Patients with type 4 gastric cancer and peritoneal metastasis respond better to chemotherapy than surgery. In particular, patients without gastric stenosis who can consume a meal usually experience better quality of l...Patients with type 4 gastric cancer and peritoneal metastasis respond better to chemotherapy than surgery. In particular, patients without gastric stenosis who can consume a meal usually experience better quality of life (QOL). However, some patients with unsuccessful chemotherapy are unable to consume a meal because of gastric stenosis and obstruction. These patients ultimately require salvage surgery to enable them to consume food normally. We evaluated the outcomes of salvage total gastrectomy after chemotherapy in four patients with gastric stenosis. We determined clinical outcomes of four patients who underwent total gastrectomy as salvage surgery. Outcomes were time from chemotherapy to death and QOL, which was assessed using the Support Team Assessment Schedule-Japanese version (STAS-J). Three of the patients received combination chemotherapy [tegafur, gimestat and otastat potassium (TS-1); cisplatin]. Two of these patients underwent salvage chemotherapy after 12 and 4 mo of chemotherapy. Following surgery, they could consume food adequately and their STAS-J scores improved, so their treatments were continued. The third patient underwent salvage surgery after 7 mo of chemotherapy. This patient was unable to consume food adequately after surgery and developed surgical complications. His clinical outcomes at 3 mo were very poor. The fourth patient received combination chemotherapy (TS-1 and irinotecan hydrochloride) for 6 mo and then underwent received salvage surgery. After surgery, he could consume food adequately and his STAS-J score improved, so his treatment was continued. After the surgery, he enjoyed his life for 16 mo. Of four patients who received salvage total gastrectomy after unsuccessful chemotherapy, the QOL improved in three patients, but not in the other patient. Salvage surgery improves QOL in most patients, but some patients develop surgical complications that prevent improvements in QOL. If salvage surgery is indicated, the surgeon and/or oncologist must provide the patient with a clear explanation of the purpose of surgery, as well as the possible risks and benefits to allow the patient to reach an informed decision on whether to consent to the procedure.展开更多
Background: This study investigated serum Glucose transporter (GLUT) 4 levels and examined the relationship between serum GLUT4 levels and sepsis in critically ill children. Methods: This was a retrospective study of ...Background: This study investigated serum Glucose transporter (GLUT) 4 levels and examined the relationship between serum GLUT4 levels and sepsis in critically ill children. Methods: This was a retrospective study of 77 critically ill children and 33 non-diabetic healthy children (controls) who were admitted between 07/2015 and 05/2016. Patient data, clinical information, and blood samples were collected on admission, alongside a large number of laboratory parameters that were routinely assessed. Critically ill patients were divided into sepsis and non-sepsis/systemic inflammatory response syndrome (SIRS). Serum GLUT4 was measured using western blotting and enzyme-linked immunosorbent assays. Insulin resistance indexes, clinical data, laboratory parameters, and inflammatory cytokines were assessed. Results: GLUT4 serum levels were higher in critically ill children than in healthy children (90.5 vs. 30.3 μg/L, P 0.05). Compared to healthy children, hyperglycemic patients (n = 48) had elevated GLUT4 serum levels (30.3 vs. 103.7 g/L, P Conclusions: GLUT4 serum levels might be significantly increased in critically ill children compared with healthy children, particularly those in septic shock. Serum GLUT4 could predict disease severity.展开更多
[目的]探讨二肽基肽酶4抑制剂(DPP-4i)对2型糖尿病(T2DM)患者血清肌酐(Cr)的影响。[方法]系统检索PubMed、Embase、Cochrane Library和Web of Science数据库,纳入DPP-4i治疗T2DM患者调节Cr的随机对照试验(RCT)。采用固定效应或随机效应...[目的]探讨二肽基肽酶4抑制剂(DPP-4i)对2型糖尿病(T2DM)患者血清肌酐(Cr)的影响。[方法]系统检索PubMed、Embase、Cochrane Library和Web of Science数据库,纳入DPP-4i治疗T2DM患者调节Cr的随机对照试验(RCT)。采用固定效应或随机效应模型进行数据拟合,采用I^(2)指数定量评价异质性,使用标准方法进行敏感性分析和发表偏倚检验。[结果]经系统检索数据库,纳入12项RCT,共计2276名受试者。由于潜在异质性的原因,故采用随机效应模型进行数据拟合,DPP-4i治疗可轻度提高T2DM患者的Cr水平(WMD:0.15 mg/L,95%CI:0.03~0.27,I^(2)=18%,P=0.02),结果具有统计学差异。根据敏感性测试,Meta分析其结果较为可靠。同时进行Begg’s与Egger’s检验,未见发表偏倚。[结论]T2DM患者应用DPP-4i进行降糖治疗,可能会出现血Cr水平轻度升高。未来还需开展更大样本量的多中心研究,以进一步探讨DPP-4i治疗引起Cr水平改变的临床意义。展开更多
