dong Bing Du Dong-Wei Fan Lei Feng jian-Ning Fu Peng Gao Xue-Fei Gong bo-Zhong Gu Yan-xin Guo Zhan-Wen Han bo-Liang He Jin-Liang Hou Yong-hui Hou Wen Hou Hong-Zhuan hu Ning-Sheng hu Zhong-Wen hu zhi-Ying huo Lei jia Fang-hua jiang Xiang jiang zhi-bo jiang Ge Jin Xiao Kong Xu Kong Ya-Juan Lei Ai-hua Li Chang-hua Li Guang-Wei Li Hai-Ning Li jian Li Qi Li Shuang Li Sha-Sha Li xin-Nan Li Yan Li Yin-Bi Li Ye-ping Li Yuan Liang Chien-cheng Lin Chao Liu Gen-Rong Liu Guan-Qun Liu zhi-Gang Liu Wen-zhi Lu Yu Luo Yin-Dun Mao Heidi Newberg Ji-Jun Ni Zhao-Xiang Qi Yong-Jun Qi Shi-Yin Shen huo-Ming Shi Jing Song Yi-Han Song Ding-Qiang Su Hong-Jun Su Zheng-Hong Tang Qing-Sheng Tao Yuan Tian Dan Wang Da-Qi Wang Feng-Fei Wang Guo-Min Wang Hai Wang Hong-Chi Wang jian Wang jia-Ning Wang jian-Ling Wang jian-ping Wang Jun-Xian Wang Lei Wang Meng-xin Wang Shou-Guan Wang Shu-Qing Wang Xia Wang Ya-Nan Wang You Wang Yue-Fei Wang You-Fen Wang Peng Wei Ming-zhi Wei Hong Wu Ke-Fei Wu Xue-Bing Wu Yu-Zhong Wu Xiao-Zheng xing Ling-Zhe Xu xin-Qi Xu Yan Xu Tai-Sheng Yan De-hua yang Hai-Feng yang hui-Qin yang Ming yang Zheng-Qiu Yao Yong Yu hui Yuan Hai-bo Yuan Hai-Long Yuan Wei-Min Yuan Chao Zhai En-Peng zhang hua-Wei zhang jian-Nan zhang Li-Pin zhang Wei zhang Yong zhang Yan-Xia zhang Zheng-Chao zhang Ming Zhao Fang Zhou Xu Zhou Jie Zhu Yong-Tian Zhu Si-cheng Zou Fang zuo National Astronomical Observatories Chinese Academy of Sciences Department of Astronomy Peking University Shanghai Astronomical Observatory Chinese Academy of Sciences Nanjing Institute of Astronomical Optics & Technology National Astronomical ObservatoriesChinese Academy of Sciences University of Science and Technology of China Department of Physics Applied Physics and AstronomyRensselaer Polytechnic InstituteTroyNY 12180USA Department of Physics and Astronomy Earlham CollegeRichmondIN 47374USA Universitt Heidelberg Zentrum für AstronomieLandessternwarteKnigstuhl 1269117 HeidelbergGermany Department of Astronomy Beijing Normal University Yunnan Observatories Chinese Academy of Sciences Purple Mountain Observatory Chinese Academy of Sciences

The Large sky Area Multi-Object Fiber Spectroscopic Telescope（LAMOST） general survey is a spectroscopic survey that will eventually cover approximately half of the celestial sphere and collect 10 million spectra of stars, galaxies and QSOs. Objects in both the pilot survey and the first year regular survey are included in the LAMOST DR1. The pilot survey started in October 2011 and ended in June 2012, and the data have been released to the public as the LAMOST Pilot Data Release in August 2012. The regular survey started in September 2012, and completed its first year of operation in June 2013. The LAMOST DR1 includes a total of 1202 plates containing 2 955 336 spectra, of which 1 790 879 spectra have observed signalto-noise ratio（SNR） ≥ 10. All data with SNR ≥ 2 are formally released as LAMOST DR1 under the LAMOST data policy. This data release contains a total of 2 204 696 spectra, of which 1 944 329 are stellar spectra, 12 082 are galaxy spectra and 5017 are quasars. The DR1 not only includes spectra, but also three stellar catalogs with measured parameters： late A,FGK-type stars with high quality spectra（1 061 918 entries）, A-type stars（100 073 entries）, and M-type stars（121 522 entries）. This paper introduces the survey design, the observational and instrumental limitations, data reduction and analysis, and some caveats. A description of the FITS structure of spectral files and parameter catalogs is also provided.

