Use of pro-/synbiotics as prophylaxis in patients undergoing colorectal resection for cancer: a meta-analysis of randomized controlled trials.

AIMS: To estimate the efficacy of pro-/synbiotics treatment in patients undergoing colorectal resection, a meta-analysis of randomized controlled trials was conducted. METHODS: An electronic search of PubMed, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Academic Search Premier, and China National Knowledge Infrastructure was performed, and RevMan 5.0 was used for statistical analysis. RESULTS: Six studies including 361 patients undergoing elective colorectal surgery were retrieved. The combined analysis revealed that perioperative pro-/synbiotics administration had a positive effect on the incidence of diarrhea (OR 0.29, 95% CI 0.14 to 0.62, P=0.001), the incidence of symptomatic intestinal obstructions (OR 0.39, 95% CI 0.19 to 0.78, P=0.008), the incidence of operative total infections (OR 0.39, 95% CI: 0.22 to 0.68, P=0.0010), and pneumonia infection (OR 0.32, 95% CI 0.11 to 0.93, P=0.04). The regimen increased the numbers of Lactobacillus (MD 2.66, 95% CI: 2.13 to 3.18; P<0.00001), and decreased the counts of Enterobacteriaceae (MD -1.52, 95% CI: -1.93 to -1.11, P<0.00001). No significant differences were found between the two groups in septic morbidity, incision infection, perineal infection, intraabdominal infection, anastomotic leak, the first defecation time, length of hospital stay, mesenteric lymph nodes for bacterial translocation. No mortality related to pro-/synbiotics treatment was revealed in all studies. CONCLUSIONS: Based on the meta-analysis, perioperatively use pro-/synbiotics as prophylaxis in patients undergoing colorectal resection improved clinical outcomes. The best preventive strategy (including species and the optimal dose) of pro-/synbiotics should be considered in future meta-analyses.

[Expression of cyclooxygenase-2 and vascular endothelial growth factor in human prostate cancer and its significance].

OBJECTIVE: To evaluate expressions of cyclooxygenase-2 (COX-2) and vascular endothelial growth factor (VEGF) in primary prostate cancer and its clinical significance. METHODS: Expressions of COX-2 and VEGF were detected by immunohistochemical assay in tissues of 40 prostate cancer and 10 benign prostatic hyperplasia samples. RESULTS: COX-2 and VEGF levels in prostate cancer were much higher than those in BPH. The degrees of cancer malignancy and invasion positively correlated with the expressions of COX-2 and VEGF. COX-2 level positively correlated with VEGF level. CONCLUSION: The abnormal expression of COX-2 plays an important role in the development of primary prostate cancer. COX-2 and VEGF are good molecular markers of prostate cancer which are hopeful to be used for the assistant diagnosis and the prediction of prognosis of prostate cancer.