目的:系统评价预后营养指数(PNI)与原发性肝癌(HCC)肝切除病人预后的关系。方法:全面检索PubMed、百度学术、CINAHL、Google Scholar、Web of Science、OVID、中国生物医学文献数据库、中国知网、万方数据库和维普数据库中关于PNI和肝...目的:系统评价预后营养指数(PNI)与原发性肝癌(HCC)肝切除病人预后的关系。方法:全面检索PubMed、百度学术、CINAHL、Google Scholar、Web of Science、OVID、中国生物医学文献数据库、中国知网、万方数据库和维普数据库中关于PNI和肝癌肝切除病人预后关系的文献,检索时限为建库至2022年5月31日,使用RevMan 5.2软件进行Meta分析。结果:共纳入6篇文献,涉及1 459例病人。Meta分析结果显示,低PNI与原发性肝癌肝切除病人的总生存期(OS)[HR=1.94,95%CI(1.53,2.44),P<0.001]、无复发生存期(RFS)[HR=1.59,95%CI(1.34,1.89),P<0.001]相关。亚组分析显示:中国人群[HR=1.95,95%CI(1.53,2.48)]与日本人群[HR=1.96,95%CI(1.21,3.18)]的PNI对肝癌肝切除病人的预测价值均有明显差异,同时PNI值为45.00~49.50对肝癌肝切除病人有较好的预测效果。结论:现有证据表明,PNI水平与肝癌肝切除病人OS、RFS明显相关,低PNI可作为此类病人预后预测的有效标志物。展开更多
BACKGROUND Obesity rates have increased sharply in recent decades. As there is a growing number of cases in which acute pancreatitis(AP) is accompanied by obesity, we found it clinically relevant to investigate how bo...BACKGROUND Obesity rates have increased sharply in recent decades. As there is a growing number of cases in which acute pancreatitis(AP) is accompanied by obesity, we found it clinically relevant to investigate how body-mass index(BMI) affects the outcome of the disease.AIM To quantify the association between subgroups of BMI and the severity and mortality of AP.METHODS A meta-analysis was performed using the Preferred Reporting Items for Systematic Review and Meta-Analysis(PRISMA) Protocols. Three databases(PubMed, EMBASE and the Cochrane Library) were searched for articles containing data on BMI, disease severity and mortality rate for AP. Englishlanguage studies from inception to 19 June 2017 were checked against our predetermined eligibility criteria. The included articles reported all AP cases with no restriction on the etiology of the disease. Only studies that classified AP cases according to the Atlanta Criteria were involved in the severity analyses. Odds ratios(OR) and mean differences(MD) were pooled using the random effects model with the DerSimonian-Laird estimation and displayed on forest plots. The meta-analysis was registered in PROSPERO under number CRD42017077890.RESULTS A total of 19 articles were included in our meta-analysis containing data on 9997 patients. As regards severity, a subgroup analysis showed a direct association between AP severity and BMI. BMI < 18.5 had no significant effect on severity;however, BMI > 25 had an almost three-fold increased risk for severe AP in comparison to normal BMI(OR = 2.87, 95%CI: 1.90-4.35, P < 0.001). Importantly,the mean BMI of patients with severe AP is higher than that of the non-severe group(MD = 1.79, 95%CI: 0.89-2.70, P < 0.001). As regards mortality, death rates among AP patients are the highest in the underweight and obese subgroups. A BMI < 18.5 carries an almost two-fold increase in risk of mortality compared to normal BMI(OR = 1.82, 95%CI: 1.32-2.50, P < 0.001). However, the chance of mortality is almost equal in the normal BMI and BMI 25-30 subgroups. A BMI >30 results in a three times higher risk of mortality in comparison to a BMI < 30(OR = 2.89, 95%CI: 1.10-7.36, P = 0.026).CONCLUSION Our findings confirm that a BMI above 25 increases the risk of severe AP, while a BMI > 30 raises the risk of mortality. A BMI < 18.5 carries an almost two times higher risk of mortality in AP.展开更多
