Efficacy of Faecal Microbiota Transplantation for the Treatment of Autism in Children: Meta-Analysis of Randomised Controlled Trials.

Objective: Evidence-based research methods were applied to assess the efficacy of faecal microbiota transplantation (FMT) for the treatment of autism in children. Methods: We searched the Chinese Biomedical Literature, CNKI, Wanfang, PubMed, Embase, Web of Science, and the Cochrane Library databases to collect randomised controlled trials on faecal microbiota transplantation for the treatment of autism in children. The search included studies published from the creation of the respective database to 5 April 2022. Literature screening, data extraction, and quality evaluation were implemented by three investigators according to the inclusion and exclusion criteria. The meta-analysis was performed using the RevMan 5.1 software. Results: Nine studies with population-based subjects and four studies with animal-based subjects were included. Five papers were screened for the meta-analysis. The results showed that FMT markedly reduced Autism Behaviour Checklist (ABC) scores in children with autism spectrum disorder (weighted mean difference (WMD) = -14.96; 95% confidence intervals (CI), -21.68 to -8.24; P < 0.001; I 2 = 0%). FMT also reduced Childhood Autism Rating Scale (CARS) scores (WMD = -6.95; 95% CI, -8.76 to -5.14; P < 0.001; I 2 = 28.1%). Conclusion: Our results indicate that FMT can benefit children with autism by reducing ABC and CARS scores, but more high-quality studies are needed to verify these results.

Perforating and nonperforating indications in repeated surgeries for Crohn's disease.

BACKGROUND: Despite advances in medical therapy for Crohn's disease (CD), most patients with CD require repeated resection surgeries. AIM: To analyze the perforating and nonperforating indications of repeated CD operations and identify the anastomosis characteristics for postoperative CD. METHODS: We retrospectively reviewed 386 patients who underwent at least one resection for CD between 2003 and 2013.Clinical characteristics of each surgery were collected. Univariate and multivariate analyses were performed to determine risk factors for recurrence. RESULTS: The indication for reoperation in CD tends to be the same as that for primary operation, i.e., perforating disease tends to represent as perforating disease and nonperforating as nonperforating. Concordance was found between the first surgery and second surgery in terms of the indication for the operation (P = 0.006), and the indication for the third surgery was also correlated with that for the second surgery (P = 0.033). Even if the correlation of surgical indications between repeated operations, the rate of perforating indication for the second and third surgeries was significantly higher than that of the first surgery. In addition, the presence of perforating CD was a predictor of recurrence for both the first and second surgeries. Moreover, anastomotic lesions were the most common sites of recurrence after the operation. Based on the importance of anastomosis, anastomosis might be a new type of disease location for the classification of postoperative CD. CONCLUSION: CD not only has stable characteristics but also progresses chronically. Perforation is a progressive surgical indication for Crohn's disease. For CD after surgery, anastomosis may be a new classification of disease location.

Disturbance of Fatty Acid Desaturation Mediated by FADS2 in Mesenteric Adipocytes Contributes to Chronic Inflammation of Crohn's Disease.

BACKGROUND AND AIMS: The aim of this study was to investigate the metabolic profile of mesenteric adipocytes and the correlations between key metabolic changes and local inflammation in the context of Crohn's disease [CD]. METHODS: Metabolic dysfunction was shown to be regulated by fatty acid desaturase-2 [FADS2], through metabolomics and functional analyses of mesenteric adipose tissue biopsies and primary mesenteric adipocytes isolated from surgical specimens collected from CD patients and control subjects. FADS2 was overexpressed in vitro and in vivo using a lentiviral vector and an adeno-associated virus [AAV], respectively. The interaction between mesenteric adipocytes and inflammation responses was evaluated by establishing a cell coculture system and a FADS2-AAV treated animal model; 3T3-L1 cells were used to elucidate the mechanism underlying FADS2 deregulation. RESULTS: We observed significant changes in the levels of metabolites involved in the multi-step synthesis of long-chain polyunsaturated fatty acids [PUFAs]. Gas chromatography analysis revealed impaired desaturation fluxes towards the n-6 and n-3 pathways, which are associated with reduced FADS2 activity in human mesentery tissue. Decreased FADS2 expression at both mRNA and protein levels was confirmed in surgical specimens. The restoration of FADS2 expression, which allows for the endogenous conversion of n-3 fatty acids into proresolving lipid mediators, resulted in a significant reduction in pro-inflammatory macrophage infiltration and attenuated expression of inflammatory cytokines or adipokines. CONCLUSIONS: These findings indicate that impaired fatty acid desaturation and lipid mediator imbalance within mesenteric adipose tissue contributes to chronic inflammation in CD. The therapeutic role of FADS2 may lead to improved CD treatment.

