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1.
BMC Gastroenterol ; 20(1): 31, 2020 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-32028908

RESUMO

BACKGROUND: The association between natural killer (NK) cells and survival in colorectal cancer (CRC) patients remains controversial. This study aimed to clarify the prognostic value of peripheral blood NK cells in CRC patients. METHODS: A total of 447 CRC patients who underwent radical surgery and chemotherapy were retrospectively analyzed. Cox regression analyses were used to identify independent prognostic indicators. Correlation between NK cell percentage and other clinicopathological features (gender, age, histological grade, tumor stage, immune cells, and inflammatory indicators) was analyzed. The prognostic values of the combinations of NK cell percentage and other clinicopathological features were also determined. RESULTS: Multivariate Cox regression analysis revealed that NK cell percentage in the peripheral blood was an independent prognostic indicator in CRC patients. A higher percentage of NK cells indicated a longer survival time than a lower percentage. NK cell percentage was positively correlated to the T and B lymphocyte counts and negatively correlated to the patients' age and albumin levels. With an area of 0.741 under a receiver operating characteristic curve, NK cells have a moderate predictive value for 3rd-year survival in CRC. This area increased to 0.851 by combining NK cell percentage with the B lymphocyte count. Elderly patients and those at an advanced clinical stage presented a lower percentage of NK cells than younger patients and those at an early clinical stage. CONCLUSIONS: This study demonstrated that NK cells in the blood were an independent predictor of survival in CRC patients, and the combined count of NK cells and B lymphocytes could increase the prognostic value.

2.
Front Genet ; 10: 1097, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31781164

RESUMO

Background: The N-acetyltransferase 1 (NAT1) gene is downregulated in several cancers and associated with patient survival. In this study, we sought to examine the prognostic value and clinical significance of NAT1 methylation in colon adenocarcinoma (COAD). Methods: Data relating to NAT1 mRNA expression and methylation and clinicopathological features of COAD were extracted from the database of The Cancer Genome Atlas. We compared the mRNA expression and methylation of NAT1 between COAD and normal tissues and performed correlation analysis to assess the association between NAT1 mRNA expression and methylation. Furthermore, we assessed patient survival based on CpG sites in the promoter region of NAT1 and analyzed the association between the NAT1 mRNA expression and CpG site methylation and clinicopathological features. An independent Gene Expression Omnibus (GEO) dataset was used to validate the results. Results: We found that the expression of NAT1 mRNA was reduced in COAD compared with normal tissues and that mean methylation of the eight CpG sites in the promoter region of NAT1 was higher in COAD tissues than in normal tissues. Furthermore, five CpG sites were demonstrated to be significantly negatively correlated with NAT1 mRNA expression in COAD. Survival analysis indicated that NAT1 mRNA expression and the cg15797286 and cg18509990 sites were associated with the overall survival of COAD patients. Combined survival analysis revealed that combinations of NAT1 mRNA expression with five CpG sites were significantly associated with the overall survival of COAD patients. Both NAT1 mRNA and cg15797286 were associated with the T, N, and clinical stages of COAD. The GEO data indicated that cg15797286 was hypermethylated in recurrent colorectal adenomas. Conclusions: Methylation of NAT1 is associated with the development of COAD, and may serve as prognostic and treatment biomarkers for COAD.

3.
Biomed Pharmacother ; 117: 109159, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31247467

RESUMO

This study designed to identify a potential novel distant metastasis-related gene (DMGs) signature that predicting prognosis in patients with gastric cancer. DMGs was screened by overlapping the differentially expressed genes between M0 and M1 stage, and between tumor and adjacent normal tissue of gastric cancer by analyzing The Cancer Genome Atlas (TCGA) dataset. There were 83 DMGs were identified, the integrative analysis revealed these DMGs were involved in several biological process and pathway. A six-DMGs prognostic signature was developed based on the risk score obtained from Cox analysis. Patients with low risk score presented significantly shorter survival time. This prognostic signature has a moderate predictive value for the overall survival in gastric cancer patients, with an area under curve of 0.604. The DMGs prognostic signature also significantly associated with the overall survival of gastric cancer patients, and showed a better performance for predicting prognosis than traditional clinical indicators. The joint effect of risk score with clinical features could remarkably increased the predictive value as compared with single variable. The results from 60 gastric cancer tissues verified the prognostic value of the six-DMGs prognostic signature. In conclusions, the present study identified a novel six-DMGs prognostic signature that could serve as a biomarker for the prognosis prediction of patients with gastric cancer.


