ObjectiveTo investigate the association between the preoperative nutritional risk and anastomotic leakage following anterior resection for the rectal cancer. MethodsA total of 321 patients with rectal cancer underwent anterior resection in our hospital between January 2008 and December 2013 were retrospectively analyzed. Preoperative nutritional status was evaluated using NRS 2002. Correlation of clinicopathologic characteristics with postoperative anastomotic leakage was evaluated using single factor analysis and Logistic regression model. ResultsAmong the 321 patients, the incidence of postoperative anastomotic leakage was 5.6% (18/321). Single factor analysis showed that the NRS2002 score≥3, clinicalpathologic stage (Ⅲ-Ⅳstage) and distance of tumor from the anal verge were the risk factors of anastomotic leakage after anterior leakage following anterior resection for rectal cancer. Logistic regression analysis revealed that the NRS2002 score (OR=4.125, 95% CI=2.062-7.004), clinicalpathologic stage (OR=3.334, 95% CI=2.062-7.004) and the distance of tumor from the anal verge (OR=2.341, 95% CI=2.559-15.838) were the independent risk factors for anastomotic leakage after anterior leakage following anterior resection for rectal cancer. Conciusions Preoperative NRS2002 score is helpful to predict the risk of anastomotic leakage after anterior resection of rectal cancer. Nutrition education should be strengthened to decrease the morbidity of the anastomotic leakage following anterior resection for the patients who's NRS2002 score≥3.
ObjectiveTo summarize the current status and progress of nutritional support therapy for pancreatic cancer in order to improve the understanding of the impact of nutritional support treatment on pancreatic cancer and guide clinical work.MethodThe literatures about nutritional support and chemotherapy for pancreatic cancer at home and abroad were read and reviewed.ResultsFor most patients with malignant pancreatic tumors, nutritional risk or malnutrition might accompany them for a lifetime. Regular nutritional risk screening, timely nutritional assessment and necessary nutritional treatment played an extremely important role in the process of comprehensive anti-tumor treatment.ConclusionAlthough there are still some core problems to be solved in nutritional support therapy and chemotherapy for pancreatic cancer, its efficacy is gradually recognized and widely used by clinical workers, which might be helpful to improve the prognosis of patients with pancreatic cancer.
ObjectiveTo understand the mechanisms of malnutrition in patients with gastric cancer (GC) and which affecting on therapy outcomes, and explore effective nutritional intervention strategies so as to improve general therapy outcomes for patients with GC. MethodThe literature on studies relevant malnutrition in the patients with GC both domestically and internationally was reviewed and analyzed. ResultsThe mechanisms of malnutrition in the patients with GC are complex and diverse, including abnormal tumor metabolism, side effects of treatment, psychological and economic factors, etc. The malnutrition made the mortality and recurrence rates increase, hospital stay prolong, and medical costs elevate, meanwhile led to the multiple complications. The use of various screening tools could effectively assess the malnutrition status at the different therapy stages, then the individualized nutritional therapy plans could be developed based on the assessment results. These plans included oral nutrition, enteral nutrition, parenteral nutrition, and immunonutrition. ConclusionsMalnutrition severely affects the treatment outcomes and quality of life of patients with GC. It is necessary to timely screen and assess. The reasonable nutritional support plan should be chosen based on the patient’s individualized situation. Future research should be needed to explore the long-term efficacy and safety of nutritional support, optimize the application of immunonutrition and parenteral nutrition, and enhance the general treatment outcomes for patients with GC.
ObjectivesTo explore the effect of the deep learning algorithm convolutional neural network (CNN) in screening of randomized controlled trials (RCTs) in Chinese medical literatures.MethodsLiterature with the topic " oral science” published in 2014 were retrieved from CNKI and exported citations containing title and abstract. RCTs screening was conducted by double independent screening, checking and peer discussion. The final results of the citations were used for CNN algorithm model training. After completing the algorithm model training, a prospective comparative trial was organized by searching all literature with the topic "oral science" published in CNKI from January to March 2018 to compare the sensitivity (SEN) and specificity (SPE) of algorithm with manual screening. The initial results of a single screener represented the performance of manual screening, and the final results after peer discussion were used as the gold standard. The best thresholds of algorithm were determined with the receptor operative characteristic (ROC) curve.ResultsA total of 1 246 RCTs and 4 754 non-RCTs were eventually included for training and testing of CNN algorithm model. 249 RCTs and 949 non-RCTs were included in the prospective trial. The SEN and SPE of manual screening were 98.01% and 98.82%. For the algorithm model, the SEN of RCTs screening decreased with the increase of threshold value while the SPE increased with the increase of threshold value. After 27 changes of threshold value, ROC curve were obtained. The area under the ROC curve was 0.9977, unveiling the optimal accuracy threshold (Threshold=0.4, SEN=98.39%, SPE=98.84%) and high sensitivity threshold (Threshold=0.06, SEN=99.60%, SPE=94.10%).ConclusionsA CNN algorithm model is trained with Chinese RCTs classification database established in this study and shows an excellent classification performance in screening RCTs of Chinese medical literature, which is proved to be comparable to the manual screening performance in the prospective controlled trial.
