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Risk factors for ventilator-associated pneumonia among patients undergoing major oncological surgeryfor head and neck cancer

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《医学前沿（英文）》 2017年 第11卷 第2期   页码 239-246 doi: 10.1007/s11684-017-0509-8

摘要：

Patients undergoing major oncological surgery for head and neck cancer (SHNC) have a particularly high risk of nosocomial infections. We aimed to identify risk factors for ventilator-associated pneumonia (VAP) in patients undergoing SHNC. The study included 465 patients who underwent SHNC between June 2011 and June 2014. The rate of VAP, risk factors for VAP, and biological aspects of VAP were retrospectively evaluated. The incidence of VAP was 19.6% (n=95) in patients who required more than 48 h of mechanical ventilation. Staphylococcus (37.7%), Enterobacteriaceae (32.1%), Pseudomonas(20.8%), and Haemophilus (16.9%) were the major bacterial species that caused VAP. The independent risk factors for VAP were advanced age, current smoking status, chronic obstructive pulmonary disease, and a higher simplified acute physiology score system II upon admission. Tracheostomy was an independent protective factor for VAP. The median length of stay in the ICU for patients who did or did not develop VAP was 8.0 and 6.5 days, respectively (P=0.006). Mortality among patients who did or did not develop VAP was 16.8% and 8.4%, respectively (P<0.001). The potential economic impact of VAP was high because of the significantly extended duration of ventilation. A predictive regression model was developed with a sensitivity of 95.3% and a specificity of 69.4%. VAP is common in patients who are undergoing SHNC and who require more than 48 h of mechanical ventilation. Therefore, innovative preventive measures should be developed and applied in this high-risk population.

关键词： ventilator-associated pneumonia (VAP)     pneumonia     risk factors     surgery for head and neck cancer (SHNC)    

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Basic consideration of research strategies for head and neck cancer

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《医学前沿（英文）》 2012年 第6卷 第4期   页码 339-353 doi: 10.1007/s11684-012-0213-7

摘要：

Head and neck cancer (HNC) consists of a group of malignancies affecting closely related anatomical regions of the upper aerodigestive tract (UADT), including the oral cavity, salivary glands, upper and lower jaw bones and facial skin; the nasal cavity, paranasal sinuses, pharynx, larynx and thyroid gland (although the latter is often excluded and considered as part of endocrine neoplasms). Of these, 90% of HNCs are histologically squamous cell carcinomas originating from the mucosal lining. These malignancies are strongly associated with certain environmental and life-style risk factors, principally tobacco in both smoked and smokeless forms, excessive alcohol consumption, diets poor in antioxidants and essential micronutrients, UV light, chemicals used in certain workplaces, and viruses, principally certain strains of human papillomavirus (HPV) and Epstein-Barr virus (EBV). These cancers are frequently aggressive in their biological behaviour with local invasion and metastasis to lymph nodes in the neck. Since most patients are already at late stages of disease at the time of diagnosis, the desirable practice of early diagnosis (first sign of the malignant lesion at an initial stage ) and early treatment, a critical priority to save lives and retain quality of life, is difficult to implement. Thus, primary prevention has been set as a key goal. This article aims to reinforce the basic knowledge of aetiology, key risk factors related to the development of head and neck cancer, basic features of clinical appearance of this group of cancers, and strategies for prevention and early detection. We also suggest basic research strategies on the basis of current knowledge, which should ultimately lead to the improvement of clinical management.

关键词： clinical management     head and neck cancer     prevention and early detection     research strategies     risk factors    

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中子俘获疗法临床应用国际进展

张紫竹,金从军,刘凯,张国珍,杨立军

《中国工程科学》 2012年 第14卷 第8期   页码 100-105

摘要：

硼中子俘获疗法（BNCT）目前在国际上已经临床应用于千余例患者,并取得了较好的治疗效果。主要对BNCT的原理、发展历史及国际BNCT临床进展情况作了主要介绍。对脑胶质瘤、恶性黑色素瘤、复发性头颈部肿瘤及转移性肝癌BNCT临床治疗情况及治疗效果作了较详细的讨论。

