Laparoscopic total mesorectal excision versus transanal total mesorectal excision for mid and low rectal cancer: A systematic review and meta-analysis.

BACKGROUND: Laparoscopic total mesorectal excision (LaTME) and transanal total mesorectal excision (TaTME) are popular mid and low rectal cancer trends. However, there is currently no systematic comparison between LaTME and TaTME of mid and low rectal cancer. Therefore, we systematically study the perioperative and pathological outcomes of LaTME and TaTME in mid and low rectal cancer. METHODS: Articles included searching through the Embase, Cochrane Library, PubMed, Medline, and Web of science for articles on LaTME and TaTME. We calculated pooled standard mean difference (SMD), relative risk (RR), and 95% confidence intervals (CIs). The protocol for this review has been registered on PROSPERO (CRD42022380067). RESULTS: There are 8761 participants included in 33 articles. Compared with TaTME, patients who underwent LaTME had no statistical difference in operation time (OP), estimated blood loss (EBL), postoperative hospital stay, over complications, intraoperative complications, postoperative complications, anastomotic stenosis, wound infection, circumferential resection margin, distal resection margin, major low anterior resection syndrom, lymph node yield, loop ileostomy, and diverting ileostomy. There are similarities between LaTME and TaTME for 2-year DFS rate, 2-year OS rate, distant metastasis rat, and local recurrence rate. However, patients who underwent LaTME had less anastomotic leak rates (RR 0.82; 95% CI: 0.70-0.97; I2 = 10.6%, P = .019) but TaTME had less end colostomy (RR 1.96; 95% CI: 1.19-3.23; I2 = 0%, P = .008). CONCLUSION: This study comprehensively and systematically evaluated the differences in safety and effectiveness between LaTME and TaTME in the treatment of mid and low rectal cancer through meta-analysis. Patients who underwent LaTME had less anastomotic leak rate but TaTME had less end colostomy. There is no difference in other aspects. Of course, in the future, more scientific and rigorous conclusions need to be drawn from multi-center RCT research.

[Determination of trace elements in different parts of grapefruit by ICP-AES].

In the present paper, a method of simultaneous determination of trace elements in grapefruit was developed by using inductively coupled plasma-atomic emission spectrometry together with HNO3-HClO4 digestion. The contents of fifteen elements, including B, Ba, Ca, Cu, Zn, Mg, Sr, Mn, Fe, Na, Be, Pb, Bi, Cd and As, were determined in four parts, namely flesh, scarfskin, endodermis and seed collected from Guangdong, Guangxi and Ganzhou, respectively. The relative standard deviations for all these elements in this method were between 0.22% and 5.54%, and the recovery rates were between 87.0% and 115.0%. The measuring method was proved to be simple, rapid, reliable, and highly sensitive. In addition, the determination of these fifteen elements can be carried out at the same time, which can meet the requests of actual sample analysis. The experimental results showed that some beneficial elements to human such as Ca, Mg, Fe, Zn, Mn, Cu and Na in grapefruit were abundant, while some comparatively harmful elements (Be, Pb, Bi, Cd and As) were not detected. Regional differences and partial differences obviously existed in the concentrations of one or more trace elements in grapefruit. As a whole, the concentrations of most elements in flesh were much lower than in other parts of grapefruit. The concentrations of B, Ba, Ca, Sr and Mn were comparatively higher in the seed capsule than in other parts. Cu, Zn and Mg had the highest concentrations in seed compared to other parts. There was little difference between scarfskin and endodermis. And as for the regional differences, the contents of Mn, Zn and Na in Gannan pomelo in all its parts were higher than those in other regions, and the contents of Ba in Guangdong pomelo in all its parts were higher than those in others, while Guangxi pomelo had the highest Fe content. These differences might resulted from the natural environmental conditions such as temperature, humidity, soil types with different pH, the mineral composition or concentration, and so on. Application of fertilizer and prunning might be an important man-made factors which could also result in the differences. The determination of these elements by using ICP-AES has important point for exploiting grapefruit fully in future.

Assessing disease activity and disease activity indices for inflammatory bowel disease.

A crucial step in the development of clinical trials to determine the efficacy of various therapies for inflammatory bowel disease (IBD) has been the creation of activity indices. This article reviews the major components and operating characteristics of clinical activity indices commonly used in randomized, controlled trials of IBD therapy. In addition, the paper provides a brief overview of the developmental requirements for any new index.