Objective To discuss the relationship between FokI gene polymorphism and colorectal canc-er.Method The references that met the inclusive criteria were assessed .The extracted data were summarized in the form of tables .Data were analyzed by heterogeneity test .Meta-analysis was conducted by using fixed effects model or random effects model .Results Fifteen experimental studies were included in this study ,including 7, 859 colorectal cancer patients and 9,933 controls.The association between VDR gene FokI and colorectal cancer was expressed as the odds ratio(OR)and 95% confidence interval(CI).FokI recessive genetic model,ff versus FF+Ff,ORrecessive=1.01(95% CI=0.87~1.17,I2 =54%,P=0.91),ORdominant =0.94(95% CI=0.83~1.06,I2 =64%,P=0.30);allele model,fversus F,OR=0.98(95% CI=0.89~1.08,I2 =71%,P=0.72).In subgroup analysis,recessive genetic model,ORCaucasian race =0.95(95% CI=0.86~1.05,I2 =0%,P=0.33);ORyellow race=1.12(95%CI=0.77~1.63,I2 =72%,P=0.54).In subgroup analysis,dom-inant gene model,ORCaucasian race =0.95(95% CI=0.86~1.04,I2 =27%,P=0.29);ORyellow race =0.89(95%CI=0.65~1.22,I2 =78%,P=0.47).In subgroup analysis,allele model,ORCaucasian race=0.97 (95%CI=0.90~1.04,I2 =31%,P=0.38);ORyellow race =1(95% CI =0.79 ~1.27,I2 =82%,P=1.00).Conclusion Our results suggested that in VDR gene FokI ,F and f alleles were not obviously directly correlated with colorectal cancer .No difference was found between Asian and Caucasian .The conclusions in other populations should be further identified by extensive experimental studies .

Objective:To study the safety and practicability of probiotics intestinal preparation combined with early enteral nutrition in perioperative period of laparoscopic rectal cancer radical proctectomy.Methods:The clinical data of 131 patients who underwent selective laparoscopic rectal cancer radical proctectomy in Shengjing Hospital of China Medical University from January to June 2018 were retrospectively analyzed. Among them, 80 patients received probiotics intestinal preparation combined with early enteral nutrition (experimental group), and 51 patients received traditional intestinal preparation and postoperative treatment (control group). The bleeding volume during operation, hospitalization expenses, first exhaust time, postoperative hospitalization time, indwelling catheter time and complications were compared between 2 groups.Results:The bleeding volume during operation, hospitalization expenses, postoperative hospitalization time in experimental group were significantly less than those in control group: (166.33 ± 15.18) ml vs. (226.47 ± 16.46) ml, (42 365 ± 3 921) yuan vs. (51 048 ± 4 772) yuan and (13.32 ± 1.03) d vs. (13.98 ± 1.29) d, and there were statistical differences ( P<0.01). There were no statistical difference in the first exhaust time, indwelling catheter time and incidence of complications between 2 groups ( P>0.05). Conclusions:The probiotics intestinal preparation combined with early enteral nutrition in perioperative period can reduce the hospitalization expenses and shorten the hospitalization time in patients undergoing laparoscopic rectal cancer radical proctectomy, which is safe and feasible.

Objective: To investigate the trends in mortality and life lost due to female breast cancer among in Suzhou City from 2007 to 2021, so as to provide insights into improvements of breast cancer control strategy in Suzhou City. Methods: The epidemiological and clinical data pertaining to dead female breast cancer cases in Suzhou City from 2007 to 2021 were collected from Suzhou Municipal Chronic Disease Surveillance System, including gender, age and cause of death. The crude mortality, standardized mortality, years of potential life lost (YPLL), years of potential life lost rate (YPLLR), standardized YPLL (SYPLL), standardized YPLLR (SYPLLR) and average years of life lost (AYLL) due to female breast cancer were calculated. All data were standardized by the Fifth National Population Census in 2000, and the trends in mortality of breast cancer were estimated using average annual percent change (AAPC). Results: Totally 4 425 death occurred due to female breast cancer in Suzhou City from 2007 to 2021, with a crude mortality rate of 8.67/105, which appeared a tendency towards a rise (AAPC=1.83%, t=5.080, P=0.001), and the standardized mortality was 4.68/105, which appeared no significant changes (AAPC=0.13%, t=0.356, P=0.727). The crude mortality rates of female breast cancer were 0.62/105, 10.33/105 and 21.69/105 among women at ages of 15 to 34, 35 to 64 years and 65 years and older, respectively, which appeared a tendency towards a rise (χ2trend=2 315.683, P=0.001). The crude mortality of female breast cancer was 8.66/105 in urban areas and 8.86/105 in rural areas, both appearing a tendency towards a rise (urban areas: AAPC=1.73%, t=3.290, P=0.006; rural areas: AAPC=2.68%, t=6.565, P=0.001). The YPLL, SYPLL, YPLLR, SYPLLR and AYLL of female breast cancer were 44 485 person-years, 30 387 person-years, 0.99‰, 0.68‰ and 14.94 years per person, and both YPLLR (AAPC=-1.06%, t=-2.193, P=0.047) and AYLL (AAPC=-1.53%, t=-4.783, P=0.001) appeared a tendency towards a reduction, respectively. Conclusion The crude mortality of female breast cancer appeared a tendency towards a rise and the life loss appeared a tendency towards a decline in Suzhou City from 2007 to 2021. The elderly population should be given a high priority for breast cancer control.

