Objective To explore the short and long-term efficacy of extralevator abdominoperineal excision (ELAPE)vs.conventional abdominoperineal excision (APE)on distal rectal cancer.Methods Relevant studies were identified by search of Medline,EMBASE,and Web of Science published between January 1,2008 and February 28,2015,and included in the systematic review and meta-analysis with Stata software (version 12.0). Results Our Meta-analysis included 14 studies involving 3278 patients,of whom 1843 (56.2%)underwent ELAPE and 1435 (43.8%)underwent APE.Compared with patients undergoing APE,those undergoing ELAPE had a significantly reduced risk of intraoperative bowel perforation (IBP)involvement (OR=0 .55 ,95% CI= 0 .37-0 .85 ),but no significant reduction in the occurrence of CRM positivity (OR=0 .81 ,95% CI=0 .52-1 .25 ), local recurrence (LR)(OR=0.49,95% CI=0.18-1.30),wound complications (WCs)(OR=0.93,95% CI=0.65-1.35)or in-hospital death (IHD)(OR=0.89,95% CI=0.47-1.71).Conclusion ELAPE can reduce the risk of IBP but not for CRM positivity or LR when compared with APE.Therefore,more higher-quality studies are needed to verify the short-and long-term effects of ELAPE procedure on distal rectal cancer.

Objective To explore the association between serum uric acid (SUA) and all-cause mortality in men. Methods In this prospective cohort study,data being used was derived from the Kailuan study cohort. A total of 81 110 male workers who had taken part in the Kailuan physical examination were enrolled. Subjects with previous myocardial infarction,stroke,cancer, eGFR<30 ml/(min·1.73 m2)accidental deaths and those ever used drugs that seemed to have showed an effect on blood uric acid,were excluded. All the information was gathered from a unified questionnaire,measured by blood biochemistry and with the mean period of follow up as(47.5±4.3) months. Based on the 2006-2007 SUA value,observed objects were divided into five groups,with multivariate Cox proportional hazard regression analysis used to estimate the relationship between SUA and all-cause mortality in men. Results 1)At the end of the follow-up period in 2010-2011, the number of deaths were 315,278,243,292 and 341 among the different SUA quinte,with incidence rates of all-cause mortality as 2.43%,2.36%,1.96%,2.42%and 2.92%,respectively. 2)Data from the Single factor Cox proportional hazard regression analysis showed that,when comparing with the third quinte,HR values of the all-cause mortality were 1.32(1.11-1.56),1.19(1.00-1.41),1.20(1.01-1.43)and 1.41(1.19-1.66)in other four groups,respectively. 3)When factors were adjusted for age, systolic blood pressure,diastolic blood pressure,body mass index,triglyceride,total cholesterol, high-density lipoprotein cholesterol, low density lipoprotein cholesterol, fasting glucose, high-sensitivity C-reactive protein,smoking history and history of drinking,education,profession, economy,etc.,results from the Multiple Cox proportional hazard regression analysis showed the HR values of the all-cause mortality were 1.26(1.06-1.51),1.20(1.01-1.44),1.25(1.05-1.49),1.42 (1.19-1.68) in other four groups,respectively,comparing to the third quinte. Conclusion Using SUA as the independent risk factor of all-cause mortality,the exceptional levels of SUA were associated with an increasing risk for all-cause mortality while the association of SUA with all-cause mortality appeared an“U”shaped curve.

OBJECTIVETo explore the association between serum uric acid (SUA) and all-cause mortality in men.

METHODSIn this prospective cohort study, data being used was derived from the Kailuan study cohort. A total of 81 110 male workers who had taken part in the Kailuan physical examination were enrolled. Subjects with previous myocardial infarction, stroke, cancer, eGFR < 30 ml/(min × 1.73 m(2)) accidental deaths and those ever used drugs that seemed to have showed an effect on blood uric acid, were excluded. All the information was gathered from a unified questionnaire, measured by blood biochemistry and with the mean period of follow up as (47.5 ± 4.3) months. Based on the 2006-2007 SUA value, observed objects were divided into five groups, with multivariate Cox proportional hazard regression analysis used to estimate the relationship between SUA and all-cause mortality in men.

RESULTS1) At the end of the follow-up period in 2010-2011, the number of deaths were 315, 278, 243, 292 and 341 among the different SUA quinte, with incidence rates of all-cause mortality as 2.43%, 2.36%, 1.96%, 2.42% and 2.92%, respectively. 2) Data from the Single factor Cox proportional hazard regression analysis showed that, when comparing with the third quinte, HR values of the all-cause mortality were 1.32 (1.11-1.56), 1.19 (1.00-1.41), 1.20 (1.01-1.43) and 1.41 (1.19-1.66) in other four groups, respectively. 3) When factors were adjusted for age, systolic blood pressure, diastolic blood pressure, body mass index, triglyceride, total cholesterol, high-density lipoprotein cholesterol, low density lipoprotein cholesterol, fasting glucose, high-sensitivity C-reactive protein, smoking history and history of drinking, education, profession, economy, etc., results from the Multiple Cox proportional hazard regression analysis showed the HR values of the all-cause mortality were 1.26 (1.06-1.51), 1.20 (1.01-1.44), 1.25(1.05-1.49), 1.42 (1.19-1.68) in other four groups, respectively, comparing to the third quinte.

CONCLUSIONUsing SUA as the independent risk factor of all-cause mortality, the exceptional levels of SUA were associated with an increasing risk for all-cause mortality while the association of SUA with all-cause mortality appeared an "U" shaped curve.

Adult ; Aged ; Cause of Death ; Humans ; Male ; Middle Aged ; Prospective Studies ; Risk Factors ; Surveys and Questionnaires ; Uric Acid ; blood