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Background: Platelet and blood coagulation abnormalities frequently occur in cancer patients. Fibrinogen is an important hemostatic factor that regulates the hemostatic pathway. Hyperfibrinogenemia is increasing recognized as an important risk factor influencing cancer development and outcome. However, few reports have investigated the prognostic potential of fibrinogen for predicting the survival of gastric cancer (GC) patients. The primary aim of this study was to evaluate the usefulness of preoperative serum fibrinogen as a biomarker for predicating tumor progression and survival of patients with GC.Patients and Methods: This retrospective study was conducted in GC patients who underwent gastrectomy from 2005 to 2007. Patient demographics, clinicopathological characteristics, preoperative plasma fibrinogen levels and median survival time (MST) were analyzed. Univariate and multivariate proportional hazard analysis of risk factors were used.Results: This study included 1196 patients (885 males and 311 females) with GC, more than half of whom had advanced GCs. Radical lymph node dissection was performed in 71.6 % of these patients. MST was 41.9 ± 32.4 months. Patient survival was significantly affected by family GC history (p <0.05), lymph node dissection mode (p <0.001), tumor size (≥5 cm; p <0.001), tumor location (p < 0.001), poor tumor differentiation (p <0.001), tumor histologic classification (p <0.001), extent of tumor invasion (p <0.001), number of metastatic lymph nodes (p <0.001), advanced stage of disease (p <0.001), extended operation duration (>150 min; p <0.001), higher operative bleeding volume (>200 ml; p <0.001), postoperative transfusion, preoperative serum fibrinogen levels, CEA levels and CA 19-9 levels (p <0.001). Multivariate analysis indicated that the independent prognostic factors significantly associated with poor survival included non-radical lymph node dissection, palliative lymph node dissection, multi-organ involvement, advanced TNM stages, poor tumor differentiation, higher preoperative serum fibrinogen levelsand higher CA19-9 levels.Conclusions: Serum fibrinogen levels are positively correlated with advanced tumor stages and poor survival in GC patients undergoing gastrectomy. Preoperative plasma fibrinogen levels are an independent risk factor for survival in these patients. Serum fibrinogen is a useful biomarker for patients with clinically advanced GC. [ABSTRACT FROM AUTHOR]

The objective of this study was to isolate, identify, and investigate lactic acid bacteria (LAB) present in tomato pomace. In total, we isolated 108 LAB strains and subsequently identified 16 species (87.5 % homofermentative LAB). Among these, the isolation of Lactobacillus harbinensis, L. manihotivorans, L. helveticus, L. camelliae, L. pontis, L. amylovorus, L. hilgardii, L. panis, L. vaginalis, and L. rapi from vegetable samples is reported for the first time. This is the first report to describe the diversity and natural populations of LAB associated with tomato pomace. The physiological and biochemical properties of the isolates could provide a platform for the future design of LAB inoculants aimed at improving silage quality. [ABSTRACT FROM AUTHOR]

Background: Previous meta-analyses have found several advantages of icodextrin compared with glucose in the application of peritoneal dialysis (PD), such as an improvement of peritoneal ultrafiltration during the long dwell and a reduction in episodes of uncontrolled fluid overload. However, the effect of icodextrin on patient-relevant outcomes remains unclear. This review aims to evaluate the benefits and harms of icodextrin in comparison with conventional glucose PD solution in patients with end-stage kidney disease receiving PD. Methods: Randomized controlled trials of icodextrin comparing with conventional glucose solution in patients with end-stage kidney disease who received PD will be deemed eligible. We will conduct systematic searches in MEDLINE, EMBASE, CENTRAL, Ichushi-Web, Chinese and Japanese databases, and in clinical trials registries (ClinicalTrials.gov, International Clinical Trials Registry Platform Search Portal (ICTRP), EU Clinical Trials Register, Japan Registries Network (JPRN), China's Clinical Trial Registry (ChiCTR)). Furthermore, we will check conference proceedings and search references from relevant studies manually. Relevant pharmaceutical companies, authors, and experts will be contacted in an effort to identify further studies. We will not apply any limitations regarding language, publication status, and publication date when searching for eligible studies. The selection of studies, data extraction, and risk of bias assessment will be carried out by two independent reviewers. Data synthesis will be performed using RevMan 5 software with either a fixed effects model or random-effects model, depending on the presence of heterogeneity. For the assessment of statistical heterogeneity, I2 will be calculated. Sources of clinical heterogeneity will be evaluated through subgroup analyses. If there are ten or more studies included in the meta-analysis, we will investigate the publication bias using funnel plots and Egger's test. The quality of the body of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Discussion: We assume that our systematic review will be more comprehensive compared to those published previously due to contacting the relevant pharmaceutical companies and a systematic search of published and unpublished non-English studies from China, Taiwan, and Japan. Systematic review registration: PROSPERO CRD42018096951 [ABSTRACT FROM AUTHOR]

