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The pretreatment prognostic nutritional index (PNI) is an indicator of nutritional and immune status, and has potential use as a predictor of survival in cancer patients. Several retrospective studies have used the PNI to predict the outcome of lung cancer patients receiving different immune checkpoint inhibitors (ICIs), but the results have been inconsistent. The objective of our study is to assess the relationship of pretreatment PNI with survival outcomes in lung cancer patients who received ICI-based treatments by meta-analysis.We searched the EMBASE, PubMed, Cochrane Library, American Society of Clinical Oncology, and European Society of Medical Oncology databases to identify studies that reported overall survival (OS) or progression-free survival (PFS) in eligible patients. Eight studies were eligible based on predefined inclusion and exclusion criteria. Data and pooled indicators were extracted from these studies. Meta-analysis was used to analyze hazard ratios (HRs) and 95% confidence intervals (CIs) for OS and/or PFS and the prognostic value of pretreatment PNI. We completed the registration of the research protocol (Registration number: INPLASY202240087, DOI number: 10.37766/inplasy2022.4.0087).We analyzed data from 8 eligible studies (831 patients). Meta-analysis showed that relative to patients with low pretreatment PNI, those with a high pretreatment PNI had better OS (HR = 2.50, 95% CI = 1.44-4.33, P = .001) and better PFS (HR = 1.94, 95% CI = 1.56-2.42, P.001). Sensitivity analysis indicated these results were robust. There was also no evidence of publication bias.Lung cancer patients receiving ICI-based treatments who had higher pretreatment PNI had better OS and PFS.

Systemic Immune-inflammation Index (SII) has been shown to correlate with the prognosis of numerous malignancies, but researchers have not yet reached an agreed conclusion on bladder cancer. To fill the blank, we conducted a meta-analysis to assess the prognostic role of SII in the prognosis of bladder cancer.After analyzing relevant literature published in PubMed, China National Knowledge Infrastructure, EMBASE, Cochrane Library, and Web Science up to April 30, 2022, we collected 83 articles to assess the significance of SII levels in assessing the prognosis of bladder cancer patients, and finally, 11 articles were included in the study. The correlation between pre-treatment Systemic Immunoinflammatory Index levels and survival in bladder cancer patients was assessed using risk ratio (HR) and 95% confidence interval (CI).Our meta-analysis comprised 11 papers altogether, and the findings revealed that higher levels of pretreatment SII were significantly associated with poorer overall survival/cancer-specific survival/progression-free survival/recurrence-free survival in bladder cancer patients (pooled HR = 1.80; 95% CI, 1.28-2.51; pooled HR = 1.68; 95% CI, 1.14-2.47; pooled HR = 1.74; 95% CI, 1.25-2.42; pooled HR = 1.73; 95% CI, 1.26-2.39). The above result was also confirmed in the subgroup analysis.Higher SII levels were significantly connected with overall survival/cancer-specific survival/progression-free survival/recurrence-free survival rates in bladder cancer patients, suggesting that SII is an important predictor of prognosis in bladder cancer patients.

This meta-analysis was conducted to compare the safety and diagnostic performance between computed tomography (CT)-guided core needle biopsy (CNB) and fine-needle aspiration biopsy (FNAB) in lung nodules/masses patients.All relevant studies in the Pubmed, Embase, and Cochrane Library databases that were published as of June 2020 were identified. RevMan version 5.3 was used for all data analyses.In total, 9 relevant studies were included in the present meta-analysis. These studies were all retrospective and analyzed outcomes associated with 2175 procedures, including both CT-guided CNB (n = 819) and FNAB (n = 1356) procedures. CNB was associated with significantly higher sample adequacy rates than was FNAB (95.7% vs 85.8%, OR: 0.26; P .00001), while diagnostic accuracy rates did not differ between these groups (90.1% vs 87.6%, OR: 0.8; P = .46). In addition, no differences in rates of pneumothorax (28.6% vs 23.0%, OR: 1.15; P = .71), hemorrhage (17.3% vs 20.1%, OR: 0.91; P = .62), and chest tube insertion (5.9% vs 4.9%, OR: 1.01; P = .97) were detected between these groups. Significant heterogeneity among included studies was detected for the diagnostic accuracy (I2 = 57%) and pneumothorax (I2 = 77%) endpoints. There were no significant differences between CNB and FNAB with respect to diagnostic accuracy rates for lung nodules (P = .90). In addition, we detected no evidence of significant publication bias.CT-guided CNB could achieve better sample adequacy than FNAB did during the lung biopsy procedure. However, the CNB did not show any superiorities in items of diagnostic accuracy and safety.

