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.
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 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 explain details of the adjuvant therapy of colorectal cancer in detail as well as their tags and structures of Database from Colorectal Cancer (DACCA) in the West China Hospital.MethodThe article was described in words.ResultsThe details of the adjuvant therapy of colorectal cancer included adjuvant treatment therapies, the necessity of adjuvant intravenous chemotherapy, the acceptance of adjuvant chemotherapy, the number of courses of adjuvant chemotherapy, the toxicity of adjuvant chemotherapy, the evaluation of curative effect after adjuvant chemotherapy, the standardized degree of adjuvant chemotherapy, targeted therapy, the necessity of adjuvant radiotherapy, the availability of specialty physicians recommending adjuvant radiotherapy to patients with colorectal cancer, the acceptance of adjuvant radiotherapy, radiotherapy related adverse reactions, and effect evaluation after adjuvant radiotherapy of the DACCA in the West China Hospital were defined. The data labels corresponding to each item in the database and the structured ways needed for the big data application stage in detail were explained. And the error correction notes for all classification items were described.ConclusionsThrough the detailed description of the details of the adjuvant therapy 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 explain surgical and medical comorbidities and preoperative physical status of colorectal cancer in detail as well as their tags and structures of Database from Colorectal Cancer (DACCA) in West China Hospital.MethodThe article was described in words.ResultsThe definition to the surgical comorbidities with its related content module, the medical comorbidity with its related content modules, and the preoperative physical status and characteristics of the DACCA in West China Hospital were given. The data label corresponding to each item in the database and the structured way needed for the big data application stage in detail were explained. And the error correction notes for all classification items were described.ConclusionsThrough the detailed description of the medical and surgical comorbidities and the preoperative physical status 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 describe the difficulties and quality evaluation of colorectal cancer surgical procedures in the West China Colorectal Cancer Database (DACCA).MethodWe used the form of text description.ResultsThe related content modules of DACCA operation in West China Hospital, included operator, operative duration, anatomy (anatomical difficulty), pelvis (pelvic stenosis), obesity (abdominal obesity), adhesion (adhesion in surgical area), mesentery (abnormal mesenteric status), hypertrophy (tissue hypertrophy or organ hypertrophy), intestinal quality, death (risk of death), injury (risk of tissue injury), recurrence (tumor recurrence), metastasis (tumor metastasis), anastomotic leakage (risk of anastomotic leakage), difficulty of operation, prognosis, and quality of operation, were elaborated. Then the surgical characteristics were detailed for their definition, label, structure, error correction, and update.ConclusionThrough detailed description and specification of surgical difficulties and quality evaluation of colorectal cancer in DACCA in West China Hospital, it can provide a reference for 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 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 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 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 analyze the follow-up data of colorectal cancer in the Database from Colorectal Cancer (DACCA).MethodsThe information in the Dacca database was screened, and the one whose operative date and follow-up date were not blank in the total data was selected. The follow-up data were analyzed, including length of follow-up, survival outcomes, coping styles (doctors’ attitude and reaction for follow-up), follow-up path (whether to choose out-patient, Wechat, QQ tools, phone call, text message, mobile application, face-to-face), the number of follow-up (the number of out-patient follow-up, the number of telephone follow-up, and the number of follow-up within 5 years).ResultsA total of 6 437 data items were analyzed for colorectal cancer adjuvant follow-up. ① The follow-up period of five years (2004–2015) was 56.6% (3 642/6 437), and the follow-up time was 0–201, 67 (26, 97) months. ② The highest data composition ratio of survival outcomes was “Survival” (79.7%, 4 611/5 787), and in the data with five-year follow-up period (2004–2015), the highest data composition ratio of survival outcomes was “Survival” (75.0%, 2 550/3 401), and the survival rate of the five-year follow-up period in 2008 was the highest (91.4%, 235/257). ③ The highest data composition ratio of the coping styles was the doctors’ active follow-up (76.8%, 2 121/2 762). ④ The highest data composition ratio of the follow-up path was out-patient service (90.6%, 4 236/4 676). ⑤ The highest data composition ratio of the number of out-patient follow-up was conducted by the original surgical team (100%, 4 380/4 380), the specific number was 0–130、5 (2, 10) times. The data composition ratio of telephone follow-up was 86.9% (3 808/4 380) and the specific number was 0–68、0 (0, 1) times. The highest frequency of follow-up was in the first year (89.9%, 3 044/3 386) and the specific number was 0–73、5 (3, 9) times.ConclusionBy expounding the characteristics of the colorectal cancer follow-up from colorectal cancer in DACCA, it provides some references for using big data to determine prognosis.