A site to transform Pubmed publications into these bibliographic reference formats: ADS, BibTeX, EndNote, ISI used by the Web of Knowledge, RIS, MEDLINE, Microsoft's Word 2007 XML.

Guowei Che - Top 30 Publications

The 'obesity paradox' does exist in patients undergoing transcatheter aortic valve implantation for aortic stenosis: a systematic review and meta-analysis.

Most recent studies have proposed the paradoxical benefits of obesity in surgical populations. For patients who underwent transcatheter aortic valve implantation (TAVI) for aortic stenosis, the prognostic roles of obesity and high body mass index remain controversial. Therefore, the objective of this meta-analysis was to evaluate whether the 'obesity paradox' exists in patients undergoing TAVI. We searched in PubMed and EMBASE to identify the eligible articles. Odds ratios and hazard ratios with the corresponding 95% confidence intervals (CI) were adopted for synthesizing short-term and long-term survival outcomes, respectively. The level of heterogeneity and the publication bias between studies were also estimated. Finally, there were 16 studies with 12 330 patients who met the eligibility criteria and who were thus included in this review. When body mass index was analysed as a continuous variable, each increase of 1 kg/m2 was significantly associated with the lower 30-day mortality rate (odds ratio = 0.95; 95% CI = 0.93-0.97; P < 0.001) and better long-term overall survival (hazard ratio = 0.96; 95% CI = 0.94-0.97; P < 0.001) for patients undergoing TAVI. The obese patients had a significantly lower risk of 30-day mortality after TAVI than did normal patients (odds ratio = 0.69; 95% CI = 0.50-0.95; P = 0.024). Further analyses indicated that the obesity could be predictive of more favourable long-term overall survival of TAVI (hazard ratio = 0.84; 95% CI = 0.72-0.97; P = 0.021). However, we found no difference in procedural complications between the obese and normal patients. In conclusion, higher body mass index and obesity seem to have protective benefits on both short-term and long-term survival of TAVI patients. Current evidence suggests that the 'obesity paradox' may really exist in TAVI.

Can Preoperative Peak Expiratory Flow Predict Postoperative Pulmonary Complications in Lung Cancer Patients Undergoing Lobectomy?

Postoperative pulmonary complications (PPCs), especially postoperative pneumonia (POP), directly affect the rapid recovery of lung cancer patients after surgery. Peak expiratory flow (PEF) can reflect airway patency and cough efficiency. Moreover, cough impairment may lead to accumulation of pulmonary secretions which can increase the risk of PPCs. The aim of this study is to investigate the effect of preoperative PEF on PPCs in patients with lung cancer.

Enhanced Lung Recovery after Surgery, Is It A Necessary for Precision Therapy?

The concept of enhanced recovery after surgery (ERAS) has already been accepted by almost all the clinicians and nurses, the practice of which is based on interdisciplinary cooperation. The reason is still unclear why the effect of ERAS varies a lot though the same ERAS scheme is used. The main cause may be the same ERAS scheme can not be suitable for different patients. In other words, does ERAS also need to conform to Precision Medicine Theory? This study is focused on the necessity and clinical efficacy of "Precision ERAS" performed in lung cancer patients. The conclusions are the following: first of all, an accurate judgment of patients who need ERAS should be done properly before surgery, which means that the high risks assessment should be done accurately. Secondly, a specific ERAS scheme should be carried out in each independent patient who has obvious clinical symptoms in order to alleviate clinical symptoms and improve the ptients' quality of life (QOL). Thirdly, for the asymptomatic patitents who also don't have severe concomitant diseases, process-optimized ERAS should be selected to make patients feel more comfortable and shorten the average length of stay (ALOS). To summary, "subtraction" instead of "addition" should be considered when performing ERAS.

Short-term high-intensity rehabilitation in radically treated lung cancer: a three-armed randomized controlled trial.

