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1.
Behav Brain Res ; 470: 115072, 2024 Jul 26.
Article de Anglais | MEDLINE | ID: mdl-38815697

RÉSUMÉ

Previous studies have shown that individuals not only successfully engage in cross-domain analogies but also accomplish cross-modal reasoning. Yet, the behavioral representation and neurophysiological basis of cross-modal and cross-domain analogical reasoning remain unclear. This study established three analogical reasoning conditions by combining a multi-to-multi learning-test paradigm with a four­term analogy paradigm: within-domain, cross-domain, and cross-modal conditions. Thirty participants were required to judge whether the relationship between C and D was the same as the learned relationship between A and B. Behavioral results revealed no significant differences in reaction times and accuracy between cross-domain and cross-modal conditions, but both conditions showed significantly lower accuracy than within-domain condition. ERP results indicated a larger P2 amplitude in the cross-modal condition, while a larger N400 amplitude was observed in the cross-domain condition. These findings suggest: (1) The P2 in cross-modal analogical reasoning is associated with more difficult access to cross-modal information. (2) The N400 in cross-domain analogical reasoning is related to more challenging semantic processing. This study provides the first evidence of behavioral and ERP differences between cross-modal and cross-domain analogical reasoning, deepening our understanding of the cognitive processes involved in cross-modal analogical reasoning.


Sujet(s)
Électroencéphalographie , Potentiels évoqués , Temps de réaction , Humains , Mâle , Femelle , Potentiels évoqués/physiologie , Jeune adulte , Temps de réaction/physiologie , Adulte , Encéphale/physiologie , Résolution de problème/physiologie
2.
Behav Sci (Basel) ; 14(4)2024 Apr 22.
Article de Anglais | MEDLINE | ID: mdl-38667144

RÉSUMÉ

The cognitive reflection test (CRT) is an experiment task commonly used in Western countries to test intuitive and analytical thinking styles. However, the validity of this task for Chinese participants has not been explored. Therefore, this study recruited Chinese college students to finish CRT tasks with various experimental designs. To gauge the accuracy of the CRT tasks, 438 Chinese college students first completed online questionnaires. Participants were then invited to participate in an offline laboratory with the same experimental settings. Finally, time pressure was used to strictly control intuition and analytical thinking to explore the performance of Chinese college students on CRT tasks. The results show that of the three experiments, Chinese college students had the highest accuracy in the offline test, and the CRT's intuitive conflict problem still applies to Chinese students under the time-limited condition. This study demonstrates the validity of the CRT in China and proves that time pressure is an effective method for identifying individuals with strong logic ability.

3.
Water Res ; 254: 121405, 2024 May 01.
Article de Anglais | MEDLINE | ID: mdl-38447376

RÉSUMÉ

The accumulation and transformation of lead (Pb) and arsenic (As) during the digestion of sewage sludge (SS) by black soldier fly larvae (BSFL) remain unclear. In this study, we used 16 s rRNA and metagenomic sequencing techniques to investigate the correlation between the microbial community, metalloregulatory proteins (MRPs), and Pb and As migration and transformation. During the 15-day test period, BSFL were able to absorb 34-48 % of Pb and 32-45 % of As into their body. Changes in bacterial community abundance, upregulation of MRPs, and redundancy analysis (RDA) results confirmed that ZntA, EfeO, CadC, ArsR, ArsB, ArsD, and ArsA play major roles in the adsorption and stabilization of Pb and As, which is mainly due to the high contribution rates of Lactobacillus (48-59 %) and Enterococcus (21-23 %). Owing to the redox reaction, the regulation of the MRPs, and the change in pH, the Pb and As in the BSFL residue were mainly the residual fraction (F4). The RDA results showed that Lactobacillus and L.koreensis could significantly (P < 0.01) reduce the reducible fraction (F2) and F4 of Pb, whereas Firmicutes and L.fermentum can significantly (P < 0.05) promote the transformation of As to F4, thus realizing the passivation Pb and As. This study contributes to the understanding of Pb and As in SS adsorbed by BSFL and provides important insights into the factors that arise during the BSFL-mediated migration of Pb and As.


