Background: Acute ischemic stroke (AIS) is the major type of stroke, which highly risks human health and life quality. Governor vessel acupuncture (GV Ac) is one specific acupoint selection treatment. This study aimed to systematically evaluate the clinical value of GV Ac in AIS patients.Methods: Seven electronic databases were searched for all related randomized controlled trials before December 2020. The included studies should meet the following criteria: all target patients were diagnosed as AIS; the experimental group used GV Ac as the only intervention or combined with routine neurology therapy as conventional treatment; the control group received ordinary acupuncture, or the same conventional treatment as the experimental group, or both. Evaluated the quality of all included trials and performed a meta-analysis of the extracted data.Results: A total of 18 trials were included, involving 1,543 AIS patients. The results showed compared to the conventional treatment, GV Ac combining with conventional therapy resulted in Barthel Index (BI) (MD

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Background and Aim: Although most chronic hepatitis B (CHB) patients achieve effective virological suppression after receiving long-term nucleos(t)ide analogs (Nucs) therapy, the safety of off-therapy is controversial under the monitor.Methods: We identified studies through searching PubMed, Embase, Cochrane Library, and Web of Science from January 1990 to February 2021. The eligible studies compare the long outcomes between discontinued and continued Nucs treatments groups among CHB patients. This study was conducted to investigate long-term outcomes, including biochemical, serological, and virological outcomes, as well as hepatocellular carcinoma (HCC) development rate between discontinued and maintained Nucs therapy groups among CHB patients.Results: Five eligible studies covering 1,425 patients were selected for meta-analysis. Our result exhibits that patients with Nucs off-treatment have a higher risk of alanine aminotransferase (ALT) flares-up than those who continued Nucs therapy under the monitor (OR = 9.39, 95%CI = 3.87–22.78). Nucs off-therapy patients have a higher virological bound incidence (OR = 617.96, 95%CI = 112.48–3,395.14) and a higher HBV DNA level (OR = 9.39, 95%CI = 3.87–22.78) than those who continued Nucs therapy. There was no statistically significant difference in the risk of hyperbilirubinaemia, hepatic decompensation, and HCC development between both two groups. Patients in Nucs off-therapy group demonstrate a higher HBsAg loss rate than those in the continued group (OR = 7.10, 95%CI = 6.68–13.69).Conclusions: Nucs off-therapy patients may exhibit a higher chance of achieving HBsAg loss than those who continue Nucs therapy. It requires close monitoring after Nucs off-therapy and timely restarting of Nucs therapy when ALT concentrations increase.

Background: The correlation between vitamin D intake and lung cancer development is controversial. This meta-analysis aims to evaluate the relationship between vitamin D and the prognosis and incidence of lung cancer. Methods: A comprehensive database search on Pubmed, Web of Science, EBSCO, and Cochrane Library was carried out from the beginning to November 2020. Long-term survival and the incidence rate of patients with lung cancer were the primary outcomes of the study. Results: Ten eligible studies were selected for the meta-analysis following specific inclusion and exclusion criteria. Four included studies, covering 5007 patients, compared the overall survival (OS) and relapse-free survival (RFS) of lung cancer patients among total vitamin D users with non-users. Significantly, the estimated pooled hazard ratio (HR) revealed that vitamin D could improve OS and RFS of lung cancer patients [HR=0.83, 95% CI (0.72-0.95); HR=0.79, 95% CI (0.61-0.97), respectively]. Vitamin D intake was inversely associated with lung cancer incidence in six studies [OR=0.90, 95% CI (0.83-0.97)]. Conclusions: The present meta-analysis shows vitamin D not only improves the long-term survival of lung cancer patients but has a beneficial effect on the incidence of lung cancer. Notwithstanding, more studies are needed to confirm the study results.