The feasibility and practicality of preoperative rehabilitation (PR) programs remains quite controversial in the treatment of lung cancer (LC). This study explored whether a short-term high-intensity rehabilitation program could improve postoperative outcomes compared to those achieved with conventional inspiratory muscle training (IMT).

Simplification and Validation of Leicester Cough Questionnaire in Mandarin-Chinese.

Patients often have cough after lung surgery, and there is a lack of tools to specifically assess postoperative coughs. LCQ-MC (Leicester Cough Questionnaire in Mandarin-Chinese) was revised and validated to explore its value on clinical application.

Validation of the Mandarin Chinese Version of the Leicester Cough Questionnaire in Patients Undergoing Lung Resection for Patients with Lung Disease.

The Mandarin Chinese version of the Leicester Cough Questionnaire (LCQ-MC) is a symptom specific questionnaire designed to assess the impact of cough severity, a major symptom of postoperative patients undergoing lung resection is cough. The aim of this study is to validate the LCQ-MC in patients with lung operation.

Evidence and Practice of Enhanced Lung Recovery after Surgery 
in Patients Undergoing Lung Surgery.

The clinic application pathway is a variant of the enhanced recovery after surgery (ERAS), which based disease and team. What are the published evidence is conducive to enhanced lung recovery after surgery (ELRAS) in clinical implementation. This article mainly from the perioperative management can adopt the measures and methods were retrospectively analyzed. The measures of education and assessment of the risk factors and prevention is emphasized in preoperative. The minimally invasive surgery and process optimization is adopted by surgeon. Postoperative focus on symptom management, such as pain is the first attention.

Body surface area is a novel predictor for surgical complications following video-assisted thoracoscopic surgery for lung adenocarcinoma: a retrospective cohort study.

Body surface area (BSA) is a biometric unit to measure the body size. Its clinical significance in video-assisted thoracoscopic surgery (VATS) was rarely understood. We aimed to estimate the predictive value of BSA for surgical complications following VATS anatomical resections for lung adenocarcinoma (LAC).

Systematic short-term pulmonary rehabilitation before lung cancer lobectomy: a randomized trial.

The goal of this study was to assess the impact of a preoperative 1-week, systematic, high-intensity inpatient exercise regimen on patients with lung cancer who had risk factors for postoperative pulmonary complications (PPCs).

Prognostic significance of soluble mesothelin in malignant pleural mesothelioma: a meta-analysis.

Soluble mesothelin is beneficial to detect the progression and the treatment response of malignant pleural mesothelioma. However, the prognostic value of soluble mesothelin in malignant pleural mesothelioma remains unclear.

Regional dietary characteristics and bronchial foreign body: a repeated misdiagnosis caused by a red pepper.

Bronchial foreign body is a common health problem worldwide, types of bronchial foreign bodies are variegated, depending on patient age and cultural background including religious beliefs as well as alimentary habits. However, misdiagnoses caused by regional dietary correlation factors were rarely concerned. In this case, a 52-year-old woman with aggravated cough and hemosputum took thoracic CT scan twice and flexible fiberoptic bronchoscopy 5 times, which all revealed the chronic pulmonary inflammation. Furthermore, the biopsies showed bronchial granulation nodule formation. With the highly suspicion of tumor, lung lobe resection was conducted. However, from the resected specimen, we belatedly found a red pepper inserted in the bronchus, without tumor cell in postoperative pathological analysis. We reviewed the case, analyzed the potential factors that may led to repeated misdiagnoses, and concluded that regional dietary characteristics and higher clinical suspicion should be seriously under consideration in the process of diagnosis.

Analysis of Postoperative Complications and Risk Factors of Patients with Lung Cancer through Clavien-Dindo Classification.

Postoperative complications (PCs) are contributing factors to patient mortality following lung resection. In this retrospective study, the Clavien-Dindo classification was used to analyze the current incidence of PCs and identify the risk factors of different grades of PCs.

