AIM:To evaluate the safety and effectiveness of twostage vs single-stage management for concomitant gallstones and common bile duct stones.METHODS:Four databases,including PubMed,Embase,the Cochrane Central Register o...AIM:To evaluate the safety and effectiveness of twostage vs single-stage management for concomitant gallstones and common bile duct stones.METHODS:Four databases,including PubMed,Embase,the Cochrane Central Register of Controlled Trials and the Science Citation Index up to September 2011,were searched to identify all randomized controlled trials(RCTs).Data were extracted from the studies by two independent reviewers.The primary outcomes were stone clearance from the common bile duct,postoperative morbidity and mortality.The secondary outcomes were conversion to other procedures,number of procedures per patient,length of hospital stay,total operative time,hospitalization charges,patient acceptance and quality of life scores.RESULTS:Seven eligible RCTs [five trials(n = 621) comparing preoperative endoscopic retrograde cholangiopancreatography(ERCP)/endoscopic sphincterotomy(EST) + laparoscopic cholecystectomy(LC) with LC + laparoscopic common bile duct exploration(LCBDE);two trials(n = 166) comparing postoperative ERCP/EST + LC with LC + LCBDE],composed of 787 patients in total,were included in the final analysis.The metaanalysis detected no statistically significant difference between the two groups in stone clearance from the common bile duct [risk ratios(RR) =-0.10,95% confidence intervals(CI):-0.24 to 0.04,P = 0.17],postoperative morbidity(RR = 0.79,95% CI:0.58 to 1.10,P = 0.16),mortality(RR = 2.19,95% CI:0.33 to 14.67,P = 0.42),conversion to other procedures(RR = 1.21,95% CI:0.54 to 2.70,P = 0.39),length of hospital stay(MD = 0.99,95% CI:-1.59 to 3.57,P = 0.45),total operative time(MD = 12.14,95% CI:-1.83 to 26.10,P = 0.09).Two-stage(LC + ERCP/EST) management clearly required more procedures per patient than single-stage(LC + LCBDE) management.CONCLUSION:Single-stage management is equivalent to two-stage management but requires fewer procedures.However,patient's condition,operator's expertise and local resources should be taken into account in making treatment decisions.展开更多
Based on the current news via Thomson Reuters "700 new regional journals in the world have been added to Web of Science since 2007",we conducted an investigation to find out that 43(6.1%) Chinese journals(in...Based on the current news via Thomson Reuters "700 new regional journals in the world have been added to Web of Science since 2007",we conducted an investigation to find out that 43(6.1%) Chinese journals(including 6 journals from Hong Kong region) are included. The results also show that up to now a total of about 153 Chinese journals(114 from China Mainland,11 from Hong Kong and 28 from Taiwan) have been included by SCI and SSCI & AHCI.展开更多
Since extrahepatic bile duct cancer is difficult to diagnose and to cure, a safe and radical surgical strategy is needed. In this review, the modes of infiltration and spread of extrahepatic bile duct cancer and surgi...Since extrahepatic bile duct cancer is difficult to diagnose and to cure, a safe and radical surgical strategy is needed. In this review, the modes of infiltration and spread of extrahepatic bile duct cancer and surgical strategy are discussed. Extended hemihepatectomy, with or without pancreatoduodenectomy (PD), plus extrahepatic bile duct resection and regional lyrnphadenectomy has recently been recognized as the standard curative treatment for hilar bile duct cancer. On the other hand, PD is the choice of treatment for middle and distal bile duct cancer. Major hepatectomy concomitant with PD (hepatopancreatoduodenectomy) has been applied to selected patients with widespread tumors. Preoperative biliary drainage (BD) followed by portal vein embolization (PVE) enables major hepatectomy in patients with hilar bile duct cancer without mortality. BD should be performed considering the surgical procedure, especially, in patients with separated intrahepatic bile ducts caused by hilar bile duct cancer. Right or left trisectoriectomy are indicated according to the tumor spread and biliary anatomy. As a result, extended radical resection offers a chance for cure of hilar bile duct cancer with improved resectability, curability, and a 5-year survival rate of 40%. A 5-year survival rate has ranged from 24% to 39% after PD for middle and distal bile duct cancer.展开更多