关键词： BNCT     脑胶质瘤     恶性黑色素瘤     复发性头颈部肿瘤     转移性肝癌    

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软骨组织工程研究进展——我们的经验与未来展望

刘豫, 周广东, 曹谊林

《工程（英文）》 2017年 第3卷 第1期   页码 28-35 doi: 10.1016/J.ENG.2017.01.010

摘要：

软骨缺损难以自行修复，组织工程是实现软骨再生的理想途径。目前，组织工程软骨主要有两类用途：一是用于骨科或关节外科，修复关节表面或半月板部位的软骨缺损，实现关节运动功能的重建；二是用于整形或头颈外科，修复耳廓、气管、睑板、鼻、喉等具有特殊形态及功能的软骨缺损。不同应用目标的组织工程软骨，其构建方法和所面临的挑战，以及临床转化进程均会有很大差别。本文旨在针对上述两大应用目标，结合我们团队在研究过程中所建立的观点及积累的经验，对组织工程软骨目前的主要研究进展和所面临的挑战，以及未来的发展方向做一简要总结。

关键词： 软骨组织工程     临床前大动物实验     临床转化     骨科     整形外科    

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“Fast Track” nasogastric decompression of rectal cancer surgery

Ka Li, Zongguang Zhou, Zengrong Chen, Yi Zhang, Cun Wang

《医学前沿（英文）》 2011年 第5卷 第3期   页码 306-309 doi: 10.1007/s11684-011-0154-6

摘要： This study evaluates the application of fast track (FT) nasogastric decompression in patients who underwent anterior resection of rectal cancer. A randomized control trial was performed comparing the group with the fast track treatment ( =β57) and the group with traditional nasogastric decompression ( =β84). Preoperative characteristics and postoperative recovery indices were recorded and analyzed. The results indicate no significant differences in gender ( =β0.614), age ( =β0.653), tumor location ( =β0.113), and TNM stages ( =β0.054) were observed between the 2 groups. The differences in the type of resection, anastomosis, and adoption of protective colostomy were all not significant between the FT and the traditional group. During the first 24 hours after surgery, the volume of nasogastric drainage averaged 197 ml in the FT group and 155 ml in the traditional group ( =β0.197). The initiation of test-meal ( =β0.000), semiliquid diet ( =β0.002), and ordinary diet ( =β0.008) were all significantly shorter in the FT group. Furthermore, compared with the other group, the patients in the FT group enjoyed earlier removal of the abdominal drainage, urinary catheter, and shorter hospital stays ( =β0.000). Based on a correlation test, the duration of nasogastric decompression is related to the time of test-meal and semiliquid diet. The routine usage of nasogastric decompression in rectal surgery is unnecessary. The fast track procedure might help in facilitating postoperative functional and diet recovery, reducing the time of catheterization, and shortening hospital stay.

关键词： fast track     nasogastric decompression     rectal cancer     surgery    

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Adjuvant chemotherapy versus adjuvant concurrent chemoradiotherapy after radical surgery for early-stagecervical cancer: a randomized, non-inferiority, multicenter trial

《医学前沿（英文）》 2023年 第17卷 第1期   页码 93-104 doi: 10.1007/s11684-021-0892-z

摘要： We conducted a prospective study to assess the non-inferiority of adjuvant chemotherapy alone versus adjuvant concurrent chemoradiotherapy (CCRT) as an alternative strategy for patients with early-stage (FIGO 2009 stage IB–IIA) cervical cancer having risk factors after surgery. The condition was assessed in terms of prognosis, adverse effects, and quality of life. This randomized trial involved nine centers across China. Eligible patients were randomized to receive adjuvant chemotherapy or CCRT after surgery. The primary end-point was progression-free survival (PFS). From December 2012 to December 2014, 337 patients were subjected to randomization. Final analysis included 329 patients, including 165 in the adjuvant chemotherapy group and 164 in the adjuvant CCRT group. The median follow-up was 72.1 months. The three-year PFS rates were both 91.9%, and the five-year OS was 90.6% versus 90.0% in adjuvant chemotherapy and CCRT groups, respectively. No significant differences were observed in the PFS or OS between groups. The adjusted HR for PFS was 0.854 (95% confidence interval 0.415–1.757; P = 0.667) favoring adjuvant chemotherapy, excluding the predefined non-inferiority boundary of 1.9. The chemotherapy group showed a tendency toward good quality of life. In comparison with post-operative adjuvant CCRT, adjuvant chemotherapy treatment showed non-inferior efficacy in patients with early-stage cervical cancer having pathological risk factors. Adjuvant chemotherapy alone is a favorable alternative post-operative treatment.

