ObjectiveTo analyze the details and efficacy of neoadjuvant therapy of colorectal cancer in the current version of Database from Colorectal Cancer (DACCA).MethodsThe DACCA version selected for this data analysis was the updated version on July 28th, 2020. The data items included “planned strategy of neoadjuvant therapy” “compliance of neoadjuvant therapy”, and “cycles of neoadjuvant therapy”. Item of “planned strategy of neoadjuvant therapy” included “accuracy of neoadjuvant therapy” and “once included in researches”. Item of “the intensity of neoadjuvant therapy” included “chemotherapy” “cycles of neoadjuvant therapy” “targeted drugs”, and “neoadjuvant radiotherapy”. Item of “effect of neoadjuvant therapy” included CEA value of “pre-neoadjuvant therapy” and “post-neoadjuvant therapy”“variation of tumor markers” “variation of symptom” “variation of gross” “variation of radiography”, and tumor regression grade (TRG). The selected data items were statistically analyzed.ResultsThe total number of medical records (data rows) that met the criteria was 7 513, including 2 539 (33.8%) valid data on the “accuracy of neoadjuvant therapy”, 498 (6.6%) valid data on “once included in researches”, 637 (8.5%) valid data on the “compliance of neoadjuvant therapy”, 2 077 (27.6%) valid data on “neoadjuvant chemotherapy”, 614 (8.2%) valid data on “cycles of neoadjuvant therapy”, 455 (6.1%) valid data on “targeted drugs”, 135 (1.8%) valid data on “neoadjuvant radiotherapy”, 5 022 (66.8%) valid data on “pre-neoadjuvant therapy CEA value”, 818 (10.9%) valid data on “post-neoadjuvant therapy CEA value ”, 614 (8.2%) valid data on “variation of tumor marker”, 464 (6.2%) valid data on “variation of symptom”, 478 (6.4%) valid data on “variation of gross”, 492 (6.5%) valid data on “variation of radiography”, and 459 (6.1%) valid data on TRG. During the correlation analysis, it appeared that “variation of tumor marker” and “variation of gross” (χ2=6.26, P=0.02), “variation of symptom” and “variation of gross”, “radiography” and TRG (χ2=53.71, P<0.01; χ2=38.41, P<0.01; χ2=8.68, P<0.01), “variation of gross” and “variation of radiography”, and TRG (χ2=44.41, P<0.01; χ2=100.37, P<0.01), “variation of radiography” and TRG (χ2=31.52, P<0.01) were related with each other.ConclusionsThe protocol choosing of neoadjuvant therapy has a room for further research and DACCA can provide data support for those who is willing to perform neoadjuvant therapy. The efficacy indicators of neoadjuvant therapy have association with each other, the better understand of it will provide more valuable information for the establishment of therapeutic prediction model.
“Patient profile” is a specific application of user profile technology in the field of healthcare. As an emerging means of integrating health information, it provides personalized and precise health management for patients by analyzing multidimensional health data, improving health management effectiveness, reducing medical costs, and increasing their satisfaction and participation. It has broad application prospects in the field of nursing, but the current research status of its application in the field of nursing is not clear. This article reviews the application progress of patient profile based on big data in the field of nursing at home and abroad, systematically analyzes its construction methods, application scenarios, implementation effects and challenges, and puts forward relevant suggestions, aiming to provide references for the precise and intelligent development of nursing services.
Objective To analyze the basic characteristics of hospitalized patients with colorectal cancer (CRC), to estimate the hospitalization scale, medical resource utilization, and cross-regional hospitalization of CRC inpatients in Sichuan Province, which will provide data support for scientifically formulating colorectal cancer medical resource allocation measures. Methods Based on the hospital discharge records of CRC inpatients collected from secondary hospitals and tertiary hospitals in Sichuan Province between 2015 and 2019, descriptive statistical analysis was performed and the cross-geographical hospitalizations was visualized using a directed network. Results During the study period, the number of CRC inpatients and hospitalizations increased with time. The average age of CRC inpatients in 2019 was 65.1 years, an increase of 1.5 years in the 5-year-period. The proportion of men was relatively high (about 60.1%) and remained stable in the 5-year-period. The median length-of-stay of CRC inpatients per year was 25 days (IQR: 13 days, 45 days), and inpatients in urban areas were 2 days longer than that in rural areas. The median hospitalization cost of CRC inpatients per year was 32 900 yuan (IQR: 11 200 yuan, 59 300 yuan), men were 500 yuan higher than women, and patients in urban areas were 9 900 yuan higher than that in rural areas. From 2016 to 2019, 13.9% hospitalizations (59 512 hospitalizations) were cross-geographical hospitalizations, where Chengdu had the lowest outflow rate (1.0%) and the highest inflow rate (29.3%). Conclusions CRC inpatients showed an aging trend, and the number of hospitalizations and annual hospitalization costs increased year by year. Cross-geographical hospitalizations mainly flow to the provincial medical center and a small part flow to the regional medical centers.
In the context of informatization and digitization, medical big data has become crucial for promoting medical research and technological innovation, posing unprecedented challenges to the construction and operation of big data research supercomputing platforms. This article systematically elaborates on the construction plan of the scientific research supercomputing platform of the West China Biomedical Big Data Center of Sichuan University, as well as the management and service models that support data research. It also compares the scale and operation of existing scientific research supercomputing platforms at home and abroad, providing a reference for the construction and management of medical big data scientific research supercomputing platforms in other institutions.
