More recently, cirrhotic patients with SIRS were reported to exhibit marked changes due to the accumulation of oxidatively modified albumin. There are several limitations to this study. First, it was a retrospective study based on a small population of patients who were all treated at a single location. Second, prognosis and mortality did not take into account variations that may have existed due to the different antibiotics being administered for treatment. Moreover, because only short-term mortality was evaluated, it is unknown whether DNI can predict long-term mortality in SBP as well. In conclusion, DNI at diagnosis of SBP is a useful prognostic factor for the determination of 30-day mortality. Patients with high DNI level should be cautiously monitored, and treatment strategies should be appropriately adapted for their future needs. Ulcerative colitis is a chronic disease characterized by diffuse mucosal inflammation within the colon, often with alternating periods of exacerbation and remission. This disease has conventionally been treated with 5-aminosalicylic acid, corticosteroids and oral immunosuppressant with the goals of achieving clinical or mucosal remission, and/or eliminating long-term corticosteroid use. However, these conventional therapies are in many instances ineffective or cannot be tolerated by the patients. This failure to pervasively treat UC patients is GW786034 citations apparent in the frequency of colectomies performed; the cumulative probability of colectomy from the time of diagnosis is 13.1% at 5 years, 18.9% at 10 years, and 25.4% at 20 years. This deficit in widespread, effective treatment of UC patients therefore warrants the development and study of alternative treatments. One potential alternative therapy is inhibition of tumor necrosis factor alpha as previous studies have established a correlation between increased production of TNF-a and UC pathophysiology. Currently, the anti-TNF-a agents most commonly used for UC treatment are infliximab and adalimumab. Intravenous and subcutaneous administration of IFX and ADA, respectively, has been shown by some studies to be effective for treating moderately to severely active UC. However, other studies pertaining to IFX treatment have yielded conflicting results. Another anti-TNF-a agents, golimumab, induces and maintains clinical remission in patients with moderate to severe UC as evidenced by two recent trials. The need for alternative UC therapies, as well as the range and conflicting reports found from studies on anti-TNF-a therapeutics, encouraged us to perform a meta-analysis to analyze the efficacy of these agents for UC patients who were intolerant or refractory to conventional medical therapy. Several systematic reviews and meta-analyses of TNF-a blockers as treatment for UC have been published in recent years _ENREF_10. However, these failed to fully take into account heterogeneity between the trials analyzed, including differences in the severity of UC in patients studied, drugs administered within the control group, and the point at which patient follow-up concluded. Moreover, the doses of the anti-TNF-a agent varied between different studies that had been included. As expected, these discrepancies skewed the results of the previous meta-analyses.