ObjectiveTo investigate the relationship between topical reactive lymphoid hyperplasia and postoperative recurrence and survival of gastric cancer patients. MethodsThe clinical and pathological data of gastric cancer patients who underwent D2 radical gastrectomy from January 2007 to July 2009 were retrospectively analyzed. Based on the number of reactive lymph nodes, cases were divided in to topical reactive lymphoid hyperplasia group (RLH, n=18) and non-RLH group (n=43) by using a median method. The postoperative disease-free survival (DFS) and overall survival (OS) rates of patients in different groups were compared using Kaplan-Meier method and log-rank test, respectively. ResultsThere were no significant difference between the two groups in age, gender, pathological stage, surgical approach, extent of surgery or methods of postoperative chemotherapy (P > 0.05). The median disease-free survival time was 50 months in RLH group, and the median disease-free survival time was 39 months in non-RLH group. DFS of patients in RLH group was significant higher than non-RLH group (66.7% vs. 34.9%, P=0.048). The median survival time was 53.6 months and 52.3 months, respectively, in RLH group and non-RLH group. No difference was found in OS between the two groups (72.2% vs. 60.5%, P=0.338). ConclusionTopical reactive lymphoid hyperplasia reactive the immunity of gastric cancer patients and contact postoperative DFS rate.
Objective To investigate the value of thyroid stimulating hormone (TSH) inhibition therapy in postoperative patients with differentiated thyroid carcinoma. Methods One hundred and six patients with differentiated thyroid carcinoma after total or near-total thyroidectomy were divided into two groups: TSH inhibition therapy group and thyroid hormone replacement therapy group. The non-recurrence and (or) non-metastasis rate in two groups was analyzed retrospectively by Wilcoxon statistical analysis. Results The non-recurrence and (or) non-metastasis rate of 3-， 5- and 10-year in TSH inhibition therapy group were 98.31%， 92.41% and 75.45% respectively， and were higher than those (93.57%， 84.18% and 52.06% respectively) in thyroid hormone replacement therapy group （P=0.046 5）. Conclusion TSH inhibition therapy after total or near-total thyroidectomy may be an essential treatment for differentiated thyroid carcinoma patients.
ObjectiveTo retrospectively analyze the risk factors of recurrent groin hernia. MethodsData came from all hernia repairs recorded in our hospital between 1991 and 2001. A total of 1 082 cases of groin hernia was analyzed through Cox proportional hazard model to determine the relative risks between recurrence and mode of admission, types of groin hernia, repair methods (traditional/tensionfree hernioplasty), and postoperative complications.ResultsFrom 1991 to 2001,1 082 groin hernia operations were performed in our hospital, 88.9% for primary hernia and 11.2% for recurrent hernia. As compared with traditional hernia repair methods, Lichtenstein’s tensionfree hernioplasty technique had less relative risk for recurrent hernia repair than that for primary hernia repair. Postoperative complications and indirect hernia were linked to an increased relative risk for recurrence. ConclusionThere are many factors affecting the recurrence of inguinal hernia, but the use of tensionfree hernia repair may decrease rerecurrence of recurrent hernia.
Objective To assess the clinical efficacy of statins for preventing stroke recurrence. Methods We searched The Cochrane Library, PubMed, EMbase, CBM, CSJD, and CJFD for randomized controlled trials on the use of statin drugs to prevent stroke recurrence (up to May 10, 2008), and manually searched key Chinese magazines in the related fields. Two reviewers extracted data independently using a designed extraction form. The quality of included trials was evaluated according to the Cochrane handbook 4.12. RevMan 5.0 software was used for data analysis. Results Six randomized controlled trials involving 9,675 patients were identified. The results of meta-analysis showed that there was no statistical difference in stroke recurrence rate (RR=0.94, 95%CI 0.84 to 1.04, P=0.21) and fatal stroke occurrence (RR=0.77, 95%CI 0.48 to 1.25, P=0.30) between statins and placebo groups, but a significant difference was found between the two groups in transient ischemic attack occurrence (RR=0.80, 95%CI 0.69 to 0.92, P=0.002). Conclusion Current evidence indicates that statin drugs have no superiority to prevent stroke recurrence and fatal stroke occurrence, but can prevent transient ischemic attack.