Assuntos
Perfilação da Expressão Gênica , Regulação Neoplásica da Expressão Gênica , Estudo de Associação Genômica Ampla , Neoplasias Gástricas/genética , Neoplasias Gástricas/patologia , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Metástase Neoplásica , Valor Preditivo dos Testes , Prognóstico , Modelos de Riscos Proporcionais , Análise de Regressão , Fatores de Risco
4.
Biomed Pharmacother ; 117: 109110, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31252263

RESUMO

Resveratrol has been suggested to mediate liver fibrosis. The switch from classically M(LPS) to alternatively activated M(IL-4) macrophages shows to protect organs from fibrosis. However, the mechanisms remain unclear. The study aimed to investigate whether resveratrol inhibited liver fibrosis by delivering IL-10 to promote the macrophage polarization in vitro and in vivo. We observed that resveratrol improved CCL4-induced liver fibrosis, upregulated Kupffer cells, increased the expression of IL-10 and M(IL-4) marks including Mrc1, Mrc2, CD163 and Arg1, whereas it slightly suppressed the level of M(LPS) including iNOS, TNF-α and MCP1. In vitro, resveratrol promoted the M(LPS) switch to M(IL-4) macrophage and elevated the expression of CD206 and iNOS as well. Meanwhile, IL-10 increased in both M(IL-4) and M(LPS). We concluded that resveratrol relieved liver fibrosis by producing more IL-10 to promote the polarization of M(LPS) to M(IL-4)-like macrophages.


Assuntos
Interleucina-4/farmacologia , Lipopolissacarídeos/farmacologia , Cirrose Hepática/genética , Macrófagos/metabolismo , Resveratrol/farmacologia , Regulação para Cima/efeitos dos fármacos , Animais , Tetracloreto de Carbono , Polaridade Celular/efeitos dos fármacos , Inflamação/patologia , Interleucina-10/metabolismo , Macrófagos do Fígado/efeitos dos fármacos , Macrófagos do Fígado/metabolismo , Cirrose Hepática/induzido quimicamente , Macrófagos/efeitos dos fármacos , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Fenótipo , Células RAW 264.7
5.
Medicine (Baltimore) ; 98(19): e15560, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31083220

RESUMO

Red blood cell distribution width (RDW) is associated with several diseases. However, the diagnostic value of RDW and its related factors remain unclear in colorectal cancer (CRC).This single-center retrospective study evaluated 211 Chinese CRC patients and 103 healthy controls. The association of RDW with the clinical parameters of CRC, as well as its correlations with carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) were analyzed. The diagnostic value of RDW alone or combined with CEA and CA19-9 was evaluated using receiver operating characteristic curve analysis. A meta-analysis was also performed to combine our data with previously published data to enhance our findings.In the CRC patients, RDW was clearly elevated and was significantly associated with CRC tumor location, histological type, T status (but not N or M status), and clinical stage. However, RDW was not significantly correlated with CEA or CA19-9 levels. Using RDW to diagnose CRC provided a sensitivity of 53.1% and specificity of 77.7%. The diagnostic accuracy of RDW was enhanced by combining RDW with CEA and CA19-9 levels. We identified 5 previous studies with 633 CRC patients and 1050 controls, which were combined with our cases and controls. The meta-analysis revealed an overall sensitivity of 69%, specificity of 70%, and an area under the curve of 0.74.In CRC cases, RDW was associated with tumor location, histological type, T status, and clinical stage. Furthermore, RDW had a moderate value for diagnosing CRC and might be useful in this setting.


