Static cold storage (SCS) and hypothermic machine perfusion (HMP) are two primary options for renal allograft preservation. Compared with SCS, HMP decreased the incidence of delayed graft function (DGF) and protected graft function. However, more evidence is still needed to prove the advantages of the HMP. In this study, the outcomes of kidney grafts from the two preservation methods were compared by conducting a systematic review and meta-analysis. Randomized controlled trials (RCTs) comparing the effect of hypothermic machine perfusion and static cold storage in deceased donor kidney transplantation were identified through searches of the MEDLINE, EMBASE, and Cochrane databases between January 1, 1980 and December 30, 2017. The primary endpoints were delayed graft function and graft survival. Secondary endpoints included primary non-function (PNF), graft renal function, duration of DGF, acute rejection, postoperative hospital stay and patient survival. Summary effects were calculated as risk ratio (RR) with 95% confidence interval (CI) or mean difference (MD) with 95% confidence intervals (CI). A total of 13 RCTs were included, including 2048 kidney transplant recipients. The results indicated that compared with SCS, HMP decreased the incidence of DGF (RR 0.78, 95% CI 0.69-0.87, P < 0.0001), and improved the graft survival at 3 years (RR 1.06, 95% CI 1.02-1.11, P = 0.009). There was no significant difference in other endpoints. HMP might be a more desirable method of preservation for kidney grafts. The long-term outcomes of kidney allografts stored by hypothermic machine perfusion still need to be further investigated.

Background:Recently, the prognostic value of the platelet-to-lymphocyte ratio (PLR) has been identified in multiple cancers. However, the prognostic significance of the PLR in prostate cancer (PCa) remains conflicting. We therefore searched relevant studies and conducted a meta-analysis.Methods:Papers from the databases of PubMed, Web of Science, and the Cochrane Library were retrieved. Six studies comprising 1324 patients were included.Results:The pooled analysis demonstrated that an elevated PLR predicted poor overall survival (OS; HR = 1.85, 95% CI = 1.51–2.25, P < .001) and disease-free survival (DFS; HR = 1.4, 95% CI = 1.1–1.79, P = .007). Subgroup analyses showed that the PLR remained a significant prognostic factor for OS irrespective of ethnicity, tumor stage, or cut-off value. The PLR was an indicator of poor DFS in Asian patients, but not in Caucasian patients. No significant publication bias was detected.Conclusion:This meta-analysis showed that a high PLR was correlated with poor DFS and OS in patients with prostate cancer. Due to this meta-analysis being derived from a few studies, the results should be validated in clinical practice.

Objective: To evaluate the relationship between allium vegetable intake and risk of prostate cancer. Methods: A systematic literature search up to May 2013 was carried out in PubMed, EMBASE, Scopus, Web of Science, Cochrane register, and Chinese National Knowledge Infrastructure (CNKI) databases, and the references of retrieved articles were also screened. The summary relative risks with 95% confidence interval for the highest versus the lowest intake of allium vegetables were calculated. Heterogeneity and publication bias were also evaluated. Results: A total of nine epidemiological studies consisting of six case-control and three prospective cohort studies were included. We found a significantly decreased risk of prostate cancer for intake of allium vegetables (OR = 0.82, 95% CI 0.70, 0.97). Moreover, in the subgroup analysis stratified by allium vegetable types, significant associations were observed for garlic (OR = 0.77, 95% CI 0.64-0.91) but not onions (OR = 0.84, 95% CI 0.62-1.13). Conclusions: Allium vegetables, especially garlic intake, are related to decreased risk of prostate cancer. Because of the limited number of studies, further well-designed prospective studies are warranted to confirm the findings of our study.

ObjectivesThe aim of this study was to explore the prognostic value of ki67 as a marker in patients with non-muscle invasive bladder cancer (NMIBC) treated with BCG.MethodsStudies were systematically retrieved from the relevant databases (Web of Science, PubMed, Cochrane Library and Embase), and the expiry date was May 2017. The research steps referred to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement.ResultsA total of 11 studies that complied with the inclusion criteria were included. The expression of ki67 was not statistically significantly associated with recurrence-free survival (RFS) (HR 1.331; 95% CI 0.980 to 1.809). No significant heterogeneity was found among all included studies (I2=36.7%, p=0.148). The expression of ki67 was statistically significantly associated with progression-free survival (PFS) (HR 2.567; 95% CI 1.562 to 4.219), and the overexpression of ki67 was the risk factor for PFS. Significant heterogeneity was noted among all the included studies (I2=55.6%, p=0.021). The studies that might cause heterogeneity were excluded using the Galbraith plot, and then the meta-analysis was performed again. The results showed that the expression of ki67 was still associated with PFS (HR 2.922; 95% CI 2.002 to 4.266).ConclusionsThe overexpression of ki67 was the risk factor for PFS, and the relationship between the expression of ki67 and RFS was not statistically significant in patients with NMIBC treated with BCG intravesical immunotherapy. Well-designed, prospective, with a large sample size are still needed to validate the findings.