Usefulness of neutrophil-to-lymphocyte ratio (NLR) as a prognostic predictor after treatment of hepatocellular carcinoma." Review article.

The neutrophil-to-lymphocyte ratio (NLR) is an inflammatory marker which has been investigated as a prognostic indicator in post-therapeutic recurrence and survival of patients with HCC. Our aim was to review all studies that assessed the prognostic value of pre-treatment NLR in predicting patient survival, cancer recurrence, and graft survival in patients undergoing various therapies for HCC. We searched the database of PubMed and Google Scholar to review all studies that have the word "NLR" and the word "HCC." We included all studies that assessed pre-treatment NLR as a prognostic factor in predicting outcomes in HCC patients. We excluded studies that assessed the correlation between post-treatment NLR or dynamic changes in NLR after treatment and HCC outcomes in an effort to minimize the confounding effect of each treatment on NLR. We reviewed 123 studies that studied the correlation between pre-treatment NLR and patient survival, 72 studies that evaluated the correlation between pre-treatment NLR and tumor recurrence, 21 studies that evaluated the correlation between NLR and tumor behavior, and 4 studies that assessed the correlation between NLR and graft survival. We found a remarkable heterogeneity between the methods of the studies, which is likely responsible for the differences in outcomes. The majority of the studies suggested a correlation between higher levels of pre-treatment NLR and poor outcomes. We concluded that NLR is a reliable and inexpensive biomarker and should be incorporated into other prognostic models to help determine outcomes following HCC treatment.

Effectiveness of smoking cessation interventions among adults: an overview of systematic reviews.

BACKGROUND: This overview of reviews aims to identify evidence on the benefits (i.e. tobacco use abstinence and reduction in smoking frequency) and harms (i.e. possible adverse events/outcomes) of smoking cessation interventions among adults aged 18 years and older. METHODS: We searched Medline, Embase, PsycINFO, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, the CADTH Health Technology Assessment Database and several other websites for grey literature. Searches were conducted on November 12, 2018, updated on September 24, 2020, with publication years 2008 to 2020. Two reviewers independently performed title-abstract and full-text screening considering pre-determined inclusion criteria. Data extraction and quality assessments were initially completed by two reviewers independently (i.e. 73% of included studies (n = 22)) using A Measurement Tool to Assess Systematic Reviews-2 (AMSTAR 2), and the remainder done by one reviewer and verified by another due to resources and feasibility. The application of Grading of Recommendations Assessment, Development and Evaluation (GRADE) was performed by one independent reviewer and verified by another. RESULTS: A total of 22 Cochrane systematic reviews evaluating the impact of smoking cessation interventions on outcomes such as tobacco use abstinence, reduction in smoking frequency, quality of life and possible adverse events were included. Pharmaceutical (i.e. varenicline, cytisine, nicotine replacement therapy (NRT), bupropion) and behavioural interventions (i.e. physician advice, non-tailored print-based self-help materials, stage-based individual counselling, etc.) showed to have increased smoking cessation; whereas, data for mobile phone-based interventions including text messaging, hypnotherapy, acupuncture, continuous auricular stimulation, laser therapy, electrostimulation, acupressure, St John's wort, S-adenosyl-L-methionine (SAMe), interactive voice response systems and other combination treatments were unclear. Considering harms related to smoking cessation interventions, small/mild harms (i.e. increased palpitations, chest pain, nausea, insomnia, headache) were observed following NRT, varenicline and cytisine use. There were no data on harms related to behavioural therapies (i.e. individual or group counselling self-help materials, internet interventions), combination therapies or other therapies (i.e. laser therapy, electrostimulation, acupressure, St John's wort, SAMe). CONCLUSION: Results suggest that pharmacological and behavioural interventions may help the general smoking population quit smoking with observed small/mild harms following NRT or varenicline. Consequently, evidence regarding ideal intervention strategies and the long-term impact of these interventions for preventing smoking was unclear. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018099691.

Analysis of the efficacy of abdominal massage on functional constipation: A meta-analysis.

