ObjectiveTo analyze the distribution, prognostic differences, and characteristics of patients with colorectal cancer (CRC) from 2007 to 2022 based on the current version of the Database from Colorectal Cancer (DACCA), so as to provide a basis for clinical decision-making. MethodsThe eligible CRC patients based on the established screening criteria from the updated DACCA were collected. The distribution and survival status of CRC patients in different residence places were analyzed. The residence places included 21 cities (prefectures) within Sichuan Province. ResultsA total of 5 416 cases that met the screening criteria from 2007 to 2022 were collected. Among these, CRC patients were predominantly concentrated in Chengdu (44.77%), Meishan (5.78%), and Nanchong (4.56%) cities. A heatmap depicting the superimposed trend of CRC patients origins revealed the distribution of patients was basically divided into eastern and western regions along the axis of “Mianyang–Chengdu–Yaan cities”. The majority of patients (5 359 cases, 98.95%) was distributed in the eastern region, while a few in the western region (57 cases, 1.05%). The patients in the eastern region were more high clustered (especially Chengdu city), while those in the western region was sporadically dispersed, and the patients in the western region increased slowly without aggregation. The 1, 3, and 5-year cumulative overall survival rates of the CRC patients in the DACCA were 96.2%, 89.7%, and 85.1%, respectively. The multivariate Cox proportional hazards regression model showed that the male, age ≥35-year old, adenocarcinoma (mucinous adenocarcinoma as a reference), poorly differentiated degree, pTNM stages Ⅲ and Ⅳ, obstruction, and perforation were the risk factors for median overall survival shortening in the CRC patients (all P<0.05). The survival curve of patients with CRC drawn by Kaplan-Meier method showed that the overall survival of CRC patients in different cities (prefectures) had no statistical differences as compared with the integral CRC patients (P>0.05), except for Neijiang city (was worse than that of the integral CRC patients, P<0.05). ConclusionsBased on data analysis for the DACCA from 2007 to 2022, the majority of CRC patients clusters in the eastern region. Chengdu city exhibits a high clustering, while the western region shows a sporadic distribution without aggregation phenomena. It is found that the cumulative overall survival of CRC patients in Neijiang city is worse than that of the integral CRC patients, while which in the other cities (prefectures) was relatively close to that of the integral CRC patients in Sichuan Province.
ObjectiveTo analyze the relationship between occupational type of patients with colorectal cancer (CRC) and decision-making and curative effect of neoadjuvant therapy in the current version of the Database from Colorectal Cancer (DACCA). MethodsThe eligible CRC patients were collected from June 29, 2022 updated DACCA according to the screening criteria, in which the data items analyzed included: gender, age, BMI, blood type, marriage, occupation, neoadjuvant therapy, symptomatic changes, imaging changes, and tumor regression grade (TRG), and the occupations were classified into the mental labour group, physical labour group, and the unemployed and resident groups according to the type of labour, then compared the decision-making and curative effect of neoadjuvant therapy among the 3 groups. ResultsA total of 2 415 eligible data were screened, of which 1 160 (48.0%) were the most in the manual labour group, followed by 877 (36.3%) in the unemployed and resident group, and finally 378 (15.7%) in the mental labour group. The proportion of those who did not use targeted drugs was higher in both patients ≤60 years old and >60 years old [75.6% (958/1 267) vs. 82.5% (947/1 148)], with both differences being statistically significant (P=0.004 and P=0.019), and among patients >60 years old, the different occupational types were associated with symptomatic changes and imaging changes after neoadjuvant therapy, with the highest number of both changes to partial remission [71.5% (161/225) vs. 66.7% (148/222)], both differences being statistically significant (P=0.001 and P=0.017). ConclusionThe analysis results of DACCA data reveal that the occupational type of CRC patients was associated with the choice of neoadjuvant therapy, and that different occupational types were associated with changes in curative effect before and after neoadjuvant therapy in CRC patients >60 years old, which needs to be further analysis for the reasons.