AIM:To compare non-liquid and clear-liquid diets,and to assess whether the latter is the optimal treatment for mild acute pancreatitis.METHODS:The Cochrane Library,PUBMED,EMBASE,EBM review databases,Science Citation I...AIM:To compare non-liquid and clear-liquid diets,and to assess whether the latter is the optimal treatment for mild acute pancreatitis.METHODS:The Cochrane Library,PUBMED,EMBASE,EBM review databases,Science Citation Index Expanded,and several Chinese databases were searched up to March 2011.Randomized controlled trials(RCTs) that compared non-liquid with clear-liquid diets in patients with mild acute pancreatitis were included.A meta-analysis was performed using available evidence from RCTs.RESULTS:Three RCTs of adequate quality involving a total of 362 participants were included in the final analysis.Compared to liquid diet,non-liquid diet significantly decreased the length of hospitalization [mean difference(MD):1.18,95% CI:0.82-1.55;P﹤0.00001] and total length of hospitalization(MD:1.31,95% CI:0.45-2.17;P = 0.003).The subgroup analysis showed solid diet was more favorable than clear liquid diet in the length of hospitalization,with a pooled MD being-1.05(95% CI:-1.43 to-0.66;P﹤0.00001).However,compared with clear liquid diet,both soft and solid diets did not show any significant differences for recurrence of pain after re-feeding,either alone [relative risk(RR):0.95;95% CI:0.51-1.87;P = 0.88] and(RR:1.22;95% CI:0.69-2.16;P = 0.49),respectively,or analyzed together as non-liquid diet(RR:0.80;95% CI:0.47-1.36;P = 0.41).CONCLUSION:The non-liquid soft or solid diet did not increase pain recurrence after re-feeding,compared with the clear-liquid diet.The non-liquid diet reduced hospitalization.展开更多
This study aimed to identify and to analyze characteristics of top-cited articles published in the Web of Science chemical engineering subject category from 1899 to 2011.Articles that have been cited more than 100 tim...This study aimed to identify and to analyze characteristics of top-cited articles published in the Web of Science chemical engineering subject category from 1899 to 2011.Articles that have been cited more than 100 times were assessed regarding publication outputs,and distribution of outputs in journals.Five bibliometric indicators were used to evaluate source countries,institution and authors.A new indicator,Y-index,was created to assess quantity and quality of contribution to articles.Results showed that 3828 articles,published between 1931 and 2010,had been cited at least 100 times.Among them 54% published before 1991,and 49% top-cited articles originated from US.The top eight productive institutions were all located in US.The top journals were Journal of Catalysis,AIChE Journal,Chemical Engineering Science and Journal of Membrane Science.Y-index was successfully applied to evaluate publication character of authors,institutions,and countries/regions.展开更多
AIM:To quantitatively assess the relationship between coffee consumption and incidence of pancreatic cancer in a meta-analysis of cohort studies. METHODS:We searched MEDLINE,EMBASE,Science Citation Index Expanded and ...AIM:To quantitatively assess the relationship between coffee consumption and incidence of pancreatic cancer in a meta-analysis of cohort studies. METHODS:We searched MEDLINE,EMBASE,Science Citation Index Expanded and bibliographies of retrieved articles.Studies were included if they reported relative risks(RRs)and corresponding 95%CIs of pancreatic cancer with respect to frequency of coffee intake.We performed random-effects meta-analyses and metaregressions of study-specific incremental estimates to determine the risk of pancreatic cancer associated with a 1 cup/d increment in coffee consumption. RESULTS:Fourteen studies met the inclusion criteria, which included 671 080 individuals(1496 cancer events) with an average follow-up of 14.9 years.Compared with individuals who did not drink or seldom drank coffee per day,the pooled RR of pancreatic cancer was 0.82 (95%CI:0.69-0.95)for regular coffee drinkers,0.86 (0.76-0.96)for low to moderate coffee drinkers,and 0.68(0.51-0.84)for high drinkers.In subgroup analyses,we noted that,coffee drinking was associated witha reduced risk of pancreatic cancer in men,while this association was not seen in women.These associations were also similar in studies from North America,Europe, and the Asia-Pacific region. CONCLUSION:Findings from this meta-analysis suggest that there is an inverse relationship between coffee drinking and risk of pancreatic cancer.展开更多
