This paper focuses on discussing a novel scoring for stage III rectal cancer patients and all the challenges in creating and developing a clinical score. Background: It is fundamental in my opinion to give space to ne...This paper focuses on discussing a novel scoring for stage III rectal cancer patients and all the challenges in creating and developing a clinical score. Background: It is fundamental in my opinion to give space to new generations of scientists, medical doctors and researchers to study and, backed with evidence-based information, improve the current knowledge of clinical medical science. It is fundamental for result obtained by medical researchers to bring their findings to the scientific community. Every scientific finding is of vital importance. In this essay a new Clinical Scoring system, the Sarandria Score, developed by myself is discussed, together with the methods and path in order for a young medical researcher with an idea to bring it to the scientific community. Main topics: Colorectal Cancer (CRC) is a major public health problem, representing the third most commonly diagnosed cancer in males and the second in females. Various studies have reported relevant differences related to CRC primary location site (right-sided colon, left-sided colon, rectum) including response to adjuvant chemotherapy and prognosis. In stage III CRC patients, previous findings showed that higher density of tumor-associated neutrophils (TANs) was associated with better response to 5-FU-based chemotherapy. Novel findings were discovered by Dr Nicola Sarandria on the role of neutrophils in rectal cancer, which include different factors which point to an anti-tumoral role of neutrophils in rectal cancer when in presence of chemotherapeutic agents (5-fluorouracil). The clinical significance of TANs was assessed and whether it can be different depended on the location of the primary CRC (right-sided colon, left-sided colon, rectum). Conclusions: This essay officially discusses a new clinical prognostic and predictive scoring (Sarandria Score) involving intratumoral neutrophilic infiltration in rectal cancer and the possibility of a new inclusion criteria based on this infiltrate for Stage III rectal cancer patients treated with 5-FU therapy. This paper includes data published on my medical degree thesis and in a previous review (on Journal of Cancer Therapy) showing that higher levels of TANs densities were associated with better disease-free survival (DFS) in 5-FU treated patients affected by rectal cancer (while it was inversely related in patients without 5-FU therapy). This was also as further evidence in support possible conceptual division of what is now known as Colorectal cancer into Colon and Rectal cancer.展开更多
BACKGROUND Bone metastasis has various negative impacts.Activities of daily living(ADL)and quality of life(QOL)can be significantly decreased,survival may be impacted,and medical expenses may increase.It is estimated ...BACKGROUND Bone metastasis has various negative impacts.Activities of daily living(ADL)and quality of life(QOL)can be significantly decreased,survival may be impacted,and medical expenses may increase.It is estimated that at least 5%cancer patients might be suffering from bone metastases.In 2016,we published the Comprehensive Guidelines for the Diagnosis and Treatment of Bone Metastasis.Since then,the therapeutic outcomes for patients have gradually improved.As life expectancy is a major determinant of surgical intervention,the strategy should be modified if the prolongation of survival is to be achieved.AIM To monitor how bone metastasis treatment has changed before and after launch of our guidelines for bone metastasis.METHODS For advanced cancer patients with bone metastasis who visited the Department of Clinical Oncology at Akita University hospital between 2012 and 2023,parameters including the site and number of bone metastases,laboratory data,and survival time,were extracted from electronic medical records and the Katagiri score was calculated.The association with survival was determined for each factor.RESULTS Data from 136 patients were obtained.The 1-year survival rate for the poor prognosis group with a higher Katagiri score was 20.0%in this study,which was 6%and an apparent improvement from 2014 when the scoring system was developed.Other factors significantly affecting survival included five or more bone metastases than less(P=0.0080),and treatment with chemotherapy(P<0.001),bone modifying agents(P=0.0175)and immune checkpoint inhibitors(P=0.0128).In recent years,advances in various treatment methods have extended the survival period for patients with advanced cancer.It is necessary not only to simply extend survival time,but also to maintain ADL and improve QOL.CONCLUSION Various therapeutic interventions including surgical approach for bone metastasis,which is a disorder of locomotor organs,are increasingly required.Guidelines and scoring system for prognosis need to be revised promptly.展开更多
