Joint effects of prescription opioid use and physical activity on depressive symptoms.

OBJECTIVES: The possible interaction of prescription opioid use and physical activity with regard to depressive symptoms has not been well studied. This study aimed to investigate the joint effects of prescription opioid use and physical activity on depressive symptoms. STUDY DESIGN: Cross-sectional study. METHODS: This cross-sectional study included 29,542 participants from the National Health and Nutrition Examination Survey (2007 to March 2020). Depressive symptoms were evaluated using the Patient Health Questionnaire-9. Multivariable logistic regression models were used to examine the association. RESULTS: Of the 29,542 adults, 2598 had depressive symptoms (weighted, 7.7%), 1845 used prescription opioids (weighted, 6.0%), and 18,373 (weighted 67.0%) achieved the recommended physical activity. After multivariable adjustment, the odds ratio (OR) of depressive symptoms was 4.06 (95% confidence interval [CI]: 3.28, 5.02) for both prescription opioid use and inactive physical activity compared to those without either condition. No multiplicative interaction was observed for prescription opioid use and inactive physical activity on depressive symptoms (OR = 1.26 [95% CI: 0.87, 1.81]). However, additive interaction was statistically significant between the 2 exposures (relative excess risk due to interaction = 1.34 [95% CI: 0.31, 2.36]; attributable proportion due to interaction = 0.33 [95% CI: 0.12, 0.54]; synergy index = 1.78 [95% CI: 1.12, 2.83]). CONCLUSIONS: Prescription opioid use and inactive physical activity interacted synergistically to affect depressive symptoms.

Oncologic outcomes of watch-and-wait strategy or surgery for low to intermediate rectal cancer in clinical complete remission after adjuvant chemotherapy: a systematic review and meta-analysis.

BACKGROUND: A watch-and-wait (WW) strategy or surgery for low to intermediate rectal cancer that has reached clinical complete remission (cCR) after neoadjuvant chemotherapy (nCRT) or total neoadjuvant therapy (TNT) has been widely used in the clinic, but both treatment strategies are controversial. OBJECTIVE: The aim of this study was to compare the oncologic outcomes of a watch-and-wait strategy or a surgical approach to treat rectal cancer in complete remission and to report the evidence-based clinical advantages of the two treatment strategies. METHODS: Seven national and international databases were searched for clinical trials comparing the watch-and-wait strategy with surgical treatment for oncological outcomes in patients with rectal cancer in clinical complete remission. RESULTS: In terms of oncological outcomes, there was no significant difference between the watch-and-wait strategy and surgical treatment in terms of overall survival (OS) (HR = 0.92, 95% CI (0.52, 1.64), P = 0.777), and subgroup analysis showed no significant difference in 5-year disease-free survival (5-year DFS) between WW and both local excision (LE) and radical surgery (RS) (HR = 1.76, 95% CI (0.97, 3.19), P = 0.279; HR = 1.98, 95% CI (0.95, 4.13), P = 0.164), in distant metastasis rate (RR = 1.12, 95% CI (0.73, 1.72), P = 0.593), mortality rate (RR = 1.62, 95% CI (0.93, 2.84), P = 0.09), and organ preservation rate (RR = 1.05, 95% CI (0.94, 1.17), P = 0.394) which were not statistically significant and on the outcome indicators of local recurrence rate (RR = 2.09, 95% CI (1.44, 3.03), P < 0.001) and stoma rate (RR = 0.35, 95% CI (0.20, 0.61), P < 0.001). There were significant differences between the WW group and the surgical treatment group. CONCLUSION: There were no differences in OS, 5-year DFS, distant metastasis, and mortality between the WW strategy group and the surgical treatment group. The WW strategy did not increase the risk of local recurrence compared with local resection but may be at greater risk of local recurrence compared with radical surgery, and the WW group was significantly better than the surgical group in terms of stoma rate; the WW strategy was evidently superior in preserving organ integrity compared to radical excision. Consequently, for patients who exhibit a profound inclination towards organ preservation and the evasion of stoma formation in the scenario of clinically complete remission of rectal cancer, the WW strategy can be contemplated as a pragmatic alternative to surgical interventions. It is, however, paramount to emphasize that the deployment of such a strategy should be meticulously undertaken within the ambit of a multidisciplinary team's management and within specialized centers dedicated to rectal cancer management.