AIM: To determine the evidence-based values of prophylactic drainage in gastric cancer surgery. METHODS: One hundred and eight patients, who underwent subtotal gastrectomy with D1 or D2 lymph node dissection for gas...AIM: To determine the evidence-based values of prophylactic drainage in gastric cancer surgery. METHODS: One hundred and eight patients, who underwent subtotal gastrectomy with D1 or D2 lymph node dissection for gastric cancer between January 2001 and December 2005, were divided into drain group or no-drain group. Surgical outcome and post-operative complications within four weeks were compared between the two groups. RESULTS: No significant differences were observed between the drain group and no-drain group in terms of operating time (171 ± 42 rain vs 156 ± 39 rain), number of post-operative days until passage of flatus (3.7 ± 0.5 d vs 3.5 ± 1.0 d), number of post-operative days until initiation of soft diet (4.9±0.7 d vs 4.8±0.8 d), length of post-operative hospital stay (9.3±2.2 d vs 8.4±2.4 d), mortality rate (5.4% vs 3.8%), and overall postoperative complication rate (21.4% vs 19.2%). CONCLUSION: Prophylactic drainage placement is not necessary afer subtotal gastrectomy for gastric cancer since it does not offer additional benefits for the patients.展开更多
AIM: To evaluate survival rate and clinical outcome of cholangiocarcinoma. METHODS: The medical records of 34 patients with cholangiocarcinoma, seen at a single hospital between the years 1999-2006, were retrospecti...AIM: To evaluate survival rate and clinical outcome of cholangiocarcinoma. METHODS: The medical records of 34 patients with cholangiocarcinoma, seen at a single hospital between the years 1999-2006, were retrospectively reviewed. RESULTS: Thirty-four patients with a median age of 75 years were included. Seventeen (50%) had painless jaundice at presentation. Sixteen (47.1%) were perihilar, 15 (44.1%) extrahepatic and three (8.8%) intrahepatic. Endoscopic retrograde cholangiography (ERCP) and/or magnetic resonance cholangiography (MRCP) were used for the diagnosis. Pathologic confirmation was obtained in seven and positive cytological examination in three. Thirteen patients had co-morbidities (38.2%). Four cases were managed with complete surgical resection. All the rest of the cases (30) were characterized as non-resectable due to advanced stage of the disease. Palliative biliary drainage was performed in 26/30 (86.6%). The mean follow-up was 32 mo (95% CI, 20-43 too). Overall median survival was 8.7 mo (95% CI, 2-16 mo). The probability of 1-year, 2-year and 3-year survival was 46%, 20% and 7%, respectively. The survival was slightly longer in patients who underwent resection compared to those who did not, but this difference failed to reach statistical significance. Patients who underwent biliary drainage had an advantage in survival compared to those who did not (probability of survival 53% vs 0% at 1 year, respectively, P = 0.038). CONCLUSION: Patients with cholangiocarcinoma were usually elderly with co-morbidities and/oradvanced disease at presentation. Even though a slight amelioration in survival with palliative biliary drainage was observed, patients had dismal outcome without resection of the tumor.展开更多
AIM:To quantitatively assess the relationship between energy intake and the incidence of digestive cancers in a meta-analysis of cohort studies.METHODS:We searched MEDLINE,EMBASE,Science Citation Index Expanded,and th...AIM:To quantitatively assess the relationship between energy intake and the incidence of digestive cancers in a meta-analysis of cohort studies.METHODS:We searched MEDLINE,EMBASE,Science Citation Index Expanded,and the bibliographies of retrieved articles.Studies were included if they reported relative risks(RRs) and corresponding 95% CIs of digestive cancers with respect to total energy intake.When RRs were not available in the published article,they were computed from the exposure distributions.Data were extracted independently by two investigators and discrepancies were resolved by discussion with a third investigator.We performed fixed-effects meta-analyses and meta-regressions to compute the summary RR for highest versus lowest category of energy intake and for per unit energy intake and digestive cancer incidence by giving each study-specific RR a weight that was proportional to its precision.RESULTS:Nineteen studies consisting of 13 independent cohorts met the inclusion criteria.The studiesincluded 995 577 participants and 5620 incident cases of digestive cancer with an average follow-up of 11.1 years.A significant inverse association was observed between energy intake and the incidence of digestive cancers.The RR of digestive cancers for the highest compared to the lowest caloric intake category was 0.90(95% CI 0.81-0.98,P < 0.05).The RR for an increment of 239 kcal/d energy intake was 0.97(95% CI 0.95-0.99,P < 0.05) in the fixed model.In subgroup analyses,we noted that energy intake was associated with a reduced risk of colorectal cancer(RR 0.90,95% CI 0.81-0.99,P < 0.05) and an increased risk of gastric cancer(RR 1.19,95% CI 1.08-1.31,P < 0.01).There appeared to be no association with esophageal(RR 0.96,95% CI 0.86-1.07,P > 0.05) or pancreatic(RR 0.79,95% CI 0.49-1.09,P > 0.05) cancer.Associations were also similar in studies from North America and Europe.The RR was 1.02(95% CI 0.79-1.25,P > 0.05) when considering the six studies conducted in North America and 0.87(95% CI 0.77-0.98,P < 0.05) for the five studies from Europe.CONCLUSION:Our findings suggest that high energy intake may reduce the total digestive cancer incidence and has a preventive effect on colorectal cancer.展开更多
