Inflammatory burden of adolescents with childhood maltreatment: results from baseline data of a school cohort.

Increasing studies have investigated inflammatory burden of adults with childhood adversity, but less is known about how childhood maltreatment affects the inflammation level of adolescents. Baseline data of a school cohort of physical and mental health status and life experience survey on primary and secondary school students in Anhui Province, China was used. Childhood maltreatment of children and adolescents was assessed by Chinese version of Childhood Trauma Questionnaire-Short Form (CTQ-SF). Urine samples were collected to assess levels of soluble urokinase Plasminogen Activator Receptor (suPAR), C-reactive protein (CRP) and cytokines interleukin-6 (IL-6) by enzyme-linked immunosorbent assay (ELISA). Logistic regression was conducted to examine the association between childhood maltreatment exposure and risk of high inflammation burden. A total of 844 students were included with mean age 11.41 ± 1.57 years old. Adolescents with emotional abuse were significantly more likely to have high level of IL-6 (OR = 3.59, 95% CI 1.16-11.14). In addition, adolescents with emotional abuse were more likely to show high IL-6 and high suPAR combination (OR = 33.41, 95% CI 1.69-659.22), and high IL-6 and low CRP combination (OR = 4.34, 95% CI 1.29-14.55). Subgroup analyses showed that emotional abuse was associated with high IL-6 burden among boys or adolescents with depression. Childhood emotional abuse was positively associated with higher burden of IL-6. Early detection and prevention of emotional abuse for children and adolescents, especially for boys or adolescents with depression status, may be helpful for preventing elevated inflammatory burden and related health problems.

You are not lab rats at teaching hospitals: A systematic review of resident and fellow participation leads to improved colonoscopy.

BACKGROUND: Participation in colonoscopies is an essential aspect of endoscopic training. The purpose of this study was to explore the impact of fellow/trainee participation on colonoscopy outcomes. METHODS: This meta-analysis was registered on the International Prospective Register of Systematic Reviews (PROSPERO). From database inception to July 2022, studies investigating fellow involvement and colonoscopy outcomes were searched across Cochrane library, PubMed, and other databases. The random-effects model was applied to generate more conservative estimates. Sensitive analysis was conducted to explore whether the result would depend on a particular study. Egger's test and Begg's test were used to estimate the potential for publication bias. RESULTS: Seventeen studies including 30,062 participants were included. We found that fellow/trainee involvement enhanced the overall rates of adenoma detection and polyp detection (OR = 1.26, 95% CI = 1.14-1.40, p < 0.001; OR = 1.29, 95% CI = 1.02-1.63, p = 0.020, respectively). The mean number of adenoma/polyps per colonoscopy was also higher with fellow/trainee participation (MD = 0.12, 95% CI = 0.08-0.17, p < 0.001; MD = 0.15, 95% CI = 0.02-0.28, p = 0.020, respectively). CONCLUSION: In addition to its educational purpose, fellow or trainee involvement is associated with beneficial effects on colonoscopy outcomes.

Associations of nickel exposure with diabetes: evidence from observational studies.

The results of environmental epidemiological studies regarding the relationship between human exposure to nickel and the risk of diabetes remain controversial. Therefore, we performed a meta-analysis to investigate the relationship between nickel exposure and diabetes. PubMed, Web of Science, and Embase electronic databases were thoroughly searched from their inception to May 2023 to obtain relevant studies. The random-effects model was employed to determine pooled odds ratios (ORs) and 95% confidence intervals (CIs). Stratified and sensitivity analyses were also performed. Cochran Q test and I2 statistic were employed to assess heterogeneity between studies. Begg's and Egger's tests were employed to evaluate publication bias. The indicated studies were evaluated using the ROBINS-E risk of bias tool. The dose-response relationship between nickel in urine and diabetes risk was estimated by restricted cubic spline. A total of 12 studies with 30,018 participants were included in this study. In this meta-analysis, comparing the highest vs. lowest levels of nickel exposure, the pooled ORs for diabetes were 1.42 (95% confidence interval 1.14-1.78) for urine and 1.03 (0.57-1.86) for blood, respectively. A linear relationship between urinary nickel and diabetes risk was discovered in the dose-response analysis (P nonlinearity = 0.6198). Each 1 µg/L increase of urinary nickel, the risk of diabetes increased by 7% (OR = 1.07, 95% CI 1.04-1.10). The risk of diabetes was positively correlated with urine nickel exposure, whereas the risk was not significantly correlated with blood nickel. In the future, more high-quality prospective studies are needed to validate this conclusion.

