[Nutritional risk screening and related factors of cancer patients in community of Shanghai, 2018-2019].

Objective: To study the risk of malnutrition and related factors of cancer patients in community of Shanghai. Methods: From October 2018 to January 2019, four communities, Pengpu New Village Street, Pengpu Town, Jiangning Road Street, and Caojiadu Street, from 14 communities in Jing 'an District, Shanghai City, were selected by using a random cluster sampling method based on the Shanghai Cancer Registration and reporting system. All cases of malignant tumors and benign tumors of the central nervous system were included. A total of 4 396 questionnaires were distributed. After the exclusion of 9 invalid questionnaires, 3 310 valid questionnaires were included with a rate of 99.73%. A self-designed questionnaire was used to collect data including basic demographic characteristics, history of malignant, physical and psychological pain, nutritional demands and cognitive status. Malnutrition Universal Screening Tools (MUST) was used to analyze the nutritional risk of cancer patients in the community. Multivariate logistic regression model was applied to analyze potential factors. Results: Among the 3 310 cancer patients who completed the survey, the average age of study participants was (64.05±13.02), and 1 467 cases (44.32%) were males. The incidence rate of nutritional risk was 12.84% (425/3 310). The result of logistic regression analysis showed that compared with male, other cancer patients and no physical pain, the risk factors of the occurrence of nutritional included: female (OR=1.53,95%CI:1.23-1.92), head and neck malignant tumors (OR=1.42,95%CI:1.07-1.90), bronchus/lung malignant tumors (OR=1.93,95%CI:1.43-2.61), liver, biliary/pancreatic malignant tumors (OR=2.11,95%CI:1.21-3.65) and upper gastrointestinal malignant tumors (OR=6.04,95%CI:4.31-8.46), patients with physical pain (OR=1.39,95%CI:1.02-1.89). Conclusion: Nutritional risk of cancer patients is higher in community of Shanghai. Gender, location of tumors and physical pain are associated with the occurrence of nutritional risk.

Meta-analysis of biomarkers predicting risk of malignant progression in Barrett's oesophagus.

BACKGROUND: Barrett's oesophagus is a precursor to the development of oesophageal adenocarcinoma. This study sought to clarify the role of genetic, chromosomal and proliferation biomarkers that have been the subjects of multiple studies through meta-analysis. METHODS: MEDLINE, Embase, PubMed and the Cochrane Library were searched for clinical studies assessing the value of p53, p16, Ki-67 and DNA content abnormalities in Barrett's oesophagus. The main outcome measure was the risk of development of high-grade dysplasia (HGD) or oesophageal adenocarcinoma. RESULTS: Some 102 studies, with 12 353 samples, were identified. Mutation (diagnostic odds ratio (DOR) 10·91, sensitivity 47 per cent, specificity 92 per cent, positive likelihood ratio (PLR) 4·71, negative likelihood ratio (NLR) 0·65, area under the curve (AUC) 0·792) and loss (DOR 16·16, sensitivity 31 per cent, specificity 98 per cent, PLR 6·66, NLR 0·41, AUC 0·923) of p53 were found to be superior to the other p53 abnormalities (loss of heterozygosity (LOH) and overexpression). Ki-67 had high sensitivity in identifying high-risk patients (DOR 5·54, sensitivity 82 per cent, specificity 48 per cent, PLR 1·59, NLR 0·42, AUC 0·761). Aneuploidy (DOR 12·08, sensitivity 53 per cent, specificity 87 per cent, PLR 4·26, NLR 0·42, AUC 0·846), tetraploidy (DOR 5·87, sensitivity 46 per cent, specificity 85 per cent, PLR 3·47, NLR 0·65, AUC 0·793) and loss of Y chromosome (DOR 9·23, sensitivity 68 per cent, specificity 80 per cent, PLR 2·67, NLR 0·49, AUC 0·807) also predicted malignant development, but p16 aberrations (hypermethylation, LOH, mutation and loss) failed to demonstrate any advantage over the other biomarkers studied. CONCLUSION: Loss and mutation of p53, and raised level of Ki-67 predicted malignant progression in Barrett's oesophagus.

Robotic thyroidectomy versus conventional open thyroidectomy for differentiated thyroid cancer: meta-analysis.

