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

Successful phased approach to a patient with synchronous traumatic descending aortic pseudoaneurysm and bronchial rupture.

A 34-year-old woman was referred to our center because of collapsed left lung and left main bronchial stenosis 1 week after a vehicular accident. Bronchoscopic observation revealed stenosis in the left main and lobar bronchus. Computed tomography (CT) angiography found traumatic descending aortic pseudoaneurysm after admission. Phased intervention strategy was adopted. The aortic rupture was repaired with endovascular stent firstly, followed by sleeve reconstruction of the left main bronchus through posterolateral thoracotomy 11 days later. She recovered uneventfully and resulted in an excellent long-term outcome. The diagnosis and treatment of this case is discussed.

Estimated intraoperative blood loss correlates with postoperative cardiopulmonary complications and length of stay in patients undergoing video-assisted thoracoscopic lung cancer lobectomy: a retrospective cohort study.

The purpose of our study was to estimate the influence of estimated intraoperative blood loss (EIBL) on postoperative cardiopulmonary complications (PCCs) in patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy for non-small-cell lung cancer (NSCLC).

Is surgical Apgar score an effective assessment tool for the prediction of postoperative complications in patients undergoing oesophagectomy?

A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was whether the surgical Apgar score (SAS) was an effective assessment tool for the prediction of postoperative complications in patients undergoing oesophagectomy. In total, 7 papers were identified using the reported search, of which 6 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. Five of 6 cohort studies demonstrated that a low SAS was significantly associated with more postoperative complications in patients undergoing oesophagectomy. The rates of major individual complications in patients with a lower SAS were commonly higher than those in patients with a higher SAS. Two cohort studies further reported that a low SAS was significantly associated with the prolonged length of stay. The cut-off value of the SAS that had the discriminative power for patients who were considered at high morbidity risk, however, was not defined but was more likely to be 6 or less. Current available evidence suggests that the SAS system may serve as an effective assessment tool for the prediction of morbidity risk after oesophagectomy.

Characteristics of genomic alterations of lung adenocarcinoma in young never-smokers.

Non-small-cell lung cancer (NSCLC) has been recognized as a highly heterogeneous disease with phenotypic and genotypic diversity in each subgroup. While never-smoker patients with NSCLC have been well studied through next generation sequencing, we have yet to recognize the potentially unique molecular features of young never-smoker patients with NSCLC. In this study, we conducted whole genome sequencing (WGS) to characterize the genomic alterations of 36 never-smoker Chinese patients, who were diagnosed with lung adenocarcinoma (LUAD) at 45 years or younger. Besides the well-known gene mutations (e.g., TP53 and EGFR), our study identified several potential lung cancer-associated gene mutations that were rarely reported (e.g., HOXA4 and MST1). The lung cancer-related copy number variations (e.g., EGFR and CDKN2A) were enriched in our cohort (41.7%, 15/36) and the lung cancer-related structural variations (e.g., EML4-ALK and KIF5B-RET) were commonly observed (22.2%, 8/36). Notably, new fusion partners of ALK (SMG6-ALK) and RET (JMJD1C-RET) were found. Furthermore, we observed a high prevalence (63.9%, 23/36) of potentially targetable genomic alterations in our cohort. Finally, we identified germline mutations in BPIFB1 (rs6141383, p.V284M), CHD4 (rs74790047, p.D140E), PARP1 (rs3219145, p.K940R), NUDT1 (rs4866, p.V83M), RAD52 (rs4987207, p.S346*), and MFI2 (rs17129219, p.A559T) were significantly enriched in the young never-smoker patients with LUAD when compared with the in-house noncancer database (p < 0.05). Our study provides a detailed mutational portrait of LUAD occurring in young never-smokers and gives insights into the molecular pathogenesis of this distinct subgroup of NSCLC.

What is Enhanced Recovery After Surgery: Humanity or Technology?