Preoperatiove Airway Bacterial Colonization: the Missing Link between Non-small Cell Lung Cancer Following Lobectomy and Postoperative Pneumonia?

Surgical procedure is the main method of treating lung cancer. Meanwhile, postoperative pneumonia (POP) is the major cause of perioperative mortality in lung cancer surgery. The preoperative pathogenic airway bacterial colonization is an independent risk factor causing postoperative pulmonary complications (PPC). This cross-sectional study aimed to explore the relationship between preoperative pathogenic airway bacterial colonization and POP in lung cancer and to identify the high-risk factors of preoperative pathogenic airway bacterial colonization.

Enhanced Recovery after Surgery from Theory to Practice
What do We Need to Do?

Enhanced recovery after surgery (ERAS) is a paradigm shift in perioperative care, resulting in substantial improvements in clinical outcomes, shorter length of hospital stay and cost savings. But the current ERAS either by application of breadth or depth is not enough, why? The main reason is the lack of "operability, evaluation, repetition" ERAS protocol and suitable for clinical extensive application protocol. How to form the clinical available protocol? Operational mainly refers to the clinical scheme is simple and feasible, and protocol compliance is good; Evaluate refers to the methods used before, during and after are the objective evaluation criteria and plan; Repeatable is clinical scheme repeatability in the process of single or multiple center.

Surfactant Protein-D: A sensitive predictor for efficiency of preoperative pulmonary rehabilitation.

Surfactant Protein D (SP-D) as a lung-derived biomarker for inflammatory lung disease is being studied in depth. Meanwhile, the Pre-operative Rehabilitation Program (PRP) has been proposed as an effective treatment to reduce the incidence of Post-operative Pulmonary Complications (PPCs) and further improve quality of life. However, the relationship between serum SP-D levels and PRP remains unclear. This study aimed to explore the correlation between these two phenomena and validate the feasibility of using preoperative serum SP-D levels to predict or assess the effectiveness of PRP.

Does the fissureless technique decrease the incidence of prolonged air leak after pulmonary lobectomy?

A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was whether the fissureless technique can reduce the incidence of prolonged air leak (PAL) after pulmonary lobectomy. Altogether 18 papers were found using the reported search, of which 1 prospective randomized study and 4 retrospective cohort studies represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Four studies demonstrated that the fissureless technique used in pulmonary lobectomy was superior to conventional lobectomy in terms of preventing PAL and shortening the time to air leak cessation. One study showed no difference in PAL formation between these 2 procedures. The definitions for PAL as defined by duration was >5 days in 4 studies and >7 days in 1 study. Current evidence demonstrates that the fissureless technique can significantly decrease the development of PAL and time to air leak cessation after pulmonary lobectomy.

Assessing the Current Status of Enhanced Recovery after Surgery in the Usage of Web-based Survey Questionnaires by Thoracic Surgeons and Nurses Attending the Meeting in Mainland China.

Though the concept of enhanced recovery after surgery (ERAS) has been progressively known by the surgeons and applied clinically, the current status of its cognition among thoracic surgeons and application in thoracic surgery is still unknown. Based on the analysis of a survey of thoracic surgeons and nurses on chest ERAS during a national conference, we aimed to analyze the status and difficulties of the application of ERAS in thoracic surgery.

Genetic alterations and epigenetic alterations of cancer-associated fibroblasts.

Cancer-associated fibroblasts (CAFs) are one major type of component identified in the tumor microenvironment. Studies have focused on the genetic and epigenetic status of CAFs, since they are critical in tumor progression and differ phenotypically and functionally from normal fibroblasts. The present review summarizes the recent achievements in understanding the gene profiles of CAFs and pays special attention to their possible epigenetic alterations. A total of 7 possible genetic alterations and epigenetic changes in CAFs are discussed, including gene differential expression, karyotype analysis, gene copy number variation, loss of heterozygosis, allelic imbalance, microsatellite instability, post-transcriptional control and DNA methylation. These genetic and epigenetic characteristics are hypothesized to provide a deep understanding of CAFs and a perspective on their clinical significance.