OBJECTIVE: To conduct a meta-analysis to compare the short-term outcomes of robotic thyroidectomy and conventional open thyroidectomy for differentiated thyroid cancer. METHODS: Medline, Embase, Science Citation Index Expanded and the Cochrane Library databases were searched for relevant literature. The evaluated endpoints were intra-operative and post-operative outcomes. RESULTS: Twelve eligible, non-randomised comparative studies involving 2513 patients were included, with 923 patients in the robotic thyroidectomy group and 1590 patients in the conventional open thyroidectomy group. Meta-analysis results revealed that robotic thyroidectomy was associated with significantly longer operative time and a lower number of retrieved central lymph nodes, as compared with conventional open thyroidectomy. No significant differences were found between robotic thyroidectomy and conventional open thyroidectomy in terms of post-operative outcomes. CONCLUSION: Robotic thyroidectomy appears to be a feasible and safe surgical procedure for patients with differentiated thyroid cancer. However, more high-quality randomised clinical trials should be undertaken to confirm these findings.

Meta-analysis of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy.

BACKGROUND: Surgical reconstruction following pancreaticoduodenectomy (PD) is associated with significant morbidity and mortality. Because of great variability in definitions of specific complications, it remains unclear whether there is a difference in complication rates following the two commonest types of reconstruction, pancreaticogastrostomy (PG) and pancreaticojejunostomy (PJ). Published consensus definitions for postoperative pancreatic fistula (POPF) have led to a series of randomized clinical trials (RCTs) uniquely placed to address this question. METHODS: A literature search was carried out to identify all RCTs comparing postoperative complications of PG versus PJ reconstruction following PD published between January 1995 and December 2013. Pooled odds ratios (ORs) with 95 percent confidence intervals (c.i.) were calculated using fixed-effect or random-effects models. RESULTS: In total, seven RCTs with 1121 patients were included. Four of these trials applied definitions as published by the International Study Group on Pancreatic Fistula (ISGPF). Using ISGPF definitions, the incidence of POPF was lower in patients undergoing PG than in those having PJ (OR 0·50, 95 per cent c.i. 0·34 to 0·73; P < 0·001). Using definitions applied by each individual study, PG was associated with significantly lower rates of POPF (OR 0·51, 0·36 to 0·71; P < 0·001), intra-abdominal fluid collection (OR 0·50, 0·34 to 0·74; P < 0·001) and biliary fistula (OR 0·42, 0·18 to 0·93; P = 0·03) than PJ. CONCLUSION: Meta-analysis of four RCTs based on ISGPF criteria, and seven RCTs using non-standard criteria, revealed that PG reduced the incidence of POPF after PD compared with PJ.

Systematic review and meta-analysis of outcomes after intraoperative pancreatic duct stent placement during pancreaticoduodenectomy.

BACKGROUND: Postoperative pancreatic leakage after pancreaticoduodenectomy is often serious. Although some studies have suggested that stenting the anastomosis can reduce the incidence of this complication, the value of stenting in the setting of pancreaticoduodenectomy remains unclear. METHODS: Studies comparing outcomes of stent versus no stent, and internal versus external stent placement for pancreaticoduodenectomy were eligible for inclusion. Pooled odds ratios (ORs) with 95 per cent confidence intervals were calculated using fixed- or random-effects models. RESULTS: From a search of the literature published between January 1973 and September 2011, five randomized clinical trials (RCTs) and 11 non-randomized observational clinical studies (OCS) involving 1726 patients were selected for inclusion in this review. Meta-analysis of RCTs revealed that placing a stent in the pancreatic duct did not reduce the incidence of postoperative pancreatic fistula. External stents had no advantage over internal stents in terms of clinical outcome. Subgroup analyses revealed that use of an external stent significantly reduced the incidence of pancreatic fistula (RCTs: OR 0·42, 0·24 to 0·76, P = 0·004; OCS: OR 0·43, 0·27 to 0·68, P < 0·001), delayed gastric emptying (RCTs: OR 0·41, 0·19 to 0·87, P = 0·02) and postoperative morbidity (RCTs: OR 0·55, 0·34 to 0·89, P = 0·02) compared with no stent. CONCLUSION: Pancreatic duct stenting did not reduce the incidence of pancreatic fistula and other complications in pancreaticoduodenectomy compared with no stenting. Although no difference was found between external and internal stents in terms of efficacy, external stents seemed to reduce the incidence of pancreatic fistula compared with control.

