ABSTRACT
Background: Colorectal signet ring cell carcinoma (SRCC) is a rare and distinct subtype of colorectal cancer (CRC), with extremely poor prognosis and aggressive tumor biological behavior. In this study, we aimed to analyze the clinicopathological characteristics and to identify the independent predictors of long-time survivors (LTSs) of nonmetastatic colorectal SRCC. Methods: Patients diagnosed with nonmetastatic colorectal SRCC were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. We compared and analyzed the clinicopathological characteristics between LTSs (patients survived over 5 years) and non-LTSs (patients survived of or less than 5 years). Afterwards, multivariate logistic regression analysis was used to identify independent predictors of LTSs, which were further used to construct a nomogram model to predict the probability of being LTSs. Results: We enrolled 2050 patients with nonmetastatic colorectal SRCC, consisting of 1441 non-LTSs and 609 LTSs. Multivariate logistic regression analysis revealed that race, marital status, tumor infiltration, lymph node involvement, and primary tumor treatment were independent predictors of LTSs. In addition, these five parameters were incorporated into a nomogram model to predict the probability of being LTSs. In terms of the model performance, the calibration curve revealed good agreement between observed and predicted probability of LTSs, and receiving operator characteristic curve showed acceptable discriminative capacity in the training and validation cohorts. Conclusion: Collectively, we analyzed and profiled the clinicopathological characteristics of LTSs in patients with nonmetastatic colorectal SRCC. Race, marital status, T stage, N stage, and primary tumor treatment were independent predictors of LTSs.
ABSTRACT
Background: Lipid metabolism disorders can damage human health, and the changes in human intestinal flora are closely related to lipid metabolism disorders. Traditional Chinese medicine (TCM) can play a role in regulating intestinal flora and balancing intestinal microecology. In this meta-analysis, the role of oral preparations of TCM that regulate intestinal flora, in the prevention and treatment of lipid metabolism disorders, was systematically evaluated. Methods: The databases CBM, Pubmed, Embase, CNKI, Wanfang, and Google Scholar were searched by rapid matching of keywords to obtain clinical controlled studies related to oral preparations of TCMs regulating intestinal flora. After screening and quality evaluation, meta-analysis was performed using Review Manager 5.3 software. Results: Total of 835 patients were enrolled in the 10 articles included in this study. Meta-analysis showed that TCM intervention could reduce the level of total cholesterol (TC) in patients with abnormal lipid metabolism [mean difference (MD) = -0.61, 95% confidence interval (95%CI) (-0.80, -0.42), p < 0.00001], reduce triacylglycerol (TG) level [MD = -0.46, 95%CI (-0.60, -0.33), p < 0.00001], increase high-density lipoprotein (HDL) level [MD = 0.25, 95%CI (0.17, 0.34), p < 0.00001], reduce the number of intestinal enterobacteria [MD = -0.64, 95%CI (-0.79, -0.49), p < 0.00001], reduce the number of enterococci [MD = -1.14, 95%CI (-1.66, -0.63), p < 0.00001], increase the number of intestinal lactobacillus [MD = 0.41, 95%CI (0.09, 0.74), p = 0.01], and increase the number of intestinal bifidobacteria [MD = 0.94, 95%CI (0.20, 1.68), p = 0.01]. Conclusion: The application of oral preparations of TCMs that regulate intestinal flora, in the prevention and treatment of lipid metabolism disorders, can increase the colonization of beneficial bacteria in the intestine of patients, inhibit the growth of harmful bacteria, and restore the intestinal microecological balance, thus indirectly acting on the regulation of blood lipids in patients and contributing to the recovery of dyslipidemia.
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BACKGROUND: Chemotherapy has become the main means to prolong the life of patients with advanced digestive tract cancer; however, it is associated with serious toxicity and side effects. Compound Kushen Injection (CKI) is a pure Chinese herbal preparation, which can assist chemotherapy, inhibit tumor cell proliferation, and reduce adverse reactions of chemotherapy. In this study, we systematically evaluated reports of CKI as an adjuvant to chemotherapeutic treatment of digestive tract cancer in recent years and provided evidence for clinical diagnosis and treatment. METHODS: The databases of PubMed, Chinese Biomedical Literature (CBM), China National Knowledge Infrastructure (CNKI) and Web Of Science were searched for clinical randomized controlled trials (RCTs) related to adjuvant chemotherapy with CKI in the treatment of advanced gastrointestinal tumors published from January 2000 to September 2021. After screening the qualified literatures, RevMan 5.4 software was used to evaluate the bias of the included literatures and perform meta-analysis. RESULTS: A total of 12 articles were included in the selection, incorporating 1080 study participants in all; meta-analysis results showed that application of the CKI in the process of chemotherapy for digestive tract tumors could improve the efficacy [odds ratio (OR) =3.11; 95% confidence interval (CI): 2.26 to 4.47, Z=7.00, P<0.00001], increase the patients' median survival time (months) (OR =3.00; 95% CI: 1.47 to 4.52, Z=3.84, P=0.0001), increase the level of CD3+ [mean difference (MD) =4.11; 95% CI: 3.24 to 4.98], CD4+ level (MD =8.24; 95% CI: 3.72 to 12.76), reduce the CD8+ level (MD =-5.42; 95% CI: -8.09 to -2.76), reduce the tumor markers carcinoembryonic antigen (CEA; MD =-14.26; 95% CI: -14.81 to -13.71), CA199 (MD =-138.87; 95% CI: -143.21 to -132.52), and reduce the adverse reactions of chemotherapy: leukopenia (OR =0.28; 95% CI: 0.19 to 0.43), thrombocytopenia (OR =0.38; 95% CI: 0.24 to 061), decreased hemoglobin (OR =0.55; 95% CI: 0.31 to 0.98), and nausea and vomiting symptoms (OR =0.35; 95% CI: 0.24 to 0.53). DISCUSSION: Adjuvant chemotherapy with CKI in the treatment of digestive tract tumors can effectively improve the symptoms of patients, improve immunity, reduce the level of serum tumor markers, improve efficacy, and reduce toxic and side effects.
ABSTRACT
Objective: The objective of the study was to explore the intestinal flora in patients with dual antiplatelet therapy.Method: We collected fresh stool specimens from 10 patients receiving dual antiplatelet therapy and 10 healthy people as control group. Then, we extracted faecal DNA, amplified 16 s rNDA V3-V4 area, and applied Illumina Miseq to analyse the structure of intestinal flora.Result: At class level, DAPT group show higher abundance of class Bacilli and lower abundance of class Erysipelotrichia. At order level, the abundance of order Lactobacillales in DAPT group is higher (p < .05), while the abundance of order Erysipelotrichales is lower in DAPT group (p < .05). At family level, the abundance of family Streptococcaceae and family Lactobacillaceae in DAPT group is higher (p < .05), while the abundance of family Acidaminococcaceae and family Erysipelotrichaceae is lower in DAPT group (p < .05). At genus level, the abundance of genus Streptococcus and genus Klebsiella in DAPT group is higher (p < .05), while the abundance of genus Blautia, genus Phascolarctobacterium and genus Megamonas is lower in DAPT group (p < .05).Conclusion: Taking aspirin and clopidogrel will not cause a change in the biodiversity of intestinal flora. There are significant differences in the intestinal flora of DAPT group compared with the control group at class, order, family and genus level.