Modified Goligher’s highly selective vagotomy (HSV) for 217 cases of duodenal ulcers is reported. In this series they were: duodenal ulcer (100 cases), combined gastric and duodenal ulcers (79 cases) and complicated perforating, bleeding or stenosed ulcers (38 cases). In the complicated duodenal ulcer, HSV was usually carried out with suturing bleeding point, perforated ulcer or with pyloroplasty. With a follow-up of 3~20 years, the recurrence rate werelt;2% and 85.7% of cases had excellent or good results as Visick classification. Considerations relevant to the HSV technic are deemed worthy of emphasis; complete resection of gastric branches of anterior and posterior vagal trunks and preservation of the first limb of the "Crow’s foot", extended dissection of the distal 5-7cm of the esophagus and division of the distal 8-10cm of the bundle of the gastroepiploic vessels in order to deprive the whole parietal cell mass of its vagal supply. In 4 patients, recurrence were easily controlled with remedies or operation for gastric retention by rational type. The authors suggest that the modified HSV plus mucusdeprived antrectomy be the rational surgical choice for duodenal ulcer.
Objective To investigate the cl inical outcome of treating dorsal wrist gangl ion with an improved surgical strategy by excising the gangl ion completely along their stalk and repairing the dorsal carpal l igaments under brachial anesthesia. Methods From March 2005 to January 2007, 34 patients with dorsal wrist gangl ion were treated and studied retrospectively. There were 14 males and 20 females, aged 25-65 years (43 years on average). The left sides were involved in 22 cases and right sides in 12 cases. Thirteen cases of relapse received excision for 1 to 4 times under local anesthesia, with amean period of 17 months (14 days to 7 years) from excision to recurrence. Twenty-one patients were first attack cases with a mean period of 11 months (15 days to 8 years) from diagnosis to excision. The size of the gangl ion ranged from 1.5 cm × 1.2 cm to 4.5 cm × 4.0 cm. Now, each surgical process was performed under brachial anesthesia, and a pneumathode tourniquet was used. In 6 patients, the stalks of gangl ion did not invade the carpal l igaments, and gangl ion was removed completely without immobil ization after operation. In 28 patients, the stalks of gangl ion invaded the carpal l igaments, gangl ion was excised completely along its stalk to the dorsal carpal structure; the l igaments were sutured directly in 16 cases and were repaired with adjacent tissue such as the wall of sheathing canal of extensor tendon in 12 cases. The wrists were immobil ised for 3 weeks. Results Primary wound heal ing was achieved in all incisions. All patients were followed up for 26-36 months with an average of 31.5 months. Only 2 cases (5.9%) recurred. The range of motion of the wrist remained normal and the symptom of the dorsal wrist was rel ieved sl ightly. Patients’ satisfaction score ranged from 60 to 100, with an average of 83.8. Conclusion The gangl ion should be excised completely together with defect repair of dorsal carpal l igament under brachial anesthesia and the wrist immobil ised for 3 weeks, the recurrence rate will be reduced greatly.
Pathological images of gastric cancer serve as the gold standard for diagnosing this malignancy. However, the recurrence prediction task often encounters challenges such as insignificant morphological features of the lesions, insufficient fusion of multi-resolution features, and inability to leverage contextual information effectively. To address these issues, a three-stage recurrence prediction method based on pathological images of gastric cancer is proposed. In the first stage, the self-supervised learning framework SimCLR was adopted to train low-resolution patch images, aiming to diminish the interdependence among diverse tissue images and yield decoupled enhanced features. In the second stage, the obtained low-resolution enhanced features were fused with the corresponding high-resolution unenhanced features to achieve feature complementation across multiple resolutions. In the third stage, to address the position encoding difficulty caused by the large difference in the number of patch images, we performed position encoding based on multi-scale local neighborhoods and employed self-attention mechanism to obtain features with contextual information. The resulting contextual features were further combined with the local features extracted by the convolutional neural network. The evaluation results on clinically collected data showed that, compared with the best performance of traditional methods, the proposed network provided the best accuracy and area under curve (AUC), which were improved by 7.63% and 4.51%, respectively. These results have effectively validated the usefulness of this method in predicting gastric cancer recurrence.