A nomogram for predicting the response to exclusive enteral nutrition in adult patients with isolated colonic Crohn's disease.

BACKGROUND: Isolated colonic Crohn's disease (cCD) responds less well to induction therapy with exclusive enteral nutrition (EEN) compared with ileal or ileocolonic disease in adult patients; therefore, we aimed to identify the factors that influence the response to EEN and develop a predictive nomogram model to optimize the use of EEN in cCD patients. MATERIALS AND METHODS: Eighty-five cCD patients treated with EEN as first-line therapy at our center between 1 June 2012 and 30 June 2018 were retrospectively analyzed as the primary cohort. The primary endpoint was clinical remission after EEN therapy. Potential predictive factors for the efficacy of EEN were assessed by univariate and multivariate analyses, and a nomogram to predict the response to EEN therapy in cCD patients was designed. Another 19 cCD patients were retrospectively included in the validation cohort to verify the accuracy of the nomogram model. RESULTS: The clinical remission rates for the primary cohort and validation cohort were 52.9% and 47.4%, respectively. Pancolitis was the greatest contributor to the risk of failure to respond to EEN [odds ratio (OR) = 4.896; 95% confidence interval (CI) = 1.223-19.607; p = 0.025], lean body mass index (LBMI), colonic lesion features, simple endoscopic scores for Crohn's disease, C-reactive protein before treatment and ∆prealbumin were also related to the efficacy of EEN in cCD. The nomogram model showed robust discrimination, with an area under the receiving operating characteristic curve of 0.906. CONCLUSION: Several predictive factors for response to EEN therapy in cCD adult patients were identified, and a promising nomogram that can predict the effect of EEN in cCD was developed.

Endothelin-A receptor in gastric cancer and enhanced antitumor activity of trastuzumab in combination with the endothelin-A receptor antagonist ZD4054.

Endothelin-A receptor (ETAR) is overexpressed in cancers and can function through transactivation of the epidermal growth factor receptor. We explored ETAR in gastric cancer and investigated the antitumor effect of trastuzumab in combination with the ETAR antagonist ZD4054. The expression of ETAR was significantly correlated with the expression of vascular endothelial growth factor. Univariate and multivariate analyses further showed that ETAR expression correlated with reduced survival in gastric cancer patients. In vitro, ZD4054 increased the antiproliferative effect of trastuzumab in gastric cancer cell lines. Moreover, the addition of ZD4054 to trastuzumab significantly increased apoptosis in gastric cancer cell lines. In vivo, tumor growth was considerably inhibited by treatment with ZD4054 and trastuzumab, and the tumor volume in the trastuzumab and ZD4054 combination group was smaller than in the other groups. The detection of ETAR could help predict the prognosis of gastric cancer patients. Additionally, this study provides support for the therapeutic use of the combination of ZD4054 and trastuzumab as an anticancer treatment, especially for gastric cancer.

[Corrigendum] Increased expression of Lgr5 is associated with chemotherapy resistance in human gastric cancer.

An interested reader drew to the attention of the Journal that the western blot featured in Fig. 3B of the above paper also appeared as Fig. 3D in the following publication, featuring many of the same authors: Xi HQ, Cai AZ, Wu XS et al: Leucine­rich repeat­containing G­protein­coupled receptor 5 is associated with invasion, metastasis, and could be a potential therapeutic target in human gastric cancer. Br J Cancer 110: 2011­2020, 2014. After having consulted the authors about this matter, they conceded that there was a data sharing violation here, and that the image should not have been reproduced in the above article without having received the prior permission of the British Journal of Cancer. This permission has now been sought after and obtained, and Fig. 3 is reproduced opposite, now including the appropriate credit for the original source of Fig. 3B. The authors apologize to the Editors of the British Journal of Cancer and Oncology Reports, and to the readership for any inconvenience caused. [the original article was published in Oncology Reports 32: 181­188, 2014; DOI: 10.3892/or.2014.3204].

