Purpose: It was aimed to clarify the casual connection between prostate cancer (PCa) and arthritis by utilizing two-sample Mendelian randomization (MR) analysis and data from National Health and Nutrition Examination Survey (NHANES) database. Materials and Methods: This study utilized NHANES data. Through association analysis and risk stratification analysis, the association between arthritis and PCa were examined. MR analysis was performed to elucidate the causal relationship between arthritis and PCa. Sensitivity analysis and Steiger directionality test confirmed the reliability of the MR analysis results. Results: A total of 23,608 (PCa:controls=413:23,195) participants after a sample exclusion and variable definition process were screened in NHANES database. Adjustments across three diverse models consistently revealed a notable influence of arthritis on PCa progression. Arthritis was identified as a risk factor for PCa (odds ratio [OR] 1.88, 95% confidence interval [CI] 1.36–2.62, p<0.001). Subsequent analysis indicated that in the arthritis-adjusted model with multiple covariates, the area under the curve of the receiver operating characteristic curve was 0.94. The inverse variance weighting method of MR analysis showed a causal relationship between rheumatoid arthritis (RA) and PCa (OR 1.090, 95% CI 1.053–1.128, p<0.001) as well as osteoar-thritis and PCa (OR 1.002, 95% CI 1.001–1.004, p=0.002). This suggested that RA and osteoarthritis were risk factors for PCa. The heterogeneity (p>0.05), horizontal pleiotropy (p>0.05), leave-one-out and Steiger test confirmed reliability of MR results. Conclusions NHANES database and MR analyses identified arthritis as a risk factor for PCa, offering fresh avenues for preventive and therapeutic approaches.

Adult ; Age Factors ; Aged ; Cause of Death ; trends ; China ; Female ; Humans ; Infant ; Male ; Middle Aged ; Neoplasms ; mortality

OBJECTIVETo investigate the clinical effect of fast-track surgery combined with Chinese medicine treatment in devascularization operation for cirrhotic esophageal varices.

METHODSSeventy-two patients with cirrhotic esophageal varices were selected from January 2009 to June 2013, and randomly assigned to a conventional group and a fast-track group (fast-track surgery combined with Chinese medicine treatment) using a randomized digital table, 36 cases in each group. Operation and anesthesia recovery time, postoperative hospitalization and quality of life were recorded and compared between groups during the perioperative period.

RESULTSCompared with the conventional group, the fast-track group had longer operation time (253.6±46.4 min vs. 220.6±51.0 min) and anesthesia recovery time (50.5±15.9 min vs. 23.5±9.6 min; P<0.01); less bleeding (311.3±46.8 mL vs. 356.2±57.5 mL; P<0.01) and less transfusion (1932.3±106.9 mL vs. 2045.6±115.4 mL; P<0.01); as well as faster recovery of gastrointestinal function, shorter postoperative hospitalization and higher quality of life. There were no serious postoperative complications and no further bleeding occurred.

CONCLUSIONFast-track surgery combined with Chinese medicine treatment is a safe and feasible approach to accelerate the recovery of patients with cirrhotic portal hypertension in perioperative period of devascularization operation.

Adult ; Aged ; Anesthesia Recovery Period ; Blood Loss, Surgical ; Blood Transfusion ; Chronic Disease ; Esophageal and Gastric Varices ; surgery ; therapy ; Female ; Humans ; Length of Stay ; Liver Cirrhosis ; complications ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Operative Time ; Postoperative Complications ; Postoperative Period ; Quality of Life ; Splenectomy

