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Objective:To investigate the risk factors of restenosis after dilation of anastomotic stenosis in patients with esophageal cancer surgery.Methods:Clinical data of 997 patients who underwent endoscopic dilation due to anastomotic stenosis after esophageal cancer radical surgery in the Affiliated Huai′an First Hospital of Nanjing Medical University from June 2015 to July 2021, were retrospectively analyzed. There were 486 cases receiving single dilation (single dilation group) and 511 cases receiving more than two dilations (multiple dilation group). The risk factors of restenosis were explored using univariate and multivariate logistic regression analysis.Results:There were 682 males and 315 females with a median age of 65 years, the median distance between the stenosis and incisor was 20 (20, 22) cm, the median stenosis diameter was 4 (3, 5) mm, and the median stenosis diameter after dilation was 11 (11, 13) mm. Univariate analysis showed that there were significant differences in the distance of the stenosis and incisor ( Z=-2.303, P<0.05), stenosis diameter ( Z=-4.637, P<0.05) and stenosis diameter after dilation ( Z=-5.773, P<0.05) between single and multiple dilation groups. Stratified multivariate logistic regression showed that for male patients, risk of multiple dilations dropped by approximately 3% for every 1-mm increase in the distance between the stenosis and incisor ( OR=0.97, 95% CI:0.93-1.00, P=0.047); the risk of multiple dilations decreased by about 15%, for every 1-mm increase in stenosis diameter ( OR=0.85, 95% CI:0.76-0.94, P=0.004); the risk of multiple dilations decreased by about 13% for every 1-mm increase in stenosis diameter after dilation ( OR=0.87, 95% CI:0.78-0.96, P=0.007). For females patients under 60 years old, the risk of multiple dilations decreased by about 31%, for every 1-mm increase in stenosis diameter after dilation ( OR=0.69, 95% CI:0.47-0.98, P=0.049); for female patients≥60 years old, the risk decreased by about 5%, for every 1-year increase in age ( OR=0.95, 95% CI:0.91-1.00, P=0.037), risk of multiple dilations dropped by 17%( OR=0.83, 95% CI:0.70-0.99, P=0.039) for every 1 mm increase in stenosis diameter after dilation. Stratified smooth curve fitting indicated that the distance between the stenosis and incisor≤23 mm, stenosis diameter≤4.5 mm, stenosis diameter after dilation≤12 mm were risk factors for multiple dilations. Conclusions:The study indicates that patients with the distance between the stenosis and incisor≤23 mm, stenosis diameter≤4.5 mm, stenosis diameter after dilation≤12 mm may need multiple dilations; and the first dilation should expand the stenosis diameter to 12 mm or above as far as possible to reduce the risk of restenosis in patients receiving esophageal cancer radical surgery.
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Objective:To study the association of non-alcoholic fatty liver disease(NAFLD) and advanced liver fibrosis with osteoporosis in patients with type 2 diabetes mellitus(T2DM).Methods:Data was collected from 391 in-patients with type 2 diabetes mellitus(T2DM) from September 2019 to September 2020 at the Department of Endocrinology and Geriatric Medicine, Affiliated Huai′an First Hospital of Nanjing Medical University in this cross-sectional study. Participants were divided into T2DM with coexistent NAFLD(TCN) and with no NAFLD(TON) group via liver B-mode ultrasound.Also, the patients were divided into low and middle-high risk group via fibrosis index based on 4 factors index(FIB-4). Participant characteristics, laboratory results, and dual energy x-ray absorptiometry were obtained and analyzed. Multivariable logistic regression models were used to evaluate the association of NAFLD and advanced liver fibrosis with osteoporosis in T2DM. Interaction and stratified analyses were conducted according to age, sex, body mass index(BMI) and duration of diabetes(DD).Results:There was no significant difference in risk of osteoporosis and bone mineral density(BMD) loss between TCN and TON group(all P>0.05). After adjusting for age, sex, BMI, and DD, total hip BMD( β=-0.044, 95% CI -0.087--0.001, P=0.046) and lumbar L 1-L 4BMD( β=-0.044, 95% CI -0.087--0.002, P=0.044) were significantly reduced, and the risk of osteoporosis was significantly increased( OR=2.428, 95% CI 1.124-5.244, P=0.024) in FIB-4 middle-high risk group compared with low risk group. The subgroup analysis showed that overweight patients with T2DM had a significantly increased risk of osteoporosis( OR=4.240, 95% CI 1.637-10.987, interaction P=0.018) in FIB-4 middle-high risk group compared with low risk group. Conclusion:There was no significant difference in risk of osteoporosis and BMD loss between TCN and TON group. However, among T2DM patients who were overweight, NAFLD-related progressive liver fibrosis emerged as an independent risk factor for both BMD decline and the development of osteoporosis.
