Pancreatic cancer is one of common malignant tumors in the digestive system.There is still no effective means for the early diag-nosis of pancreatic cancer.As a mixture of oral gland secretion and oral mucosal transudate,saliva contains abundant biological information including microorganisms,proteins,and nucleic acids,which will change when the disease occurs.So saliva can be used for the early diag-nosis of pancreatic cancer.Through summarizing and analyzing the current studies and advantages of its application for early diagnosis,this article suggests that saliva bioinformatics holds promise for the application in the early diagnosis of pancreatic cancer.

Objective To evaluate the efficacy and safety of lentinan injection plus cisplatin (LIC) in the treatment of malignant pleural effusion (MPE).Methods We searched the database of Cochrane Library,PubMed,EMBASE,ISI Web of Knowledge,Chinese Biomedical Literature Database,Chinese Scientific Journals Full-text Database,Chinese Journal Full-text,and Google Scholar,etc.,up to February 28th,2011 to identify randomized controlled trials (RCTs) about lentinan injection (LI) for MPE,evaluate the quality of the included studies,and analyze the data by Cochrane Collaboration's RevMan5.0 software.Results Twenty-nine RCTs involving 1831 patients were included.Meta analysis results suggested that there were some differences when comparing LIC with control groups suffering from MPE,for LIC could improve the near-term curative effect and the quality of life to some extent.Besides,compared with chemotherapy alone,LI plus chemotherapy had an advantage in relieving adverse reactions,such as gastrointestinal reactions,myelosuppression,chest pain,and general malaise.Conclusion The current evidence indicates that LI may have adjuvant therapeutic effects for MPE.

Objective To assess the effects of gastric bypass versus medical therapy in patients with obesity and type 2 diabetes. Methods The Cochrane library, Embase, PubMed, Chinese biomedical literature database and Wanfang database up to April 2014 were searched. Randomized controlled trails(RCTs) of frequently-used bariatric surgery for obese patients with type 2 diabetes were included. Study selection, data extraction, quality assessment, and data analyses were performed according to the Cochrane standards. Results Four RCTs involving 157 patients in the gastric bypass groups and 152 patients in the medical therapy group were enrolled. Compared with medical therapy, gastric bypass for type 2 diabetes significantly decreased the levels of HbA1C(mean difference = -1. 85% , 95% CI -2. 15 ~ -1. 56, P< 0. 01), fasting blood glucose( standard mean difference = - 0. 90 mmol/ L, 95% CI-1. 24 ~ -0. 57, P<0. 01), body weight(mean difference=-23. 39 kg, 95% CI -29. 17 ~ -17. 61, P<0. 01), waist circumference(mean difference= -15. 36 cm, 95% CI -17. 51 ~ -13. 22, P<0. 01) and the dose of hypoglycemic medicine; while it increased the number of patients with HbA1C<6% (RR=5. 49, 95% CI 2. 22 ~ 13. 56, P<0. 01), the rate of adverse events(RR=1. 96, 95% CI 1. 42 ~ 2. 70, P<0. 01), and the level of high-density lipoprotein-cholesterol(mean difference=1. 24 mmol/ L, 95% CI 0. 64 ~ 1. 84, P<0. 01). Conclusions Gastric bypass surgery is more effective compared with medical therapy alone for obese patients with type 2 diabetes. Further intensive RCTs of high-quality in multiple centers with long-term follow-up should be carried out to provide more reliable evidences.