关键词： chemotherapy     cervical cancer     lymph node metastasis     concurrent chemoradiotherapy     quality of life    

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Lobectomy by video-assisted thoracoscopic surgery (VATS) for early stage of non-small cell lung cancer

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《医学前沿（英文）》 2011年 第5卷 第1期   页码 53-60 doi: 10.1007/s11684-011-0121-2

摘要：

Video-assisted thoracoscopic surgery (VATS) provides a new approach for treating early-stage lung cancer. Lobectomy by VATS has many advantages over conventional thoracotomy, such as shorter recovery time, less postoperative pain, and faster resumption of a normal lifestyle. However, there is still much debate on the role of VATS in lobectomy for the treatment of lung cancer. Concerns regarding safety, the extent of mediastinal lymph node dissection, and long-term survival have made some surgeons apprehensive of its validity for lung cancer. In this paper, we review the development of thoracoscopy, the present status of VATS for early stage of non-small cell lung cancer (NSCLC), and comparison between VATS and open thoracotomy in the management of NSCLC.

关键词： non-small cell lung cancer     video-assisted thoracoscopic surgery     lobectomy    

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Clinical outcomes and prognostic factors of patients with epithelial ovarian cancer subjected to first-line

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《医学前沿（英文）》 2014年 第8卷 第1期   页码 91-95 doi: 10.1007/s11684-014-0305-7

摘要：

A total of 251 patients with epithelial ovarian cancer (EOC) treated between 2002 and 2008 was retrospectively analyzed to investigate the long-term outcomes and prognostic factors of these patients, particularly those who underwent primary debulking surgery followed by platinum-based chemotherapy. Clinico-pathological parameters, including progression-free survival (PFS) and overall survival (OS), were also analyzed. The median follow-up period from the end of initial treatment to June 2010 was 58 months. The three-year PFS rate was 61.7% for International Federation of Gynecology and Obstetrics (FIGO) I–II, 19.9% for FIGO III–IV, and 33.9% for all stages. By comparison, the five-year PFS rate was 44.6% for FIGO I–II, 17.7% for FIGO III–IV, and 28.3% for all stages. The three-year OS rate was 67.9% for FIGO I–II, 41.7% for FIGO III–IV, and 50.2% for all stages. The five-year OS rate was 52.7% for FIGO I–II, 30.8% for FIGO III–IV, and 39.2% for all stages. Univariate analysis revealed that advanced FIGO stage, serum CA125, and suboptimal debulking were significant factors affecting PFS and OS. In multivariate analysis, PFS was significantly influenced by FIGO stage and suboptimal debulking. However, OS was significantly influenced by advanced FIGO stage only. Our study confirms the efficacy of surgery followed by platinum-based chemotherapy for EOC. FIGO stage is considered as one of the most reliable predictors of the prognosis of patients with EOC.

关键词： ovarian carcinoma     prognostic factors     surgery     chemotherapy     survival    

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Laparoscopic surgery for pancreatic lesions: current status and future

Taiping Zhang, Xiao Du, Yupei Zhao

《医学前沿（英文）》 2011年 第5卷 第3期   页码 277-282 doi: 10.1007/s11684-011-0147-5

摘要： Laparoscopic pancreatic surgery has been gaining increasing recognition in recent years, and its practice has increased despite its highly complex procedure and longer learning curve compared with surgeries for other abdominal organs. Laparoscopic distal pancreatectomy and tumor enucleation are two of the fastest-growing techniques and are currently in wide use because of their comparable technical simplicity. Literature review showed that laparoscopic distal pancreatectomy and enucleation are safe and efficient approaches for benign and low-degree malignant tumors; however, the indication for malignant tumors remains controversial. Laparoscopic pancreaticoduodenectomy is practiced in a limited number of surgical centers and presented as case reports or in small series. Although its feasibility was demonstrated by many surgeons, whether the laparoscopic procedure can achieve benefits comparable to or even more prominent than those of an open procedure has not been clinically proven. Prospective, randomized, controlled trials of laparoscopic operation versus open pancreatic surgery are necessary to justify the wide application and routine practice of the laparoscopic procedure for pancreatic lesions.