ObjectiveTo analyze the relation between the place of residence of patients with colorectal cancer (CRC) and patient compliance or regimen decision-making or outcomes for neoadjuvant therapy (NAT) in the current version of the Database from Colorectal Cancer (DACCA). MethodsThe version of DACCA selected for this analysis was updated on June 29, 2022. The patients were enrolled according to the established screening criteria and then assigned into inside and outside of Sichuan Province groups as well as inside and outside of Chengdu City groups. The differences in the patient compliance or regimen decision-making or outcomes (changes of symptom and imaging, and cancer marker carcinoembryonic antigen) for NAT were analyzed. ResultsA total of 3 574 data that met the screened criteria were enrolled, 3 142 (87.91%) and 432 (12.09%) were inside of Sichuan Province group and outside of Sichuan Province group, respectively; 1 340 (42.65%) and 1 802 (57.35%) were inside of Chengdu City group and outside of Chengdu City group in Sichuan Province, respectively. ① The constituent ratios of the patient compliance for NAT had no statistical differences between the inside and outside of Sichuan Province groups (χ2=0.299, P=0.585) as well as between the inside and outside of Chengdu City groups (χ2=3.109, P=0.078). ② In terms of the impact of the place of residence on the decision-making of NAT: For the patients with targeted therapy or not, there was a statistical difference between the inside and outside of Sichuan Province groups (χ2=5.047, P=0.025), but which had no statistical difference between the inside and outside of Chengdu City groups (χ2=0.091, P=0.762); For the patients with radiotherapy or not, there were no statistical differences in the constituent ratios of patients between the inside and outside of Sichuan Province groups as well as between the inside and outside of Chengdu City groups (χ2=2.215, P=0.137; χ2=2.964, P=0.085); For the neoadjuvant intensity, there was a statistical difference between the inside and outside of Sichuan Province groups (χ2=12.472, P=0.002), but which had no statistical difference between the inside and outside of Chengdu City groups (χ2=2.488, P=0.288). ③ The outcomes for NAT: The changes of carcinoembryonic antigen had no statistical differences between the inside and outside of Sichuan Province groups as well as between the inside and outside of Chengdu City groups (H=1.762, P=0.184; H=3.531, P=0.060); In the symptom changes, there was a statistical difference between the inside and outside of Sichuan Province groups (χ2=3.896, P=0.048), which had no statistical difference between the inside and outside of Chengdu City groups (χ2=0.016, P=0.900); In the image changes, the difference was statistically significant between the inside and outside of Chengdu City groups (χ2=7.975, P=0.005), but which had no statistical difference between the inside and outside of Sichuan Province groups (χ2=0.063, P=0.802). ConclusionsThrough data analysis in DACCA in this study, it is found that there are no statistical differences in compliance and carcinoembryonic antigen changes. However, decision-making of NAT for patients of inside and outside of Sichuan Province has different choices on whether to assist targeted therapy and chemotherapy intensity for NAT; Symptom changes of NAT in patients of inside of Sichuan Province has a better effect than in patients of outside of Sichuan Province; Imaging change of NAT in patients of inside of Chengdu City has a better effect than in patients of outside of Chengdu City.
ObjectiveTo analyze the relation between the marital status of patients with colorectal cancer and surgical treatment options decision-making and outcomes in the current version of the Database from Colorectal Cancer (DACCA). MethodsThe version of DACCA selected for this analysis was updated on August 31, 2022. The patients were enrolled according to the established screening criteria and then assigned to 3 groups: the unmarried, married, and divorced or widowed groups. The differences in the surgical modality decisions, surgical quality, and surgical complications among these 3 groups were analyzed. ResultsA total of 7 634 data that met the screened criteria were enrolled. It was found that the difference in the composition of the willingness to conserve anus among patients with different marital status was statistically significant (χ2=28.635, P<0.001), reflecting that the willingness to conserve anus was “strong” among unmarried and married patients, and the overall willingness to conserve anus was relatively more positive among unmarried patients, while the willingness to conserve anus was “rational” among widowed or divorced patients. No statistical differences were found in the surgical modality decisions (rectal surgery: χ2=0.493, P=0.782; colon surgery: χ2=0.213, P=0.899), including the presence of prophylactic stoma for the patient with radical resection (χ2=5.156, P=0.076）, surgical quality (H=3.452, P=0.178）, presence of surgical in-hospital complications (χ2=1.663, P=0.435), and the presence of short-term surgical complications (χ2=1.695, P=0.428). ConclusionsAnalysis of the data in DACCA reveals that there is difference in willingness to preserve anus among colorectal cancer patients with different marital status. Married and unmarried patients have stronger anal preservation intention, suggesting that clinical care and family support should be strengthened during clinical diagnosis and treatment.