Effect of aspirin on incidence, recurrence, and mortality in prostate cancer patients: integrating evidence from randomized controlled trials and real-world studies.

PURPOSE: Aspirin has been suggested to reduce the risk of cancer. However, previous studies have been inconsistent regarding the relationship between aspirin use and the risk of occurrence of prostate cancer (PCa). The purpose of this study was to assess the effect of aspirin on clinical outcomes in patients with PCa in a meta-analysis and to explore the possible dose-response relationship. METHODS: A systematic literature search was conducted in 10 electronic databases and 4 registries. The combined relative risks (RRs) were calculated using a random-effects model with 95% confidence interval (CIs) to assess the effect of aspirin on the risk of PCa. Relevant subgroup analyses and sensitivity analyses were performed. RESULTS: The across studies results show that aspirin use associated with lower incidence of PCa (RR: 0.96, 95% CI: 0.95-0.98), and reduced mortality (RR: 0.88, 95% CI: 0.82-0.95). The results of the subgroup analysis indicated that both cohort and population studies in the Americas showed a reduction in PCa incidence and mortality with aspirin use. A linear correlation was observed between dosage/duration of aspirin use and its protective effect. Additionally, post-diagnosis aspirin use was associated with decreased risk of PCa mortality. CONCLUSIONS: This meta-analysis revealed an independent correlation between the use of aspirin and reductions in both the incidence and mortality rates of PCa. However, randomized controlled trials did not find any association between aspirin use and PCa. Furthermore, the impact of aspirin on PCa occurrence was found to be dependent on both dosage and duration.

Effect of physical activity on incidence and mortality in patients with gastric cancer: evidence from real-world studies.

PURPOSE: Physical activity (PA) has been suggested to reduce the risk of cancer. However, previous studies have been inconsistent regarding the relationship between PA and the risk of developing gastric cancer (GC). The purpose of this study was to evaluate the impact of PA on the incidence and mortality risk of GC through a meta-analysis, as well as investigate potential dose-response relationships. METHODS: A systematic literature search was conducted in 10 electronic databases and 4 registries. The combined relative risks (RRs) were calculated using a random-effects model with 95% confidence interval (CIs) to assess the effect of PA on the risk of GC. Relevant subgroup analyses and sensitivity analyses were performed. RESULTS: The results showed that PA correlated with lower incidence of GC (RR: 0.83, 95% CI: 0.77-0.90), decreased risk of GC mortality (RR: 0.76, 95% CI: 0.66-0.89). The results of the subgroup analysis showed that PA was associated with reduced incidence of GC across gender, different regions, study designs, different sites of GC and different types of PA. A linear relationship was found for frequency of PA. CONCLUSIONS: This meta-analysis found that PA was associated with a reduced risk of GC incidence and mortality. The correlation between PA and GC occurrence was in a dose-response relationship.

Association of sugar-sweetened beverages with the risk of colorectal cancer: a systematic review and meta-analysis.