关键词： minimally invasive surgery     pancreatic surgery     pancreatic neoplasm     distal pancreatic lesions     pancreatic fistula    

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Expression pattern and regulation of head-to-head genes

Xinxing CUI,Chunhong YANG,Li KANG,Guiyu ZHU,Qingqing WEI,Yunliang JIANG

《农业科学与工程前沿（英文）》 2014年 第1卷 第2期   页码 130-136 doi: 10.15302/J-FASE-2014013

摘要： Vacuolar protein sorting 36 (VPS36), a protein primarily known for its role in the Endosomal Sorting Complex Required for Transport pathway, has recently been shown to be linked to chicken reproduction. Previous research showed that is significantly downregulated in sexually mature chicken ovaries compared to immature ones. In this study, using real-time quantitative RT-PCR, we investigated the expression pattern of and its head-to-head gene mRNA in chicken follicles. Small white follicles were found to have significantly higher expression of and mRNA than any other sized follicles ( <0.05). The expression of and mRNA were detected in both granulosa and theca layers of pre-ovulatory follicles, the expression of in theca layers was slightly higher than in granulosa cells. Treatment of small yellow follicles with follicle-stimulating hormone and estradiol resulted in a marked decrease of both and mRNA ( <0.05); however, progesterone, transforming growth factor-β 1 and luteinizing hormone induced no significant changes in and mRNA expression in these follicles. These results indicate that the head-to-head genes of and exhibit similar expression in chicken follicles and are involved in chicken follicle development.

关键词： chicken     Vps36     Ckap2     mRNA     follicle    

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Influence of surface cracking, anchor head profile, and anchor head size on cast-in headed anchors in

《结构与土木工程前沿（英文）》   页码 1163-1187 doi: 10.1007/s11709-023-0987-5

摘要： In this study, the concrete cone capacity, concrete cone angle, and load–displacement response of cast-in headed anchors in geopolymer concrete are explored using numerical analyses. The concrete damaged plasticity (CDP) model in ABAQUS is used to simulate the behavior of concrete substrates. The tensile behavior of anchors in geopolymer concrete is compared with that in normal concrete as well as that predicted by the linear fracture mechanics (LFM) and concrete capacity design (CCD) models. The results show that the capacity of the anchors in geopolymer concrete is 30%–40% lower than that in normal concrete. The results also indicate that the CCD model overestimates the capacity of the anchors in geopolymer concrete, whereas the LFM model provides a much more conservative prediction. The extent of the difference between the predictions by the numerical analysis and those of the above prediction models depends on the effective embedment depth of the anchor and the anchor head size. The influence of concrete surface cracking on the capacity of the anchor is shown to depend on the location of the crack and the effective embedment depth. The influence of the anchor head profile on the tensile capacity of the anchors is found to be insignificant.

关键词： cast-in anchor     concrete cone capacity     geopolymer concrete     head size     surface crack     anchor profile    

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Advances in tissue state recognition in spinal surgery: a review

Hao Qu, Yu Zhao

《医学前沿（英文）》 2021年 第15卷 第4期   页码 575-584 doi: 10.1007/s11684-020-0816-3

摘要： Spinal disease is an important cause of cervical discomfort, low back pain, radiating pain in the limbs, and neurogenic intermittent claudication, and its incidence is increasing annually. From the etiological viewpoint, these symptoms are directly caused by the compression of the spinal cord, nerve roots, and blood vessels and are most effectively treated with surgery. Spinal surgeries are primarily performed using two different techniques: spinal canal decompression and internal fixation. In the past, tactile sensation was the primary method used by surgeons to understand the state of the tissue within the operating area. However, this method has several disadvantages because of its subjectivity. Therefore, it has become the focus of spinal surgery research so as to strengthen the objectivity of tissue state recognition, improve the accuracy of safe area location, and avoid surgical injury to tissues. Aside from traditional imaging methods, surgical sensing techniques based on force, bioelectrical impedance, and other methods have been gradually developed and tested in the clinical setting. This article reviews the progress of different tissue state recognition methods in spinal surgery and summarizes their advantages and disadvantages.