Impact of heterogeneous nuclear ribonucleoprotein A/B subtype overexpression on the expression of cancer stem cell markers CD133 and CD44 and cellular proliferation capacity.

The occurrence and progression of intestinal cancer are complex, multifactorial processes in which tumor stem cells are believed to play a crucial role. An in-depth understanding of their molecular mechanisms holds imperative clinical significance for improving intestinal cancer treatment. HT-29 and HCT116intestinal cancer cell lines were utilized as research models. The experimental group (group E) and control group (group C) were established by transfecting the hnRNPA1 subtype and empty vector, respectively. The expression (EP) levels of hnRNPA1 and changes in Wnt/ß-catenin signaling-related markers were evaluated using techniques such as RNA extraction, reverse transcription reactions, real-time quantitative PCR (RT qPCR), and protein extraction. The EP of tumor stem cell markers CD133 and CD44 was assessed using immunohistochemistry. Additionally, cell invasion assays, scratch assays, and cell counting kit-8 (CCK-8) proliferation assays were conducted. Furthermore, a mouse tumor model was established to observe the growth of tumors in both groups. overexpression (OP) of hnRNPA1 in group E greatly increased the protein EP levels of ß-catenin, Axin2, and Cyclin D1 and exhibited a higher positivity rate for CD133 and CD44. The invasive, migratory, and proliferative abilities of cells in group E were notably enhanced, and tumor growth was observably faster versus group C. OP of hnRNPA1 was closely associated with the activation of Wnt/ß-catenin signaling and promoted the proliferation and invasive capacity of tumor cells. hnRNPA1 played an imperative role in intestinal cancer stem cells.

Effect of Gastrointestinal Bleeding on Gastrointestinal Stromal Tumor Patients: A Retrospective Cohort Study.

BACKGROUND The contemporary risk classification criteria of gastrointestinal stromal tumors (GISTs) may still have room to improve. The aim of our research was to analyze the impact factors for GIST patients' relapse-free survival (RFS). Furthermore, we explore whether gastrointestinal (1) bleeding will be a valuable indicator to predict GIST patients' prognosis. MATERIAL AND METHODS R0 resection GISTs patients were retrospectively enrolled during an 8-year period at West China Hospital of Sichuan University, and all patients' data were from the WCHSU-GIST database. Of a total of 333 GIST patients, 164 patients had GI bleeding. Univariate analysis and Cox regression analysis were used to calculate the survival and recurrence rates. RESULTS Compared with non-GI-bleeding patients, GI-bleeding patients had a shorter relapse-free survival (RFS, P=0.003), but among the different risk groups, GI bleeding only affected the RFS rate of the high-risk group. A Cox regression analysis illustrated that tumor site (P<0.001), tumor size (P=0.009), mitotic index (P<0.001), tumor rupture (P<0.001), and GI-bleeding (P=0.01) were independent indicators for GIST patients' RFS. CONCLUSIONS Our study demonstrates that the RFS of GIST patients with GI bleeding was significantly shorter than that of non-GI-bleeding patients, and GI bleeding was an independent negative factor predicting RFS, while GI bleeding had more influence among high-risk patients.

Screening and Analysis of the Marker Components in Ganoderma lucidum by HPLC and HPLC-MSn with the Aid of Chemometrics.