Assuntos
Neoplasias Colorretais/sangue , Índices de Eritrócitos , Biomarcadores Tumorais/sangue , Neoplasias Colorretais/patologia , Neoplasias Colorretais/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Retrospectivos , Sensibilidade e Especificidade
6.
BMC Gastroenterol ; 19(1): 46, 2019 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-30917791

RESUMO

BACKGROUND: Colorectal cancer (CRC) originating from the right-sided or left-sided colon is distinct clinicopathological entity. The KRAS status and its prognostic value in CRC remain controversial. This study aimed to investigate the association of KRAS status with clinicopathological features and prognostic value in CRC. METHODS: 178 colon cancer and 145 rectal cancer patients were enrolled. KRAS mutation test was performed on paraffin-embedded tumor samples using PCR methods. The colon cancer was divided into right-sided colon cancer (RCC) and left-sided colon cancer (LCC). Studies that reported the association of KRAS mutation with CRC clinical features and prognosis in databases were searched prior to 2018. The data of the present study was combined with the data of published studies using meta-analysis methods. RESULTS: No significant difference between colon cancer and rectal cancer regarding the KRAS status. The KRAS mutation was much frequent in RCC than in LCC (p = 0.010). 17 studies with 11,385 colon cancer patients were selected, the pooled results of our data and previous published data showed that KRAS mutation was more frequent in RCC compared with in LCC (p < 0.01); KRAS mutation was not associated with the prognosis in RCC patient; however, KRAS mutation indicated a poor prognosis in LCC patients compared with KRAS wild type (p < 0.01). CONCLUSION: KRAS status has no difference between colon cancer and rectal cancer. KRAS mutation was more frequent in RCC than in LCC, and associated with a poor prognosis in LCC patients, but not in RCC patients.


Assuntos
Biomarcadores Tumorais/genética , Neoplasias Colorretais/genética , Neoplasias Colorretais/patologia , Mutação , Proteínas Proto-Oncogênicas p21(ras)/genética , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos
7.
J Crit Care ; 48: 145-152, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30195194

RESUMO

PURPOSE: The aim of this meta-analysis was to clarify the diagnostic role of plasma BNP and NT-proBNP in predicting mortality for septic patients. METHODS: A systematic review was conducted prior to January 2018. Summary sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DOR) of the prognostic value of plasma BNP and NT-proBNP for septic patients. The area under the receiver operating curves (AUROC) were used to summarize overall test performance. RESULTS: Twenty-two studies with 3417 septic patients were selected in the analysis. The summary sensitivity, specificity, PLR, NLR, DOR and the AUROC of the overall analysis of BNP were: 0.84, 0.73, 3.1, 0.22, 14, 0.85; and these values of NT-proBNP were: 0.71, 0.73, 2.6, 0.39, 7 and 0.7 respectively; Subgroup analysis and meta-regression analyses showed that the tested method and observation endpoint influenced the summary sensitivity, specificity of BNP, but the tested day, tested method or observation endpoint did not influence the summary sensitivity, specificity of NT-proBNP. CONCLUSIONS: This meta-analysis indicates that both elevated plasma BNP and NT-proBNP have moderate predicts value for the mortality of septic patients, and the tested method and observation endpoint influence the results of BNP.


Assuntos
Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Sepse/mortalidade , Área Sob a Curva , Biomarcadores/sangue , China , Humanos , Razão de Chances , Prognóstico , Sensibilidade e Especificidade , Sepse/sangue
8.
Sci Rep ; 6: 36436, 2016 11 07.
Artigo em Inglês | MEDLINE | ID: mdl-27819314

RESUMO

IL-22 ameliorates liver fibrosis by inhibiting hepatic stellate cells (HSC), and loss of miR-200a is associated with the development of liver fibrosis. The study aimed to investigate the interplay between IL-22 and miR-200a in regulating liver fibrosis in vivo and in vitro. We observed that IL-22 significantly reduced the proliferation of HSC and increased the expression of p-STAT3. ß-catenin was identified as a target gene of miR-200a by luciferase reporter assay, and upregulation of miR-200a significantly attenuated the proliferation of HSC and reduced ß-catenin expression. IL-22 treatment increased expression of miR-200a and decreased expression of ß-catenin in HSC. The expression of p-STAT3 and miR-200a was elevated while ß-catenin was decreased in fibrotic rat liver after IL-22 treatment. Expression levels of ß-catenin and p-STAT3 were inversely correlated in fibrotic rat liver and HSC. Upregulation of ß-catenin suppressed expression of p-STAT3 in HSC. We concluded that IL-22 inhibits HSC activation and ameliorates liver fibrosis through enhancing expression of miR-200a and reducing expression of ß-catenin, suggesting there may be a crosstalk between IL-22/STAT3 and ß-catenin pathway.


