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Objective: To compare the short-term and long-term outcomes between robotic-assisted and laparoscopic-assisted radical right hemicolectomy in patients with adenocarcinoma of the right colon. Methods: Retrospective review of a prospectively collected database identified 288 right colon cancer patients who underwent either robotic-assisted (n=57) or laparoscopic-assisted right hemicolectomy (n=231) between October 2014 and October 2020 at Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University. There were 161 males and 127 females, aging (60.3±12.8) years (range: 17 to 86 years). After propensity score matching as 1∶4 between robotic-assisted and laparoscopic-assisted right hemicolectomy, there were 56 cases in robotic group and 176 cases in laparoscipic group. Perioperative outcomes and overall survival were compared between the two groups using t test, Wilcoxon rank sum test, χ2 test, Fisher exact test, Kaplan-Meier method and Log-rank test, respectively. Results: The total operative time was similar between the robotic and laparoscopic group ((206.9±60.7) minutes vs. (219.9±56.3) minutes, t=-1.477, P=0.141). Intraoperative bleeding was less in the robotic group (50 (20) ml vs. 50 (50) ml, Z=-4.591, P<0.01), while the number of lymph nodes retrieved was significantly higher (36.0±10.0 vs. 29.0±10.1, t=4.491, P<0.01). Patients in robotic group experienced significantly shorter hospital stay, shorter time to first flatus, and defecation (t: -2.888, -2.946, -2.328, all P<0.05). Moreover, the overall peri-operative complication rate was similar between robotic and laparoscopic group (17.9% vs. 22.7%, χ²=0.596,P=0.465). The 3-year overall survival were 92.9% and 87.9% respectively and the 3-year disease-free survival rates were 83.1% and 82.6% with no statistical significance between the robotic and laparoscopic group (P>0.05). Conclusions: Compared to laparoscopic-assisted right hemicolectomy, robot-assisted right hemicolectomy could improve some short-term clinical outcomes. The two procedures are both achieving comparable survival.
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Female , Humans , Male , Colectomy , Colonic Neoplasms/surgery , Laparoscopy , Prognosis , Propensity Score , Retrospective Studies , Robotic Surgical Procedures , Treatment OutcomeABSTRACT
Objective:To obtain the temporal and spatial trends on prostate cancer mortality in China from 2004 to 2018. Methods:The data of prostate cancer mortality was collected from 605 national disease surveillance sites and age-standardized according to the demographic structure of China in 2000. The crude mortality rate （CMR） and age-standardized mortality rate （ASMR）， and the ratio of ASMRs of rural to urban areas（RR）， were calculated to analyze the distributions of the mortality of prostate cancer stratified by age， sex， region （rural/urban areas， eastern/central/western areas） or time. Results:The temporal trend on the CMR of prostate cancer from 2004 to 2018 increased significantly （APC=5.23%，P<0.001）， whereas the trend on the ASMR did not change （APC=0.65%，P=0.336）. The ASMR of urban areas was higher than that of rural areas（P<0.05）. The temporal trend on the ASMR of urban or rural did not change（P>0.05）. The same trend was detected for the RR value （P>0.05）. The ASMR of eastern urban areas was higher than that of the central or the western urban areas. The ASMR of eastern rural areas was higher than that of central and western areas. In the eastern areas， both the temporal trends for the ASMRs of the urban and the rural increased （The urban： APC=1.6%， P=0.015； the rural： APC=1.02%， P=0.013）. However， the RR values for the East， the Center or the West did not change. The ASMR of the people over 60 years old was higher than that of the people under 60 years old. However， the temporal trends on the ASMRs of the group under 60 years old or the group over 60 years did not change （P>0.05）. The ASMR of the people under 60 years old in 2018 was significantly lower than that in 2004（P=0.004）. Conclusion:A significant correlation exists between the death of prostate cancer and age. The mortality of prostate cancer in urban is higher than that in rural. The current screening strategy for prostate cancer has a limited impact on the prognosis of prostate cancer patients in China. Stratified refinement of prostate cancer screening strategies for people aged over 60 years in urban areas and the causal prophylaxis of prostate cancer are priorities for future prostate cancer prevention and control.
