Objective To analyze the influencing factors of single-center day surgery patients who are discharged from the hospital on the same-day, in order to provide reference and basis for the clinical practice of follow-up day surgery. Methods The electronic medical records of patients who underwent day surgery in the Day Surgery Center of the First Affiliated Hospital of the Air Force Military Medical University between February and October 2021 were analyzed retrospectively. The patients were divided into the same-day discharge group and non-same-day discharge group. The baseline data and perioperative indicators of the patients were analyzed. Results A total of 857 patients were included, including 264 patients (30.81%) in the same-day discharge group and 593 patients (69.19%) in the non-same-day discharge group. Univariate analysis showed that there were significant differences between the two groups in gender, age, body mass index, whether the first one, disease classification, anesthesia method, and intraoperative blood loss (P<0.05). Logistic regression analysis showed that gender, whether the first one, disease classification, surgical grade, anesthesia method, and intraoperative blood loss were independent factors affecting the delayed discharge of patients undergoing daytime surgery (P<0.05). Conclusions There are many factors that affect day surgery patients’ discharge. It is suggested that more rigorously screen patients for day surgery, improve medical technology, strengthen out-of-hospital continued care, and optimize management procedures, so as to shorten the time of patients in hospital and provide more information for patients, and provide more efficient and convenient medical services for patients.
ObjectiveTo systematically evaluate whether primary tumor resection (PTR) has a statistical survival benefit as compared with chemotherapy alone (CTA) for asymptomatic stage Ⅳ colorectal cancer patients with unresectable synchronous metastasis (ACRCUSR). MethodsThe PubMed, Embase, Web of Science, Cochrane Central, CNKI, Wanfang, and the other databases were searched systematically and the prospective or retrospective controlled studies of PTR versus CTA in treatment of ACRCUSR were collected. The outcomes included overall survival (OS) and overall 1–5-year survival rates. The Stata 12.0 and RevMan 5.3 softwares were used for the pooled-analysis of relative risk (RR) and hazard ratio (HR). The trial sequential analysis (TSA) software was used to analyze overall 5-year survival rate and calculate the sample size required to achieve stable results. ResultsA total of 35 studies involving 258 478 patients were included. The results of pooled-analysis showed that the OS of ACRCUSR with PTR was statistically better than that with CTA [HR=0.57, 95%CI (0.52, 0.61), P<0.001]; Meanwhile, it was found that the overall survival rates at 1-, 2-, 3-, 4-, and 5-year of ACRCUSR with PTR were statistically better than those with CTA [1-year: RR=1.30, 95%CI (1.21, 1.40), P<0.001; 2-year: RR=1.78, 95%CI (1.64, 1.93), P<0.001; 3-year: RR=2.10, 95%CI (1.65, 2.68), P<0.001; 4-year: RR=3.05, 95%CI (2.07, 3.44), P<0.001; 5-year: RR=3.43, 95%CI (3.00, 3.92), P<0.001]. The TSA showed the reliable outcome at overall 5-year survival rate and the sample size required to achieve stable result was 96 662 cases. ConclusionFrom analysis results of this study, for ACRCUSR with PTR can benefit survival as compared with CTA, which still needs to be verified by more randomized controlled trials.
Trial Sequential Analysis (TSA), one kind of cumulative meta-analysis, is a method which introduces sequential analysis into traditional meta-analysis to avoid random errors (false positive or false negative outcomes) that occurred during repeated updates when traditional meta-analysis is performing. It is also applied to calculate required information size (RIS) of a firm conclusion. This study aims to summarize the proposal, fundamental theory, application software, and current limitation of TSA, and to clarify the advantages of TSA on the basis of detailed examples, in order to attract more attention of researchers and promote the methodological development of meta-analysis in China.
