Objective To systematically evaluate the differences in clinicopathologic features and prog-nosis of colorectal cancer(CRC)between youth and middle-aged and elderly people.Methods The relevant literatures in Chinese and English databases before June 2024 were retrieved.The Stata 18 and RevMan5.3 softwares were used to perform the heterogeneity and sensitivity analyses as well as publication bias tests for the relevant outcome indicators.Results A total of 17 case-control studies were included,including a total of 6 817 patients with pathologically diagnosed CRC,among them 1 939 cases in the young group and 4 878 cases in the middle-aged and elderly group.The results of meta analysis showed that the proportion of family histo-ry in the young adult group(OR=3.09,95%CI:2.33-4.09),misdiagnosis rate(OR=4.40,95%CI:3.30-5.86),proportion of poorly differentiated carcinomas(OR=3.57,95%CI:2.73-4.67),proportion of mucin-ous adenocarcinomas and imprinted cell carcinomas(OR=3.41,95%CI:2.79-4.18),and proportion of TNM stage at diagnosis(stage Ⅲ-Ⅳ,OR=1.71,95%CI:1.44-2.02),incidence rate of lymph node metas-tasis(OR=1.92,95%CI:1.61-2.28),incidence rate of distant metastasis(OR=2.09,95%CI:1.53-2.86)were higher than those in the middle-aged and elderly group(all P<0.05);the CEA-positive rate at diagnosis(OR=0.68,95%CI:0.57-0.80)and 5-year survival rate(OR=0.24,95%CI:0.16-0.36)in the young group were lower than those in the middle-aged and elderly group(all P<0.05).The difference in the tumor diameter size(OR=1.32,95%CI:0.98-1.77)between the two groups was not statistically significant(P=0.07).Conclusion Compared with middle-aged and elderly CRC,young patients with CRC has a closer famil-ial correlation,may be more easily misdiagnosed clinically,its malignant degree would be higher,and the TNM stage in diagnosis is relatively late;in clinic the young population with CRC high risk could be appropriately relaxed in the age limit for screening.

Objective To analyze the relationship of oxidized low density lipoprotein (ox-LDL) and homocysteine (Hcy) with coronary in-stent restenosis (ISR),and to discuss the clinical predictors of ISR after rapamycin-eluting coronary stent implantation.Methods A total of 400 patients,who had received rapamycin-eluting coronary stent implantation,were enrolled in this study.According to follow-up coronary angiography findings,the patients were divided into ISR group and non-ISR group.Plasma ox-LDL and Hcy levels were tested before percutaneous coronary intervention (PCI) as well as at the time of follow-up coronary angiography.Multivariate logistic regression analysis was used to evaluate ISR-related clinical parameters,angiographic features and surgical factors.Results ISR group had 48 patients and non-ISR group had 352 patients,the clinical incidence rate of ISR was 13.6％.Compared with non-ISR group,the plasma ox-LDL and Hcy levels tested before stent implantation and at the time of follow-up coronary angiography were strikingly increased,the differences were statistically significant (P＜0.05).The results of multivariate logistic regression analysis showed that the independent correlative factors for ISR included hypertension (OR=1.12,95％CI:1.02-3.92;P=0.033),diabetes (OR=2.61,95％CI:1.93-4.26;P=0.016 0),Hcy (OR=2.45,95％CI:1.57-4.48;P=0.036),ox-LDL (OR=2.18,95％CI:1.45-4.96;P=0.006),taking statins (OR=0.50,95％CI:0.26-0.82;P=0.013),smoking (OR=5.62,95％CI:4.13-7.18;P=0.002),coronary artery disease (OR=3.32,95％CI:2.12-5.34;P=0.017),coronary bifurcation lesion (OR=3.51,95％CI:2.36-5.58;P=0.021),chronic total occlusion (OR=2.01,95％CI:1.22-4.84;P=0.014),reference vessel diameter (OR=0.25,95％CI:0.12-0.62;P=0.001),preoperative vascular stenosis degree (OR=2.06,95％ CI:1.21-4.32;P=0.024),stent diameter (OR=0.20,95％CI:0.10-0.53;P=0.001) and stent length (OR=2.60,95％CI:1.22-4.84;P=0.036).Conclusion Clinically,ISR is not an uncommon finding in patients who have received rapamycin-eluting coronary stent implantation.This study indicates that hypertension,diabetes,Hcy,ox-LDL,taking statins,smoking,coronary artery disease,coronary bifurcation lesion,chronic total occlusion,reference vessel diameter,preoperative vascular stenosis degree,stent diameter and stent length are the independent factors for ISR.Long-term use of statins can reduce the risk of ISR.

Air Pollution, Indoor ; analysis ; China ; Environmental Monitoring ; Humans ; Surveys and Questionnaires