To evaluate the clinical efficiency, feasibility, and safety of computed tomography (CT)-guided trans-scapular coil localization (TSCL) approach to treating scapula-blocked pulmonary nodules (SBPNs). In total, 105 patients with pulmonary nodules underwent CT-guided CL and subsequent video-assisted thoracoscopic surgery (VATS)-guided wedge resection (WR) between January 2016 and July 2020. Six of these patients (5.7%) had SBPNs that led them to undergo CT-guided TSCL. Rates of technical success and localization-related complications were then recorded and analyzed. CT-guided TSCL was associated with a 100% technical success rate, with one coil being placed per patient. The median CT-guided TSCL duration was 15 min. No patients experienced any complications associated with this procedure, and subsequent VATS-guided WR of SBPNs was 100% technically successful. In two patients with invasive adenocarcinoma, additional lobectomy was performed. Median VATS duration and intraoperative blood loss were 120 min and 150 mL, respectively. In summary, these results indicate that CT-guided TSCL could be easily and safely implemented to achieve high success rate when performing the VATS-guided WR of SBPNs.

Background: This study will evaluate the effectiveness of different acupuncture courses for functional constipation (FC) through network meta-analysis. Methods: Eight database (PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials (Central), China National Knowledge Infrastructure (CNKI), China Biomedical Literature Database (CBM) and Wanfang Database) will be searched from inception to October 2019. Only randomized controlled trials comparing different acupuncture courses or acupuncture versus sham acupuncture or placebo will be included. The outcomes involved weekly stool frequency, Bristol Fecal score, responder rate and safety evaluation. The risk of bias assessment and quality of evidence will be appraised using the Cochrane Risk of Bias Tool and the Grading of Recommendations, Assessment, Development and Evaluation guidelines. RevMan 5.3 software, STATA V.14.0 and GeMTC software will be used to perform the network meta-analysis. Results: This work will compare and arrange the comparative efficacy of different acupuncture treatments for FC by summarizing the current evidences. The results will be submitted in the form of a journal publication. Conclusion: The results of this network meta-analysis may help doctors determine the best treatments for patients to manage FC. PROSPERO registration number: CRD42020153801.

This study was designed to explore the safety, feasibility, and clinical efficacy of preoperative computed tomography (CT)-guided coil localization of sub-fissural lung nodules (LNs). A total of 105 LN patients underwent CT-guided coil localization followed by video-assisted thoracoscopic surgery (VATS)-guided wedge resection at our hospital from January 2016 to December 2019. Of these patients, 4 had sub-fissural LNs and were therefore subjected to trans-fissural coil localization procedures. We analyzed data pertaining to the coil localization and VATS procedures in these patients. A total of 4 coils were used to localize 4 LNs in 4 separate patients. One of these patients suffered from parenchymal hemorrhage around the needle path, while one other patient exhibited asymptomatic pneumothorax following coil localization. A thoracoscope was able to successfully visualize the coil tails in all of these patients. There were no instances of coils having been dislodged, and wedge resection was conducted with a 100% technical success rate in these patients. These 4 LNs were subsequently diagnosed as adenocarcinomas in situ (n = 3) and benign nodules (n = 1). CT-guided coil localization can be used to safely and easily localize sub-fissural LNs in patients scheduled to undergo VATS.

