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BackgroundAdequate bowel preparation is required for magnetic resonance enterography (MRE), which can be achieved by administering contrast solution after mid-gut tubing or taking contrast solution orally. We present the design of randomized controlled trial (RCT) to compare the efficacy and compliance of bowel preparation between mid-gut tubing and oral administering for MRE in patients with Crohn’s disease (CD).Methods/designThis is an open-label, multicenter RCT. Ninety-six patients with CD in need of MRE examination and mid-gut tubing (prepared for fecal microbiota transplantation and/or enteral nutrition), aged ≥ 14 years, will be included. Patients will be randomized 1:1 into either bowel preparation by oral administering (oral group) or bowel preparation through mid-gut transendoscopic enteral tubing (TET) (tubing group). The primary outcome measures are: (1) degree of discomfort before/during/after bowel preparation for MRE using a visual 5-grade scale (1 = few, 5 = very severe); and (2) grade of bowel distention evaluated by a 5-grade scale (1 = 0–20% segmental distention, 2 = 20–40% distention, 3 = 40–60% distention, 4 = 60–80% distention, 5 = 80–100% distention). The secondary outcome measure is the accuracy of lesion detection through MRE confirmed by colonoscopy which is evaluated by a 5-point scale.DiscussionThe outcome of this study is expected to provide a novel effective clinical protocol of bowel preparation for MRE in patients with CD. We hope to highlight the concept of physician–patient satisfaction based on different methods of bowel preparation for MRE.Trial registrationClinicalTrials.gov, NCT03541733. Registered on 30 May 2018.Electronic supplementary materialThe online version of this article (10.1186/s13063-018-3101-x) contains supplementary material, which is available to authorized users.

Insulin-like growth factor 1 (IGF1) and its main binding protein, IGF-binding protein 3 (IGFBP3), play an important role in cancer development. Circulating levels and functional polymorphisms of IGF1 and IGFBP3 may be biomarkers of cancer development. However, the results of published studies remain conflicting rather than conclusive. We searched MEDLINE and EMBASE databases for all published studies related to circulating levels and polymorphisms of IGF1 and IGFBP3 and cancer risk. In all, 96 studies and over 110 000 subjects were available for this meta-analysis. Higher IGF1 circulating levels significantly increased 15% of cancer risk (odds ratio (OR), 1.15, 95% confidence interval (CI), 1.03-1.29), especially among prostate, pre-menopausal breast and colorectal cancer patients, whereas higher concentrations of IGFBP3 significantly decreased the risk of advanced prostate cancer by 56% (OR, 0.44, 95% CI, 0.25 -0.77). Meanwhile, IGFBP3 À202CC genotype was associated with an increased risk of prostate cancer with borderline significance (OR, 1.18, 95% CI, 0.99 -1.41). Genotype-phenotype correlation analyses showed that circulating levels of IGFBP3 could be modified by its promoter polymorphism AÀ202C (P o 0.001). In conclusion, circulating levels of IGF1, IGFBP3 and IGFBP3 AÀ202C play a crucial role in carcinogenesis and could serve as susceptibility biomarkers for cancer development.

Introduction: Human epidermal growth factor receptor 2 (HER2) is regarded as a poor prognostic factor in many tumors. Conflicting data in many literatures were reported about the association between HER2 and poor prognosis in lung cancer. Methods: We conducted a meta-analysis of published studies from 1966 to the 12th week of 2010. In absence of significant quality difference between positive and negative studies, combined hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs) were calculated in terms of overall survival. Results: Forty studies(6135 patients) were included in the analysis. The pooled data showed that HER2 overexpression was a marker of poor prognosis in lung cancer. HR was 1.48 (95% CI: 1.22-1.80) and 3.11 (95% CI: 2.26 -4.28) for non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) by immunohistochemistry (IHC) assay, respectively. In the NSCLC subgroup analysis of early stage and ethnicities using IHC and in SCLC subgroup of extensive stage using IHC, it also showed that HER2 overexpression determined by IHC was a marker of poor prognosis in NSCLC and SCLC. In other subgroup of squamous cell carcinoma tested by IHC, the combined HR was 0.87 (95% CI: 0.61-1.25), indicating that HER2 overexpression was not a prognostic factor for squamous cell carcinoma. Finally, in the subgroup analysis of HER2 amplification status of NSCLC using fluorescence in situ hybridization, we also found that HER2 amplification determined by fluorescence in situ hybridization was not significantly related to prognosis. Conclusions: Although bias could be inevitable, this meta-analysis suggests that HER2 overexpression is a poor prognostic factor in lung cancer, especially for SCLC, adenocarcinoma, and early-stage NSCLC.

