Patients who have a shorter mesentery and concern of excessive mesenteric tension should have colectomy performed, preserving the MVA from the middle colic artery to the ileal branch of the ICA. The preserved MVA can be a reliable alternative blood supply to the pouch if more mesenteric vessel ligations are necessary.
Background Metabolic syndrome (MetS) is a major risk factor for cardiovascular diseases. The objective of the study was to evaluate the updated prevalence of MetS and provide a comprehensive illustration of the possible temporal changes in MetS prevalence in China from 2011 to 2015. Methods The data for this study are from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS). CHARLS is a nationally representative survey targeting populations aged 45 and above from 28 provinces in mainland China. A total of 11,847 and 13,013 participants were eligible for data analysis at the two time points. Results The estimated prevalence of MetS in 2015 was 20.41% (95% CI: 19.02–21.8%) by the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III) criteria, 34.77% (95% CI: 33.12–36.42%) by the International Diabetes Federation (IDF) criteria, 39.68% (95% CI: 37.88–41.47%) by the revised ATP III criteria, and 25.55% (95% CI: 24.19–26.91%) by the Chinese Diabetes Society (CDS) criteria. The prevalence was higher among women and elderly adults and in urban and northern populations. Furthermore, the trends in the prevalence decreased significantly between 2011 and 2015 by the ATP III, revised ATP III and CDS criteria. However, trends increased significantly from 2011 to 2015 by the IDF criteria. Conclusions A higher prevalence of MetS is found in those who reported being middle aged and elderly, women, residing in northern China or living in urban areas. Additionally, temporal changes in the prevalence of MetS varied according to different criteria. Increased attention to the causes associated with populations who have higher levels of MetS is warranted.
Objectives: Biliary tract cancers (BTCs) are rare but highly fatal. Although the etiology of BTC is poorly understood, gallstones are proposed to be an imperative risk factor.We conducted a systematic review and meta-analysis to examine the associations between gallstone characteristics and the risk of BTC. Methods:We searched the Medline, Embase, and Cochrane Central databases and systematically reviewed cohort and case-control studies published before April 9, 2018.All the included studies reported appropriate risk estimates and their confidence intervals (CIs) on the association between the presence, size, number, or duration of gallstones and the risk of BTC, including gallbladder cancer (GBC), extrahepatic bile duct cancer (EBDC), and ampulla of Vater cancer (AOVC). Summary odds ratios (ORs) and their 95% CIs were calculated using a random-effects model meta-analysis.Subgroup analyses were conducted to inspect the source of potential heterogeneity, and Egger's test was performed to assess publication bias.Results: A total of seven cohort studies and 23 case-control studies in the Asian, European, and American populations were included. The presence of gallstones was associated with an increased risk of BTC (OR=4.38; 95% CI=3.23-5.93; I 2 =91.2%), GBC (OR=7.26; 95% CI=4.33-12.18), EBDC (OR=3.17; 95% CI=2.24-4.50), and AOVC (OR=3.28; 95% CI=1.33-8.11). Gallstone size (>1 cm vs. <1 cm; OR=1.88, 95% CI=1.10-3.22) was significantly associated with the risk of GBC. Conclusions:This systematic review and meta-analysis indicates that gallstone characteristics, such as presence, size, and number, are associated with an increased risk of BTC. However, the study has limitations that significantly high heterogeneities were E p u b a h e a d o f p r i n t present in the meta-analyses.
Objective: Previous work has demonstrated that metastases are not uniformly distributed across the brain. This study aims to determine there are low-risk brain metastasis (BM) areas that may be avoided during whole-brain radiotherapy (WBRT) to reduce neurocognitive toxicity. Methods: Clinical and magnetic resonance imaging (MRI) data of 991 metastases in 192 patients with advanced cancer were analyzed retrospectively. Eleven anatomically defined regions of interest (ROIs) were contoured, and the locations of the BMs were recorded. Using the same definition, ROIs were contoured in 20 healthy volunteers.The proportions of patients with BMs in different ROIs, proportion of BMs, and proportion of different ROI volumes relative to the total volume were calculated. Results: The proportion of observed BMs was lower than expected in the brainstem, insula, diencephalon and internal structures, corpus callosum, and pituitary gland. The proportion of BMs was significantly higher than expected in the parietal lobe, occipital lobe, and cerebellum. For those patients with single BM, there was very low rate of low-risk ROIs involvement (0%), with 2-4 BMs, 6-13% of the patients had low-risk ROIs involvement, with ≥5 BMs, significant (> 30%) of the patients had low-risk ROIs involvement. Conclusion: The brainstem, insula, diencephalon and internal structures, corpus callosum, and pituitary gland demonstrate low risk for metastatic involvement. Involvement of low risk areas occurs in patients with more than 1 BM.
