Incidence of venous thromboembolism in esophageal cancer: a real-world study of 8 458 cases / 中华消化外科杂志

Objective:To investigate the incidence of venous thromboembolism (VTE) in patients with esophageal cancer (EC).Methods:The retrospective cohort study was conducted. The clinicopathological data of 8 458 EC patients who were admitted to Sichuan Cancer Hospital from January 2017 to December 2021 were collected. There were 6 923 males and 1 535 females, aged (64±9)years. There were 3 187 patients undergoing surgical treatment, and 5 271 cases undergoing non-surgical treatment. Observation indicators: (1) incidence of VTE in EC patients; (2) treatment and outcomes of patients with VTE. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was analyzed using the nonparameter rank sum test. Count data were expressed as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Comparison of ordinal data was analyzed using the nonparameter rank sum test. Results:(1) Incidence of VTE in EC patients. Of 8 458 EC patients, 175 cases developed VTE, with an incidence rate of 2.069%(175/8 458). Among 175 VTE patients, there were 164 cases of deep venous thrombosis (DVT), 4 cases of pulmonary embolism (PE), 7 cases of DVT and PE. There were 59 surgical patients and 116 non-surgical patients. There was no significant difference in thrombus type between surgical and non-surgical EC patients with VTE ( χ2=1.95, P>0.05). Of 3 187 surgical patients, the incidence of VTE was 1.851%(59/3 187), including an incidence of 0.157%(5/3 187) of PE. PE accounted for 8.475%(5/59) of surgical patients with VTE. Of 5 271 non-surgical patients, the incidence of VTE was 2.201%(116/5 271), including an incidence of 0.114%(6/5 271) of PE. PE accounted for 5.172%(6/116) of non-surgical patients with VTE. There was no significant difference in the incidence of VTE or PE between surgical patients and non-surgical patients ( χ2=1.20, 0.05, P>0.05). (2) Treatment and outcomes of patients with VTE. Among 175 EC patients with VTE, 163 cases underwent drug treatment, and 12 cases did not receive treatment. Among 163 cases with drug therapy, 158 cases underwent anticoagulant therapy, 5 cases were treated with thrombolysis. All the 163 patients were improved and discharged from hospital. Conclusions:The incidence of VTE in patients with EC is relatively low, as 2.069%. There is no significant difference in the incidence of VTE or thrombus type between surgical EC patients and non-surgical EC patients.

COVID-19 infection after minimally invasive esophagectomy: Two cases report / 中国胸心血管外科临床杂志

@#Two male patients (75 years and 51 years, respectively) suffered infection of novel coronavirus after minimally invasive surgery for esophageal squamous cell carcinoma in Sichuan Cancer Hospital since December 2022. Both patients developed severe hypoxemia after surgery, and were treated with advanced oxygen therapy, antiviral therapy, hormone shock therapy, antibiotic anti-infection and nutritional support. The two patients stayed in the intensive care unit for 6 days and 8 days respectively. They were transferred to the general ward for symptomatic treatment and were discharged successfully. Both patients required low-flow oxygen maintenance after discharge. On the 20th day of follow-up after discharge, patient 1 still needed low-flow oxygen, his oxygen saturation could be maintained above 97%, but intermittent deoxygenation could be performed for half an hour. Patient 2 was in good condition on 35 days after discharge.

Diffusion tensor field estimation based on 3D U-Net and diffusion tensor imaging model constraint / 南方医科大学学报

OBJECTIVE@#To propose a diffusion tensor field estimation network based on 3D U-Net and diffusion tensor imaging (DTI) model constraint (3D DTI-Unet) to accurately estimate DTI quantification parameters from a small number of diffusion-weighted (DW) images with a low signal-to-noise ratio.@*METHODS@#The input of 3D DTI-Unet was noisy diffusion magnetic resonance imaging (dMRI) data containing one non-DW image and 6 DW images with different diffusion coding directions. The noise-reduced non-DW image and accurate diffusion tensor field were predicted through 3D U-Net. The dMRI data were reconstructed using the DTI model and compared with the true value of dMRI data to optimize the network and ensure the consistency of the dMRI data with the physical model of the diffusion tensor field. We compared 3D DTI-Unet with two DW image denoising algorithms (MP-PCA and GL-HOSVD) to verify the effect of the proposed method.@*RESULTS@#The proposed method was better than MP-PCA and GL-HOSVD in terms of quantitative results and visual evaluation of DW images, diffusion tensor field and DTI quantification parameters.@*CONCLUSION@#The proposed method can obtain accurate DTI quantification parameters from one non-DW image and 6 DW images to reduce image acquisition time and improve the reliability of quantitative diagnosis.