In the field of artificial intelligence (AI) medical imaging, data annotation is a key factor in all AI development. In the traditional manual annotation process, there are prominent problems such as difficult data acquisition, high manual labor intensity, strong professionalism and low labeling quality. Therefore, an intelligent multimodal medical image annotation system is urgently needed to meet the requirements of labeling. Based on the image cloud, West China Hospital of Sichuan University collected the multimodal image data of hospital and allied hospitals, and designed a multi-modal image annotation system through information technology, which integrated various image processing algorithms and AI models to simplify the image data annotation. With the construction of annotation system, the efficiency of data labeling in the hospitals is improved, which provides necessary data support for the AI image research and related industry construction in the hospital, so as to promote the implementation of artificial intelligence industry related to medical images in the hospital.
ObjectiveTo analyze the impact of the residence of patients with colorectal cancer (CRC) on surgical characteristics in the current version Database from Colorectal Cancer (DACCA). MethodsAccording to the established screening conditions, the patients with CRC were collected from the updated version of DACCA on January 23, 2023. The analysis indicators enrolled in this study included: the grouping indicator was residence, the surgical characteristic indicators included the surgical timing, surgical nature, expanded resection, intersphincteric resection (ISR) type, patient’s willingness of preserving the anus, and whether preserving the anus. The patients were categorized into three groups based on the residence: inside Chengdu City, outside Chengdu City within Sichuan Province, and outside Sichuan Province. The surgical characteristic indicators of patients with CRC from different residences were comparatively analyzed. ResultsA total of 6 832 analyzable data rows were enrolled. The results of statistical analysis revealed the following findings: there were no statistical differences in the surgery timing and surgery nature among the patients with colon cancer or rectal cancer from the different residences (Surgery timing: H=1.665, P=0.435; H=4.153, P=0.125. Surgery nature: χ2=1.586, P=0.453; χ2=0.990, P=0.610); For the patients with rectal cancer from the different residences, the distributions of the ISR type (H=0.514, P=0.773), patients’ willingness of preserving the anus (χ2=1.437, P=0.487), and whether preserving the anus (χ2=5.513, P=0.064) had no statistical differences. In addition, although there was no statistical difference in the distribution of expanded resection or not among the patients with rectal cancer in different residences (χ2=2.363, P=0.307), it was found that there was statistical difference in the distribution of enlarged resection or not among the patients with colon cancer in different residences (χ2=17.324, P＜0.001). ConclusionsFrom the data analysis in DACCA, there are not statistical differences in surgical characteristic indicators such as surgical timing, surgical nature, ISR type, patients’ willingness of preserving the anus, and whether preserving the anus among patients with colon or rectal cancer from different residences. However, the proportion of underwent expanded surgery in the colon cancer patients who from outside Sichuan Province as compared with inside Sichuan Province is relatively higher, this suggests that surgical difficulty is more difficult for the patients from outside Sichuan Province.