Isolated colonic Crohn's disease is associated with a reduced response to exclusive enteral nutrition compared to ileal or ileocolonic disease.

BACKGROUND & AIMS: Exclusive enteral nutrition (EEN) as a primary therapy is safe and effective for inducing the clinical remission of active luminal Crohn's disease (CD). Whether isolated colonic involvement affects the efficacy of EEN is controversial. We aimed to identify the influence of isolated colonic CD on the efficacy of EEN and to determine other potential predictors of the response to induction therapy with EEN in adult patients with CD. METHODS: Data for adult CD patients treated with EEN as an induction therapy at our centre from January 1, 2014, to May 31, 2017, were reviewed. Eligible patients were divided into an isolated colonic Crohn's disease (cCD) group and a non-isolated colonic Crohn's disease (non-cCD) group according to the disease location. The rates of clinical remission and inflammatory and nutritional serum markers were compared between the groups. Possible relationships between isolated colonic involvement or other potential factors and the efficacy of EEN were assessed by univariate and multivariate analyses. The propensity score matching method was used to confirm the results. RESULTS: Overall, 241 patients were included in the analysis: 52 patients in the cCD group and 189 patients in the non-cCD group. The rates of clinical remission differed between the two groups (cCD group: 51.9% versus non-cCD group: 68.3%, P = 0.029). Multivariate analyses indicated that isolated colonic involvement was associated with a reduced response to EEN (OR = 2.74; [CI] 95% = [1.2-6.23], P = 0.016). Additionally, the lean body mass index (LBMI) before treatment was associated with the efficacy of EEN (OR = 0.636; [CI] 95% = [0.444-0.912], P = 0.014). These associations were confirmed using the propensity score model. For patients with isolated colonic CD, multivariate analysis showed that pancolitis (OR = 16.7; [CI] 95% = [1.074-260.5], P = 0.044) was another independent factor for the efficacy of EEN. Further analysis showed that even in patients who achieved clinical remission after EEN, inflammatory serum markers declined more slowly in the cCD group than in the non-cCD group, and the time to remission was longer in the cCD group. CONCLUSIONS: Isolated colonic CD showed a reduced response to induction therapy with EEN compared with ileal or ileocolonic disease in adult patients. Patients with isolated colonic CD required more time to benefit from EEN therapy compared with patients with non-colonic CD. Additionally, LBMI before treatment was associated with the efficacy of EEN.

Mesenteric Adipose Tissue Alterations in Crohn's Disease Are Associated With the Lymphatic System.

Background: Mesenteric fat wrapping and thickening are typical characteristics of Crohn's disease (CD). The purpose of this study was to explore the cause of mesenteric adipose hypertrophy and analyze the role of lymphatic vessels in mesenteric adipose tissue in CD. Methods: Twenty-three CD patients who underwent ileocolonic resection were included. In CD patients, specimens were obtained from hypertrophic mesenteric adipose tissue (htMAT) next to the diseased ileum. The mesenteric lymphatic vessels in mesenteric adipose tissue were separated under stereoscope microscope. Transmission electron microscopy and immunofluorescence were used to observe the structure of mesenteric lymphatic vessels. The NF-κB signaling pathway in mesenteric adipose tissue was detected in CD specimens using Western blotting. Results: Electron microscopy showed that the structure of mesenteric lymphatic vessel was discontinuous, and the microstructure of lymphatic endothelial cells appeared ruptured and incomplete. Through an immunofluorescence technique, we found that the surface of lymphatic endothelial cells lacked tight junction protein staining in CD. Also, the expression of claudin-1, occludin, and ZO-1 in the mesenteric lymphatic vessel of htMAT was significantly lower than that of control. These results indicated that the structure of the mesenteric lymphatic vessel in htMAT was mispatterned and ruptured, which could lead to lymph leakage. Leaky lymph factors could stimulate adipose tissue to proliferate. Antigens that leaked into the mesenteric adipose tissue could effectively elicit an immune response. The levels of cytokines (TNF-a, IL-1ß, IL-6) was increased in the htMAT of CD patients by activated NF-κB signaling pathway. Conclusions: Our findings demonstrated that the hypertrophy of mesenteric adipose tissue may result from mispatterned and ruptured lymphatic vessels. Alteration of mesenteric adipose tissue was associated with activated NF-κB signaling pathway. This study enhances support for elucidating the importance of mesenteric lymphatic vessels and adipose tissue in CD.