The effects of the polymorphism in exon 3 of the FAS gene on the death of chicken embryos during the incubation period.

To investigate the effect of a factor-associated suicide (FAS) gene polymorphism on the death of chicken embryos, we genotyped 190 dead embryos and 69 normally developing embryos from 7200 hatching Short-Leg Yellow Chicken eggs, as well as 119 dead embryos and 69 normally developing embryos from 4650 hatching Yellow B Chicken eggs. The results showed that there were significant (P < 0.05) genotypic differences between dead and normally developing embryos for this FAS gene polymorphism, a SNP in exon 3 (NC_006093.2:g.6514A>C, rs15793179). Logistic regression revealed that Short-Leg Yellow Chicken embryos with genotype g.6514CC had a significantly (P < 0.01) higher risk of death than those with genotype g.6514AC. This polymorphism has the potential to be an effective tool when used in conjunction with traditional selection methods.

Evidence for seasonal plasticity in the gonadotropin-releasing hormone (GnRH) system of the ewe: changes in synaptic inputs onto GnRH neurons.

In the Suffolk ewe, seasonal reproductive transitions are due primarily to changes in the responsiveness of the GnRH neurosecretory system to the negative feedback influence of estradiol. As GnRH neurons in the sheep, like those in other mammals, lack estrogen receptors, the influence of estradiol on GnRH neurosecretory activity is probably conveyed via afferents. As a possible structural basis for seasonality, we examined the ultrastructure and synaptic inputs of GnRH neurons in the preoptic area of ewes during the breeding season and seasonal anestrus. GnRH neurons were examined in both ovary-intact ewes and ovariectomized ewes bearing implants that produced constant levels of estradiol to eliminate a changing hormonal milieu as a factor in any seasonal variations. We found that preoptic GnRH neurons in breeding season ewes received more than twice the mean number of synaptic inputs per unit of plasma membrane as GnRH neurons in anestrous animals. Although GnRH dendrites received more synaptic input than GnRH somas, significant seasonal differences were seen in both axodendritic and axosomatic inputs. In contrast, unidentified neurons in the preoptic area showed no significant seasonal changes in their synaptic inputs. Seasonal changes in synaptic inputs onto GnRH neurons were seen in both intact animals and ovariectomized ewes bearing estradiol implants. Consequently, these seasonal alterations are unlikely to be due to changing levels of endogenous sex steroids, but may instead reflect changes in the environmental photoperiod and/or the expression of an endogenous circannual rhythm.

Differential responses of oxytocin and vasopressin neurons to the osmotic and stressful components of hypertonic saline injections: a Fos protein double labeling study.

Expression of Fos protein, detected immunocytochemically, was used to assess the relative responses of supraoptic nucleus (SON) oxytocin- (OX) and vasopressin- (VP) containing neurons to the osmotic vs. the osmotic plus stressful components of intraperitoneal hypertonic saline injections. The percentage of SON neurons showing Fos-like immunoreactivity (Fos-ir) was quantified for rats receiving general anesthesia only, anesthesia 1 h prior to either isotonic or hypertonic saline injection or no anesthesia prior to hypertonic injection. Hypertonic saline injection with and without anesthesia induced Fos-ir in 66% and 77% of SON neurons, respectively, whereas isotonic saline with anesthesia and anesthesia alone resulted in 15% and 13%, respectively, of cells showing Fos-ir. Double labeling for Fos-ir and either OX-ir or VP-ir resulted in quantitatively different responses to hypertonic injections with and without anesthesia in OX-ir and VP-ir neurons. The VP-ir neuronal response was similar under the two conditions: 49% and 48% of VP cells displaying Fos-ir with and without prior anesthesia, respectively. By contrast, a higher percentage of OX-ir neurons was found to exhibit Fos-ir without (68%) than with (53%) anesthesia. Thus, a greater percentage of neurons was induced to express Fos-ir when the stressful components of the hypertonic injection were unattenuated by anesthesia, and this difference was entirely due to increased numbers of responding OX neurons. These data indicate that, under these experimental conditions, SON OX neurons respond in larger numbers to the osmotic components of hypertonic saline injections and have a greater responsiveness than do VP neurons to the stressful components.