ObjectiveTo describe the constructive process of follow-up of colorectal cancer part in the Database from Colorectal Cancer (DACCA) in West China Hospital. MethodThe article was described in words. ResultsThe specific concepts of follow-up of colorectal cancer including end-stage of follow-up, survival status, follow-up strategy, follow-up emphasis, follow-up plan, follow-up record using communication tools, follow-up frequency, annual follow-up times, and single follow-up record of the DACCA in the West China Hospital were defined. Then they were detailed for their definition, label, structure, error correction, and update. ConclusionThrough the detailed description of the details of follow-up of colorectal cancer of DACCA in West China Hospital, it provides the standard and basis for the clinical application of DACCA in the future, and provides reference for other peers who wish to build a colorectal cancer database.
Objective To analyze the impact of body mass index (BMI) on tumor characteristics of colorectal patients served by West China Hospital as a regional center in the current version of Database from Colorectal Cancer (DACCA). MethodsThe data of DACCA was updated on October 16, 2021. All data items included BMI, precancerous lesions, cancer family, tumor site, tumor morphology, location, differentiation, pathological properties of tumor, obstruction, overlap, perforation, pain, edema, and bleeding. The patients were divided into lean (BMI<18.5 kg/m2), normal (BMI 18.5–23.9 kg/m2), overweight (BMI 24.0–27.9 kg/m2) and obesity (BMI≥28.0 kg/m2) by Chinese classification methods. ResultsAfter scanning, 5 761 data rows were analyzed. Chi-square test showed that there was significant difference in the type composition ratio of tumor location in colorectal cancer patients under different BMI groups (χ2=31.477, P<0.001). Rank sum test showed that there was significant difference in the degree of obstruction (H=42.490, P<0.001), intussusception (H=8.179, P=0.042), edema (H=14.795, P=0.002), and bleeding (H=9.884, P=0.020) among different BMI groups. ConclusionsThe BMI classification of colorectal cancer patients is related to the location of tumor and the occurrence of some tumor complications. Patients with tumor involving intestinal lumens for one week are more likely to have low BMI. The patients with low BMI are more likely to have severe bleeding, obstruction, intestinal intussusception, and severe intestinal wall edema.
ObjectiveTo investigate the characteristics and corrective strategies of various limb deformities treated by QIN Sihe orthopaedic team in the past 40 years, so as to provide a large sample for understanding the causes, types, and treatment methods of limb deformity and disability in China.MethodsA clinical data of 35 075 cases who were treated by QIN Sihe orthopaedic team between May 1978 and December 2018 was summarized. The age, gender, deformity characteristics, etiological and pathological composition, regional distribution, and surgical methods of the patients were analyzed.ResultsThere were 20 458 males (58.33%) and 14 617 females (41.67%). The age ranged from 1 to 82 years (mean, 20.5 years). The majority people (19 363 cases, 55.20%) were 11-25 years old. Of which, 33 259 cases (94.82%) were operated on lower extremity. The geographical distribution of patients covered 33 regions in China and 12 foreign countries. There were 202 etiologies involved neurological, heredity, metabolism, traumatic sequelae, congenital, vascular, lymphoid, skin, endocrine, iatrogenic, and so on. The disease covered all subsubjects of orthopaedics. The top six deformities secondary to poliomyelitis sequelae, cerebral palsy, traumatic sequelae, spondylolysis sequelae, genu varum and genu valgum, and congenital talipes equinovarus. There were 280 kinds of surgical methods, the majority of which were Achilles tendon lengthening, supracondylar osteotomy, subtalar joint arthrodesis, tibiofibular osteotomy, metatarsal aponeurosis, and Achilles tendon replacement of peroneal longus muscle, etc. Orthopaedic surgery combined with external fixation were applied in 8 702 cases, including Ilizarov fixator in 3 696 cases and Hybrid fixator in 5 006 cases.ConclusionQIN Sihe orthopaedic database with 40 years is the largest one of limb deformity and disability in China. It reflects the etiology, type, population characteristics, surgical methods and strategy of limb disability and deformity which can be treated by orthopaedic surgery. The data needs to be further excavated and deeply studied in future because of its important academic value and historical significance.
ObjectiveTo describe the constructive process of neoadjuvant therapy for colorectal cancer part in the West China Colorectal Cancer Database (DACCA).MethodWe used the form of text description.ResultsThe specific concept of neoadjuvant therapy for colorectal cancer including neoadjuvant treatment therapies, compliance of patients with neoadjuvant therapy, neoadjuvant therapy intensity scheme, the CEA value of patients during neoadjuvant therapy, changes of symptoms, changes of primary tumor size in colorectal cancer, and TRG grading of the DACCA in the West China Hospital were defined. Then the neoadjuvant therapies were detailed for their definition, label, structure, error correction, and update.ConclusionThrough detailed description and specification of neoadjuvant therapy for colorectal cancer in DACCA in West China Hospital, it can provide a reference for the standardized treatment of colorectal cancer and also provide experiences for the 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.
In recent years, day surgery has developed rapidly in China. Day surgery management has shifted from extensive to refined, but there are still many problems in the service system of day surgery in Chinese hospitals. In order to further optimize the allocation of medical resources, improve the level of medical service capacity, and build a “patient-centered, safe, efficient, and orderly” day surgery service system, Northern Jiangsu People’s Hospital has integrated big data, mobile internet, and artificial intelligence since 2019, creating a smart information big data platform. This paper summarizes the experience of Northern Jiangsu People’s Hospital in promoting the high-quality development of day surgery services in the whole hospital from five aspects of top-level design, diagnostic and therapeutic process, medical quality and safety, medical supporting services, and supervision mechanism, with a view to providing reference for the implementation of overall management of day surgery in the hospital.