Comparison of robotic- and laparoscopic-assisted gastrectomy in advanced gastric cancer: updated short- and long-term results.

BACKGROUND: Emerging evidence has demonstrated that either laparoscopic-assisted gastrectomy (LAG) or robotic-assisted gastrectomy (RAG) could be adopted as standard treatment for early gastric cancer. However, the long-term survival and recurrence rate after LAG or RAG for locally advanced gastric cancer (AGC) has seldom been reported. METHODS: We retrospectively analyzed the data from 339 patients who underwent LAG and 163 patients who underwent RAG from a prospectively established database in the Chinese People's Liberation Army General Hospital. We compared the short- and long-term oncological outcomes of the RAG group versus the LAG group in the entire cohort, and in a propensity score-matched cohort. RESULTS: Before propensity score matching (PSM), the two groups revealed comparable 3-year overall survival rates (OS, RAG vs. LAG: 76.1 vs. 81.7%, p = 0.118), and recurrence-free survival rates (RFS, RAG vs. LAG: 73.0 vs. 67.6%, p = 0.297). Similar results were obtained in the propensity score-matched cohort; the respective overall survival rates in the propensity score-matched RAG and LAG groups were 76.1 and 79.8% (p = 0.552), and the respective RFS rates were 73.0 and 68.7% (p = 0.386). After PSM, RAG was still associated with a significantly longer mean operating time (249.46 ± 63.26 vs. 232.17 ± 65.39 min, p = 0.008) and higher total costs (133.38 ± 41.62 vs. 95.34 ± 29.39 103 RMB, p < 0.001) than LAG; the two groups did not significantly differ in other surgical and oncological characteristics. CONCLUSION: Although there were some differences in the outcomes of RAG versus LAG in AGC patients, both RAG and LAG were similar in short-term recovery and long-term oncological outcomes.

Thickness of Subcutaneous Fat Is a Predictive Factor of Incisional Surgical Site Infection in Crohn's Disease Surgery: A Retrospective Study.

BACKGROUND: Incisional surgical site infection (iSSI) is a frequent postoperative complication of abdominal surgeries in patients with Crohn's disease (CD). In this study, we investigated the association between thickness of subcutaneous fat (TSF) and iSSI in patients with CD undergoing intestinal resections. PATIENTS AND METHODS: Patients with CD who had undergone abdominal surgery from January 2014 to January 2017 were included in this retrospective study. Patients' TSF and other possible predictors of iSSI, including clinical characteristics, preoperative medications, hematological index, surgery-related data, and postoperative outcomes, were collected. Univariate and multivariate statistical analyses were used to examine the potential factors. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of factors. RESULTS: The patient cohort comprised 246 patients (167 male (67.9%); mean age 35.7 ± 12.4 years; mean disease duration 69.6 ± 60.8 months). The incidence of iSSI was 24.8% (61/246). TSF was a significant predictor of iSSI (OR 1.079, 95% CIs (1.020, 1.142), P = 0.008), being 13.7 mm in patients with iSSI and 9.9 mm in those without iSSI (P < 0.001). Additionally, C-reactive protein (CRP) concentrations (OR 1.059, P = 0.003) were also possible predictors of iSSI, as indicated by both univariate and multivariate analysis. A model of iSSI comprising TSF and CRP concentrations was moderately accurate (AUC 0.827, CIs (0.766, 0.888)). CONCLUSIONS: Preoperative TSF and CRP independently affect iSSI in patients with CD undergoing intestinal resections.

Decreased Expression of Prox1 Is Associated With Postoperative Recurrence in Crohn's Disease.