Sujet(s)
Arsenic , Diptera , Élimination des déchets , Animaux , Larve/métabolisme , Eaux d'égout , , Plomb/métabolisme , Aliments , Biotransformation , Bactéries , Lactobacillus
4.
J Youth Adolesc ; 53(3): 609-620, 2024 Mar.
Article de Anglais | MEDLINE | ID: mdl-38157184

RÉSUMÉ

Creativity encompasses both novelty and usefulness, with novelty referring to the generation of unique and uncommon ideas, while usefulness pertains to the effectiveness and appropriateness of these ideas in addressing the given task. The comprehension of the process of coordinated development for children's novelty and usefulness, including the potential gender differences, is crucial; however, it still lacks clarity in the current academic discourse. To address these gaps, this study investigated the joint developmental trajectories of novelty and usefulness as well as the gender differences in trajectory group membership among Chinese children. A sample of primary school children (initial grade 3, N = 665; 46.4% girls; initial Mage = 8.60 years) were followed for three years. The results revealed a negative association between novelty and usefulness across all three time points. Through parallel-process latent class growth modeling, three distinct trajectories of novelty and usefulness were identified: the High Novelty Decline-Medium Usefulness Increase-Stability Group (66%), the Low Novelty Increase-High Usefulness Decline-Convergence Group (19%), and the Low Novelty Decline-High Usefulness Increase-Divergence Group (15%). These findings suggest that the development of children's creativity is influenced by a multifaceted pattern involving both novelty and usefulness. Moreover, gender differences in trajectory group membership were examined and discussed within the context of creativity development in Chinese children.


Sujet(s)
Créativité , Enfant , Femelle , Humains , Mâle , Chine
5.
Front Surg ; 10: 1272628, 2023.
Article de Anglais | MEDLINE | ID: mdl-37829598

RÉSUMÉ

Background: Flail chest is a common and serious traumatic condition in thoracic surgery. The treatment of flail chest often includes open reduction and internal fixation, which is relatively traumatic, complicated, and expensive. As three-dimensional (3D) printing technology is widely used in the clinical field, the application of 3D-printed products to chest trauma will become a new treatment option. To date, the use of 3D-printed external fixation guides for flail chests has not been reported. Thus, we aimed to assess the short-term efficacy of a new technology that treated flail chests with an individualized 3D-printed external fixation guide combined with video-assisted thoracoscopic surgery (VATS). Patients and methods: A retrospective analysis was performed on patients with flail chest treated with this new technique at our center from January 2020 to December 2022. The following parameters were included: operative time, thoracic tube extraction time, intensive care unit time, thoracic volume recovery rate, visual analog scale score 1 month postoperatively, and postoperative complication rate. All patients were followed up for at least 3 months. Results: Five patients (mean age: 45.7 years) were enrolled; they successfully underwent surgery without chest wall deformity and quickly returned to daily life. The average number of rib fractures was 8.4; all patients had lung contusion, hemopneumothorax, and anomalous respiration. The abnormal breathing of all patients was completely corrected on postoperative day 1, and the chest wall was stable. One case experienced mild loosening of the 3D-printed guide postoperatively; however, the overall stability was not affected. The other four cases did not experience such loosening because we replaced the ordinary silk wire with a steel wire. All cases were discharged from the hospital 2 weeks postoperatively and returned to normal life 1 month after the removal of the 3D-printed guide on average. Only one case developed a superficial wound infection postoperatively, and no perioperative death occurred. Conclusions: The 3D-printed external fixation guide combined with video-assisted thoracoscopic surgery is a novel technique in the treatment of flail chest and is safe, effective, feasible, and minimally invasive, with satisfactory clinical efficacy.