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Parkinson's disease (PD) is a common neurodegenerative disease in middle-aged and elderly people. Patients with PD often suffer from gastrointestinal symptoms in the early stage of the disease. Several studies have confirmed that gut microbiota is involved in the progress of PD. As one of the most effective ways to reconstruct the gut microbiota, fecal microbiota transplantation (FMT) has shown potential therapeutic effects on PD. This review summarizes the basic and clinical studies of FMT in the treatment of PD.
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Aged , Humans , Middle Aged , Fecal Microbiota Transplantation , Gastrointestinal Microbiome , Neurodegenerative Diseases , Parkinson Disease/therapyABSTRACT
OBJECTIVE: To analyze the inter-laboratory comparison results of occupational hygiene laboratories of Guangdong Province. METHODS: The 42 laboratories that continuously participated in the inter-laboratory comparison of occupational hygiene technical service institutions in Guangdong Province from 2014 to 2018 were selected as the research subjects Guangdong Occupational Health Test Center from 2014 to 2018 were selected by convenient sampling method. The data of detection of organic compounds, metal element, non-metal element in the workplace air, detection of metal element in biological materials, and the detection of free silica in dust were analyzed. The results were statistically analyzed by four-point robust statistical technique. RESULTS: From 2014 to 2018, a total of 1 205 items of sample detection results were submitted in these 5 years. The qualified rate of sample test was 92.4%(1 114/1 205) in these laboratories. The qualified rate of test of organics in workplace air, metals in workplace air, inorganic non-metals in workplace air, metals in biological materials and free silica in dust were 93.3%, 94.4%, 91.6%, 84.4% and 91.8% respectively. There was no significant difference in the qualified rate of sample test between the laboratories in the Pearl River delta in Guangdong Province and the laboratories in other regions the laboratories in other regions(92.8% vs 89.6%, P>0.05). There was no significant difference in the qualified rate of sample test among the occupational disease prevention and treatment institute, center for disease control and prevention and private laboratories(93.1% vs 93.6% vs 89.0%, P>0.05). Among the 91 unqualified items, 35 items were │z score of inter-laboratory(z_B)│≥ 3(38.5%), 40 items were │z score of within-laboratory(z_w)│≥ 3(44.0%), and 16 items were│z_B│≥ 3 and │z_w│≥ 3(17.6%). CONCLUSION: The laboratories in Guangdong Province that participated in the inter-laboratory comparison of occupational health test for 5 consecutive years have a relatively high level of occupational health testing, and the test results are accurate.
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OBJECTIVE: To analyze the results of inter-laboratory comparison among occupational hygiene laboratories. METHODS: A convenient sampling method was used. The laboratories participating in the inter-laboratory comparison organized by the Guangdong Occupational Health Test Center from 2013 to 2017 were selected as study subjects. The data of detection of organic compounds, metal element, inorganic non-metal element in workplace air, detection of metal element in biological materials, and detection of free silica in dust were analyzed. The results were statistically analyzed by four-point robust statistical technique. RESULTS: A total of 615 laboratories(times) participated in the comparison, and 2 785 items of sample detection results were submitted from 2013 to 2017.Among them, a total of 2 484 items were tested qualified and the sample test qualified rate was 89.2%. The test qualified rates of organics in workplace air, metals in workplace air, inorganic nonmetals in workplace air, metals in biological materials and free silica in dust were 91.1%, 92.0%, 86.6%, 80.4% and 85.0%, respectively. The sample test qualified rates of the laboratories in different regions from high to low were: the laboratories Pearl River Delta region in Guangdong Province, the laboratories in non-pearl river delta region in Guangdong Province and the laboratories outside of Guangdong Province were 91.6%, 87.2% and 72.6%(P<0.01), respectively. The sample test qualified rate of the public laboratories was higher than that of the private laboratories(90.3% vs 87.0%, P<0.05). CONCLUSION: The accuracy of the occupational hazard factor test in the participating laboratories needs to be improved. It is necessary to further strengthen the investment, supervision and management to non-pearl river delta region laboratories and private laboratories in Guangdong Province.