BACKGROUND: Prox1 is a transcription factor necessary for lymphangiogenesis and lymphatic function. The aim of the study was to assess the correlation between the expression of Prox1 and postoperative recurrence in Crohn's disease [CD]. METHODS: Forty CD patients who underwent ileo-colonic resection were included. Expression levels of Prox1 and D2-40 were detected using immunohistochemistry. Expression levels of Prox1, VEGFR3, and VEGFC protein were also detected in fresh CD specimens using western blotting and quantitative polymerase chain reaction [Q-PCR]. Endoscopic recurrence was used as the endpoint. Patients comprised two groups: endoscopic recurrence [Group R+] and no endoscopic recurrence [Group R-]. RESULTS: Prox1 protein expression was significantly higher in CD than in normal tissues [p <0.05], as detected using both immunohistochemistry and western blotting. Analysis of inter-relationships revealed significant correlation between Prox1 expression and lymphatic vessel density [p <0.001, r = 0.823]. There was also significant correlation between Prox1 expression and the visceral fat area [VFA] [p = 0.002, r = -0.469]. The Group R- patients had significantly higher Prox1 expression than the Group R+ patients [21.08 ± 1.61 versus 15.64 ± 1.17, p = 0.011]. Also, the lymphatic vessel density value was lower in Group R+ than in Group R- patients [6.02 ± 0.39 versus 8.13 ± 0.59, p = 0.004]. Moreover, there was a significant difference in the VFA between Group R- and Group R+ patients [64.43 ± 7.76 versus 90.44 ± 6.11, p = 0.016]. In addition to Prox1, VEGFC/VEGFR3 was found to increase, which was further confirmed using Q-PCR. CONCLUSIONS: Prox1 expression could be useful as a protective factor against recurrence in CD patients. The therapeutic role of Prox1 may lead to improved treatments.

Visceral Fat Is Associated With Mucosal Healing of Infliximab Treatment in Crohn's Disease.

BACKGROUND: Visceral fat is the pathogenesis of Crohn's disease and is associated with disease status. OBJECTIVE: This study aimed to evaluate the effect of the visceral fat on mucosal healing in patients with Crohn's disease after infliximab induction therapy DESIGN:: This was a retrospective study. SETTINGS: The study was conducted in a tertiary referral hospital. PATIENTS: Between 2011 and 2017, 97 patients with Crohn's disease with the presence of ulcers underwent infliximab therapy. MAIN OUTCOME MEASURES: We studied them retrospectively. Mucosal healing was the end point. Patients composed 2 groups: mucosal healing and no mucosal healing. Univariate, multivariate, and receiver operating characteristic curve analyses determined the predictive value of the visceral fat area. RESULTS: Univariate analysis showed a statistically significant difference in the smoking history between the groups. Mucosal healing rates after infliximab were lower among active smokers (p = 0.022). Healed patients had significantly less visceral fat area before therapy (47.76 ± 4.94 vs 75.88 ± 5.55; p = 0.000) and a lower mesenteric fat index (0.52 ± 0.04 vs 0.89 ± 0.07; p = 0.000). There was no significant difference in the subcutaneous fat area (87.39 ± 5.01 vs 93.31 ± 6.95; p = 0.500). Multivariate analysis showed that only visceral fat area (OR = 0.978 (95% CI, 0.964-0.992); p = 0.002) and smoking history (OR = 0.305 (95% CI, 0.089-0.996); p = 0.041) were independent factors for mucosal healing. Receiver operating characteristic curve analysis showed predictive cutoff values of 61.5 cm and 0.62 for visceral fat area and mesenteric fat index. LIMITATIONS: This was a retrospective study. CONCLUSIONS: There was an association between increased visceral fat area and attenuated mucosal healing after infliximab therapy in biologically naive patients with Crohn's disease, indicating a need for earlier increased infliximab doses among patients with increased visceral fat. See Video Abstract at http://links.lww.com/DCR/A590.

Prognostic role of extracellular matrix metalloproteinase inducer/CD147 in gastrointestinal cancer: a meta-analysis of related studies.