6.
Brain Cogn ; 169: 105995, 2023 07.
Article de Anglais | MEDLINE | ID: mdl-37201418

RÉSUMÉ

In Chinese culture, the mother holds a special meaning in one's self-concept, and is perceived as being stablyincorporated into and consistent with the self. However, it is unclear whether the evaluation of mothers by individuals is affected following the initiation of upward and downward social comparisons (USC and DSC). This experiment manipulated USC and DSC by evaluating positive and negative public figures and used functional near-infrared spectroscopy to record changes in brain activity during the evaluation. It was found that participants' evaluations of their mothers and their brain activity did not differ from the self during USC, verifying the equivalence of the mother and the self. In DSC, participants made significantly more positive social judgments about their mothers, accompanied by greater activation of the left temporal lobe. These results suggest that the mother was not only stably incorporated into the self but was in a position of even greater importance than the self. In DSC in particular, individuals are more likely to maintain a positive image of their mother.


Sujet(s)
Peuples d'Asie de l'Est , Mères , Femelle , Humains , Asiatiques , Lobe temporal , Concept du soi
7.
Article de Anglais | MEDLINE | ID: mdl-35954905

RÉSUMÉ

The effects of digital Cognitive Behavior Therapy for insomnia (dCBT-i) on sleep quality have been previously demonstrated but the spillover effects on fatigue, flow (a state of immersion in activities of interest), and cognitive flexibility remain unclear. The current study examined the effectiveness of dCBT-i. A total of 97 college students (20.96 ± 1.87 years, 73.1% female students) were randomly selected from a shortlist and divided into sleep intervention (n = 39), conventional education (n = 37), and healthy control (n = 21) groups. Task switching paradigm, Fatigue Severity Scale (FSS), Flow Experience Scale (FES), and the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) were measured pre- and post-intervention. Results show that the sleep quality of the intervention group improved, and fatigue was relieved. Participants in the sleep intervention group had increased flow experience scores post-intervention and improved cognitive flexibility. The control group's sleep quality deteriorated and fatigue level increased. dCBT-i can not only achieve a significant improvement in sleep quality and reduce fatigue, but also improve learning abilities, quality of life, flow, and cognitive flexibility. Future research should pay attention to indicators such as work efficiency, sedative use, and the durability and stability of such effects.


Sujet(s)
Thérapie cognitive , Troubles de l'endormissement et du maintien du sommeil , Thérapie cognitive/méthodes , Fatigue , Femelle , Humains , Mâle , Qualité de vie , Troubles de l'endormissement et du maintien du sommeil/thérapie , Résultat thérapeutique
8.
Biol Psychol ; 172: 108359, 2022 07.
Article de Anglais | MEDLINE | ID: mdl-35609716

RÉSUMÉ

The damaging effect of threat on creativity has been confirmed by many studies. However, the neural mechanism underlying this effect has not been clarified. We designed an experiment to explore changes in brain activation when creativity is threatened. Specifically, participants performed the Chinese Remote Associates Test (RAT) under three conditions. The control condition was accompanied by no sound, the neutral condition was accompanied by unpredictable neutral sounds, and the threat condition was manipulated through unpredictable aversive sounds. We used functional near-infrared spectroscopy measurements to collect cognitive neurological data. The results showed that the threat condition reduced the accuracy and response time of the RAT and led to individual negative emotions. Participants' prefrontal cortex and supramarginal gyrus activation decreased under threat. These results provide a reference for clarifying the negative impact of threat on creativity and highlight its cognitive neural mechanisms.


