bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of prognostic factors of metastatic endometrial cancer based on surveillance, epidemiology, and end results database
Authors: Zhang Meng , Li Ruiping , Zhang Shan , Xu Xin , Liao Lixin , Yang Yan , Guo Yuzhen 
Published: January 2023

ObjectiveTo explore the risk factors for survival and prognosis of patients with metastatic endometrial cancer and to build and verify a reliable prediction model.MethodsWe retrospectively analyzed patients diagnosed with metastatic endometrial cancer in the US Surveillance, Epidemiology, and End Results (SEER) database between January 2010 and December 2015. Univariate and multivariate Cox regression analyses were used to assess clinical variables impact on survival and to construct nomograms. The results of the consistency index (C-index), subject operating characteristic (ROC) curve, and calibration curve were used to evaluate the predictive ability of the nomogram.ResultsThis study included 3,878 patients with metastatic endometrial cancer. In the univariate analysis, variables associated with overall survival (OS) and cancer-specific survival (CSS) included age, race, marital status, pathological type, pathological grade, T-stage, N-stage, surgery, radiotherapy, chemotherapy, bone metastasis, brain metastasis, liver metastasis, and lung metastasis. In the multivariate analysis, age, race, pathological type, pathological grade, T-stage, N-stage, surgery, radiotherapy, chemotherapy, brain metastasis, liver metastasis, and lung metastasis were independent risk factors for OS and CSS (all P &lt; 0.05). Combined with the results of the multiple factors, the 1-, 3-, 5-, and 8-year nomograms were constructed. For OS and CSS, T-stage had the greatest impact on the adverse prognosis of patients with metastatic endometrial cancer. The C-indexes of the OS and CSS nomograms in the training cohort were 0.749 (95% CI, 0.739–0.760) and 0.746 (95% CI, 0.736–0.756), respectively. The C-indices of OS and CSS in the validation cohort were 0.730 (95% CI, 0.714–0.746) and 0.728 (95% CI, 0.712–0.744), respectively. The ROC curve revealed our model's good prediction accuracy and clinical practicability. The calibration curve also confirmed the consistency between the model and actual existence. The Kaplan-Meier curves revealed statistically significant differences between the risk subgroups (P &lt; 0.05).ConclusionOur SEER-based nomograms for predicting survival in patients with metastatic endometrial cancer were helpful for the clinical evaluation of patient prognosis.
Double-stapled anastomosis without “dog-ears” reduces the anastomotic leakage in laparoscopic anterior resection of rectal cancer: A prospective, randomized, controlled study
Authors: Yang Yuanfeng , Ding Feng , Xu Tianbao , Pan Zhen , Zhuang Jinfu , Liu Xing , Guan Guoxian 
Published: January 2023

BackgroundAnastomotic leakage (AL) is a major cause of postoperative morbidity and mortality in the treatment of colorectal cancer. The aim of this study was to investigate whether the resection of “dog-ears” in laparoscopic anterior resection of rectal cancer (called modified double-stapling technique, MDST) could reduce the rate of AL in patients with middle and high rectal cancer, as compared with the conventional double-stapling technique (DST).MethodsThe clinical data of 232 patients with middle and high rectal cancer were prospectively collected from September 2015 to October 2018. They were randomly divided into the MDST group (n = 116) and the DST group (n = 116) and the data were prospectively analyzed. Morbidity and AL rate were compared between the two groups.ResultsPatient demographics, tumor size, and time of first flatus were similar between the two groups. No difference was observed in the operation time between the two groups. The AL rate was significantly lower in the MDST group than in the DST group (3.4 vs. 11.2%, p = 0.032). The age and anastomotic technique were the factors associated with AL according to the multivariate analysis. The location of the AL in the DST group was further investigated, revealing that AL was in the same place as the “dog-ears” (11/13, 84.6%).ConclusionsOur prospective comparative study demonstrated that MDST have a better short-term outcome in reducing AL compared with DST. Therefore, this technique could be an alternative approach to maximize the benefit of laparoscopic anterior resection on patients with middle and high rectal cancer. The “dog-ears” create stapled corners potentially ischemic, since they represent the area with high incidence of AL.(NCT:02770911)
Case Report: Using Medtronic AP360 mechanical prosthesis in mitral valve replacement for patients with mitral insufficiency after primum atrial septal defect repair to reduce left ventricular outflow tract obstruction risk
Authors: Guo Lei , Yang Qiqi , Han Yu , Zhao Haige , Chen Liangwei , Zheng Junnan , Ni Yiming 
Published: January 2023