Assuntos
Proteínas do Domínio Armadillo/metabolismo , Interleucinas/uso terapêutico , Cirrose Hepática/prevenção & controle , MicroRNAs/metabolismo , Proteínas do Tecido Nervoso/metabolismo , Actinas/análise , Animais , Antagomirs/metabolismo , Apoptose/efeitos dos fármacos , Proteínas do Domínio Armadillo/antagonistas & inibidores , Proteínas do Domínio Armadillo/genética , Linhagem Celular , Proliferação de Células/efeitos dos fármacos , Colágeno Tipo I/análise , Células Estreladas do Fígado/citologia , Células Estreladas do Fígado/metabolismo , Interleucinas/genética , Interleucinas/metabolismo , Interleucinas/farmacologia , Cirrose Hepática/patologia , Masculino , MicroRNAs/antagonistas & inibidores , MicroRNAs/genética , Proteínas do Tecido Nervoso/antagonistas & inibidores , Proteínas do Tecido Nervoso/genética , Ratos , Ratos Sprague-Dawley , Proteínas Recombinantes/biossíntese , Proteínas Recombinantes/isolamento & purificação , Proteínas Recombinantes/farmacologia , Proteínas Recombinantes/uso terapêutico , Fator de Transcrição STAT3/metabolismo , Alinhamento de Sequência , Fator de Crescimento Transformador beta1/farmacologia , Regulação para Cima/efeitos dos fármacos
9.
Sci Rep ; 6: 18694, 2016 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-26728971

RESUMO

T helper 9 (Th9) cells, a recently recognized Th cell subset, are involved in autoimmune diseases. We aimed to investigate the role of Th9/interleukin-9 (IL-9) in the pathogenesis of hepatic fibrosis. Th9 and Th17 cells were quantified in chronic hepatitis B (CHB) patients with hepatic fibrosis, HBV-associated liver cirrhosis (LC) patients and healthy controls (HC). The percentages of Th9 and Th17 cells, concentrations of IL-9 and IL-17, as well as expression of IL-17, TNF-α, IL-6, IL-4, IL-21, TGF-ß1 and IFN-γ were significantly increased in plasma of CHB and LC patients compared with those in HC. Splenic Th9 and Th17 cells, plasma concentrations and liver expression of IL-9 and IL-17A were significantly elevated in mice with hepatic fibrosis compared with controls. Neutralization of IL-9 in mice ameliorated hepatic fibrosis, attenuated the activation of hepatic stellate cells, reduced frequencies of Th9, Th17 and Th1 cells in spleen, and suppressed expression of IL-9, IL-17A, IFN-γ, TGF-ß1, IL-6, IL-4 and TNF-α in plasma and liver respectively. Our data suggest a deleterious role of Th9/IL-9 in increasing hepatic fibrosis and exacerbating disease endpoints, indicating that Th9/IL9 based immunotherapy may be a promising approach for treating hepatic fibrosis.


Assuntos
Interleucina-9/metabolismo , Cirrose Hepática/etiologia , Cirrose Hepática/metabolismo , Subpopulações de Linfócitos T , Linfócitos T Auxiliares-Indutores/imunologia , Linfócitos T Auxiliares-Indutores/metabolismo , Adolescente , Adulto , Idoso , Animais , Anticorpos Monoclonais/farmacologia , Anticorpos Neutralizantes/farmacologia , Estudos de Casos e Controles , Citocinas/metabolismo , Modelos Animais de Doenças , Feminino , Hepatite B Crônica/complicações , Hepatite B Crônica/metabolismo , Humanos , Imunofenotipagem , Interleucina-17/antagonistas & inibidores , Interleucina-17/sangue , Interleucina-17/genética , Interleucina-17/metabolismo , Interleucina-9/antagonistas & inibidores , Interleucina-9/sangue , Interleucina-9/genética , Cirrose Hepática/patologia , Contagem de Linfócitos , Masculino , Camundongos , Pessoa de Meia-Idade , RNA Mensageiro/genética , Baço/imunologia , Baço/metabolismo , Baço/patologia , Células Th17/imunologia , Células Th17/metabolismo , Adulto Jovem
10.
Pak J Med Sci ; 31(4): 1002-8, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26430448

