Cholecystectomy and risk of pancreatic cancer: a meta-analysis of observational studies.

OBJECTIVE: Data from epidemiological studies related to the association of cholecystectomy and pancreatic cancer (PaC) risk are inconsistent. We conducted a meta-analysis of observational studies to explore this relationship. METHODS: We identified studies by a literature search of Medline (from 1 January 1966) and EMBASE (from 1 January 1974), through 30 June 2011, and by searching the reference lists of pertinent articles. Summary relative risks with their 95% confidence intervals were calculated with a random-effects model. Between-study heterogeneity was assessed using Cochran's Q statistic and the I (2). RESULTS: A total of 18 studies (10 case-control studies, eight cohort studies) were included in this meta-analysis. Analysis of these 18 studies found that cholecystectomy was associated with a 23% excess risk of PaC (SRR = 1.23, 95% CI = 1.12-1.35), with moderate heterogeneity among these studies (p (heterogeneity) = 0.006, I (2) = 51.0%). Sub-grouped analyses revealed that the increased risk of PaC was independent of geographic location, gender, study design and confounders. There was no publication bias in the current meta-analysis. CONCLUSIONS: The results of this meta-analysis suggest that individuals with a history of cholecystectomy may have an increased risk of pancreatic cancer.

Diffusion tensor imaging detects Wallerian degeneration of the corticospinal tract early after cerebral infarction.

To investigate the feasibility and time window of early detection of Wallerian degeneration in the corticospinal tract after middle cerebral artery infarction, 23 patients were assessed using magnetic resonance diffusion tensor imaging at 3.0T within 14 days after the infarction. The fractional anisotropy values of the affected corticospinal tract began to decrease at 3 days after onset and decreased in all cases at 7 days. The diffusion coefficient remained unchanged. Experimental findings indicate that diffusion tensor imaging can detect the changes associated with Wallerian degeneration of the corticospinal tract as early as 3 days after cerebral infarction.

[A study on the recurrence of ischemic stroke in nonvalvular atrial fibrillation].

OBJECTIVE: To study the recurrence of ischemic stroke in patient with nonvalvular atrial fibrillation (NVAF) and to determine the recurrence related factors of ischemic stroke in patients with NVAF. METHODS: The clinical data of 386 NVAF patients with ischemic stroke treated in our hospital from January 1992 to February 2002 were included in this study. The basic clinical information of each patient was recorded. Analysis of recurrence and recurrence related factors of ischemic stroke in patients with NVAF was conducted. RESULTS: Overall the 10-year recurrence rate of ischemic stroke in patients with NVAF was 34%. Hypertension, diabetes mellitus, transient ischemic attack (TIA), hyperlipemia and mural thrombus in left atrium were significantly correlated with the recurrence rate by univariate Cox proportional hazards regression analysis; but aspirin therapy, warfarin therapy and hypertension control were protective factors for the recurrence of ischemic stroke in patients with NVAF. Multivariate Cox proportional hazards regression analysis revealed that hypertension, TIA and mural thrombus in left atrium were independent recurrence related factors for ischemic stroke in patients with NVAF; but aspirin therapy and warfarin therapy were protective factors for the recurrence. CONCLUSIONS: Hypertension, TIA and mural thrombus in left atrium were independent recurrence related factors for ischemic stroke in patient with NVAF; but aspirin therapy and warfarin therapy were protective factors for the recurrence.