Ganoderma triterpenes (GTs) are the major secondary metabolites of Ganoderma lucidum, which is a popularly used traditional Chinese medicine for complementary cancer therapy. The present study was to establish a fingerprint evaluation system based on Similarity Analysis (SA), Cluster Analysis (CA) and Principal Component Analysis (PCA) for the identification and quality control of G. lucidum. Fifteen samples from the Chinese provinces of Hainan, Neimeng, Shangdong, Jilin, Anhui, Henan, Yunnan, Guangxi and Fujian were analyzed by HPLC-PAD and HPLC-MSn. Forty-seven compounds were detected by HPLC, of which forty-two compounds were tentatively identified by comparing their retention times and mass spectrometry data with that of reference compounds and reviewing the literature. Ganoderic acid B, 3,7,15-trihydroxy-11,23-dioxolanost-8,16-dien-26-oic acid, lucidenic acid A, ganoderic acid G, and 3,7-oxo-12-acetylganoderic acid DM were deemed to be the marker compounds to distinguish the samples with different quality according to both CA and PCA. This study provides helpful chemical information for further research on the anti-tumor activity and mechanism of action of G. lucidum. The results proved that fingerprints combined with chemometrics are a simple, rapid and effective method for the quality control of G. lucidum.

Quality Evaluation and Chemical Markers Screening of Salvia miltiorrhiza Bge. (Danshen) Based on HPLC Fingerprints and HPLC-MSn Coupled with Chemometrics.

Danshen, the dried root of Salvia miltiorrhiza Bge., is a widely used commercially available herbal drug, and unstable quality of different samples is a current issue. This study focused on a comprehensive and systematic method combining fingerprints and chemical identification with chemometrics for discrimination and quality assessment of Danshen samples. Twenty-five samples were analyzed by HPLC-PAD and HPLC-MSn. Forty-nine components were identified and characteristic fragmentation regularities were summarized for further interpretation of bioactive components. Chemometric analysis was employed to differentiate samples and clarify the quality differences of Danshen including hierarchical cluster analysis, principal component analysis, and partial least squares discriminant analysis. Consistent results were that the samples were divided into three categories which reflected the difference in quality of Danshen samples. By analyzing the reasons for sample classification, it was revealed that the processing method had a more obvious impact on sample classification than the geographical origin, it induced the different content of bioactive compounds and finally lead to different qualities. Cryptotanshinone, trijuganone B, and 15,16-dihydrotanshinone I were screened out as markers to distinguish samples by different processing methods. The developed strategy could provide a reference for evaluation and discrimination of other traditional herbal medicines.

Screening and Analysis of the Potential Bioactive Components of Poria cocos (Schw.) Wolf by HPLC and HPLC-MS(n) with the Aid of Chemometrics.

The aim of the present study was to establish a new method based on Similarity Analysis (SA), Cluster Analysis (CA) and Principal Component Analysis (PCA) to determine the quality of different samples of Poria cocos (Schw.) Wolf obtained from Yunnan, Hubei, Guizhou, Fujian, Henan, Guangxi, Anhui and Sichuan in China. For this purpose 15 samples from the different habitats were analyzed by HPLC-PAD and HPLC-MS(n). Twenty-three compounds were detected by HPLC-MS(n), of which twenty compounds were tentatively identified by comparing their retention times and mass spectrometry data with that of reference compounds and reviewing the literature. The characteristic fragmentations were summarized. 3-epi-Dehydrotumulosic acid (F13), 3-oxo-16α,25-dihydroxylanosta-7,9(11),24(31)-trien-21-oic acid (F4), 3-oxo-6,16α-dihydroxylanosta-7,9(11),24(31)-trien-21-oic acid (F7) and dehydropachymic acid (F15) were deemed to be suitable marker compounds to distinguish between samples of different quality according to CA and PCA. This study provides helpful chemical information for further anti-tumor activity and active mechanism research on P. cocos. The results proved that fingerprint combined with a chemometric approach is a simple, rapid and effective method for the quality discrimination of P. cocos.

A spatiotemporal graph transformer approach for Alzheimer's disease diagnosis with rs-fMRI.