The association between sugar-sweetened beverages intake and colorectal cancer (CRC) remains controversial. A metaanalysis was performed to clarify the correlation between sugar-sweetened beverages and CRC risk/mortality. A systematic literature search was conducted in PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), Sinomed (CBM), Wanfang Data Knowledge Service Platform, and China Science and Technology Journal VIP database. Articles were restricted to be available in any language until March 31, 2022. The highest exposed categories were used to calculate the pooled relative risks (RR) values. Pooled relative risks (RR) and 95% confidence intervals (CI) were used to estimate the association of sugar-sweetened beverages with CRC risk and mortality. Heterogeneity was assessed with the Cochran Q statistic and quantified with the I2 statistic. A total of 17 studies (6 case-control and 11 cohort) involving 557,391 subjects were included in this meta-analysis. The pooled RRs for CRC incidence and mortality among people taking sugar-sweetened beverages were 1.17 (95% CI: 1.07-1.28) and 1.13 (95% CI: 0.99-1.29), respectively. In subgroup analysis, a correlation was found in the distal colon with a pooled RR of 1.41 (95% CI: 1.10-1.80). There was no correlation in the proximal colon with a pooled RR of 1.58 (95% CI: 0.79-3.17). We found statistically significant associations between CRC incidence and sugar-sweetened beverages intake in North America and Oceania, with pooled RRs of 1.16 (95% CI: 1.00-1.33) and 1.32 (95% CI: 1.13-1.55), respectively. In sensitivity analysis, after excluding each study and calculating heterogeneity and effect sizes, there was still a correlation between sugar-sweetened beverages intake and CRC risk. This meta-analysis suggests that sugar-sweetened beverages intake may increase CRC risk, independent of CRC mortality. Whether CRC risk increases with increased sugar-sweetened beverage intake needs further investigation in the future. This meta-analysis aimed to indicate the relationship between sugar-sweetened beverages intake and the risk and mortality of colorectal cancer. A total of 17 studies involving 557,391 subjects were included. The results showed that sugar-sweetened beverages may increase the risk of colorectal cancer but may not be associated with colorectal cancer mortality.

Coffee, Green Tea Intake, and the Risk of Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis of Observational Studies.

Several studies suggest an inverse relationship between coffee intake and risk of hepatocellular carcinoma (HCC), but the association between green tea intake and the risk of HCC is still inconclusive. We performed a meta-analysis of observational studies to clarify the association. We identified eligible studies published from January 1, 1992, to February 28, 2022, by searching PubMed, Web of Science, and EMBASE. A total of 32 studies were included in the meta-analysis. Among them, 21 studies involving 2,492,625 participants and 5980 cases of HCC reported coffee intake, 18 studies involving 1,481,647 participants and 6985 cases of HCC reported green tea intake, and seven studies reported both coffee intake and green tea intake. The results showed that a higher coffee (RR = 0.53; 95% CI: 0.47-0.59; I2 = 0.0%; Pheterogeneity = 0.634) or green tea (RR = 0.80; 95% CI: 0.67-0.95; I2 = 72.30%; Pheterogeneity < 0.001) intake may be associated with a lower risk of HCC. The same results were observed in both cohort and case-control subgroups. Our findings suggest that drinking coffee or green tea may be a potentially effective approach for the prevention or mitigation of HCC, but this still needs to be confirmed by further well-designed observational studies and clinical experimental research.

Meat Intake and the Risk of Bladder Cancer: A Systematic Review and Meta-Analysis of Observational Studies.

The evidence for the association between meat intake and the risk of bladder cancer (BC) is still inconclusive. A total of 29 studies involving 1,475,125 participants and 18,836 cases of BC were included in the meta-analysis. Among these studies, 11 reported total meat intake, 20 reported red meat intake, 19 reported processed meat intake, 15 reported white meat intake, and 15 reported fish intake. The results suggested that there was an overall increase in BC risk associated with total meat intake (RR = 1.10; 95% confidence interval: 0.92-1.31; I2 = 55.20%; P = 0.014), and a higher red meat (RR = 1.23; 95% CI: 1.08-1.39; I2 = 51.30%; P = 0.004) or processed meat (RR = 1.16; 95% CI: 1.08-1.25; I2 = 28.00%; P = 0.125) intake may increase the risk of BC. In contrast, a higher intake of fish (RR = 0.80; 95% CI: 0.67-0.95; I2 = 62.90%; P = 0.001) was inversely associated with the risk of BC. Moreover, we did not observe an association between white meat (RR = 0.96; 95% CI: 0.83-1.10; I2 = 53.70%; P = 0.007) and the risk of BC. Our findings suggested that dietary intervention may be an effective approach to preventing BC, which still needs to be confirmed by further well-designed observational studies.