To accurately capture and effectively integrate the spatiotemporal features of electroencephalogram (EEG) signals for the purpose of improving the accuracy of EEG-based emotion recognition, this paper proposes a new method combining independent component analysis-recurrence plot with an improved EfficientNet version 2 (EfficientNetV2). First, independent component analysis is used to extract independent components containing spatial information from key channels of the EEG signals. These components are then converted into two-dimensional images using recurrence plot to better extract emotional features from the temporal information. Finally, the two-dimensional images are input into an improved EfficientNetV2, which incorporates a global attention mechanism and a triplet attention mechanism, and the emotion classification is output by the fully connected layer. To validate the effectiveness of the proposed method, this study conducts comparative experiments, channel selection experiments and ablation experiments based on the Shanghai Jiao Tong University Emotion Electroencephalogram Dataset (SEED). The results demonstrate that the average recognition accuracy of our method is 96.77%, which is significantly superior to existing methods, offering a novel perspective for research on EEG-based emotion recognition.
【Abstract】ObjectiveTo investigate the efficacy of radiofrequency (RF) ablation comparing with percutaneous ethanol injection (PEI) in the treatment of postoperative recurrent hepatocellular carcinoma. MethodsOne hundred and thirtyseven patients with recurrent hepatocellular carcinoma excluding those with extrahepatic metastasis or Child C liver function were analyzed retrospectively. Of these patients, 74 cases with 86 lesions underwent RF therapy, while the other 63 cases with 75 lesions treated with PEI therapy. In RF group, the average size of lesions was 2.05 cm in diameter including 9 lesions were more than 3 cm in diameter (the maximum size of the lesions was 4 cm in diameter). In PEI group, all lesions were less than 3 cm in diameter, averagely 2.03 cm. Blood routine, liver function, AFP level and Doppler ultrasound were observed before and after therapy 1-year, 2-year, 3-year survival rates were calculated in two groups as well. Results①There was no serious complications in two groups. ②Complete tumor necrosis was 93.0%(80/86) in RF group and 81.3%(61/75) in PEI group. In RF group, complete tumor necrosis rate for lesions less than 3 cm in diameter was 96.1%(74/77), while that was only 66.7%(6/9) for lesions greater than 3 cm in diameter. ③The 1-year, 2-year, 3-year survival rates were 74.3%(55/74), 62.2%(46/74) and 54.8% (17/31) in RF group as well as 68.3%(43/63), 57.1%(36/63) and 45.0%(9/20) in PEI group， respectively. ④The average treatment needed to achieve tumor ablation were 1.3 for RF group, and 2.5 for PEI group，respectively. ConclusionRF is an efficient treatment for recurrent hepatocellular carcinoma.
ObjectiveTo compare the efficacy and safety of Huaier and Sorafenib in treatment of small hepatocellular carcinoma(HCC)following radical resection. MethodsEighty-two patients with small HCC accepted radical liver resection and then taken Huaier or Sorafenib were collected retrospectively. These patients were divided into Huaier group(51 cases)and Sorafenib group(31 cases)according to the different administration drugs after operation. The baseline characteristics, tumor characteristics, survival rate, tumor recurrence rate, and side effects were compared between two groups. Results①There were no significant differences on the baseline demographic characteristics, liver function, and tumor characteristics between two groups(P > 0.05).②The overall survival rate and tumor-free survival rate had no significant differences between the Huaier group and the Sorafenib group(P=0.737, P=0.699).③The rate of recurrence or metastasis had no significant difference between the Huaier group and Sorafenib group(37.3% versus 32.3%, P=0.648). The most common site of the recurrence or metastasis was the liver and the lung followed.④There were only 5 cases suffered side effects after taking Huaier and no case needed Huaier discontinuance. However, 11 cases suffered side effects after taking Sorafenib and 3 cases needed Sorafenib discontinuance, and the rate of the side effect in the Sorafenib group was much higher than that in the Huaier group(35.5% versus 9.8%, P=0.026). ConclusionFor the small HCC who accepted radical liver resection, Huaier seems to be an effective and safe drug.