OBJECTIVE： To systematically evaluate the efficacy and safety of hydrotalcite combined with omeprazole for gastric ulcer， and to provide evidence-based reference for clinical treatment. METHODS： Retrieved from PubMed， Embase， Medline， the Cochrane library， CNKI， VIP and Wanfang database， randomized controlled trials （RCTs） about hydrotalcite combined with omeprazole （trial group） versus omeprazole alone （control group） for gastric ulcer during the database establishment to Aug. 2018. After data extraction of included literatures met inclusion criteria， and quality evaluation with Cochrane evaluator manual 5.0.1， Meta-analysis was performed for response rate， the incidence of ADR， recurrence rate of gastric ulcer bleeding， needed time of clinical symptom improvement and hospitalization stays by using Rev Man 5.3 statistical software. RESULTS： A total of 16 RCTs， involving 1 802 patients were included. The results of Meta-analysis showed that response rate [RR＝1.24， 95％CI（1.19，1.29）， P＜0.001] of trial group was significantly higher than that of control group； recurrence rate of gastric ulcer [RR＝0.27，95％CI（0.17，0.45），P＜0.001]， clinical symptom improvement time [MD＝－2.04，95％CI（－2.25，       －1.83），P＜0.001] and hospitalization time [MD＝－4.25，95％CI（－4.55，－3.95），P＜0.001] of trial group were significantly lower or shorter than those of control group， with statistical significance. There was no statistical significance in the incidence of ADR [RR＝0.68，95％CI（0.46，1.02），P＝0.06] between 2 groups. CONCLUSIONS： Compared with omeprazole alone， hydrotalcite combined with omeprazole for gastric ulcer can obviously increase the clinical response rate， decrease the recurrence rate of gastric ulcer and shorten the needed time of clinical symptom improvement and hospitalization time， but do not increase the incidence of ADR.

OBJECTIVE： To systematically review therapeutic efficacy and safety of mirtazapine combined with selective calcium channel blocker （SCCB） in the treatment of irritable bowel syndrome （IBS）， and provide evidence-based reference for clinical medication. METHODS： Retrieved from the Cochrane Library， PubMed， Embase， Medline， CNKI， VIP and Wanfang database， randomized controlled trials （RCTs） about mirtazapine combined with SCCB （trial group） versus SCCB （control group） for IBS were collected. After literature screening and data extraction， quality evaluation was performed by using Cochrane system evaluator manual 5.1.0 recommend bias risk evaluation tool. Meta-analysis was performed by using Stata 14.0 software. RESULTS： A total of 14 RCTs involving 1 005 patients were included. The results of Meta-analysis showed that the total response rate [RR＝1.34，95％CI（1.25，1.44），P＜0.001]，neuropeptide-Y level after treatment [SMD＝0.77，95％CI（0.49，1.05），P＜0.001]， response rate of abdominal pain therapy [RR＝1.32，95％CI（1.06，1.66），P＝0.014] and response rate of treatment for abnormal stool characteristics [RR＝1.75，95％CI（1.36，2.27）， P＜0.001] were significantly higher than control group； the scores of depression scale after treatment [SMD＝－1.87， 95％CI （－2.35， －1.39）， P＜0.001]， anxiety scale after treatment [SMD＝－2.25， 95％CI （－3.35， －1.15）， P＜0.001]， abdominal pain symptom score after treatment [SMD＝－7.41， 95％CI  （－8.30，－6.51）， P＜0.001]， diarrhea symptom score after treatment [SMD＝－6.39， 95％CI （－7.96，－4.81）， P＜0.001] were significantly lower than those of the control group. There were no statistical significance in response rate of abdominal distension therapy [RR＝1.07，95％CI（0.90，1.28），P＝0.421] and response rate of abnormal defecation therapy [RR＝1.05，95％CI（0.88，1.26），P＝0.588]， the incidence of abdominal pain [RR＝0.45，95％CI（0.11，1.97）， P＝0.291] and exhaustion [RR＝5.00，95％CI（0.60，41.79），P＝0.137] between 2 groups. CONCLUSIONS： Mirtazapine combined with SCCB can significantly improve therapeutic efficacy of IBS patients， promote clinical symptoms， but do not increase the occurrence of ADR as abdominal pain and exhaustion.