The prognostic role of Extracellular matrix metalloproteinase inducer (EMMPRIN/ CD147) in gastrointestinal cancer remains controversial. We systematically reviewed the evidence of assessment of CD147 expression in gastrointestinal cancer to help clarify this issue. Pubmed, Embase, Cochrane Library and Web of Science databases were searched to identify eligible studies to evaluate the association of CD147 expression and disease-free and overall survival of gastrointestinal cancer. Hazard ratios (HRs) were pooled to estimate the effect. CD147 overexpression was significantly correlated with poor disease-free survival (HR 2.38, 95% CI 1.43-3.97) and overall survival (HR 1.64, 95% CI 1.25-2.14) of cancer patients. Furthermore, CD147 overexpression was significantly association with TNM stage (TIII/TIV vs TI/TII: OR 3.60, 95% CI 1.85-7.01), the depth of invasion (T3/T4 vs T1/T2: OR 2.04, 95% CI 1.25-3.33), lymph node metastasis (positive vs negative: 2.35, 95% CI 1.14-4.86), distant metastasis (positive vs negative: OR 4.78, 95% CI 1.43-16.00). Our analyses demonstrate that CD147 was effectively predictive of worse prognosis in gastrointestinal cancer. Moreover, Identifying CD147 may help identify new drug targets for cancer therapy.

Palliative Therapy for Gastric Outlet Obstruction Caused by Unresectable Gastric Cancer: A Meta-analysis Comparison of Gastrojejunostomy with Endoscopic Stenting.

BACKGROUND: Gastrojejunostomy (GJJ) and endoscopic stenting (ES) are palliative treatments for gastric outlet obstruction (GOO) caused by gastric cancer. We compared the outcomes of GJJ with ES by performing a meta-analysis. METHODS: Clinical trials that compared GJJ with ES for the treatment of GOO in gastric cancer were included in the meta-analysis. Procedure time, time to resumption of oral intake, duration of hospital stay, patency duration, and overall survival days were compared using weighted mean differences (WMDs). Technical success, clinical success, procedure-related mortality, complications, the rate of re-obstruction, postoperative chemotherapy, and reintervention were compared using odds ratios (OR s). RESULTS: Nine studies were included in the analysis. Technical success and clinical success were not significantly different between the ES and GJJ groups. The ES group had a shorter procedure time (WMD = -80.89 min, 95% confidence interval [CI] = -93.99 to -67.78,P < 0.001), faster resumption of oral intake (WMD = -3.45 days, 95% CI = -5.25 to -1.65,P < 0.001), and shorter duration of hospital stay (WMD = -7.67 days, 95% CI = -11.02 to -4.33,P < 0.001). The rate of minor complications was significantly higher in the GJJ group (OR = 0.13, 95% CI = 0.04-0.40,P < 0.001). However, the rates of major complications (OR = 6.91, 95% CI = 3.90-12.25,P < 0.001), re-obstruction (OR= 7.75, 95% CI = 4.06-14.78,P < 0.001), and reintervention (OR= 6.27, 95% CI = 3.36-11.68,P < 0.001) were significantly lower in the GJJ group than that in the ES group. Moreover, GJJ was significantly associated with a longer patency duration (WMD = -167.16 days, 95% CI = -254.01 to -89.31,P < 0.001) and overall survival (WMD = -103.20 days, 95% CI = -161.49 to -44.91, P= 0.001). CONCLUSIONS: Both GJJ and ES are effective procedures for the treatment of GOO caused by gastric cancer. ES is associated with better short-term outcomes. GJJ is preferable to ES in terms of its lower rate of stent-related complications, re-obstruction, and reintervention. GJJ should be considered a treatment option for patients with a long life expectancy and good performance status.

Association of thymidylate synthase expression and clinical outcomes of gastric cancer patients treated with fluoropyrimidine-based chemotherapy: a meta-analysis.

PURPOSE: Although several studies have suggested an association between thymidylate synthase (TS) expression and outcomes of gastric cancer (GC) patients treated with fluoropyrimidine-based chemotherapy (FUC), the predictive value of TS for response and survival in this setting is unclear. This meta-analysis aimed to estimate prognostic and predictive significance of TS more precisely. METHODS: We searched PubMed, Embase, Cochrane Library, and Web of Science databases for literature published up to June 2015. Primary outcomes included hazard ratios (HRs) for overall survival (OS), and event-free survival (EFS) and odds ratio (OR) for chemotherapy response. Fixed- or random-effects models were used to calculate pooled HR and OR according to heterogeneity. RESULTS: A total of 2,442 GC patients in 25 studies met our inclusion criteria. Response rates for FUC were significantly lower in patients with high TS expression than in those with low expression (OR: 0.43, 95% confidence interval [CI]: 0.22-0.84, P=0.013). High TS expression was significantly correlated with unfavorable OS (HR: 1.62, 95% CI: 1.28-2.05, P<0.001) and EFS (HR: 1.54, 95% CI: 1.22-1.93, P<0.001) in advanced disease. However, TS expression was not significantly related to OS (HR: 1.06, 95% CI: 0.74-1.50, P=0.760) or EFS (HR: 1.16, 95% CI: 0.84-1.61, P=0.374) in the adjuvant setting. CONCLUSION: Higher TS expression might predict drug resistance and adverse prognosis in patients with advanced GC treated with FUC.

