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Article: [Enhanced recovery after surgery based on medical ethics].

Zhao, Qingchuan

Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery

2016 Volume 19, Issue 3, Page(s) 250–252

Abstract: Enhanced recovery after surgery (ERAS), a new model of perioperative management developed in recent years, can shorten hospital stay, reduce medical cost and postoperative discomfort. However, some of these measures under the strategy are negation of the ...

Abstract	Enhanced recovery after surgery (ERAS), a new model of perioperative management developed in recent years, can shorten hospital stay, reduce medical cost and postoperative discomfort. However, some of these measures under the strategy are negation of the traditional recommendation and many surgeons are concerned about the medical tangle by the complications coming with the ERAS strategy. In this paper, ERAS strategy is evaluated from an ethical standpoint and the assessment factors of medical behavior are introduced based on medical virtues and medical ethnics. It is also analyzed that how to deal with the conflicts between the textbooks and the ERAS strategy, and elaborated that the medical ethics should be observed if the ERAS strategy is implemented. The scientific principles must be followed, the rights and interests of the patients need to be protected, and the informed consent should be guaranteed.
MeSH term(s)	Digestive System Surgical Procedures ; Ethics, Medical ; Humans ; Length of Stay ; Perioperative Care/ethics ; Postoperative Period
Language	Chinese
Publishing date	2016-03
Publishing country	China
Document type	English Abstract ; Journal Article
ISSN	1671-0274
ISSN	1671-0274
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Article ; Online: Physical and psychological correlates of somatic symptom in patients with functional constipation: a cross-sectional study.

Zhao, Zhifeng / Bai, Bin / Wang, Shiqi / Zhou, Yin / Yu, Pengfei / Zhao, Qingchuan / Yang, Bin

BMC psychiatry

2024 Volume 24, Issue 1, Page(s) 134

Abstract: Background: The symptoms of functional constipation (FC) were obviously affected by mental symptoms, which was consistent with somatic symptoms. However, the characteristics of FC patients with somatic symptom remains unexplored.: Methods: Clinical ... ...

Abstract	Background: The symptoms of functional constipation (FC) were obviously affected by mental symptoms, which was consistent with somatic symptoms. However, the characteristics of FC patients with somatic symptom remains unexplored. Methods: Clinical characteristics including somatic symptom (SOM, PHQ-15), depression (PHQ-9), anxiety (GAD-7), quality of life (PAC-QOL), constipation (KESS), demographic variables, anatomical abnormalities and symptoms were investigated. Subsequent analyses encompassed the comparison of clinical parameters between patients with SOM + group (PHQ-15 ≥ 10) and SOM- group (PHQ-15 < 10), subgroup analysis, correlation analysis, and logistic regression. Lastly, we evaluated the somatic symptom severity (SSS) among FC patients subjected to various stressors. Results: Notable disparities were observed between SOM + and SOM- groups in variety of physiological and psychological variables, including gender, stressful events, sleep disorders, reduced interest, GAD-7, PHQ-15, PHQ-9, PAC-QOL, anterior rectocele, KESS, and internal anal sphincter achalasia (IASA) (P < 0.05). Subgroup analysis affirmed consistent findings across mental symptoms. Correlation analyses revealed significant associations between SSS and KESS, anterior rectocele, GAD-7, PHQ-9, and PAC-QOL (P < 0.05). Logistic regression identified PHQ-9 (OR = 7.02, CI: 2.06-27.7, P = 0.003), GAD-7 (OR = 7.18, CI: 2.00-30.7, P = 0.004), and KESS (OR = 16.8, CI: 3.09-113, P = 0.002) as independent predictors of SSS. Elevated SSS scores were significantly associated with couple, parental, and work-related stressors (P < 0.05). Conclusion: A marked heterogeneity was observed between SOM + and SOM- patients of FC, with SOM + accompanied by more severe constipation, anxiety and depression symptoms. This finding underscores the importance of considering somatic symptoms in diagnosis and treatment of FC.
MeSH term(s)	Humans ; Quality of Life/psychology ; Cross-Sectional Studies ; Medically Unexplained Symptoms ; Rectocele ; Surveys and Questionnaires ; Outpatients ; Anxiety/diagnosis ; Depression/diagnosis ; Depression/psychology ; Constipation/diagnosis
Language	English
Publishing date	2024-02-16
Publishing country	England
Document type	Journal Article
ZDB-ID	2050438-X
ISSN	1471-244X ; 1471-244X
ISSN (online)	1471-244X
ISSN	1471-244X
DOI	10.1186/s12888-024-05559-9
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Article ; Online: Effects of a Perioperative Safety Checklist on Postoperative Complications Following Surgery for Gastric Cancer: A Single-Center Preliminary Study.