Background To investigate the efficacy and safety of compound glycyrrhizin (CG) combined with antihistamines in the treatment of chronic urticaria (CU). Methods We will use computers to search all databases including Medline, Embase, Pubmed, Web of Science and Cochrane Central Register of Controlled Trials and China's 4 databases: China National Knowledge Infrastructure Database, China Biomedical Literature Database, China Science Journal Database, and Wanfang Database. Find data from creation date to July 2020. In addition, we will manually search the list of medical journals as a supplement. The scope of the search included randomized controlled clinical studies related to CG combined with antihistamines for CU. The primary outcome is the disease activity control. Secondary outcomes include response rate, adverse events, and recurrence rates. The Cochrane RevMan V5.3 Deviation Assessment Tool will be used to assess bias assessment risk, data integration risk, meta-analysis risk, and subgroup analysis risk (if conditions are met). The average difference, standard mean difference, and binary data will be used to represent continuous results. Results This study will comprehensively review the existing evidence on CG combined with antihistamines for CU. Conclusion This systematic review will provide a basis for judging the effectiveness and safety of CG combined with antihistamines in the treatment of CU. Systematic review registration PROSPERO, CRD42020156153.

Background: To investigate the efficacy and safety of acupoint injection of Bacillus Calmette–Guerin polysaccharide nucleic acid (BCG-PSN) in the treatment of chronic urticaria (CU). Methods: The following databases will be searched from their inception: Medline, Embase, Pubmed, Web of Science, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure Database, China Biomedical Literature Database, China Science Journal Database, and Wanfang Database. All databases will be searched from the date of creation until October 2019. In addition, we will manually search the list of medical journals as a supplement. The scope of the search included randomized controlled clinical studies related to acupoint injection of BCG-PSN for CU. The primary outcome is the disease activity control. Secondary outcomes include response rate, adverse events, and recurrence rates. The Cochrane RevMan V5.3 Deviation Assessment Tool will be used to assess bias assessment risk, data integration risk, meta-analysis risk, and subgroup analysis risk (if conditions are met). The average difference, standard mean difference and binary data will be used to represent continuous results. Results: This study will comprehensively review the existing evidence on the treatment of CU by acupoint injection of BCG-PSN. Conclusion: This systematic review will provide a judgment basis for the effectiveness and safety of acupoint injection of BCG-PSN in the treatment of CU. Systematic review registration: PROSPERO, CRD42019139885.

Cytomegalovirus (CMV) gastritis is a rare opportunistic infection with diverse clinical manifestations. Our study aimed to investigate the clinical features of Chinese patients with CMV gastritis. Six inpatients diagnosed with CMV gastritis were retrospectively enrolled, based on the finding of inclusion bodies in routine hematoxylin and eosin staining or positive anti-CMV monoclonal antibodies under immunohistochemistry in the gastric biopsy. Data, including demographics, diagnostic measurements, and medications, were collected. Abdominal pain was the most frequently reported symptom, occurring in 4 patients. Five patients were immunocompromised with associated underlying diseases, and 3 patients had decreased leukocyte differentiation antigen 4 positive (CD4+) T lymphocyte counts. Only 3 patients had either positive cytomegalovirus (CMV)-immunoglobulin (Ig) M or increased copies of CMV-DNA peripherally. All patients had gastric lesions in the antrum of the stomach, including ulcers or erosions observed by gastroscopy. All patients received ganciclovir by intravenous injection (IV) as the first line anti-CMV therapy, and attained complete (4) or partial remission (2) during the follow-up. CMV gastritis should be taken into consideration in patients with immunocompromised status who have abdominal pain, nausea, or vomiting. Gastroscopy and necessary biopsy are the major diagnostic methods for CMV gastritis. Early diagnosis leads to a better prognosis for these patients.