文摘Patients with type 4 gastric cancer and peritoneal metastasis respond better to chemotherapy than surgery. In particular, patients without gastric stenosis who can consume a meal usually experience better quality of life (QOL). However, some patients with unsuccessful chemotherapy are unable to consume a meal because of gastric stenosis and obstruction. These patients ultimately require salvage surgery to enable them to consume food normally. We evaluated the outcomes of salvage total gastrectomy after chemotherapy in four patients with gastric stenosis. We determined clinical outcomes of four patients who underwent total gastrectomy as salvage surgery. Outcomes were time from chemotherapy to death and QOL, which was assessed using the Support Team Assessment Schedule-Japanese version (STAS-J). Three of the patients received combination chemotherapy [tegafur, gimestat and otastat potassium (TS-1); cisplatin]. Two of these patients underwent salvage chemotherapy after 12 and 4 mo of chemotherapy. Following surgery, they could consume food adequately and their STAS-J scores improved, so their treatments were continued. The third patient underwent salvage surgery after 7 mo of chemotherapy. This patient was unable to consume food adequately after surgery and developed surgical complications. His clinical outcomes at 3 mo were very poor. The fourth patient received combination chemotherapy (TS-1 and irinotecan hydrochloride) for 6 mo and then underwent received salvage surgery. After surgery, he could consume food adequately and his STAS-J score improved, so his treatment was continued. After the surgery, he enjoyed his life for 16 mo. Of four patients who received salvage total gastrectomy after unsuccessful chemotherapy, the QOL improved in three patients, but not in the other patient. Salvage surgery improves QOL in most patients, but some patients develop surgical complications that prevent improvements in QOL. If salvage surgery is indicated, the surgeon and/or oncologist must provide the patient with a clear explanation of the purpose of surgery, as well as the possible risks and benefits to allow the patient to reach an informed decision on whether to consent to the procedure.
文摘Background: This study investigated serum Glucose transporter (GLUT) 4 levels and examined the relationship between serum GLUT4 levels and sepsis in critically ill children. Methods: This was a retrospective study of 77 critically ill children and 33 non-diabetic healthy children (controls) who were admitted between 07/2015 and 05/2016. Patient data, clinical information, and blood samples were collected on admission, alongside a large number of laboratory parameters that were routinely assessed. Critically ill patients were divided into sepsis and non-sepsis/systemic inflammatory response syndrome (SIRS). Serum GLUT4 was measured using western blotting and enzyme-linked immunosorbent assays. Insulin resistance indexes, clinical data, laboratory parameters, and inflammatory cytokines were assessed. Results: GLUT4 serum levels were higher in critically ill children than in healthy children (90.5 vs. 30.3 μg/L, P 0.05). Compared to healthy children, hyperglycemic patients (n = 48) had elevated GLUT4 serum levels (30.3 vs. 103.7 g/L, P Conclusions: GLUT4 serum levels might be significantly increased in critically ill children compared with healthy children, particularly those in septic shock. Serum GLUT4 could predict disease severity.
文摘[目的]探讨二肽基肽酶4抑制剂(DPP-4i)对2型糖尿病(T2DM)患者血清肌酐(Cr)的影响。[方法]系统检索PubMed、Embase、Cochrane Library和Web of Science数据库,纳入DPP-4i治疗T2DM患者调节Cr的随机对照试验(RCT)。采用固定效应或随机效应模型进行数据拟合,采用I^(2)指数定量评价异质性,使用标准方法进行敏感性分析和发表偏倚检验。[结果]经系统检索数据库,纳入12项RCT,共计2276名受试者。由于潜在异质性的原因,故采用随机效应模型进行数据拟合,DPP-4i治疗可轻度提高T2DM患者的Cr水平(WMD:0.15 mg/L,95%CI:0.03~0.27,I^(2)=18%,P=0.02),结果具有统计学差异。根据敏感性测试,Meta分析其结果较为可靠。同时进行Begg’s与Egger’s检验,未见发表偏倚。[结论]T2DM患者应用DPP-4i进行降糖治疗,可能会出现血Cr水平轻度升高。未来还需开展更大样本量的多中心研究,以进一步探讨DPP-4i治疗引起Cr水平改变的临床意义。