Sujet(s)
Créativité , Cortex préfrontal , Encéphale/physiologie , Cartographie cérébrale/méthodes , Humains , Lobe pariétal , Cortex préfrontal/physiologie
9.
Conscious Cogn ; 97: 103260, 2022 01.
Article de Anglais | MEDLINE | ID: mdl-34920252

RÉSUMÉ

Dual process theory proposes that there are two different types of human thinking: an intuitive process and an analytical process. However, if these two types of thinking could maintain their characteristics in the subliminal environment, further exploration of their relationship is required. This study used the Embedded Chinese Character Task (ECCT) with event-related potentials to investigate the behavioral and neural patterns of the intuitive and analytical processes in the subliminal environment. In this task, one Chinese character (target character) was extracted from another character (test character) with problem solving that required either an intuitive process (in which the two characters were spatially separated or adjacent) or analytical process (in which the target characters were embedded in the test characters). Participants were asked to judge whether the target character was included or excluded from the test character in the subliminal environment. Results showed that a difference in reaction time occurred between inclusion and exclusion only in the analytical materials, but there was a difference in N2 between the inclusion and exclusion conditions in both intuitive and analytical materials, indicating that participants preferred to choose intuitive processing to solve intuitive and analytical problems in an unconscious environment. These findings support the traditional dual process theory, which states that the intuitive process is unconscious and effortless, while the analytical process may perform like an intuitive process in a subliminal environment.


Sujet(s)
Potentiels évoqués , Chine , Potentiels évoqués/physiologie , Humains , Temps de réaction/physiologie
10.
Biol Psychol ; 163: 108132, 2021 07.
Article de Anglais | MEDLINE | ID: mdl-34098043

RÉSUMÉ

Previous research has focused on the event-related potential of the old/new effect, but the mechanism for cognitive conflict and subsequent integration processing both induced by intermixed (old and new) stimuli have not been widely researched. This paper describes the effect of familiar stimuli mixed with new information and presented as intermixed stimuli. Three conditions were set within a study-test paradigm incorporating old, new, and intermixed conditions. The intermixed condition resulted in the lowest accuracy, thereby implying the greatest old/new effect. Moreover, compared with the old condition, the intermixed condition elicited a greater N270 as well as a stronger N400, while the new condition only induced a stronger N270. These results elucidate that when new information is intermixed with old information, the old/new effect is more pronounced, indicating that intermixed stimuli are possibly more difficult to integrate than old and new stimuli.


Sujet(s)
Électroencéphalographie , Potentiels évoqués , Femelle , Humains , Mâle , Stimulation lumineuse , Temps de réaction
11.
Sci Rep ; 10(1): 21958, 2020 12 15.
Article de Anglais | MEDLINE | ID: mdl-33319861

RÉSUMÉ

Although it is increasingly recognized that evaluation is a key phase for a two-fold creativity model, the neural model is not yet well understood. To this end, we constructed a theoretical model of creative evaluation and supported it with neural evidence through event-related potentials (ERPs) technology during a creative advertising task. Participants were required to evaluate the relationship between target words and advertising that systematically varied in novelty and usefulness. The ERPs results showed that (a) the novelty-usefulness and novelty-only conditions evoked a larger N1-P2 amplitude, reflecting an automatic attentional bias to novelty, and (b) these two novelty conditions elicited a larger N200-500 amplitude, reflecting an effort to process the novel content; (c) the novelty-usefulness and usefulness-only conditions induced a larger LPC amplitude, reflecting that valuable associations were formed through retrieval of relevant memories. These results propose a neural model of creative evaluation in advertising: the N1-P2, N200-500, and LPC should be the key indices to define three sub-processes of novelty perception, conception expansion, and value selection, respectively.


Sujet(s)
, Créativité , Potentiels évoqués/physiologie , Réseau nerveux , Adulte , Cartographie cérébrale , Femelle , Humains , Mâle
12.
Front Neurosci ; 13: 744, 2019.
Article de Anglais | MEDLINE | ID: mdl-31379493

