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Hospital Costs of Adverse Events in Patients with Metastatic Colorectal Cancer

Journal of Cancer Therapy 2013年第1期4卷 153-158页

作者： Alex Z. Fu Zhongyun Zhao Song Wang Beth Barber Gordon G. Liu Amgen Inc One Amgen Center Drive Thousand Oaks USA Cancer Prevention and Control program Lombardi Comprehensive Cancer Center Georgetown University Washington DC USA Guanghua School of Management Peking University Beijing China

Background: Monoclonal antibody treatments for metastatic colorectal cancer (mCRC) have distinct treatment-related safety profiles. This study aimed to elucidate the hospitalisation costs of adverse events (AEs) commonly associated with monoclonal antibodies when administered to patients with mCRC. Methods: This study extracted data for patients newly diagnosed with mCRC from a large US claims database from January 2005 to June 2008. The first distant metastasis diagnosis date was defined as the index date. Main outcomes were length of hospital stay (days) and hospitalisation costs (2010 US$) for AEs (identified by primary discharge diagnoses). All analyses are presented descriptively. Results: The study population (aged ≥18 years;n = 12,648) was balanced according to gender and was mainly aged 50 years or older (90.1%). Most patients had colon cancer (70.1%) as opposed to rectal cancer. Gastrointestinal (gi) perforation incurred the longest median length of stay (11.5 days) for hospitalisations, followed by wound-healing complications (7 days), arterial and venous thromboembolism (5.5 and 4 days, respectively), and congestive heart failure (4 days). The highest inpatient cost per event was for gi perforations (mean $66,224 and median $ 34,027), followed by arterial thromboembolism ($40,992 and $18,587), wound-healing complications ($36,440 and $21,163), interstitial lung disease ($26,705 and $19,111) and acute myocardial infarction ($22,395 and $15,223). Skin toxicity (mean $6475 and median $6110) and hypertension ($14,108 and $6047) were associated with relatively low costs. Conclusions: Hospital costs for monoclonal antibody treatment-related AEs in patients with mCRC vary greatly. This study provides source data for economic evaluations of head-to-head comparisons of monoclonal antibody treatments.

关键词： Monoclonal Antibody Metastatic Colorectal Cancer Adverse Events mCRC Hospital Costs

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Metabolic signatures in pancreatic ductal adenocarcinoma:diagnostic and therapeutic implications

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Journal of Pancreatology 2023年第4期6卷 185-195页

作者： Ruining Gong Yonglu Hu Qian Yu Lin Fang He Ren Shandong Provincial Key Laboratory of Clinical Research for Pancreatic Diseases Center for GI Cancer Diagnosis and TreatmentTumor Immunology and CytotherapyMedical Research CenterThe Affiliated Hospital of Qingdao UniversityQingdao 266003China Department of Gastroenterology The Affiliated Hospital of Qingdao UniversityQingdao 266003China Department of Endocrinology The Affiliated Hospital of Qingdao UniversityQingdao266003China Phase I Clinical Research Center The Affiliated Hospital of Qingdao UniversityQingdao266003China

Pancreatic ductal adenocarcinoma(PDAC)is the prototypical aggressive cancer that develops in nutrient-deficient and hypoxic *** overcomes these restrictions by employing unconventional tactics for the procurement and usage of fuel *** substantial reprogramming of PDAC cell metabolism is driven by oncogene-mediated cell-autonomous *** cells use glucose,glutamine,and lipids for energy and depend on autophagy and macropinocytosis for survival and *** also interact metabolically with non-cancerous cells,aiding tumor *** clinical trials focusing on altered metabolism are *** the metabolic regulation of PDAC cells will not only help to increase understanding of the mechanisms of disease progression but also provide insights for the development of new diagnostic and therapeutic approaches.

关键词： Diagnosis Metabolism Pancreatic ductal adenocarcinoma Treatment Tumor microenvironment

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Current status of robot-assisted gastric surgery

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World Journal of Gastrointestinal Oncology 2011年第10期3卷 137-143页

作者： Se-Jin Baek Dong-Woo Lee Sung-Soo Park Seon-Hahn Kim Department of Surgery Korea University College of MedicineMIS Robotic Surgery Center Korea University Medical Center Korea University Anam Hospital Seoul 136-705South Korea Robotic Surgery Center Korea University Medical Center Division of Upper gi Surgery Department of SurgeryKorea University College of MedicineMIS Division of Colorectal Department of SurgeryKorea University College of MedicineMIS