Alzheimer's disease (AD) is a neurodegenerative disease accompanied by cognitive impairment. Early diagnosis is crucial for the timely treatment and intervention of AD. Resting-state functional magnetic resonance imaging (rs-fMRI) records the temporal dynamics and spatial dependency in the brain, which have been utilized for automatically diagnosis of AD in the community. Existing approaches of AD diagnosis using rs-fMRI only assess functional connectivity, ignoring the spatiotemporal dependency mining of rs-fMRI. In addition, it is difficult to increase diagnosis accuracy due to the shortage of rs-fMRI sample and the poor anti-noise ability of model. To deal with these problems, this paper proposes a novel approach for the automatic diagnosis of AD, namely spatiotemporal graph transformer network (STGTN). The proposed STGTN can effectively extract spatiotemporal features of rs-fMRI. Furthermore, to solve the sample-limited problem and to improve the anti-noise ability of the proposed model, an adversarial training strategy is adopted for the proposed STGTN to generate adversarial examples (AEs) and augment training samples with AEs. Experimental results indicate that the proposed model achieves the classification accuracy of 92.58%, and 85.27% with the adversarial training strategy for AD vs. normal control (NC), early mild cognitive impairment (eMCI) vs. late mild cognitive impairment (lMCI) respectively, outperforming the state-of-the-art methods. Besides, the spatial attention coefficients reflected from the designed model reveal the importance of brain connections under different classification tasks.

Risk and incidence of colorectal stricture progressing to colorectal neoplasia in patients with inflammatory bowel disease: a systematic review and meta-analysis.

This study aims to assess the risk of colorectal stricture progressing to colorectal neoplasia (CRN) in patients with inflammatory bowel disease (IBD). The literature from PubMed, Embase, Web of Science, and Cochrane Library databases was searched from the date of databases' creation to 5 November 2022. The Newcastle-Ottawa Scale was used to evaluate the quality of the included literature. Meta-analysis was conducted using the Stata 15 software and R 4.04 software. Two case-control studies and 12 cohort studies were eventually included. Colorectal stricture in patients with IBD increased the risk of progressing to CRN [odds ratio (OR): 1.52, 95% confidence interval (CI): 1.02-2.29, P = 0.042], but was irrelevant to the risk of progressing to ACRN (OR: 3.56, 95% CI 0.56-22.70, P = 0.180). The risk of CRN were further distinguished in patients with ulcerative colitis (UC) and Crohn's disease (CD) Our findings showed that colorectal stricture may increase the risk of progressing to CRN in patients with UC (OR = 3.53, 95%CI 1.62-7.68, P = 0.001), but was irrelevant to the risk of progressing to CRN in patients with CD (OR = 1.09, 95% CI 0.54-2.21, P = 0.811). In conclusion, colorectal stricture in patients with IBD can be used as a risk factor for predicting CRN but cannot be used as a risk factor for predicting ACRN. Stricture is a risk factor for CRN in patients with UC but not in patients with CD. More prospective, multi-center studies with large samples are expected to confirm our findings.

Compression and Encryption of Heterogeneous Signals for Internet of Medical Things.

Psychophysiological computing can be utilized to analyze heterogeneous physiological signals with psychological behaviors in the Internet of Medical Things (IoMT). Since IoMT devices are generally limited by power, storage, and computing resources, it's very challenging to process the physiological signal securely and efficiently. In this work, we design a novel scheme named Heterogeneous Compression and Encryption Neural Network (HCEN), which aims to protect signal security and reduce the required resources in processing heterogeneous physiological signals. The proposed HCEN is designed as an integrated structure that introduces the adversarial properties of Generative Adversarial Networks (GAN) and the feature extraction functionality of Autoencoder (AE). Moreover, we conduct simulations to validate the performance of HCEN using the MIMIC-III waveform dataset. Electrocardiogram (ECG) and Photoplethysmography (PPG) signals are extracted in the simulation. The results reveal that the proposed HCEN can effectively encrypt floating-point signals. Meanwhile, the compression performance outperforms baseline compression methods.

Epidemic-Like Calcium Signaling in Mobile Molecular Communication Networks.