Does aspirin reduce the incidence, recurrence, and mortality of hepatocellular carcinoma? A GRADE-assessed systematic review and dose-response meta-analysis.

PURPOSE: Aspirin has been suggested to reduce the risk of cancer. However, previous studies have been inconsistent regarding the relationship between aspirin use and the risk of occurrence of hepatocellular carcinoma (HCC). The purpose of this study was to assess the effect of aspirin on clinical outcomes in patients with HCC in a meta-analysis and to explore the possible dose-response relationship. METHODS: A systematic literature search was conducted in 10 electronic databases and 4 registries. The combined hazard ratios (HRs) were calculated using a random-effects model with 95% confidence interval (CIs) to assess the effect of aspirin on the risk of HCC. Relevant subgroup analyses and sensitivity analyses were performed. RESULTS: The results show that aspirin use correlated with lower incidence of HCC (HR: 0.75, 95% CI: 0.71-0.80), decreased risk of HCC recurrence (HR: 0.79, 95% CI: 0.65-0.96), and reduced mortality (HR: 0.72, 95% CI: 0.60-0.87). The results of the subgroup analysis showed that aspirin use was consistently associated with reduced incidence of HCC across different regions, study designs, and populations. A linear relationship was found for both dosage and duration of aspirin use. An increased of bleeding with aspirin use among patients was also observed (HR 1.10, 95% CI: 1.02-1.20). CONCLUSIONS: This meta-analysis found that aspirin use was independently associated with a reduced risk of HCC incidence, recurrence, and death. Furthermore, aspirin use influenced HCC occurrence in a dose-dependent and duration-dependent manner. However, an increased risk of bleeding with aspirin use was noted.

High spicy food intake may increase the risk of esophageal cancer: A meta-analysis and systematic review.

Spicy food is popular with people around the world and reports on the association between spicy food intake and esophageal cancer (EC) risk have been controversial. Therefore, we conducted a meta-analysis of 25 studies to provide the latest evidence for this uncertainty. We hypothesized that high spicy food intake is associated with an increased risk of EC. A database was searched to identify case-control or cohort studies of spicy food intake associated with EC through March 2022. Combined odds ratios (ORs) and their 95% CIs were used to estimate the effect of spicy food intake on EC. Subgroup analyses and sensitivity analyses were also performed. All data were analyzed using STATA 15.1 software. Twenty-five studies from 22 articles met the inclusion criteria for the meta-analysis (7810 patients with EC and 515,397 controls). Despite significant heterogeneity (P < .001), the comparison of highest versus lowest spicy food intake in each study showed a significant OR of 1.70 (95% CI, 1.30-2.22). In subgroup analyses, this positive association was found among the Chinese population, different sample sizes of EC, different sources of the control group, and different quality of articles. However, for India, as well as for other countries, esophageal squamous cell carcinoma and esophageal adenocarcinoma showed no statistically significant association. This meta-analysis suggests that high levels of spicy food intake may be associated with an increased risk of EC, although 1 prospective study found an inverse association. Additional studies are necessary to confirm the relationship between spicy food and EC risk.

Identification and Verification of Potential Biomarkers in Gastric Cancer By Integrated Bioinformatic Analysis.