AIM To perform a meta-analysis to investigate the correlation between body mass index(BMI) and the shortterm outcomes of laparoscopic gastrectomy(LG) for gastric cancer(GC) in Asian patients. METHODS The Pub Med, Coch...AIM To perform a meta-analysis to investigate the correlation between body mass index(BMI) and the shortterm outcomes of laparoscopic gastrectomy(LG) for gastric cancer(GC) in Asian patients. METHODS The Pub Med, Cochrane, EMBASE, and Web of Science databases were searched for studies that focused on the impact of obesity on the short-term outcomes of LG for GC in Asian patients who were classified into a high BMI(BMI ≥ 25 kg/m^2) or low BMI group(BMI < 25 kg/m^2). The results are expressed using the pooled odds ratio(OR) for binary variables and standard mean difference(SMD) for continuous variables with 95%confidence interval(CI), and were calculated according to the fixed-effects model while heterogeneity was not apparent or a random-effects model while heterogeneity was apparent.RESULTS Nine studies, with a total sample size of 6077, were included in this meta-analysis. Compared with the low BMI group, the high BMI group had longer operative time(SMD = 0.26, 95%CI: 0.21 to 0.32, P < 0.001), greater blood loss(SMD = 0.19, 95%CI: 0.12 to 0.25, P < 0.001), and fewer retrieved lymph nodes(SMD =-0.13, 95%CI: 0.18 to 0.07, P < 0.001). There was no significant difference between the high and low BMI groups in postoperative complications(OR = 1.12, 95%CI: 0.95 to 1.33, P = 0.169), the duration of postoperative hospital stay(SMD = 0.681, 95%CI:-0.05 to 0.07, P = 0.681), postoperative mortality(OR = 1.95, 95%CI: 0.78 to 4.89, P = 0.153), or time to resuming food intake(SMD = 0.00, 95%CI:-0.06 to 0.06, P = 0.973).CONCLUSION Our meta-analysis provides strong evidence that despite being associated with longer operative time, greater blood loss, and fewer retrieved lymph nodes, BMI has no significant impact on the short-term outcomes of LG for GC in Asian patients, including postoperative complications, the duration of postoperative hospital stay, postoperative mortality, and time to resuming food intake. BMI may be a poor risk factor for shortterm outcomes of LG. Other indices should be taken into account.展开更多
目的系统评价结直肠癌患者术后肺部感染的影响因素。方法检索中国知网、万方、维普、中国生物医学文献数据库(SinoMed)、PubMed、Web of Science、Embase、the Cochrane Library数据库,系统检索结直肠癌患者术后发生肺部感染影响因素的...目的系统评价结直肠癌患者术后肺部感染的影响因素。方法检索中国知网、万方、维普、中国生物医学文献数据库(SinoMed)、PubMed、Web of Science、Embase、the Cochrane Library数据库,系统检索结直肠癌患者术后发生肺部感染影响因素的相关文献,检索时间为建库至2024年6月28日。采用Stata 16.0软件进行数据分析。结果共纳入25篇文献,包含16043例结直肠癌患者、32个影响因素。Meta分析结果显示,年龄[OR=2.72,95%CI(2.04~3.61),P<0.001]、体重指数(body mass index,BMI)[OR=3.76,95%CI(2.10~6.75),P<0.001]、男性[OR=2.08,95%CI(1.49~2.91),P<0.001]、吸烟史[OR=2.78,95%CI(2.31~3.36),P<0.001]、合并慢性呼吸道疾病[OR=4.18,95%CI(2.70~6.47),P<0.001]、合并糖尿病[OR=2.59,95%CI(1.66~4.05),P<0.001]、合并低蛋白血症[OR=4.15,95%CI(1.95~8.83),P<0.001]、术前白蛋白<35 g/L[OR=2.29,95%CI(1.31~4.00),P=0.003]、手术时间[OR=2.75,95%CI(1.84~4.11),P<0.001]、开腹手术[OR=3.25,95%CI(2.42~4.38),P<0.001]、美国麻醉师协会(American Society of Anesthesiologists,ASA)评分[OR=2.26,95%CI(1.51~3.38),P<0.001]、术中输血[OR=3.51,95%CI(1.48~8.32),P=0.004]是结直肠癌患者术后并发肺部感染的主要影响因素。结论年龄、BMI、男性、吸烟史、合并慢性呼吸道疾病、合并糖尿病、合并低蛋白血症、术前白蛋白<35 g/L、手术时间、开腹手术、ASA评分、术中输血均为结直肠癌患者术后肺部感染的危险因素。有效防治慢性呼吸道疾病,积极指导患者戒烟、控制血糖和调整营养饮食,完善术前筛查、提高术者操作标准有助于预防和控制结直肠癌患者术后并发肺部感染。展开更多