In an effort to minimize the limitations of laparoscopy,a robotic surgery system was introduced,but its role for gastric cancer is still *** objective of this article is to assess the current status of robotic surgery for gastric cancer and to predict future *** the current study was limited by its small number of patients and retrospective nature,robot-assisted gastrectomy with lymphadenectomy for the treatment of gastric cancer is a feasible and safe procedure for experienced laparoscopic *** studies have reported satisfactory results for postoperative short-term coutcomes,such as:postoperative oral feeding,gas out,hospital stay and complications,compared with laparoscopic surgery;the difference is a longer operation ***,robotic surgery showed a shallow learning curve compared with the familarity of conventional open surgery;after the accumulation of several cases,robotic surgery could be expected to result in a similar operation ***-assisted gastrectomy can expand the indications of minimally invasive surgery to include advanced gastric cancer by improving the ability to perform ***," total" robotic gastrectomy can be facilitated using a robotsewing technique and gastric submucosal tumors near the gastroesophageal junction or pylorus can be resected safely by this novel *** conclusion,robotassisted gastrectomy may offer a good alternative to conventional open or laparoscopic surgery for gastric cancer,provided that long-term oncologic outcomes can be confirmed.

关键词： Robot surgery Stomach Minimally invasive surgery

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Action-oriented obesity counseling attains weight stabilization and improves liver enzymes among overweight and obese children and adolescents

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Open Journal of Pediatrics 2012年第3期2卷 236-243页

作者： Allison C. Sylvetsky Jean A. Welsh Stephanie M. Walsh Miriam B. Vos Children’s Healthcare of Atlanta at Egleston Atlanta USA Department of Pediatrics School of Medicine Emory University Atlanta USA Nutrition and Health Sciences program Division of Biological and Biomedical Sciences Laney Graduate School Emory University Atlanta USA

Introduction: Pediatricians are encouraged to promote behavior modification to reduce childhood obesity and its co-morbidities, yet the effectiveness of office counseling is unclear. We aimed to evaluate if a low-intensity intervention (action-oriented counseling) in a clinic setting results in weight stabilization, and if the effect is modified by a diagnosis of non-alcoholic fatty liver disease (NAFLD). We hypothesized that patients with NAFLD would be more motivated to adhere to the lifestyle goals set in clinic, due to the diagnosis of an obesity-related condition;and, would therefore achieve greater weight reduction compared to similarly overweight and obese patients without a diagnosis of NAFLD. Methods: A retrospective chart review was conducted on 73 (35 male, 38 female) overweight and obese patients (BMI ≥ 85th percentile) attending a pediatric gi clinic between January 2006 and October 2011. Analysis was conducted to determine if lifestyle goals discussed with the patient at each clinic visit were associated with improved BMI, BMI z-score, and liver enzymes. Treatment outcomes among NAFLD patients and similarly obese patients without NAFLD were compared using t-tests and chi-square tests. Results: Of the children evaluated, 74.0% achieved a reduction or stabilization in BMI z-score after 3 months of follow-up. Among NAFLD patients, liver enzymes improved in 72% of those who were able to stabilize or reduce their BMI and among 43% of those who gained weight. Treatment outcome did not significantly differ based on having a diagnosis of NAFLD, although there was a trend towards greater improvements. Conclusion: Our study suggests that action oriented counseling including goal-setting in a low intensity, clinic based approach is effective in improving patient BMI, in the presence or absence of an obesity-related co-morbidity, such as NAFLD. Further, we demonstrated that lifestyle modification led to improvement of liver enzymes in NAFLD patients and may result

关键词： Obesity Non-Alcoholic Fatty Liver Disease Lifestyle Behavior Change

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Ciliopathy-associated proteins are involved in vesicle distribution in sensory cilia

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Journal of Genetics and Genomics 2019年第5期46卷 269-271页

作者： Ming Li Wanzhong He Wei Li Guangshuo Ou PTN Graduate program School of Life SciencesTsinghua UniversityBeijing100084China Tsinghua-Peking Center for Life Sciences School of Life SciencesTsinghua UniversityBeijing100084China National Institute of Biological Science BeijingW2206China National Institute of Biological Science Beijing102206China School of Medicine Tsinghua UniversityBeijing100084China Tsinghua-Peking Center for Life Sciences School of Life SciencesTsinghua UniversityBeijingW0084China