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Objective:To analyze bladder cancer mortality in China from 2004 to 2018. Methods:The dataset of bladder cancer mortality from 2004 to 2018， based on 605 national surveillance sites and regularly published by the Chinese Center for Disease Control and Prevention， was collected and age-standardized according to the demographic structure of China in 2000. The crude mortality rate （CMR）， the age-standard mortality rate （ASMR）， and the ratio of ASMRs of rural to urban areas（RR）were calculated to analyze the distributions of the mortality of bladder cancer stratified by age， sex， region （rural/urban areas， eastern/central/western areas） or time. Results:The CMR of bladder cancer in China from 2004 to 2018 was 1.69/105， and the ASMR was 1.09/105. The temporal trend on the CMR of bladder cancer from 2004 to 2018 increased significantly （APC=2.91%，P<0.001）， whereas the trend on the ASMR decreased a little （APC=-1.29，P=0.008）. The temporal trend on the CMR of bladder cancer in the males increased （APC=3.29%，P<0.001）， whereas the trend on the ASMR did not change. The temporal trend on the CMR of bladder cancer in the female increased （APC=2.12%，P<0.001）， whereas the trend on the ASMR decreased （APC=-1.94，P=0.008）. Both the CMR and ASMR of urban areas were higher than those of rural areas （P<0.05）. However， the temporal trend on the ASMR of bladder cancer in the urban decreased significantly （APC=-2.05%，P=0.002）， mainly exhibited in eastern and western urban. The ASMR of eastern urban areas was higher than that of western urban areas. The temporal trend on the ASMR of bladder cancer in the rural did not change （P>0.05）， and no differences in the ASMR were detected between eastern， central and western rural areas. The gaps between rural and urban areas in the eastern （P<0.001） or western （P=0.002） region reduced. Although the temporal trend on the ASMR in urban people over 40 years old decreased significantly， the ASMR of urban people over 60 years old was much higher than that of other age groups in the urban or any age groups in rural areas. Conclusion:The age group over 60 years old in the urban is the major target population for bladder cancer prevention and treatment. Screening， diagnosis and treatment for bladder cancer in rural should be strengthened.
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At present， there is little research on the new teaching mode for the practice course of epidemiology. Based on the situation， this paper mainly discussed how the MOOC （Massive Open Online Course）-based multi-teaching mode was applied to the practice course of Epidemiology. The structure of this multi- teaching mode consisted of case base construction， class preparation， class presentation and learning evaluation. Thus， MOOC， flipped Class Mode and other new teaching modes were integrated into traditional face-to-face teaching. In addition， this paper also demonstrated the implementation of the multi-teaching mode in the teaching of preventive medicine. It is worth exploring how to integrate MOOC into the teaching of the practice course of epidemiology in the future.
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[Objective] To investigate the cure and mortality trend in the early outbreak of Coronavirus Disease 2019 (COVID-19) in China, enhance the entire epidemiological knowledge about COVID-19, screen the more effective evaluation indicators, and supply the solid evidence for assessing the prevention and control measures and input-output. [Methods] The daily new confirmed cases, the cumulative cure and death cases in China and Hubei Province and outside Hubei Province, which were reported officially from January 20, 2020 to February 20, 2020, were collected to calculate the fatality rate, the ratio of the numbers of cumulative cure cases to cumulative death cases, et al, and to make the epidemiological description. [Results] Till Feb 20, 2020, the fatality rate of COVID-19 in Hubei Province was 3.42%, which was a little higher than that of the global country (2.96%). The fatality rate of COVID-19 outside Hubei Province in China was 0.71%. The trends on the indexes, including the daily new cure cases, daily new death and the ratio of cumulative cure cases to cumulative death, in Hubei Province and the whole country was highly consistent, while the significant difference existed between Hubei Province and outside Hubei Province in China. The daily ratio of cumulative cure cases to cumulative death in Hubei Province (the global country) exhibited the U trend, which reached to the lowest point on Jan 27 and subsequently grew more rapidly after Feb 5. [Conclusion] The ratio of cumulative cure cases to cumulative death was easier and effective to reflect the outbreak situation than other absolute indexes like the daily new cure cases or death. Since Feb 5, 2020, the daily cure status of COVID-19 was superior to the daily death, which indicated the effectiveness of series of the joint defense and control measures from our government and society. However, plenty of challenges exist when recovering the normal production and life if the epidemic reaches to be sustainably defensed and controlled.
