BackgroundThe present study focused on understanding the prognostic value of the methylenetetrahydrofolate reductase (MTHFR) single nucleotide polymorphisms rs1801133 (C667T) and rs1801131 (A1298C) in patients with colorectal cancer (CRC).MethodsA systematic literature search was conducted in March 2016. Databases, including Medline, EMBASE, Cochrane and Chinese databases (including CNKI, Wanfang and VIP), were searched to identify the relevant articles describing MTHFR polymorphisms in patients with CRC. Data regarding overall survival (OS), progression‐free survival (PFS) and disease‐free survival (DFS) were collected and analysed.ResultsTwenty‐four studies with 5423 patients with CRC were included. Significant differences in OS, PFS and DFS were not observed among the different comparisons of patients carrying different alleles of the MTHFR rs1801133 polymorphism (including TT versus CC, TT versus CT + CC, CT + TT versus CC and CT versus CC). Compared with patients with the rs1801131 CA + AA genotypes, patients with the CC genotype had a shorter OS (hazard ratio = 1.85; 95% confidence interval = 1.30–2.65) and DFS (hazard ratio = 2.16; 95% confidence interval= 1.19–3.93). Significant differences in OS, PFS and DFS were not observed among the other patient groups (including CC versus AA, CC + CA versus AA and CA versus AA). Subgroup analysis of rs1801133 and rs1801131 showed that patients with CRC from Asian regions and Western regions demonstrated similar results.ConclusionsThe MTHFR rs1801133 polymorphism was not associated with the prognosis of patients with CRC; however, rs1801131 may be associated with the prognosis of patients with CRC. Well‐designed prospective studies are necessary to obtain a better understanding of the prognostic value of rs1801133 and rs1801131.

Background Several descriptive studies have reported that higher neutrophil count (NC) may be correlated with poor prognosis in patients with confirmed COVID‐19 infection. However, the findings from these studies are limited by methodology and data analysis. Methods This study is a cohort study. We non‐selectively and consecutively collected a total of 663 participants in a Chinese hospital from January 7 to February 28. Standardized and two‐piecewise Cox regression model were employed to evaluated the association between baseline neutrophil count (bNC), NC change rate (NCR), and death. Results bNC had a U‐shaped association with death. In the range of 0.1 to ≤1.49×10 9 /L (HR = 0.19, 95% CI = 0.05 to 0.66) and > 3.55×10 9 /L of bNC (HR = 2.82, 95% CI = 1.19 to 6.67), the trends on bNC with mortality were opposite. By recursive algorithm, the bNC at which the risk of the death was lower was range of >1.49 to ≤3.55×10 9 /L (HR=13.64, 95%CI=0.25 to 74.71). In addition, we find NCRs (NCR1 and NCR2) is not associated with COVID‐19‐related deaths. Conclusions Compared with NCR, bNC has the potential to be used for early risk stratification in patients with COVID‐19 infection. The relationship between bNC and mortality was U‐shaped. The safe range of bNC was 1.64 to 4.0 ×10 9 /L. Identifying the correlation may be helpful for early risk stratification and medical decision making. This article is protected by copyright. All rights reserved.

Abstract. Cloacal exstrophy variants are comprised of a wide range of characteristics, of which there are four primary features, including omphalocele, bladder exstrophy, an imperforate anus and spina bifida. The existing literature regarding the differential diagnosis from alternative urinary diseases prenatally are limited. If the bladder is present, defects in the ventral wall may not be visualized with prenatal ultrasound in certain conditions, including oligohydramnios, and differential diagnosis from urorectal septum malformation sequence is a challenge. In order to improve the diagnosis of cloacal exstrophy variants, the present study investigated the misdiagnosis of a cloacal exstrophy variant as a urorectal septum malformation in a fetus by ultrasound and analyzed the reasoning of diagnosis in detail.