This study aimed to examine the clinical and radiographic outcomes of primary total knee arthroplasy（TKA） with use of Nex Gen#174; Legacy#174; Constrained Condylar Knee（CCK） prosthesis for severe knee deformity. C...This study aimed to examine the clinical and radiographic outcomes of primary total knee arthroplasy（TKA） with use of Nex Gen#174; Legacy#174; Constrained Condylar Knee（CCK） prosthesis for severe knee deformity. Clinical data of 46 patients（48 knees in total, aged 61 years on average） with severe knee deformity who underwent TKA with Nex Gen#174; Legacy#174; CCK prosthesis between December 2007 and February 2012 were retrospectively analyzed. There were 34 knees with severe valgus with incompetent medial collateral ligament, 11 knees with severe flexion contracture with inability to achieve knee balancing in flexion and extension by posterior soft tissue release, 2 knees with Charcot arthritis with severe varus and bone loss, and 1 with traumatic osteoarthritis with severe varus and ligamentous instability. The mean duration of follow-up was 71 months（range 40–90 months）. The New Knee Society scoring（NKSS） system and the Hospital for Special Surgery（HSS） score were used to evaluate the functional and clinical outcomes. Visual Analogue Scale（VAS） was used for pain measurement and Knee Society criteria for evaluation of radiological images. The results showed that, in the total 48 knees, 1 case of loosening due to short-stem tibial component at 3 months post-operatively underwent revision. The 6-year prosthesis survival rate in this cohort was 97.9%. There was no component infection occurring within 6 years. Significant post-operative improvements were found in NKSS and HSS scores. Patient satisfaction was significantly increased. Pain score was decreased significantly. Total functional score was improved from 31.46±11.43 to 86.42±8.87, range of motion（ROM） from 42.42°±23.57° to 95.31°±23.45° and the flexion contracture from 5.31°±7.87° to 0.92°±1.80°. Preoperative radiographic study showed excessive valgus（≥7°） in 37 knees, and varus deformity in 3 knees. Post-operative femorotibial alignment was valgus 3.88°±1.76° in 48 knees. Antero/posterior（A/P） view of X-ray films showed 4 radiolucent lines（RLL） in 48 tibial components. It was concluded that TKA with CCK is effective for the treatment of the severe unstable knee that cannot be balanced by soft tissue.展开更多
Purpose:The injury severity score(ISS)and new injury severity score(NISS)have been widely used in trauma evaluation.However,which scoring system is better in trauma outcome prediction is still disputed.The purpose of ...Purpose:The injury severity score(ISS)and new injury severity score(NISS)have been widely used in trauma evaluation.However,which scoring system is better in trauma outcome prediction is still disputed.The purpose of this study is to evaluate the value of the two scoring systems in predicting trauma outcomes,including mortality,intensive care unit(ICU)admission and ICU length of stay.Methods:The data were collected retrospectively from three hospitals in Zhejiang province,China.The comparisons of NISS and ISS in predicting outcomes were performed by using receiver operator characteristic(ROC)curves and Hosmer-Lemeshow statistics.Results:A total of 1825 blunt trauma patients were enrolled in our study.Finally,1243 patients were admitted to ICU,and 215 patients died before discharge.The ISS and NISS were equivalent in predicting mortality(area under ORC curve[AUC]:0.886 vs.0.887,p=0.9113).But for the patients with ISS>25,NISS showed better performance in predicting mortality.NISS was also significantly better than ISS in predicting ICU admission and prolonged ICU length of stay.Conclusion:NISS outperforms ISS in predicting the outcomes for severe blunt trauma and can be an essential supplement of ISS.Considering the convenience of NISS in calculation,it is advantageous to promote NISS in China's primary hospitals.展开更多
文摘This paper focuses on discussing a novel scoring for stage III rectal cancer patients and all the challenges in creating and developing a clinical score. Background: It is fundamental in my opinion to give space to new generations of scientists, medical doctors and researchers to study and, backed with evidence-based information, improve the current knowledge of clinical medical science. It is fundamental for result obtained by medical researchers to bring their findings to the scientific community. Every scientific finding is of vital importance. In this essay a new Clinical Scoring system, the Sarandria Score, developed by myself is discussed, together with the methods and path in order for a young medical researcher with an idea to bring it to the scientific community. Main topics: Colorectal Cancer (CRC) is a major public health problem, representing the third most commonly diagnosed cancer in males and the second in females. Various studies have reported relevant differences related to CRC primary location site (right-sided colon, left-sided colon, rectum) including response to adjuvant chemotherapy and prognosis. In stage III CRC patients, previous findings showed that higher density of tumor-associated neutrophils (TANs) was associated with better response to 5-FU-based chemotherapy. Novel findings were discovered by Dr Nicola Sarandria on the role of neutrophils in rectal cancer, which include different factors which point to an anti-tumoral role of neutrophils in rectal cancer when in presence of chemotherapeutic agents (5-fluorouracil). The clinical significance of TANs was assessed and whether it can be different depended on the location of the primary CRC (right-sided colon, left-sided colon, rectum). Conclusions: This essay officially discusses a new clinical prognostic and predictive scoring (Sarandria Score) involving intratumoral neutrophilic infiltration in rectal cancer and the possibility of a new inclusion criteria based on this infiltrate for Stage III rectal cancer patients treated with 5-FU therapy. This paper includes data published on my medical degree thesis and in a previous review (on Journal of Cancer Therapy) showing that higher levels of TANs densities were associated with better disease-free survival (DFS) in 5-FU treated patients affected by rectal cancer (while it was inversely related in patients without 5-FU therapy). This was also as further evidence in support possible conceptual division of what is now known as Colorectal cancer into Colon and Rectal cancer.