Objective : To analyze the trends in mortality and life lost due to bladder cancer in Suzhou City, Jiangsu Province from 2003 to 2022, so as to provide the reference for prevention and treatment strategy of bladder cancer. Methods: The data of bladder cancer death in Suzhou City from 2003 to 2022 were collected through Suzhou Residents' Death Registration System, including age, gender, date of death and underlying cause of death. The crude mortality, standardized mortality, years of potential life lost (PYLL), standardized years of potential life lost (SPYLL), years of potential life lost rate (PYLLR), standardized years of potential life lost rate (SPYLLR) and average years of life lost (AYLL) were calculated. The average annual percent change (AAPC) was used to analyze the trends in bladder cancer death and life lost. Results: Totally 2 978 deaths occurred due to bladder cancer in Suzhou City from 2003 to 2022. The crude mortality was 2.22/105, which appeared a tendency towards a rise (AAPC=4.271%, P<0.05). The standardized mortality was 0.91/105, which appeared no significant changing trend (P>0.05). The standardized mortality was 1.58/105 in males and 0.37/105 in females, which appeared no significant tendency in males (P>0.05) and appeared a tendency towards a decline in females (AAPC=-2.331%, P<0.05). The age-specific crude mortality was low among people who aged under 45 years, began to rise among people aged over 45 years and peaked among people aged 60 years and older. The crude mortality of bladder cancer in males aged 60 years and older showed an increasing trend (AAPC=2.864%, P<0.05), but there was no significant tendency in females aged 60 years and older (P>0.05). The PYLL, SPYLL, PYLLR, SPYLLR and AYLL of bladder cancer were 5 020.00 person-years, 2 945.14 person-years, 0.04‰, 0.03‰ and 9.07 years per person. SPYLL, SPYLLR and AYLL showed an decreasing trend (AAPC=-2.867%, -3.321%, -3.738%, P<0.05). Conclusions The mortality of bladder cancer in Suzhou City appeared a tendency towards a rise from 2003 to 2022. The PYLL appeared a downward trend. Males aged 60 years and older are the key groups for the prevention and control of bladder cancer.

Objective: To examine the dose-response association between cardiorespiratory fitness ( CRF ) and the risk of cardiovascular and cerebrovascular diseases. Methods: A joint search was performed in Chinese and English electronic databases, including China National Knowledge Infrastructure ( CNKI ) , Wanfang Data, VIP, CBM, PubMed, Embase and Web of Science, to retrieve publications reporting the correlation between CRF and the risk of cardiovascular and cerebrovascular diseases until May, 2021. The pooled risk was estimated using the random effects model, and the dose-response association was evaluated using restricted cubic splines. The source of heterogeneity was assessed by subgroup analysis, and the stability of the results was tested by the trim-and-fill method, while the publication bias was assessed using funnel plots. Results: Totally 37 280 literatures were identified, and 23 eligible studies were finally included in the analysis, which covered 2 605 622 subjects. There were 22 publications identified as high-quality. Meta-analysis revealed that the pooled risk of cardiovascular and cerebrovascular diseases reduced by 42% in the highest CRF group relative to the lowest CRF group ( OR=0.58, 95%CI: 0.52-0.65 ), and a one metabolic equivalent ( MET ) increase in CRF caused a 10% reduction in the pooled risk of cardiovascular and cerebrovascular diseases ( OR=0.90, 95%CI: 0.88-0.92 ). There was a negative linear correlation between CRF and the incidence of cardiovascular and cerebrovascular diseases ( P=0.396 ). Subgroup analysis identified gender, sample size and study regions as possible sources of heterogeneity, and sensitivity analysis showed that the study results were stable. Conclusions There is a negative linear correlation between CRF and the risk of cardiovascular and cerebrovascular diseases, and an increase in CRF may reduce the risk of cardiovascular and cerebrovascular diseases.