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OBJECTIVE: To investigate the individual external dose level of medical radiation staffs in Guangzhou City.METHODS: The medical radiation staffs of Guangzhou City who conducted individual dose monitoring at Guangdong Province Hospital Center for Occupational Diseases Prevention and Treatment from 2008 to 2014 were selected as study subjects by convenient sampling method.Their individual dosage monitoring data were analyzed.RESULTS: A total of 17 754 person-times were monitored in 7 years.The annual collective effective dose was 10 621.1 person·mSv and the median per capita annual effective dose was 0.21 mSv/a.The per capita annual effective dose in 2008-2012 showed an increasing trend each year( P < 0.05),peaked in 2012,and then decreased in 2013 and 2014( P < 0.05).The per capita annual effective dose of radiology staffs in level Ⅱ medical institutions was higher than that of level Ⅲ medical institutions,level Ⅰ medical institutions and those below level Ⅰ( P < 0.01).The per capita annual effective dose of radiation staffs in level Ⅲ medical institutions was higher than level Ⅰ medical institutions and those below level Ⅰ( P <0.01).The effective monitoring rates of radiation staffs monitored for 4 cycles every year increased with time from 2008 to 2014( P < 0.01).The effective monitoring rate increased with the hospital level( P < 0.01).The per capita annual effective dose of the staffs in radiological diagnosis department was lower than that of clinical nuclear medicine,radiotherapy and interventional radiology( P < 0.01).CONCLUSION: The radiation dose of medical radiation staffs in Guangzhou City was within the national standard limit.Protection should be focused on the the staffs in secondary hospitals,clinical nuclear medicine,radiotherapy and interventional radiology.
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OBJECTIVE: To evaluate the technical level and ability of the detection of free silica in dust in occupational health technical service institutions of Guangdong Province through inter-laboratory comparison. METHODS: The interlaboratory detection of free silica in dust in 55,61,58 and 66 occupational health technical service institutions were carried out and compared in 2012-2015. The results were statistically analyzed by four points robust statistical technique,and the relative deviation between the laboratory test results and the Median of them was used as the auxiliary evaluation index of the laboratory's technical ability. RESULTS: The stable coefficient of variation(CV) of samples with free silica content > 20. 00% was less than 5. 00%,and the stable CV of samples with free silica content ≤20. 00% was more than5. 00%. The qualified rate in 2012-2015 were 89. 09%,81. 97%,77. 59% and 81. 82%,respectively. There was no statistical difference(P > 0. 05) in the annual reference between private and non-private institutions compared to the qualified rate in 2012-2015. There was no statistical difference(P > 0. 05) in the qualified rate of the institutions in the Pearl River Delta region and in the non-triangular regions of the Pearl River Delta in 2012-2015. CONCLUSION: Comparison of the detection technology service ability in the detection of free silica in dust should be conducted to improve its technical service quality.
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Objective To study the effectiveness and safety of different endoscopic papillary balloon dilation time in treatment of common bile duct stones. Methods 45 patients with common bile duct stones received ERCP treat﹣ment, and they were randomly divided into short-term and long-term balloon dilatation group, then compared opera﹣tive time, intraoperative and postoperative complication rate, hospitalization days and the total cost of hospitalization between the two groups. Results Short-term group included 22 people, the long term group included 23 people, there were no significant difference in stones' size, number and diameter of common bile duct between the two groups (P> 0.05), however, the success rate of surgery, time of stones' extraction, intraoperative complications and postoperative fistula were significant differences (P<0.05). Conclusion Long-term balloon dilation during ERCP for treatment of common bile duct stones can improve the success rate of stone removal and reduce complications.
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Body mass index [BMI] has been demonstrated to be associated with serum uric acid [SUA] level in many developed countries, however, there is still a lack of large sample study in Jiangsu Province, one of the most economically developed regions in China, where fat-rich diet is common. Through retrospective analysis in healthy subjects, we determined the association of BMI with hyperuricemia risk. Data of 39,736 participants from January 2011 to June 2013 in China were analyzed for parameters including physical examinations and biochemical blood analysis. On univariate analysis, SUA was positively correlated with age, SBP, DBP, BMI, FPG, red blood cell count, hemoglobin, white blood cell count, platelet, cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol, ALT, AST, bilirubin, albumin, BUN and creatinine. SUA was significantly elevated in a linear fashion as BMI increased, and SUA in obesity was significantly higher than underweight. The prevalence of hyperuricemia remained approximately 2.98 times greater among individuals with overweight, and 5.96 times greater among obesity, compared to individuals with underweight. There is a positive relationship between BMI and SUA among healthy subjects in Jiangsu province, China
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Humans , Male , Female , Body Mass Index , Cross-Sectional Studies , Retrospective StudiesABSTRACT
Objective To investigate the value of endoscopic submucosal dissection (ESD) and submucosal tunneling endoscopic resection (STER) for the diagnosis and therapy of gastric ectopic pancreas.Methods A total of 86 patients who were suspicion diagnose with gastric ectopic pancreas received ESD or STER in hospital,and the therapeutic effect and safety were followed-up.Results Fifty-four gastric ectopic pancreas patients were definitely diagnosed by postoperative pathology.Of the 54 patients,43 cases were located at the gastric antrum,7 cases were located at gastric fundus and gastric corpus juncture,4 cases were located at gastric corpus.Forty-five cases received ESD,9 cases received STER,rate of completely resection was 88.9％ (48/54),6 cases had a little tissue residual after resection.One case (1.9％,1/54) happened postoperative delay-bleeding,intraoperative and postoperative perforation was not found.During 1-32 months followed up,recurrence was not found.Conclusion ESD could excise the whole lesion to offer an accurate pathology diagnose,meanwhile good for treatment,ESD is an effective and relatively safe method for gastric ectopic pancreas,STER may be a new approach for gastric ectopic pancreas.