The role of fecal microbial transplant(FMT) in the treatment of pediatric gastrointestinal disease has become increasingly popular among pediatric practitioners, patients, and parents. The success of FMT for the treat...The role of fecal microbial transplant(FMT) in the treatment of pediatric gastrointestinal disease has become increasingly popular among pediatric practitioners, patients, and parents. The success of FMT for the treatment of recurrent Clostridium difficile infection(RCDI) has bolstered interest in its potential application to other disease states, such as inflammatory bowel disease(IBD). FMT has particular interest in pediatrics, given the concerns of patients and parents about rates of adverse events with existing therapeutic options, and the greater cumulative medication burden associated with childhoodonset disease. Published literature on the use of FMT in pediatrics is sparse. Only 45 pediatric patients treated for RCDI have been reported, and only 27 pediatric patients with pediatric IBD. The pediatric microbiome may uniquely respond to microbial-based therapies. This review will provide a comprehensive overview of fecal microbial transplant and its potential role in the treatment of pediatric inflammatory bowel disease. We will discuss the microbiome in pediatric inflammatory bowel disease, existing adult and pediatric literature on the use of FMT in IBD treatment, and pediatric FMT trials that are currently recruiting patients. This review will also discuss features of the microbiome that may be associated with host response in fecal transplant, and potential challenges and opportunities for the future of FMT in pediatric IBD treatment.展开更多
Shandong Province has its own advantage in leisure farm development aspect. But in development, it still exists the phenomenon of single product, insufficient development depth, lacking of unified planning of leisure ...Shandong Province has its own advantage in leisure farm development aspect. But in development, it still exists the phenomenon of single product, insufficient development depth, lacking of unified planning of leisure farm, professional talent shortage and leisure farm development not obtaining local cognition. The development of Shandong Province family farm should increase the support of the government guidance, strengthen scientific planning and design, innovate Shandong leisure farm brand image and implement leisure farm talent development strategy, in order to promote the healthy development of Shandong Province leisure farm.展开更多
文摘AIM:To evaluate the safety and effectiveness of twostage vs single-stage management for concomitant gallstones and common bile duct stones.METHODS:Four databases,including PubMed,Embase,the Cochrane Central Register of Controlled Trials and the Science Citation Index up to September 2011,were searched to identify all randomized controlled trials(RCTs).Data were extracted from the studies by two independent reviewers.The primary outcomes were stone clearance from the common bile duct,postoperative morbidity and mortality.The secondary outcomes were conversion to other procedures,number of procedures per patient,length of hospital stay,total operative time,hospitalization charges,patient acceptance and quality of life scores.RESULTS:Seven eligible RCTs [five trials(n = 621) comparing preoperative endoscopic retrograde cholangiopancreatography(ERCP)/endoscopic sphincterotomy(EST) + laparoscopic cholecystectomy(LC) with LC + laparoscopic common bile duct exploration(LCBDE);two trials(n = 166) comparing postoperative ERCP/EST + LC with LC + LCBDE],composed of 787 patients in total,were included in the final analysis.The metaanalysis detected no statistically significant difference between the two groups in stone clearance from the common bile duct [risk ratios(RR) =-0.10,95% confidence intervals(CI):-0.24 to 0.04,P = 0.17],postoperative morbidity(RR = 0.79,95% CI:0.58 to 1.10,P = 0.16),mortality(RR = 2.19,95% CI:0.33 to 14.67,P = 0.42),conversion to other procedures(RR = 1.21,95% CI:0.54 to 2.70,P = 0.39),length of hospital stay(MD = 0.99,95% CI:-1.59 to 3.57,P = 0.45),total operative time(MD = 12.14,95% CI:-1.83 to 26.10,P = 0.09).Two-stage(LC + ERCP/EST) management clearly required more procedures per patient than single-stage(LC + LCBDE) management.CONCLUSION:Single-stage management is equivalent to two-stage management but requires fewer procedures.However,patient's condition,operator's expertise and local resources should be taken into account in making treatment decisions.