Objective To study the perioperative predictors of portal vein thrombosis (PVT) after splenectomy in cirrhotic patients.Methods We searched the Web of Science,PubMed,EMBASE,Science Direct,CNKI,VIP,CSCD,and Wan Fang Databases up to April 2014.Only case-controlled studies which evaluated predictive factors of portal vein thrombosis (PVT) after splenectomy in cirrhotic patients were included.The Stata 12 software was used to perform the meta-analysis.Results Twenty-four casecontrolled studies were included.The sample size was 4 335,and the incidence rate of PVT was 25.0％.The risk factors of PVT included splenic volume (WMD =13.75,95％ CI:6.47 ～21.00),splenic vein diameter (WMD =1.34,95％ CI:0.39 ～ 2.30),portal vein diameter (WMD =1.54,95 ％ CI:0.56 ～ 2.52 ;WMD=2.09,95％CI:0.55 ～3.64),portal venous flow (WMD =-5.78,95％ CI:-10.46 ～-1.10;WMD =-5.57,95 ％ CI:-5.92 ～-5.22),difference in portal venous pressure (WMD =1.90,95 ％ CI:1.29～2.50) and ascites (OR =1.83,95％ CI:1.19,2.82).There were no significant differences between patients with and without PVT in terms of sex,age,Child-Pugh classification,prothrombin time,PLT,D-dimer,operating time.Conclusion The risk factors of portal vein thrombosis after splenectomy in cirrhotic patients were splenic volume,splenic vein diameter,portal vein diameter,portal venous flow,difference in portal venous pressure and ascites.

Objective To estimate the safety and feasibility of fast track surgery (FTS) in operations for gastric cancer.Methods The Cochrane library,PubMed,EMBASE,Chinese biomedical literature database,China journal full text database,Chinese scientific journals full text database were searched with the key words of gastric cancer,gastric carcinoma, FTS,fast track surgery, enhanced recovery after surgery,ERAS, 胃癌,and 快速康复外科.The search was finished in April,2011.Randomized controlled trials of FTS for patients with gastric cancer were included.Two reviewers evaluated the quality of the included studies and extracted the data independently.Meta analysis was performed by RevMan 5.1.2 software.Results Fourteen randomized controlled trials involving 1270 patients were included.The results of meta analysis showed that FTS could significantly shorten the first exhaust time (MD =-6.15,95 ％ confidence interval:-8.22- -4.07,P＜ 0.05) and hospital stay ( MD =- 2.68,95％ confidence interval:- 3.26- - 2.10,P ＜ 0.05 ),and reduced the hospital fees ( MD =- 0.39,95 ％ confidence interval:- 0.55- - 0.22,P ＜ 0.05 ).FTS could lighten the postoperative stress and relatively enhance the immunity.Conclusion Compared with conventional methods,FTS could speed up the rehabilitation for patients with gastric cancer postoperatively without increasing the adverse reactions.

OBJECTIVETo study the efficacy and safety of brucea javanica oil emulsion (BJOE) combining platinum-contained first-line chemotherapy in treating non small cell lung cancer (NSCLC).

METHODCochrane library, PubMed, EMBASE, VIP, CBM and CNKI were searched through computers. The search was finished in February, 2011. Randomized controlled trials (RCTs) of BJOE combining platinum-contained first-line chemotherapy were included. Two researchers extracted data and assess literature quality separately,and made a meta-analyses by RevMan 5.1.2 software.

RESULTTotally 22 RCTs involving 1512 patients were included. The Meta-analysis showed that compared with the pure application of platinum-contained first-line chemotherapy,the combination of BJOE and chemotherapy can enhance the near-term curative effect (RR = 1. 31, 95% CI: 1.18-1.45, P < 0. 000 01), improve the quality of life (RR = 1.78, 95% CI: 1.51-2. 09, P < 0.00001) and reduce the suppression of bone marrow (OR = 0.37, 95% CI: 0. 27-0. 51, P < 0.00001) and the gastrointestinal reactions (OR = 0.59, 95% CI: 0.44-0.80, P = 0.0007) ,with an improvement in organism immunity.

CONCLUSIONThe current evidence indicates that BJOE can enhance the chemotherapeutic effect on NSCLC patients, improve the quality of life and reduce adverse effect of platinum-contained chemotherapeutics and thus it is worth referring in clinic.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Brucea ; chemistry ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; Drugs, Chinese Herbal ; administration & dosage ; Emulsions ; administration & dosage ; Female ; Humans ; Lung Neoplasms ; drug therapy ; Male ; Middle Aged ; Organoplatinum Compounds ; administration & dosage ; Phytotherapy ; Randomized Controlled Trials as Topic ; Young Adult