The goal of this study is to determine the feasibility, diagnostic accuracy, and risk factor of complications of computed tomography (CT)-guided percutaneous cutting needle biopsy (PCNB) for small lung nodules. From January 2014 to May 2015, 141 patients with small lung nodule were performed with CT-guided PCNB procedure. Data on technical success, diagnostic accuracy, and complication were collected and analyzed. Technical success of CT-guided PCNB for small lung nodules was 100%. A total of 141 nodules were punctured. The mean time of the procedure was 15.7 ± 4.3 minutes. The PCNB results included malignancy (n = 79), suspected malignancy (n = 6), specific benign lesion (n = 8), nonspecific benign lesion (n = 47), and invalid diagnosis (n = 1). The final diagnosis of the 141 nodules included malignancy (n = 90), benign (n = 37), and nondiagnostic lesion (n = 14). The nondiagnostic nodules were not included for calculating the diagnostic accuracy. The sensitivity, specificity, and overall diagnostic accuracy of CT-guided PCNB for small lung nodule were 94.4% (85/90), 100% (37/37), and 96.1% (122/127), respectively. Pneumothorax and lung hemorrhage (≥ grade 2) occurred in 17 (12.1%) and 22 (15.6%) patients, respectively. Based on the univariate and multivariate logistic analyses, the risk factors of pneumothorax included nonprone position (P = .019) and longer procedure time (P = .018). The independent risk factor of lung hemorrhage (≥ grade 2) was deeper lesion distance from pleura along needle path (P = .024). This study demonstrates that CT-guided PCNB can provide a high diagnostic accuracy for small lung nodule with acceptable complications.

Background: The program aims to evaluate the effectiveness and safety of cupping in patients with chronic urticaria (CU). Methods: We will search the databases including PubMed, Medline, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, China Science Journal Database, China National Knowledge Infrastructure, Wan-fang Database, and China Biomedical Literature Database from their inception to May 2019. In addition, we will manually search the list of medical journals as a supplement. The clinical randomized controlled trials or quasi-randomized controlled trials related to cupping for the treatment of CU will be included in the study. Data were synthesized by using a fixed-effect model or random effect model depend on the heterogeneity test. The primary outcome is the total effective rate. Secondary outcomes include skin disease quality of life index scores, adverse events, and recurrence rates. RevMan V.5.3 statistical software will be used for meta-analysis. If it is not appropriate for a meta-analysis, then a descriptive analysis will be conducted. Data synthesis will use the risk ratio and the standardized or weighted average difference of continuous data to represent the results. Results: This study will provide a comprehensive review of the available evidence to assess the effectiveness and safety of cupping for patients with CU. Conclusion: This systematic review (SR) will provide evidence to judge whether cupping is an effective intervention for patients with CU. Ethics and dissemination: The protocol of the SR does not require ethical approval because it does not involve humans. We will publish this article in peer-reviewed journals and presented at relevant conferences. Systematic review registration: PROSPERO, CRD42019137451

Rationale:Relapse is the main cause of death after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Unfortunately, there are no efficient methods to prevent relapse after allo-HSCT. Chimeric antigen receptor T (CAR-T) cells have achieved favorable outcomes in the treatment of

Background Chronic urticaria (CU) is a common and easily recurring skin disease in the world. Many trials have shown that autologous whole-blood or autologous serum acupoint injection therapy is effective in treating CU. There is currently no systematic review of this therapy. The program aims to evaluate the effectiveness and safety of this therapy in patients with CU. Methods Literature search will be conducted at Medline, PubMed, Excerpt Medica Database, Springer, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Chinese Scientific Journal Database, and other databases. The search date is until May 2019. We will search for popular terms including CU and this therapy. Import the literature electronically. Duplicate documents will be deleted. The primary outcome is the urticaria activity score or other validated scales. Secondary outcomes included response rate, quality of life scale, recurrence rate, and adverse events. A systematic review and search for a randomized controlled trial of this therapy for CU. Implement the Cochrane RevMan V5.3 bias assessment tool to assess bias assessment risk, data integration risk, meta-analysis risk, and subgroup analysis risk (if conditions are met). The mean difference, standard MD, and binary data will be used to represent continuous results. Results This study will provide a comprehensive review of the available evidence for the treatment of CU with this therapy. Conclusion This study will provide new evidence for assessing the effectiveness and side effects of this therapy for CU. Since the data is not individualized, there is no need for formal ethical approval. Prospero registration number CRD42019128364.

