Abstract： Objective To investigate the effect of preoperative oral carbohydrate （CHO） administration on perioperative risks of patients with surgical thoracic oncology，and provide evidence for establishing new scientific preoperative fasting strategy.Methods?In this prospective study， from July to September 2010，32 out of 65 enrolled patients with surgical thoracic oncology in Department 1 of Thoracic Surgery，Cancer Hospital of Peking University， were randomly allocated to preoperative experiment group （fasting overnight and oral 12.5% dextrose 400 ml administration 2 h before anesthesia induction） or control group （fasting overnight and water deprivation from midnight）. Clinical data were collected including subjective evaluation of thirst and hunger measured by visual analogue scale （VAS）， blood glucose level（BGL），serum insulin level， homeostasis model assessment insulin resistance（HOMA-IR），postoperative length of hospital stay （LOS） and complications.Results?Sixteen patients were enrolled in each group. VAS scores of thirst and hunger of the preoperative experiment group at 1 h before anesthesia induction were significantly lower than those of the control group（24 vs. 49，24 vs. 62 ，P=0.000）. BGL（8.59±0.43 mmol/L vs. 5.59±0.43 mmol/L， P=0.000）， serum insulin level （24.33±1.80 mIU/ ml vs. 16.28±1.80 mIU/ml， P=0.004）and HOMA-IR（9.23±0.77 vs. 4.03±0.77，P=0.000）of the preoperative experiment group before anesthesia induction were significantly higher than those of the control group，and these three variables of the preoperative experiment group returned to baseline level soon after surgery. There was no statistical difference in postoperative LOS and complication rate between the two groups （P＞0.05）.Conclusion?Preoperative oral CHO treatment is safe for non-diabetic patients with surgical thoracic oncology， can alleviate their subjective discomfort，decrease insulin resistance， and ameliorate their perioperative stress and metabolism.
ObjectiveTo explore the feasibility and significance of self-training system for oncology nurses by observing the effect of the training in primary hospitals. MethodsFrom January 2013 to January 2015, a cohort of nurses from a primary oncology hospital were trained based on the practical needs of oncologists, nurses and patients.The training system included nursing measures for chemotherapy drug extravasation and other adverse reactions, tumor emergency, peripherally inserted central catheter catheterization, cancer patients' psychological state, rehabilitation of cancer patients and cancer pain.Training and assessment were conducted using a method of combination of theory and practice. ResultsA total of 240 nurses were trained.The theory score before and after training was respectively 72.28±2.56 and 84.85±4.17;the practice score was respectively 63.39±1.42 and 72.68±2.63.There were significant differences between the pre-training and post-training results of theory and practice scores (P < 0.05).The adverse nursing events rate three months before training was 22.1%, and was 8.8% three months after training, and the difference was significant (P < 0.05).The satisfaction rate increased from 59% one month before training to 84% one month after training. ConclusionThe self-training system in primary tumor hospitals can improve the level of nursing care for oncology nurses and is worthy of promotion.
This article reviewed other literatures in the quality management of clinical trials and summarized author’s experience in quality control of clinical trials which the author conducted as principle investigator over the past years. It provides a reference for fresh investigators before they conduct their own clinical trials.
With the increasing global burden of various cancer, an abundance of papers emerged every year in the research hotspots of oncology, covering a wide range of research types and topics. In order to facilitate interested readers to quickly grasp the frontier and hotspots of cancer research, it would be helpful to sort out and summarize the research topic in a timely manner. According to the classification of disciplines, we screened the Essential Science Indicators (ESI) hot papers released in 2019 for the ones in the oncology field, utilized methods such as bibliometrics, statistical description, hierarchical induction, analysis and interpretation to further reveal the context and characteristics of research in the field of oncology, summarized the latest progresses and future directions in the field, and provided information and hints for the trajectory of future research. A total of 549 papers were included, which were mainly from the field of clinical medicine; the country with the most publications was the United States, while China ranked the fourth in terms of contribution; the research institution with the highest number of published papers was University of Texas system; N Engl J Med published the most papers, with contribution also from highly influential journals in the field of oncology such as Lancet Oncol, J Clin Oncol, JAMA Oncol and Cancer Discov. Oncology remained the most popular research topic in the medical research and spanned a wide spectrum of sub-topics. In this study, we demonstrated and sorted out research frontiers in the field of oncology in 12 different research directions including the basic cancer research, cancer epidemiology, and various tumors types related to different systems and organs.