Yu, Deliang / Zhao, Qingchuan

Surgical innovation

2020 Volume 27, Issue 2, Page(s) 173–180

Abstract: ... ...

Abstract	Objective
MeSH term(s)	Aged ; Checklist ; Female ; Gastrectomy/adverse effects ; Gastrectomy/mortality ; Humans ; Intestinal Fistula/epidemiology ; Intestinal Fistula/prevention & control ; Length of Stay/statistics & numerical data ; Male ; Middle Aged ; Patient Safety ; Perioperative Care/methods ; Postoperative Complications/epidemiology ; Postoperative Complications/prevention & control ; Reoperation/statistics & numerical data ; Retrospective Studies ; Stomach Neoplasms/surgery
Language	English
Publishing date	2020-01-02
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	2182571-3
ISSN	1553-3514 ; 1553-3506
ISSN (online)	1553-3514
ISSN	1553-3506
DOI	10.1177/1553350619894836
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Book ; Online: L-AutoDA

Guo, Ping / Liu, Fei / Lin, Xi / Zhao, Qingchuan / Zhang, Qingfu

Leveraging Large Language Models for Automated Decision-based Adversarial Attacks

2024

Abstract: In the rapidly evolving field of machine learning, adversarial attacks present a significant challenge to model robustness and security. Decision-based attacks, which only require feedback on the decision of a model rather than detailed probabilities or ... ...

Abstract	In the rapidly evolving field of machine learning, adversarial attacks present a significant challenge to model robustness and security. Decision-based attacks, which only require feedback on the decision of a model rather than detailed probabilities or scores, are particularly insidious and difficult to defend against. This work introduces L-AutoDA (Large Language Model-based Automated Decision-based Adversarial Attacks), a novel approach leveraging the generative capabilities of Large Language Models (LLMs) to automate the design of these attacks. By iteratively interacting with LLMs in an evolutionary framework, L-AutoDA automatically designs competitive attack algorithms efficiently without much human effort. We demonstrate the efficacy of L-AutoDA on CIFAR-10 dataset, showing significant improvements over baseline methods in both success rate and computational efficiency. Our findings underscore the potential of language models as tools for adversarial attack generation and highlight new avenues for the development of robust AI systems. Comment: Under Review of IJCNN 2024
Keywords	Computer Science - Cryptography and Security ; Computer Science - Artificial Intelligence ; Computer Science - Computer Vision and Pattern Recognition ; Computer Science - Machine Learning
Subject code	006
Publishing date	2024-01-27
Publishing country	us
Document type	Book ; Online
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Article: Effect Of Surgical Safety Checklists On Gastric Cancer Outcomes: A Single-Center Retrospective Study.

Yu, Deliang / Zhao, Qingchuan

Cancer management and research

2019 Volume 11, Page(s) 8845–8853

Abstract: Aims: Surgery is the primary treatment option for patients with gastric cancer, however the rate of postoperative complications are still high. The implementation of surgical safety checklists (SSCs) has been shown to reduce morbidity and mortality. ... ...

