The establishment of a high-quality gastric cancer database significantly improves the efficiency and standardization of diagnosis and treatment of this disease. Our center has developed a specialized, single-center gastric cancer database and initiated the China Gastrointestinal Cancer Surgery Union, catalyzing the exploration of multi-center databases. This article encapsulates multi-level experience and provides a detailed overview of the quality control methods we implement in both constructing and managing the gastric cancer database. Utilizing an electronic medical record system and a multi-disciplinary treatment (MDT) approach, we have designed the database in a modular and multi-nodal manner. A synthesis of automatic retrieval of structured data and manual entry, coupled with a rigorous MDT system and real-time supervision at various nodes, bolster our real-time quality control efforts. Ensuring data security and digitized management plans alongside real-time review protocol and a multi-level review system, we maintain the highest standards in the initiation and management of the database. Through the establishment of the China Gastrointestinal Cancer Surgery Union platform, we endorse the concept that multi-center database construction should be driven by research objectives, consider data accessibility, while placing an emphasis on building inter-center consensus on data quality control. Moving forward, it is crucial that the development of multi-center databases promotes uniformity in medical standards across centers, cultivates stable public data sharing platforms, ensures robust data security protocols, routinely conducts data quality assessments, and bolsters multi-center cooperation and exchanges to promote the homogeneity of medical standards.

The establishment of a high-quality gastric cancer database significantly improves the efficiency and standardization of diagnosis and treatment of this disease. Our center has developed a specialized, single-center gastric cancer database and initiated the China Gastrointestinal Cancer Surgery Union, catalyzing the exploration of multi-center databases. This article encapsulates multi-level experience and provides a detailed overview of the quality control methods we implement in both constructing and managing the gastric cancer database. Utilizing an electronic medical record system and a multi-disciplinary treatment (MDT) approach, we have designed the database in a modular and multi-nodal manner. A synthesis of automatic retrieval of structured data and manual entry, coupled with a rigorous MDT system and real-time supervision at various nodes, bolster our real-time quality control efforts. Ensuring data security and digitized management plans alongside real-time review protocol and a multi-level review system, we maintain the highest standards in the initiation and management of the database. Through the establishment of the China Gastrointestinal Cancer Surgery Union platform, we endorse the concept that multi-center database construction should be driven by research objectives, consider data accessibility, while placing an emphasis on building inter-center consensus on data quality control. Moving forward, it is crucial that the development of multi-center databases promotes uniformity in medical standards across centers, cultivates stable public data sharing platforms, ensures robust data security protocols, routinely conducts data quality assessments, and bolsters multi-center cooperation and exchanges to promote the homogeneity of medical standards.

Objective:To investigate the treatment methods for patients with gastric cancer liver metastasis and prognostic factors.Methods:The retrospective cohort study was conducted. The clinicopathological data of 282 patients with gastric cancer liver metastasis who were admitted to Peking University Cancer Hospital from January 1st,2010 to January 1st,2020 were collected. There were 237 males and 45 females, aged (66±10)years. Of the 282 patients, there were 94 cases with liver oligometastasis and 188 cases with liver multiple metastases. Patients underwent surgical treatment, systemic treatment or local treatment based on the individual condition. Observation indicators: (1) treatment methods for patients with gastric cancer liver metastasis; (2) follow-up and prognosis of patients with gastric cancer liver metastasis; (3) prognostic factors analysis in patients with gastric cancer liver metastasis. Comparison of count data between groups was conducted using the chi-square test. Comparison of ordinal data was conducted using the nonparameter rank sum test. The univariate analysis was conducted using the log-rank test. The multivariate analysis was conducted using the Cox proportional hazards regression model, and relevant variables were screened through stepwise regression forward method. The Kaplan-Meier method was used to calculate survival rate and plot survival curve, and the log-rank test was used for survival analysis.Results:(1) Treat-ment methods for patients with gastric cancer liver metastasis. There were significant differences in surgical treatment methods, hepatic artery infusion chemotherapy, and radiofrequency ablation between the 94 patients with gastric cancer liver oligometastasis and the 188 patients with gastric cancer liver multiple metastases ( χ2=21.97, 6.04, 8.78, P<0.05). (2) Follow-up and prognosis of patients with gastric cancer liver metastasis. All 282 patients with gastric cancer liver metastasis were followed up for 781(range, 3-4 100)days, and the 1-, 3-, 5-year overall survival rates were 61.0%, 19.5%, 11.0%, respectively. The overall survival time and 1-, 3-, 5-year overall survival rates were 659(range, 549-769)days and 69.1%, 30.9%, 18.1% in patients with gastric cancer liver oligometastasis, versus 519(range, 451-587)days and 56.9%, 13.8%, 7.4% in patients with gastric cancer liver multiple metastases, showing a significant difference in survival situations between them ( χ2=8.45, P<0.05).(3) Prognostic factors analysis in patients with gastric cancer liver metastasis. Results of multi-variate analysis showed that Eastern Cooperative Oncology Group (ECOG) score, surgical treatment methods, chemotherapy, targeted therapy, radiofrequency ablation were all independent factors affecting prognosis of patients with gastric cancer liver metastasis ( odds ratio=3.68, 0.82, 0.58, 0.64, 0.52, 95% confidence interval as 1.85-7.33, 0.67-1.00, 0.40-0.86, 0.44-0.92, 0.30-0.90, P<0.05). Conclusions:The treatment methods for patients with gastric cancer liver oligometastasis and multiple liver metastases are different, with the former mostly using surgical treatment and the latter mostly using non-surgical treatment. Patients with gastric cancer liver oligometastasis have better prognosis than patients with multiple liver metastases. ECOG score, surgical treatment methods, chemo-therapy, targeted therapy, radiofrequency ablation are independent factors affecting prognosis of patients with gastric cancer liver metastasis.