Objective: To investigate the effects of cadmium exposure on cardiovascular system of occupational workers. Methods: Cross-sectional study was applied to 992 workers in a nickel-cadmium battery plant in November, 2011, of which 749 were cadmium exposed workers and 243 were controls without cadmium and other expose. Urinary cadmium、electrocardiogram (ECG) and blood pressure were examined simultaneously among 992 workers. The risk factors of ECG abnormality rate and hypertension rate were analyzed by Logistic regression. Results: The level of urinary cadmium in cadmium exposed workers was significantly higher than controls (8.89±4.00 vs 1.34±1.18 μg/g creatinine, P<0.01) . Urinary cadmium level in women was significantly higher than men in both exposure and control group (P<0.05) . According to the group of working years, Urinary cadmium level raised with the increase of working years (F=28.272, P<0.001) . The ECG abnormality rate and hypertension rate of cadmium exposed workers were higher than that of control group, the differences were all statistically significant (P<0.01) . The abnormal rate of ECG and the hypertension rate increased with the prolonging of working years and demonstrated dose-response relationship. With the increase of urinary cadmium level, the abnormal rate of ECG and hypertension rate raised (OR=1.11, P<0.01) and (OR=1.15, P<0.01) respectively. Conclusion Occupational cadmium exposure increased the abnormal rate of ECG and blood pressure and therefore damaged cardiovascular system of workers. This study provided base data for protecting health of cadmium exposed workers.

Objective To study the feasibility and practicability of contralateral saphenous vein bypass in the treatment of chronic femoral vein obstruction.Methods A retrospective analysis was consisted of 33 patients who received contralateral great saphenous vein bypass during the period of June 2013 to June 2017 in the Deperrtment of Biloary Vascular Surgery of Shengjing Hospital of China Medical University.All patients after operation were followed up of 2 months deadline to August 2017 by telephone or outpatient,the follow-up content including lower limb activity after resting and subjective sensation,lower limb swelling degree and so on.The measurement data was expressed by mean standard deviation ((x) ± s),paired samples t test was used for comparison among groups.Linear correlation coefficient was used to describe the difference between ankle circumference and the time to maintain anticoagulation therapy after acute thrombosis,then we explored the effect and advantages of this surgical methods.Results Compared with the preoperative index,the activated partial thromboplastin time [(21.93 ± 3.36) svs(18.11 ±2.24)s,P＜0.05],the thrombus elastic map R value[(5.45 ±0.73)min vs(4.20 ± 0.39) min,P ＜ 0.05],the D-dimer [(3 502.79 ± 4 028.02) μg/L vs (5127.76 ± ± 4722.42) μg/L,P ＜ 0.05] and the ankle circumference [(22.23 ± 1.28) cm vs (25.38 ± 0.78) cm,P ＜ 0.05] were improved,and the prothrombin time [(12.63 ± 1.74) s vs (12.32 ± 1.14),P ＞0.05] showed no difference before and after the operation (P ＞ 0.05).With the extension of time,the effect of bypass on the treatment of lower limb edema weakened.Postoperative follow-up indicated that 33 cases of patients were unobstructed and returned to normal state,21 cases could tolerated normal physical activity and had no or mild swelling,12 cases occasional had moderate swelling while the swelling could disappear after lying down for a rest,symmetric of double lower limbs in all patients returned to acceptable degree and did not affect the clothing or appearance.Conclusion The contralateral saphenous vein bypass operation has better effect and less trauma,it can improve the lower limb edema and endogenous coagulation system of chronic obstructive iliac vein disease,and the effect is better after conservative treatment for half a year.