RÉSUMÉ

Previous studies have revealed a specific role of the prefrontal-parietal network in rapid goal-directed chunking (RGDC), which dissociates prefrontal activity related to chunking from parietal working memory demands. However, it remains unknown how the prefrontal and parietal cortices collaborate to accomplish RGDC. To this end, a novel experimental design was used that presented Chinese characters in a chunking task, testing eighteen undergraduate students (9 females, mean age = 22.4 years) while recoding the electroencephalogram (EEG). In the experiment, radical-level chunking was accomplished in a timely stringent way (RT = 1485 ms, SD = 371 ms), whereas the stroke-level chunking was accomplished less coherently (RT = 3278 ms, SD = 1083 ms). By comparing the differences between radical-level chunking vs. stroke-level chunking, we were able to dissociate the chunking processes in the radical-level chunking condition within the analyzed time window (-200 to 1300 ms). The chunking processes resulted in an early increase of gamma band synchronization over parietal and occipital cortices, followed by enhanced power in the beta-gamma band (25-38 Hz) over frontal areas. We suggest that the posterior rhythmic activities in the gamma band may underlie the processes that are directly associated with perceptual manipulations of chunking, while the subsequent beta-gamma activation over frontal areas appears to reflect a post-evaluation process such as reinforcement of the selected rules over alternative solutions, which may be an important characteristic of goal-directed chunking.

13.
Front Psychol ; 9: 2149, 2018.
Article de Anglais | MEDLINE | ID: mdl-30538648

RÉSUMÉ

Efficiently perceiving a threatening intention conveyed by others' bodily actions has great survival value. The current study examined if the human brain is sensitive to differences in intentions that are conveyed via bodily actions. For this purpose, a new intention categorization task was developed in which participants sat in front of a computer screen on which the pictures of highly threatening (HT), moderately threatening (MT), and non-threatening (NT) body actions were presented randomly. Participants were asked to press the corresponding buttons using threatening intention judgment, while event-related potentials (ERPs) were recorded. According to a cluster permutation test, we analyzed N190, N2, EPP (early posterior positivity), and P3. The results showed there was a positive correlation between the amplitude of the EPP induced by three kinds of body actions and the reaction time of the task. The results also revealed that when the deflection of EPP was less positive, the reaction time was shorter. We suggest that EPP might be useful as an index of body intention processing of the brain. The current study revealed that intention perception of body actions modulates brain processing.

14.
Neuropsychologia ; 121: 186-192, 2018 12.
Article de Anglais | MEDLINE | ID: mdl-30385118

RÉSUMÉ

Tests of the principles of dual process theory are typically conducted in the reasoning and judgement/decision-making literature. The present study explores dual process explanations with a new paradigm - the Embedded Chinese Character Task (ECCT). The beauty of this task is that it allows the contrast of automatic and deliberate processes without the potential for conflict. We used event-related potentials (ERPs) and behavioral measures to investigate the time course of automatic (Type 1) and deliberative (Type 2) processes on the ECCT. Thus we explored whether there were differences in processing speed in neural activation. The ECCT requires the extraction of one Chinese character from another, which requires either an automatic strategy reliant on knowledge of Chinese character formation and meaning (based on the radical), or a deliberative strategy using the shape of the components of the character (based on the stroke). Participants judged whether character elements were included or excluded in test characters. Faster response time were observed when judging 'inclusion relations' on automatic problems supporting the proposal that they required a Type 1 process. In line with the behavioral results, the hypothesized faster automatic process showed the rapid differentiation of N2 and P3b components between inclusion and exclusion responses, while no difference was shown for deliberative problems. Thus, neural differences in processing were shown between automatic and deliberate problems, and automatic processing was faster than deliberate processing.