Objective To investigate the incidence and the correlative factors of diabetic retinopathy (DR) in patients with diabetes mellitus（DM）who lives in Beixinjing blocks, Shanghai. Methods Residents with DM were enrolled according to resident health archives. The data of disease history, visual acuity, eye disease and introcular pressure were collected by inquiry and examination. Photography of ocular fundus was used to confirm the diagnosis of DR. Results A total of 535 residents excepted the examination with the participating rate of 90.68%, in whom 146 (27.29%) were identified as with DR. The incidence of single and proliferative DR was 22.29% and 4.30%, respectively. Duration of DM was the independent risk factor of DR, while long duration of DM, accompanied with peripheral neuropathy and body mass index was the in-order independent factor of proliferative DR. Conclusions The incidence of DR is high in residents with DM. Monitoring DR progress in DM residents with risk factors is recommended. (Chin J Ocul Fundus Dis, 2006, 22: 31-34)
ObjectiveBased on the clinical data of patients with foot and ankle deformities in the QIN Sihe Orthopaedic Surgery Database, to analyze the characteristics and treatment strategies of foot and ankle deformities, and provide a basis for clinical decision-making. Methods A total of 22 062 patients with foot and ankle deformities who received orthopedic surgery between May 25, 1978 and December 31, 2020 were searched in the QIN Sihe Orthopedic Surgery Database. The gender, age at operation, regional distribution, etiology, type of deformity, operation method, postoperative fixation method, and other information were collected. Results Among the 22 062 patients, there were 13 046 males (59.13%) and 9 016 females (40.87%); the age at operation ranged from 1 to 77 years, with a median of 17 years, and 20 026 cases (90.77%) were aged 5 to 40 years. The patients came from 32 provinces, municipalities, and autonomous regions across the China and 5 countries including India and the United States, et al. The etiology and diseases type covered 154 kinds (of which sequelae of poliomyelitis, cerebral palsy, spina bifida and tethered spinal cord, congenital equinovarus foot, post-traumatic foot and ankle deformity, and Charcot-Marie-Tooth disease accounted for the highest proportion). The types of deformities included varus foot, equinus foot, valgus foot, talipes calcaneus, equinocavus, high arched foot, claw toe, and flail foot. Surgical methods included tendon lengthening, soft tissue release, tendon transposition, osteotomy orthopedics, and ankle arthrodesis. The 36 620 operations were performed, including 11 561 cases of hip, knee, and lower leg operations to correct the foot and ankle deformities. Postoperative fixation methods included Ilizarov external fixator in 2 709 cases (12.28%), combined external fixator in 3 966 cases (17.98%), and plaster or brace fixation in 15 387 cases (69.74%). ConclusionMale patients with foot and ankle deformities account for a large proportion, and the population distribution is mainly adolescents, with a wide distribution of regions, causes and diseases, and talipes equinovarus and varus foot are the main types of deformities. Foot and ankle deformities are often combined with deformities of other parts of the lower limb, which requires a holistic treatment concept. The application of foot soft tissue and bone surgery combined with Ilizarov external fixator and combined external fixators provides a guarantee for the correction of complex foot and ankle deformities.
Objective To analyze the influence of the age of colorectal cancer patients served by West China Hospital as a regional center on hospitalization process in the current version of Database from Colorectal Cancer (DACCA). Methods The DACCA version was updated on January 5, 2022. All data items analyzed included age, date of admission, date of operation, date of discharge, pre-operation time, post-operation time, total hospital stay and management process. Data were assigned to three groups according to age with ≤45, 46–64 and ≥65 years old. Results After scanning, 8 013 data rows were obtained, from 2005 to 2022. The patients’ ages ranged from 14 to 104 years old, and were (58.01±13.52) years old in average. The results showed that the relationship between age and post-operative time was not statistically related (P>0.05). However, the pre-operative time (P=0.001) and total hospital stay time (P=0.005) were positively correlated with the age of colorectal cancer patients. The pre-operation time was longer in the older-aged group (P=0.021). Youth group had longer total hospital stay than other groups (P=0.028). Additionally, there was significant difference in the management process of colorectal cancer patients of different age groups (χ2=32.824, P＜0.05), but in terms of each process management classification, patients in different age groups had the same choice tendency as the overall choice, with “routine” management accounting for the largest proportion. “ERAS (enhanced recovery after surgery)” management was in the second place. Conclusions This study showed that the age group of patients with colorectal cancer has a certain influence on the length of hospital stay. Older patients have longer pre-operation time, but the effect of age on the total length of hospital stay still remains to be discussed. The composition of clinical management process varies among different age groups, and the elderly patients received the highest proportion of “ERAS” management process.
The data collection form is a bridge in-between the original studies and the final systematic reviews. It’s the basis for data analyses, directly related to the results and conclusions of systematic reviews, and plays an important role in systematic reviews. There are strict requirements of data collection forms in making Cochrane systematic reviews. In this article, the authors introduce their experiences regarding to the design of data collection form.