BackgroundAtrial septal defect is one of the most common congenital heart diseases in adults. Primum atrial septal defect (PASD) accounts for 4%–5% of congenital heart defects. Patients with PASD frequently suffer mitral insufficiency (MI), and thus, mitral valvuloplasty (MVP) or mitral valve replacement (MVR) is often required at the time of PASD repair. Unfortunately, recurrent unrepairable severe mitral regurgitation can develop in many patients undergoing PASD repair plus MVP in either short- or long-term after the repair surgery, requiring a re-do MVR. In those patients, the risk of left ventricular outflow tract obstruction (LVOTO) has increased.Case presentationWe present five such cases, ranging in age from 24 to 47 years, who had a PASD repair plus MVP or MVR for 14–40 years while suffering moderate to severe mitral regurgitation. Using Medtronic AP360 mechanical mitral prostheses, only one patient experienced mild LVOTO.ConclusionsThe use of Medtronic AP360 mechanical mitral prostheses to perform MVR in patients with MI who had a history of PASD repair can potentially reduce the risk of LVOTO. Long-term follow-up is required to further confirm this clinical benefit associated with AP360 implantation in patients with PASD.
A nomogram to predict the risk of colorectal anastomotic leakage combining inflammatory-nutritional and abdominal aorta calcium index
Authors: Zhang Zhaoxiong , Sun Weilin , Wang Jun , Deng Yuanlin , Yan Yongjia , Li Dong , Fu Weihua 
Published: January 2023

BackgroundAnastomotic leakage is a serious complication after colorectal cancer surgery, which affects the quality of life and the prognosis. This study aims to create a novel nomogram to predict the risk of anastomotic leakage for patients with colorectal cancer based on the preoperative inflammatory-nutritional index and abdominal aorta calcium index.Methods292 patients at Tianjin Medical University General Hospital (Tianjin, China) from January 2018 to October 2021 who underwent colorectal cancer surgery with a primary anastomosis were retrospectively reviewed. A nomogram was constructed based on the results of multivariate logistic regression model. The calibration curves and receiver operating characteristic curves were used to verify the efficacy of the nomogram.ResultsUnivariate and multivariate analyses showed that tumor location (P = 0.002), preoperative albumin (P = 0.006), preoperative lymphocyte (P = 0.035), preoperative neutrophil to lymphocyte ratio (P = 0.024), and superior mesenteric artery calcium volumes score (P = 0.004) were identified as the independent risk factors for postoperative anastomotic leakage in patients with colorectal carcinoma. A nomogram was constructed based on the results of the multivariate analysis, and the C-index of the calibration curves was 0.913 (95%CI: 0.870–0.957) in the training cohort and 0.840 (95%CI: 0.753–0.927) in the validation cohort.ConclusionThe nomogram, combining basic variables, inflammatory-nutritional index and abdominal aorta calcium index, could effectively predict the possibility of postoperative anastomotic leakage for patients with colorectal cancer, which could guide surgeons to carry out the appropriate treatment for the prevention of anastomotic leakage.
Comparing the techniques and outcomes of laparoscopic transverse colectomy to laparoscopic hemicolectomy in mid-transverse colon cancer resection
Authors: Sun Rui , Zhang Guannan , Sun Xiyu , Niu Beizhan , Zhou Jiaolin , Cong Lin , Qiu Huizhong , Lin Guole , Wu Bin , Xiao Yi 
Published: January 2023