Abstract	Aims: Surgery is the primary treatment option for patients with gastric cancer, however the rate of postoperative complications are still high. The implementation of surgical safety checklists (SSCs) has been shown to reduce morbidity and mortality. This study aimed to evaluate the effect of SSCs on the clinical outcomes of gastric cancer. Methods: A total of 881 gastric cancer patients who underwent D2 gastrectomy from May 2009 to April 2011 in a large teaching hospital in China were included in this retrospective study. Patients were matched and divided into the control group (SSC nonimplementation) and intervention group (SSC implementation). The outcomes including intraoperative condition, postoperative complications, and prognosis were then compared between the groups. Results: The control group comprised 414 patients (47.0%), and the intervention group included 467 patients (53.0%). Patients in the intervention group had a significantly shorter length of postoperative stay (P < 0.001). Operation time, blood loss, blood transfusion, and hospital charges were comparable between the two groups (all P > 0.05). SSC was not associated with postoperative complications (all P > 0.05). Overall survival was also comparable between patients in the two groups (P > 0.05). Conclusion: The implementation of an SSC was associated with a decreased length of postoperative stay in gastric cancer patients following D2 gastrectomy but did not significantly affect the other outcomes.
Language	English
Publishing date	2019-10-08
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2508013-1
ISSN	1179-1322
ISSN	1179-1322
DOI	10.2147/CMAR.S218686
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Book ; Online: AVA

Meng, Xiangtao / Wang, Li / Guo, Shanqing / Ju, Lei / Zhao, Qingchuan

Inconspicuous Attribute Variation-based Adversarial Attack bypassing DeepFake Detection

2023

Abstract: While DeepFake applications are becoming popular in recent years, their abuses pose a serious privacy threat. Unfortunately, most related detection algorithms to mitigate the abuse issues are inherently vulnerable to adversarial attacks because they are ... ...

Abstract	While DeepFake applications are becoming popular in recent years, their abuses pose a serious privacy threat. Unfortunately, most related detection algorithms to mitigate the abuse issues are inherently vulnerable to adversarial attacks because they are built atop DNN-based classification models, and the literature has demonstrated that they could be bypassed by introducing pixel-level perturbations. Though corresponding mitigation has been proposed, we have identified a new attribute-variation-based adversarial attack (AVA) that perturbs the latent space via a combination of Gaussian prior and semantic discriminator to bypass such mitigation. It perturbs the semantics in the attribute space of DeepFake images, which are inconspicuous to human beings (e.g., mouth open) but can result in substantial differences in DeepFake detection. We evaluate our proposed AVA attack on nine state-of-the-art DeepFake detection algorithms and applications. The empirical results demonstrate that AVA attack defeats the state-of-the-art black box attacks against DeepFake detectors and achieves more than a 95% success rate on two commercial DeepFake detectors. Moreover, our human study indicates that AVA-generated DeepFake images are often imperceptible to humans, which presents huge security and privacy concerns.
Keywords	Computer Science - Computer Vision and Pattern Recognition ; Computer Science - Cryptography and Security
Subject code	006
Publishing date	2023-12-14
Publishing country	us
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: S100A9 as a novel diagnostic and prognostic biomarker in human gastric cancer.

Zhao, Zhanwei / Zhang, Chaojun / Zhao, Qingchuan

Scandinavian journal of gastroenterology

2020 Volume 55, Issue 3, Page(s) 338–346

Abstract: Objective: ...

Abstract	Objective:
MeSH term(s)	Biomarkers, Tumor/metabolism ; Calgranulin B/metabolism ; Carcinogenesis ; Case-Control Studies ; Disease Progression ; Female ; Gastritis, Atrophic/diagnosis ; Gastritis, Atrophic/pathology ; Humans ; Immunohistochemistry ; Male ; Metaplasia/diagnosis ; Metaplasia/pathology ; Middle Aged ; Multivariate Analysis ; Prognosis ; Stomach/pathology ; Stomach Neoplasms/diagnosis ; Stomach Neoplasms/metabolism ; Stomach Neoplasms/mortality ; Stomach Neoplasms/pathology ; Survival Analysis
Chemical Substances	Biomarkers, Tumor ; Calgranulin B ; S100A9 protein, human
Language	English
Publishing date	2020-03-15
Publishing country	England
Document type	Journal Article
ZDB-ID	82042-8
ISSN	1502-7708 ; 0036-5521
ISSN (online)	1502-7708
ISSN	0036-5521
DOI	10.1080/00365521.2020.1737883
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Zs.A 567: Show issues

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Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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Jg. 1995 - 2021: Lesesall (1.OG)
ab Jg. 2022: Lesesaal (EG)

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Article: Comprehensive Analysis of Alternative Polyadenylation Events Associated with the Tumor Immune Microenvironment in Colon Adenocarcinoma.