Objective To evaluate the association between TNFα-308 polymorphism and inflammatory bowel disease susceptibility in Chinese people.Methods The literatures about the association between TNFα-308 polymorphism and inflammatory bowel disease were collected by searching related database until July 2017.The theme words included "TNFα gene polymorphism inflammatory bowel disease" and "the free words" included "single nucleotide polymorphism nucleic acid polymorphism ulcerative colitis Crohn's disease nonspecific enteritis" were used for searching,then x2 wasapplied test to determine the combined effect heterogeneity and then analyzed the relationship between TNFα-308 polymorphism and inflammatory bowel disease disease through recessive and dominant model.Results A total of 6 references met inclusion criteria,and there were 536 patients in the case group (patients with inflammatory bowel disease) and 927 patients in the control group (normal people) healthy controls were included in this study.Recessive model OR =0.86 (95％ CI:0.30-2.46,x2 =3.02,P ＞ 0.05),Dominant model OR =1.32(95％ CI:0.95-1.84,x2 =21.58,P ＜ 0.05),After heterogeneity analysis and sensitivity test,the original research with more influence was excluded,and the final results with higher credibility were consistent with previous one.Conclusion Compared to A alleles,an individual who carries G alleles is more susceptible to ulcerative colitis,while Crohn's disease has no business with the polymorphism of TNFα.

Objective To explore the influence of goal-directed fluid therapy guided by stroke volume variation (SVV) on the recovery of gastrointestinal function and the length of hospital stay in patients undergoing gastrointestinal surgery, thus provide evidence for clinical application. Methods The studies related to the functional recovery of patients undergoing gastrointestinal surgery, including goal-directed fluid therapy guided by SVV were search in the PubMed, Medline, Google Scholar, Web of Science, CNKI, VIP and Wanfang data from 2008 to 2017. The experiment group was treated with goal-directed fluid therapy, and the control group was treated with open fluid therapy. The key indexes included first time of exhaust time, postoperative first defecation time, postoperative first feeding time, length of postoperative hospital stay or total length of hospital of stay. The Meta-analysis used RevMan 5.3 statistical software. Results A total of 13 randomized controlled trials containing 851 patients was included. The total length of hospitalization was compared in 8 articles, and the results showed that the difference was statistically significant ( MD = -4.12, 95% CI-5.93 to-2.30, P < 0.01). The length of postoperative hospital stay was compared in 6 articles, and the results showed that the difference was statistically significant ( MD=-2.64, 95% CI-3.84 to-1.43, P<0.01). The first time of exhaust time was compared in 12 articles, and the results showed that the difference was statistically significant ( MD=-15.32, 95% CI-19.96 to-10.69, P<0.01). The postoperative first defecation time was compared in 7 articles, and the results showed that the difference was statistically significant ( MD=-13.55, 95% CI-17.86 to -9.24, P < 0.01). The postoperative first feeding time was compared in 7 articles, and the results showed that the difference was statistically significant ( MD=-13.20, 95% CI-17.61 to-8.80, P < 0.01). Conclusions Goal-directed fluid therapy by SVV programs can help patients undergoing gastrointestinal surgery with earlier recovery in gastrointestinal function and shorter length of hospital stay or postoperative hospital stay.

Objective:To systematically evaluate the role of nanocarbon in the surgical treatment of thyroid cancer.Method:Searched Pubmed database, Web of Science, Cochrane Library, CNKI database, Wanfang database and VIP database for researches related to nanocarbon and thyroid cancer. The search key words included nano carbon, nano-carbon, carbon nanoparticles, nano-carbon parathyroid negative imaging technique, thyroid neoplasms, thyroid cancer, thyroid carcinoma. And also manually retrieved article references. The search time was from the establishment of the database to March 10, 2020. Two researchers separately screened and sorted out the data, and evaluated the quality of the articles and evaluated the publication bias. Revman 5.3 was used for data analysis.Results:Twenty-six randomized controlled studies were included, with a total of 2291 patients, including 1149 in the test group and 1142 in the control group. The results showed that the postoperative complications rate of the test group using nanocarbon was significantly lower than that of the blank control group, and the differences were statistically significant, including the parathyroid erroneous excision rate ( OR=0.24, 95% CI: 0.16-0.34, P<0.001), the incidence of postoperative hypoparathyroidism ( OR=0.38, 95% CI: 0.28-0.52, P<0.001), the incidence of postoperative hypocalcemia ( OR=0.40, 95% CI: 0.30-0.54, P<0.001) and the recurrent laryngeal nerve injury rate ( OR=0.50, 95% CI: 0.31-0.81, P<0.001). Conclusion:The use of nanocarbon tracing technology during the operation can reduce the complications of thyroid cancer resection and is worthy of clinical use.