Molecular Communication is an emerging technology enabling communications in nano-networks. Ca2+ signal is one promising option of MC due to the important role in bio-metabolisms and the available characteristics in communication engineering. So far, scientists analyze Ca2+ signaling via bio-experiments and simulations. Current researches lack a mathematical model for quantitative analysis of Ca2+ signal propagation on the network scale. In this work, we investigate the propagation patterns of Ca2+ signals in bio-cellular network. Firstly, we propose an improved Ca2+ dynamics model to describe Ca2+ signals considering movements of cells and attenuation of Ca2+ concentration. Then, we perform multi-modal analysis through the waveform characteristics, and classify cells according to their states. Moreover, a mathematical model is put forward to analyze the propagation of calcium signals based on typical epidemic model. The proposed model fully considers the similarity between: 1) epidemic disease propagates among mobile individuals; 2) Ca2+ signal propagates among mobile cells. The proposed model is amended to fit the case considering unique characters of Ca2+ signal. Finally, simulation results show that the proposed Ca2+ propagation model is coincident with Monte Carlo simulation results, indicating that the model is helpful for understanding how far and how fast Ca2+ signal can propagate.

Inflammatory bowel diseases and the risk of adverse health outcomes: Umbrella review of meta-analyses of observational studies.

BACKGROUND AND AIM: Accumulating evidence indicates a plausible association between inflammatory bowel diseases and the risk of adverse health outcomes. However, the conclusions are inconsistent. We aimed to perform an umbrella review of meta-analyses to appraise and grade the evidence of the association between inflammatory bowel diseases and the risk of adverse health outcomes. METHODS: Meta-analyses of observational studies that examined the associations between inflammatory bowel disease and the risk of adverse health outcomes in PubMed, EMBASE, and Web of Science were screened. RESULTS: This umbrella review identified 25 meta-analyses, which yielded 123 effect estimates for 60 unique putative health outcomes. Patients with inflammatory bowel diseases had a higher risk of adverse health outcomes, including multiple cancers, cardiovascular disease, adverse pregnancy outcomes, adverse oral outcomes, and other adverse events. Moreover, inflammatory bowel diseases caused greater harm to health based on the presented evidence. However, none of the evidence was classified as "high" quality, only 15% was classified as "moderate," and 65% of outcomes were rated as "very low." CONCLUSION: Patients with inflammatory bowel diseases had a higher risk of adverse health outcomes and further studies should be conducted to draw firmer conclusions.

Inflammatory bowel disease and risk of gastric, small bowel and colorectal cancer: a meta-analysis of 26 observational studies.

PURPOSE: The purpose of this meta-analysis was to assess the associations between inflammatory bowel disease (IBD) and risk of the gastric, small bowel and colorectal cancer. METHODS: We searched the PubMed and Web of Science for observational studies published before June 2020, and the quality of each included study was evaluated according to the Newcastle-Ottawa-Scale. RESULTS: Twenty-six studies comprising 531 449 IBD patients and more than 65 million reference individuals were included. Although IBD was significantly associated with 67% increased risk of the total gastric, small bowel and colorectal cancer. After stratifying by cancer location, IBD mainly increased the risk of intestinal cancer instead of gastric cancer. Furthermore, Crohn's disease (CD) significantly increased the risk of both small bowel cancer and colorectal cancer, while ulcerative colitis (UC) only increased the risk of colorectal cancer. In subgroup analysis, associations between IBD and risk of total gastric, small bowel and colorectal cancer were similar between male and female, except for that male IBD patients but not female had a significantly higher risk of small bowel cancer. Additionally, IBD patients in different geographical areas had different associations with risk of various gastrointestinal tract cancers. CONCLUSIONS: IBD is mainly associated with increased risk of cancers in the lower gastrointestinal tract, including small bowel cancer and colorectal cancer. Because studies about the association between IBD and risk of gastric cancer and the populations in Asia are limited, more observational studies are required in the future.

Identification of microRNA-451a as a Novel Circulating Biomarker for Colorectal Cancer Diagnosis.

BACKGROUND: Colorectal cancer (CRC) is one of the leading causes of cancer death worldwide. Successful treatment of CRC relies on accurate early diagnosis, which is currently a challenge due to its complexity and personalized pathologies. Thus, novel molecular biomarkers are needed for early CRC detection. METHODS: Gene and microRNA microarray profiling of CRC tissues and miRNA-seq data were analyzed. Candidate microRNA biomarkers were predicted using both CRC-specific network and miRNA-BD tool. Validation analyses were carried out to interrogate the identified candidate CRC biomarkers. RESULTS: We identified miR-451a as a potential early CRC biomarker circulating in patient's serum. The dysregulation of miR-451a was revealed both in primary tumors and in patients' sera. Downstream analysis validated the tumor suppressor role of miR-451a and high sensitivity of miR-451a in CRC patients, further confirming its potential role as CRC circulation biomarker. CONCLUSION: The miR-451a is a potential circulating biomarker for early CRC diagnosis.