关键词： techniques: spectroscopic survey—data release—catalog

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Ⅱ、Ⅲ型食管胃结合部腺癌的临床分析

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四川大学学报（医学版） 2012年第2期43卷 289-292页

作者：陈秀峰陈海宁张波陈志新胡建昆王芳杨弘鑫陈佳平四川大学华西医院胃肠外科成都610041 四川大学华西临床医学院临床医学系成都610041

目的探讨Ⅱ、Ⅲ型食管胃结合部腺癌(AEG)的临床病理特点、手术治疗以及术后并发症情况。方法回顾性分析2008年1月至2010年7月实施开腹手术的112例Ⅱ、Ⅲ型AEG病例资料。其中Ⅱ型AEG 77例,Ⅲ型35例;72例行近端胃切除,40例行全胃切除。结... 详细信息

目的探讨Ⅱ、Ⅲ型食管胃结合部腺癌(AEG)的临床病理特点、手术治疗以及术后并发症情况。方法回顾性分析2008年1月至2010年7月实施开腹手术的112例Ⅱ、Ⅲ型AEG病例资料。其中Ⅱ型AEG 77例,Ⅲ型35例;72例行近端胃切除,40例行全胃切除。结果 112例Ⅱ、Ⅲ型AEG患者肿瘤分期较晚、淋巴转移率高。按肿瘤部位分为Ⅱ型AEG组和Ⅲ型AEG组,两组在手术方式选择上差异有统计学意义(P<0.05),分别有57例(74.0%)和15例(42.9%)行近端胃切除。按手术方式分为近端胃切除组和全胃切除组,两组在手术时间、术后并发症等方面的差异有统计学意义(P<0.05),手术时间分别为(275.76±27.02)min和(304.12±23.12)min;在术后并发症方面,近端胃切除组有15例(20.8%)患者出现烧心、返酸,有9例(12.5%)患有返流性食管炎;全胃切除组有15例(37.5%)每日进食大于5次。结论Ⅱ、Ⅲ型AEG目前主要经腹手术治疗,根据肿瘤的位置、大小选择行近端胃切除或全胃切除手术,两种术式术后都伴随有不同程度的并发症。

关键词：食管胃结合部腺癌近端胃切除全胃切除并发症

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Detection of an anti-angina therapeutic module in the effective population treated by a multi-target drug Danhong injection:a randomized trial

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Signal Transduction and Targeted Therapy 2021年第10期6卷 3009-3018页

