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 detect expression of DTX2 molecule in colorectal cancer (CRC) tissues and investigate its clinical significances.MethodsOncomine and GEPIA databases were used to analyze the expression of DTX2 gene in CRC tissues and normal colorectal tissues, and online data of human protein atlas (HPA) was used to analyze the relationship between DTX2 protein expression and survival prognosis of patients with CRC. The expressions of DTX2 mRNA and protein were detected in the 55 cases of CRC tissues and corresponding paracancerous normal (PN) tissues by using qRT-PCR, Western blot, and immunohistochemistry methods, respectively. The correlations between the expression of DTX2 and the clinicopathologic characteristics were analyzed.Results① The data from Oncomine and GEPIA databases showed that the expression levels of DTX2 mRNA in the CRC tissues were significantly higher than those in the normal colorectal tissues (P<0.05); HPA online data analysis showed that the overall survival of CRC patients with low expression of DTX2 was better than that with high expression of DTX2 (P=0.009 8). ② The results of qRT-PCR and Western blot showed that the expression levels of DTX2 mRNA and protein in the CRC tissues were higher than those in the PN tissues (t=0.722, P<0.001; t=1.314, P<0.001); The results of immunohistochemical staining showed that the positive rate of DTX2 protein expression in the CRC tissues was higher than that in the PN tissues (χ2=0.899, P<0.001). The positive rate of DTX2 protein expression and the expression levels of DTX2 mRNA and protein were related to the depth of tumor invasion, lymph node metastasis, and TNM stage of CRC patients, that was, the deeper depth of tumor invasion, the more lymph node metastasis, and the later TNM stage, the higher positive rate of DTX2 protein expression, the higher expression levels of DTX2 mRNA and protein (P<0.05).ConclusionsDTX2 protein may be a novel biomarker for estimating progression of CRC. However, prognosis evaluation of DTX2 protein on CRC needs further clinical research.
ObjectiveTo investigate the prognostic factors of primary gastric squamous cell carcinoma (SCC) and develop a nomogram for predicting the survival of gastric SCC.MethodsData of 199 cases of primary gastric SCC from 2004 to 2015 were collected in the National Cancer Institute SEER database by SEER Stat 8.3.5 software. X-tile software was used to determine the best cut-off value of the age, SPSS 25.0 software was used to analyze the prognostic factors of gastric SCC and draw a Kaplan-Meier curve, and then the Cox proportional hazard regression model analysis was performed to obtain independent prognostic factors of gastric SCC. We used R studio software to visualize the model and draw a nomogram. C-index was used to evaluate the prediction effect of the nomogram. Bootstrap analyses with 1 000 resamples were applied to complete the internal verification of the nomogram.ResultsAmong the 199 patients, survival rates for 1-, 3-, and 5-year were 40.7%, 22.4%, and 15.4%, respectively. Age (χ2=6.886, P=0.009), primary site (χ2=14.918, P=0.037), race (χ2=7.668, P=0.022), surgery (χ2=16.523, P<0.001), histologic type (χ2=9.372, P=0.009), T stage (χ2=11.639, P=0.009), and M stage (χ2=31.091, P<0.001) had a significant correlation with survival time of patients. The results of the Cox proportional hazard regression model showed that, age [HR=1.831, 95%CI was (1.289, 2.601)], primary site [HR=1.105, 95%CI was (1.019, 1.199)], M stage [HR=2.222, 95%CI was (1.552, 3.179)], and surgery [HR=0.561, 95%CI was (0.377, 0.835)] were independent prognostic factors affecting the survival of gastric SCC. Four independent prognostic factors contributed to constructing a nomogram with a C-index of 0.700.ConclusionIn this research, a reliable predictive model is constructed and drawn into a nomogram, which can be used for clinical reference.
Objective To explore the relationship between the metastatic sites and prognosis in newly diagnosed stage Ⅳ breast cancer. Methods The data of newly diagnosed female patients with stage Ⅳ invasive breast cancer with complete follow-up data from SEER database from 2010 to 2015 were grouped according to different metastatic sites, and the differences of breast cancer-specific survival (BCSS) in different metastatic sites were analyzed by univariate and multivariate Cox. Kaplan-Meier method was used to draw the survival curve, and log-rank test was used to analyze the prognostic factors of BCSS in newly diagnosed stage ⅳ breast cancer. Results A total of 8 407 patients were included in the final analysis. Among them, 5 619 (66.84%) patients were confirmed with bone metastasis only, 1 483 (17.64%) patients with lung metastasis only, 1 096 (13.04%) patients with liver metastasis only, and 209 (2.49%) patients with brain metastasis only. The median follow-up time was 22 months, with 4 180 (49.72%) breast cancer-related deaths and a median BCSS of 39 months in those patients. The location of metastasis in newly diagnosed stage Ⅳ invasive breast cancer was significantly correlated with BCSS (χ2=151.07, P<0.001). Multivariate Cox model analysis showed that the BCSS was worse in patients with liver metastasis [HR=1.34, 95%CI (1.21, 1.49), P<0.001], lung metastasis [HR=1.09, 95%CI (1.04, 1.14), P<0.001] and brain metastases [HR=1.28, 95%CI (1.20, 1.36), P<0.001] than in patients with bone metastases. Further subgroup analysis showed that the BCSS of breast cancer patients with different molecular subtypes and different metastatic sites were also significantly different (P<0.05). Patients with brain and liver metastases in the HR+/HER2– subtype had worse BCSS than those with bone metastases (P<0.001). Patients with brain metastases in the HR+/HER2+ subtype had worse BCSS than those with bone metastases (P=0.001). In HR–/HER2+ subtype, the BCSS of patients with liver metastasis, lung metastasis and brain metastasis were worse than that of patients with bone metastasis (P<0.05). In HR–/HER2– subtype, the BCSS of patients with brain metastasis and liver metastasis were worse than that of patients with bone metastasis (P<0.05) . Conclusion The prognosis of newly diagnosed stage ⅳ breast cancer patients with different metastatic sites is different, and the prognosis of different molecular subtypes and different metastatic sites is also different.