Background: In the last few decades, health systems research (HSR) has garnered much attention with a rapid increase in the related literature. This study aims to review and evaluate the global progress in HSR and assess the current quantitative trends.Methods: Based on data from the Web of Science database, scientometric methods and knowledge visualization techniques were applied to evaluate global scientific production and develop trends of HSR from 1900 to 2012.Results: HSR has increased rapidly over the past 20 years. Currently, there are 28,787 research articles published in 3,674 journals that are listed in 140 Web of Science subject categories. The research in this field has mainly focused on public, environmental and occupational health (6,178, 21.46%), health care sciences and services (5,840, 20.29%), and general and internal medicine (3,783, 13.14%). The top 10 journals had published 2,969 (10.31%) articles and received 5,229 local citations and 40,271 global citations. The top 20 authors together contributed 628 papers, which accounted for a 2.18% share in the cumulative worldwide publications. The most productive author was McKee, from the London School of Hygiene & Tropical Medicine, with 48 articles. In addition, USA and American institutions ranked the first in health system research productivity, with high citation times, followed by the UK and Canada.Conclusions: HSR is an interdisciplinary area. Organization for Economic Co-operation and Development countries showed they are the leading nations in HSR. Meanwhile, American and Canadian institutions and the World Health Organization play a dominant role in the production, collaboration, and citation of high quality articles. Moreover, health policy and analysis research, health systems and sub-systems research, healthcare and services research, health, epidemiology and economics of communicable and non-communicable diseases, primary care research, health economics and health costs, and pharmacy of hospital have been identified as the mainstream topics in HSR fields. These findings will provide evidence of the current status and trends in HSR all over the world, as well as clues to the impact of this popular topic; thus, helping scientific researchers and policy makers understand the panorama of HSR and predict the dynamic directions of research. [ABSTRACT FROM AUTHOR]

Background: Translational medical research literature has increased rapidly in the last few decades and played a more and more important role during the development of medicine science. The main aim of this study is to evaluate the global performance of translational medical research during the past few decades.Methods: Bibliometric, social network analysis, and visualization technologies were used for analyzing translational medical research performance from the aspects of subject categories, journals, countries, institutes, keywords, and MeSH terms. Meanwhile, the co-author, co-words and cluster analysis methods were also used to trace popular topics in translational medical research related work.Results: Research output suggested a solid development in translational medical research, in terms of increasing scientific production and research collaboration. We identified the core journals, mainstream subject categories, leading countries, and institutions in translational medical research. There was an uneven distribution of publications at authorial, institutional, and national levels. The most commonly used keywords that appeared in the articles were "translational research", "translational medicine", "biomarkers", "stroke", "inflammation", "cancer", and "breast cancer".Conclusions: The subject categories of "Research & Experimental Medicine", "Medical Laboratory Technology", and "General & Internal Medicine" play a key role in translational medical research both in production and in its networks. Translational medical research and CTS, etc. are core journals of translational research. G7 countries are the leading nations for translational medical research. Some developing countries, such as P.R China, also play an important role in the communication of translational research. The USA and its institutions play a dominant role in the production, collaboration, citations and high quality articles. The research trends in translational medical research involve drug design and development, pathogenesis and treatment of disease, disease model research, evidence-based research, and stem and progenitor cells. [ABSTRACT FROM AUTHOR]

Background: Platelet and blood coagulation abnormalities frequently occur in cancer patients. Fibrinogen is an important hemostatic factor that regulates the hemostatic pathway. Hyperfibrinogenemia is increasing recognized as an important risk factor influencing cancer development and outcome. However, few reports have investigated the prognostic potential of fibrinogen for predicting the survival of gastric cancer (GC) patients. The primary aim of this study was to evaluate the usefulness of preoperative serum fibrinogen as a biomarker for predicating tumor progression and survival of patients with GC., Patients and Methods: This retrospective study was conducted in GC patients who underwent gastrectomy from 2005 to 2007. Patient demographics, clinicopathological characteristics, preoperative plasma fibrinogen levels and median survival time (MST) were analyzed. Univariate and multivariate proportional hazard analysis of risk factors were used., Results: This study included 1196 patients (885 males and 311 females) with GC, more than half of whom had advanced GCs. Radical lymph node dissection was performed in 71.6 % of these patients. MST was 41.9 ± 32.4 months. Patient survival was significantly affected by family GC history (p <0.05), lymph node dissection mode (p <0.001), tumor size (≥5 cm; p <0.001), tumor location (p < 0.001), poor tumor differentiation (p <0.001), tumor histologic classification (p <0.001), extent of tumor invasion (p <0.001), number of metastatic lymph nodes (p <0.001), advanced stage of disease (p <0.001), extended operation duration (>150 min; p <0.001), higher operative bleeding volume (>200 ml; p <0.001), postoperative transfusion, preoperative serum fibrinogen levels, CEA levels and CA 19-9 levels (p <0.001). Multivariate analysis indicated that the independent prognostic factors significantly associated with poor survival included non-radical lymph node dissection, palliative lymph node dissection, multi-organ involvement, advanced TNM stages, poor tumor differentiation, higher preoperative serum fibrinogen levelsand higher CA19-9 levels., Conclusions: Serum fibrinogen levels are positively correlated with advanced tumor stages and poor survival in GC patients undergoing gastrectomy. Preoperative plasma fibrinogen levels are an independent risk factor for survival in these patients. Serum fibrinogen is a useful biomarker for patients with clinically advanced GC.