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Objective To investigate the cure and mortality trend in the early outbreak of COVID-19 in China, to increase its entire epidemiological understanding, providing evidence for assessing the prevention and control measures against it and input-output in this regard. Methods Data were collected concerning daily new confirmed cases, the cumulative cure and death cases in China and Hubei Province and outside Hubei Province, which were reported officially from January 20th, 2020 to February 20th, 2020.Calculation was done of the fatality rate, the ratio of the numbers of cumulative cure cases to cumulative death cases, etc, and then the epidemiological description was made. Results As of Feb 20, 2020, the fatality rate of COVID-19 in Hubei Province was 3.42%, which was a little higher than the national figure of 2.96%.The fatality rate of COVID-19 outside Hubei Province in China was 0.71%.The trends on the indexes, including the daily new cure cases, daily new death and the ratio of cumulative cure cases to cumulative death, in Hubei Province and the whole country were found to be highly consistent, while the significant difference existed between Hubei Province and outside Hubei Province in China.The daily ratio of cumulative cure cases to cumulative death in Hubei Province (the whole country) exhibited the U-curve trend, which reached the lowest point on Jan 27 and subsequently rose more rapidly after Feb 5. Conclusion The ratio of cumulative cure cases to cumulative death is easier and effective to reflect the outbreak situation than other absolute indexes like the daily new cure cases or death.Since Feb 5, 2020, the daily cure status of COVID-19 is significantly better than the daily death, which indicates the effectiveness of series of the joint defense and control measures.However, plenty of challenges exist in recovering normal production and life when the epidemic comes to be sustainably prevented and controlled.
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Objective To analyze the incidence of colorectal cancer ( CRC) for patients with census registration in Qidong , Jiangsu Province . Methods The clinical data of CRC for patients with census registration in Qidong were sorted out from the cancer registration center in Qidong , Jiangsu province .The incidence was standardized by utilizing the standard population age composition based on the nationwide census in 2000 .The annual percent change ( APC) model was used to analyze the trend over time for the incidence of CRC . Results A total of 4 648 new cases of CRC were diagnosed in Qidong from 1993 to 2012 , of which 2 328 were male cases and 2 320 were female cases .The crude incidence rate for CRC was 23 .00/100 000 and the APC for the standardized incidence rate for CRC was 14 .13/100 000 , with the incidence thereof for males significantly higher than that for females ( P<0.001).The incidence rate of CRC for seniors aged over 50 rose quickly .From 1993 to 2012 , the average annual increase rate of the incidence for CRC was 5 .1%and the average annual increase rate of the standardized incidence therefor was 5.0%in Qidong. Conclusion The incidence of CRC increases in Qidong on a yearly basis from 1993 to 2012 , with the incidence thereof for males being significantly higher than that for females .
