Background. Inflammation plays an important role in the development of tumors. Several serum based-markers and ratios have been investigated for their prognostic value in pancreatic cancer. However, the prognostic value of the neutrophil-to-monocyte ratio (NMR) and platelet-to-white blood cell ratio (PWR) for patients with pancreatic cancer has scarcely been investigated. Methods. From October 2013 to November 2018, a retrospective cohort study was performed on 269 pancreatic cancer patients without treatment. Receiver operating characteristic curves were generated, and areas under the curve were compared for the evaluation of the discriminatory ability of inflammation-based prognostic scoring systems. Kaplan-Meier curves and the Cox proportional hazard model were employed to analyze the relationships among NMR, PWR, and overall survival (OS). Results. The optimal cutoff values of NMR and PWR were 48 and 6, respectively. In univariate analysis, the survival time of NMR > 48 and PWR ≤ 6 was shorter than that of NMR ≤ 48 and PWR > 6 in patients with pancreatic cancer ( P < 0.001 ). In Cox univariate and multivariate analyses, NMR (hazard ratio (HR), 9.095; 95% confidence interval (CI), 3.64–22.72; P < 0.001 ) and PWR (HR, 8.230; 95% CI, 3.32–20.43; P < 0.001 ) were significantly correlated with OS. Conclusions. The current study demonstrated that NMR and PWR may serve as novel and promising inflammatory prognostic scores for patients with pancreatic cancer. Elevated NMR (>48) and depressed PWR (<6) were independently associated with poor prognosis in patients with pancreatic cancer.
Background: Sodium sulfate-based purge has shown better quality of bowel preparation than polyethylene glycol (PEG) in a large retrospective study. However, its side effects and impact to gut microbiota have not been assessed. Besides, evidence from intestinal microecology that probiotics were beneficial to individuals who received bowel preparation is still lacking. The aims are to evaluate the side effects and microecological impact of two bowel cleansing agents (PEG and mirabilite), as well as the regulating effect of probiotics on microecosystem perturbed by bowel preparation.Results: Mirabilite preparation appeared superior to PEG preparation in terms of side effects, consumed time and volume of solutions. Quantitative PCR results showed that the recovery rate of total microbial load in mirabilite group was faster than that in PEG group. 16S rRNA sequencing showed that there were no significant differences in effects of two bowel cleansing agents on multiple microbiota diversity metrics. And both laxatives may affect the relative abundance of core microbiota until 28 days after bowel preparation. Probiotics supplementation was beneficial to recovery of perturbed microecosystem and the maintenance of homeostasis in the gut according to our results. Moreover, probiotics supplementation relieved abdominal symptoms and few individual events induced by bowel preparation during long-term follow-up.Conclusions: Mirabilite could be an optimal bowel cleansing agent for healthy people and can be applied broadly. Besides, probiotics are suggested to administrate after bowel cleansing as it brings multiple benefits in our study.
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