关键词： spinal surgery     tissue state recognition     image     force sensing     bioelectrical impedance    

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Non-closure of the peritoneum and subcutaneous tissue at radical hysterectomy: A randomized controlled trial

Zhou-Fang XIONG MD, Wei-Hong DONG MD, Ze-Hua WANG MD,

《医学前沿（英文）》 2010年 第4卷 第1期   页码 112-116 doi: 10.1007/s11684-010-0016-7

摘要： We conducted a trial to assess the influence of closure or nonclosure of the peritoneum and subcutaneous tissue on the clinical outcomes of cervical cancer patients who underwent radical hysterectomy with lower abdominal cross incision. This randomized controlled trial was performed on 158 cervical cancer patients in our hospital between January 2002 and June 2004. Eighty-two patients were allocated to the “closure” group and 76 patients to the “nonclosure” group. Results showed that non-closure of the peritoneum and subcutaneous tissue could shorten operation time and febrile duration, reduce antibiotics requirement, increase the volume of drainage and decrease the incidence of liquefaction of subcutaneous fat (<0.05). There was no difference in blood loss, postoperative complications, bowel function restoration and post-operative stay between the two groups (>0.05). Our study revealed that closure of the peritoneum and subcutaneous tissue provides no immediate postoperative benefits while unnecessarily lengthening surgical time and anesthesia exposure. The practice of closure of the peritoneum and subcutaneous tissue at radical hysterectomy should be questioned.

关键词： cervical cancer     radical surgery     peritoneum     subcutaneous tissue    

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Current progress on natural orifice transluminal endoscopic surgery (NOTES)

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《医学前沿（英文）》 2012年 第6卷 第2期   页码 187-194 doi: 10.1007/s11684-012-0198-2

摘要：

Natural orifice transluminal endoscopic surgery (NOTES) has received considerable interest in recent years as a novel surgical technique. Here, we aim to review the current progress on NOTES, particularly focusing on the advantages and complications related to NOTES, the recent advances of surgical approaches, new instruments for closure of the natural orifice incision, and the newly developed platform for NOTES. Finally, we make a prediction of the conceivable applications of NOTES on human subjects.

关键词： natural orifice transluminal endoscopic surgery (NOTES)     laparotomy     laparoscopy    

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标题 作者 时间 类型 操作

Risk factors for ventilator-associated pneumonia among patients undergoing major oncological surgeryfor head and neck cancer

null

期刊论文

Basic consideration of research strategies for head and neck cancer

null

期刊论文

中子俘获疗法临床应用国际进展

张紫竹,金从军,刘凯,张国珍,杨立军

期刊论文

软骨组织工程研究进展——我们的经验与未来展望

刘豫, 周广东, 曹谊林

期刊论文

“Fast Track” nasogastric decompression of rectal cancer surgery

Ka Li, Zongguang Zhou, Zengrong Chen, Yi Zhang, Cun Wang

期刊论文

Adjuvant chemotherapy versus adjuvant concurrent chemoradiotherapy after radical surgery for early-stagecervical cancer: a randomized, non-inferiority, multicenter trial

期刊论文

Lobectomy by video-assisted thoracoscopic surgery (VATS) for early stage of non-small cell lung cancer

null

期刊论文

Clinical outcomes and prognostic factors of patients with epithelial ovarian cancer subjected to first-line

null

期刊论文

Laparoscopic surgery for pancreatic lesions: current status and future

Taiping Zhang, Xiao Du, Yupei Zhao

期刊论文

Expression pattern and regulation of head-to-head genes

Xinxing CUI,Chunhong YANG,Li KANG,Guiyu ZHU,Qingqing WEI,Yunliang JIANG

期刊论文

Influence of surface cracking, anchor head profile, and anchor head size on cast-in headed anchors in

期刊论文

Advances in tissue state recognition in spinal surgery: a review

Hao Qu, Yu Zhao

期刊论文

Non-closure of the peritoneum and subcutaneous tissue at radical hysterectomy: A randomized controlled trial

Zhou-Fang XIONG MD, Wei-Hong DONG MD, Ze-Hua WANG MD,

期刊论文

Current progress on natural orifice transluminal endoscopic surgery (NOTES)

null

期刊论文

hepatectomy: comments on “Expert Consensus on Laparoscopic Hepatectomy (2013 Version) by National Hepatic SurgeryGroup, Society of Surgery, Chinese Medical Association”

null

期刊论文