Sujet(s)
Encéphale/physiologie , Potentiels évoqués , Reconnaissance visuelle des formes/physiologie , Lecture , Femelle , Humains , Mâle , Modèles neurologiques , Tests neuropsychologiques , Stimulation lumineuse/méthodes , Théorie psychologique , Jeune adulte
15.
Front Psychol ; 9: 471, 2018.
Article de Anglais | MEDLINE | ID: mdl-29686637

RÉSUMÉ

The electrophysiological correlates of experiencing novelty in creative advertising were studied in 28 healthy subjects using event-related potentials. Participants viewed images that were difficult to interpret until a description was presented providing either a creative description (CD) featuring an unexpected description of the image based on the original advertisement, or a normal description (ND), which was a literal description of the image (and served as a baseline condition). Participants evaluated the level of creativity of the description. The results showed that the N2 amplitude was higher for CDs than for NDs across middle and right scalp regions between 240 and 270 ms, most likely reflecting conflict detection. Moreover, CDs demonstrated greater N400 than NDs in a time window between 380 and 500 ms, it is argued that this reflects semantic integration. The present study investigates the electrophysiological correlates of experiencing novelty in advertising with ecologically valid stimuli. This substantially extends the findings of earlier laboratory studies with more artificial stimuli.

16.
J Cell Mol Med ; 22(7): 3605-3613, 2018 07.
Article de Anglais | MEDLINE | ID: mdl-29700972

RÉSUMÉ

Early detection is vital for prolonging 5-year survival for patients with gastric cancer (GC). Numerous studies indicate that circulating long non-coding RNAs (lncRNAs) can be used to diagnose malignant tumours. This study aimed to investigate the capacity of novel lncRNAs for diagnosing GC. A lncRNA microarray assay was used to screen differentially expressed lncRNAs between plasma of patients with GC and healthy controls. Plasma samples from 100 patients with healthy controls were used to construct a multiple-gene panel. An additional 50 pairs of GC patients with healthy controls were used to evaluate the diagnostic accuracy of the panel. Expression levels of lncRNAs were quantified through real-time polymerase chain reaction. The receiver operating characteristic curve and area under curve (AUC) were used to estimate the diagnostic capacity. We identified three lncRNAs, CTC-501O10.1, AC100830.4 and RP11-210K20.5 that were up-regulated in the plasma of GC patients with AUCs 0.724, 0.730 and 0.737, respectively (P < .01). Based on the logistic regression model, the combined AUC of the three lncRNAs was 0.764. The AUC of the panel was 0.700 in the validation cohort. These findings indicate that plasma lncRNAs can serve as potential biomarkers for detection of GC.


Sujet(s)
Acides nucléiques acellulaires/sang , ARN long non codant/sang , Tumeurs de l'estomac/génétique , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Aire sous la courbe , Marqueurs biologiques tumoraux/génétique , Études cas-témoins , Lignée cellulaire tumorale , Femelle , Humains , Modèles logistiques , Mâle , Adulte d'âge moyen , Séquençage par oligonucléotides en batterie , Reproductibilité des résultats , Sensibilité et spécificité
17.
Front Psychol ; 9: 473, 2018.
Article de Anglais | MEDLINE | ID: mdl-29681875

RÉSUMÉ

Self-positivity bias is one of the well-studied psychological phenomena, however, little is known about the bias in the specific dimension on social interaction, which we called herein interpersonal self-positivity bias-people tend to evaluate themselves more positively on social interactions, prefer to be included rather than to be excluded by others. In the present study, we used a modified self-reference task associated with N400 to verify such bias and explore whether impoverished social interaction (loneliness) could modulate it. Findings showed that exclusion verbs elicited larger N400 amplitudes than inclusion verbs, suggesting that most people have interpersonal self-positivity bias. However, loneliness was significantly correlated with N400 effect, showing those with high scores of loneliness had smaller differences in the N400 than those with lower scores. These findings indicated impoverished social interaction weakens interpersonal self-positivity bias; however, the underlying mechanisms need to be explored in future research.