Objective:To investigate the treatment methods for patients with gastric cancer liver metastasis and prognostic factors.Methods:The retrospective cohort study was conducted. The clinicopathological data of 282 patients with gastric cancer liver metastasis who were admitted to Peking University Cancer Hospital from January 1st,2010 to January 1st,2020 were collected. There were 237 males and 45 females, aged (66±10)years. Of the 282 patients, there were 94 cases with liver oligometastasis and 188 cases with liver multiple metastases. Patients underwent surgical treatment, systemic treatment or local treatment based on the individual condition. Observation indicators: (1) treatment methods for patients with gastric cancer liver metastasis; (2) follow-up and prognosis of patients with gastric cancer liver metastasis; (3) prognostic factors analysis in patients with gastric cancer liver metastasis. Comparison of count data between groups was conducted using the chi-square test. Comparison of ordinal data was conducted using the nonparameter rank sum test. The univariate analysis was conducted using the log-rank test. The multivariate analysis was conducted using the Cox proportional hazards regression model, and relevant variables were screened through stepwise regression forward method. The Kaplan-Meier method was used to calculate survival rate and plot survival curve, and the log-rank test was used for survival analysis.Results:(1) Treat-ment methods for patients with gastric cancer liver metastasis. There were significant differences in surgical treatment methods, hepatic artery infusion chemotherapy, and radiofrequency ablation between the 94 patients with gastric cancer liver oligometastasis and the 188 patients with gastric cancer liver multiple metastases ( χ2=21.97, 6.04, 8.78, P<0.05). (2) Follow-up and prognosis of patients with gastric cancer liver metastasis. All 282 patients with gastric cancer liver metastasis were followed up for 781(range, 3-4 100)days, and the 1-, 3-, 5-year overall survival rates were 61.0%, 19.5%, 11.0%, respectively. The overall survival time and 1-, 3-, 5-year overall survival rates were 659(range, 549-769)days and 69.1%, 30.9%, 18.1% in patients with gastric cancer liver oligometastasis, versus 519(range, 451-587)days and 56.9%, 13.8%, 7.4% in patients with gastric cancer liver multiple metastases, showing a significant difference in survival situations between them ( χ2=8.45, P<0.05).(3) Prognostic factors analysis in patients with gastric cancer liver metastasis. Results of multi-variate analysis showed that Eastern Cooperative Oncology Group (ECOG) score, surgical treatment methods, chemotherapy, targeted therapy, radiofrequency ablation were all independent factors affecting prognosis of patients with gastric cancer liver metastasis ( odds ratio=3.68, 0.82, 0.58, 0.64, 0.52, 95% confidence interval as 1.85-7.33, 0.67-1.00, 0.40-0.86, 0.44-0.92, 0.30-0.90, P<0.05). Conclusions:The treatment methods for patients with gastric cancer liver oligometastasis and multiple liver metastases are different, with the former mostly using surgical treatment and the latter mostly using non-surgical treatment. Patients with gastric cancer liver oligometastasis have better prognosis than patients with multiple liver metastases. ECOG score, surgical treatment methods, chemo-therapy, targeted therapy, radiofrequency ablation are independent factors affecting prognosis of patients with gastric cancer liver metastasis.