Association of metformin use with risk and prognosis of esophageal cancer in patients with diabetes: A systematic review and meta-analysis / 中国胸心血管外科临床杂志

@#Objective    To explore the relationship between metformin use and the risk and prognosis of esophageal cancer in patients with diabetes. Methods    The PubMed, Web of Science, EMbase, VIP, WanFang and CNKI databases were searched by computer to identify relevant studies from inception to August 21, 2021. Newcastle-Ottawa scale (NOS) was used to evaluate research quality. The STATA 12.0 software was used to conduct the statistical analysis. Results    A total of 14 studies involving 5 605 218 participants were included finally. NOS of all researches were≥6 points. The pooled results indicated that metformin use could decrease the risk of esophageal cancer in diabetics (OR=0.84, 95%CI 0.71-1.00, P=0.045), and could also prolong the overall survival of diabetics with esophageal cancer (HR=0.89, 95%CI 0.80-0.99, P=0.025). Conclusion    Metformin use can not only decrease the risk of esophageal cancer in patients with diabetes, but also improve the prognosis of diabetics with esophageal cancer significantly. However, more prospective high-quality studies are still needed to verify the conclusion.

Advancement of Cancer Associated Fibroblasts-derived Exosomes in Lung Cancer / 中国肺癌杂志

Tumor microenvironment (TME) is a dynamic network distributed around tumor cells. Cancer-associated fibroblasts (CAFs), as an important component of the TME, are not only closely related to normal fibroblasts, but also can secrete a variety of substances to participate in the regulation of the TME. Exosomes, one of the substances from CAFs, can promote the formation and development of lung cancer, including promoting the formation of TME, increasing pulmonary tumor cell invasion and metastasis, mediating pulmonary tumor immunosuppression and participating in radiotherapy and chemotherapy resistance. This article reviews the current research status and progress of cancer associated fibroblasts-derived exosomes in lung cancer.
.

The association between preoperative D-dimer level and prognosis of Chinese esophageal cancer patients: A systematic review and meta-analysis / 中国胸心血管外科临床杂志

@#Objective    To explore the correlation of preoperative D-dimer (DD) level with prognosis in Chinese esophageal cancer patients. Methods    PubMed, EMbase, Web of Science, Cochrane Library, CNKI, VIP, Wanfang, SinoMed databases were searched to identify potential studies which assessed prognostic value of preoperative DD level in Chinese esophageal cancer patients from the establishment date of each database to March 20, 2019. The Stata 12.0 software was applied to conduct the meta-analysis and the hazard ratio (HR) with 95% confidence interval (CI) was combined to evaluate the relation between preoperative DD level and survival of Chinese esophageal cancer patients. Results    A total of 5 studies involving 1 277 patients were included. The quality score of each study was ≥6 points. The results showed that the elevated preoperative DD level was significantly associated with poor overall survival (OS, HR=1.49, 95%CI 1.05-2.10, P=0.025) and cancer-specific survival (CSS, HR=1.83, 95%CI 1.39-2.42, P<0.001). However, no significant relation of preoperative DD with disease-free survival (DFS) was observed (HR=1.55, 95%CI 0.89-2.70, P=0.125). Conclusion    High preoperative DD level may be an independent prognostic factor for Chinese patients with esophageal cancer. More prospective studies with bigger sample sizes are still needed to verify our results.

Development of capacity-controlled ventriculoperitoneal shunt device / 医疗卫生装备

Objective To develop a capacity-controlled ventriculoperitoneal shunt device to relieve the symptoms of hydrocephalus patient.Methods The device was composed of head-end shunt tube,middle reservoir and celiac shunt tube.The ends of the reservoir were equipped with one-way valve to drive cerebrospinal fluid to celiac shunt tube in case of the pressure on the reservoir.The capacity-controlled drainage of cerebrospinal fluid was implemented through the times of the pressure.Results The device drained cerebrospinal fluid to relieve the symptoms of hydrocephalus patient,and the complications due to over-or under-drainage were eliminated.Conclusion The device gains advantages in design and easy operation,and is an effective and safe shunt choice for types of hydrocephalus patients.

Clinical application of minimally invasive surgery in elderly patients with cerebral hemorrhage / 中国医师进修杂志

Objective To explore the efficacy of minimally invasive surgery in elderly patients with cerebral hemorrhage.Methods Clinical data of hypertensive cerebral hemorrhage patients who were older than 65 years were retrospectively analyzed,and they were divided into two groups by different surgical methods.Regular group:from March 2010 to February 2011,123 cases of conventional bone window surgery.Minimally invasive group:from March 2011 to February 2012,136 cases of minimally invasive surgery.One month after surgery,two groups of patients with the scores of Glasgow outcome scale (GOS) to determine the prognosis.Results The better prognosis rate in minimally invasive group was higher than that in regular group [39.7％(54/136) vs.29.3％(36/123)],but there was no significant difference (P ＞0.05).The incidence rate of death in minimally invasive group was significantly lower than that in regular group [17.6％ (24/136) vs.28.5％ (35/123)],and there was significant difference (P ＜ 0.05).Conclusion For elderly patients with cerebral hemorrhage,the minimally invasive surgery can significantly improve the prognosis.

Surgical treatment of moyamoya disease / 国际脑血管病杂志

Moyamoya disease is a chronic progressive cerebrovascular disease. Its disability rate and lethality rate are higher. The direct and indirect revascularization can increase cerebral blood flow and reduce the occurrence of cerebral ischemia and cerebral hemorrhage. This article reviews the pathophysiological basis of its surgical treatment, surgical timing, indications, surgical treatment methods and efficacy.