ObjectiveTo summarize the research status of intelligent patient monitoring and risk warning, and provide reference and enlightenment for promoting the construction of intelligent monitoring and management platform of clinical patient risk.MethodThe literatures about patient monitoring and risk warning at home and abroad in recent years were reviewed.ResultsAt present, the research at home and abroad mainly focused on the retrospective construction of the prediction model of severe complications of inpatients by using the electronic medical record database. The clinical decision support system based on real-time vital signs and dynamic electronic medical record data was still in the early development stage, and there was no mature product with high market share.ConclusionsThe construction process of structured electronic medical record system should be further strengthened, and the fully integrated clinical decision support system and artificial intelligence self-learning system should be the key research and development direction in the future, so as to promote the deep integration of big data and artificial intelligence technology with clinical scenes.
Objective To explore the value of surgical treatment in rectal small cell neuroendocrine carcinoma (RSCC). Method The clinical data of patients with pathologically diagnosed as RSCC from 2000 to 2019 were extracted from the Surveillance, Epidemiology and End Results (SEER) database, to explore the effect of surgical treatment on cancer-specific survival (CSS) and overall survival (OS). Results A total of 348 cases were included with the median follow-up of 8 months (IQR: 3–16 months). Of the 101 patients in the operation group, 84 died (83.2%), including 56 tumor-related deaths (55.4%). Of the 247 patients in the non-operation group, 215 died (87.0%), including 131 tumor-related deaths (53.0%). The estimated 1-year OS of the operation group and the non-operation group were 49.6% and 34.4%, respectively, and the estimated 1-year CSS of those were 62.2% and 49.2%, respectively. There were significant differences between the two groups (both P<0.05). Results of multivariate prognostic analysis by Cox proportional hazard model showed that differentiation, SEER stage, receiving operative treatment or not, receiving chemotherapy or not, and receiving radiotherapy or not were independent influencing factors for OS, and SEER stage, receiving operative treatment or not, receiving chemotherapy or not, and receiving radiotherapy or not were independent influencing factors for CSS (all P<0.05). The OS [RR=0.61, 95%CI was (0.45, 0.81), P<0.001] and CSS [RR=0.67, 95%CI was (0.47, 0.95), P=0.025] in RSCC patients were significantly improved by surgical treatment. Conclusion Surgical treatment can improve the OS and CSS in RSCC patients.
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 explore the pathogenesis of the level of gene and therapeutic target genes associated with intestinal obstruction by analyzing the differential expression gene. Methods The gene expression data that came from public database gene expression omnibus （GEO） which provided adhesion formation’ gene expression data on 1， 3， 7，and 14 days after operation （n=8） and normal intestinal tissues’ gene expression data （n=2） of mouse were collected. The gene function and differential expression of genes were analyzed by using gene ontology （GO） and significance analysis of microarray （SAM）. Results There were a lot of response stimulated up-regulation of gene expression when occurrence of adhesion， and the products of these genes were distributed on cell membrane. The analysis results of gene expression at different time point after operation showed that expression up-regulated of Hmgcs 2 gene occurred on 3-14 days ofter operation and expression up-regulated of Stxbp 5 gene occurred on 14 days ofter operation. Conclusions The adhesion formation may be closely associated with the genes of response to stimulus and the gene product in membrane. The Hmgcs 2 and Stxbp 5 genes may be closely associated with the occurrence of other diseases which induced by adhesion formation.This provides a basis for the discovery of potential therapeutic targets.
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 unscramble personal data and its tags and structures of Database from Colorectal Cancer (DACCA) in West China Hospital.MethodThe way of words for description was used.ResultsThe definition and setting of 23 items with 18 categories for the personal data from DACCA in West China Hospital was performed. The relevant data label of each item and the structured way needed at the big data application stage were elaborated and the corrective precautions of classification items were described. The three classification items involved privacy attention were described in detailed.ConclusionsBased on description about personal data from DACCA in West China Hospital, it is provided a clinical standard and guide for analyzing of DACCA in future. It also could provide enough experience for construction of colorectal cancer database by staff from same occupation.