目的评价度拉糖肽对2型糖尿病(T2DM)患者体重指数(BMI)的影响。方法计算机检索中国知网、维普网、万方数据库以及PubMed、Web of Science、EMBASE、Scopus、Google Scholar等数据库,收集度拉糖肽对T2DM患者BMI影响的随机对照试验(RCT)...目的评价度拉糖肽对2型糖尿病(T2DM)患者体重指数(BMI)的影响。方法计算机检索中国知网、维普网、万方数据库以及PubMed、Web of Science、EMBASE、Scopus、Google Scholar等数据库,收集度拉糖肽对T2DM患者BMI影响的随机对照试验(RCT)。检索时间为建库至2023年2月。根据Cochrane偏倚风险工具评估偏倚风险,Revman 5.3.0软件进行Meta分析。结果共纳入7项RCT文献,573例受试者,其中试验组285例,对照组288例。Meta分析结果显示,度拉糖肽能改善T2DM患者的BMI,差异具有统计学意义[WMD=-0.75,95%CI:(-1.17,-0.34),P=0.0003]。结论度拉糖肽可能降低T2MD患者的BMI,但受限于纳入文献质量及数量,仍需高质量多中心的RCT加以验证。展开更多
目的比较不同体重指数（BMI）在白血病发病风险中的相关性。方法在Pub Med、Web of Science、万方数据库、中国知网、中国生物医学文献等数据库中,检索从2000年1月至2015年7月发表的不同BMI与白血病发病关系的病例对照研究。根据纳入标...目的比较不同体重指数（BMI）在白血病发病风险中的相关性。方法在Pub Med、Web of Science、万方数据库、中国知网、中国生物医学文献等数据库中,检索从2000年1月至2015年7月发表的不同BMI与白血病发病关系的病例对照研究。根据纳入标准和排除标准进行资料的提取,并对纳入的病例对照研究进行质量评价,采用RevMan5.3软件对其进行Meta分析。结果共有四个病例对照研究纳入本Meta分析,其文献质量的评分均为4分以上,其中,白血病患者共2 681例（病例组）,非白血病及相关肿瘤的其他患者共7 389例（对照组）。Meta分析显示,低BMl组的合并效应量OR=0.84[95%CI（0.62-1.13）,P=0.26],超重组的合并效应量OR=0.93[95%CI（0.72-1.20）,P=0.59],肥胖组的合并效应量OR=1.38[95%CI（0.96-2.00）,P=0.08]。结论 BMI与白血病的发病风险呈正相关,提示低BMI可能是白血病发病的保护性因素,而肥胖可能是白血病发病的危险因素。展开更多
基金Supported by a Project Grant (No. KH125678 to PH)an Economic Development and Innovation Operative Program Grant (GINOP 2.3.2-15-2016-00048 to PH)+2 种基金a Human Resources Development Operational Program Grant (No. EFOP-3.6.2-16-2017-00006 to PH) from the National ResearchDevelopment and Innovation Office as well as by a Momentum Grant from the Hungarian Academy of Sciences (No. LP2014- 10/2014 to PH)EFOP-3.6.3- VEKOP-16-2017-00009 and UNKP- 18-3-INew National Excellence Program of the Ministry of Human Capacities (No. PTE/38329-1/2018 to KM)
文摘BACKGROUND Obesity rates have increased sharply in recent decades. As there is a growing number of cases in which acute pancreatitis(AP) is accompanied by obesity, we found it clinically relevant to investigate how body-mass index(BMI) affects the outcome of the disease.AIM To quantify the association between subgroups of BMI and the severity and mortality of AP.METHODS A meta-analysis was performed using the Preferred Reporting Items for Systematic Review and Meta-Analysis(PRISMA) Protocols. Three databases(PubMed, EMBASE and the Cochrane Library) were searched for articles containing data on BMI, disease severity and mortality rate for AP. Englishlanguage studies from inception to 19 June 2017 were checked against our predetermined eligibility criteria. The included articles reported all AP cases with no restriction on the etiology of the disease. Only studies that classified AP cases according to the Atlanta Criteria were involved in the severity analyses. Odds ratios(OR) and mean differences(MD) were pooled using the random effects model with the DerSimonian-Laird estimation and displayed on forest plots. The meta-analysis was registered in PROSPERO under number CRD42017077890.RESULTS A total of 19 articles were included in our meta-analysis containing data on 9997 patients. As regards severity, a subgroup analysis showed a direct association between AP severity and BMI. BMI < 18.5 had no significant effect on severity;however, BMI > 25 had an almost three-fold increased risk for severe AP in comparison to normal BMI(OR = 2.87, 95%CI: 1.90-4.35, P < 0.001). Importantly,the