Objective:Albumin-globulin ratio(AGR),prognostic nutritional index(PNI),and platelet to-lymphocyte ratio(PLR)have been validated as prognostic factors for gastric cancer(GC).However,significant gender differences exis...Objective:Albumin-globulin ratio(AGR),prognostic nutritional index(PNI),and platelet to-lymphocyte ratio(PLR)have been validated as prognostic factors for gastric cancer(GC).However,significant gender differences exist in albumin levels and inflammatory cell counts,and further research is required to understand how these differences influence GC prognosis.This study aims to investigate the prognostic impact of nutritional and inflammatory indicators on GC patients undergoing radical surgery,as well as the influence of gender on these indicators’prognostic value.Methods:The study included 596 patients with advanced GC hospitalized in the Department of Gastrointestinal Surgery,General Surgery,Xiangya Hospital of Central South University from January 2012 to December 2016.Receiver operating characteristic(ROC)analysis was performed to determine cutoff values for nutritional and inflammatory factors.Univariate analysis was used to identify factors significantly affecting survival in GC patients,while multivariate and Kaplan-Meier analyses determined independent prognostic factors for GC.Results:Multivariate analysis revealed that postsurgical tumor node metastasis(pTNM)stage[stage II:hazard ratio(HR)=3.284,P=0.012;stage III:HR:8.062,P<0.001],low preoperative AGR(HR=1.499,P=0.012),and postoperative PNI(HR=1.503,P=0.008)were risk factors for overall survival in male patients after radical GC surgery.For female patients,pN2-3(HR=3.185,P<0.001),total gastrectomy(HR=2.286,P=0.004),low preoperative PLR(HR=1.702,P=0.027),and postoperative PNI(HR=1.943,P=0.011)were identified as risk factors for overall survival.Conclusion:Postoperative PNI is an independent risk factor for all advanced GC patients.Preoperative PLR is an independent prognostic factor only for female patients,while preoperative AGR is an independent prognostic factor only for male patients.Further research is warranted to investigate the gender-specific differences in GC prognosis.展开更多
目的评价前锯肌平面阻滞(serratus anterior plane block,SAPB)用于减轻胸腔镜术后阿片类药物所致恶心呕吐的有效性和安全性。方法计算机检索PubMed、Ovid、Cochrane Library、ISI Web of knowledge、中国生物医学文献数据库(CBM)、中...目的评价前锯肌平面阻滞(serratus anterior plane block,SAPB)用于减轻胸腔镜术后阿片类药物所致恶心呕吐的有效性和安全性。方法计算机检索PubMed、Ovid、Cochrane Library、ISI Web of knowledge、中国生物医学文献数据库(CBM)、中文科技期刊全文数据库(VIP)、中国期刊全文数据库(CNKI)及万方数据库中SAPB用于胸腔镜术后镇痛的随机对照试验(RCT),对照组为注入安慰剂或不阻滞,检索时间均从建库至2019年12月。2位研究者按照纳入标准筛选文献、提取资料,2位评价员独立对纳入文献的质量进行评价,采用RevMan5.3进行meta分析。结果纳入12个RCT共703例患者。在有效性方面,与对照组相比,SAPB组术后各时点静息状态、运动状态下疼痛视觉模拟评分(Visual Analogue Scale,VAS)降低,差异有统计学意义;在安全性方面,与对照组相比,SAPB组术后恶心呕吐发生率较低,差异有统计学意义(RR=0.36,95%CI:0.20~0.65,P=0.0006),SAPB组术后24 h吗啡累积使用量较少,差异有统计学意义(MD=-1.51,95%CI:-1.93^-1.10,P<0.00001)。结论SAPB能够降低胸腔镜术后恶心呕吐发生率,减少术后阿片类镇痛药物的使用,用于胸腔镜术后镇痛安全有效。展开更多
基金supported by the National Natural Science Foundation of China(8197103463).
文摘Objective:Albumin-globulin ratio(AGR),prognostic nutritional index(PNI),and platelet to-lymphocyte ratio(PLR)have been validated as prognostic factors for gastric cancer(GC).However,significant gender differences exist in albumin levels and inflammatory cell counts,and further research is required to understand how these differences influence GC prognosis.This study aims to investigate the prognostic impact of nutritional and inflammatory indicators on GC patients undergoing radical surgery,as well as the influence of gender on these indicators’prognostic value.Methods:The study included 596 patients with advanced GC hospitalized in the Department of Gastrointestinal Surgery,General Surgery,Xiangya Hospital of Central South University from January 2012 to December 2016.Receiver operating characteristic(ROC)analysis was performed to determine cutoff values for nutritional and inflammatory factors.Univariate analysis was used to identify factors significantly affecting survival in GC patients,while multivariate and Kaplan-Meier analyses determined independent prognostic factors for GC.Results:Multivariate analysis revealed that postsurgical tumor node metastasis(pTNM)stage[stage II:hazard ratio(HR)=3.284,P=0.012;stage III:HR:8.062,P<0.001],low preoperative AGR(HR=1.499,P=0.012),and postoperative PNI(HR=1.503,P=0.008)were risk factors for overall survival in male patients after radical GC surgery.For female patients,pN2-3(HR=3.185,P<0.001),total gastrectomy(HR=2.286,P=0.004),low preoperative PLR(HR=1.702,P=0.027),and postoperative PNI(HR=1.943,P=0.011)were identified as risk factors for overall survival.Conclusion:Postoperative PNI is an independent risk factor for all advanced GC patients.Preoperative PLR is an independent prognostic factor only for female patients,while preoperative AGR is an independent prognostic factor only for male patients.Further research is warranted to investigate the gender-specific differences in GC prognosis.