Pang, Fangning / Yang, Peng / Wang, Tongfei / Li, Xuzhao / Wu, Xiaoyong / Yue, Rong / Bai, Bin / Zhao, Qingchuan

Current genomics

2023 Volume 24, Issue 1, Page(s) 48–61

Abstract: Objective: Colon adenocarcinoma (COAD) is one of the leading causes of cancer death worldwide. Alternative polyadenylation (APA) is relevant to the variability of the 3'-UTR of mRNA. However, the posttranscriptional dysregulation of APA in COAD is ... ...

Abstract	Objective: Colon adenocarcinoma (COAD) is one of the leading causes of cancer death worldwide. Alternative polyadenylation (APA) is relevant to the variability of the 3'-UTR of mRNA. However, the posttranscriptional dysregulation of APA in COAD is poorly understood. Methods: We collected APA data from The Cancer Genome Atlas (TCGA) COAD (n =7692). APA events were evaluated using PDUI values, and the prognostically significant APA events were screened by LASSO Cox regression to construct a prognostic model. Then, prognostic model functions and possible regulatory genes of characteristic APA events were analyzed. Finally, the immune regulatory network based on APA regulatory genes was analyzed and established. Results: A total of 95 APA events were found to influence the COAD outcomes. Among them, 39 genes were screened as characteristic prognostic APA events by LASSO Cox regression to construct a COAD prognostic signature. The analysis results suggested that a high signature score was associated with poor prognosis and was significantly correlated with a variety of immune cells, including NK and Th1, 2 and 17 cells. Further analysis showed that APA regulators mainly served roles in the prognosis of COAD. Based on the above results, we constructed an immunoregulatory network for APA regulatory genes-APA genes-immune cells. Conclusion: Our study revealed that APA events in COAD may regulate tumor progression by influencing immune cells, which provides a new direction for exploring the influencing mechanism of the tumor immune microenvironment and is expected to provide a potential new target for COAD immunotherapy.
Language	English
Publishing date	2023-11-02
Publishing country	United Arab Emirates
Document type	Journal Article
ZDB-ID	2033677-9
ISSN	1875-5488 ; 1389-2029
ISSN (online)	1875-5488
ISSN	1389-2029
DOI	10.2174/1389202924666230503122134
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Zs.A 5571: Show issues

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Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
Jg. 1995 - 2021: Lesesall (2.OG)
ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Association of adherence to the enhanced recovery after surgery pathway and outcomes after laparoscopic total gastrectomy.

Hao, Yiming / Zhao, Qingchuan / Jiang, Kun / Feng, Xiangying / Ma, Yumei / Zhang, Jianzhong / Han, Xi'an / Ji, Gang / Dong, Hailong / Nie, Huang

BMC anesthesiology

2024 Volume 24, Issue 1, Page(s) 110

Abstract: Objective: The current study used a composite outcome to investigate whether applying the ERAS protocol would enhance the recovery of patients undergoing laparoscopic total gastrectomy (LTG).: Exposures: Laparoscopic total gastrectomy and ... ...