mean BMI of patients with severe AP is higher than that of the non-severe group(MD = 1.79, 95%CI: 0.89-2.70, P < 0.001). As regards mortality, death rates among AP patients are the highest in the underweight and obese subgroups. A BMI < 18.5 carries an almost two-fold increase in risk of mortality compared to normal BMI(OR = 1.82, 95%CI: 1.32-2.50, P < 0.001). However, the chance of mortality is almost equal in the normal BMI and BMI 25-30 subgroups. A BMI >30 results in a three times higher risk of mortality in comparison to a BMI < 30(OR = 2.89, 95%CI: 1.10-7.36, P = 0.026).CONCLUSION Our findings confirm that a BMI above 25 increases the risk of severe AP, while a BMI > 30 raises the risk of mortality. A BMI < 18.5 carries an almost two times higher risk of mortality in AP.
基金Supported by the Project of Science and Technology Research Program of Fujian Province,No.2016B044the Fujian Provincial Natural Science Foundation,No.2017J01279+2 种基金the Nursery Garden Scientific Research Fund of Fujian Medical University,No.2015MP024Startup Fund for Scientific Research,Fujian Medical University,the Fujian Provincial Health Department Youth Foundation Project,No.2017-1-51the National Clinical Key Specialty Construction Project(General Surgery)of China
文摘AIM To perform a meta-analysis to investigate the correlation between body mass index(BMI) and the shortterm outcomes of laparoscopic gastrectomy(LG) for gastric cancer(GC) in Asian patients. METHODS The Pub Med, Cochrane, EMBASE, and Web of Science databases were searched for studies that focused on the impact of obesity on the short-term outcomes of LG for GC in Asian patients who were classified into a high BMI(BMI ≥ 25 kg/m^2) or low BMI group(BMI < 25 kg/m^2). The results are expressed using the pooled odds ratio(OR) for binary variables and standard mean difference(SMD) for continuous variables with 95%confidence interval(CI), and were calculated according to the fixed-effects model while heterogeneity was not apparent or a random-effects model while heterogeneity was apparent.RESULTS Nine studies, with a total sample size of 6077, were included in this meta-analysis. Compared with the low BMI group, the high BMI group had longer operative time(SMD = 0.26, 95%CI: 0.21 to 0.32, P < 0.001), greater blood loss(SMD = 0.19, 95%CI: 0.12 to 0.25, P < 0.001), and fewer retrieved lymph nodes(SMD =-0.13, 95%CI: 0.18 to 0.07, P < 0.001). There was no significant difference between the high and low BMI groups in postoperative complications(OR = 1.12, 95%CI: 0.95 to 1.33, P = 0.169), the duration of postoperative hospital stay(SMD = 0.681, 95%CI:-0.05 to 0.07, P = 0.681), postoperative mortality(OR = 1.95, 95%CI: 0.78 to 4.89, P = 0.153), or time to resuming food intake(SMD = 0.00, 95%CI:-0.06 to 0.06, P = 0.973).CONCLUSION Our meta-analysis provides strong evidence that despite being associated with longer operative time, greater blood loss, and fewer retrieved lymph nodes, BMI has no significant impact on the short-term outcomes of LG for GC in Asian patients, including postoperative complications, the duration of postoperative hospital stay, postoperative mortality, and time to resuming food intake. BMI may be a poor risk factor for shortterm outcomes of LG. Other indices should be taken into account.