文摘Based on the current news via Thomson Reuters "700 new regional journals in the world have been added to Web of Science since 2007",we conducted an investigation to find out that 43(6.1%) Chinese journals(including 6 journals from Hong Kong region) are included. The results also show that up to now a total of about 153 Chinese journals(114 from China Mainland,11 from Hong Kong and 28 from Taiwan) have been included by SCI and SSCI & AHCI.
文摘Since extrahepatic bile duct cancer is difficult to diagnose and to cure, a safe and radical surgical strategy is needed. In this review, the modes of infiltration and spread of extrahepatic bile duct cancer and surgical strategy are discussed. Extended hemihepatectomy, with or without pancreatoduodenectomy (PD), plus extrahepatic bile duct resection and regional lyrnphadenectomy has recently been recognized as the standard curative treatment for hilar bile duct cancer. On the other hand, PD is the choice of treatment for middle and distal bile duct cancer. Major hepatectomy concomitant with PD (hepatopancreatoduodenectomy) has been applied to selected patients with widespread tumors. Preoperative biliary drainage (BD) followed by portal vein embolization (PVE) enables major hepatectomy in patients with hilar bile duct cancer without mortality. BD should be performed considering the surgical procedure, especially, in patients with separated intrahepatic bile ducts caused by hilar bile duct cancer. Right or left trisectoriectomy are indicated according to the tumor spread and biliary anatomy. As a result, extended radical resection offers a chance for cure of hilar bile duct cancer with improved resectability, curability, and a 5-year survival rate of 40%. A 5-year survival rate has ranged from 24% to 39% after PD for middle and distal bile duct cancer.
文摘AIM:To compare non-liquid and clear-liquid diets,and to assess whether the latter is the optimal treatment for mild acute pancreatitis.METHODS:The Cochrane Library,PUBMED,EMBASE,EBM review databases,Science Citation Index Expanded,and several Chinese databases were searched up to March 2011.Randomized controlled trials(RCTs) that compared non-liquid with clear-liquid diets in patients with mild acute pancreatitis were included.A meta-analysis was performed using available evidence from RCTs.RESULTS:Three RCTs of adequate quality involving a total of 362 participants were included in the final analysis.Compared to liquid diet,non-liquid diet significantly decreased the length of hospitalization [mean difference(MD):1.18,95% CI:0.82-1.55;P﹤0.00001] and total length of hospitalization(MD:1.31,95% CI:0.45-2.17;P = 0.003).The subgroup analysis showed solid diet was more favorable than clear liquid diet in the length of hospitalization,with a pooled MD being-1.05(95% CI:-1.43 to-0.66;P﹤0.00001).However,compared with clear liquid diet,both soft and solid diets did not show any significant differences for recurrence of pain after re-feeding,either alone [relative risk(RR):0.95;95% CI:0.51-1.87;P = 0.88] and(RR:1.22;95% CI:0.69-2.16;P = 0.49),respectively,or analyzed together as non-liquid diet(RR:0.80;95% CI:0.47-1.36;P = 0.41).CONCLUSION:The non-liquid soft or solid diet did not increase pain recurrence after re-feeding,compared with the clear-liquid diet.The non-liquid diet reduced hospitalization.