[Robotic versus laparoscopic gastrectomy for gastric cancer: a meta-analysis].

OBJECTIVE: To compare the clinical efficacy with meta-analysis between robot-assisted gastrectomy(RAG) and laparoscopy-assisted gastrectomy (LAG) for gastric cancer. METHODS: A literature search was performed in PubMed, Embase, Cochrane Library, Web of Science, Wanfang Data, CNKI(Chinese National Knowledge Infrastructure), and CBM(China Biological Medicine) databases for clinical researches published before July 2015 that compared RAG with LAG. Operative time, estimated blood loss, harvested lymph nodes, proximal margin, distal margin, hospital stay, conversion and complications were compared using weighted mean differences(WMD) and odds ratios (OR). RESULTS: Sixteen studies were included in the analysis, comprising 5 764 patients(1 593 RAGs, 4 171 LAGs). RAG was associated with longer operative time (WMD=49.68, 95% CI: 35.54 to 63.82, P=0.000), less estimated blood loss (WMD=-26.10, 95% CI: -42.90 to -9.31, P=0.002), and shorter hospital stay(WMD=-0.72, 95% CI: -1.35 to -0.09, P=0.024). Conversion, mortality, complications, proximal margin, distal margin and harvested lymph nodes of RAG were similar to LAG. In meta-analysis results of distal gastrectomy and early-stage gastric cancer, RAG had more harvested lymph nodes (distal gastrectomy: WMD=2.23, 95% CI: 0.33 to 4.13, P=0.021; early-stage gastric cancer: WMD=2.58, 95% CI: 1.05 to 4.12, P=0.001). CONCLUSIONS: RAG can be performed safely with less estimated blood loss and more harvested lymph nodes as compared to LAG. Radical resection can be achieved by RAG.

Ion exchange induced removal of Pb(ii) by MOF-derived magnetic inorganic sorbents.

Nanoporous adsorbents of ZnO/ZnFe2O4/C were synthesized by using a metal organic framework (Fe(III)-modified MOF-5) as both the precursor and the self-sacrificing template. The adsorption properties of ZnO/ZnFe2O4/C toward Pb(ii) ions were investigated, including the pH effect, adsorption equilibrium and adsorption kinetics. The adsorption isotherms and kinetics were well described by using the Langmuir isotherm model and pseudo-second-order model, respectively. The MOF-derived inorganic adsorbents exhibited high absorption performance with a maximum adsorption capacity of 344.83 mg g(-1). X-ray powder diffraction and high-resolution X-ray photoelectron spectroscopy suggest that Zn(ii) was substituted by a significant portion of Pb(ii) on the surface of ZnO nanocrystals. Microscopic observations also demonstrate the effect of Pb(ii) ions on ZnO crystals as reflected by the considerably reduced average particle size and defective outer layer. Quantitative measurement of the released Zn(ii) ions and the adsorbed Pb(ii) ions indicated a nearly linear relationship (R(2) = 0.977). Moreover, Pb-containing ZnO/ZnFe2O4/C adsorbents are strongly magnetic allowing their separation from the water environment by an external magnet.

Robotic versus laparoscopic gastrectomy for gastric cancer: comparison of short-term surgical outcomes.

