2024年,全球数字出版研究继续深化革新。本文在Web of Science数据库检索并筛选文献,围绕人工智能+出版、电子书、有声读物、数字游戏、数字音乐、数字阅读、数字版权、开放获取8个主题开展综述,意图勾勒2024年国外数字出版研究的总体景...2024年,全球数字出版研究继续深化革新。本文在Web of Science数据库检索并筛选文献,围绕人工智能+出版、电子书、有声读物、数字游戏、数字音乐、数字阅读、数字版权、开放获取8个主题开展综述,意图勾勒2024年国外数字出版研究的总体景观,尤其关注思想、议题、理论、方法层面的最新进展,并结合中国本土经验进行评价,以期为中国数字出版研究发展提供参考。展开更多
BACKGROUND Esophageal cancer constitutes one of the most aggressive malignant neoplasms associated with poor clinical outcomes.While surgical resection remains the cornerstone of curative intervention,optimization of ...BACKGROUND Esophageal cancer constitutes one of the most aggressive malignant neoplasms associated with poor clinical outcomes.While surgical resection remains the cornerstone of curative intervention,optimization of perioperative care protocols has emerged as an essential strategy to reduce postoperative complications and potentially improve long-term survival rates in patients undergoing esophagectomy.However,substantial debate persists regarding the relative importance of various perioperative risk factors and their impact on post-resection outcomes.AIM To identify perioperative factors affecting prognosis after radical esophagectomy,aiming to improve patient outcomes through targeted interventions.METHODS A retrospective study analyzed 378 patients with esophageal cancer who underwent radical esophagectomy(McKeown,Sweet,or Ivor-Lewis procedures)from January 2022 through December 2023.All operations were performed by experienced surgeons following standardized perioperative protocols.The investigation gathered data on patient demographics,surgical parameters,tumor pathology(using the 8th edition American Joint Committee on Cancer staging system),and survival outcomes.Statistical analyses utilized Kaplan-Meier estimates and Cox proportional hazards modeling,with adjustment for confounding variables.RESULTS Multivariate Cox proportional hazards analysis identified three independent predictors of survival:Tumor-nodemetastasis staging[Hazard ratio(HR)=2.31,95%confidence interval(CI):1.72-3.10,P<0.001],tumor differentiation(moderate:HR=1.46,95%CI:1.02-2.09,P=0.038;poor:HR=2.15,95%CI:1.47-3.14,P<0.001),and extended postoperative analgesic use(>5 days)(HR=1.43,95%CI:1.08-1.89,P=0.012).Kaplan-Meier analysis demonstrated significantly lower overall survival rates in patients requiring analgesics for>5 days compared to≤5 days(P=0.003),with consistent patterns observed for both opioid(P=0.019)and nonsteroidal anti-inflammatory drug use(P=0.028).The extended analgesic group exhibited a higher proportion of elderly patients(48.47%vs 35.57%,P=0.015),while other baseline characteristics and tumor features remained comparable between groups.CONCLUSION Tumor-node-metastasis staging,tumor differentiation,and duration of postoperative analgesic use independently predict survival following radical esophagectomy,underscoring the significance of optimal pain management protocols.展开更多
文摘2024年,全球数字出版研究继续深化革新。本文在Web of Science数据库检索并筛选文献,围绕人工智能+出版、电子书、有声读物、数字游戏、数字音乐、数字阅读、数字版权、开放获取8个主题开展综述,意图勾勒2024年国外数字出版研究的总体景观,尤其关注思想、议题、理论、方法层面的最新进展,并结合中国本土经验进行评价,以期为中国数字出版研究发展提供参考。
文摘BACKGROUND Esophageal cancer constitutes one of the most aggressive malignant neoplasms associated with poor clinical outcomes.While surgical resection remains the cornerstone of curative intervention,optimization of perioperative care protocols has emerged as an essential strategy to reduce postoperative complications and potentially improve long-term survival rates in patients undergoing esophagectomy.However,substantial debate persists regarding the relative importance of various perioperative risk factors and their impact on post-resection outcomes.AIM To identify perioperative factors affecting prognosis after radical esophagectomy,aiming to improve patient outcomes through targeted interventions.METHODS A retrospective study analyzed 378 patients with esophageal cancer who underwent radical esophagectomy(McKeown,Sweet,or Ivor-Lewis procedures)from January 2022 through December 2023.All operations were performed by experienced surgeons following standardized perioperative protocols.The investigation gathered data on patient demographics,surgical parameters,tumor pathology(using the 8th edition American Joint Committee on Cancer staging system),and survival outcomes.Statistical analyses utilized Kaplan-Meier estimates and Cox proportional hazards modeling,with adjustment for confounding variables.RESULTS Multivariate Cox proportional hazards analysis identified three independent predictors of survival:Tumor-nodemetastasis staging[Hazard ratio(HR)=2.31,95%confidence interval(CI):1.72-3.10,P<0.001],tumor differentiation(moderate:HR=1.46,95%CI:1.02-2.09,P=0.038;poor:HR=2.15,95%CI:1.47-3.14,P<0.001),and extended postoperative analgesic use(>5 days)(HR=1.43,95%CI:1.08-1.89,P=0.012).Kaplan-Meier analysis demonstrated significantly lower overall survival rates in patients requiring analgesics for>5 days compared to≤5 days(P=0.003),with consistent patterns observed for both opioid(P=0.019)and nonsteroidal anti-inflammatory drug use(P=0.028).The extended analgesic group exhibited a higher proportion of elderly patients(48.47%vs 35.57%,P=0.015),while other baseline characteristics and tumor features remained comparable between groups.CONCLUSION Tumor-node-metastasis staging,tumor differentiation,and duration of postoperative analgesic use independently predict survival following radical esophagectomy,underscoring the significance of optimal pain management protocols.