Objective To investigate the predictive value of metastatic lymph node ratio (MLNR) combined with preoperative serum carcinoembryonic antigen (CEA) in the detection of distant metastasis of stage Ⅱ-Ⅲ colon cancer after radical resection.Methods A retrospective study was performed on the clinical data of 325 patients with stage Ⅱ-Ⅲ colon cancer undergoing radical resection in the Second Hospital of Lanzhou University from Jan 2010 to Jan 2015.Results MLNR was correlated with the maximum diameter of tumors,the degree of differentiation of tumors,clinical TNM stage and distant metastasis (P ＜ 0.05),serum CEA was correlated with the maximum diameter of tumors,clinical TNM stage,nerve or vascular invasion and distant metastasis (P ＜ 0.05).Logistic regression analysis showed that low differentiation of tumor tissue,TNM Ⅲ stage,high MLNR and high serum CEA were independent risk factors for distant metastasis of colon cancer after radical operation.Conclusions The combined detection of MLNR and serum CEA has a good predictive value for distant metastasis with stage Ⅱ-Ⅲ colon cancer.

The application of Pseudomonas aeruginosa-mannose-sensitive hemagglutinin(PA-MSHA)in the field of an-titumors has been increasing.PA-MSHA has been found to promote tumor cell apoptosis,inhibit tumor cell invasion and migration,differentiation,and change drug resistance and epithelial-mesenchymal transformation(EMT)by inhibiting the EGFR pathway.Meanwhile,PA-MSHA also enhances the immune killing and inhibition of macrophages and T cells to tumor cells through toll-like receptors(TLRs).In this paper,we reviewed the reported anti-tumor mechanism and clinical application of PA-MSHA,suggesting that PA-MSHA may alter the glycosylation of EGFR and TLR proteins by acting on the regulatory process of the cellular mannosy-lation process.PA-MSHA can act on cell membrane proteins,including more receptors with high-mannosylation of signaling path-ways.Elucidating the deep relationship between PA-MSHA and mannosylation is of great significance for the mechanism research and clinical application of PA-MSHA.

OBJECTIVE: To systematically evaluate the efficiency and safety of total thyroidetomy (including near-total tyhroidectomy) versus subtotal thyroidectomy for multinodular goiter. METHODS: The literatures were searched from Cochrane Library, PubMed, Embase, Chinese Biological Medical Datebase, Chinese National Knowledge Infrastructure, and Chinese Science and Technology Journal Full-text Database as of November 2013. We included all randomizad controlled trials on total (including near-total) versus subtotal thyroidectomy in the treatment of multinodular goiter. The collecting of data and quality assessment were respectively completed by 2 researchers. RevMan5.1 software was used for Meta-analysis. RESULTS: We collected 7 literatures conforming to the standard, incuding 2 192 patients. The Metaanalysis outcomes showed that total thyroidectomy was associated with lower nodule recurrence rate (OR=0.13, 95% CI: 0.07-0.22, P<0.001) and higher in transient hypoparathyroidism rate (OR=2.33, 95% CI: 1.72-3.17, P<0.001). However, no statistical difference was seen comparing total and subtotal thyroidectomy in permanent recurrent laryngeal nerve paralysis rate (OR= 0.81, 95% CI: 0.24-2.74, P=0.74) and permanent hypoparathyroidism rate (OR=2.94, 95% CI: 0.48- 18.11, P=0.24). CONCLUSION Nodule recurrence rate of total thyroidectomy for multinodular goiter is lower than subtotal thyroidectomy and does not increase permanent complications.
Goiter, Nodular ; surgery ; Humans ; Hypoparathyroidism ; Randomized Controlled Trials as Topic ; Recurrence ; Thyroidectomy ; methods ; Vocal Cord Paralysis

Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases in China and manifests as simple fatty liver, non-alcoholic steatohepatitis, liver cirrhosis, and hepatocellular carcinoma. Studies have shown that intestinal flora can affect the development and progression of NAFLD via the "gut-liver axis" . Probiotics are active microorganisms with beneficial effects on the host, and more and more studies have found that probiotics play a positive role in improving NAFLD. They are cheaper, less harmful, and safer compared with antibiotics and surgery, and therefore, it may become a new method for the prevention and treatment of NAFLD. This article reviews the research advances in probiotics in the treatment of NAFLD, in order to provide a basis for the treatment of NAFLD using probiotics.