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Objective: To elucidate the major reasons for unexpected death nude mice when they were used for establishing human metastatic cancer models. Methods: The fresh specimens of human renal cell carcinoma (RCC), prostate cancer (PC), and DU-145 cells were transplanted/injected into nude mice ecotopically and orthotopically. Tumorigenesis and pathological changes (including the symptoms, pathological sections, survival time, etc.) of mouse liver were investigated subsequently. Results: The tumorigenesis and metastasis rates were respectively 21.7% (35/161) and 1.2% (2/161) after implantation of RCC sample, and were respectively 100% (20/20) and 25% (5/20) after implantation of DU-145 cell line, while there was no tumorigenesis or metastasis after implantation of PC specimens. Liver pathological changes were found in 58.4% (94/161) of mice implanted with RCC samples and in 43.4% (46/106) of mice implanted with PC samples. No pathological lesion was found in mice implanted with DU-145 cells. The death peak of mice with pathological changes after implanting RCC and PC samples was consistent with that of the total mice used in this study, all occurring in the winter and spring of the year. Conclusion: The pathological changes of liver appear to be the major reason of unexpected death of the nude mice when they were used for establishing human metastatic cancer models. A specified pathogen-free environment is very important for establishment of the models.
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Objective: To isolate the invasive and non-invasive cells from primary human renal cell carcinoma (RCC) in vitro. Methods: Fresh RCC surgical specimens from 32 primary RCC patients were primarily cultured following enzyme digestion or mechanical minimization in vitro. In vitro invasion assay using the Transwell cultures coating Matrigel was performed for separation and recovery of invasive and non-invasive cells from the primary culture of 3 RCC patients. The concentration of Matrigel, recovery time and trypsinization were subsequently optimized. Results: The successful rate of primary culture was 90.6% (29/32). Recovery of invasive cells was performed ideally when matrigel (diluted into 1.0 mg/ml and 20 μl) was coated onto the filter of the well; cell suspension was at a concentration of 5 × 105/ml and invasive cells were recovered on the 5th day of culture. The growth of non-invasive cells was scattered, while that of the invasive cells was focal. The doubling time of invasive cells was 36.1 h and that of non-invasive was 50.6 h. Conclusion: The in vitro invasion assay using the Transwell is able to separate and recover the highly invasive primary RCC cells. The primary cells represent intact subpopulation composition, but it can hardly get through the life span of human primary tumor cells.
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Objective: To establish orthotopic mouse models of human renal cell carcinoma and to separate metastatic or non-metastatic renal cell carcinoma (RCC) from the same source. Methods: Surgical specimens/cell suspensions were transplanted into the various tissues of BALB/c nude mice (subcutis, cellular orthotopic injection into renal capsule, perinephrium, surgical orthotopic implantation into renal capsule). Tumorigenicity and metastasis were subsequently evaluated. Immunohistochemical analysis was employed to determine the expression of VEGF, bFGF, P16, Bcl-2 and C-met in the metastatic and non-metastatic RCC xenograft. Results: The incidences of tumorigenicity and metastasis of orthotopic model were the highest, being at 73.3% (11/15) and 20% (3/15), respectively. Compared with the non-metastastic RCC, VEGF expression was upregulated in the metastatic RCC (P<0.05), while the expression of C-met was downregulated significantly (P<0.05); the expression of bFGF, Bcl-2 and P16 was also downregulated but without significance. Conclusion: Mouse orthotopic transplantation is the most effective way for the growth and natural metastasis of human RCC. Primary and metastatic RCC from the same patient has been successfully harvested. Expression of VEGF in the metastatic tumor tissues is significantly higher than that in the non-metastatic RCC.
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<p><b>OBJECTIVE</b>To investigate the expression of TGF-betaR I, Smad2, Smad3 and Smad7 in keloids, normal scars and normal skins. Discuss the significance of these proteins in the course of keloid.</p><p><b>METHODS</b>Immunohistochemistry method was used to detect the expression intensity and distribution of these proteins in above 3 kinds of different tissues in 44 cases. Statistics was used to analyze the data.</p><p><b>RESULTS</b>The expression of TGF-betaR I were much stronger in keloid than in the other two tissues. The expression of Smad7 were lower in keloids. The increase expression of Smad2,3 were not obvious, but they were found to accumulate in the nucleus.</p><p><b>CONCLUSIONS</b>The results indicate that over-expression of TGF-betaR I, low-expression of Smad7 and accumulation of Smad2,3 may be one of the etiological factors of keloids. This research may provide a new idea to prevent and treat keloids or other fibrosis diseases in the future.</p>