IntroductionThe mid-transverse colon cancer is relatively uncommon in all colon cancers and the optimal surgical approach of mid-transverse colon cancer remains debatable.Aim and ObjectivesOur study aimed to depict the techniques and outcomes of laparoscopic transverse colectomy in one single clinical center and compare this surgical approach to traditional laparoscopic right hemicolectomy and laparoscopic left hemicolectomy.MethodThis was a retrospective cohort study of patients with mid-transverse colon cancer in one single clinical center from February 2012 to October 2020. The enrolled patients were divided into two groups undergoing laparoscopic transverse colectomy and laparoscopic right/left hemicolectomy, respectively. The intraoperative, postoperative complications, oncological outcomes and functional outcomes were compared between the two groups. The primary endpoint was disease free survival (DFS).ResultsThe study enrolled 70 patients with 40 patients undergoing laparoscopic transverse colectomy and 30 patients undergoing laparoscopic hemicolectomy. The intraoperative accidental hemorrhage and multiple organ resection occurred similarly in the two groups. In transverse colectomy, caudal-to-cephalic approach was likely to harvest more lymph nodes although require more operation time than cephalic-to-caudal approach (23.1 ± 14.3 vs. 13.4 ± 5.4 lymph nodes, P = 0.004; 184.3 ± 37.1 min vs. 146.3 ± 44.4 min, P = 0.012). The laparoscopic transverse colectomy was marginally associated with lower incidence of overall postoperative complications and shorter postoperative hospital stay although without statistical significance (8(20.0%) vs. 12(40.0%), P = 0.067; 7(5–12) vs. 7(5–18), P = 0.060). The 3-year DFS showed no significant difference (3-year DFS 89.7% in transverse colectomy vs. 89.9% in hemicolectomy, P = 0.688) between the two groups. The alternating consistency of defecation occurred significantly less after laparoscopic transverse colectomy than laparoscopic hemicolectomy (15(51.7%) vs. 20(80.0%), P = 0.030).ConclusionThe laparoscopic transverse colectomy is technically feasible with satisfactory oncological and functional outcomes for mid-transverse colon cancer. Performing the caudal-to-cephalic approach might be more advantageous in lymphadenectomy.
Femoral–tibial contact stresses on fixed rotational femur models
Authors: Yuwen Peizhi , Sun Weiyi , Guo Jialiang , Chang Wenli , Wei Ning , Wang Haicheng , Ding Kai , Chen Wei , Zhang Yingze 
Published: January 2023

ObjectivesThis study aims to quantitatively evaluate the femoral–tibial contact pressure on the knee under certain malrotaional degrees.MethodsFemoral–tibial contact pressure was carried out on 14 fixed rotational knee models under 200/400/600 N vertical load using ultra-low-pressure sensitive film technology, rotation angles including neutral position (0°, anatomically reduced), 5°, 10°, and 15° internally and externally. Data were collected and analyzed with SPSS software.ResultsThere are significant statistical differences between the medial contact pressure among rotational deformities (including neutral position) (P &lt; 0.01), the increase in the degree of fixed internal malrotation of the femur resulted in a linear increase in the medial femoral–tibial contact pressures (P &lt; 0.05) under 200/400/600 N vertical load, while increase in the degree of fixed external malrotation resulted in a linear decrease (P &lt; 0.05). Except the 200 N compression, we can't find significant differences in lateral contact pressures (P &gt; 0.05). In the comparison of medial to lateral contact pressures, no statistically significant differences were found in neutral and 5° internal rotation under 200/400 N, neutral, 5° internal rotation, and 15° external rotation under 600 N. In contrast, medial contact pressures were higher than lateral at other angles (P &lt; 0.05).ConclusionObvious contact pressure changes were observed in rotatory femur. Doctors should detect rotational deformity as much as possible during operation and perform anatomical reduction. For patients with residual rotational deformities, indication of osteotomy should not be too broad.
A nomogram for predicting cancer-specific survival and overall survival in elderly patients with nonmetastatic renal cell carcinoma
Authors: Zhanghuang Chenghao , Wang Jinkui , Zhang Zhaoxia , Yao Zhigang , Ji Fengming , Li Li , Xie Yucheng , Yang Zhen , Tang Haoyu , Zhang Kun , Wu Chengchuang , Yan Bing 
Published: January 2023