Dose-response meta-analysis of coffee consumption and risk of colorectal adenoma.

BACKGROUND: The association between coffee and colorectal adenoma risk remains controversial. We conducted a meta-analysis of cohort and case-control studies to sum up the existing proof about this matter. METHODS: We searched Pubmed, Medline, and Embase for studies published before 1 September 2018 on coffee consumption and colorectal adenoma in any language. The different ORs were calculated for cohort and case-control studies in this study, and we use a random-effects model to aggregate the relative risks of individual studies and conduct dose response, heterogeneity, and publication bias. RESULTS: A total of 8 studies (6 case-control studies, 2 cohort studies) were identified, including 7090 subjects. In a summary analysis of all studies, high coffee intake (compared the highest with the lowest categories) was associated with a reduced risk of colorectal adenoma (odds ratio [OR] = 0.70, 95% confidence interval [CI] = 0.55-0.90). The results of subgroup analysis of adenoma location were similar with the pooled analysis, except for rectal adenoma. In the dose-response meta-analysis study, the estimated total odds ratio for increasing coffee consumption by 150 ml per day (about one cup) was 0.91 (95% CI = 0.87-0.95). CONCLUSIONS: The meta-analysis demonstrates possible evidence that increased coffee intake is related to a reduced risk of colon adenoma. However, because of latent confusion and different exposure classification, this finding should be carefully considered.

Sarcopenia and adverse health-related outcomes: An umbrella review of meta-analyses of observational studies.

OBJECTIVE: The purpose of this umbrella review was to assess the associations between sarcopenia and adverse health-related outcomes. DESIGN: An umbrella review of meta-analyses of observational studies. SETTING AND PARTICIPANTS: Patients with sarcopenia and controls without sarcopenia were included. MEASURES: The PubMed, Web of Science and Embase were searched for relevant systematic review and meta-analysis. AMSTAR and GRADE system were used for methodological quality and evidence quality assessments, respectively. RESULTS: Totally 54 outcomes extracted from 30 meta-analyses were analyzed. Twenty out of 21 prognostic outcomes indicated that sarcopenia was significantly associated with poorer prognosis of gastric cancer, hepatocellular cancer, urothelial cancer, head and neck cancer, hematological malignancy, pancreatic cancer, breast cancer, colorectal cancer, lung cancer, esophageal cancer, and ovarian cancer. Besides, 10 out of 16 postoperative outcomes suggested that sarcopenia significantly increased the risk of multiple postoperative complications and prolonged the length of hospitalization of patients with digestive cancer. In age-related outcomes, sarcopenia significantly increased the risk of dysphagia, cognitive impairment, fractures, falls, hospitalization, and all-cause mortality of elderly populations. Moreover, sarcopenia was also associated with higher level of albuminuria, risk of depression, and several metabolic diseases. CONCLUSIONS AND IMPLICATIONS: Sarcopenia significantly affected a wide range of adverse health-related outcomes, particularly in patients of tumor and elderly populations. Because evidences of most outcomes were rated as "low" and "very low," more prospective cohort studies are required in the future.

Predictive Risk Factors of Intestinal Necrosis in Patients with Mesenteric Venous Thrombosis: Retrospective Study from a Single Center.

