BackgroundTo compare surgical and oncological outcomes of laparoscopic versus open liver resection for colorectal liver metastases.ResultsA total of 14 retrospective studies with 1679 colorectal liver metastases patients were analyzed: 683 patients treated with laparoscopic liver resection and 996 patients with open liver resection. With respect to surgical outcomes, laparoscopic compared with open liver resection was associated with lower blood loss (MD, -216.7, 95% CI, -309.4 to -124.1; P < 0.00001), less requiring blood transfusion (OR, 0.36; 95% CI, 0.23 to 0.55; P < 0.00001), lower postoperative complication morbidity (OR, 0.61; 95% CI, 0.47 to 0.80; P = 0.003), and shorter hospitalization time (MD, -3.85, 95% CI, -5.00 to -2.71; P < 0.00001). However, operation time and postoperative mortality were no significant difference between the two approaches. With respect to oncological outcomes, laparoscopic liver resection group was prone to lower recurrence rate (OR, 0.78; 95% CI, 0.61−0.99; P = 0.04), but surgical margins R0, overall survival and disease-free survival were no significant difference.Materials and MethodsWe performed a systematic search in MEDLINE, EMBASE, and CENTRAL for all relevant studies. All statistical analysis was performed using Review Manager version 5.3. Dichotomous data were calculated by odds ratio (OR) and continuous data were calculated by mean difference (MD) with 95% confidence intervals (CI).ConclusionsLaparoscopic and open liver resection for colorectal liver metastases have the same effect on oncological outcomes, but laparoscopic liver resection achieves better surgical outcomes.

The principal objective of this present study was to compare the effects of different acupuncture methods on pain, stiffness, and physical function for osteoarthritis of the knee by the pairwise and network meta-analysis (NMA). A network meta-analysis of randomized controlled trials (RCTs) was searched from three English databases and one Chinese database until January 2018. A pairwise meta-analysis was performed with a random effects model. Then we carried out the NMA within a Bayesian framework. Mean difference (MD) and its 95% confidence interval (CI) were calculated by R 3.4.1, Stata 14.0, and RevMan 5.3 software to assess the relief of pain, the effectiveness for stiffness, and physical function recovery. Node-splitting method was used to calculate the inconsistency. Rank probabilities were assessed and clustered by the surface under the cumulative ranking curve (SUCRA). 16 trials mostly researched short-term effectiveness and showed that fire needle and electro-acupuncture were statistically significant to decrease WOMAC pain and physical function scores when compared with other treatments, but there was no significant difference in stiffness calculations. Our NMA demonstrated that acupuncture with heat pain or electrical stimulation might be suggested as the better choices in all acupuncture methods to osteoarthritis of the knee.

To investigate the association between alcohol consumption and multiple sclerosis risk, we performed a systematic literature search of PubMed, EmBase and Web of Science databases for all relevant articles regarding alcohol and multiple sclerosis. Our meta-analysis consisted of 10 studies, including nine case-controls and one cohort study. The odds ratios (OR) of the association between alcohol consumption and multiple sclerosis were 0.92 [95 % confidence interval (CI) 0.73-1.17] overall, 0.91 (95 % CI 0.39-2.41) for prospective study, and 0.92 (95 % CI 0.72-1.19) for retrospective studies. In addition, neither subgroup analyses nor sensitivity analyses showed a substantially change in the pooled OR and 95 % CI. Meta-analysis showed that there is no evidence that alcohol consumption is associated with an increased risk of multiple sclerosis. There may be a potential protective effect of alcohol consumption on MS incidence, however, this trend may not be obvious and should be validated by further research.

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