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Objective To analyze the kinds and diug resistance of bacterial.Methods 1 200 cases were detected who used the antimicrobial drugs.The drug use and drug resistance were investigated.Results 612 bacterias were isolated from the 1 200 patients,the rate was 51.0％.The top five pathogens were Pseudomonas aeruginosa,fungi,Escherichia coli,Klebsiella pneumoniae,Pseudomonas alcaligenes etc..The Cefoperazone/sulbactam and imipenem against Pseudomonas aeruginosa,Escherichia coli and Klebsiella pneumoniae had better antibacterial activity,and the cefazolin,cotrimoxazole and chloramphenicol antibacterial activity were relatively low.Conclusion The clinical use and drug resistance in different regions are unique,it should pay attention to the pathogenic examination and drug susceptibility testing,early and timely antimicrobial therapy.
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ObjectiveTo investigate the possible association of interleukin-23 receptor(IL-23R) polymorphisms with the susceptibility and phenotype of inflammatory bowel diseases (IBD) in Jiangsu Han population.MethodsWe genotyped 178 IBD patients including 135 patients with ulcerative colitis ( UC),43 patients with Crohn's disease (CD),and 134 headthy controls for rs11805303,rs1343151,rs11465804,rs11209032,rs17375018,rs11465788.ResultsComparing with the controls (50.4％ ),there was a significant increase in the carriage of the T allele of rs11805303 in UC (60.4％) ( P =0.020).In genotypephenotype correlation of rs17375018 in UC,clinical severity(UCDAI) was associated with the prevalence of the G allele showed a trend to mild activity.Genotype polymorphisms of rs17375018A was observed more in younger than 25 in the genotype-phenotype correlation in CD(41.7％ vs 22.0％,P =0.050,OR =2.532,95％ CI 0.988-6.494),while rs11805303 was associated with age at diagnose and disease lesion (P =O.039 and 0.044).The risk of extra intestinal manifestation in rs17375018A allele carriers was lower (23.1％ vs46.7％,P=0.040,OR =2.917,95％CI 1.027-8.283).ConclusionsWe confirmed the susceptibility of rs11805303polymorphisms with UC and first demonstrated the genotype-phenot correlation of rs11805303,rs17375018 with UC,CD in Jiangsu Han population.
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Objective To investigate the correlation between single nucleotide polymorphisms (SNP) of gene interleukin-23 receptor (IL-23R) rs1004819, rs1495965, rs1884444, rs2201841,rs6677188, rs7517847, rs7530511, rs10489629, rs10889677 and rs11209026 with susceptibility of inflammatory bowel disease (IBD) in Han population of Jiangsu province in China. Methods The gene polymorphism in 134 healthy volunteers, 135 cases of ulcerative colitis(UC) and 43 cases of Crohn's disease(CD) were detected with SNaPshot. Experimental data were analyzed with SPSS 17.0 software. Results In UC, genotype frequency of CC and CT on rs7530511 was 99.26％ (134/135)and 0.74％(1/135), allele frequency of C and T was 99.63％(269/270)and 0. 37％(1/270). While in normal controls, which were 94.03％(126/134), 5.97％(8/134), 97.01 ％(260/268)and 2.99％(8/268)respectively. Compared genotype frequency of these two group, P value was 0. 040 (OR＝0.118、95％CI:0.014～0.953). Compared allele frequency of these two group, P value was 0. 043 (OR＝0.121、95％CI:0.015～0.973). In wild type and mutation type UC patients, the age distribution was different, more young patients in mutation type while more middle-aged patients in wild type, P value was 0.032 and 0.001 respectively. Most UC patients of rs6677188 AT type were in remission under endoscope (P＝0.032). Conclusion The mutation of IL-23R rs7530511 may be a protective factor of UC. The polymorphism of rs6677188 was associated with the age of patients and the remission under endoscope.
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Objective To study the pollution of organic components in landfill leachates which produced from industrial city-Z and their cytogenetic toxicity. Methods The landfill leachates and groundwater samples collected from an industrial city-Z were analyzed by GC-MS and determined by micronucleus test of the root-tip cells of Vicia faba. The organic extracts of the landfill leachates samples were also determined by micronucleus test of early spermatids of mice exposed to organic extracts to be tested via peritoneal injection. Results Benzene, phenol, B(a)P were found in this two samples. Significantly higher levels of micronucleus rates of the root-tip cells of Vicia faba were observed in the original landfill leachates and diluted samples(1∶10,1∶2)compared with those of the negative samples(P