RESUMO

BACKGROUND AND OBJECTIVE: The association between smoking and clinical outcomes after coronary stenting is controversial. The aim of this meta-analysis was to assess the association between smoking and in stent restenosis (ISR), major adverse cardiac events (MACE), or major adverse cardiac and cerebrovascular events (MACCE) after coronary stenting. METHODS: A search for studies published before December 2014 was conducted in PubMed, Embase, and Cochrane library. An inverse random weighted meta-analysis was conducted using logarithm of the odds ratio (OR) and its standard error for each study. RESULTS: Ten studies investigated the association between smoking and ISR. Overall, smoking was not associated with ISR (OR: 1.05, 95% CI: 0.79-1.41; I(2) = 47.8%). Subgroup analysis also failed to show a significant association between smoking and ISR risk regardless of bare metal stent (BMS) and drug-eluting stent (DES) implantation. Eight studies explored the association between smoking and MACE, but no association was found (OR: 0.92, 95% CI: 0.77-1.10; I(2) = 25.5%), and subgroup analysis revealed that no distinct difference was found between BMS and DES implantation. Three studies investigated the association between smoking and MACCE and significant association was found (OR: 2.09, 95% CI: 1.43-3.06; I(2) = 21.6%). CONCLUSIONS: Our results suggest that in patients undergoing percutaneous coronary intervention with stent implantation, smoking is not associated with ISR and MACE; however, smoking is an independent risk factor for MACCE.

11.
Hum Immunol ; 75(10): 1062-8, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25223469

RESUMO

BACKGROUND: The association between ADIPOQ polymorphisms and the risk of obesity remains controversial. We perform a comprehensive meta-analysis to clarify the current understanding of this association. METHODS: We searched for relevant studies in PubMed, Embase and Cochrane library before February 2014. The strengths of the association between ADIPOQ polymorphisms and obesity risk were estimated by odds ratios (OR) with 95% confidence intervals (CI). RESULTS: Eighteen case-control studies analyzing four SNPs (rs17300539, rs266729, rs1501299 and rs2241766) of ADIPOQ gene were eligible for the present meta-analysis. The pooling results showed that rs17300539 (2GG+GA vs. 2AA+GA: OR=0.78, 95%CI=0.69-0.89) and rs1501299 (2GG+GA vs. 2AA+GA: OR=0.89, 95%CI=0.80-0.98) were associated with obesity risk in Caucasian ethnicity. The rs266729 were associated with obesity risk in Asian ethnicity (2CC+CG vs. 2GG+GCG: OR=0.77, 95%CI=0.65-0.92). However, there were no associations between rs2241766 and the obesity risk (P>0.05). No publication bias was found among these studies (all P>0.05). CONCLUSIONS: This study suggests that ADIPOQ rs17300539 and rs1501299 are associated with risk of obesity in Caucasian ethnicity, and the rs266729 is associated with obesity risk in Asian ethnicity. However, there is no association between rs2241766 and obesity risk.


Assuntos
Adiponectina/genética , Grupo com Ancestrais do Continente Asiático , Grupo com Ancestrais do Continente Europeu , Obesidade/genética , Estudos de Associação Genética , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Humanos , Polimorfismo de Nucleotídeo Único , Risco
12.
PLoS One ; 8(9): e72710, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24066025