Background: Constipation is a digestive disorder with a high global prevalence, with approximately 20-25% of the population suffering from constipation, and the majority of constipated patients experience functional constipation (FC). Although abdominal massage is an effective intervention, there is a lack of analysis of the efficacy of abdominal massage in the treatment of functional constipation. Objective: To evaluate the clinical efficacy of abdominal massage in the treatment of functional constipation. Methods: A computerized retrieval of randomized controlled trials on abdominal massage for functional constipation was conducted on China National Knowledge Infrastructure (CNKI), Wanfang, VIP Chinese Science and Technology Periodical Database, Chinese BioMedical Literature Database, Cochrane Database, PubMed, Embase, and Web of Science until October 1, 2022. Meta-analysis was performed using RevMan 5.3 software after the initial screening and re-screening of the literature. Results: A total of 13 papers involving 830 patients were included. The results of the meta-analysis showed that abdominal massage had better efficacy in the treatment of functional constipation. Constipated patients in the treatment group showed greater improvement in the frequency of defecation, difficulty in defecation, stool properties, and PAC-QOL scores than those in the control group. The SMD/MD values and 95% CI of each score were: SMD = 1.05, 95%CI (0.63,1.46); SMD = -1.51, 95%CI (-2.35,-0.68); SMD = 0.95, 95%CI (0.31,1.59); MD = -13.24, 95%CI (-25.83, -0.65). Conclusion: Abdominal massage can increase the frequency of defecation, reduce the symptoms of difficulty in defecation, improve stool properties, and positively affect the quality of life of patients with constipation. Hence, abdominal massage therapy shows definite therapeutic efficacy for functional constipation, providing a more specific plan for clinical treatment.

Non pharmacological treatments for psychological and behavioural disorders following traumatic brain injury (TBI). A systematic literature review and expert opinion leading to recommendations.

INTRODUCTION: The non pharmacological approach is an important issue in the treatment of psychological and behavioural disorders in traumatic brain injury (TBI) patients. It remains nevertheless insufficiently known and defined. The objective of this work was to develop precise recommendations for caregivers and relatives. METHOD: The elaboration of these guidelines followed the procedure validated by the French health authority for good practice recommendations, close to the Prisma statement, involving a systematic, critical review of the literature and the expert opinions of the French Society of Physical Medicine and Rehabilitation (SOFMER) group. RESULTS: 458 articles were identified, among which 98 were selected for their relevance to the theme of the research. None of the studies reached the highest level of evidence. Fifteen controlled studies reached a relatively high level of evidence (level 2); other studies were case series or expert opinions, and other articles again were reviews of the literature and theoretical points of view. The holistic approach structured into programmes, cognitive-behavioural therapy, and family and systemic therapy, despite the low levels of proof, are recommended in first intention at all stages in the evolution of TBI. Relational and adaptive approaches, rehabilitation and vocational approaches, and psychoanalytical therapies may be useful, provided that therapists are familiar with and trained in traumatic brain injury. CONCLUSION: Despite the small number of publications and a low level of proof, a number of recommendations for the non-pharmacological approach to psychological and behavioural disorders in TBI is proposed by the consensus conference of experts. Scientific research in this domain is needed to confirm and complete these first recommendations.

Review on TCM Treat and Intervene Blood Pressure Variability / 浙江中医药大学学报

[Objective]Through the literature retrieval in recent years, knowledge of blood pressure variability prediction and evaluation of hypertension and its complications, and prognostic judgment, review various methods on blood pressure variability changes of traditional Chinese medicine clinical research. [Method]Acupuncture for its target, overal adjustment, green therapy, which has certain advantages in the treatment of abnormal blood pressure variation, in recent years, clinical research has made a lot of useful discussion in this paper on review.[Result]Based on these clinical observations, it indicates the ef-fect of acupuncture on hypertension is significant. [Conclusion]Acupuncture in the treatment of abnormal blood pressure variation has certain advantages, should design the rigorous large sample, multicenter, randomized, blinded, end point of cardiovascular events as indicators of clinical research and the relat-ed experimental research, provide more convincing acupuncture intervention reverse abnormal blood pressure circadian rhythm of scientific basis.