SUMSearch and TRIP database are meta search engines for searching clinical evidence. This article introduces major contents and search methods of the SUMSearch and TRIP database, so as to provide quick search resources and technical help for evidence-based practice.
ObjectiveTo analyze the follow-up data of colorectal cancer in the Database from Colorectal Cancer (DACCA).MethodsThe information in the Dacca database was screened, and the one whose operative date and follow-up date were not blank in the total data was selected. The follow-up data were analyzed, including length of follow-up, survival outcomes, coping styles (doctors’ attitude and reaction for follow-up), follow-up path (whether to choose out-patient, Wechat, QQ tools, phone call, text message, mobile application, face-to-face), the number of follow-up (the number of out-patient follow-up, the number of telephone follow-up, and the number of follow-up within 5 years).ResultsA total of 6 437 data items were analyzed for colorectal cancer adjuvant follow-up. ① The follow-up period of five years (2004–2015) was 56.6% (3 642/6 437), and the follow-up time was 0–201, 67 (26, 97) months. ② The highest data composition ratio of survival outcomes was “Survival” (79.7%, 4 611/5 787), and in the data with five-year follow-up period (2004–2015), the highest data composition ratio of survival outcomes was “Survival” (75.0%, 2 550/3 401), and the survival rate of the five-year follow-up period in 2008 was the highest (91.4%, 235/257). ③ The highest data composition ratio of the coping styles was the doctors’ active follow-up (76.8%, 2 121/2 762). ④ The highest data composition ratio of the follow-up path was out-patient service (90.6%, 4 236/4 676). ⑤ The highest data composition ratio of the number of out-patient follow-up was conducted by the original surgical team (100%, 4 380/4 380), the specific number was 0–130、5 (2, 10) times. The data composition ratio of telephone follow-up was 86.9% (3 808/4 380) and the specific number was 0–68、0 (0, 1) times. The highest frequency of follow-up was in the first year (89.9%, 3 044/3 386) and the specific number was 0–73、5 (3, 9) times.ConclusionBy expounding the characteristics of the colorectal cancer follow-up from colorectal cancer in DACCA, it provides some references for using big data to determine prognosis.
ObjectiveTo analyze the characteristics of colorectal cancer surgery in the current version of Database from Colorectal Cancer (DACCA).MethodsThe DACCA version selected for this data analysis was the updated version on July 16th, 2020. The data items included operative duration, anatomy (anatomical difficulty), pelvis (pelvic stenosis), obesity (abdominal obesity), adhesion (adhesion in surgical area), mesentery (abnormal mesenteric status), hypertrophy (tissue hypertrophy or organ hypertrophy), intestinal quality, death (risk of death), injury (risk of tissue injury), recurrence (tumor recurrence), metastasis (tumor metastasis), anastomotic leakage (risk of anastomotic leakage), difficulty of operation, prognosis, quality of operation. The selected data items were statistically analyzed.ResultsThetotal number of medical records (data rows) that met the criteria was 6 116. Spearman correlation text showed a negative correlation between operative duration and years (rs=–0.433, P<0.001). In anatomy, pelvis, obesity, adhesion, mesentery, and hypertrophy, the most cases were “normal or basically normal”, and the percentages were 32.55%, 44.52%, 48.68%, 55.79%, 53.36%, and 57.72%, respectively. In quality of intestinal, the highest proportion was “bad” (43.25%). In risk of death, risk of tissue injury, and tumor recurrence, the most cases were “very small”, and the percentages were 69.00%, 94.41%, and 68.21%, respectively. In tumor metastasis, risk of anastomotic leakage, difficulty of operation, prognosis, and quality of operation, the highest proportion were “small” (48.58%), “average” (49.25%), “average” (32.96%), “uncertain” (45.65%), and “very good” (39.85%).ConclusionsIn the DACCA, the intestinal quality is characteristic of difficulty in operation, and in the evaluation of operation quality, the judgment of anastomotic leakage deserves much more attention. However, the relationship between the difficulty of operation and postoperative effects, and the relationship between the quality of operation and the prognosis still need to be further studied.