Background: Gastric cancer (GC) is a common cancer with high mortality. This study aimed to identify its differentially expressed genes (DEGs) using bioinformatics methods. Methods: DEGs were screened from four GEO (Gene Expression Omnibus) gene expression profiles. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed. A protein-protein interaction (PPI) network was constructed. Expression and prognosis were assessed. Meta-analysis was conducted to further validate prognosis. The receiver operating characteristic curve (ROC) was analyzed to identify diagnostic markers, and a nomogram was developed. Exploration of drugs and immune cell infiltration analysis were conducted. Results: Nine up-regulated and three down-regulated hub genes were identified, with close relations to gastric functions, extracellular activities, and structures. Overexpressed Collagen Type VIII Alpha 1 Chain (COL8A1), Collagen Type X Alpha 1 Chain (COL10A1), Collagen Triple Helix Repeat Containing 1 (CTHRC1), and Fibroblast Activation Protein (FAP) correlated with poor prognosis. The area under the curve (AUC) of ADAM Metallopeptidase With Thrombospondin Type 1 Motif 2 (ADAMTS2), COL10A1, Collagen Type XI Alpha 1 Chain (COL11A1), and CTHRC1 was >0.9. A nomogram model based on CTHRC1 was developed. Infiltration of macrophages, neutrophils, and dendritic cells positively correlated with COL8A1, COL10A1, CTHRC1, and FAP. Meta-analysis confirmed poor prognosis of overexpressed CTHRC1. Conclusion: ADAMTS2, COL10A1, COL11A1, and CTHRC1 have diagnostic values in GC. COL8A1, COL10A1, CTHRC1, and FAP correlated with worse prognosis, showing prognostic and therapeutic values. The immune cell infiltration needs further investigations.

CCNB2 expression correlates with worse outcomes in breast cancer patients: a pooled analysis.

Cyclin B2 (CCNB2) is upregulated in Breast Cancer (BC) and associated with worse relapse-free survival (RFS). However, its correlation with other clinical outcomes in BC was yet to be clarified. Therefore, this study aimed to explore the clinical significance of CCNB2 in BC. A comprehensive search was performed in PrognoScan and Gene Expression Omnibus (GEO) databases by searching the keywords of CCNB2 and breast cancer. Pooled hazard ratios (HRs) of overall survival (OS), relapse-free survival (RFS), distant metastasis-free survival (DMFS), disease-specific survival (DSS), and disease-free survival (DFS), and their corresponding 95 percent confidence intervals (CI) were calculated. Sensitivity analysis by omitting one study at a time and publication bias assessment by Egger's test and Begg's test were conducted. The clinical outcomes were externally verified via Kaplan-Meier Plotter. All of the statistical analyses were performed through STATA 17.0, and P values of less than 0.05 were taken to be statistically significant. Seven records with 1,074 participants were included for OS, with HR of 1.71 (95 percent CI = 1.24-2.35). Verification through Kaplan-Meier Plotter online tool based on 1,897 patients showed an HR of 1.75 (95 percent CI = 1.45-2.12, P < .01). For RFS, 11 records with 1,253 participants were included with the pooled HR of 1.37 (95 percent CI: 1.10-1.71). Verification based on 4,929 patients found and HR of 1.97 (95 percent CI = 1.78-2.19, P < .01). Regarding DMFS, the pooled HR of 10 records with 1,395 participants was 1.60 (95 percent CI: 1.24-2.05) and verification based on 2,765 patients revealed an HR of 1.97 (95 percent CI = 1.68-2.31, P < .01). For DSS, four records with 689 participants were included for DSS, with HR of 1.38 (95 percent CI = 0.59-3.24). The HR of DFS was 1.60 (95 percent CI: 0.46-5.51) after pooling 3 records with 379 participants. High expression of CCNB2 in BC is associated with worse OS, RFS, and DMFS, but not with DSS and DFS. More well-designed studies from different populations and different BC types are still needed.

Meat Intake and the Risk of Hepatocellular Carcinoma: A Meta-Analysis of Observational Studies.

The association between meat intake and hepatocellular carcinoma (HCC) risk is still unclear. We conducted a meta-analysis with observational studies to clarify this relationship. A total of 17 studies involving 2,915,680 participants and 4,953 cases of HCC were included in the meta-analysis. Ten studies reported red meat intake, nine reported white meat intake, nine reported fish intake, seven reported processed meat intake, and five reported total meat intake. The results showed that the consumption of red meat (relative risk [RR] = 1.04; 95% confidence interval [CI]: 0.91-1.18; I2=50.50%; P = 0.033) and total meat intake (RR = 1.01; 95% CI: 0.90-1.13; I2 = 15.50%; P = 0.316) were not associated with risk of HCC. However, a higher dietary intake of processed meat (RR = 1.20; 95% CI: 1.02-1.41; I2 = 26.30%; P = 0.228) may increase the risk of HCC. In contrast, the intake of white meat (RR = 0.76; 95% CI: 0.63-0.92; I2 = 68.30%; P = 0.001) and fish (RR = 0.91; 95% CI: 0.86-0.96; I2 =40.90%; P = 0.095) were inversely associated with risk of HCC. Our findings suggest that dietary intervention may be an effective approach to preventing HCC. These need to be verified with further well-designed observational studies and experimental clinical research.

