Objective To analyze the influence of the age of colorectal cancer patients served by West China Hospital as a regional center on hospitalization process in the current version of Database from Colorectal Cancer (DACCA). Methods The DACCA version was updated on January 5, 2022. All data items analyzed included age, date of admission, date of operation, date of discharge, pre-operation time, post-operation time, total hospital stay and management process. Data were assigned to three groups according to age with ≤45, 46–64 and ≥65 years old. Results After scanning, 8 013 data rows were obtained, from 2005 to 2022. The patients’ ages ranged from 14 to 104 years old, and were (58.01±13.52) years old in average. The results showed that the relationship between age and post-operative time was not statistically related (P>0.05). However, the pre-operative time (P=0.001) and total hospital stay time (P=0.005) were positively correlated with the age of colorectal cancer patients. The pre-operation time was longer in the older-aged group (P=0.021). Youth group had longer total hospital stay than other groups (P=0.028). Additionally, there was significant difference in the management process of colorectal cancer patients of different age groups (χ2=32.824, P＜0.05), but in terms of each process management classification, patients in different age groups had the same choice tendency as the overall choice, with “routine” management accounting for the largest proportion. “ERAS (enhanced recovery after surgery)” management was in the second place. Conclusions This study showed that the age group of patients with colorectal cancer has a certain influence on the length of hospital stay. Older patients have longer pre-operation time, but the effect of age on the total length of hospital stay still remains to be discussed. The composition of clinical management process varies among different age groups, and the elderly patients received the highest proportion of “ERAS” management process.
ObjectiveTo analyze the impact of the residence of patients with colorectal cancer (CRC) on surgical characteristics in the current version Database from Colorectal Cancer (DACCA). MethodsAccording to the established screening conditions, the patients with CRC were collected from the updated version of DACCA on January 23, 2023. The analysis indicators enrolled in this study included: the grouping indicator was residence, the surgical characteristic indicators included the surgical timing, surgical nature, expanded resection, intersphincteric resection (ISR) type, patient’s willingness of preserving the anus, and whether preserving the anus. The patients were categorized into three groups based on the residence: inside Chengdu City, outside Chengdu City within Sichuan Province, and outside Sichuan Province. The surgical characteristic indicators of patients with CRC from different residences were comparatively analyzed. ResultsA total of 6 832 analyzable data rows were enrolled. The results of statistical analysis revealed the following findings: there were no statistical differences in the surgery timing and surgery nature among the patients with colon cancer or rectal cancer from the different residences (Surgery timing: H=1.665, P=0.435; H=4.153, P=0.125. Surgery nature: χ2=1.586, P=0.453; χ2=0.990, P=0.610); For the patients with rectal cancer from the different residences, the distributions of the ISR type (H=0.514, P=0.773), patients’ willingness of preserving the anus (χ2=1.437, P=0.487), and whether preserving the anus (χ2=5.513, P=0.064) had no statistical differences. In addition, although there was no statistical difference in the distribution of expanded resection or not among the patients with rectal cancer in different residences (χ2=2.363, P=0.307), it was found that there was statistical difference in the distribution of enlarged resection or not among the patients with colon cancer in different residences (χ2=17.324, P＜0.001). ConclusionsFrom the data analysis in DACCA, there are not statistical differences in surgical characteristic indicators such as surgical timing, surgical nature, ISR type, patients’ willingness of preserving the anus, and whether preserving the anus among patients with colon or rectal cancer from different residences. However, the proportion of underwent expanded surgery in the colon cancer patients who from outside Sichuan Province as compared with inside Sichuan Province is relatively higher, this suggests that surgical difficulty is more difficult for the patients from outside Sichuan Province.