The development of surgical techniques and the innovation of surgical instruments promote the changes in surgical methods, which in turn, leads to the reforms of surgical idea. The concept of enhanced recovery after surgery (ERAS) results in the surgery connotation switching from "to treat an illness" to "to save patients". ERAS also causes the change of surgery denotation from "only operation" to "enhance recovery". The concept of ERAS is derived from but not only restricted to the development of surgical techniques. Also, ERAS pays more attention to patients than disease and thinks more about patient safety and recovery than surgical technique. Specifically, ERAS has three advantages: first, ERAS attaches importance to multidisciplinary assessment (patient-oriented) and select appropriate (personalized) treatment and tries to decrease the rate of complication and mortality. Second, ERAS pays attention to preoperative preparation and high-risk prevention performed by multi-disciplinary collaboration in order to prevent complication and save cost for patients. Third, ERAS always focus on optimizing the process of perioperative period and trying to change the working habits of surgeons and the old cooperation mode among doctors, nurses and rehabilitation physicians. To sum up, the goal is to apply the concept of ERAS to all the links of perioperative period and try hard to decrease patients' stress and pain, which finally helps doctors fulfill the ultimate aims of "no pain and no risk".

Effects of degree of pulmonary fissure completeness on major in-hospital outcomes after video-assisted thoracoscopic lung cancer lobectomy: a retrospective-cohort study.

To evaluate the clinical significance of degree of pulmonary fissure completeness (PFC) on major in-hospital outcomes following video-assisted thoracoscopic (VATS) lobectomy for non-small-cell lung cancer (NSCLC).

Validation of the Mandarin Chinese version of the Leicester Cough Questionnaire in non-small cell lung cancer patients after surgery.

There are no validated and reliable cough-specific instruments to assess health-related quality of life with respect to postoperative cough in non-small cell lung cancer (NSCLC) patients. We used the Leicester Cough Questionnaire in Mandarin-Chinese (LCQ-MC) and investigated the validity, reliability, and repeatability of this instrument.

Establishment and Optimization of Enhanced Recovery after Surgery System 
for Lung Cancer.

With the development of key techniques and programs, the concept of enhanced recovery after surgery (ERAS) has been utilized in a wide range of diseases and surgical specialties. The key technological elements of enhanced lung recovery after surgery (ELRAS), which is regarded as the mainstay of minimally invasive lung cancer surgery, consist of the airway management and the lung protection. A multidisciplinary team cooperation based on physicians, nurses and rehabilitative therapists is needed to achieve the goals of airway management and lung protection, thus establishing a comprehensive ELRAS system for lung cancer patients. Such ELRAS systems should meet the following demands: firstly, there are accurate and objective assessment models for each section in an ELRAS program; secondly, the ELRAS protocols should be made as simple and repeatable as possible; thirdly, there are rigorous evaluation systems for the clinical efficacy of an ELRAS program; finally, a question-oriented team should be constructed in an ELRAS program. In summary, the ELRAS system needs to be constantly optimized and improved in the clinical practices.

Short-term inpatient-based high-intensive pulmonary rehabilitation for lung cancer patients: is it feasible and effective?

This study was conducted to develop a preoperative in-hospital short-term rehabilitation program for surgical lung cancer patients, and investigate its feasibility, potential cost benefit and effectiveness on outcome measures including reduction of postoperative pulmonary complications (PPCs) and postoperative length of stay.

Enhanced recovery programs in lung cancer surgery: systematic review and meta-analysis of randomized controlled trials.

Enhanced recovery after surgery (ERAS) program is an effective evidence-based multidisciplinary protocol of perioperative care, but its roles in thoracic surgery remain unclear. This systematic review of randomized controlled trials (RCTs) aims to investigate the efficacy and safety of the ERAS programs for lung cancer surgery.

Current Status of Prevention and Nursing on Venous Thromboembolism among Perioperative Patients with Lung Cancer.

The purpose of this study was to explore the status of prevention and nursing on venous thromboembolism (VTE) among perioperative patients with lung cancer in Chinese hospital.

Degree of pulmonary fissure completeness can predict postoperative cardiopulmonary complications and length of hospital stay in patients undergoing video-assisted thoracoscopic lobectomy for early-stage lung cancer.

To estimate the effects of pulmonary fissure completeness on postoperative cardiopulmonary complications (PCCs) and hospital stay in patients undergoing video-assisted thoracoscopic surgery lobectomy for early-stage non-small-cell lung cancer.

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.