Abstract	Objective: The current study used a composite outcome to investigate whether applying the ERAS protocol would enhance the recovery of patients undergoing laparoscopic total gastrectomy (LTG). Exposures: Laparoscopic total gastrectomy and perioperative interventions were the exposure. An ERAS clinical pathway consisting of 14 items was implemented and assessed. Patients were divided into either ERAS-compliant or non-ERAS-compliant group according the adherence above 9/14 or not. Main outcomes and measures: The primary study outcome was a composite outcome called 'optimal postoperative recovery' with the definition as below: discharge within 6 days with no sever complications and no unplanned re-operation or readmission within 30 days postoperatively. Univariate logistic regression analysis and multivariate logistic regression analysis were used to model optimal postoperative recovery and compliance, adjusting for patient-related and disease-related characteristics. Results: A total of 252 patients were included in this retrospective study, 129 in the ERAS compliant group and 123 in the non-ERAS-compliant group. Of these, 79.07% of the patients in ERAS compliant group achieved optimal postoperative recovery, whereas 61.79% of patients in non-ERAS-compliant group did (P = 0.0026). The incidence of sever complications was lower in the ERAS-compliant group (1.55% vs. 6.5%, P = 0.0441). No patients in ERAS compliant group had unplanned re-operation, whereas 5.69% (7/123) of patients in non-ERAS-compliant group had (p = 0.006). The median length of the postoperative hospital stay was shorter in the in the ERAS compliant group (5.51 vs. 5.68 days, P = 0.01). Both logistic (OR 2.01, 95% CI 1.21-3.34) and stepwise regression (OR 2.07, 95% CI 1.25-3.41) analysis showed that high overall compliance with the ERAS protocol facilitated optimal recovery in such patients. In bivariate analysis of compliance for patients who had an optimal postoperative recovery, carbohydrate drinks (p = 0.0196), early oral feeding (P = 0.0043), early mobilization (P = 0.0340), and restrictive intravenous fluid administration (P < 0.0001) were significantly associated with optimal postoperative recovery. Conclusions and relevance: Patients with higher ERAS compliance (almost 70% of the accomplishment) suffered less severe postoperative complications and were more likely to achieve optimal postoperative recovery.
MeSH term(s)	Humans ; Laparoscopy/methods ; Enhanced Recovery After Surgery ; Retrospective Studies ; Gastrectomy/methods ; Length of Stay ; Postoperative Complications/epidemiology
Language	English
Publishing date	2024-03-22
Publishing country	England
Document type	Journal Article
ZDB-ID	2091252-3
ISSN	1471-2253 ; 1471-2253
ISSN (online)	1471-2253
ISSN	1471-2253
DOI	10.1186/s12871-024-02433-9
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Article: Development and External Validation of Safe Discharge Criteria After Radical Gastrectomy.

Yu, Deliang / Wu, Xiaoyong / Li, Xuzhao / Liu, Xiaonan / Jiang, Kun / Zhao, Qingchuan / Nie, Huang

Cancer management and research

2021 Volume 13, Page(s) 5251–5261

Abstract: Aim: Enhanced recovery after surgery (ERAS) gradually shortens the length of stay but increases the rate of unplanned readmission after discharge. Currently, objective discharge criteria for patients after radical gastrectomy is lacking. This study ... ...

Abstract	Aim: Enhanced recovery after surgery (ERAS) gradually shortens the length of stay but increases the rate of unplanned readmission after discharge. Currently, objective discharge criteria for patients after radical gastrectomy is lacking. This study aimed to construct and validate a nomogram for estimation of the possibility of safe discharge on the fifth-day post radical gastrectomy. Methods: We enrolled 496 consecutive patients undergoing radical gastrectomy as the development cohort. After the fifth day of surgery, patients were assigned to the postoperative complication group and no postoperative complication group. Multivariate logistic regression analyses were performed for both groups. Then, we constructed the risk prediction model of postoperative severe complications (PSCs) and applied it to evaluate whether the patient could be discharged safely. The external validation cohort comprised 245 patients, whom we used to evaluate the capability of our model to predict the risk of PSCs. The primary measure was the negative predictive rate (NPR) and the area under the curve (AUC). Results: Through multivariate analysis, gender, maximum body temperature on the 4th postoperative day (POD4), oral intake and ambulatory duration on POD4, the proportion of neutrophils (≥75% or <75%) and pain score (≥4 or <4) on POD5, and defecation with 5 days after the procedure (yes or no) were identified as independent predictors for PSCs. Upon incorporation of these variables, the nomogram demonstrated a good NPR of 0.957 and 0.916 and AUC of 0.918 and 0.719 in the two cohorts, respectively. With a nomogram score of 110, patients were stratified into low and high risk of PSCs. Conclusion: The nomogram demonstrated good predictive potential for low-risk patients. It could serve as an objective safe discharge approach for patients after the fifth day of radical gastrectomy.
Language	English
Publishing date	2021-07-01
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2508013-1
ISSN	1179-1322
ISSN	1179-1322
DOI	10.2147/CMAR.S305046
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