BackgroundRenal cell carcinoma (RCC) is a common malignant tumor in the elderly, with an increasing trend in recent years. We aimed to construct a nomogram of cancer-specific survival (CSS) and overall survival (OS) in elderly patients with nonmetastatic renal cell carcinoma (nmRCC).MethodsClinicopathological information was downloaded from the Surveillance, Epidemiology, and End Results (SEER) program in elderly patients with nmRCC from 2010 to 2015. All patients were randomly assigned to a training cohort (70%) or a validation cohort (30%). Univariate and multivariate Cox regression analyses were used to identify independent risk factors for patient outcomes in the training cohort. A nomogram was constructed based on these independent risk factors to predict the 1-, 3-, and 5-year CSS and OS in elderly patients with nmRCC. We used a range of methods to validate the accuracy and reliability of the model, including the calibration curve, consistency index (C-index), and the area under the receiver operating curve (AUC). Decision curve analysis (DCA) was used to test the clinical utility of the model.ResultsA total of 12,116 patients were enrolled in the study. Patients were randomly assigned to the training cohort (N = 8,514) and validation cohort (N = 3,602). In the training cohort, univariate and multivariate Cox regression analysis showed that age, marriage, tumor histological type, histological tumor grade, TN stage, tumor size, and surgery are independent risk factors for prognosis. A nomogram was constructed based on independent risk factors to predict CSS and OS at 1-, 3-, and 5- years in elderly patients with nmRCC. The C-index of the training and validation cohorts in CSS were 0.826 and 0.831; in OS, they were 0.733 and 0.734, respectively. The AUC results of the training and validation cohort were similar to the C-index. The calibration curve indicated that the observed value is highly consistent with the predicted value, meaning the model has good accuracy. DCA results suggest that the clinical significance of the nomogram is better than that of traditional TNM staging.ConclusionsWe built a nomogram prediction model to predict the 1-, 3- and 5-year CSS and OS of elderly nmRCC patients. This model has good accuracy and discrimination and can help doctors and patients make clinical decisions and active monitoring.
Analysis of the common complications and recurrence-related factors of superior parasagittal sinus meningioma
Authors: Chen Wei-Wei , Wang Yong , Hu Yang-Chun , Zhao Yuan-Li 
Published: January 2023

ObjectivesParasagittal meningioma resection is prone to postoperative complications and tumor recurrence because the tumor invades the superior sagittal sinus. This study aimed to clarify the incidence of perioperative complications and the recurrence of superior sagittal paranasal meningiomas and explored potential predictors in this context.MethodsThe study retrospectively reviewed the clinical, imaging, and follow-up data of parasagittal meningiomas among patients who underwent microsurgical resection in the authors' institution from January 2008 to December 2017. Univariate and multivariate logistic regression analyses were conducted to explore independent predictors of perioperative complications and tumor recurrence.ResultsA total of 212 parasagittal meningioma patients were included in this study. The incidence of perioperative complications was 23.6% (50/212), and perioperative death occurred in 6 (2.8%) patients. In univariate and multivariate logistic regression analyses of perioperative complications, peritumoral edema ≥1 cm (odds ratio [OR] 2.163, 95% confidence interval [CI] 1.057–4.428, P = 0.035) and the Sindou invasion Class V-VI(OR0.018, 95% CI 1.248–11.064, P = 0.018) were independent predictors. After an average of 83 (39–154) months of clinical follow up among the living 206 patients, 22 (10.7%) patients showed tumor recurrence. In univariate and multivariate logistic regression analyses of tumor recurrence, the Sindou invasion Class III-IV (OR 5.539, 95%CI 1.469–20.884, P = 0.011) and the Sindou invasion Class V-VI (OR 9.144, 95%CI 2.215–37.757, P = 0.002) were independent predictors.ConclusionsPeritumoral edema ≥1 cm and the Sindou invasion Class V-VI were the independent predictors of perioperative complications, and the Sindou invasion Class III-IV and the Sindou invasion Class V-VI were the independent predictors of tumor recurrence. The part of the parasagittal meningioma involving the sinus wall should be actively removed to the largest degree possible to reduce the recurrence rate.
Prognostic nomogram for cancer-specific survival in patients with intrahepatic cholangiocarcinoma after hepatectomy: A population study of 919 patients
Authors: Huang Gaobo , Song Weilun , Zhang Yanchao , Ren Bingyi , Lv Yi , Liu Kang 
Published: January 2023

Background and AimsIntrahepatic cholangiocarcinoma has an increasing global incidence and mortality rate. Hepatectomy is still the most effective curative treatment for patients with ICC, but the prognosis of patients with ICC is still poor even after curative resection. This study aimed to incorporate important factors obtained from SEER database to construct and validate a nomogram for predicting the cancer-specific survival of patients with ICC after hepatectomy.MethodsWe obtained patient data from SEER database. The nomogram was constructed base on six prognostic factors for predicting CSS rates in ICC patients. The nomogram was validated by C-index, ROC curve and calibration curves.ResultsA total of 919 patients with ICC after hepatectomy between 2000 and 2018 were included in this study. A nomogram based on six independent prognostic factors (Black race, AJCC T, AJCC N, AJCC M, chemotherapy and PLNR ≥ 0.15) was developed for the prediction of CSS at 3 and 5 years. The C-index of the nomogram and AJCC stage system were 0.709 and 0.657 in the training cohort respectively. The 3- and 5-year AUCs of nomogram were 0.744 and 0.75 in the training cohort. The calibration plots indicated that there was good agreement between the actual observations and predictions.ConclusionsIn conclusion, we constructed and validated a nomogram for predicting the 3- and 5-year CSS in ICC patients after hepatectomy. We have confirmed the precise calibration and acceptable discrimination power of our nomogram. The predictive power of this nomogram may be improved by considering other potential important factors and also by external validation.
A nomogram for prediction of deep venous thrombosis risk in elderly femoral intertrochanteric fracture patients: A dual-center retrospective study
Authors: Xiang Guangheng , Dong Xiaoyu , Lin Shenglei , Cai Leyi , Zhou Feiya , Luo Peng , Zhu Juanjuan 
Published: January 2023