objective To analyze the impact of body mass index (BMI) on medical and surgical complications of colorectal cancer patients served by West China Hospital, based on the current version of Database from Colorectal Cancer (DACCA). Methods The data of DACCA was updated on September 27, 2021. The data included BMI, surgical complications, liver nodules, liver function, renal nodules, renal function, operation history, medical complications, diabetes, hypertension, pneumonia, pulmonary nodules, pulmonary function, heart disease, thrombosis, and cardiac function. Results After scanning, 5 305 data rows were included. BMI was divided by Chinese four classification methods. The analysis results showed that in terms of surgical complications, obese patients were more likely to be complicated with surgical complications of digestive system (χ2= 43.883, P<0.001) and reproductive system (χ2=13.139, P=0.004). Lean patients were more likely to have surgical complications of urinary system (χ2=223.415, P<0.001), and obese patients had liver function (H=61.521, P<0.001) and renal function (H=9.994, P=0.019) might be even worse. In terms of operation history, BMI in colorectal cancer patients had nothing to do with the number of times of operation (H=6.262, P=0.100), and operation history of each system or department (P>0.05). Regarding to medical complications, with the increase of BMI, the risk of colorectal cancer patients with diabetes mellitus (χ2=118.597, P<0.001), or hypertension (χ2= 163.334, P< 0.001) increased. Patients with low BMI were more likely to have pneumonia (H=7.899, P= 0.048) and worse pulmonary function (H=40.673, P<0.001). Conclusions The analysis results of DACCA database show that BMI is not related to the occurrence of any special surgical history included in the research. Because the internal and external complications of patients are closely related to the treatment plan and prognosis, we should pay more attention to the obese patients in the process of clinical treatment, and they are more likely to have multisystemic abnormalities and various abnormal indicators than other patients. For thin patients, we should pay more attention to their lung function and inflammatory lesions, so as to improve the clinical therapeutic effect.
ObjectiveTo investigate the expression of gasdermin (GSDM) gene family in primary liver cancer and its clinical significance. MethodsThe Gene Expression Profile Data Dynamic Analysis (GEPIA2) database was used to analyze the expression levels of GSDM gene family in primary liver cancer and normal tissues, and survival analysis was performed to explore its relationship with prognosis; GEPIA2 database was used to explore the relationship between GSDM gene family and TNM staging of patients with primary liver cancer. We used GeneMANIA database to predict genes that may interact with GSDM gene family, and used Metascape website for functional enrichment analysis. Finally, we used TIMER database to explore the relationship of expression of GSDM gene family and immune cell infiltration in the tumor microenvironment of primary liver cancer. ResultsCompared with normal liver tissues, GSDMA, GSDMC, GSDMD, and GSDME were highly expressed in primary liver cancer (P<0.050), and GSDMB and DFNB59 were low expressed (P<0.050); results of univariate Cox proportional hazard regression model showed that the differential expressions of GSDMD, GSDME, and DFNB59 were related to the overall survival of patients (P<0.050), and the results of the multivariate Cox proportional hazard regression model showed that GSDME could be used as an independent predictor of the prognosis of liver cancer patients (P<0.050). With the increase of TNM staging in patients with liver cancer, the expressions of GSDMA and GSDMC also gradually increased (P<0.050). Further enrichment analysis showed that the GSDM gene family was involved in pyrolysis and various immune-related biological processes. ConclusionThe GSDM gene is differentially expressed in primary liver cancer, participates in immune-related biological processes, and its expression is related to clinicopathological staging and patients’ prognosis.
ObjectiveTo explain surgery reaction and perioperative complications of colorectal cancer in detail as well as their tags and structures of Database from Colorectal Cancer (DACCA) in the West China Hospital.MethodThe article was described in words.ResultsThe surgery reaction and perioperative complications of colorectal cancer module including temperature, flatus, pain, and mental status, as well as preoperative complications, intraoperative complications, postoperative complications (short-term complications and long-term complications) of the DACCA in the West China Hospital were defined. The data label corresponding to each item in the database and the structured way needed for the big data application stage in detail were explained. And the error correction notes for all classification items were described.ConclusionsThrough the detailed description of the surgery reaction and perioperative complications of colorectal cancer of DACCA in West China Hospital, it provides standard and basis for clinical application of DACCA in future, and provides reference for other peers who wish to build a colorectal cancer database.