Diagnostic Value, Prognostic Value, and Immune Infiltration of LOX Family Members in Liver Cancer: Bioinformatic Analysis.

Background: Liver cancer (LC) is well known for its prevalence as well as its poor prognosis. The aberrant expression of lysyl oxidase (LOX) family is associated with liver cancer, but their function and prognostic value in LC remain largely unclear. This study aimed to explore the function and prognostic value of LOX family in LC through bioinformatics analysis and meta-analysis. Results: The expression levels of all LOX family members were significantly increased in LC. Area under the receiver operating characteristic curve (AUC) of LOXL2 was 0.946 with positive predictive value (PPV) of 0.994. LOX and LOXL3 were correlated with worse prognosis. Meta-analysis also validated effect of LOX on prognosis. Nomogram of these two genes and other predictors was also plotted. There was insufficient data from original studies to conduct meta-analysis on LOXL3. The functions of LOX family members in LC were mostly involved in extracellular and functions and structures. The expressions of LOX family members strongly correlated with various immune infiltrating cells and immunomodulators in LC. Conclusions: For LC patients, LOXL2 may be a potential diagnostic biomarker, while LOX and LOXL3 have potential prognostic and therapeutic values. Positive correlation between LOX family and infiltration of various immune cells and immunomodulators suggests the need for exploration of their roles in the tumor microenvironment and for potential immunotherapeutic to target LOX family proteins.

Dietary carbohydrate intake is associated with a lower risk of breast cancer: A meta-analysis of cohort studies.

The association between dietary carbohydrate intake and breast cancer (BC) remains controversial. This meta-analysis aimed to elucidate the association between dietary carbohydrate intake (dietary fiber, whole grain, sugar, and unidentified carbohydrate) and BC risk in a cohort study. We hypothesized that dietary carbohydrate intake is associated with an increased risk of BC. PubMed, Cochrane Library, Web of Science, Embase, and Chinese databases were searched for relevant articles through March 2021. Pooled relative risks (RRs) were calculated using random-effects model. The results showed the pooled RRs for dietary carbohydrate intake and BC incidence, mortality, and recurrence were 0.98 (95% confidence interval [CI], 0.95-1.00), 0.96 (95% CI, 0.89-1.03), and 0.96 (95% CI, 0.83-1.11), respectively. In subgroup analysis, a negative association was found between dietary fiber and BC incidence and mortality. Pooled RRs were 0.94 (95% CI, 0.91-0.98) and 0.88 (95% CI, 0.78-1.00). Dose-response analysis showed that every 10-g/d increments in dietary fiber intake was associated with a significant 3% reduction in BC incidence, and every 10-g/d increase in dietary fiber intake, BC incidence in premenopausal women was significantly reduced by 14%. In addition, the marginal relation for whole grain, which may decrease BC incidence (RR = 0.95; 95% CI, 0.86-1.05), but increase BC mortality (RR = 1.02; 95% CI, 0.92-1.14). A marginal positive relation was also observed between sugar and BC incidence (RR = 1.04; 95% CI, 0.94-1.14). This meta-analysis of cohort studies suggested that dietary carbohydrate intake is associated with a lower risk of BC incidence, mortality, and recurrence.

Comprehensive Analysis of SFRP Family Members Prognostic Value and Immune Infiltration in Gastric Cancer.