文摘This study aimed to identify and to analyze characteristics of top-cited articles published in the Web of Science chemical engineering subject category from 1899 to 2011.Articles that have been cited more than 100 times were assessed regarding publication outputs,and distribution of outputs in journals.Five bibliometric indicators were used to evaluate source countries,institution and authors.A new indicator,Y-index,was created to assess quantity and quality of contribution to articles.Results showed that 3828 articles,published between 1931 and 2010,had been cited at least 100 times.Among them 54% published before 1991,and 49% top-cited articles originated from US.The top eight productive institutions were all located in US.The top journals were Journal of Catalysis,AIChE Journal,Chemical Engineering Science and Journal of Membrane Science.Y-index was successfully applied to evaluate publication character of authors,institutions,and countries/regions.
文摘AIM:To quantitatively assess the relationship between coffee consumption and incidence of pancreatic cancer in a meta-analysis of cohort studies. METHODS:We searched MEDLINE,EMBASE,Science Citation Index Expanded and bibliographies of retrieved articles.Studies were included if they reported relative risks(RRs)and corresponding 95%CIs of pancreatic cancer with respect to frequency of coffee intake.We performed random-effects meta-analyses and metaregressions of study-specific incremental estimates to determine the risk of pancreatic cancer associated with a 1 cup/d increment in coffee consumption. RESULTS:Fourteen studies met the inclusion criteria, which included 671 080 individuals(1496 cancer events) with an average follow-up of 14.9 years.Compared with individuals who did not drink or seldom drank coffee per day,the pooled RR of pancreatic cancer was 0.82 (95%CI:0.69-0.95)for regular coffee drinkers,0.86 (0.76-0.96)for low to moderate coffee drinkers,and 0.68(0.51-0.84)for high drinkers.In subgroup analyses,we noted that,coffee drinking was associated witha reduced risk of pancreatic cancer in men,while this association was not seen in women.These associations were also similar in studies from North America,Europe, and the Asia-Pacific region. CONCLUSION:Findings from this meta-analysis suggest that there is an inverse relationship between coffee drinking and risk of pancreatic cancer.
文摘AIM: To determine the evidence-based values of prophylactic drainage in gastric cancer surgery. METHODS: One hundred and eight patients, who underwent subtotal gastrectomy with D1 or D2 lymph node dissection for gastric cancer between January 2001 and December 2005, were divided into drain group or no-drain group. Surgical outcome and post-operative complications within four weeks were compared between the two groups. RESULTS: No significant differences were observed between the drain group and no-drain group in terms of operating time (171 ± 42 rain vs 156 ± 39 rain), number of post-operative days until passage of flatus (3.7 ± 0.5 d vs 3.5 ± 1.0 d), number of post-operative days until initiation of soft diet (4.9±0.7 d vs 4.8±0.8 d), length of post-operative hospital stay (9.3±2.2 d vs 8.4±2.4 d), mortality rate (5.4% vs 3.8%), and overall postoperative complication rate (21.4% vs 19.2%). CONCLUSION: Prophylactic drainage placement is not necessary afer subtotal gastrectomy for gastric cancer since it does not offer additional benefits for the patients.
文摘AIM: To evaluate survival rate and clinical outcome of cholangiocarcinoma. METHODS: The medical records of 34 patients with cholangiocarcinoma, seen at a single hospital between the years 1999-2006, were retrospectively reviewed. RESULTS: Thirty-four patients with a median age of 75 years were included. Seventeen (50%) had painless jaundice at presentation. Sixteen (47.1%) were perihilar, 15 (44.1%) extrahepatic and three (8.8%) intrahepatic. Endoscopic retrograde cholangiography (ERCP) and/or magnetic resonance cholangiography (MRCP) were used for the diagnosis. Pathologic confirmation was obtained in seven and positive cytological examination in three. Thirteen patients had co-morbidities (38.2%). Four cases were managed with complete surgical resection. All the rest of the cases (30) were characterized as non-resectable due to advanced stage of the disease. Palliative biliary drainage was performed in 26/30 (86.6%). The mean follow-up was 32 mo (95% CI, 20-43 too). Overall median survival was 8.7 mo (95% CI, 2-16 mo). The probability of 1-year, 2-year and 3-year survival was 46%, 20% and 7%, respectively. The survival was slightly longer in patients who underwent resection compared to those who did not, but this difference failed to reach statistical significance. Patients who underwent biliary drainage had an advantage in survival compared to those who did not (probability of survival 53% vs 0% at 1 year, respectively, P = 0.038). CONCLUSION: Patients with cholangiocarcinoma were usually elderly with co-morbidities and/oradvanced disease at presentation. Even though a slight amelioration in survival with palliative biliary drainage was observed, patients had dismal outcome without resection of the tumor.