Objective To analyze the data of external fixation instruments (including Ilizarov instruments) used by QIN Sihe orthopaedic surgical team in the treatment of limb deformities in the past 30 years, and to explore the indications for the application of modern external fixation techniques in the correction of limb deformities and individual device configuration selection strategy. Methods According to QIN Sihe orthopaedic surgical team, the use of external fixator between January 1988 and December 2017 was analyzed retrospectively. The total use of external fixation and the proportion of different external fixators were analyzed in gender, different operation time, different age, different parts, and different diseases. Results External fixators were used in 8 113 patients, 69 of them were used simultaneously in both lower extremity surgery, so 8 182 external fixators were used. Among them, there were 4 725 (57.74%) combined external fixators, 3 388 (41.41%) Ilizarov circle fixators, 64 (0.78%) single arm external fixators (including Orthofix), 5 (0.06%) Taylor space external fixators. There were 4 487 males (55.31%) and 3 626 females (44.69%). According to the analysis of different time periods, the number of external fixators increased year by year, and the number of applications increased after 2000. The main age of the patients was 11-30 years old, of which 1 819 sets (22.23%) were used at the age of 21-25 years. The use of the external fixator covered almost all parts of the limbs, with the ankle and toe areas being the most common, reaching 4 664 sets (57.00%), and the upper extremities the least, with 152 sets (1.86%). The 8 113 cases covered more than a dozen disciplines and more than 150 kinds of diseases. The top 5 diseases were poliomyelitis sequelae, cerebral palsy, deformity of lower extremity after spina bifida, traumatic sequelae, and congenital equinovarus foot. Conclusion Ilizarov technique has been widely used in extremity deformity, disability, and complicated orthopedic diseases caused by vascular, lymphoid, nerve, skin, endocrine, and other diseases. The indication of operation is far beyond the scope of orthopedics. The domestic external fixator and its mounting tools can basically meet the requirements of various treatments. The technique of external fixation has entered a new era of tension tissue regeneration under stress control, natural repair of tissue trauma and deformity, and reconstruction of limb function.
ObjectiveTo analyze the relationship between educational level and oncological characteristics of colorectal patients served by Sichuan University West China Hospital in the current version of the Database from Colorectal Cancer (DACCA). MethodsThe DACCA version selected for this data analysis was the updated version on June 29, 2022. The data items analyzed included: educational level, precancerous lesions, family history of cancer, tumor location, tumor orientation, tumor pathology, tumor morphology, tumor differentiation and preoperative TNM staging. According to Article 17 of the Education Law of the People’s Republic of China, the educational level of the research subjects was divided into four categories: illiteracy group, the primary educated group (elementary school), the secondary educated group (middle school, high school, vocational school and technical school), and the higher educated group (university, higher vocational school, junior college and above). ResultsThe DACCA database was filtered by conditions to obtain 5 512 valid data. The data analysis results showed that there were statistically significant differences in the composition ratios of precancerous lesions (χ2=27.398, P<0.001), tumor site (χ2=42.610, P<0.001) and tumor orientation (χ2=18.967, P=0.025) among the different education groups, and there were not statistically significant differences in the composition ratios of family history of cancer in oneself (χ2=9.345, P=0.133) or in the family (χ2=4.310, P=0.635), tumor pathological properties (χ2=27.027, P=0.202), tumor morphology (χ2=16.283, P=0.061), tumor differentiation degree (H=3.672, P=0.299) and the TNM staging of tumors before operation (H=0.156, P=0.984) among the different education groups. ConclusionsData analysis in DACCA reveal multiple associations between educational level and oncological characteristics of colorectal cancer patients. The education level of patients has a certain reference value in the investigation of various precancerous lesions. With the increase of education level, the proportion of tumors located in the rectum gradually decreases, and the proportion located in the colon gradually increases, and education level may affect treatment and prognosis by influencing preoperative tumor characteristics.
ObjectiveTo investigate the methods and significances of the breast ultrasonographic breast imaging reporting and data system (BI-RADS) category 4 lesions divided into category 4a, 4b, and 4c, and to assess the risk of malig-nancy of lesions with BI-RADS category 4 in order to improve the accuracy of diagnosis.
MethodsTwo hundred and eighty-eight breast lesions with BI-RADS category 4 confirmed by histopathology were collected. The ultrasonographic characteristics of benign and malignant lesions, containing the shape, aspect ration, margin, calcification, changes of the surrounding tissue, boundary, blood flow characteristics, internal echo, rear echo of the lesions, were comparatively anal-yzed, and the lesions with BI-RADS-US category 4 were divided into 4a, 4b, 4c according to these ultrasonographic charac-teristics and analyzed by statistics.