Cilia play a wide range of critical roles in regulating cell motility,sensory signaling and metazoan development(Goetz and Anderson,2010;Reiter and Leroux,2017).Both motile cilia and pri-mary cilia consist of a basal body and a microtubule-based axoneme that is encompassed within the ciliary *** formationand maintenance of ciliary structure depends on bidirectional intraflagellar transport(IFT):the kinesin-2 family motor proteins deliver ciliary precursors bound to the IFT particle protein complex from the ciliary base to the tip and the cytoplasmic dynein-2 recy-cles the anterograde IFT-protein machinery and ciliary turnover products back to the base(Scholey,2013;Reiter and Leroux,2017).Defects of ciliary structure and function lead to more than 35 types of systemic disorders in most human organ *** are collectively called ciliopathies(Reiter and Leroux,2017).187 established and 241 candidate ciliopathy-associated genes have been identified from the human genome(Reiter and Leroux,2017).

关键词： vesicle distribution sensory cilia

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Clinical nutrition in the hepatogastroenterology curriculum

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World Journal of Gastroenterology 2016年第5期22卷 1729-1735页

作者： Chris JJ Mulder Geert JA Wanten Carol E Semrad Palle B Jeppesen Hinke M Kruizenga Nicolette J Wierdsma Matthijs E Grasman Adriaan A van Bodegraven Department of Gastroenterology and Hepatology VU University Medical Center Amsterdam1007 MD AmsterdamThe Netherlands Department of Gastroenterology and Hepatology Radboud University Nijmegen Medical Center6500 HB NijmegenThe Netherlands Department of Medicine gi Section The University of ChicagoChicagoIL 60637United States Department of Medical Gastroenterology Rigshospitalet University Hospital of Copenhagen2100 KHB CopenhagenDenmark Department of Dietetic VU University Medical Center Amsterdam1081 HZ AmsterdamThe Netherlands Department of Internal Medicine Gastroenterologyand GeriatricsORBIS Medical Center6130 MB Sittard-GeleenThe Netherlands

Gastroenterology(GE) used to be considered a subspecialty of internal medicine. Today, GE is generally recognized as a wide-ranging specialty incorporating capacities, such as hepatology, oncology and interventional endoscopy, necessitating GEexpert differentiation. Although the European Board of Gastroenterology and Hepatology has defined specific expertise areas in Advanced endoscopy, hepatology, digestive oncology and clinical nutrition, training for the latter topic is lacking in the current hepatogastroenterology(HGE) curriculum. given its relevance for HGE practice, and being at the core of gastrointestinal functioning, there is an obvious need for training in nutrition and related issues including the treatment of disease-related malnutrition and obesity and its associated metabolic derangements. This document aims to be a starting point for the integration of nutritional expertise in the HGE curriculum, allowing a central role in the management of malnutrition and obesity. We suggest minimum endpoints for nutritional knowledge and expertise in the standard curriculum and recommend a focus period of training in nutrition issues in order to produce well-trained HGE specialists. This article provides a road map for the organization of such a training program. We would highly welcome the World Gastroenterology Organisation, the European Board of Gastroenterology and Hepatology, the American Gastroenterology Association and other(inter)national Gastroenterology societies support the necessary certifications for this item in the HGE-curriculum.

关键词： Gastroenterology Training Clinical nutrition Malnutrition Metabolism Curriculum Targeted therapy Enteral feeding Parenteral feeding Obesity

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EUS引导下FNA结合流式细胞分析术诊断可疑性或复发性胸内或腹膜后淋巴瘤

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世界核心医学期刊文摘（胃肠病学分册） 2006年第2期2卷 38-39页

作者： Mehra M. Tamhane A. Eloubeidi M.A. 王志宇 Endoscopic Ultrasound program University of Alabama at Birmingham 1530 3rdAve. S.-ZRB636 BirminghamAL 35294- 0007United States Dr.