TIPS is currently the first choice to prevent rebleeding except that TIPS is worse than endoscopic therapy for encephalopathy. An exploration of new approaches out of above complications will be of considerable clinical significance and be a challenge to clinicians.

Background: During the current COVID-19 pandemic, a link between acute cardiac injury and COVID-19 infection has been observed. There is currently no consensus on the incidence of cardiac injury, its relationship to prognosis, or its possible cause. In this article we provide a comprehensive review and meta-analysis of the incidence, comorbidities, outcomes, and possible mechanisms of acute cardiac injury in COVID-19 patients. Methods: We searched PubMed and Embase for studies that evaluated cardiac injury in hospitalized COVID-19 patients. Data on Therefore, the purpose of this study was to present a systematic review and meta-analysis of the literature to investigate the incidence of cardiac injury, its correlations with comorbidities and outcomes, and its possible mechanisms in the global COVID-19 population. Methods Data source and searchesWe performed a systematic literature search in PubMed and Embase. We used the following search terms: ("coronavirus") and ("cardiac injury" or "myocardial injury" or "myocarditis" or "troponin"). The search was limited to Chinese and English and all articles from January 1, 2020 to May 30, 2020 were reviewed. Study selection, data extraction, and definitionsOriginal studies that reported cardiac injury as elevated troponin levels were included. Review articles, meta-analysis and case reports were excluded. An aggregate data meta-analysis was performed. The extracted data included the number of patients enrolled in each study, age, sex, comorbidities (coronary artery disease [CAD], diabetes [DM], hypertension [HTN], and chronic obstructive pulmonary disease [COPD]), laboratory values (Creactive protein [CRP], procalcitonin, and N-terminal pro brain natriuretic peptide [NT-proBNP]), mortality, and other outcome CJC Open 2 (2020) 386e394

The published data about thymidylate synthase (TS) expression and its predictive value in advanced colorectal cancer (CRC) patients receiving fluoropyrimidine-based chemotherapy seemed inconclusive. To derive a more precise estimation of the relationship, a metaanalysis was performed. Studies have been identified by searching PubMed and Embase. Inclusion criteria were advanced CRC patients, received fluoropyrimidine-based chemotherapy and evaluation of TS expression and overall response rate (ORR). The relative ratio (RR) for ORR in patients with low-TS expression over those with high-TS expression with 95% confidence interval (CI) was calculated for each study as an estimation of the predictive effect of TS. A total of 24 studies including 1,112 patients were involved in this metaanalysis. The overall RR was 2.20 (95% CI, 1.82-2.66; p 5 0.000). For studies evaluating TS expression in metastatic lesions, the pooled RR was 3.23 (95% CI, 2.27-4.59; p 5 0.000); for studies testing TS expression in primary lesions, a pooled RR of 1.89 (95% CI, 1.45-2.48; p 5 0.000) was estimated. Focusing the analysis on immunohistochemistry (IHC)-based or RTPCR-based assessments, the pooled RR was 1.83 (95% CI, 1.44-2.34; p 5 0.000) and 2.96 (95% CI, 2.07-4.22; p 5 0.000), respectively. The results indicated that low-TS expression tumors in advanced CRC patients were more sensitive to fluoropyrimidine-based chemotherapy. Subgroup analyses indicated that the predictive value of TS expression evaluated in metastases was more prominent than that of primary lesions, and that TS expression tested by RTPCR was also of greater predictive value than by IHC. ' 2008 Wiley-Liss, Inc.Key words: thymidylate synthase; predictive value; advanced colorectal cancer; fluoropyrimidine-based chemotherapy; metaanalysis Colorectal cancer (CRC) is the 3rd most common malignant disease and the 4th most frequent cause of cancer-related deaths worldwide, with an estimated 1 million new cases and 0.5 million deaths every year. In developed countries, CRC is the 2nd most common tumor with a lifetime incidence of 5%. The prognosis of CRC is poor, with about half of all diagnosed patients dying of metastatic spread. In the advanced setting, the mainstay of treatment remains fluoropyrimidine-based chemotherapy. 1,2 Unfortunately, some patients do not benefit from fluoropyrimidine-based treatment strategies. Therefore, predictive factors are needed to identify the subgroup that is most likely to profit from such chemotherapy protocols. Thymidylate synthase (TS), which is an important enzyme for DNA synthesis, is the target of fluoropyrimidine. 3 The main mechanism of fluoropyrimidines antitumor effect is ascribed to be the competitive inhibition of TS after conversion to its active metabolite. 4 TS expression as a determinant of sensitivity to fluoropyrimidines has been demonstrated in vitro, 5,6 whereas TS expression in vivo has attracted a considerable attention because of its potential role as a promising predictive factor for response to fluoropyrimidine-base...