Associations between serum trace elements and the risk of nasopharyngeal carcinoma: a multi-center case-control study in Guangdong Province, southern China.

Background: Associations between trace elements and nasopharyngeal carcinoma (NPC) have been speculated but not thoroughly examined. Methods: This study registered a total of 225 newly diagnosed patients with NPC and 225 healthy controls matched by sex and age from three municipal hospitals in Guangdong Province, southern China between 2011 and 2015. Information was collected by questionnaire on the demographic characteristics and other possibly confounding lifestyle factors. Eight trace elements and the level of Epstein-Barr virus (EBV) antibody were measured in casual (spot) serum specimens by inductively coupled plasma-mass spectrometry (ICP-MS) and enzyme-linked immunosorbent assay (ELISA), respectively. Restricted cubic splines and conditional logistic regression were applied to assess the relationship between trace elements and NPC risk through single-and multiple-elements models. Results: Serum levels of chromium (Cr), cobalt (Co), nickel (Ni), arsenic (As), strontium (Sr) and molybdenum (Mo) were not associated with NPC risk. Manganese (Mn) and cadmium (Cd) were positively associated with NPC risk in both single-and multiple-element models, with ORs of the highest tertile compared with the reference categories 3.90 (95% CI, 1.27 to 7.34) for Mn and 2.30 (95% CI, 1.26 to 3.38) for Cd. Restricted cubic splines showed that there was a linear increasing trend between Mn and NPC risk, while for Cd there was a J-type correlation. Conclusion: Serum levels of Cd and Mn was positively related with NPC risk. Prospective researches on the associations of the two trace elements with NPC ought to be taken into account within the future.

Analysis of risk factors of hepatocellular carcinoma and establishment of a clinical prognosis model.

Liver cancer is a common malignancy of the digestive system. Hepatocellular carcinoma (HCC) accounts for the most majority of these tumors and it has brought a heavy medical burden to underdeveloped countries and regions. Many factors affect the prognosis of HCC patients, however, there is no specific statistical model to predict the survival time of clinical patients. This study derived a risk factor signature of HCC and reliable clinical prediction model by statistically analyzing The Surveillance, Epidemiology, and End Results (SEER) database patient information using an open source package in the python environment.

Synergy of Losartan and chemotherapy for patients with cholangiocarcinoma: A propensity score-matched analysis.

Background: Cholangiocarcinoma (CCA) is a malignant tumor originating from bile duct epithelial cells that no obvious clinical symptoms and specific clinical manifestations are shown in the early stage of CCA. Methods: Propensity score matching (PSM) is a quasi-experimental method in which this study used. Patients were enrolled from Department of General surgery, First Affiliated Hospital of Jinzhou Medical University from March 1, 2010, to December 30, 2019. Totally 170 patients with CCA were enrolled in this study. Results: We performed a 1:2 PSM study and found that patients with losartan group showed both comparable median OS (overall survival) and TTR (time to recurrence) to those in the patients without losartan group before PSM. However, after matching, patients with losartan group showed favorable median OS and TTR than those in the patients without losartan group. Then we performed Cox proportional hazards models and found that patients with losartan was an independent factor after multivariable analysis for patients with CCA. Furtherly, we sequenced serial cfDNA were performed in 10 patients with losartan and 9 patients without losartan who received adjuvant chemotherapy after tumor resection. These results showed that the treatment of losartan was related with tumor microenvironment and could be potentially useful to combine the immunotherapy for patients with CCA. Conclusion: In conclusion, this study demonstrated that the treatment of losartan could increase the efficacy of adjuvant chemotherapy and identified as an independent survival predictor for patients with CCA. Moreover, losartan could be potentially useful to combine the immunotherapy for patients with CCA.

Analysis of risk factors of gastrointestinal stromal tumors in different age groups based on SEER database.

Objective: To investigate the risk factors affecting the survival of patients with gastrointestinal stromal tumors (GISTs) in different age groups. Methods: Information on 6089 GIST patients was screened from the Surveillance, Epidemiology, and End Results (SEER) database. Risk factor analysis was performed using a chi-square test (univariate analysis). Survival analysis was performed using the Kaplan-Meier method (log-rank test) and the COX proportional hazard model. p Value < .05 was considered statistically significant. Results: Analyzed statistically to reveal that in addition to tumor size, mitotic index, and primary location, age, gender, race, and surgical treatment also were independent risk factors for GISTs. Gender, race, and location of disease influenced the survival rate of patients, which was higher in the young group (≤60 years old) than the elderly group (>60 years). Risk factors such as primary location, tumor diameter, and mitotic index varied significantly between the different age groups. Conclusions: Age, gender, race, and surgical treatment are independent risk factors that influence the prognosis in patients with GISTs. Some risk factors affecting prognosis are age dependent.

Dexmedetomidine for antiemesis in gynecologic surgery: a meta-analysis of randomized controlled trials.

PURPOSE: Postoperative nausea and vomiting (PONV) is a common complication after gynecological surgeries. This meta-analysis was conducted to evaluate the efficacy of dexmedetomidine on PONV after gynecological surgeries. METHODS: Three main electronic databases including Pub Med, Embase and Cochrane Central Register of Controlled Trials for randomized controlled trials (RCTs) were searched by two researchers independently. The metaanalysis was completed using Review Manager. RESULTS: Eleven RCTs with 692 patients were included in this metaanalysis. Dexmedetomidine a bridged postoperative nausea [Risk Ratio (RR)=0.59, 95% confidence interval (CI): 0.44 to 0.79] and vomiting [RR=0.48, 95% CI: 0.36 to 0.64] compared with placebo. Despite of higher incidence of intra operative bradycardia [RR 2.87, 95% CI 1.08 to 7.58] and hypotension [RR 4.26, 95% CI 1.43 to 12.69], we found significant decrease in postoperative shivering [RR 0.23, 95% CI 0.13 to 0.40] and pruritus [RR 0.40, 95% CI 0.17 to 0.93] in dexmedetomidine group, as well as the pain scores [standard mean difference (SMD)-0.96, 95% CI-1.37 to-0.54]. Significant reductions in the need for intraoperative fentanyl (RR 0.10, 95% CI 0.01-0.76, I(2) 0%), antiemetic (RR 0.62, 95% CI 0.39-0.99, I(2) 0%) and postoperative analgesic (RR 0.18, 95% CI 0.08-0.42, I(2) 0%) were also elicited. CONCLUSIONS: The current meta-analysis exhibits that dexmedetomidine is superiority to placebo in attenuating the incidence of PONV, postoperative shivering, pruritus, as well as the pain scores in patients undergoing gynecological surgeries. Still, the potential cardiovascular complications should be taken seriously.