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.
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.
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.
目的 為避免選擇和發表偏倚,系統評價者應采用多種查詢技術,并盡力獲得未發表的研究.本文試圖探討,英特網檢索對鑒定未發表和正在進行的臨床試驗是否有用.研究設計 利用七個Cochrane系統評價的查詢策略回顧性地在英特網上檢索未納入的隨機對照試驗.方法 檢索策略 以普通檢索式"研究方法學 NEAR干預措施NERA 條件"、用AltaVista在英特網上搜索.測量指標包括搜索時間、英特網搜索已發表研究的回溯率、精確度(已發表和未發表的隨機臨床試驗鏈接的網頁比例)、英特網檢索到的未納入的未發表和正在進行的研究數.結果 用21小時查詢了429個網頁,找到14個鏈接到未發表的、正在進行的或最近完成的試驗,至少有9個與4篇系統評價相關.英特網檢索已發表研究文獻的回溯率在0~43.6%,其鏈接已發表和未發表研究的精確度在0~20.2%.結論 未發表尤其是正在進行的試驗的信息可在英特網上找到.潛在的問題是如何評價未經同行評審的電子出版物的質量.急需更強的搜索工具.建議用"Open Trial Initiative"定義英特網發表試驗的語法,以加強試驗登記的共同操作性.因此,專門的搜索引擎可找到更多有關正在進行和已完成的臨床試驗信息.
ObjectiveTo investigate the current research status and its developing trend of Crohn’s disease (CD) in Chinese journals in the past 40 years, and to provide reference for future research on CD.MethodsWith “Crohn’s disease” as the retrieval word, the literature about CD published from January 1978 to December 2017 were retrieved in the SinoMed database. The distributions of publication dates, journals, research institutions, and regions of literature were analyzed by EndNote, Excel, MySQL, and GraphPad Prism softwares.ResultsA total of 2 140 papers matched the searching criteria, including 1 391 papers published in the core journals. The number of papers increased by year, especially in the past 20 years, the growth rate of the total number of papers every 5 years was 96.67%, 202.54%, 85.15%, and 29.35%, respectively. A total of 152 papers met the criteria of evidence-based documents, and the proportion of evidence-based articles in the total papers every 5 years was 2.54%, 3.92%, 4.69%, and 12.16%, respectively. In the respect of region distribution of literature, the first addresses of 1 060 papers were in East China, accounting for 50.36% of the total number of papers. Jiangsu Province, Guangdong Province, Shanghai, Zhejiang Province, and Beijing had published a total of 1 257 papers, accounting for 59.71% of the total number of papers. In our research field, most of the studies were conducted by teaching hospitals.ConclusionsIn the past 40 years, the output of research on CD increased significantly in China. The proportion of evidence-based articles has increased, while the number of evidence-based research still needs to be improved. The regional distribution of literature was unbalanced, and teaching hospitals played a vital role in the research field.
The emergence of single-cell sequencing technology enables people to observe cells with unprecedented precision. However, it is difficult to capture the information on all cells and genes in one single-cell RNA sequencing (scRNA-seq) experiment. Single-cell data of a single modality cannot explain cell state and system changes in detail. The integrative analysis of single-cell data aims to address these two types of problems. Integrating multiple scRNA-seq data can collect complete cell types and provide a powerful boost for the construction of cell atlases. Integrating single-cell multimodal data can be used to study the causal relationship and gene regulation mechanism across modalities. The development and application of data integration methods helps fully explore the richness and relevance of single-cell data and discover meaningful biological changes. Based on this, this article reviews the basic principles, methods and applications of multiple scRNA-seq data integration and single-cell multimodal data integration. Moreover, the advantages and disadvantages of existing methods are discussed. Finally, the future development is prospected.
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.
Hazard ratio (HR) is usually regarded as the effect size in survival studies. Meanwhile, it is supposed to be perfect for pooling results in the meta-analysis of survival data. However, it does not function usually due to absence of original data for pooling HR. As a compromise method, entering data from reading Kaplan-Meier curves and follow-up times into the calculation spreadsheet can also be used to obtain related survival data. But related study on the subject is scarce, and opinions are inconsistent. Accordingly, we conduct this study to further illustrate the procedure in details.
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.
As an interdisciplinary subject of medicine and artificial intelligence, intelligent diagnosis and treatment has received extensive attention in both academia and industry. Traditional Chinese medicine (TCM) is characterized by individual syndrome differentiation as well as personalized treatment with personality analysis, which makes the common law mining technology of big data and artificial intelligence appear distortion in TCM diagnosis and treatment study. This article put forward an intelligent diagnosis model of TCM, as well as its construction method. It could not only obtain personal diagnosis varying individually through active learning, but also integrate multiple machine learning models for training, so as to form a more accurate model of learning TCM. Firstly, we used big data extraction technique from different case sources to form a structured TCM database under a unified view. Then, taken a pediatric common disease pneumonia with dyspnea and cough as an example, the experimental analysis on large-scale data verified that the TCM intelligent diagnosis model based on active learning is more accurate than the pre-existing machine learning methods, which may provide a new effective machine learning model for studying TCM diagnosis and treatment.