RESUMO

BACKGROUND: Previous studies have shown inconsistent results on the association between diabetes mellitus (DM) and some clinical outcomes. We conducted a meta-analysis of observational studies to assess effect of DM on clinical outcomes after coronary stenting. METHODS: We searched for studies without language restriction in PubMed, Embase and Cochrane library prior to 2012. The clinical outcomes including in-stent restenosis (ISR), major adverse cardiac events (MACE), stent thrombosis (ST), target lesion revascularization (TLR) and target vessel revascularization (TVR). Adjusted odds ratio (OR), and the corresponding 95% confidence interval (95% CI) was summarized. RESULTS: 55 studies involving 128,084 total patients (38,416 DM patients and 89,668 controls) were eligible for our analysis. Overall, there were significant associations between DM and ISR (OR = 1.70, 95% CI: 1.53-1.89, I(2) = 0.0%), MACE (OR = 1.54, 95% CI: 1.36-1.73, I(2) = 29.0%), ST (OR = 2.01, 95% CI: 1.36-2.97, I(2) = 47.7%), TLR (OR = 1.46, 95% CI: 1.26-1.68, I(2) = 43.3%) as well as TVR (OR = 1.33, 95% CI: 1.17-1.51, I(2) = 48.3). Subgroup analysis showed that the associations were similar between BMS and DES implantation. Moreover, there was no significant association in the ST subgroup after 1-3 years follow-up. CONCLUSIONS: Our meta-analysis suggests that after coronary stent implantation, DM is associated with ISR, MACE, ST, TLR and TVR. DM appears to be a vital risk factor of these clinical outcomes.


Assuntos
Angioplastia Coronária com Balão/efeitos adversos , Diabetes Mellitus/fisiopatologia , Stents Farmacológicos/efeitos adversos , Intervalos de Confiança , Humanos , Fatores de Risco
13.
Clin Res Hepatol Gastroenterol ; 37(6): 619-25, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23830279

RESUMO

BACKGROUND: The role of Helicobacter pylori (H. pylori) in the pathogenesis of hepatic encephalopathy (HE) is still under debate. We reviewed the available evidence for a pathogenic role of H. pylori infection in determining HE in cirrhotic patients. METHODS: We searched PubMed, EMBASE, and Cochrane Library prior to 2012 for studies that explored the role of H. pylori in HE pathogenesis. RESULTS: Twenty studies were eligible for our analysis. Eleven studies investigated the epidemiology of H. pylori infection; there is evidence suggesting that the prevalence of H. pylori is higher in older HE patients. The evidence of nine studies failed to find that blood ammonia level was higher in H. pylori positive cirrhotic patients than in negative patients. Four studies suggested that gastric ammonia level was higher in H. pylori positive than H. pylori negative patients. Eleven studies investigated the effect of H. pylori eradication on the change of blood ammonia levels and the HE improvement. No new reliable evidence was found to support the effect of H. pylori eradication in reducing blood ammonia levels and improving HE symptoms. CONCLUSIONS: Current evidence confirmed the higher prevalence of H. pylori infection in HE patients. However, no new evidence supported the effect of H. pylori on the increased of blood ammonia level, nor the efficacy of H. pylori eradication in decreasing of blood ammonia level and improving HE.


Assuntos
Amônia/análise , Infecções por Helicobacter/sangue , Encefalopatia Hepática/sangue , Cirrose Hepática/sangue , Infecções por Helicobacter/complicações , Helicobacter pylori , Encefalopatia Hepática/complicações , Humanos , Cirrose Hepática/complicações , Prevalência , Medição de Risco , Estômago/química
14.
Yonsei Med J ; 54(4): 832-8, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23709415

RESUMO

PURPOSE: The association between Helicobacter pylori (H. pylori) and blood ammonia levels in cirrhotic patients is controversial. We aimed to clarify this controvercy by performing a meta-analysis of published studies. MATERIALS AND METHODS: We searched PubMed, EMBASE and Cochrane library for studies which explored the association between H. pylori and blood ammonia levels in cirrhotic patients before May 2012. Six cohort studies involved in 632 H. pylori positive and 396 H. pylori negative cirrhotic patients were eligible for our analysis. The summary estimates were presented as standard means differences (SMD) and 95% confidence intervals (CI) from individual studies. RESULTS: Overall, there was significant association between H. pylori infection and the elevated blood ammonia levels in cirrhotic patients (SMD=0.34, 95% CI=0.21-0.47, I²=42.1%). Sensitivity analysis further confirmed this association. Subgroup analysis showed that the association was found only in Asian ethnicity, but not in Caucasian ethnicity. CONCLUSION: H. pylori infection is associated with elevated blood ammonia levels in cirrhotic patients, and more large scale studies and stratify analysis are warranted in order to further evaluate this association.