ObjectiveDeep venous thrombosis (DVT) of the lower extremity is a common perioperative complication of femoral intertrochanteric fracture. This study aimed to identify the risk factors of lower extremity deep vein thrombosis (DVT) in elderly femoral intertrochanteric fracture patients and establish a nomogram model.MethodsFrom August 2014 to June 2021, a total of 1,652 femoral intertrochanteric fracture patients over the age of 65 were enrolled in our study. We distinguished independent risk factors by univariate and multivariate Cox analyses. A nomogram model was then built, and the discriminative and calibration of the model was evaluated through receiver operating characteristics (ROC) and calibration plots.ResultsA total of 378 patients developed DVT (292 in the training group, 86 in the validation group) while the remaining patients did not. According to the univariate and multivariate Cox analyses results, age (OR = 1.07, 95% CI: 1.04–1.10), fibrinogen (OR = 2.09, 95% CI: 1.68–2.60), D-dimer (OR = 1.33, 95% CI: 1.27–1.40), time from injury to admission (OR = 1.78, 95% CI: 1.55–2.05), functional status (OR = 4.21, 95% CI: 2.86–6.20), and diabetes (OR = 1.65, 95% CI: 1.10–2.48) were identified as independent risk factors of DVT. The ROC values for DVT of the training and validation group were 0.862 and 0.912, and the P-value of the Hosmer-Lemeshow calibration test was 0.767.ConclusionThis nomogram model can be used to predict the probability of preoperative DVT in elderly patients with femoral intertrochanteric fracture and guide physician in perioperative thrombosis management.
Association between hypoalbuminemia and complications after degenerative and deformity-correcting spinal surgeries: A systematic review and meta-analysis
Authors: Li Xia , Li Haidong , Huang Shufeng , Pan Yiping 
Published: January 2023

ObjectiveThe current review was designed to explore if hypoalbuminemia is associated with increased complications in patients undergoing spinal degenerative and deformities surgeries.MethodsThe search for eligible studies was conducted on the databases of PubMed, Embase, Web of Science, and CENTRAL up to 20th June 2022. Complication rates were pooled to obtain odds ratio (OR) and 95% confidence intervals.ResultsThirteen studies were included. We found that hypoalbuminemia was significantly associated with increased risk of all complications (OR: 2.72 95% CI: 2.04, 3.63 I2 = 58% p &lt; 0.00001), mortality (OR: 7.73 95% CI: 3.81, 15.72 I2 = 0% p &lt; 0.00001), revision surgery (OR: 3.15 95% CI: 1.53, 6.48 I2 = 87% p = 0.002), readmissions (OR: 1.96 95% CI: 1.29, 2.98 I2 = 23% p = 0.02), surgical site infections (OR: 2.97 95% CI: 1.90, 4.63 I2 = 38% p &lt; 0.00001), wound complications (OR: 2.31 95% CI: 1.17, 4.56 I2 = 48% p = 0.02), pulmonary complications (OR: 3.74 95% CI: 2.66, 5.26 I2 = 0% p &lt; 0.00001), renal complications (OR: 3.04 95% CI: 1.22, 7.54 I2 = 0% p = 0.02), cardiac complications (OR: 4.33 95% CI: 2.14, 8.77 I2 = 0% p &lt; 0.0001), urinary tract infections (OR: 2.08 95% CI: 1.80, 2.41 I2 = 0% p &lt; 0.00001), and sepsis (OR: 4.95 95% CI: 1.87, 13.08 I2 = 64% p = 0.01) as compared to those with normal albumin.ConclusionHypoalbuminemia is a significant risk factor for complications after spinal degenerative and deformity surgeries. Research is also needed on the role of nutritional support in improving outcomes after spinal degenerative and deformity surgeries.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42022340024.