ResultsThere were 192 malignant lesions and 96 benign lesions in the 288 breast lesions. There were statistical significances in the benign and malignant lesions with the shape, aspect ratio, margin, calci-fication, change of surrounding tissue, and boundary (P < 0.05), in other words, the proportion of these ultrasonographic characteristics were higher in the malignant lesions as compared with the benign lesions. But there were no significant differences of internal echo, rear echo, and blood flow characteristics between two lesions (P > 0.05). The positive predictive value of malignant tumor with BI-RADS category 4a, 4b, and 4c were 21.74%, 58.90%, and 91.78%, respectively, and there was significant difference (χ2=106.09, P=0.000).
ConclusionsThe classification of breast lesions with BI-RADS category 4 is refined, it could more accurately assess the risk of benign and malignant breast masses. At the same time, it has an important clinical significance for diagnosis and treatment of benign and malignant breast masses.
Objective To analyze the relationship between age and prognosis of colorectal patients in the database from colorectal cancer (DACCA). Methods The DACCA version selected for this data analysis was updated on January 5, 2022. The data items analyzed included age, sex, tumor site, tumor pathological nature, obstruction, pathological TNM (pTNM) stage, positive lymph node ratio, survival status and survival time. According to China’s age segmentation standard, the included data were grouped into younger group (<35 years old), middle-aged group (35–59 years old) and elderly group (>59 years old). Overall survival (OS) and disease specific survival (DFS) were analyzed in three age group, and OS and DSS in three age group were analyzed in pTNM stage stratification. Results Three thousand six hundred and twenty-five rows of data were obtained from DACCA database according to the screening conditions. The survival analysis results of different age groups show that: The middle-aged group had better OS compared with the elderly group at 1-year (97.4% vs. 96.0%, P=0.037), 3-year (90.9% vs. 88.0%, P=0.030) and 5-year (81.7% vs. 75.7%, P=0.002). Also, the middle-age group had better 5-year DSS (82.2% vs. 77.7%, P=0.020). There was no statistical difference in survival between the younger group and the elderly group (P>0.05). The survival analysis results of different age groups in each pTNM stage show that: ① The middle-aged group had better medium-term and long-term OS than the elderly group. In the pTNM Ⅰ stage, the 3- and 5-year OS in the middle-aged group were better than those in the elderly group (100% vs. 93.4%, P=0.004; 100% vs. 91.4%, P=0.005). In the pTNM Ⅱ stage, the 5- and 10-year OS in the middle-aged group were better than those in the elderly group (96.5% vs. 91.3%, P=0.018; 88.2% vs. 54.3%, P<0.001). In pTNM Ⅲ stage, 10-year OS in the middle-aged group was better than that in the elderly group (36.5% vs. 36.0%, P<0.001). In pTNM Ⅳ stage, the 5- and 10- year of OS in the middle-aged group were better than those in the elderly group (67.7% vs. 58.4%, P=0.016; 19.1% vs. 7.2%, P=0.049). ② The middle-aged group had better medium-term and long-term DSS than the elderly group. In the pTNM Ⅰ stage, the 3- and 5- year DSS in the middle-aged group wrer better compared to the elderly group (100% vs. 96.9%, P=0.047; 100% vs. 94.9%, P=0.049). In the pTNM Ⅱ stage, the 10-year DSS in the middle-aged group outperformed that in the elderly group (88.2% vs. 61.9%, P=0.002). In the pTNM Ⅳ stage, the 5- and 10-year DSS in the middle-aged group were better than the elderly group (68.3% vs. 59.1%, P=0.020; 20.9% vs. 7.7%, P=0.040). ③ Except pTNM I stage, there was no significant difference in survival of other pTNM stages between young group and old group (P>0.05). In the pTNM Ⅰ stage, 3- and 5- year OS were better in the younger group compared with the elderly group (100% vs. 93.4%, P=0.004; 100% vs. 91.4%, P=0.005), and better 3- and 5- year DSS in the younger group (100% vs. 96.9%, P=0.047; 100% vs. 94.9%, P=0.049). Conclusions The age of colorectal cancer patients may have an impact on long-term survival. Middle-aged patients have better prognosis compared with elderly patients, and the younger group patients have better prognosis in pTNM stage Ⅰ only.