Objective:To establish standard spatial brain template and ROIs template of 11C-methyl- N-2β-carbomethoxy-3β-(4-fluorophenyl)tropane (CFT) PET images for automated quantitative analysis of dopamine transporter (DAT) distribution. Methods:From May 2014 to December 2015, 11C-CFT PET and MRI T 1 brain images of 16 healthy volunteers (3 males, 13 females; age (63.3±6.9) years) from Huashan Hospital, Fudan University were co-registered and smoothed using statistical parametric mapping(SPM)5 software based on MATLAB to create a standard spatial brain template. The ROIs template was established by ScAnVp procedures. These templates were clinically verified by using 11C-CFT PET images of 37 healthy volunteers (23 males, 14 females; age (61.7±7.1) years), 32 Parkinson′s disease (PD) patients (20 males, 12 females; age (61.1±5.4) years), 10 multiple system atrophy with predominant parkinsonism (MSA-P) patients (7 males, 3 females; age (60.8±7.1) years) and 10 progressive supranuclear palsy (PSP) patients (5 males, 5 females; age (58.4±6.1) years) from Huashan Hospital, Fudan University between January 2014 and March 2019. One-way analysis of variance was used to analyze data. Results:Based on the 11C-CFT PET images and MRI T 1 images of healthy volunteers, a standard spatial brain template for normalization of 11C-CFT PET images was created. The ROIs template was established including seven regions: bilateral caudate, anterior putamen, posterior putamen (along the long axis) and the occipital cortex. The ROIs template was accurately aligned in each verification group. The normal reference values of semi-quantitative DAT distribution in caudate, anterior putamen and posterior putamen were obtained (1.84±0.13, 2.18±0.16, 1.77±0.11). The semi-quantitative values of 11C-CFT uptake in each ROI in patients were significantly lower than those in healthy volunteers ( F values: 49.79-283.83, all P<0.05). Conclusion:The established brain templates with accurate spatial alignment for 11C-CFT image analysis can provide foundational tools for the application of 11C-CFT PET imaging in clinical practice and scientific research.

Due to the availability of 18F-FDG in PET centers, this article aims to advocate and promote the standardization of 18F-FDG PET brain imaging in dementia in order to improve the reliability, repeatability and comparison of the imaging process and results. It is also provided to guide the PET imaging operation standard and to give suggestions on image interpretation.

Since the outbreak of Corona Virus Disease 2019 occurred in December 2019, the reduction of population mobility has curbed the spread of the epidemic to some extent but also prolonged the waiting time for the treatment of patients with gastric cancer. Based on fully understanding the different staging characteristics of gastric cancer, clinical departments should develop reasonable out-of-hospital management strategies. On one hand, reasonable communication channels should be established to allow patients to receive adequate guidance out of the hospital. On the other hand, shared decisions with patients should be made to adjust treatment strategies, and education on viral prevention should be implemented to minimize the impact of the epidemic on tumor treatment.