Background: General practitioners (GPs) are the most important providers of primary health care, as proven by related research published several decades ago. However, the knowledge structure and theme trends of such research remain unclear. Accordingly, this study aimed to provide an overview of the development of research on GPs over the period of 1999 to 2014., Methods: Studies on GPs conducted from 1999 to 2014 were retrieved from PubMed. In this work, co-word, social network analysis, and theme trends analyses were conducted to reveal the knowledge structures and thematic evolution of research on GPs., Results: The number of conducted studies on GPs increased. However, growth speed slowed down during the past 16 years. A total of 27 high-frequency keywords were identified in 1999 to 2003, and more new and specific high-frequency keywords emerged in the subsequent periods. The dynamic of this field was first divergent and then considered convergent. Specifically, network centralization is 19.77%, 19.09%, and 13.04% in 1999 to 2003, 2004 to 2008 and 2009 to 2014, respectively. The major topics of research on GPs completed from 1999 to 2014 were "physician/family,""attitude of health personnel," and "primary health care," and "general practitioner" communities, and so on., Conclusion: The research themes on GPs are relatively stable at the beginning of the 21(st) century. However, the thematic evolution and research topics of research on GPs are changing dynamically in recent years. Themes related to the roles and competencies of GPs, and the relations between general practitioner and patients/others have become research foci on GPs. In addition, more substantial research especially on comprehensive approaches and holistic modeling, which have been defined in the European Definition of General Practice/Family Medicine, are expected to be accomplished.

Background: In recent years, China's healthcare reforms and related studies have drawn particular global attention. The main objective of this study is to evaluate quantitatively the publication trends and collaboration performance of China in healthcare science and services (HSS) research., Methods: Scientometric methods and visualization technology were used to survey the growth and development trends of HSS research based on the Web of Science publications during the past 15 years., Results: China's international publications on HSS research increased rapidly compared to those of the global HSS and Chinese scientific studies. Growth trends indicate that collaboration among countries, institutions and authors has also increased. China's leading partners were all developed countries, such as the US, the UK, Australia and Canada, which have contributed to the majority of the joint publications. The academic impact of publications involving partners from European and American countries was relatively higher than those involving partners from Asian countries. Prominent institutions were universities that could be primarily classified into two groups, namely, Mainland China on the one hand and Hong Kong universities and foreign universities on the other. The most prominent actors were elite institutions, such as Peking University, Fudan University, Chinese University of Hong Kong, University of Hong Kong. The papers published by the Chinese Ministry of Health had relatively high academic impact, whereas those published by Mainland China universities alone had a lower academic impact compared to foreign cooperation papers. Issues related to the Chinese healthcare reform, priority diseases (e.g., breast cancer, HIV/AIDS, tuberculosis, etc.), health systems performance, quality of life and measurement tools, aging problems and research methods have been the most popular HSS topics in China in recent years., Conclusions: Despite the extensive achievement of the Chinese HSS reforms and research, gaps and challenges remain to be addressed, including those related to health insurance and the effects of the evaluation of essential medicine systems, human resources training and allocation in the health sector, government hospitals reforms and health services systems remodeling. These findings could help scholars and decision-makers understand the current status and likely future trends of the Chinese HSS research, and help them select the most appropriate collaboration partners and policies.

Objective: To assess the impact of the National Essential Medicines Scheme (NEMS) with respect to urban-rural inequalities regarding drug prescriptions in primary care facilities., Methods: A stratified two-stage random sampling strategy was used to sample 23,040 prescriptions from 192 primary care facilities from 2009 to 2010. Difference-in-Difference (DID) analyses were performed to test the association between NEMS and urban-rural gaps in prescription patterns. Between-Group Variance and Theil Index were calculated to measure urban-rural absolute and relative disparities in drug prescriptions., Results: The use of the Essential Medicines List (EML) achieved a compliance rate of up to 90% in both urban and rural facilities. An overall reduction of average prescription cost improved economic access to drugs for patients in both areas. However, we observed an increased urban-rural disparity in average expenditure per prescription. The rate of antibiotics and glucocorticoids prescription remained high, despite a reduced disparity between urban and rural facilities. The average incidence of antibiotic prescription increased slightly in urban facilities (62 to 63%) and reduced in rural facilities (67% to 66%). The urban-rural disparity in the use of parenteral administration (injections and infusions) increased, albeit at a high level in both areas (44%-52%)., Conclusion: NEMS interventions are effective in reducing the overall average prescription costs. Despite the increased use of the EML, indicator performances with respect to rational drug prescribing and use remain poor and exceed the WHO/INRUD recommended cutoff values and worldwide benchmarks. There is an increased gap between urban and rural areas in the use of parenteral administration and expenditure per prescription.