Objective To systematically review the differences of selenium levels in environment between endemic and normal regions and in patients with Kaschin-Beck disease and health people. Methods Such databases as PubMed, The Cochrane Library (Issue 8, 2013), EMbase, ISI Web of Knowledge, CNKI, CBM, VIP and WanFang Data were electronically searched to August 16th, 2013 for all observational studies about the differences of selenium levels in environment (including soil, water, and cereal) between endemic and normal regions, and in patients with Kaschin-Beck disease and health people (including blood, urine, and hair) were included. Meta-analysisi was performed using RevMan 5.2 software. Results Forty-six controlled studies were included. The results of meta-analysis showed that, selenium levels in water (SMD= –0.99, 95%CI –1.31 to –0.66), soil (SMD= –1.20, 95%CI –1.92 to –0.49), cereal (SMD= –1.94, 95%CI –2.63 to –1.26) and corn (SMD= –1.66, 95%CI –2.33 to –0.98) in endemic region were lower than those in normal region. The selenium in blood (SMD= –1.03, 95%CI –1.54 to –0.53), blood serum (SMD= –0.66, 95%CI –1.01 to –0.31), red blood cell (SMD= –2.75, 95%CI –4.13 to –1.37), urine (SMD= –0.99, 95%CI –1.43 to –0.55) and hair (SMD= –1.67, 95%CI –2.14 to –1.20) of Kaschin-Beck disease patients were lower than those in healthy people. The results of subgroup analysis also showed that significant differences were found between patients and healthy people in endemic region. The selenium in blood (SMD= –6.12, 95%CI –8.58 to –3.66), blood serum (SMD= –1.02, 95%CI –1.34 to –0.69), red blood cell (SMD= –3.37, 95%CI –5.38 to –1.35), urine (SMD= –1.94, 95%CI –2.54 to –1.34), and hair (SMD –3.49, 95%CI –5.32 to –1.66) of healthy people in endemic region were lower than those in normal region. After removing the specific studies on every pooling outcome with high risk of heterogeneity, the results of sensitivity analysis showed that the results were of robustness and the impact due to heterogenicity was fairly low. Conclusion Selenium levels in external environment in endemic region are significantly lower than those in normal region, and patients’ selenium levels in the body are also significantly lower than the healthy in endemic region. The selenium levels of the healthy in endemic region are also significantly lower than those of the healthy in normal region. Current evidence indicated that lack of selenium in external environment might be related to Kaschin-Beck disease.
Objective To study the effect of Fe 3+ -modified carborymethyl celluiose (Fe 3+ -CMC ) on preventing postoperative adhesion and inhibiting the expressions of tumor necrosis factor-α (TNF-α) and fibroblast growth factor (FGF) in the injured parts of postoperative peritoneum. Methods Fourty Wistar mice were divided into 2 groups randomly, and abdominal adhesion models were made, then 0.9% NaCl (control group) and Fe 3+ -CMC (experimental group) were sprayed into the wound surface of abdominal cavity. All mice were killed to observe the adhesion condition on day 14 after operation. Another 120 Wistar mice were divided into 2 groups randomly, and abdominal adhesion models were made as mentioned above. Ten mice were killed which were chosen randomly from 2 groups on day 1, 3, 5, 7, 14 and 60, respectively. The expressions of TNF-α and FGF in the peritoneal injured and adhesion tissues were observed by immunohistochemistry technique. Results The adhesion grade in experimental group was much lower than that in control group ( P ＜ 0.01). The expression of TNF-α (day 3-7 after operation) and FGF (day 5-7 after operation) in experimental group were lower than those in control group ( P ＜ 0.05).Conclusion Fe 3+ -CMC can decrease postoperative adhesion grade and prevent the expressions of TNF-α and FGF in injured parts of postoperative peritoneum.
Lung cancer is a most common malignant tumor of the lung and is the cancer with the highest morbidity and mortality worldwide. For patients with advanced non-small cell lung cancer who have undergone epidermal growth factor receptor (EGFR) gene mutations, targeted drugs can be used for targeted therapy. There are many methods for detecting EGFR gene mutations, but each method has its own advantages and disadvantages. This study aims to predict the risk of EGFR gene mutation by exploring the association between the histological features of the whole slides pathology of non-small cell lung cancer hematoxylin-eosin (HE) staining and the patient's EGFR mutant gene. The experimental results show that the area under the curve (AUC) of the EGFR gene mutation risk prediction model proposed in this paper reached 72.4% on the test set, and the accuracy rate was 70.8%, which reveals the close relationship between histomorphological features and EGFR gene mutations in the whole slides pathological images of non-small cell lung cancer. In this paper, the molecular phenotypes were analyzed from the scale of the whole slides pathological images, and the combination of pathology and molecular omics was used to establish the EGFR gene mutation risk prediction model, revealing the correlation between the whole slides pathological images and EGFR gene mutation risk. It could provide a promising research direction for this field.
Incidence rate is a common effect measure. The incidence rate ratio refers to the ratio of two different incidence rates. It is used to compare the difference in the number of cases per unit person-time between two groups. RevMan software can not perform a meta-analysis with the incidence rate ratio as the effect size at present. A set of simulation data was used to demonstrate a meta-analysis process with the incidence rate ratio as the effect size by using the meta package of R Studio software in this article.