Objective: To explore the feasibility of assessing complications registration through medical information. Methods: A descriptive case series study was performed to retrospectively collect medical information and complication registration information of gastric cancer patients at Department of Gastrointestinal Cancer Center Ward I, Peking University Cancer Hospital from November 1, 2016 to March 1, 2017 (the first period), and from November 1, 2018 to March 1, 2019 (the second period). Case inclusion criteria: (1) adenocarcinoma confirmed by gastroscopy and biopsy; (2) patients undergoing open surgery or laparoscopic radical gastrectomy; (3) complete postoperative medical information and complication information. Patients who were directly transferred to ICU after surgery and underwent emergency surgery were excluded. Because difference of the complication registration procedure at our department existed before and after 2018, so the above two periods were selected to be used for analysis on enrolled patients. The prescription information during hospitalization, including nursing, medication, laboratory examination, transference, surgical advice, etc. were compared with the current Standard Operating Procedure (SOP, including preoperative routine examinations, inspection, perioperative preventive antibiotic use, postoperative observational tests, inspection, routine nutritional support, prophylactic anticoagulation, and prophylactic inhibition of pancreatic enzymes, etc.) for gastric cancer at our department. Medical order beyond SOP was defined as medical order variation. Postoperative complication was diagnosed using the Clavien-Dindo classification criteria, which was divided into I, II, IIIa, IIIb, IVa, IVb, and V. Medical order variation and complication registration information were compared between the two periods, including consistence between medical order variation and complication registration, missing report, underestimation or overestimation of medical order variation, and registration rate of medical order variation [registration rate = (total number of patients–number of missing report patients)/total number of patients], severe complications (Clavien-Dindo classification ≥ III), medical order variation deviating from SOP and the corresponding inferred grading of complication. The data was organized using Microsoft Office Excel 2010. Results: A total of 177 gastric cancer patients were included in the analysis. The first period group and the second period group comprised 89 and 88 cases, respectively. The registrated complication rate was 23.6% (21/89) and 36.4% (32/88), and the incidence of severe complication was 2.2% (2/89) and 4.5% (4/88) in the first and the second period, respectively. The complication rate inferred from medical order variation was 74.2% (66/89) and 78.4% (69/88), and the incidence of severe complication was 7.9% (7/89) and 4.5% (4/88) in the first and second period, respectively. In the first and second period, the proportions of medical order variation in accordance with registered complication were 36.0% and 45.5% respectively; the proportion of underestimation, overestimation and missing report were 5.6% and 4.5%, 4.5% and 4.5%, 53.9% and 45.5%, respectively; the registration rate of medical order variation was 46.1% and 54.5%; the number of case with grade I complications inferred from medical order variation was 34 (38.2%) and 25 (28.4%), respectively; and the number of grade II was 12 (13.5%) and 15 cases (17.0%), respectively. The reason of the missing report of medical order variation corresponding to grade I complication was mainly the single use of analgesic drugs outside SOP, accounting for 76.5% (26/34) and 64.0% (16/25) in the first and second period respectively, and that corresponding to grade II complication was mainly the use of non-prophylactic antibiotics, accounting for 9/12 cases and 5/15 cases, respectively. Conclusions Medical information can evaluate the morbidity of complication feasibly and effectively. Attention should be paid to routine registration to avoid specific missing report.

Objective To explore the feasibility of assessing complications registration through medical information. Methods A descriptive case series study was performed to retrospectively collect medical information and complication registration information of gastric cancer patients at Department of Gastrointestinal Cancer Center Ward I, Peking University Cancer Hospital from November 1, 2016 to March 1, 2017 (the first period), and from November 1, 2018 to March 1, 2019 (the second period). Case inclusion criteria: (1) adenocarcinoma confirmed by gastroscopy and biopsy; (2) patients undergoing open surgery or laparoscopic radical gastrectomy; (3) complete postoperative medical information and complication information. Patients who were directly transferred to ICU after surgery and underwent emergency surgery were excluded. Because difference of the complication registration procedure at our department existed before and after 2018, so the above two periods were selected to be used for analysis on enrolled patients. The prescription information during hospitalization, including nursing, medication, laboratory examination, transference, surgical advice, etc. were compared with the current Standard Operating Procedure (SOP, including preoperative routine examinations, inspection, perioperative preventive antibiotic use, postoperative observational tests, inspection, routine nutritional support, prophylactic anticoagulation, and prophylactic inhibition of pancreatic enzymes, etc.) for gastric cancer at our department. Medical order beyond SOP was defined as medical order variation. Postoperative complication was diagnosed using the Clavien?Dindo classification criteria, which was divided into I, II, IIIa, IIIb, IVa, IVb, and V. Medical order variation and complication registration information were compared between the two periods, including consistence between medical order variation and complication registration, missing report, underestimation or overestimation of medical order variation, and registration rate of medical order variation [registration rate=(total number of patients–number of missing report patients)/ total number of patients], severe complications (Clavien?Dindo classification ≥ III), medical order variation deviating from SOP and the corresponding inferred grading of complication. The data was organized using Microsoft Office Excel 2010. Results A total of 177 gastric cancer patients were included in the analysis. The first period group and the second period group comprised 89 and 88 cases, respectively. The registrated complication rate was 23.6% (21/89) and 36.4% (32/88), and the incidence of severe complication was 2.2% (2/89) and 4.5% (4/88) in the first and the second period, respectively. The complication rate inferred from medical order variation was 74.2% (66/89) and 78.4% (69/88), and the incidence of severe complication was 7.9% (7/89) and 4.5% (4/88) in the first and second period, respectively. In the first and second period, the proportions of medical order variation in accordance with registered complication were 36.0% and 45.5% respectively; the proportion of underestimation, overestimation and missing report were 5.6% and 4.5%, 4.5% and 4.5%, 53.9% and 45.5%, respectively;the registration rate of medical order variation was 46.1% and 54.5%; the number of case with grade I complications inferred from medical order variation was 34 (38.2%) and 25 (28.4%), respectively;and the number of grade II was 12 (13.5%) and 15 cases (17.0%), respectively. The reason of the missing report of medical order variation corresponding to grade I complication was mainly the single use of analgesic drugs outside SOP, accounting for 76.5% (26/34) and 64.0% (16/25) in the first and second period respectively, and that corresponding to grade II complication was mainly the use of non?prophylactic antibiotics, accounting for 9/12 cases and 5/15 cases, respectively. Conclusions Medical information can evaluate the morbidity of complication feasibly and effectively. Attention should be paid to routine registration to avoid specific missing report.

