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BACKGROUND: Body water measured by bioelectrical impedance analysis (BIA) predicts the outcomes of many diseases. This study aimed to evaluate the relationship between body water and the prognosis of cancer patients with sarcopenia. METHODS: This study employed 287 cancer patients with sarcopenia underwent BIA from a prospective multicenter study of patients with cancer in China from 2013 to 2020. The primary outcome of interest was all-cause mortality presented as the longest time to follow-up available. Eight indicators of body water [total body water, extracellular water, intracellular water, free fat mass, active cell mass, extracellular water/intracellular water, extracellular water/total body water (ECW/TBW), and intracellular water/total body water] were included in the research. Neutrophil-lymphocyte ratio (NLR) = neutrophil (× 109)/lymphocyte (× 109). The discriminatory ability and prediction accuracy of each factor were assessed using the C-index. The hazard ratios (HR) and 95% confidence intervals (CI) were calculated using the Cox proportional hazard model. RESULTS: The median age was 65 years old, and 138 (48%) patients were men. During a mean follow-up of 46 months, 140 deaths were recorded, resulting in a rate of 204.6 events per 1000 patient-years. ECW/TBW showed the best predictive accuracy (C-index = 0.619) compared to the other indicators [p = 0.004, adjusted HR (95% CI) 1.70 (1.18,2.44)]. In the middle tertile (0.385-0.405), ECW/TBW had a strong independent negative association with patient survival [adjusted HR (95% CI) 2.88 (1.39-5.97), p = 0.004]. Patients who had a high ECW/TBW (ECW/TBW ≥ 0.395) combined with a high NLR had 3.84-fold risk of mortality (p < 0.001, 95% CI 1.99,7.38). CONCLUSIONS: ECW/TBW was better than other indicators in predicting survival of cancer patients with sarcopenia. High ECW/TBW combined with high NLR would further increase the risk of mortality. TRIAL REGISTRATION: The Investigation on Nutrition Status and Clinical Outcome of Common Cancers (INSCOC) (Chinese Clinical Trial Registry: ChiCTR1800020329, URL of registration: http://www.chictr.org.cn/showprojen.aspx?proj=31813 ).
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The aim of the study was to compare the efficacy and safety profiles of fondaparinux and enoxaparin in preventing the venous thromboembolism (VTE) after total hip replacement. A systematic literature search in the PubMed, EMBASE and Cochrane library databases was performed to identify relevant articles published in English since inception up to November 16, 2014. The efficacy outcomes were all VTE, total deep vein thrombosis (DVT) and symptomatic VTE, while the safety outcome was major bleeding. Four eligible studies were included in the meta-analysis. The incidences of total VTEs and DVTs were significantly decreased with the use of fondaparinux when compared to enoxaparin [total VTE: risk ratio (RR)=0.59, 95% confidence interval (CI): 0.46-0.74, P<0.01; total DVT: RR=0.58, 95% CI: 0.46-0.74, P<0.01]. Significantly fewer symptomatic VTEs and major bleeding cases were observed for the enoxaparin group (symptomatic VTE: RR=2.62, 95% CI: 1.07-6.45, P=0.04; major bleeding: RR=1.75, 95% CI: 1.20-2.53, P<0.01). In conclusion, the pooled analysis revealed that, compared to enoxaparin, fondaparinux was significantly more effective in preventing VTE after total hip replacements in terms of total VTEs and DVTs, although this was accompanied with an increased risk of major bleeding. However, the pooled analysis of two small sample trials from Japan failed to demonstrate any significant advantage for fondaparinux compared to enoxaparin.
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Based on the technique of passive nighttime warming (PNW), a convenient and energy-saving PNW facility was designed for a rice-wheat cropping system in Danyang, Jiangsu Province. The facility could guarantee 15.75 m2 effective sampling area, with a homogeneous amplitude of increased temperature, and making the nighttime canopy temperature during whole rice growth season increased averagely by 1.1 degrees C and the nighttime canopy temperature and 5 cm soil temperature during whole winter wheat growth period increased averagely by 1.3 degrees C and 0.8 degrees C, respectively. During the operation period of the facility, the variation trends of the canopy temperature and 5 cm soil temperature during the whole growth periods of rice and winter wheat in the warming plots were similar to those of the control. Though the facility slightly decreased the soil moisture content during winter wheat growth period, wheat growth was less impacted. The application of this facility in our main production areas of rice and winter wheat showed that the facility could advance the initial blossoming stages of rice and winter wheat averagely by 3 d and 5 d, respectively. In despite of the discrepancy in the warming effect among different regions and seasons, this energy-saving facility was reliable for the field research on crop responses to climate warming, when the homogeneity of increased temperature, the effective area, and the effects on crop growth period were taken into comprehensive consideration.