18.
Int J Psychophysiol ; 123: 199-206, 2018 01.
Article de Anglais | MEDLINE | ID: mdl-28843609

RÉSUMÉ

As N270 has been widely shown to be sensitive to nonsocial information conflict, the present study investigated whether social information conflict can elicit increased N270 in either explicit or implicit processing conditions. Gender stereotype-related picture-word pairs and picture-word pairs in specific colors were used as social and nonsocial information, respectively. Participants performed an explicit task based on the S1-S2 paradigm in Study 1, and both social and nonsocial information conditions elicited larger N270 than the no-conflict condition. In Study 2, participants performed a word judgment task that was modified from the S1-S2 paradigm of Study 1. However, neither social information nor nonsocial information elicited larger N270 within the conflict condition. Social trials generally elicited a more negative ERP waveform than nonsocial trials overall. These findings suggest that N270 may reflect the processing of social information conflict only in explicit conditions and also that the cognitive basis of N270 is thus a general but explicit processing of working memory representation conflict.


Sujet(s)
Conflit psychologique , Potentiels évoqués/physiologie , Langage , Mémoire à court terme/physiologie , Temps de réaction/physiologie , Perception sociale , Stéréotypes , Perception visuelle/physiologie , Adulte , Électroencéphalographie , Reconnaissance faciale/physiologie , Femelle , Humains , Mâle , Lecture , Jeune adulte
19.
Neuroreport ; 29(1): 36-40, 2018 Jan 03.
Article de Anglais | MEDLINE | ID: mdl-29140846

RÉSUMÉ

This study investigated motivational effect of reward and punishment on directed forgetting using the event-related potential technique. Participants were instructed to encode two-character words in Chinese, followed by the indicator of 'remember' or 'forget'. Then, participants were required accomplishing the judgment task of old and new words. The results suggest that (i) directed forgetting effect is significant in the punishment condition but not in the reward condition, and (ii) a positive amplitude is induced in the punishment condition but not in the reward condition. Furthermore, directed forgetting can be effectively influenced by reward motivation, whereas punishment motivation is antagonistic to active forgetting because a substantial cognitive resource attracts considerable attention. Therefore, this study supports encoding inhibition theory.


Sujet(s)
Encéphale/physiologie , Potentiels évoqués/physiologie , Motivation/physiologie , Punition , /physiologie , Adulte , Électroencéphalographie , Femelle , Humains , Inhibition psychologique , Mâle , Jeune adulte
20.
Int J Cancer ; 141(5): 1052-1065, 2017 09 01.
Article de Anglais | MEDLINE | ID: mdl-28560805

RÉSUMÉ

We asked what preoperative radiotherapy/chemoradiotherapy (PRT/PCRT) has brought to patients in terms of perioperative and long-term outcomes over the past decades. A systematic review and meta-analysis was conducted using PubMed, Embase and Web of Science databases. All original comparative studies published in English that were related to PRT/PCRT and surgical resection and which analyzed survival, postoperative and quality of life outcomes were included. Data synthesis and statistical analysis were carried out using Stata software. Data from 106 comparative studies based on 80 different trials enrolling 41,121 patients were included in our study. Based on our overall analyses, PRT/PCRT significantly improved patients' local recurrence-free survival (LRFS), but neither overall survival (OS) nor metastasis-free survival (MFS) showed improvement. In addition, PRT significantly increased the postoperative morbidity and mortality but PCRT did not have a significant effect. Furthermore, PRT/PCRT significantly increased the risk of postoperative wound complications but not anastomotic leakage and bowel obstruction. Our comprehensive subgroup analyses further supported the aforementioned results. Meanwhile, long-term anorectal symptoms (impaired squeeze pressures, use of pads, incontinence and urgency) and erectile dysfunction were also significantly increased in patients after PRT/PCRT. The benefits of PRT/PCRT as applied over the last several decades have not been sufficient to improve OS. Metastases of primary tumor and postoperative adverse effects were the two primary obstacles for an improved OS. In fact, the greatest advantage of PRT/PCRT is still local tumor control and a significantly improved LRFS.


Sujet(s)
Chimioradiothérapie adjuvante/méthodes , Traitement néoadjuvant/méthodes , Tumeurs du rectum/thérapie , Humains , Tumeurs du rectum/mortalité , Résultat thérapeutique
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