Objective To explore the feasibility of assessing complications registration through medical information. Methods A descriptive case series study was performed to retrospectively collect medical information and complication registration information of gastric cancer patients at Department of Gastrointestinal Cancer Center Ward I, Peking University Cancer Hospital from November 1, 2016 to March 1, 2017 (the first period), and from November 1, 2018 to March 1, 2019 (the second period). Case inclusion criteria: (1) adenocarcinoma confirmed by gastroscopy and biopsy; (2) patients undergoing open surgery or laparoscopic radical gastrectomy; (3) complete postoperative medical information and complication information. Patients who were directly transferred to ICU after surgery and underwent emergency surgery were excluded. Because difference of the complication registration procedure at our department existed before and after 2018, so the above two periods were selected to be used for analysis on enrolled patients. The prescription information during hospitalization, including nursing, medication, laboratory examination, transference, surgical advice, etc. were compared with the current Standard Operating Procedure (SOP, including preoperative routine examinations, inspection, perioperative preventive antibiotic use, postoperative observational tests, inspection, routine nutritional support, prophylactic anticoagulation, and prophylactic inhibition of pancreatic enzymes, etc.) for gastric cancer at our department. Medical order beyond SOP was defined as medical order variation. Postoperative complication was diagnosed using the Clavien?Dindo classification criteria, which was divided into I, II, IIIa, IIIb, IVa, IVb, and V. Medical order variation and complication registration information were compared between the two periods, including consistence between medical order variation and complication registration, missing report, underestimation or overestimation of medical order variation, and registration rate of medical order variation [registration rate=(total number of patients–number of missing report patients)/ total number of patients], severe complications (Clavien?Dindo classification ≥ III), medical order variation deviating from SOP and the corresponding inferred grading of complication. The data was organized using Microsoft Office Excel 2010. Results A total of 177 gastric cancer patients were included in the analysis. The first period group and the second period group comprised 89 and 88 cases, respectively. The registrated complication rate was 23.6% (21/89) and 36.4% (32/88), and the incidence of severe complication was 2.2% (2/89) and 4.5% (4/88) in the first and the second period, respectively. The complication rate inferred from medical order variation was 74.2% (66/89) and 78.4% (69/88), and the incidence of severe complication was 7.9% (7/89) and 4.5% (4/88) in the first and second period, respectively. In the first and second period, the proportions of medical order variation in accordance with registered complication were 36.0% and 45.5% respectively; the proportion of underestimation, overestimation and missing report were 5.6% and 4.5%, 4.5% and 4.5%, 53.9% and 45.5%, respectively;the registration rate of medical order variation was 46.1% and 54.5%; the number of case with grade I complications inferred from medical order variation was 34 (38.2%) and 25 (28.4%), respectively;and the number of grade II was 12 (13.5%) and 15 cases (17.0%), respectively. The reason of the missing report of medical order variation corresponding to grade I complication was mainly the single use of analgesic drugs outside SOP, accounting for 76.5% (26/34) and 64.0% (16/25) in the first and second period respectively, and that corresponding to grade II complication was mainly the use of non?prophylactic antibiotics, accounting for 9/12 cases and 5/15 cases, respectively. Conclusions Medical information can evaluate the morbidity of complication feasibly and effectively. Attention should be paid to routine registration to avoid specific missing report.