Assuntos
Infecções por Helicobacter/sangue , Cirrose Hepática/sangue , Cirrose Hepática/microbiologia , Amônia/sangue , Grupo com Ancestrais do Continente Asiático , Grupo com Ancestrais do Continente Europeu , Helicobacter pylori/patogenicidade , Humanos , Viés de Publicação , Análise de Regressão
15.
Atherosclerosis ; 227(2): 360-6, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23411039

RESUMO

BACKGROUND: Previous studies have shown inconsistent results on the association between baseline plasma Lipoprotein (a) [Lp(a)] levels and in-stent restenosis (ISR) after coronary stenting. OBJECTIVE: We conducted a meta-analysis of observational studies to assess the association between baseline Lp(a) levels and the restenosis after successful coronary stenting. METHODS: We searched for studies without language restriction in PubMed, Embase, Cochrane library, Ovid library database prior to October 2012. Random-effects method was applied to estimate the pooled standard mean difference (SMD). Heterogeneity, sensitivity and subgroup analysis were used to evaluate the results. Meta-regression analysis was employed to investigate sources of heterogeneity. RESULTS: 9 cohort studies including 1834 patients (600 ISR and 1234 no-ISR patients) were eligible for our analysis. Overall, we found significantly elevated baseline Lp(a) levels in ISR (in-stent restenosis) patients (SMD = 0.42, 95% CI: 0.14-0.71, P = 0.003). High heterogeneity existed between the individual studies (P < 0.001, I(2) = 86.9%). The association was stronger in the Asian population than the overall association found. Further, similar observations were made in the subgroup with drug-eluting stent and the group in which Lp(a) was assayed by immunoturbidimetry. Multivariable regression analysis suggested that ethnicity was the major source of heterogeneity in the data (P = 0.036). CONCLUSIONS: Our meta-analysis suggests that significantly elevated baseline plasma Lp(a) level is associated with ISR. The Lp(a) level appears to be a good predictor of ISR, especially in the Asian population or patients who received drug-eluting stent implantation. Further research is warranted to evaluate the association by taking the ethnicity and type of stent into account.


Assuntos
Angioplastia Coronária com Balão/métodos , Reestenose Coronária/sangue , Stents Farmacológicos , Lipoproteína(a)/sangue , Grupo com Ancestrais do Continente Asiático , Ensaios Clínicos como Assunto , Estudos de Coortes , Angiografia Coronária/métodos , Humanos , Pessoa de Meia-Idade , Análise Multivariada
16.
Hepatogastroenterology ; 59(120): 2576-81, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22591680

RESUMO

BACKGROUND/AIMS: The effect of Helicobacter pylori (H. pylori) eradication on blood ammonia levels in cirrhotic patients is still controversial. We aimed to clarify this effect by performing a quantitative meta-analysis of published studies. METHODOLOGY: We searched PubMed, EMBASE and Cochrane library for studies which explored the effect of H. pylori eradication on blood ammonia levels in cirrhotic patients before March 2012. A random-effects meta-analysis was performed. RESULTS: Nine studies (five non-randomized control studies and four before-after studies) involved in 699 cirrhotic patients who were given H. pylori eradication eligible to our analysis. The before-after studies suggested that H. pylori eradication can significantly reduce the blood ammonia levels in cirrhotic patients (SMD=0.32, 95%CI=0.11-0.53, 12=39.6%). After included five non-randomized control studies,the overall results suggested that H. pylori eradication can not reduce the blood ammonia levels in cirrhotic patients (SMD=-0.36, 95% CI=-0.83-0.11) and with significant heterogeneity (1=89.3%). Subgroup analysis suggested that the no effect was found between Caucasian and Asian ethnicity and between cirrhotic patients with Child-Pugh class B/C <70% and >70%. CONCLUSIONS: The effect of eradication of H. pylori on blood ammonia levels in cirrhotic patients is mainly caused by the non-specific effect of antibiotics regardless of patients' ethnicity and impairment of liver function. However, due to limited studies available and low methodological quality that marked by high risks of bias, our study should be interpreted cautiously.


