Background: The role of dietary inflammatory index (DII) in cardiovascular disease (CVD) risk and mortality is still controversial. This systematic review and meta-analysis of cohort studies aimed to evaluate the effect of DII, indicating a pro-inflammatory diet, on the incidence and mortality of CVD. Methods: A comprehensive literature search of articles published through August 2019 was performed in Medline, EMBASE, and Web of Science. The pooled relative risks (RRs) and 95% confidence intervals (CIs) for highest vs lowest DII in relation to CVD risk or mortality were estimated using a DerSimonian and Laird random effects model. The heterogeneity among studies was tested using Cochran's Q test and I 2 statistic. Results: A total of 15 cohort studies were finally included in this meta-analysis. The highest DII score was significantly associated with a higher risk of CVD incidence (RR = 1.41, 95% CI 1.12–1.78) or mortality (RR = 1.31, 95% CI 1.19–1.44), compared with the lowest DII score. There was statistically significant heterogeneity among the studies on the association between DII and CVD mortality (P < .001; I 2 = 70.8%). No obvious heterogeneity was observed among the studies on the association between DII and CVD risk (P = .160; I 2 = 37.0%). In the sensitivity analysis, exclusion of any single study did not materially alter the pooled RRs. Conclusion: The present systematic review and meta-analysis indicates that a higher DII score is related to a higher risk of CVD. Further well-designed prospective cohort or trials are warranted to validate our preliminary findings.

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Acute respiratory distress syndrome (ARDS) is a disease that seriously threatens human life and health. The aim of the study was to investigate the effects of ulinastatin combined with mechanical ventilation on oxygen metabolism, inflammation and stress response, as well as the antioxidant capacity of ARDS. Eighty patients with ARDS treated in Yiwu Central Hospital from January, 2015 to December, 2016 were enrolled in the present study and divided into the observation (n=40) and control (n=40) groups, using a random number table. The control group was treated with mechanical ventilation, while the observation group, based on treatment of the control group, was treated with ulinastatin for 14 consecutive days as one course of treatment. The changes in the relevant indexes of oxygen metabolism, lung function, time of ventilator treatment, total hospital stay, and St. George's Respiratory Questionnaire (SGRQ) score of the two groups after intervention were compared, and the changes in inflammatory cytokine levels, dopamine receptor-related hormone levels, superoxide dismutase (SOD), malondialdehyde (MDA) and total antioxidant capacity of the two groups before intervention and at 1 and 4 weeks after intervention were compared. After intervention, the arterial blood lactate in the observation group was significantly lower than that in the control group (P<0.05), the oxygen uptake rate was significantly higher than that in the control group (P<0.05) and the arterial oxygen content was significantly higher than that in the control group (P<0.05). In the lung function indexes, the FEV1 and FEV1/FVC levels in the observation group were smaller than those in the control group (P<0.05), the duration of ventilator treatment was significantly shorter than that in the control group (P<0.05), and the hospital stay was significantly less than that in the control group (P<0.05). Prior to intervention, SGRQ scores in the two groups were not statistically significant (P>0.05). At 1 and 4 weeks after intervention, the SGRQ scores of the observation group were significantly increased to those of the control group (P<0.05). The tumor levels of necrosis factor-α (TNF-α), interleukin-6 (IL-6) and CRP were significantly lower than those of the control group (P<0.05). The levels of adrenaline and norepinephrine were significantly lower than those of the control group (P<0.05). The levels of MDA, SOD and the total antioxidant capacity were significantly increased to those of control group (P<0.05). The application of ulinastatin combined with mechanical ventilation in ARDS patients is of great significance in improving the oxygen delivery-consumption balance of body, increasing the lung function, reducing the inflammatory and stress response, and improving the antioxidant capacity.

The association between alcohol consumption and venous thromboembolism (VTE) risk has been investigated by various observational studies with inconsistent results. We examined this association by performing a meta-analysis of prospective studies. A comprehensive literature search was carried out in the PubMed, EMBASE, and Web of Science from its inception to February 2020. Pooled effect estimates were calculated using a random effect model. Ten prospective studies (14 cohorts) were included in this meta-analysis with a total of 441,128 individuals and 10,221 VTE cases. Overall, the highest consumption of alcohol was not associated with the VTE risk compared with the lowest group [relative risk (RR), 0.96 (95% CI, 0.89-1.04), P = 0.293]. No obvious heterogeneity of RRs was observed across these studies (P = 0.249 for heterogeneity, I 2 = 18.8%). Egger's and Begg's tests showed no evidence of publication bias (Egger, P = 0.443; Begg, P = 0.730). In the subgroup analysis by sex, a borderline significant association between alcohol consumption and VTE risk was observed in women [RR, 0.91 (95% CI, 0.82-1.00)]. In the dose-response analysis, we observed a linear decrease in VTE risk with increasing alcohol intake (P = 0.634 for nonlinearity). However, the reduced risk was not statistically significant. In conclusion, the results from this meta-analysis suggest that alcohol intake is not related with the risk of VTE. Further large well-designed cohort studies are warranted to investigate a potential protective role of alcohol against VTE in women.

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