ObjectiveTo analyze the current version of the West China Database from Colorectal Cancer (DACCA) and explore how the occupational background of colorectal cancer patients affects the complexity of surgical difficulty and postoperative complications. MethodsWhen using the updated version of DACCA data on May 28, 2023 for analysis, the data items concerned covered occupation, operative duration, anatomical difficulty, pelvic stenosis, abdominal obesity, adhesion in surgical area, abnormal mesenteric status, tissue or organ hypertrophy, intestinal quality in surgical area, postoperative complications in hospital, short-term postoperative complications and long-term postoperative complications. According to the “Occupational Classification Code of the People’s Republic of China”, the occupations of patients were divided into professional and technical personnel, staff, service personal, production personnel, manufacturing personnel and retirees according to different occupations. The operative difficulty and postoperative complications of 6 groups were analyzed. ResultsAccording to the screening conditions, 5 734 valid data rows were obtained from DACCA. The results of occupation analysis showed that there were significant difference in operative duration (H=11.609, P=0.041), anatomical difficulty (H=29.166, P<0.001), pelvic stenosis (H=16.412, P=0.006), abdominal obesity (H=44.622, P<0.001), adhesion in surgical area (H=23.695, P<0.001), abnormal mesenteric status (χ2=39.252, P=0.035), tissue or organ hypertrophy (χ2=58.284, P<0.001) and intestinal quality in surgical area (H=21.041, P=0.001) between different groups. There were no significant differences in the occurrence of complications in hospital, near and short-term and long-term after operation among different occupations (P>0.05). Further subgroup analysis showed that only the difference of fever (χ2=10.969, P=0.041) and intestinal obstruction (χ2=12.025, P=0.021) were statistically significant among different occupations. ConclusionThe occupation of patients may affect the difficulty of colon cancer surgery, and the occurrence of postoperative complications is nothing to do with the occupation of patients, but the occurrence of postoperative fever and postoperative intestinal obstruction is related to occupations, and the possible causes need to be further explored.
Objective To establish the Chinese Evidence-Based Medicine/Cochrane Centre Database of Clinical Trials and Diagnostic Tests to provide reliable scientific data for clinical practice, teaching, research and systematic reviewers and submit the results of randomised controlled trials (RCTs) and controlled clinical trials (CCTs) to The Cochrane Collaboration. Methods Data were collected by handsearching and electronic searching based on the criterion of the Collaboration and clinical epidemiology. Results Up to December 2003, there were 16 652 RCTs /CCTs and 3 786 DT included in the database. A total of 4 966 RCTs and CCTs were submitted to the Collaboration. Nineteen specialized databases were set up. Conclusions The first phase of the Chinese Evidence-Based Medicine/Cochrane Centre Database of Clinical Trials and Diagnostic Tests has been completed. The database has provided advice for contributiors both at home and abroad.
ObjectiveTo evaluate the efficacy of multicycle neoadjuvant chemotherapy combined with apatinib in the treatment of advanced rectal cancer through the Database from Colorectal Cancer (DACCA).MethodsA total of 173 patients with advanced rectal cancer who underwent surgery after 2–4 cycles of neoadjuvant chemotherapy combined with apatinib were selected from the DACCA (Version January 20, 2019). The patients were grouped by treated cycle and clinical TNM (cTNM) stage, and the overall variation of clinical and pathological indicators before and after treatment were compared.ResultsAmong 173 cases, 63 cases (36.42%), 45 cases (26.01%), and 65 cases (37.57%) were respectively in the 2, 3, and 4-cycle group; 54 cases (31.21%), 91 cases (52.60%), and 28 cases (16.18%) in stage Ⅱ, Ⅲ, and Ⅳ-group. Clinical response degree: complete pathologic response (cPR) was observed in 23 cases (13.29%), and the rate of conversion resection was 100% (173/173). Clinical response grade: complete response (CR) in 58 cases (33.53%), partial response (PR) in 93 cases (53.76%), stable disease (SD) in 21 cases (12.14%), progressive disease (PD) in 1 cases (0.58%). Tumor regression grade: TRG0 in 21 cases (12.57%), TRG1 in 22 cases (13.17%), TRG2 in 84 cases (50.30%), TRG3 in 40 cases (23.95%). There was a statistical difference in CEA before and after the treatment (P<0.001). All cases underwent radical resection, and the successful rate of transformed resection was 100%. There was significant difference on the clinical response grade among the cases of different treatment cycle (H=18.513, P<0.001), and the longer treatment cycle was correlated with better clinical response (G=–0.474, P<0.001). In addition, there was significant difference on the cPR rate among the cases of different cTNM stage (χ2=6.450, P=0.040).ConclusionsMulticycle neoadjuvant chemotherapy combined with apatinib in treating patients with advanced rectal cancer is efficient. More treatment cycles lead to better efficacy. The lower cTNM stage maybe means more chance of achieving cPR and a satisfactory rate of conversion resection.
To promote the accessibility and application of guidelines, it is necessary to establish a professional guideline database to adapt to the rapid growth of TCM clinical practice guidelines. This study described the framework design, technology module, information management, and quality control of the clinical practice guideline database of traditional Chinese medicine (G-TCM). G-TCM had included 658 TCM clinical practice guidelines, which would provide a platform for clinicians, researchers, guideline makers (revision), and evaluators to quickly query and obtain clinical guideline information, and play a supporting role in promoting the standardization and accessibility of TCM clinical practice guidelines and better guiding clinical practice.