Diabetes retinopathy (DR) is listed as one of the chronic diseases that should be focused on in the “14th Five-Year” National Eye Health Plan (2021-2025). Early screening is one of the effective measures to reduce blindness caused by DR. Establishing an efficient and practical community screening model is a powerful guarantee for completing early screening. The Ocular Fundus Diseases Group of the Ophthalmology Branch of the Chinese Medical Association has led the development of Expert consensus on community screening of diabetic retinopathy among DR community screening experts that is suitable for the current national situation, in order to guide and promote the further improvement of DR community screening work in China. This Expert Consensus provides detailed specifications on the current domestic trend of DR, the necessity of screening, the role of artificial intelligence grading, screening process, and quality control. This interpretation further emphasizes the importance of DR community screening, while emphasizing the responsibilities of different departments in the screening process. Finally, recommendations are provided for the sustainability of DR community screening. It is hoped that the screening rate of DR in China can be improved and blindness can be reduced by DR through Expert consensus on community screening of diabetic retinopathy and interpretation of the content.
Being a non-invasive diagnostic technique for molecular biological markers, exhaled breath detection has the most latent capacity and future in the diagnosis and treatment of tumors. The National Key Research and Development Plan named "Strategic Advanced Electronic Materials" in 2020 has laid out the application of exhaled breath detection technology in the medical field, and the scientific research project led by Sichuan Cancer Hospital has been successfully launched. For the moment, as a novel strategy for early detection of lung cancer, exhaled breath detection is being perfected further and popularized or put in clinical practice step by step to reduce the mortality of lung cancer patients.
The emergence of regular short repetitive palindromic sequence clusters (CRISPR) and CRISPR- associated proteins 9 (Cas9) gene editing technology has greatly promoted the wide application of genetically modified pigs. Efficient single guide RNA (sgRNA) is the key to the success of gene editing using CRISPR/Cas9 technology. For large animals with a long reproductive cycle, such as pigs, it is necessary to screen out efficient sgRNA in vitro to avoid wasting time and resource costs before animal experiments. In addition, how to efficiently obtain positive gene editing monoclonal cells is a difficult problem to be solved. In this study, a rapid sgRNA screening method targeting the pig genome was established and we rapidly obtained Fah gene edited cells, laying a foundation for the subsequent production of Fah knockout pigs as human hepatocyte bioreactor. At the same time, the method of obtaining monoclonal cells using pattern microarray culture technology was explored.
Pulmonary adenocarcinoma in situ is reclassified as precursor glandular lesions in the fifth edition of WHO classification of thoracic tumours, causing widespread attention and heated debate among domestic thoracic oncologists, radiologists, pathologists and surgeons. We would like to comment on the topic and make a few suggestions on the management of pulmonary nodule during lung cancer screening. We are open to all suggestion and welcome debates.
Objective To study the prevalence of combined pulmonary fibrosis and emphysema (CPFE) in a community-based lung cancer screening program in Shanghai. Methods From June 2018 to July 2019, eligible participants who were assessed through a high-risk lung cancer questionnaire in Xuhui, Shanghai underwent low-dose computed tomography of the lungs. The suspected CPFE patients were invited to provide medical history and blood for analysis, and received high-resolution CT (HRCT) scanning for confirmation. Results Of the 15 cases of suspected CPFE from a total of 4478 participants in which 1704 males and 2774 females, 4 declined further examination and 11 received further examine. Eight subjects were confirmed as CPFE, and all were male, of whom two were ex-smokers and six were active smokers. These CPFE patients had cough, chest tightness and dyspnea. There were 3 cases of centrilobular emphysema, 2 cases of paraseptal emphysema, 1 case of panlobular emphysema and 2 cases of mixed emphysema. There were 2 cases of usual interstitial pneumonia, 3 cases of non-specific interstitial pneumonia, 2 cases of airspace enlargement with fibrosis and 1 case of unclassifiable smoking-related interstitial fibrosis. The KBILD scores were 61.7±7.5 and mMRC scores were 1.5±0.8. Serum Krebs von den Lungen-6 concentration was (380.75±212.05)U/mL. Lung function test showed normal or mild restrictive ventilatory function, and mild-moderate impairment in diffusion capacity. Conclusions The prevalence of CPFE is 1.79‰ in a community-based lung cancer screening population, and is 4.69‰ in male lung cancer screening population.
Objective To define an evidence-based conclusion concerning ultrasound screening for fetal genital system malformations during pregnancy. Methods In order to assess whether or not ultrasound screening for fetal genital system malformations is effective and feasible, we searched The Cochrane Library (Issue 3, 2009), MEDLINE (1981 to 2009), ACP Journal Club (1991 to 2008), and BMJ Clinical Evidence (1999 to 2008) for systematic reviews, randomized controlled trials (RCTs), cohort studies, and controlled clinical trials. Results Five cohort studies and three crosssectional studies were retrieved. The results showed ultrasound screening detected fetal sex determination by the contour of the rump and the angle of the genital tubercle to a horizontal line through the lumbosacral skin surface in the first trimester. Scrotal size and penile length increases with gestational age for male fetuses, and by 32 weeks, bilateral testicular descent was observed in most cases. Ultrasonographic scans, fetal genetic studies, and hormonal assays of amniotic fluid can diagnosis certain diseases, fetal sex differentiation disorders, fetal endocrinal disorders, and chromosome abnormality. Conclusion The findings of this study should reassure physicians and parents alike that ultrasound screening is an reliable option for the prenatal diagnosis of fetal genital system malformations, but more randomized controlled trials are needed to further supply relevant evidence.