Small-molecule chemical drugs are of great significance for tumor-targeted and individualized therapies. However, the development of new small-molecule drugs, from basic experimental research and clinical trials to final application in clinical practice, is a long process that has a high cost. It takes at least 5 years for most drugs to be developed in the laboratory to prove their effectiveness and safety. Compared with the development of new drugs, repurposing traditional non-tumor drugs can be a shortcut. Metformin is a good model for a new use of an old drug. In recent years, the antitumor efficacy of metformin has attracted much attention. Epidemiological data and in vivo , and in vitro experiments have shown that metformin can reduce the incidence of cancer in patients with diabetes and has a strong antagonistic effect on metabolism-related tumors. Recent studies have shown that metformin can induce autophagy in esophageal cancer cells, mainly by inhibiting inflammatory signaling pathways. In recent years, studies have shown that the antitumor functions and mechanisms of metformin are multifaceted. The present study aims to review the application of metformin in tumor prevention and treatment.
Radiotherapy is one of the most important treatments for brain metastasis (BM). This study aimed to assess whether whole-brain radiation therapy (WBRT) with simultaneous integrated boost (SIB) provided any therapeutic benefit compared to WBRT followed by stereotactic radiosurgery (SRS). Seventy-two consecutive cases of lung cancer with BM treated from January 2014 to June 2020 were analyzed retrospectively. Thirty-seven patients were treated with WBRT (30 Gy in 10 fractions) and SIB (45 Gy in 10 fractions), and 35 patients were treated with WBRT (30 Gy in ten fractions) followed by SRS (16–24 Gy according to the maximum tumor diameter). The primary endpoint was intracranial progression-free survival (PFS). The secondary endpoints were intracranial objective response (partial and complete responses), pattern of intracranial progression, overall survival (OS), and toxicity. The WBRT + SIB group had a significantly longer median intracranial PFS (9.1 vs. 5.9 months, P = 0.001) than the WBRT + SRS group. The intracranial objective response rate was 67.6% and 62.9% in the WBRT + SIB and in WBRT + SRS groups, respectively (P = 0.675). The incidence of progression outside the P-GTV in the WBRT + SIB group was significantly lower than that in the WBRT + SRS group (39.4% vs. 75.0%, P = 0.004). The median OS was 24.3 and 20.3 months in the WBRT + SIB and WBRT + SRS groups, respectively (P = 0.205). There was no significant difference in the incidence of grade 3 or worse adverse reactions between the two groups. Compared to treatment with WBRT + SRS, that with WBRT + SIB for BM appeared to contribute to local control.
The optimal body mass index (BMI) range for predicting survival in Asian colorectal cancer patients is unknown. We established the most appropriate cut-off point of BMI to predict better survival in Asian colorectal cancer patients using a two-stage approach. Two cohorts of colorectal cancer patients were included in this study: 5815 hospital-based development cohort and 54,043 nationwide validation cohort. To determine the optimal BMI cut-off point at diagnosis, the method of Contal and O’Quigley was used. We evaluated the association between BMI and overall survival (OS) using the Cox proportional hazard model. During a median follow-up of 5.7 and 5.1 years for the development and the validation cohort, 1180 (20.3%) and 10,244 (19.0%) deaths occurred, respectively. The optimal cut-off of BMI identified as 20.2 kg/m2 (plog-rank < 8.0 × 10−16) for differentiating between poorer and better OS in the development cohort. When compared to the patients with a BMI < 20.2 kg/m2, the patients with a BMI ≥ 20.2 kg/m2 had a significantly better OS (HR = 0.62, 95% CI = 0.54–0.72, p = 1.1 × 10−10). The association was validated in the nationwide cohort, showing better OS in patients with a BMI ≥ 20.2 kg/m2 (HR = 0.64, 95% CI = 0.60–0.67, p < 0.01). We suggest the use of a BMI value of 20.2 kg/m2 to predict survival in Asian colorectal cancer patients.
Cholelithiasis is a disease that manifests frequently in adults, and the prevalence rate of gallstones is 10% to 15% in western countries and 3% to 10% in Asian countries [1,2]. In Korea, the prevalence rate of gallstones ranges from 2% to 5%, and there is a trending increase in the number of patients diagnosed with gallstones annually [1]. The reasons for this increase include the aging population, changes in the dietary habits of people in the modern era, such as consumption of high cholesterol foods, and ease of detecting the disorder through examinations, such as ultrasonography, due to the advancement of diagnostic technologies. Gallstones induce complications, including acute cholangitis, hepatocirrhosis and acute pancreatitis, and it has been suggested that gallstones may increase the risk of gallbladder and biliary tract cancers [3,4]. Gallstones occur in approximately 75% to 90% of patients with gallbladder cancer, and the rate of gallbladder cancer is high in regions with frequent detection of gallstones [5-7]. According to previous studies, gallstones are considered to damage various tissues due to repetitive inflammatory exposure or changes in bile due to gallstones rather than gallstones themselves and cause the development of relevant cancers by depleting detoxification and carcinogenic suppressing substances. Several studies have demonstrated a correlation between gallstones and liver, biliary duct and pancreatic cancer when considering gallstones overall. How
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.