Cancer remains a great challenge for mankind. The complex and diverse phenotypes, mechanisms, as well as therapeutic responsiveness of cancer have gradually been understood since the second half of the 20th century, which was a representative of entering the molecular era of oncology research. In 2000, the groundbreaking review “Hallmarks of Cancer” came out and it had been updated to the third version with 14 characteristics of cancer in 2022. These series of reviews helped to distil the increasingly complicated concepts of oncology into a logical science, which contributed to a more comprehensive understanding of the mechanisms for cancer genesis and development and applying the knowledges to the diagnosis and treatment of tumors. Mastering, applying, and exploring the hallmarks of cancer will help us face the challenges of cancer more confidently in the future.
ObjectiveTo compare the clinical outcomes of transcatheter aortic valve implantation (TAVI) in oncology and non-oncology patients with severe aortic stenosis (AS).MethodsA computer-based search in PubMed, The Cochrane Library, EMbase, CBM, CNKI and Wanfang databases from their date of inception to December 2021 was performed, together with reference screening, to identify eligible clinical trials. Two investigators screened the articles, extracted data, and evaluated quality independently. RevMan 5.3 and Stata 12.0 softwares were used for meta-analysis.ResultsThe selected 8 cohort studies contained 57 988 patients, including 12 335 cancer patients and 45 653 non-cancer patients. The results of meta-analysis showed that in patients with cancer, the 30-day mortality [OR=0.74, 95%CI (0.65, 0.84), I2=0%, P<0.000 01], stroke [OR=0.87, 95%CI (0.76, 0.99), I2=0%, P=0.04] and acute kidney injury [OR=0.81, 95%CI (0.76, 0.85), I2=49%, P<0.000 01] were lower than those in patients without cancer. The 1-year mortality [OR=1.46, 95%CI (1.15, 1.86), I2=62%, P=0.002] and late mortality [OR=1.51, 95%CI (1.24, 1.85), I2=61%, P<0.000 1] were higher in patients with cancer.ConclusionIt is effective and safe in cancer patients with severe AS undergoing TAVI. However, compared with patients without cancer, it is still high in long-term mortality, and further study of the role of TAVI in cancer patients with AS is necessary.
The umbrella trial has received increasing attention in the design of clinical trials for oncology drugs in recent years. This trial design categorizes a single disease into multiple sub-types based on predictive biomarkers or other predictive factors, and simultaneously evaluates the efficacy of multiple targeted therapies. When compared with the traditional drug development model of phase Ⅰ, phaseⅡ, and phase Ⅲ randomized controlled trials, umbrella trials are a more scientifically rigorous trial design that can speed up drug evaluation to address the conflict between numerous untested drugs and diseases with a lack of effective treatment options. This article will focus on the concept, main characteristics, eligibility criteria, design and statistical considerations, ethical considerations, and future directions of umbrella trials, with the aim of providing methodological guidance for the design of clinical trials for oncology drugs.
ObjectiveTo explore the rehabilitation treatment of postoperative dysfunction in hepatocellular carcinoma based on digital therapy and its clinical significance. MethodsThe postoperative rehabilitation clinic process of a patient was retrospectively analyzed according to the relevant clinical symptoms and dysfunctions, as well as the postoperative rehabilitation measures based on digital therapy and the patient’s prognosis. ResultsCombined with medical history, physical examination and rehabilitation assessment, the patient had pain, activity intolerance, insomnia, and symptom of anxiety and depression. The physical ability, pain, fatigue condition, symptom of anxiety and depression, and insomnia improved on 1 month after digital therapy-based exercise rehabilitation. ConclusionExercise rehabilitation based on digital therapy can improve the adverse symptoms and dysfunctional condition of patients with certain advantages.
Cancer presents a significant global public health challenge, impacting human health on a broad scale. In recent years, the rapid advancement of big data-based bioinformatics has unveiled crucial potential in precision oncology through various omics research methods. The advent of radiomics has notably expanded the application scope of medical imaging in the field. However, due to the multi-level and multifactorial nature of tumor initiation and progression, a single omics information remains insufficient to meet the demands for advancing precision oncology strategies. Multi-omics research has become an emerging trend. The research paradigm integrating radiomics with other omics offers a novel perspective for personalized decision-making in oncology. Nevertheless, there persists a need to introduce more integrated new technologies and theories to expedite the progress of this field.