24-Hour Urinary Sodium Excretion Association with Cardiovascular Events:A Systematic Review and Dose-Response Meta-Analysis

Objective The relationship between sodium intake and cardiovascular(CV)events remains unconfirmed.Therefore,we carried out a systematic review and dose-response meta-analysis for evaluating the potential impact of 24-hour sodium excretion on CV risk.Besides,24-hour sodium excretion was used to replace daily sodium diet intake.Methods We searched ISI Web of Science,Embase,Pub Med,and the Cochrane Library.Our study included cohort studies reporting hazard ratio(HR).The random-effects model was used for summarizing the total relative risks(RRs)between the included studies.In addition,the generalized least-squares regression was employed to fit the study model.Results A total of 9 studies involving 645,006 participants were included in this study.A significant non-linear relationship was observed between sodium excretion and CV events(P^(non-linearity)<0.001).In studies collecting 24-h urine samples,the sodium excretion and CV events risk were associated linearly(RR:1.04;95%CI:1.01,1.07).Conclusion In a linear dose-response manner,every 1 g increase in sodium intake was associated with an increased risk of CV events up to 4%.Further studies are required to validate our conclusions further.

Overexpression of CD155 is associated with PD-1 and PD-L1 expression on immune cells,rather than tumor cells in the breast cancer microenvironment

BACKGROUND CD155 is an immune checkpoint protein in cancers and interacts with ligands to regulate the immune microenvironment.The expression of CD155 is correlated with the prognosis and pathological features of breast cancer.AIM To investigate the expression status of CD155 and the association with exhausted CD4+helper and CD8+cytotoxic tumor infiltrating lymphocytes(TILs)and PD-L1 in the breast cancer microenvironment.METHODS One hundred and twenty-six breast cancer patients with invasive ductal breast cancer were consecutively recruited into this study.Immunohistochemistry was used to detect the expression CD155,PD-L1 and PD-1 on tumor-infiltrating immune cells and tumor cells in the microenvironment.RESULTS The proportion of patients with CD155 expression was higher in triple negative breast cancer(72.7%)than in Luminal A patients(22.2%,P<0.05).Patients with positive CD155 expression had a higher percentage of CD4+/PD-1+helper TILs(30%)than patients with negative CD155 expression(21%,P<0.05).Patients with positive CD155 expression also had higher cell counts of exhausted CD4+TILs[47 vs 20/high-power fields(HPF)]and unexhausted CD8+TILs(30 vs 17/HPF)than patients with negative expression(P<0.05).CD155 expression was correlated with increased PD-L1 expression in immune cells,0.8%and 0.02%immune cells expressed PD-L1 in patients with positive and negative CD155 expression,respectively(P<0.05).CONCLUSION CD155 was related to an inhibitory immune breast cancer microenvironment.CD155 was associated with a high proportion of exhausted CD4+and unexhausted CD8+TILs and high PD-L1 expression in immune cells.

Association between atherogenic index of plasma and colorectal neoplasms in patients with hypertension

To the Editor:Colorectal cancer(CRC)is the third most commonmalignancy and the second leading cause of cancer death worldwide.[1]Colorectal adenoma(CRA)is a precursor lesion of CRC.Timely diagnosis and treatment ofCRAare important for preventing the occurrence ofCRC and improving prognosis.Considering the risks associated with invasive procedures and the high cost of colonoscopy,there is an urgent need to identify reliable non-invasive markers of colorectal neoplasms(CRNs).

Diagnostic Value of Soluble Suppression of Tumorigenicity-2 for Heart Failure

Background：Many studies have explored the diagnostic performance of soluble suppression of tumorigenicity-2 （sST2） for heart failure （HF）,but the results are inconsistent.Here,we performed a meta-analysis to assess the role of sST2 in the diagnosis of HF.Methods：We searched PubMed,Web of Science,Cochrane Library,China National Knowledge Infrastructure,and Wanfang Database from inception to April 2015.Studies that investigated the diagnostic role of sST2 for HF were reviewed.The numbers of true-positive,false-positive,false-negative,and true-negative results were extracted to calculate pooled diagnostic odds ratio （DOR） with 95% confidence interval （CI） and the summary receiver operating characteristic curve and area under the curve （AUC）.The Spearman correlation coefficient was used to check the threshold effect.The Cochran Q statistic （P 〈 0.05） and the inconsistency index （I2 〉 50%） were used to assess the nonthreshold effect.Meta-regression was conducted to explore the source of heterogeneity;subgroup analysis showed the results in different subgroups.Finally,the Deeks＇ test was performed to assess the publication bias.Results：Nine articles including 10 studies were included in the meta-analysis.The pooled sensitivity was 0.84 （95% CI：0.81-0.86）,and pooled specificity was 0.74 （95% CI：0.72-0.76）.The summary DOR was 8.49 （95% CI：4.54-15.86）,and AUC was 0.81 （standard error：0.03）.The Spearman correlation coefficient identified the nonsignificant threshold effect （coefficient =0.49,P =0.148）,but the nonthreshold effect heterogeneity was significant （Cochran Q =58.52,P 〈 0.0001;I2 =84.6%）.Meta-regression found that characteristics of controls might be the suggestive source ofnonthreshold effect heterogeneity （P =0.095）.Subgroup analysis found that DOR was 5.65 and 7.86,respectively for the controls of hospital patients and healthy populations.Deeks＇ test demonstrated that there was no publication bias （P =0.616）.Conclusion：The meta-analysis illustrated that sST2 might play a role in diagnosing HF.