Gastric cancer (GC) is the fifth most common cancer globally. Secreted frizzled-related proteins (SFRP) are important elements associated with the Wnt signaling pathway, and its dysregulated expression is found in multiple cancers. However, the function of distinct SFRPs in GC remains poorly understood. We investigated the differential expression, prognostic value, and immune cell infiltration of SFRPs in gastric cancer patients from the Oncomine, Gene Expression Profiling Interactive Analysis (GEPIA), UALCAN, Kaplan-Meier plotter, cBioPortal, STRING, Gene-MANIA, DAVID, MethSurv, and TIMER databases. We found that the expression levels of SFRP2 and SFRP4 were significantly increased in GC tissues, whereas the SFRP1 and SFRP5 expressions were reduced. SFRP1, SFRP2, and SFRP5 were significantly correlated with the clinical cancer stage in GC patients. Higher expression of SFRPs was associated with short overall survival (OS) in GC patients. Besides, high SFRPs methylation showed favorable OS in GC patients. The functions of SFRPs were primarily related to the Wnt signaling pathway, immune system development, and basal cell carcinoma. The expression of SFRPs was strongly correlated with immune infiltrating cells, including CD4+ T cells and macrophages in GC. Our study indicated that SFRPs could be potential targets of precision therapy and prognostic biomarkers for the survival of GC patients.

Radiofrequency ablation versus stereotactic body radiotherapy for hepatocellular carcinoma: a meta-analysis.

The present meta-analysis was performed to evaluate the efficacy of radiofrequency ablation (RFA) and stereotactic body radiotherapy (SBRT) in hepatocellular carcinoma (HCC) patients. A systematic literature search was conducted of online databases prior to February 21, 2021. Eleven articles involving 8429 patients were included. The pooled hazard ratio for overall survival (OS) of RFA versus SBRT was 0.79 (p < 0.001). Statistically significant differences were found in the 1-, 2-, 3-, 4- and 5-year pooled OS and freedom from local progression (FFLP) rates between the two groups, favoring the RFA arms. However, the pooled local control (LC) rates were higher in the SBRT arm. RFA provided better OS and FFLP for treating HCC, while SBRT achieved superior LC. PROSPERO registration number: CRD42020207877.

Lay abstract Radiofrequency ablation (RFA) and stereotactic body radiation therapy (SBRT) are two common nonsurgical methods for the treatment of hepatocellular carcinoma patients. The purpose of this meta-analysis was to compare the efficacy of the two methods. The analysis included 11 original studies after online databases search prior to 21 February 2021. The results showed that RFA provided better survival benefits and less local disease progression for the treatment of HCC patients, while SBRT obtained superior local control of tumor tissues.

Aspirin Use and Risk of Breast Cancer: A Meta-analysis of Observational Studies from 1989 to 2019.

BACKGROUND: Some evidence shows that aspirin can reduce the morbidity and mortality of different cancers, including breast cancer. Aspirin has become a new focus of cancer prevention and treatment research at present, however, clinical studies found conflicting conclusions of its anticancer characteristics. MATERIALS AND METHODS: A systematic literature search was performed in 8 electronic databases. The pooled relative risk (RR) with 95% confidence interval (CI) was calculated using the random effects model to estimate the effect of aspirin on breast cancer. RESULTS: Forty-two published articles with 99,769 patients were identified. The meta-analysis showed a significant decrease in breast cancer risk with aspirin use (RR, 0.92; 95% CI, 0.89-0.96; I2 = 72%). Aspirin use decreased the risk of hormone receptor-positive tumors (estrogen receptor [ER]-positive RR, 0.89; 95% CI, 0.82-0.97; I2=54%; progesterone receptor [PR]-positive RR, 0.86; 95% CI, 0.78-0.95; I2=32%; ER- and PR-positive RR, 0.92; 95% CI, 0.85-1.00; I2=45%) and reduced the risk of breast cancer in postmenopausal women (RR, 0.92; 95% CI, 0.86-0.98; I2=59%). Further analysis showed that for the in situ breast cancer, regular-dose and more than 3 years use of aspirin were associated with the reduced risk of breast cancer. CONCLUSION: This meta-analysis suggested that aspirin may reduce the overall risk of breast cancer, reduce the risk of breast cancer in postmenopausal women, hormone receptor-positive tumors, and in situ breast cancer. Larger, multicenter clinical studies are needed to find the optimal dose range, frequency, and duration of the aspirin use to explore the best benefit-risk ratio.

