ObjectiveTo analyze the tumor characteristics of colorectal cancer in the current version of Database from Colorectal Cancer (DACCA).MethodsThe DACCA version was the updated version on April 16, 2020. The data items including: procedure of anastomosis, shape of anastomosis, enhanced suture for anastomosis, stuffing, drainage, coverage of major omentum, anti-adhesion material, reconstruction of pelvic peritoneum, contaminate, and drug implants were analyzed for the characteristics of each selected data item.ResultsA total of 6 338 analyzable data rows were obtained by screening the DACCA database. Among the 6 338 pieces of data, the most common one was the double staple technique (58.1%), end-to-end anastomosis (69.4%), one-total-circle of enhancement (33.2%), and without stuffing (54.1%) in the items of procedure of anastomosis, shape of anastomosis, enhanced suture for anastomosis, stuffing, respectively; the ratio with drainage was higher (79.2%) in the term of drainage, the drainage time was (3.74±2.89) d and median drainage time was 3.00 d; the ratio with covering part of major omentum, without anti-adhesion material, with unilateral partial closure, without contaminate, and without drug implants were more higher, which was 41.1%, 79.8%, 58.7%, 73.9%, and 53.9% in the items of coverage of major omentum, anti-adhesion material, reconstruction of pelvic peritoneum, contaminate, and drug implants, respectively.ConclusionIt might better explain the outcome of surgery associated with intraoperative operation by studying the features of surgery of DACCA and guide the operation in the future for better outcomes.
Objective To analyze the influence of the ABO blood types of colorectal cancer patients served by West China Hospital as a regional center on surgical characteristics and postoperative complications in the current version of Database from Colorectal Cancer (DACCA). Methods The DACCA version was updated on January 5, 2022. The data items included ABO blood type, sex, type of operation, nature of operation and postoperative complications. The operative characteristics and complications at different stages after operation (in hospital, short-term and long-term after operation) of colorectal cancer patients with different blood types (A, B, AB, O) were analyzed. Results According to the DACCA database, we obtained 5 010 analysable data rows, covering 2005–2022. The results of blood types analysis showed that there was no significant difference among different blood types in the overall postoperative complications and the occurrence of complications in hospital, short-term and long-term after operation (P>0.05). Further subgroup analysis showed that only the difference of anastomotic leakage among different blood types was statistically significant (χ2=9.588, P=0.022). There was no significant difference among different blood types in whether the primary focus of colon cancer surgery was removed or not, the degree of radical resection of the primary focus, and whether the anus was preserved or not in rectal cancer surgery (P>0.05), and there was significant difference among different blood types with different degrees of radical resection of primary rectal cancer (χ2=15.773, P=0.001). Conclusions The ABO blood types of patients with colorectal cancer has nothing to do with the occurrence of overall complications in the short and long term after operation, and has no impact on the implementation of different surgical methods. However, the occurrence of a single postoperative anastomotic leakage is related to blood type, and its possible causes need to be further explored.
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 April 16th, 2020. The data items included timing of operation, types of operative procedure, radical resection level of operation, patient’s wish of anus-reserving, types of stomy, date of stoma closure, surgical approaches, extended resection, and type of intersphincteric resection (ISR). The data item interval of stoma closure was added, and the selected data items were statistically analyzed.ResultsThe total number of medical records (data rows) that met the criteria was 11 757, including 2 729 valid data on the timing of operation (23.2%), 11 389 valid data on the types of operative procedure (96.9%), 4 255 valid data on the radical resection level of operation (36.2%), 3 803 valid data on patient’s wish of anus-reserving (32.3%), 4 377 valid data on types of stomy (37.2%), 989 valid data on date of stoma closure (8.4%), 4 418 valid data on surgical approaches (37.6%), 3 941 valid data on extended resection (33.5%), and 1 156 valid data on type of ISR (9.8%). In the timing of operation, the most cases were performed immediately after discovery or neoadjuvant completion (915, 33.5%). In types of operative procedure, ultra low anterior resection (ULAR), right hemicolectomy (RHC), and low anterior resection (LAR) were the most, including 1 986 (17.4%), 1 412 (12.4%), and 1 041 (9.1%) lines. Respectively in the colon and rectal cancer surgery, the proportion of RHC (50.0%) and ULAR (26.0%) was the highest, with 172 (26.1%) and 815 (27.9%) extended resection. In ISR surgery the majority was ISR-2 (741, 64.1%). In radical resection level of operation, the number of R0 was the largest with 2 575 (60.5%) lines. In patient’s wish of anus-reserving, positive and rational were the most with 1 811 (47.6%) and 1 440 (37.9%) lines, respectively. And in types of stomy, there were 2 628 lines (60.0%) without stoma and 1 749 cases (40.0%) with stoma, among which the most lines were right lower ileum stoma (612, 35.0%). The minimum value, maximum value, and median value of interval of stoma closure were 0 d, 2 678 d and 112 d. The linear regression prediction of date of stoma closure by year was \begin{document}${\hat {y}} $\end{document}=9.234 3x+22.394 (R2=0.2928, P=0.07). In the surgical approaches, the majority was standard with 3 182 (72.0%) lines.ConclusionsIn the DACCA, rectal cancer surgery is still the majority, and ULAR is the most type. The application of extended resection in both colon and rectal cancer has important significance. The data related to stoma are diversified and need to be further studied.