作者： Jun Liu Dan-Dan Li Wei Dong Yu-Qi Liu yang Wu Da-Xuan Tang Fu-Chun zhang Meng Qiu Qi hua Jing-Yu He Jun Li Bai Du Ting-Hai Du Lin-Lin Niu Xue-Jun jiang bo Cui jiang-Bin chen yang-Gan Wang Hai-Rong Wang Qin Yu Jing He Yi-Lin Mao Xiao-Fang Bin Yue Deng Yu-Dan Tian Qing-hua Han Da-Jin Liu Li-Qin Duan Ming-Jun Zhao Cui-Ying zhang Hai-Ying Dai Ze-hua Li Ying Xiao You-zhi hu Xiao-Yu huang kun xing xin jiang Chao-Feng Liu Jing An Feng-Chun Li Tao Tao Jin-Fa jiang Ying yang Yao-Rong Dong Lei zhang Guang Fu Ying Li Shu-Wei huang Li-ping Dou Lan-Jun Sun Ying-Qiang Zhao Jie Li Yun Xia Jun Liu Fan Liu Wen-Jin He Ying Li jian-Cong Tan yang Lin Ya-Bin Zhou jian-Fei yang Guo-Qing Ma hui-Jun chen He-ping Liu Zong-Wu Liu jian-Xiong Liu Xiao-jia Luo Xiao-Hong Bin Ya-Nan Yu Hai-Xia Dang Bing Li Fei Teng Wang-Min Qiao Xiao-Long Zhu Bing-Wei chen Qi-Guang chen Chun-Ti Shen Yong-Yan Wang Yun-Dai chen Zhong Wang Institute of Basic Research in Clinical Medicine China Academy of Chinese Medical SciencesBeijingChina Department of Cardiology Chinese PLA General HospitalBeijingChina Department of Cardiology Dongfang Hospital Affiliated to Beijing University of Chinese MedicineBeijingChina Department of Geratology Peking University Third HospitalBeijingChina Department of Cardiology Xuan Wu HospitalCapital Medical UniversityBeijingChina Department of Cardiology Guang'anmen HospitalChina Academy of Chinese Medical SciencesBeijingChina Department of Cardiology First Affiliated Hospital of Henan University of Chinese MedicineZhengzhouHenanChina Department of Cardiology Wuhan University Renmin HospitalWuhanHubeiChina Department of Cardiology Wuhan University Zhongnan HospitalWuhanHubeiChina Affiliated Zhongshan Hospital of Dalian University DalianLiaoningChina Department of Cardiology Second Affiliated Hospital to Hunan University of Chinese MedicineChangshaHunanChina Department of Cardiology First Affiliated Hospital to Changchun University of Chinese MedicineChangchunJilinChina Department of Cardiology First Affiliated Hospital to Shanxi Medical UniversityTaiyuanShanxiChina Department of Cardiology Affiliated Hospital of Shanxi University of Chinese MedicineXianyangShanxiChina Department of Cardiology Changsha Central HospitalChangshaHunanChina Department of Cardiology Hubei Provincial Hospital of Traditional Chinese MedicineWuhanHubeiChina Department of Cardiology Shanxi Provincial People's HospitalXi'anShanxiChina Department of Cardiology Shanxi Province Hospital of Traditional Chinese MedicineXi'anShanxiChina Department of Cardiology Xi'an City Hospital of Traditional Chinese MedicineXi'anShanxiChina Department of Cardiology Shanghai Tongji HospitalShanghaiChina Department of Cardiology Shanghai Municipal Hospital of Traditional Chinese MedicineShanghaiChina Department of Cardiology The First Hospital of ChangshaChangshaHunanChina Department of Cardiology Xinhua Hospi

It's a challenge for detecting the therapeutic targets of a polypharmacological drug from variations in the responsed networks in thedfferentiated populations with complex diseases,as stable coronary heart ***,in an adaptive,31-center,randomized,double-blind trial invoving 920 patients with moderate symptomatic stable angina treated by 14-day Danhong injection(DHI),a kind of polyphamacological drug with high quality control,or placebo(0.9%saline),with 76-day following-up,we firstly confrmed that DHl couldincrease the proportion of patients with clinically significant changes on angina-frequency assessed by Seattle Angina Questionnaire(ASAQ-AF220)(12.78%at Day 30,95%confidence interval[C]5.86-19.71%,P=0.0003,13.82%at Day 6C0,95%CI 6.82-20.82%,P=0.0001and 8.95%at Day 90,95%CI 2.06-15.85%,P=0.01).We also found that there were no significant differences in new-onset major vascularevents(P=0.8502)and serious adverse events(P=0.9105)between DHl and *** performing the RNA sequencing in 62 selectedpatients,we developed a systemic modular approach tp identfy differentilly expressed modules(DEMs)of DHI with the Z_(summay)valueless than 0 compared with the control group,calculated by weighted gene co-expression network analysis(WGCNA),and sketched out thebasic framework on a modular map with 25 functional modules targeted by ***,the effective therapeutic module(ETM),defined as the highest corelation value with the phenotype alteration(SAQ-AF,the change in SAQ-AF at Day 30 from baseline)calculatedby WGCNA,was identifed in the population with the best effect(ASAQ-AF240),which is related to anticoagulation and regulation ofcholesterol *** assessed the modular flexbility of this ETM using the global topological D value based on Euclidean distance,which is corelated with phenotype alteration(r^(2):0.8204,P=0.019)by linear *** study identified the ant-angina therapeuticmodule in the effective population treated by the multi-target