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Objective: The aim of this study was to investigate the value of multi-slice spiral CT (MSCT) in the diagnosis of malignant gastrointestinal stromal tumors (GISTs). Methods: Twenty-seven cases of MSCT images of malignant GIST proved by surgery and pathology were retrospectively analyzed. Both plain and enhanced CT scan was performed and multiplanar reconstruction was made in all cases. Results: The lesions originated from the stomach (n = 11), small intestine (n = 9), colon (n = 4), rectum (n = 1), and mesentery (n = 2). The transverse diameters of mass were 4.2-22 cm , the edges clearly (n = 12), unclearly (n = 15). The mass were mainly irregular in shape lobulated (n = 19). The lesions were mainly heterogeneity on plain scan, moderate to marked enhancement in arterial phase and durative enhanced in venous phase. Cystic necrosis were observed in all the lesions, 9 cases were cystic and solid mixed mass. Hepatic metastases (n = 4), pulmonary metastasis (n = 1), lymphatic metastasis (n = 2) were detected. The accuracy rate of MSCT diagnosis for location and pathologic features of GISTs were 85.2% (23/27) and 77.8% (21/27). Conclusion: Two-phase MSCT examination and axial images combined with multiplanar reconstruction images have important value for diagnosis of malignant GIST.

BackgroundThe health‐related quality of life (HRQoL) of patients with localized prostate cancer (LPCa) after treatment mainly surgery and radiotherapy (RT) has received increasing attention. The aim of this study is to compare the HRQoL of LPCa after surgery and RT.MethodsWeb of Science, Embase, PubMed and Cochrane databases were searched after January 2000 to observe the HRQoL scores after surgery and RT at different treatment time points.ResultsA total of 28 studies were included in this study, and the results showed that LPCa received surgery had better bowel scores than RT at ≤3 (weighted mean differences [WMD] = 4.18; p = 0.03), 3–6 (WMD = 4.16; p < 0.001), 6–12 (WMD = 2.99; p = 0.004), 24–60 (WMD = 1.87; p = 0.06), and ≥60 (WMD = 4.54; p = 0.02) months. However, LPCa received RT had higher urinary scores at ≤3 (WMD = −7.39; p = 0.02), 3–6 (WMD = −6.03; p = 0.02), 6–12 (WMD = −4.90; p < 0.001), 24–60 (WMD = −3.96; p < 0.001), ≥60 (WMD = −2.95; p < 0.001) months and had better sexual scores at ≤3 (WMD = −13.58; p = 0.09), 3–6 (WMD = −12.32; p = 0.06), 6–12 (WMD = −12.03; p = 0.002), 24–60 (WMD = −11.29; p < 0.001), and ≥60 (WMD = −3.10; p = 0.46) months than surgery. The scores difference between surgery and RT decreased over time.ConclusionOverall, for LPCa, surgery was associated with better HRQoL in the bowel domain, whereas RT was associated with better HRQoL in the urinary and sexual domains, with the difference between surgery and RT narrowing over time.

Objective. To examine the long-term risk of stroke in women who have experienced symptomatic menopausal transition. Methods. In this nationwide, population-based cohort study conducted from January 1, 2000 to December 31, 2013, we identified 22058 women with no prior history of stroke, who experienced symptomatic menopausal transition at ≥ 45 years of age. Moreover, 22058 women without symptomatic menopause were matched by propensity scores and enrolled as a comparison group. The propensity score was calculated by using all characteristic variables of each subject, including demographics (age and monthly income), comorbidities (hypertension, hyperlipidemia, diabetes mellitus, obesity, chronic kidney disease, coronary artery disease, congestive heart failure, chronic obstructive pulmonary disease, dysrhythmia, peripheral artery occlusive disease), Charlson's comorbidity index score, clinic visit frequency, and longterm medications (antihypertensives, antidiabetic agents, statins, antiplatelets, aspirin, warfarin, and hormone replacement therapy). The primary endpoint was the development of stroke after the onset of symptomatic menopausal transition. The Fine and Gray's proportional subhazards model was performed to assess the association between symptomatic menopausal transition and subsequent stroke. All subjects were followed up until December 31, 2013. Results. During a mean follow-up of 8.5 years (standard deviation 4.7 years, maximum 14 years), 2274 (10.31%) women with symptomatic menopausal transition and 1184 (5.37%) matched comparison participants developed stroke. The incidence rates were 11.17 per 1000 person-years in the symptomatic menopausal transition group compared with 8.57 per 1000 person-years in the comparison group. The risk of developing stroke was significantly higher in women with symptomatic menopausal transition (crude subhazard ratio, 1.31; 95% confidence interval, 1.22 to 1.41;