文摘BACKGROUND Bone metastasis has various negative impacts.Activities of daily living(ADL)and quality of life(QOL)can be significantly decreased,survival may be impacted,and medical expenses may increase.It is estimated that at least 5%cancer patients might be suffering from bone metastases.In 2016,we published the Comprehensive Guidelines for the Diagnosis and Treatment of Bone Metastasis.Since then,the therapeutic outcomes for patients have gradually improved.As life expectancy is a major determinant of surgical intervention,the strategy should be modified if the prolongation of survival is to be achieved.AIM To monitor how bone metastasis treatment has changed before and after launch of our guidelines for bone metastasis.METHODS For advanced cancer patients with bone metastasis who visited the Department of Clinical Oncology at Akita University hospital between 2012 and 2023,parameters including the site and number of bone metastases,laboratory data,and survival time,were extracted from electronic medical records and the Katagiri score was calculated.The association with survival was determined for each factor.RESULTS Data from 136 patients were obtained.The 1-year survival rate for the poor prognosis group with a higher Katagiri score was 20.0%in this study,which was 6%and an apparent improvement from 2014 when the scoring system was developed.Other factors significantly affecting survival included five or more bone metastases than less(P=0.0080),and treatment with chemotherapy(P<0.001),bone modifying agents(P=0.0175)and immune checkpoint inhibitors(P=0.0128).In recent years,advances in various treatment methods have extended the survival period for patients with advanced cancer.It is necessary not only to simply extend survival time,but also to maintain ADL and improve QOL.CONCLUSION Various therapeutic interventions including surgical approach for bone metastasis,which is a disorder of locomotor organs,are increasingly required.Guidelines and scoring system for prognosis need to be revised promptly.
基金supported by a grant from the National Nature Science Foundation of China(No.81371973)
文摘This study aimed to examine the clinical and radiographic outcomes of primary total knee arthroplasy（TKA） with use of Nex Gen#174; Legacy#174; Constrained Condylar Knee（CCK） prosthesis for severe knee deformity. Clinical data of 46 patients（48 knees in total, aged 61 years on average） with severe knee deformity who underwent TKA with Nex Gen#174; Legacy#174; CCK prosthesis between December 2007 and February 2012 were retrospectively analyzed. There were 34 knees with severe valgus with incompetent medial collateral ligament, 11 knees with severe flexion contracture with inability to achieve knee balancing in flexion and extension by posterior soft tissue release, 2 knees with Charcot arthritis with severe varus and bone loss, and 1 with traumatic osteoarthritis with severe varus and ligamentous instability. The mean duration of follow-up was 71 months（range 40–90 months）. The New Knee Society scoring（NKSS） system and the Hospital for Special Surgery（HSS） score were used to evaluate the functional and clinical outcomes. Visual Analogue Scale（VAS） was used for pain measurement and Knee Society criteria for evaluation of radiological images. The results showed that, in the total 48 knees, 1 case of loosening due to short-stem tibial component at 3 months post-operatively underwent revision. The 6-year prosthesis survival rate in this cohort was 97.9%. There was no component infection occurring within 6 years. Significant post-operative improvements were found in NKSS and HSS scores. Patient satisfaction was significantly increased. Pain score was decreased significantly. Total functional score was improved from 31.46±11.43 to 86.42±8.87, range of motion（ROM） from 42.42°±23.57° to 95.31°±23.45° and the flexion contracture from 5.31°±7.87° to 0.92°±1.80°. Preoperative radiographic study showed excessive valgus（≥7°） in 37 knees, and varus deformity in 3 knees. Post-operative femorotibial alignment was valgus 3.88°±1.76° in 48 knees. Antero/posterior（A/P） view of X-ray films showed 4 radiolucent lines（RLL） in 48 tibial components. It was concluded that TKA with CCK is effective for the treatment of the severe unstable knee that cannot be balanced by soft tissue.
基金This research was supported by grants from the Research Fund of Health Ministry,China(Grant No.WKJ2007-2-013).
文摘Purpose:The injury severity score(ISS)and new injury severity score(NISS)have been widely used in trauma evaluation.However,which scoring system is better in trauma outcome prediction is still disputed.The purpose of this study is to evaluate the value of the two scoring systems in predicting trauma outcomes,including mortality,intensive care unit(ICU)admission and ICU length of stay.Methods:The data were collected retrospectively from three hospitals in Zhejiang province,China.The comparisons of NISS and ISS in predicting outcomes were performed by using receiver operator characteristic(ROC)curves and Hosmer-Lemeshow statistics.Results:A total of 1825 blunt trauma patients were enrolled in our study.Finally,1243 patients were admitted to ICU,and 215 patients died before discharge.The ISS and NISS were equivalent in predicting mortality(area under ORC curve[AUC]:0.886 vs.0.887,p=0.9113).But for the patients with ISS>25,NISS showed better performance in predicting mortality.NISS was also significantly better than ISS in predicting ICU admission and prolonged ICU length of stay.Conclusion:NISS outperforms ISS in predicting the outcomes for severe blunt trauma and can be an essential supplement of ISS.Considering the convenience of NISS in calculation,it is advantageous to promote NISS in China's primary hospitals.