Systematic review of prognostic roles of body mass index for patients undergoing lung cancer surgery: does the 'obesity paradox' really exist?

The paradoxical benefit of obesity, the 'obesity paradox', has been recently identified in surgical populations. Our goal was to evaluate by a systematic review with meta-analysis the prognostic role of body mass index (BMI) and to identify whether the 'obesity paradox' exists in lung cancer surgery. Comprehensive literature retrieval was conducted in PubMed to identify the eligible articles. The odds ratios (OR) and hazard ratios (HR) with the corresponding 95% confidence intervals (CI) were used to synthesize in-hospital and long-term survival outcomes, respectively. The heterogeneity level and publication bias between studies were also estimated. Finally, 25 observational studies with 78 143 patients were included in this review. The pooled analyses showed a significantly better long-term survival rate in patients with higher BMI, but no significant benefit of increased BMI was found for in-hospital morbidity. The pooled analyses also showed that overall morbidity (OR: 0.84; 95% CI: 0.73-0.98; P  =   0.025) and in-hospital mortality (OR: 0.78; 95% CI: 0.63-0.98; P  =   0.031) were significantly decreased in obese patients. Obesity could be a strong predictor of the favourable long-term prognosis of lung cancer patients (HR: 0.69; 95% CI: 0.56-0.86; P  =   0.001). The robustness of these pooled estimates was strong. No publication bias was detected. In summary, obesity has favourable effects on in-hospital outcomes and long-term survival of surgical patients with lung cancer. The 'obesity paradox' does have the potential to exist in lung cancer surgery.

Seven-day intensive preoperative rehabilitation for elderly patients with lung cancer: a randomized controlled trial.

As a newly developed treatment, preoperative pulmonary rehabilitation (PR) has been studied in depth. However, few studies have assessed the relationship between advanced age and a shorter term intensive pattern of preoperative PR in patients with lung cancer (LC) and especially those patients waiting for therapeutic LC surgeries. This study investigated short-term preoperative PR combined with inspiratory muscle training (IMT) and aerobic endurance training in elderly patients scheduled to undergo LC lobectomy.

Review of primary extra-adrenal myelolipoma of the thorax.

Extra-adrenal myelolipoma happens in adrenal glands, and the thoracic location is extremely unusual. This is the first study involving 36 of patients with thoracic myelolipoma of English literature by investigating the clinical data, pathologic findings, radiological manifestation, and treatment strategy of all patients. Imageologic diagnosis including computed tomography, magnetic resonance imaging, and positron emission tomography/computed tomography scans is useful to identify the feature of extra-adrenal myelolipoma. Pathologic analysis is an effective method to clarify the diagnosis. In view of the potential progressive enlargement of the lesion, most myelolipomas are removed by surgery, and this operation has frequently been accomplished by using video-assisted thoracic surgery.

What is Result: Short-term Medium Chain Triglyceride Diet Effective on
Postoperative Outcome in Lung Cancer Surgery? A Prospective Randomized Study.

It has been proven that medium chain triglyceride (MCT) diet was contribute to fast track recovery after surgery in patients with operation. In this study, the benefit of postoperative short term MCT diet support was investigated for non-small cell lung cancer patients who underwent anatomic resection.

Impact and Effect of Preoperative Short-term Pulmonary Rehabilitation Training on 
Lung Cancer Patients with Mild to Moderate Chronic Obstructive Pulmonary Disease: 
A Randomized Trial.

Pulmonary rehabilitation (PR) is proposed as an effective strategy to decrease surgical morbidity. However, appropriate rehabilitation plan, initiation time, and optimal duration of PR remain unclear. Lung cancer patients with chronic obstructive pulmonary disease (COPD) are considered high-risk population for postoperative pulmonary complications (PPCs) because of poor lung fitness and cardiopulmonary endurance. This study aims to assess the impact of a one-week, systematic and highly-intensive rehabilitation on surgical lung cancer patients with mild to moderate COPD.