Purposes: Mesenteric venous thrombosis (MVT) is a serious condition. The current study aimed to identify risk factors of intestinal necrosis (IN) in patients with MVT to predict the onset of patients. Methods: Data pertaining to patients diagnosed with MVT between 2014 and May 2018 were reviewed. Patients' characteristics and risk factors of IN were assessed. Results: Seventy-eight patients were included in our study, of whom all cases were diagnosed as superior mesenteric venous thrombosis. There were fifty-eight cases (74%) with intestinal necrosis and twenty cases (26%) without intestinal necrosis. Multivariate analysis of factors associated with IN was organ failure (odds ratio (OR): 4.1; 95% confidence interval (95%CI): 1.26-8.59; P=0.028), elevated serum lactate (OR:3.6; 95% CI: 1.51-5.47; P=0.024), bowel loop dilation on computerized tomography (CT) scan (OR: 2.8; 95% CI: 1.32-7.23; P=0.031), and the time between onset of symptoms and operation (OR: 4.8; 95% CI: 1.36-9.89; P=0.012). Area under the receiver operating characteristics curve for the diagnosis of IN with MVT was 0.901 (95%CI: 0.809-0.993; P=0.000) depending on the different number of predictive factors. Conclusion: Predictive risk factors for IN with MVT were organ failure, elevated serum lactate level, bowel loop dilation on CT, and the time between onset of symptoms and operation. However, this result is from a retrospective study and further long-term, large-sample prospective studies are required to confirm this finding.

Prognostic values of preoperative platelet-to-lymphocyte ratio, albumin and hemoglobin in patients with non-metastatic colon cancer.

Purpose: Preoperative platelet-to-monocyte ratio (PLR), albumin and hemoglobin are suggested prognostic indicators in various malignancies. However, the prognostic values of PLR, albumin and hemoglobin remain elusive. The objective of the present study was to evaluate the prognostic values of PLR, albumin and hemoglobin in stage I-III colon cancer. Patients and methods: A total of 312 patients with non-metastatic colon cancer undergoing curative resection were enrolled in this study. The prognostic values of PLR, albumin and hemoglobin were identified by receiver operating characteristics, and univariate and multivariate analyses. Results: Univariate analysis revealed that preoperative PLR, albumin and hemoglobin were significantly associated with overall survival (OS) and that preoperative PLR and albumin were significantly associated with progression-free survival (PFS). Multivariate analysis revealed that preoperative PLR was significantly associated with OS. Conclusion: Reduced preoperative PLR was significantly associated with better OS in patients with stage I-III colon cancer. Preoperative PLR was an independent prognostic indictor for OS in patients with colon cancer undergoing curative resection.

Effects of the resistant starch on glucose, insulin, insulin resistance, and lipid parameters in overweight or obese adults: a systematic review and meta-analysis.

BACKGROUND: The role of resistant starch (RS) in glucose, insulin, insulin resistance or sensitivity, and lipid parameters have been reported in several studies and remained controversial. A pooled analysis which assessed these parameters has not been performed. Thus, we conducted a meta-analysis to sum up existing evidence about the issue. METHODS: We searched in MEDLINE and PUBMED for studies that were published before November 2018. Meta-analysis of diabetics and nondiabetics trials were performed by use of a random-effects model. RESULTS: A total of 13 case-control studies that included 428 subjects with body mass index ≥25 were identified. RS supplementation reduced fasting insulin in overall and stratified (diabetics and nondiabetics trials) analysis (SMD = -0.72; 95% CI: -1.13 to -0.31; SMD = -1.26; 95% CI: -1.66 to -0.86 and SMD = -0.64; 95% CI: -1.10 to -0.18, respectively), and reduced fasting glucose in overall and stratified analysis for diabetic trials (SMD = -0.26; 95% CI: -0.5 to -0.02 and SMD = -0.28; 95% CI: -0.54 to -0.01, respectively). RS supplementation increased HOMA-S% (SMD = 1.19; 95% CI: 0.59-1.78) and reduced HOMA-B (SMD =-1.2; 95% CI: -1.64 to -0.77), LDL-c concentration (SMD =-0.35; 95% CI: -0.61 to -0.09), and HbA1c (SMD = -0.43; 95% CI: -0.74 to -0.13) in overall analysis. CONCLUSIONS: This meta-analysis has provided evidence that RS supplementation can improve fasting glucose, fasting insulin, insulin resistance and sensitivity, especially for diabetic with overweight or obesity. However, owing to potential sophistication, individual difference and composition of intestinal microbiota, this result should be carefully taken into account.