BACKGROUND: Robot-assisted gastrectomy (RAG) is a new minimally invasive surgical technique for gastric cancer. This study was designed to compare RAG with laparoscopy-assisted gastrectomy (LAG) in short-term surgical outcomes. METHODS: Between October 2011 and August 2014, 423 patients underwent robotic or laparoscopic gastrectomy for gastric cancer: 93 RAG and 330 LAG. We performed a comparative analysis between RAG group and LAG group for clinicopathological characteristics and short-term surgical outcomes. RESULTS: RAG was associated with a longer operative time (P < 0.001), lower blood loss (P = 0.001), and more harvested lymph nodes (P = 0.047). Only three patients in LAG group had positive margins, and R0 resection rate for RAG and LAG was similar (P = 0.823). The RAG group had postoperative complications of 9.8 %, comparable with those of the LAG group (P = 0.927). Proximal margin, distal margin, hospital stay, days of first flatus, and days of eating liquid diet for RAG and LAG were similar. In the subgroup of serosa-negative patients, RAG had a longer operation time (P = 0.003), less intraoperative blood loss (P = 0.005), and more harvested lymph nodes (P = 0.04). However, in the subgroup of serosa-positive patients, RAG had a longer operation time (P = 0.001), but no less intraoperative blood loss (P = 0.139) and no more harvested lymph nodes (P = 0.139). Similarly, in the subgroup of total gastrectomy patients, RAG had a longer operation time (P = 0.018), but no less intraoperative blood loss (P = 0.173). CONCLUSIONS: The comparative study demonstrates that RAG is as acceptable as LAG in terms of surgical and oncologic outcomes. With lower estimated blood loss, acceptable complications, and radical resection, RAG is a promising approach for the treatment of gastric cancer. However, the indication of patients for RAG is critical.

Controlled Synthesis of Recyclable, Porous FMO/C@TiO2 Core-Shell Nanofibers with High Adsorption and Photocatalysis Properties for the Efficient Treatment of Dye Wastewater.

One-dimensional magnetite/manganese iron oxide modified by carbon coating and with TiO2 nanoparticles into core-shell composite nanofibers (FMO/C@TiO2 ) with porous structure were fabricated using organometallic compounds as templates. The structure and physicochemical properties of the as-obtained composite nanofibers were characterized by a series of techniques, including X-ray diffraction, scanning electron microscopy, transmission electron microscopy, nitrogen adsorption-desorption isotherms, X-ray photoelectron spectroscopy and UV/Vis diffuse reflectance. The results demonstrate that the one-dimensional core-shell structure was formed by coating TiO2 nanoparticles onto a substrate of FMO/C nanofibers. The porous nanostructures and photoresponse range of the composite nanofibers can be controlled by varying the proportion of both template and titanium source. The resultant composite nanofibers exhibited highly efficient removal of dye from wastewater by combining adsorption and photocatalysis processes. In addition, the composite nanofibers are superparamagnetic, and can be recovered by magnet easily with almost no decline in the removal efficiency. The facile synthesis strategy used here might provide a universal and efficient method to fabricate one-dimensional magnetic nanocomposites with porous structures for various functional applications.

[Association of prognosis with insulin-like growth factor receptor type I expression in gastric cancer patients: a meta-analysis].

OBJECTIVE: To systemically evaluate the relationship between the expression of insulin-like growth factor receptor type I (IGF-1R) and prognosis in gastric cancer (GC) patients. METHODS: A literature search was conducted from PubMed, EMBASE, Web of Science, CNKI, Wanfang and VIP databases to retrieve the clinical studies relevant to IGF-1R expression and its prognostic value in GC patients. Meta-analysis was performed using STATA 12.0 software. The methodology was assessed according to the European Lung Cancer Working Party Quality Scale for Biological Prognostic Factors for Lung Cancer. The quality of studies was assessed using the Newcastle-Ottawa scale. RESULTS: Four eligible studies including 685 patients were enrolled for this meta-analysis. Analysis results suggested that up-regulation of IGF-1R in GC patients was significantly associated with TNM staging (OR=5.20, 95%CI:1.12 to 24.15, P=0.035), lymph node metastasis(OR=8.24, 95%CI:2.68 to 25.34, P=0.000) and distant metastasis(OR=17.34, 95%CI:6.52 to 46.15, P=0.000). Moreover, up-regulated IGF-1R expression was significantly associated with poor overall survival of gastric cancer patients(HR=2.63, 95% CI:1.29 to 5.40, Z=2.64, P=0.008). CONCLUSION: High IGF-1R expression may be an adverse prognostic factor in gastric cancer patients.