Introduction:The effect of high-flow nasal cannula (HFNC) on adult post cardiothoracic operation remains controversial. We conducted a meta-analysis of randomized controlled trials to evaluate the effect of HFNC and conventional oxygen therapy (COT) on postcardiothoracic surgery.Methods:A se

Supplemental Digital Content is available in the text, The assessment of pain in patients with brain injury is challenging due to impaired ability to communicate. We aimed to test the reliability and validity of the critical-care pain observation tool (CPOT) and the bispectral index (BIS) for pain detection in critically brain-injured patients. This prospective observational study was conducted in a neurosurgical intensive care unit in a University-Affiliated Hospital. Adult brain-injured patients undergoing mechanical ventilation were enrolled. Nociceptive (endotracheal suctioning) and non-nociceptive (gentle touching) procedures were performed in a random crossover fashion. Before and immediately after the procedure, CPOT was evaluated by 2 residents and 2 chief nurses, and BIS was documented. The ability to self-report pain was also assessed. The inter-observer reliability of CPOT was analyzed. The criterion and discriminant validities of the CPOT and the BIS were tested. During the study, we enrolled 400 brain-injured patients. The ability to self-report pain was maintained in 214 (54%) and 218 (55%) patients during suctioning and gentle touching, respectively. The intraclass correlation coefficients (95% confidence interval) for inter-observer reliability of CPOT ranged from 0.86 (0.83–0.89) to 0.93 (0.91–0.94). Using self-reported pain as the reference, the area under the receiver operating characteristic curve (95% confidence interval) was 0.84 (0.80–0.88) for CPOT and 0.76 (0.72–0.81) for BIS. When the 2 instruments were combined as either CPOT ≥2 or BIS ≥88 after the procedure, the sensitivity and specificity were 0.90 (0.85–0.93) and 0.59 (0.52–0.66), respectively; and when the 2 instruments were combined as both CPOT ≥2 and BIS ≥88, the sensitivity and specificity were 0.62 (0.55—0.68) and 0.89 (0.83–0.93). Both CPOT and BIS increased significantly after suctioning (all P

The etiology and pathogenesis of respiratory epithelial adenomatoid hamartoma (REAH) remain poorly understood, although some reports have suggested that REAH features an inflammatory process. T-helper type 9 (Th9) cells are a newly identified subset of CD4+ T-helper cells characterized by the expression of high levels of interleukin (IL)-9, which may promote inflammation. As REAH may involve an inflammatory process, we evaluated whether IL-9 and/or Th9 cells were present in REAH and compared the levels thereof to those of normal nasal mucosa. Eleven patients with REAH and 5 exhibiting cerebrospinal fluid leakage were included in the study. Flow cytometry was used to measure Th9 cell numbers, a cytometric bead assay was applied to measure IL-9 levels, and real-time polymerase chain reaction was used to quantify the levels of mRNA encoding IL-9. Th9 cells, IL-9 mRNA, and IL-9 were detected in all REAH and control samples. The proportion of Th9 cells in the patients with REAH was significantly greater than that in the controls. The expression levels of IL-9-encoding mRNA and IL-9 protein were significantly higher in the patients with REAH than in the controls. The Th9 cell subset was expanded, the synthesis of IL-9-encoding mRNA was upregulated, and IL-9 secretion was increased in REAH tissue, suggesting that Th9 cells play a central role in the pathogenesis of the disease.