Objective:To explore the effects and mechanism of zedoary turmeric oil and its active components on the vascular endothelial growth factor A （VEGFA）， signal transducer and activator of transcription 3 （STAT3）， and mechanistic target of rapamycin （mTOR） in the ovarian cancer （OC）. Method:Network pharmacology technology was employed to analyze the mechanism of Curcumae Rhizoma on OC. Bioinformatics was used to analyze the expression of VEGFA， STAT3， and mTOR in OC and the effect on the prognosis of OC to explore the feasibility of zedoary turmeric oil in regulating VEGFA， STAT3， and mTOR in OC.The xenograft tumor model of nude mice was established， and the effects of zedoary turmeric oil and its active components on VEGFA， STAT3， and mTOR in OC were observed by hematoxylin-eosin （HE） staining， real-time fluorescence-based quantitative polymerase chain reaction （Real-time PCR）， Western blot， and immunohistochemistry （IHC）. Result:Bioinformatics analysis and literature research showed that VEGFA， STAT3， and mTOR played a special regulatory role in the occurrence and development of OC， and were potential key targets for the proliferation of OC. Network pharmacology analysis revealed that Curcumae Rhizoma could regulate multiple disease targets of OC， and mediate VEGFA， STAT3， and mTOR in OC through these multiple targets. As demonstrated by HE staining， the tumor cells in the model group were densely arranged， with no erosion on the edge and no vesicles inside. Compared with the model group， the cell density in other treatment groups was reduced， and strip-shaped erosion on the edge and small empty vesicles were observed in the tumor tissue， especially in the zedoary turmeric oil group. According to the results of Real-time PCR and IHC， zedoary turmeric oil and its active components could inhibit the mRNA and protein expression of VEGFA， STAT3， and mTOR in the OC tissue （P<0.05）. Conclusion:Zedoary turmeric oil and its active components could reduce the expression of VEGFA， STAT3， and mTOR in tumor tissue of nude mice， and inhibited the proliferation of OC through VEGFA， STAT3， and mTOR.

INTRODUCTIONHead and neck squamous cell carcinoma (HNSCC) is a common cancer worldwide and has a poor prognosis. A biomarker predicting the clinical outcome of HNSCC patients could be useful in guiding treatment planning. Overexpression of the T lymphoma invasion and metastasis 1 (Tiam1) protein has been implicated in the migration and invasion of neoplasms. However, its role in HNSCC progression needs to be further validated. We detected the expression of Tiam1 in normal and tumor tissues and determined its association with clinical outcomes in patients with HNSCC.

METHODSWe measured the expression of Tiam1 in normal and cancerous tissue samples from the patients with HNSCC treated at Sun Yat-sen University Cancer Center between 2001 and 2008. The Tiam1 expression was scored from 0 to 12 based on the percentage of positively stained cells and the staining intensity. We then determined the diagnostic performance of this score in predicting overall survival (OS) and disease-free survival (DFS).

RESULTSOf the 194 evaluable patients, those with advanced disease, lymph node metastasis at diagnosis, and recurrence or metastasis during follow-up had a higher tendency of having high Tiam1 expression as compared with their counterparts (P < 0.05). The proportion of samples with high Tiam1 expression was also higher in cancerous tissues than in non-cancerous tissues (57.7% vs. 13.9%, P < 0.001). Cox proportional hazards regression analysis revealed that Tiam1 expression scores of 5 and greater independently predicted short OS and DFS.

CONCLUSIONThe Tiam1 expression is shown as a promising biomarker of clinical outcomes in patients with HNSCC and should be evaluated in prospective trials.

Adult ; Aged ; Biomarkers, Tumor ; metabolism ; Carcinoma, Squamous Cell ; diagnosis ; pathology ; secondary ; Disease Progression ; Female ; Follow-Up Studies ; Guanine Nucleotide Exchange Factors ; metabolism ; Head and Neck Neoplasms ; diagnosis ; pathology ; secondary ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Proteins ; metabolism ; Predictive Value of Tests ; Prognosis ; ROC Curve ; Retrospective Studies ; Survival Analysis ; T-Lymphoma Invasion and Metastasis-inducing Protein 1