Background: Limited data exist on the combined use of EUS guided FNA (EUS-FNA) and flow cytometry (FC) in the diagnosis of lymphoma. The aim of this study was to evaluate the accuracy of EUS-FNA combined with FC in the diagnosis of primary or recurrent lymphoma. Methods: This study was a retrospective analysis of a prospective collection of data over a 3-year period. Over 3 years, 29 patients with lesions (n = 31) suspicious for lymphoma underwent EUS-FNA and FC. Results: Of the 29 patients, 10 patients had lymphoma and 17 patients had nonlymphoma lesions; for two patients, final diagnosis was indeterminate because of insufficient material for FC. The lymphoma cases included non-Hodgkin’s lymphoma (n = 6, including 3 recurrences), mucosa-associated lymphoid tissue (MALT) lymphoma (n = 2), a non-gi lymphoma with mediastinal lymphadenopathy (n = 1), and an uncharacterized lymphoma (n = 1). Of the 31 lesions, 8 were true positive, 18 were true negative, and 3 were false negative; for two lesions, we could not determine the final diagnosis. No false-positive results were encountered. The sensitivity, the specificity, and the accuracy of EUS-FNA combined with FC for diagnosing lymphoma were 72.7% : 95% CI [43.3% , 90.3% ], 100% : 95% CI [82.4% , 100.0% ], and 89.7% : 95% CI [73.6% , 96.4% ], respectively. Limitations to this study include a short duration of follow-up and a lack of a surgical criterion standard. Conclusions: EUS-FNA in combination with FC allows the diagnosis of primary suspected or recurrent lymphoma. It also is an adjunct in staging MALT lymphoma and could direct clinicians toward further investigative procedures.

关键词：流式细胞分析术 EUS FNA 淋巴瘤病非霍奇金淋巴瘤可疑病灶淋巴瘤诊断纵隔淋巴结细针抽吸

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Prevalence of Helicobacter pylori infection and atrophic gastritis in patients with dyspeptic symptoms in Myanmar

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World Journal of Gastroenterology 2015年第2期21卷 629-636页

作者： Thein Myint Seiji Shiota Ratha-korn Vilaichone New Ni Than Than Aye Miyuki Matsuda Trang Thi Huyen Tran Tomohisa Uchida Varocha Mahachai Yoshio Yamaoka Department of Gastroenterology Yangon General Hospital and University of Medicine (1)Yangon 11131Myanmar Department of Environmental and Preventive Medicine Oita University Faculty of MedicineYufu-CityOita 879-5593Japan Gastroenterology Unit Department of MedicineThammasat University HospitalPathumthani 12120Thailand Department of Gastroenterology Mandalay General Hospital and University of Medicine (Mandalay)Mandalay 4802Myanmar Department of Gastroenterology Thingangyun Sanpya General Hospital and University of Medicine (2)Thingangyun 11071Myanmar Department of Molecular Pathology Oita University Faculty of MedicineYufu-CityOita 879-5593Japan gi and Liver Center Bangkok Medical CenterBangkok 10310Thailand Department of Medicine-Gastroenterology Michael E.De Bakey Veterans Affairs Medical Center and Baylor College of MedicineHoustonTX 77030United States

AIM: To survey the detailed analyses for Helicobacter pylori(H. pylori) infection and gastric mucosal status in ***: A total of 252 volunteers with dyspeptic symptoms(155 female and 97 male; mean age of 43.6 ± 14.2 years) was participated in Yangon and Mandalay. The status of H. pylori infection was determined based on 5 different tests including rapid urease test, culture, histology, immunohistochemistry and serology. Histological scores were evaluated according to the update Sydney system and the Operative Link for Gastritis Assessment system. Pepsinogen(PG)Ⅰand PG Ⅱ were measured using enzyme-linked immunosorbent ***: The overall prevalence of H. pylori infectionwas 48.0%. There was no relationship between age and infection rate. Even in young group(less than 29 years old), the H. pylori infection rate was relatively high(41.9%). The prevalence of H. pylori infection was significantly higher in Yangon than that of Mandalay. H. pylori infection was significantly associated with the presence of gastric mucosal atrophy. All 7 subjects with peptic ulcer were infected with H. pylori. Although H. pylori-positive subjects showed stronger gastritis than H. pylori-negative subjects, most cases had mild ***: We revealed the prevalence of H. pylori infection in patients with dyspeptic symptoms in Myanmar. The H. pylori infection was a risk factor for peptic ulcer and stronger gastritis.

关键词： Helicobacter pylori Myanmar Pepsinogen Atrophy

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20Ne10＋ Irradiation Induced Histological Changes in Murine Small Intestine

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近代物理研究所和兰州重离子加速器实验室年报：英文版 2009年第1期 171-171页

作者： Ma Xiaofei Zhang Hong Liu Yang Supported by National Basic Research program of China the National Natural Science Foundation of China the Scientific TechnologyResearch Projects of Gansu Province.

