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51.
Type 2 diabetes mellitus (T2DM) is a major health problem, worldwide, that is associated with increased morbidity and mortality. Several randomized controlled clinical trials (RCTs) have investigated the effect of nettle (Urtica dioica) supplementation on markers of glycemic status in patients with T2DM, with conflicting results. Therefore, the present study assessed the effect of nettle on some glycemic parameters in patients with T2DM. A comprehensive search was conducted in PubMed, Scopus, Cochrane Library, and Web of Science, from database inception up to June 2019, to identify RCTs investigating the effect of nettle supplementation on glycemic markers, including fasting blood sugar (FBS) concentrations, insulin levels, homeostasis model assessment‐estimated insulin resistance index, and glycosylated hemoglobin percentage in adults with T2DM. The Cochrane Collaboration tool was used to assess the methodological quality of the included studies. Results of this meta‐analysis were reported based on the random effects model. Eight RCTs, comprising 401 participants, were included in the present systematic review and meta‐analysis. Based on the Cochrane Collaboration risk of bias tool, five studies were considered as good quality, one was fair, and two studies were poor, respectively. The results of the meta‐analysis revealed a significant reduction in FBS concentrations (weighted mean difference [WMD]: ?18.01 mg/dl, 95% confidence interval [CI]: ?30.04 to ?5.97, p < .001, I2 = 94.6%) following nettle supplementation. However, no significant reduction was observed in insulin levels (WMD: 0.83 Hedges' g, 95% CI: ?0.26 to 1.92, p = .13, I2 = 89.4%), homeostasis model assessment‐estimated insulin resistance index (WMD: ?0.22, 95% CI: ?0.83 to 0.40, p = .49, I2 = 69.2%), or glycosylated hemoglobin percentage (WMD: ?0.77%, 95% CI: ?1.77 to 0.22, p = .12, I2 = 83.0%). The findings of the present study suggest that nettle supplementation may be effective in controlling FBS for T2DM patients. However, further studies are needed to confirm the veracity of these results.  相似文献   
52.
Liu  R.  Zhou  J.  Xia  S.  Li  T. 《Clinical & translational oncology》2020,22(5):694-702
Clinical and Translational Oncology - The specific association between PTEN deletion or ERG rearrangement and the recurrence of prostate cancer (PC) treated with radical prostatectomy (RP) or...  相似文献   
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Background

Though the optimal treatment regimen in older patients with glioblastoma multiforme (GBM) remains to be established, multiple randomized studies have supported the use of hypofractionated (1–3?weeks) versus traditional regimens (6?weeks). Here we examine hypofractionated regimen practice patterns among older patients with GBM.

Methods

We used the National Cancer Database and included individuals aged ≥65?years with GBM diagnosed from 2005 to 2014 undergoing biopsy/resection followed by chemotherapy and radiation initiated ≤8-weeks of diagnosis. We defined traditional fractionation as ≤200?cGy and hypofractionation as >200?cGy. We compared patient characteristics using a chi-squared test and multivariable logistic regression. We compared 90-day mortality rates following initiation of radiation using the Wald statistic in propensity score matched cohorts.

Results

The final cohort included 14,931 individuals with 1524 undergoing hypofractionated treatment. From 2005 to 2014 hypofractionated utilization rates were 7%, 9%, 13%, and 18% among those 65–69, 70–74, 75–79, and ≥80?years of age, respectively. Patients treated at an academic/research center had a >60% increased odds (OR, 1.61; 95% CI, 1.43–1.81) of undergoing hypofractionated regimens versus a community center. Ninety-day mortality rates were high in both groups (hypofractionated: 32%; traditional: 24%; p?<?.001).

Conclusions

The majority of older GBM patients do not undergo hypofractionated radiation. High 90-day mortality in both groups suggests that hypofractionation may improve the survival-to-treatment time ratio and positively impact patient quality of life. Hypofractionated radiation regimens for GBM should be discussed with older patients and considered for inclusion in efforts to improve the quality and value of cancer care.  相似文献   
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