There is a lack of high-quality,large-scale,real-world evidence from patients with metastatic colorectal cancer(mCRC),especially in China.It remains unclear whether efforts to improve the quality of care for mCRC woul...There is a lack of high-quality,large-scale,real-world evidence from patients with metastatic colorectal cancer(mCRC),especially in China.It remains unclear whether efforts to improve the quality of care for mCRC would improve patient survival outcomes in real-world practice.On the basis of an intelligent bigdata platform,we established a large-scale retrospective cohort of mCRC patients.We investigated the temporal changes in the systemic and local treatment(resection,ablation,or radiation to liver,lung,or extrahepatic and/or extrapulmonary metastases)patterns of mCRC,and whether these changes were associated with improved overall survival(OS)over time.Between July 2012 and December 2018,3403 eligible patients were included in this research.The median OS was 42.8 months(95%confidence interval(CI),40.7–46.6)for the entire cohort,25.6 months(95%CI,24.7–26.9)for those treated with systemic therapy only,and not reached(95%CI,78.6 months–not reached)for those receiving local therapy.The utility rate of local therapy increased continuously from 37.9%in 2012–2014 to 46.9%in 2017–2018.A dramatic increase in the utility rate of either cetuximab or bevacizumab was observed since 2017(39.9%,43.2%,and 60.3%in 2012–2014,2015–2016,and 2017–2018,respectively).Compared with 2012–2014,the OS of the entire population significantly improved in 2015–2016(hazard ratio(HR)=0.87(95%CI,0.78–0.99);P=0.034),but not for patients receiving systemic therapy only(HR=0.99(95%CI,0.86–1.14);P=0.889),whereas an improved OS was found in 2015–2018 for both the entire population(HR=0.75(95%CI,0.70–0.81);P<0.001)and for patients receiving systemic therapy only(HR=0.83(95%CI,0.77–0.91);P<0.001).In summary,the quality of care for mCRC,as indicated by the utility rate of targeted and local therapies,has been continuously improving over time in this study cohort,which is associated with continuously improving survival outcomes for these patients.展开更多
With the improvement of the degree of aging,the traditional pension model can no longer meet the growing needs of the elderly.Therefore,it is necessary to use the intelligent means of information technology to improve...With the improvement of the degree of aging,the traditional pension model can no longer meet the growing needs of the elderly.Therefore,it is necessary to use the intelligent means of information technology to improve the level of pension services.This paper will integrate multi-sensor fusion technology,NB-IoT communication technology and cloud platform technology to develop and design a smart pension online monitoring system to realize real-time collection of human health and motion status information and realize monitoring platform management.In this system,STM32 microcontroller will be used as the main control module,and MAX30102,ADXL345 and DS18B20 sensors will be used to collect the heart rate,blood oxygen,displacement and body temperature of the human body in real time.On the one hand,the communication part is completed by the BC20 Internet of Things module.The data transmission between the terminal detection device and the cloud platform,on the other hand,the HC-42 Bluetooth module is used to complete the data communication with the mobile phone.The test results show that the system can collect and process data accurately in real time and maintain good communication with the cloud platform and mobile phone.The designed system has strong pertinence,easy operation,high reliability and broad development prospects.展开更多
基金This study was supported by the grants from the National Natural Science Foundation of China(81930065)the Natural Science Foundation of Guangdong Province(2014A030312015)+1 种基金the Science and Technology Program of Guangdong(2019B020227002)the Science and Technology Program of Guangzhou(201904020046,201803040019,and 201704020228).
文摘There is a lack of high-quality,large-scale,real-world evidence from patients with metastatic colorectal cancer(mCRC),especially in China.It remains unclear whether efforts to improve the quality of care for mCRC would improve patient survival outcomes in real-world practice.On the basis of an intelligent bigdata platform,we established a large-scale retrospective cohort of mCRC patients.We investigated the temporal changes in the systemic and local treatment(resection,ablation,or radiation to liver,lung,or extrahepatic and/or extrapulmonary metastases)patterns of mCRC,and whether these changes were associated with improved overall survival(OS)over time.Between July 2012 and December 2018,3403 eligible patients were included in this research.The median OS was 42.8 months(95%confidence interval(CI),40.7–46.6)for the entire cohort,25.6 months(95%CI,24.7–26.9)for those treated with systemic therapy only,and not reached(95%CI,78.6 months–not reached)for those receiving local therapy.The utility rate of local therapy increased continuously from 37.9%in 2012–2014 to 46.9%in 2017–2018.A dramatic increase in the utility rate of either cetuximab or bevacizumab was observed since 2017(39.9%,43.2%,and 60.3%in 2012–2014,2015–2016,and 2017–2018,respectively).Compared with 2012–2014,the OS of the entire population significantly improved in 2015–2016(hazard ratio(HR)=0.87(95%CI,0.78–0.99);P=0.034),but not for patients receiving systemic therapy only(HR=0.99(95%CI,0.86–1.14);P=0.889),whereas an improved OS was found in 2015–2018 for both the entire population(HR=0.75(95%CI,0.70–0.81);P<0.001)and for patients receiving systemic therapy only(HR=0.83(95%CI,0.77–0.91);P<0.001).In summary,the quality of care for mCRC,as indicated by the utility rate of targeted and local therapies,has been continuously improving over time in this study cohort,which is associated with continuously improving survival outcomes for these patients.
基金supported by Jiangsu Provincial Natural Science Fund(BK20150247)the Fundamental Research Funds for Postgraduate Research&Practice Innovation Program of Jiangsu Province(XSJCX22_36,XSJCX22_44,SJCX22_1479)
文摘With the improvement of the degree of aging,the traditional pension model can no longer meet the growing needs of the elderly.Therefore,it is necessary to use the intelligent means of information technology to improve the level of pension services.This paper will integrate multi-sensor fusion technology,NB-IoT communication technology and cloud platform technology to develop and design a smart pension online monitoring system to realize real-time collection of human health and motion status information and realize monitoring platform management.In this system,STM32 microcontroller will be used as the main control module,and MAX30102,ADXL345 and DS18B20 sensors will be used to collect the heart rate,blood oxygen,displacement and body temperature of the human body in real time.On the one hand,the communication part is completed by the BC20 Internet of Things module.The data transmission between the terminal detection device and the cloud platform,on the other hand,the HC-42 Bluetooth module is used to complete the data communication with the mobile phone.The test results show that the system can collect and process data accurately in real time and maintain good communication with the cloud platform and mobile phone.The designed system has strong pertinence,easy operation,high reliability and broad development prospects.