Clinicopathological and prognostic significance of mTOR and phosphorylated mTOR expression in patients with esophageal squamous cell carcinoma: a systematic review and meta-analysis.

Mammalian target of rapamycin (mTOR) is a serine/threonine protein kinase responsible for regulating ribosomal biogenesis and protein synthesis. Dysregulation of mTOR contributes to tumorigenesis, angiogenesis, cellular growth and metastasis but its roles in esophageal squamous cell carcinoma (ESCC) are controversial. Therefore, the objective of this study is to evaluate the prognostic and clinicopathological significance of mTOR/p-mTOR expression in ESCC.

A rare case of primary peripheral epithelial myoepithelial carcinoma of lung: Case report and literature review.

Primary salivary gland-type tumors of lung are rare. Epithelial-myoepithelial carcinoma (EMC) of the lung is a minor salivary gland-type tumor subtype.

Letter to the Editor: More on Achalasia with Megaesophagus.

Clinicopathological and prognostic significance of heat shock protein 27 (HSP27) expression in non-small cell lung cancer: a systematic review and meta-analysis.

Numbers of clinical and experimental investigations have provided increasing evidences to demonstrate that heat shock protein 27 (HSP27) is a qualified predictor for many cancers. However, no consensus has been reached on its clinicopathological and prognostic significance in patients with non-small cell lung cancer (NSCLC). Therefore, we performed this systematic meta-analysis to help addressing this issue. PubMed, EMBASE, the Web of Science and China National Knowledge Infrastructure were searched for full-text literatures met out eligibility criteria. We determined the odds ratio (OR) and hazard ratio (HR) as the appropriate summarized statistics for assessments of clinicopathological and prognostic roles of HSP27, respectively. Q-test and I(2)-statistic were used to evaluate the level of heterogeneity. Sensitivity analysis was conducted to examine the stability of overall estimates. Potential publication bias was detected by Begg's test and Egger's test. Finally, ten articles were identified to be included into our meta-analysis. The pooled analyses suggested that HSP27 expression was significantly associated with the unfavorable conditions for differentiation degree, lymphatic metastasis, clinical stage, squamous cell carcinoma and tumor size. However, HSP27 expression had no significant relationship to gender, age and smoking status. Meanwhile, pooled HRs indicated that HSP27 expression could be a predictor for a lower 5-year overall survival (OS) rate (HR: 1.832; 95 % CI 1.322-2.538; P < 0.001) but not for 1-year OS of NSCLC (HR: 0.885; 95 % CI 0.140-5.599; P = 0.896). In conclusion, our meta-analysis demonstrates that HSP27 expression may be a strong biomarker to predict both the poor clinicopathological and prognostic characteristics in patients with NSCLC.

Method for discriminating synchronous multiple lung cancers of the same histological type: miRNA expression analysis.

With the development of imaging technology, an increasing number of synchronous multiple lung cancers (SMLCs) have been diagnosed in recent years. Patients with >1 tumor are diagnosed with either synchronous multiple primary lung cancers (SMPLCs) or other primary tumors and metastases. Clinical guidelines, histological characteristics, and molecular diagnostics have been used to discriminate SMPLCs from other multiple lung cancers. However, there is still ambiguity in the diagnosis of SMPLCs of the same histological type. We enrolled 24 patients with the same histological type of SMLCs and assessed their status using established clinical guidelines, comprehensive histological subtyping, and molecular analysis. The sum value of the differential microRNA (miRNA) expression profiles (ΔΔCt) with matched tumors was evaluated to discriminate SMPLCs of the same histological type from metastases. Twelve patients with lymph node metastases were included for comparison, and the sum value of the ΔΔCt of 5 miRNAs between primary tumors and lymph node metastases was <9. Patients definitively diagnosed with SMPLCs by integrated analysis were also classified as SMPLCs by miRNA analysis; 6 patients showed conflicting diagnoses by integrated and miRNA analysis and 14 were given the same classification. Analysis of miRNA expression profiles is considered to be a useful tool for discriminating SMPLCs from intrapulmonary metastases.