Assuntos
Amônia/sangue , Antibacterianos/uso terapêutico , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori/efeitos dos fármacos , Cirrose Hepática/sangue , Viés , Biomarcadores/sangue , Regulação para Baixo , Medicina Baseada em Evidências , Infecções por Helicobacter/complicações , Infecções por Helicobacter/etnologia , Infecções por Helicobacter/microbiologia , Helicobacter pylori/isolamento & purificação , Humanos , Cirrose Hepática/complicações , Cirrose Hepática/etnologia , Pessoa de Meia-Idade , Resultado do Tratamento
17.
J Neuroimmunol ; 243(1-2): 18-24, 2012 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-22236374

RESUMO

BACKGROUND AND OBJECTIVES: The findings on the associations between potential genetic variants and risk of Guillain-Barré syndrome (GBS) are controversial. We conducted a meta-analysis for candidate genes to provide the evidences for the current understanding of the genetic association with GBS. METHODS: We searched relevant studies without language restriction in PubMed, Embase and Cochrane library through May 2011. The strengths of the associations between genetic variants and GBS risk were estimated by odds ratios (ORs) with 95% confidence intervals (CIs). Random-effects models or fixed effects model was applied based on the heterogeneity test. RESULTS: We identified 12 case-control studies involving 1,590 GBS cases and 2,154 controls for the analysis. Because of limited eligible data, our meta-analysis specifically focused on 6 genetic variants of 3 candidate genes, TNF-α, FcγR and CD1. We found that TNF-α 308 G/A polymorphism was significantly associated with the risk of GBS in the overall population (GG+GA vs. AA: OR=0.32, 95%CI=0.16-0.62; GG vs. AA: OR=0.36, 95%CI=0.19-0.68). Subgroup analysis further provided evidence of significant association between TNF-α 308 G/A and risk of the GBS in Asian population (GG+GA vs. AA: OR=32, 95%CI=0.11-0.93; GG vs. AA: OR=0.32, 95%CI=0.15-0.68). In addition, we did not observe significant associations between FcγRIIA R/H, FcγRIIIA F/V, FcγRIIIB NA1/NA2, CD1A 1/2 and CD1E 1/2 polymorphisms and susceptibility for developing GBS. CONCLUSIONS: Our findings showed that TNF-α 308A allele might be a moderate risk factor for GBS. However, the results should be interpreted with caution due to the limited number of studies available.


Assuntos
Antígenos CD1/genética , Predisposição Genética para Doença , Síndrome de Guillain-Barré/genética , Polimorfismo Genético/genética , Receptores de IgG/genética , Fator de Necrose Tumoral alfa/genética , Bases de Dados Bibliográficas/estatística & dados numéricos , Feminino , Humanos , Masculino , Razão de Chances , Fatores de Risco
18.
Zhonghua Yi Xue Za Zhi ; 91(25): 1766-9, 2011 Jul 05.
Artigo em Chinês | MEDLINE | ID: mdl-22093736

RESUMO

OBJECTIVE: To evaluate the diagnostic value of 64-slice spiral computed tomographic angiography (CTA) in vertebral artery stenosis through a meta-analysis of the relevant data. METHODS: A database search of Cochrane Library, PubMed, EBSCO, CBM-disc and CNKI was performed to identify the relevant English and Chinese language articles with such keywords as 64-slice computer tomography, angiography and vertebral artery stenosis. Quality evaluation, heterogeneity test and sensitivity and specificity to the qualified original data were conducted. Summary receiver operating characteristic (SROC) curve, the area under curve (AUC) and diagnostic odds ratio (DROC) were also calculated. RESULTS: A total of 4 studies were eligible for meta-analysis. Among them, 1 was graded as A and 3 were graded as B. No heterogeneity was found based upon a fixed effect model. For vertebral artery stenosis > or = 50%, the pooled weighted sensitivity, specificity, DROC and SROC AUC was 0.98 (0.94 -1.00), 0.93 (0.89 -0.96), 526.33 and 0.9899 respectively; while for vertebral artery stenosis > or = 50%, the parameters were 0.98 (0.91 - 1.00), 0.97 (0.94 -0.99), 838.40 and 0.9932 respectively. CONCLUSIONS: 64-slice spiral CTA has such a high level of accuracy, sensitivity and specificity in the non-invasive diagnosis of vertebral artery stenosis.


Assuntos
Tomografia Computadorizada Espiral/métodos , Insuficiência Vertebrobasilar/diagnóstico por imagem , Humanos
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