关键词： angina injection sketch

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新型超声刀在胃癌根治术中的应用及技巧

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中国普外基础与临床杂志 2008年第10期15卷 718-721页

作者：胡建昆张波陈心足杨昆陈志新陈佳平四川大学华西医院胃肠外科成都610041

目的探讨新型超声刀在胃癌根治术中使用的效果及技巧。方法回顾性分析四川大学华西医院2007年1月至2008年5月期间使用新型超声刀进行胃癌根治术的152例患者的临床资料。结果本组资料平均手术时间为(189.5±24.2)min;清扫淋巴结数量平均... 详细信息

目的探讨新型超声刀在胃癌根治术中使用的效果及技巧。方法回顾性分析四川大学华西医院2007年1月至2008年5月期间使用新型超声刀进行胃癌根治术的152例患者的临床资料。结果本组资料平均手术时间为(189.5±24.2)min;清扫淋巴结数量平均为(30.4±11.6)个,与传统手术相比明显增加;缩短了手术时间,减少了手术出血,手术视野清晰。本组资料术后无吻合口漏、淋巴漏、术后出血及手术死亡。结论新型超声刀在胃癌根治术中使用是安全的,并有助于提高胃癌淋巴结清扫的彻底性。

关键词：胃肿瘤手术超声刀

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胃癌第6组及其亚组淋巴结转移率和转移度的初步研究

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中国普外基础与临床杂志 2011年第3期18卷 295-299页

作者：刘杰杨昆陈心足张波陈志新陈佳平胡建昆四川大学华西医院胃肠外科中心四川成都610041

目的检测胃幽门下(第6组)及其亚组淋巴结转移情况,以探讨临床合理清扫第6组淋巴结的价值。方法回顾性分析2006年1月至2009年12月期间我院80例接受根治性手术且有完整第6组及其3个亚组淋巴结送检资料的胃癌患者的临床病理资料,以胃网膜... 详细信息

目的检测胃幽门下(第6组)及其亚组淋巴结转移情况,以探讨临床合理清扫第6组淋巴结的价值。方法回顾性分析2006年1月至2009年12月期间我院80例接受根治性手术且有完整第6组及其3个亚组淋巴结送检资料的胃癌患者的临床病理资料,以胃网膜右静脉为参照将第6组淋巴结分为第6a、6b和6c亚组,计算第6组及其亚组淋巴结转移率和转移度,并对其淋巴结转移情况与胃癌临床病理特征和其他组(第7、8a和9组)淋巴结转移情况的关系进行logistic回归分析。结果 80例胃癌患者中第6组淋巴结转移率为41.3%(33/80),转移度为26.0%(108/415)。第6a亚组淋巴结转移率为7.5%(6/80),明显低于第6b亚组(16.3%,13/80)和第6c亚组(36.3%,29/80),P<0.001;第6a、6b和6c亚组淋巴结转移度分别为25.0%(8/32)、17.6%(13/74)和28.2%(87/309),差异无统计学意义(P=0.292)。第6a亚组阳性淋巴结与T分期(P=0.042)和N分期(P=0.006)有关;第6b亚组阳性淋巴结与N分期(P=0.002)和TNM分期(P=0.013)有关;第6c亚组阳性淋巴结与肿瘤分化程度(P=0.008)、T分期(P=0.003)、N分期(P=0.000)和TNM分期(P=0.000)有关。logistic回归分析显示:第6组淋巴结转移情况与第8a组淋巴结转移(P=0.023)和N分期(P=0.002)均有关;第6a亚组淋巴结转移与第8a组淋巴结转移有关(P=0.018);第6b亚组淋巴结转移与N分期有关(P=0.005);第6c亚组淋巴结转移与第8a组淋巴结转移(P=0.016)和N分期(P=0.004)均有关。结论胃癌手术中要彻底清扫第6组淋巴结,尤其要重视第6a和6b亚组淋巴结的清扫。

关键词：胃癌淋巴结清扫第6组淋巴结淋巴结转移

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