Incidence, risk factors and prognosis of postoperative atrial arrhythmias after lung transplantation: a systematic review and meta-analysis.

Postoperative atrial arrhythmia is the most common dysrhythmia seen after lung transplantation. However, risk factors for postoperative atrial arrhythmias and their impact on outcomes were inconsistent. The aim of our study was to conduct a meta-analysis to analyse risk factors of postoperative atrial arrhythmias and the impact of postoperative atrial arrhythmias on outcomes after lung transplantation. All eligible articles from MEDLINE, EMBASE, CENTRAL and the Chinese BioMedical Literature Database (until November 2015) were incorporated into this study. We extracted the data from the included studies and performed a meta-analysis to evaluate predictors for postoperative atrial arrhythmias and their impact on outcomes. R software and STATA 13.0 software were used for the meta-analysis. A total of 2094 patients from 11 studies were included in this meta-analysis. The pooled incidence of postoperative atrial arrhythmias after lung transplantation was 31% [95% confidence interval (CI), 25-37%]. We found that gender (female versus male) with an odds ratio (OR) of 0.44 (95% CI 0.35-0.56, P < 0.001), age (>50 vs ≤50 or atrial arrhythmias versus non-atrial arrhythmias) with OR of 2.73 (95% CI 1.86-4.00, P < 0.001) and weighted mean difference (WMD) of 5.88 years (95% CI 3.69-8.07, P < 0.001), history of atrial arrhythmias with OR of 1.76 (95% CI 1.34-2.32, P = 0.002), vasopressor use with OR of 1.76 (95% CI 1.34-2.32, P < 0.001), cystic fibrosis with OR of 0.32 (95% CI 0.18-0.59, P < 0.001), interstitial lung disease with OR of 1.85 (95% CI 1.27-2.71, P = 0.001), hypertension with OR of 1.49 (95% CI 1.12-1.97, P = 0.006), coronary artery disease with OR of 1.58 (95% CI 1.20-2.08, P = 0.001), hyperlipidaemia with OR of 1.52 (95% CI 1.06-2.20, P = 0.025) and left atrial enlargement with OR of 2.99 (95% CI 1.91-4.67, P < 0.001) were significantly associated with postoperative atrial arrhythmias after lung transplantation. Postoperative atrial arrhythmias had a significant influence on length of stay (WMD 9.72, 95% CI 5.07-14.38, P < 0.001) and overall survival (OS) (hazard ratio 1.72, 95% CI 1.39-2.12, P < 0.001) after lung transplantation. In conclusion, the significant risk factors for postoperative atrial arrhythmias were gender, age, history of atrial arrhythmias, vasopressor use, cystic fibrosis, interstitial lung disease, hypertension, coronary artery disease, hyperlipidaemia, cardiac index and left atrial size. Development of postoperative atrial arrhythmias has prognostic implications for length of stay and overall survival after lung transplantation. Prospective and randomized trials are needed to address these issues in the future.

Classification and Risk-factor Analysis of Postoperative Cardio-pulmonary 
Complications after Lobectomy in Patients with Stage I Non-small Cell Lung Cancer.

There are incresing lung cancer patients detected and diagnosed at the intermediate stage when the pre-malignant or early lesions are amenable to resection and cure, owing to the progress of medical technology, the renewal of detection methods, the popularity of medical screening and the improvement of social health consciousness. The aim of this study is to investigate the risk factors of the occurrence of postoperative cardio-pulmonary complications in stage I non-small cell lung cancer (NSCLC) patients, based on routine laboratory tests, basic characteristics, and intraoperative variables in hospital.