ObjectiveTo summarize the pathological characteristics of primary left ventricular tumors and their influence on surgical treatment.MethodsThe clinical data of 32 patients with primary left ventricular tumor in Fuwai Hospital from January 2008 to March 2019 were retrospectively analyzed, including 17 males and 15 females with an average age of 33.88±17.89 years. The impact of different types of left ventricular tumor pathology on the surgical outcome was analyzed.ResultsThirty-two patients with primary left ventricular tumors underwent surgery. Postoperative pathological biopsy results revealed benign tumor in 31 patients, including myxoma in 10 patients, lipomas in 7 patients, fibroma in 4 patients, hemangioma in 3 patients, rhabdomyoma in 2 patients, cyst in 2 patients, schwannoma in 1 patient, papillary fibroelastoma in 1 patient, cavernous hyperplasia of valvular lymphatic vessels in 1 patient. There was 1 patient of carcinoid (low-grade malignant tumor). Thirty patients underwent tumor resection surgery under hypothermic anesthesia and cardiopulmonary bypass followed by cardiac arrest while 2 patients without cardiopulmonary bypass. Nine patients received partial resection of the tumor, including lipomas in 6 patients, rhabdomyoma in 2 patients, schwannoma in 1 patient. Twenty-three patients received complete resection of the tumor. There were no in-hospital deaths, bleeding, secondary thoracotomy, low cardiac output, renal failure, postoperative embolism or other surgical complications. All the patients were normal before they were discharged out of the hospital. Their average postoperative hospital stay was 8.1±2.7 d. Within 6 months after the surgery, all 32 patients returned to the hospital for reexamination, and ultrasound results were all normal. Afterwards, the patients were followed up by telephone or in an outpatient clinic, and 3 patients were lost. The follow-up rate was 90.63%. During the follow-up of 3-120 (61.4±38.5) months, among the 9 patients whose tumors were partially resection, 2 patients recurred. One patient with schwannoma recurred 30 months after the surgery, and in the other patient lipomas grew 15 months later which resulted in massive regurgitation of the mitral valve.ConclusionSurgical resection is the first choice for the treatment of left ventricular benign tumors. For malignant left ventricular tumors, it is necessary to be cautious, and the surgical risk needs to be carefully evaluated. Most of the primary left ventricular tumors need to be operated as soon as possible. A surgeon should develop different surgical strategies according to different pathological types of tumors.
ObjectiveTo analyze the patterns of recurrent strokes among patients with initial ischemic stroke and investigate the possible predictors of recurrent ischemic stroke. MethodPatients with recurrent strokes after initial ischemic strokes hospitalized in our hospital between January 2008 and December 2012 were included in the study, and the data of general demographic information, life history, past medical history and laboratory test results were all retrospectively analyzed. The patterns of recurrent strokes in patients with initial ischemic stroke were analyzed, and multivariate logistic regression analysis was used to investigate the independent risk factors for recurrent ischemic stroke. ResultsA total of 237 patients were included in this study, including 198 patients with recurrent ischemic stroke and 39 patients with recurrent hemorrhagic stroke. Among patients with recurrent ischemic stroke, there were 137 patients with anterior circulation stroke, 52 with posterior circulation stroke and 9 with multiple infarction. Multivariate logistic regression analysis showed that older age at initial stroke onset[OR=1.968, 95%CI (1.533, 2.152), P=0.009], frequent mood swings[OR=1.345, 95%CI (1.121, 1.783), P=0.011], hyperlipidemia[OR=1.436, 95%CI (1.216, 1.732), P=0.018] and atrial fibrillation[OR=3.417, 95%CI (2.927, 4.897), P=0.005] were independent risk factors for recurrent ischemic stroke. ConclusionsIschemic stroke is the most common pattern of recurrent strokes; and aging, frequent mood swings, hyperlipidemia and atrial fibrillation are possible predictors of recurrent ischemic stroke after the initial ischemic stroke.
Spinal fusion is a standard operation for treating moderate and severe intervertebral disc diseases. In recent years, the proportion of three-dimensional printing interbody fusion cage in spinal fusion surgery has gradually increased. In this paper, the research progress of molding technology and materials used in three-dimensional printing interbody fusion cage at present is summarized. Then, according to structure layout, three-dimensional printing interbody fusion cages are classified into five types: solid-porous-solid (SPS) type, solid-porous-frame (SPF) type, frame-porous-frame (FPF) type, whole porous cage (WPC) type and others. The optimization process of three-dimensional printing interbody fusion cage and the advantages and disadvantages of each type are analyzed and summarized in depth. The clinical application of various types of 3D printed interbody fusion cage was introduced and summarized later. Lastly, combined with the latest research progress and achievements, the future research direction of three-dimensional printing interbody fusion cage in molding technology, application materials and coating materials is prospected in order to provide some reference for scholars engaged in interbody fusion cage research and application.
Difference of chronotypes makes influence to cognitive performance of individuals in routine duties. In this paper, 55 subjects with different chronotypes were subjected to continuous sleep deprivation for 30 h by using the constant routine protocol, during which core body temperature was measured continuously, and subjective sleepiness self-rating and the performance of selective attention were measured hourly. The results showed that the phase difference of core body temperature has no significant difference, yet the amplitude and term difference among the three chronotypes are significant. There was an advance in phase between subjective sleepiness self-rating and core body temperature, and the self-rating sleepiness of evening type came the latest, and the self-rating sleepiness of morning type dissipated the fastest. The response time of selective attention showed a 2 h phase delay with subjective sleepiness self-rating. And the analysis of core body temperature showed that the later the chronotype was, the greater the phase delay was. The correct rate of selective attention of different chronotypes were inconsistent with delay of subjective sleepiness self-rating and core body temperature. We provide reference for industry, aviation, military, medical and other fields to make a more scientific scheduling/ shifting based on cognitive performance characteristics of different chronotypes.