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Prognostic significance of regional lymphadenectomy in T1b gallbladder cancer:Results from 24 hospitals in China

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World Journal of Gastrointestinal Surgery 2021年第2期13卷 176-186页

作者： Tai Ren Yong-Sheng Li Xue-Yi Dang Yang Li Zi-Yu Shao Run-Fa Bao Yi-Jun Shu Xu-An Wang Wen-Guang Wu Xiang-Song Wu Mao-Lan Li Hong Cao Kun-Hua Wang Hong-Yu Cai Chong Jin Hui-Han Jin Bo Yang Xiao-Qing Jiang Jian-Feng Gu Yun-Fu Cui Zai-Yang Zhang Chun-Fu Zhu Bei Sun Chao-Liu Dai Lin-Hui Zheng Jing-Yu Cao Zhe-Wei Fei Chang-Jun Liu Bing Li Jun Liu Ye-Ben Qian Yi Wang Ya-Wei Hua Xi Zhang Chang Liu Wan-Yee Lau Ying-Bin Liu Department of General Surgery Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200092China Shanghai Key Laboratory of Biliary Tract Disease Research Shanghai 200092China Department of Biliary-Pancreatic Surgery Renji Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200127China State Key Laboratory for Oncogenes and Related Genes Shanghai 200127China Department of General Surgery Shanxi Provincial Cancer HospitalTaiyuan 030013Shanxi ProvinceChina Department of gi Surgery China-Japan Union Hospital of Jilin UniversityChangchun 130033Jilin ProvinceChina Department of Gastrointestinal and Hernia Surgery The First Affiliated Hospital of Kunming Medical UniversityKunming 650031Yunnan ProvinceChina Department of Hepatobiliary Surgery Nantong Tumor HospitalNantong 226361Jiangsu ProvinceChina Department of General Surgery Taizhou Municipal HospitalTaizhou 318000Jiangsu ProvinceChina Department of Hepatobiliary Surgery Wuxi Second People's HospitalWuxi 214002Jiangsu ProvinceChina Department of General Surgery The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325015Zhejiang ProvinceChina Department of Biliary Tract Surgery Second Military Medical UniversitySecondary Military Medical UniversityShanghai 200438China Department of General Surgery Changshu No.1 People’s Hospital Affiliated to Soochow UniversityChangshu 215500Jiangsu ProvinceChina Department of Hepatopancreatobiliary Surgery Second Affiliated Hospital of Harbin Medical UniversityHarbin 150086Heilongjiang ProvinceChina Department of General Surgery Shaoxing Second HospitalShaoxing 312000Zhejiang ProvinceChina Department of HPB Surgery Changzhou No.2 People’s HospitalChangzhou 213003Jiangsu ProvinceChina Department of Pancreatic and Biliary Surgery The First Affiliated Hospital of Harbin Medical UniversityHarbin 150009Heilongjiang ProvinceChina Department of Hepatobiliary Surgery Shengjing Hospital of China Medical UniversityShenyang 1

BACKGROUND Whether regional lymphadenectomy(RL)should be routinely performed in patients with T1b gallbladder cancer(GBC)remains a subject of *** To investigate whether RL can improve the prognosis of patients with T1b *** We studied a multicenter cohort of patients with T1b GBC who underwent surgery between 2008 and 2016 at 24 hospitals in 13 provinces in *** logrank test and Cox proportional hazards model were used to compare the overall survival(OS)of patients who underwent cholecystectomy(Ch)+RL and those who underwent Ch *** investigate whether combined hepatectomy(Hep)improved OS in T1b patients,we studied patients who underwent Ch+RL to compare the OS of patients who underwent combined Hep and patients who did *** Of the 121 patients(aged 61.9±10.1 years),77(63.6%)underwent Ch+RL,and 44(36.4%)underwent Ch ***(9.1%)patients in the Ch+RL group had lymph node *** 5-year OS rate was significantly higher in the Ch+RL group than in the Ch group(76.3%vs 56.8%,P=0.036).Multivariate analysis showed that Ch+RL was significantly associated with improved OS(hazard ratio:0.51;95%confidence interval:0.26-0.99).Among the 77 patients who underwent Ch+RL,no survival improvement was found in patients who underwent combined Hep(5-year OS rate:79.5%for combined Hep and 76.1%for no Hep;P=0.50).CONCLUSION T1b GBC patients who underwent Ch+RL had a better prognosis than those who underwent ***+Ch showed no improvement in prognosis in T1b GBC *** recommended by both the National Comprehensive Cancer Network and Chinese Medical Association guidelines,RL was only performed in 63.6%of T1b GBC *** Ch+RL should be advised in T1b GBC.

关键词： Gallbladder cancer Lymphadenectomy Hepatectomy Staging Prognosis Surgery

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