文摘目的系统评价结直肠癌患者术后肺部感染的影响因素。方法检索中国知网、万方、维普、中国生物医学文献数据库(SinoMed)、PubMed、Web of Science、Embase、the Cochrane Library数据库,系统检索结直肠癌患者术后发生肺部感染影响因素的相关文献,检索时间为建库至2024年6月28日。采用Stata 16.0软件进行数据分析。结果共纳入25篇文献,包含16043例结直肠癌患者、32个影响因素。Meta分析结果显示,年龄[OR=2.72,95%CI(2.04~3.61),P<0.001]、体重指数(body mass index,BMI)[OR=3.76,95%CI(2.10~6.75),P<0.001]、男性[OR=2.08,95%CI(1.49~2.91),P<0.001]、吸烟史[OR=2.78,95%CI(2.31~3.36),P<0.001]、合并慢性呼吸道疾病[OR=4.18,95%CI(2.70~6.47),P<0.001]、合并糖尿病[OR=2.59,95%CI(1.66~4.05),P<0.001]、合并低蛋白血症[OR=4.15,95%CI(1.95~8.83),P<0.001]、术前白蛋白<35 g/L[OR=2.29,95%CI(1.31~4.00),P=0.003]、手术时间[OR=2.75,95%CI(1.84~4.11),P<0.001]、开腹手术[OR=3.25,95%CI(2.42~4.38),P<0.001]、美国麻醉师协会(American Society of Anesthesiologists,ASA)评分[OR=2.26,95%CI(1.51~3.38),P<0.001]、术中输血[OR=3.51,95%CI(1.48~8.32),P=0.004]是结直肠癌患者术后并发肺部感染的主要影响因素。结论年龄、BMI、男性、吸烟史、合并慢性呼吸道疾病、合并糖尿病、合并低蛋白血症、术前白蛋白<35 g/L、手术时间、开腹手术、ASA评分、术中输血均为结直肠癌患者术后肺部感染的危险因素。有效防治慢性呼吸道疾病,积极指导患者戒烟、控制血糖和调整营养饮食,完善术前筛查、提高术者操作标准有助于预防和控制结直肠癌患者术后并发肺部感染。
文摘目的评价度拉糖肽对2型糖尿病(T2DM)患者体重指数(BMI)的影响。方法计算机检索中国知网、维普网、万方数据库以及PubMed、Web of Science、EMBASE、Scopus、Google Scholar等数据库,收集度拉糖肽对T2DM患者BMI影响的随机对照试验(RCT)。检索时间为建库至2023年2月。根据Cochrane偏倚风险工具评估偏倚风险,Revman 5.3.0软件进行Meta分析。结果共纳入7项RCT文献,573例受试者,其中试验组285例,对照组288例。Meta分析结果显示,度拉糖肽能改善T2DM患者的BMI,差异具有统计学意义[WMD=-0.75,95%CI:(-1.17,-0.34),P=0.0003]。结论度拉糖肽可能降低T2MD患者的BMI,但受限于纳入文献质量及数量,仍需高质量多中心的RCT加以验证。