Objective To reveal the worldwide research status and hot topics of sleep apnea syndrome ( SAS) . Methods Articles were searched from Web of Science ( SCI) , Essential Science Indicator ( 2000 to 2010) database using sleep apnea syndrome or apnea as keywords. Retrieved documents were analyzed using the database with its own statistical functions and histcite software ( version 8.12. 16) .Results Since 1992 the international scientific papers on the SAS study showed a gradual upward trend.The United States is a world leader in this field. Recent research has focused on vascular endothelial barrier function and repair, oxidative stress, inflammation, cognitive function, special populations such as the elderlyor children patients with SAS. Conclusion Clinical researchers have paid more attention to SAS than before, but there are still many important issues unresolved.
Objective To establish a Chinese clinical controlled trials database of neurology. Methods We identified relevant studies by electronic searching of CBMdisc from 1978 to April 2002, and the Library of Evidence-Based Medicine (Chinese). We also searched manually 11 journals and 4 conference proceedings relevant to neurological diseases. The studies included in this database should be controlled studies relevant to treatment on neurological disease, randomized or only controlled without randomization. Results 3 641 studies were included in this database. Conclusions The Chinese neurological trials database was established. This database will provide Chinese evidence on treatments of various neurological diseases. Studies in this database will also be included in the Cochrane Library to facilitate systematic reviewers.
ObjectiveTo analyze the relationship between occupational type of patients with colorectal cancer (CRC) and decision-making and curative effect of neoadjuvant therapy in the current version of the Database from Colorectal Cancer (DACCA). MethodsThe eligible CRC patients were collected from June 29, 2022 updated DACCA according to the screening criteria, in which the data items analyzed included: gender, age, BMI, blood type, marriage, occupation, neoadjuvant therapy, symptomatic changes, imaging changes, and tumor regression grade (TRG), and the occupations were classified into the mental labour group, physical labour group, and the unemployed and resident groups according to the type of labour, then compared the decision-making and curative effect of neoadjuvant therapy among the 3 groups. ResultsA total of 2 415 eligible data were screened, of which 1 160 (48.0%) were the most in the manual labour group, followed by 877 (36.3%) in the unemployed and resident group, and finally 378 (15.7%) in the mental labour group. The proportion of those who did not use targeted drugs was higher in both patients ≤60 years old and >60 years old [75.6% (958/1 267) vs. 82.5% (947/1 148)], with both differences being statistically significant (P=0.004 and P=0.019), and among patients >60 years old, the different occupational types were associated with symptomatic changes and imaging changes after neoadjuvant therapy, with the highest number of both changes to partial remission [71.5% (161/225) vs. 66.7% (148/222)], both differences being statistically significant (P=0.001 and P=0.017). ConclusionThe analysis results of DACCA data reveal that the occupational type of CRC patients was associated with the choice of neoadjuvant therapy, and that different occupational types were associated with changes in curative effect before and after neoadjuvant therapy in CRC patients >60 years old, which needs to be further analysis for the reasons.
ObjectiveTo analyze the relation between the age of patients with colorectal cancer and neoadjuvant therapy (NAT) regimen decision-making and outcomes in the current version of the Database from Colorectal Cancer (DACCA). MethodsThe version of DACCA selected for this analysis was updated on January 5, 2022. The patients were enrolled according to the established screening criteria and then assigned to 3 age groups: ≤45, 45–65, and ≥65 years old groups. The differences in the NAT regimen decision-making and changes of symptom, imaging, and cancer markers in these 3 age groups were analyzed. ResultsA total of 4 882 data that met the screened criteria were enrolled. The results of statistical analysis showed that the difference in the constituent ratio of patients chosen NAT strategies among 3 age groups was not statistically significant (χ2=8.885, P=0.180). There was a statistical difference in the constituent ratio of patients chosen combined target drug among 3 age groups (χ2=8.530, P=0.014), it was found that the proportion of the patients with ≤45 years old adopting combined target drug regimen was higher. Although the changes of symptom (H=12.299, P=0.056), image (H=1.775, P=0.412), and cancer markers (H=11.351, P=0.183) had no statistical differences of the 3 age groups after NAT, it was found that the proportions of patients with ≥65 years old with progresses of symptom and imaging changes and elevated cancer markers after NAT were higher, and the proportions of patients with ≤45 years old with complete and partial remissions of symptom and imaging changes and with normal cancer markers after NAT were higher. ConclusionsThrough analysis of DACCA data, it is found that in the selection of NAT strategy for colorectal cancer, the lower age group, the higher proportion of patients adopting combined target drug regimen. Although it is not found that age is related to changes of symptoms, imaging, and cancer markers after NAT, it still shows a trend of better outcomes in younger patients.
