Background and aims Currently, surgical resection is the most commonly performed and effective treatment for intrahepatic cholangiocarcinoma (ICC) worldwide. However, the prognosis of ICC is unsatisfactory. This study aimed to compare the efficacy and safety of neoadjuvant chemotherapy followed by surgery and upfront surgery in treating intrahepatic cholangiocarcinoma (ICC). The study also intends to explore whether chemotherapy should be introduced before surgery and which populations should be considered for neoadjuvant chemotherapy. Method Four databases, including PubMed, EMBASE, Cochrane Library, and Web of Science, were searched from their inception dates to January 2022 for relevant articles. The statistical analysis was performed using the Review Manager Software (version5.3). The non-randomized interventions (ROBINS-I) was used to assess the methodological quality of included studies and the overall quality of evidence was assessed through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. Moreover, the primary outcomes included 1-year, 3-year and 5-year overall survival (OS), while the secondary outcomes were R0 resection, 1-year, 3-year and 5-year recurrence-free survival (RFS), postoperative complications and ninety-day postoperative mortality. Results Five studies involving 2412 patients were included in this meta-analysis. There was no significant difference in 1-year OS, 3-year OS, 1-year, 3-year and 5-year RFS, postoperative complications and ninety-day postoperative mortality between the two groups. However, the meta-analysis showed that the neoadjuvant chemotherapy group had a better 5-year OS benefit in ICC patients than the upfront surgery group (OR = 1.27, 95% CI: 1.02–1.58), while the R0 resection rate was lower in neoadjuvant chemotherapy group than that in the upfront surgery group (OR = 0.49, 95% CI: 0.26–0.91). Conclusion Compared with the upfront surgery, neoadjuvant chemotherapy followed by surgery could prolong the 5-year OS without increasing the risk of postoperative complications in ICC patients. Considering that the patients in the neoadjuvant chemotherapy followed by surgery group had more advanced ICC cases, the benefits of neoadjuvant chemotherapy may be more significant in patients with more advanced ICC.

Introduction Cervical hybrid surgery (HS) combines anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) to establish an individualized surgical plan for patients with multiple cervical disc degenerative diseases. In order to maintain the stability of the spine after HS, an external cervical collar is often used. However, there is still controversy regarding the importance of a cervical collar following surgery. This study aims to determine whether the cervical collar is effective and how long it should be worn after surgery. Methods This is a randomized, single-center, prospective, parallel-controlled trial. Eligible participants will be selected according to the inclusion and exclusion criteria. The primary outcome is the neck disability index, which will be evaluated before surgery and at one week, 3 weeks, 6 weeks, 3 months, 6 months, and 12 months following surgery. The secondary outcomes consist of the Japanese Orthopedic Association Scores, MOS 36-item short-form health survey (SF-36), visual analog scale, Pittsburgh Sleep Quality Index (PSQI), Bazaz dysphagia scoring system, Falls Efficacy Scale, cervical collar satisfaction score, neck soft tissue assessment, and Braden Scale, as well as radiologic assessments for cervical lordosis, disc height of the operative levels, fusion rate, range of motion (ROM), and complications including anterior bone loss, prosthesis migration, and heterotopic ossification. The clinical and radiologic examinations were performed by investigators with no therapeutic relationship with the individual patient. All radiographs were examined by one independent radiologist. Ethics and dissemination The results of this study will be published in peer-reviewed journals and presented at conferences. Upon completion of this trial, our findings could provide an appropriate cervical collar-wearing guideline for patients receiving HS. Trial registration ChiCTR.org.cn ChiCTR2000033002. Registered on 2020–05-17.

Background and Aims Currently, surgical resection is the most commonly performed and effective treatment for intrahepatic cholangiocarcinoma (ICC) worldwide. However, the prognosis of ICC is unsatisfactory. This study aimed to compare the efficacy and safety of neoadjuvant chemotherapy followed by surgery and upfront surgery in treating intrahepatic cholangiocarcinoma (ICC). The study also intends to explore whether chemotherapy should be introduced before surgery and which populations should be considered for neoadjuvant chemotherapy. Method Four databases, including PubMed, EMBASE, Cochrane Library, and Web of Science, were searched from their inception dates to January 2022 for relevant articles. The statistical analysis was performed using the Review Manager Software (version5.3). The non-randomized interventions (ROBINS-I) was used to assess the methodological quality of included studies and the overall quality of evidence was assessed through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. Moreover, the primary outcomes included 1-year, 3-year and 5-year overall survival (OS), while the secondary outcomes were R0 resection, 1-year, 3-year and 5-year recurrence-free survival (RFS) and mortality in 90 days. Results Five studies involving 2412 patients were included in this meta-analysis. There was no significant difference in 1-year OS, 3-year OS, 1-year, 3-year and 5-year RFS between the two groups. However, the meta-analysis showed that the neoadjuvant chemotherapy group had a better 5-year OS benefit in ICC patients than the upfront surgery group (OR = 1.27, 95% CI: 1.02–1.58), while the R0 resection rate was lower in neoadjuvant chemotherapy group than that in the upfront surgery group (OR = 0.49, 95% CI: 0.26–0.91). Conclusion Compared with the upfront surgery, neoadjuvant chemotherapy followed by surgery could prolong the 5-year OS in ICC patients. Considering that the patients in the neoadjuvant chemotherapy followed by surgery group had more advanced ICC cases, the benefits of neoadjuvant chemotherapy may be more significant in patients with locally advanced (stage II-III) ICC.

Background Recently, the role of long non-coding RNA small nucleolar host gene14 (SNHG14) in various human cancers has attracted much attention. We will investigate the effects of SNHG14 expression on clinicopathological features and prognosis of different types of human cancer patients by meta-analysis. Methods We had speculated the potential association between SNHG14 expression and the prognostic significance and clinical features of cancer patients during some studies were searched electronically using PubMed, EMBASE and Cochrane Library. Cochrane collaboration software (RevMan 5.3) was used to analyze the potential association between SNHG14 expression and prognostic significance and clinical features of cancer patients. Fixed and random-effects were used to measure pooled estimates. Corresponding odds ratios (OR) OR risk ratios (HR) and their 95% confidence intervals (CI) were compared to evaluate the prognostic value of SNHG14. Result Overall, 19 randomized controlled trials were included in this meta-analysis, with a total of 1221 patients. The high expression rate of SNHG14 in the TNM stage I-II group was lower than that in the stage III-IV group (OR = 0.63; 95% CI,0.45 ~ 0.88; P = 0.006). In terms of lymph node metastasis, the high expression rate of SNHG14 in the group without lymph node metastasis was significantly lower than that in the group with lymph node metastasis (OR = 0.47; 95%CI, 0.33 ~ 0.65, P＜0.00001); As for distant metastasis, the high expression rate of SNHG14 in the group without distant metastasis was lower than that in the group with distant metastasis (OR = 0.41; 95%CI, 0.20 ~ 0.83;P = 0.01). In terms of survival outcome, high SNHG14 expression was significantly associated with poor OS (HR = 1.56; 95%CI, 1.22 ~ 1.99, P = 0.0004). Conclusion High expression of LncRNA SNHG14 is significantly associated with poor prognosis and advanced clinical features, suggesting that LncRNA SNHG14 can be used as a potential biomarker for predicting prognosis and clinical features in patients with various cancers.