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.
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.
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.
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.
ObjectiveTo analyze the characteristics of adjuvant treatment of colorectal cancer in the Database from Colorectal Cancer (DACCA).MethodsThe informations in the DACCA database were screened, including adjuvant therapy (adjuvant strategy, compliance), adjuvant chemotherapy (indication selection, acceptance, actual cycles of chemotherapy, effect, and standardized application), adjuvant radiotherapy (indication selection, acceptance, and effect), and targeted therapy (uses of oral and intravenous targeted drugs). The data that at least one of items must not be “empty” were selected.ResultsA total of 3 955 data items were analyzed for colorectal cancer adjuvant therapy. ① The highest data composition ratio of “planned strategy of adjuvant therapy” and “compliance of adjuvant therapy” was “adjuvant therapy” (35.6%, 929/2 611) and “coordination” (28.1%, 664/2362), respectively. ② The highest data composition ratios of “indication of chemotherapy”, “acceptance of chemotherapy”, “cycles of chemotherapy”, “effect of chemotherapy”, and “chemotherapy based guidelines” were “must” (38.6%, 1 140/2 963), “rejection” (53.1%, 1 373/2 586), “6-cycle adjuvant chemotherapy” (12.4%, 338/2 722), “stability” (59.9%, 618/1031), and “standardization” (78.6%, 903/1 149). There was an obvious relationship between the planned strategy of adjuvant chemotherapy and the final acceptance of chemotherapy (χ2=505.262, P<0.001), that was, when the planned strategy of adjuvant chemotherapy was “optional”, the proportion of final rejection was very high (89.0%, 137/154). ③ The highest data composition ratios of “indication of radiation”, “acceptance of radiation”, and “effect of radiation” were “unnecessary” (49.1%, 1 423/2 915), “rejection” (93.8%, 2 629/2 803), and “stability” (38.1%, 45/118). There was a correlation between the planned strategy of adjuvant radiotherapy and the final acceptance of radiotherapy (χ2=139.593, P<0.001), that was, when the patients who should receive radiotherapy had not high acceptance (10.6%, 127/1 194), and the patients who should select optional radiotherapy all refused radiotherapy (100%).④ The data composition ratios of “none” of oral and intravenous targeted therapy drugs in targeted therapy were the highest, at 84.2% (2 121/2 520) and 73.3% (206/281), respectively. ConclusionBy expounding the characteristics of the current adjuvant treatment of colorectal cancer in DACCA, it provides a reference for the adjuvant treatment of colorectal cancer.
ObjectiveTo analyze the risks and complications after operation 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 surgery reaction, body temperature, flatus, pain and mental status; preoperative complication, postoperative complication, short-term and long-term complication. The selected data items were statistically analyzed.ResultsThe total number of medical records (data rows) that met the criteria was 6 422, including 4 185 (65.2%) valid data on surgery reaction, 3 833 (59.7%) valid data on body temperature, 3 835 (59.7%) valid data on flatus, 3 597 (56.0%) valid data on pain, 3 551 (55.3%) valid data on mental status, 6 422 (100%) valid data on preoperative complications, postoperative complications, short-term complications and long-term complications. In the surgical response, 1 517 (36.2%) lines of data showed “normal” structure were the most. Among the days with elevated body temperature, the number of 0-day data lines with the structure of “body temperature >37.5 ℃” was the highest, with 1 980 (51.7%). In postoperative flatus, there were 1 675 (43.7%) data lines with the structure showing “3 days”. The largest number of rows (2 755, 76.6%) showed a structure that was “not obvious” in the pain scale. The mental status showed the highest number of “better” rows (2 976, 83.8%). There were 50 preoperative complications (0.8%). And 595 postoperative complications (9.3%), including anastomotic leakage (80, 13.4%), inflammatory ileus (62, 10.4%), pulmonary infection (57, 9.6%), and anastomotic bleeding (56, 9.4%), etc. There were 6 169 (96.1%) without short-term complication in structural form. There were 6 283 (97.8%) without long-term complications.ConclusionsThe changes in complications shown in the real world data from DACCA suggest that the focus of postoperative risks must be changed with the over the follow-up time. As for the complication evaluation system, it is necessary to establish a complete evaluation system combining the corresponding types and risks, to carry out valuable complication researches.
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.
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.
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.
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.