文摘AIM:To quantitatively assess the relationship between energy intake and the incidence of digestive cancers in a meta-analysis of cohort studies.METHODS:We searched MEDLINE,EMBASE,Science Citation Index Expanded,and the bibliographies of retrieved articles.Studies were included if they reported relative risks(RRs) and corresponding 95% CIs of digestive cancers with respect to total energy intake.When RRs were not available in the published article,they were computed from the exposure distributions.Data were extracted independently by two investigators and discrepancies were resolved by discussion with a third investigator.We performed fixed-effects meta-analyses and meta-regressions to compute the summary RR for highest versus lowest category of energy intake and for per unit energy intake and digestive cancer incidence by giving each study-specific RR a weight that was proportional to its precision.RESULTS:Nineteen studies consisting of 13 independent cohorts met the inclusion criteria.The studiesincluded 995 577 participants and 5620 incident cases of digestive cancer with an average follow-up of 11.1 years.A significant inverse association was observed between energy intake and the incidence of digestive cancers.The RR of digestive cancers for the highest compared to the lowest caloric intake category was 0.90(95% CI 0.81-0.98,P < 0.05).The RR for an increment of 239 kcal/d energy intake was 0.97(95% CI 0.95-0.99,P < 0.05) in the fixed model.In subgroup analyses,we noted that energy intake was associated with a reduced risk of colorectal cancer(RR 0.90,95% CI 0.81-0.99,P < 0.05) and an increased risk of gastric cancer(RR 1.19,95% CI 1.08-1.31,P < 0.01).There appeared to be no association with esophageal(RR 0.96,95% CI 0.86-1.07,P > 0.05) or pancreatic(RR 0.79,95% CI 0.49-1.09,P > 0.05) cancer.Associations were also similar in studies from North America and Europe.The RR was 1.02(95% CI 0.79-1.25,P > 0.05) when considering the six studies conducted in North America and 0.87(95% CI 0.77-0.98,P < 0.05) for the five studies from Europe.CONCLUSION:Our findings suggest that high energy intake may reduce the total digestive cancer incidence and has a preventive effect on colorectal cancer.
文摘The role of fecal microbial transplant(FMT) in the treatment of pediatric gastrointestinal disease has become increasingly popular among pediatric practitioners, patients, and parents. The success of FMT for the treatment of recurrent Clostridium difficile infection(RCDI) has bolstered interest in its potential application to other disease states, such as inflammatory bowel disease(IBD). FMT has particular interest in pediatrics, given the concerns of patients and parents about rates of adverse events with existing therapeutic options, and the greater cumulative medication burden associated with childhoodonset disease. Published literature on the use of FMT in pediatrics is sparse. Only 45 pediatric patients treated for RCDI have been reported, and only 27 pediatric patients with pediatric IBD. The pediatric microbiome may uniquely respond to microbial-based therapies. This review will provide a comprehensive overview of fecal microbial transplant and its potential role in the treatment of pediatric inflammatory bowel disease. We will discuss the microbiome in pediatric inflammatory bowel disease, existing adult and pediatric literature on the use of FMT in IBD treatment, and pediatric FMT trials that are currently recruiting patients. This review will also discuss features of the microbiome that may be associated with host response in fecal transplant, and potential challenges and opportunities for the future of FMT in pediatric IBD treatment.
文摘Shandong Province has its own advantage in leisure farm development aspect. But in development, it still exists the phenomenon of single product, insufficient development depth, lacking of unified planning of leisure farm, professional talent shortage and leisure farm development not obtaining local cognition. The development of Shandong Province family farm should increase the support of the government guidance, strengthen scientific planning and design, innovate Shandong leisure farm brand image and implement leisure farm talent development strategy, in order to promote the healthy development of Shandong Province leisure farm.