Association of smoking history with severe and critical outcomes in COVID-19 patients: A systemic review and meta-analysis.

INTRODUCTION: The highly infectious coronavirus disease 2019 (COVID-19) has now rapidly spread around the world. This meta-analysis was strictly focused on the influence of smoking history on the severe and critical outcomes on people with COVID-19 pneumonia. METHODS: A systematic literature search was conducted in eight online databases before 1 February 2021. All studies meeting our selection criteria were included and evaluated. Stata 14.0 software was used to analyze the data. RESULTS: A total of 109 articles involving 517,020 patients were included in this meta-analysis. A statistically significant association was discovered between smoking history and COVID-19 severity, the pooled OR was 1.55 (95%CI: 1.41-1.71). Smoking was significantly associated with the risk of admission to intensive care unit (ICU) (OR=1.73, 95%CI: 1.36-2.19), increased mortality (OR=1.58, 95%CI: 1.38-1.81), and critical diseases composite endpoints (OR=1.61, 95%CI: 1.35-1.93), whereas there was no relationship with mechanical ventilation. The pooled prevalence of smoking using the random effects model (REM) was 15% (95%CI: 14%-16%). Meta-regression analysis showed that age (P=0.004), hypertension (P=0.007), diabetes (P=0.029), chronic obstructive pulmonary disease (COPD) (P=0.001) were covariates that affect the association. CONCLUSIONS: Smoking was associated with severe or critical outcomes and increased the risk of admission to ICU and mortality in COVID-19 patients, but not associated with mechanical ventilation. This association was more significant for former smokers than in current smokers. Current smokers also had a higher risk of developing severe COVID-19 compared with non-smokers. More detailed data, which are representative of more countries, are needed to confirm these preliminary findings.

Does aspirin reduce the incidence, recurrence, and mortality of colorectal cancer? A meta-analysis of randomized clinical trials.

BACKGROUND: Colorectal cancer (CRC) is the third most common diagnosed cancer and the third leading cause of all cancer deaths in the USA. Some evidences are shown that aspirin can reduce the morbidity and mortality of different cancers, including CRC. Aspirin has become a new focus of cancer prevention and treatment research so far; clinical studies, however, found conflicting conclusions of its anti-cancer characteristics. This study is to summarize the latest evidence of correlation between aspirin use and CRC and/or colorectal adenomas. METHODS: Databases were searched to identify randomized controlled trials (RCTs) in the salvage setting. The pooled relative risk (RR) with 95% confidence interval (CI) was used to estimate the effect of aspirin on colorectal cancer and/or colorectal adenomas. Subgroup analysis and sensitivity analysis were also conducted. RESULTS: The result showed that aspirin use was not associated with incidence of CRC (RR 0.97; 95% CI 0.84-1.12; P = 0.66; I2 = 34%), aspirin use was found to be associated with reduced recurrence of colorectal adenomas (RR 0.83; 95% CI 0.72-0.95; P = 0.006; I2 = 63%) and reduced mortality of CRC (RR 0.79; 95% CI 0.64-0.97; P = 0.02; I2 = 14%). Subgroup analysis found a statistically significant association in low dose with a pooled RR of 0.85 (95% CI 0.74-0.99; P = 0.03; I2 = 31%). CONCLUSIONS: This meta-analysis of randomized controlled trial data indicates that aspirin reduces the overall risk of recurrence and mortality of CRC and/or colorectal adenomas. Incidence of CRC was also reduced with low-dose aspirin. The emerging evidence on aspirin's cancer protection role highlights an exciting time for cancer prevention through low-cost interventions. TRIAL REGISTRATION: Clinicaltrials.gov no: CRD42020208852; August 18, 2020; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020208852 ).