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Objective:To analyze the clinical and pathological characteristics of colorectal laterally spreading tumor (CLST) and provide reference for clinical diagnosis and treatment of CLST.Methods:From January 1, 2016 to June 30, 2021, the clinical data of patients with CLST who underwent endoscopic resection at the Second Affiliated Hospital of Dalian Medical University were retrospectively collected. The clinical and pathological characteristics of CLST were analyzed in terms of lesion location (right colon, left colon, rectum) and morphological type (granular-homogeneous type, granular-mixed type, flat-elevated type, and pseudo-depressed type). One-way analysis of variance, Pearson′s chi-square test and Fisher′s exact test were used for statistical analysis.Results:A total of 266 patients with CLST and 296 CLST lesions were included. The most common maximum diameters of the lesions were 10 to 29 mm, accounting for 85.1% (252/296). The main morphological type was granular type, accounting for 81.4% (241/296), and the main pathological type was adenoma, accounting for 79.7% (236/296), and the most common histological type was low-grade intraepithelial neoplasia (LGIN), accounting for 81.1% (240/296). The maximum diameter of CLST lesion of rectum was larger than that of the right colon and the left colon ((24.20±16.97), (18.38±8.24) and (18.59±7.95) mm, respectively), and the difference was statistically significant ( F=6.62, P<0.001). The detection rate of granular-homogeneous type CLST in rectum was lower than that in the right colon and the left colon (22.0%, 11/50, 53.5%, 69/129 and 58.9%, 69/117, respectively), while the detection rate of granular-mixed type CLST in rectum was higher than that in the right colon and the left colon (50.0%, 25/50; 29.4%, 38/129 and 24.8%, 29/117, respectively), and the differences were statistically significant ( χ2=20.06 and 10.67, both P<0.01). The incidence of adenoma in CLST in the right colon was lower than that in the left colon and rectum (68.2%, 88/129; 87.2%, 102/117 and 92.0%, 46/50, respectively), while the incidence of serrated adenoma in CLST in the right colon was higher than that in the left colon and rectum (30.2%, 39/129; 12.8%, 15/117 and 4.0%, 2/50, respectively), and the differences were statistically significant ( χ2=19.25 and 20.85, both P<0.001). The CLST in left colon was mostly treated by endoscopic submucosa dissection (94.9%, 111/117), while the CLST in rectum was mostly treated by endoscopic mucosal resection (20.0%, 10/50), and the difference was statistically significant ( χ2=8.77, P=0.012). The maximum diameter of the pseudo-depressed type CLST was larger than that of the granular-homogeneous type, granular-mixed type and flat-elevated type ((24.18±14.07), (15.96±5.70), (23.49±13.80) and (21.21±8.02) mm), and the difference was statistically significant ( F=13.40, P<0.001). The incidence of adenoma in flat-elevated type CLST was higher than that of the granular-homogeneous type, granular-mixed type and pseudo-depressed type (92.1%, 35/38; 71.1%, 106/149; 86.9%, 80/92 and 15/17, respectively), and the difference was statistically significant ( χ2=14.13, P=0.003). The incidence of serrated adenoma in the granular-homogeneous type CLST was higher than that of the granular-mixed type, flat-elevated type and pseudo-depressed type (28.9%, 43/149; 10.9%, 10/92; 5.3%, 2/38 and 1/17, respectively), and the difference was statistically significant ( χ2=19.98, P<0.001). The incidence of adenocarcinoma in the pseudo-depressed type CLST was higher than that of the granular-homogeneous type, granular-mixed type and flat-elevated type (1/17; 0, 0/149; 2.2%, 2/92 and 2.6%, 1/38, respectively), and the difference was statistically significant (Fisher′s exact test, P=0.049). The incidence of LGIN in the granular-homogeneous type CLST was higher than that of the granular-mixed type, flat-elevated type and pseudo-depressed type (90.6%, 135/149; 76.1%, 70/92; 65.8%, 25/38 and 10/17, respectively), while the incidences of high-grade intraepithelial neoplasia and carcinoma in the pseudo-depressed type CLST were higher than those of the granular-homogeneous type, granular-mixed type and flat-elevated type (6/17; 9.4%, 14/149; 21.7%, 20/92; 31.6%, 12/38 and 1/17; 0, 0/149; 2.2%, 2/92 and 2.6%, 1/38), and the differences were statistically significant( χ2=21.58 and 16.81 and Fisher′s exact test, all P<0.05). Conclusions:The clinicopathological characteristics of CLST have certain specificity. The maximum diameter and malignant potential of the rectal CLST are both larger and higher than those of the colonic CLST. Although the granular-mixed type CLST is the granular type, it shows a larger maximum diameter and a higher degree of malignancy.
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Objective:To analyze the willingness of elderly individuals from a certain community to choose different retirement care methods and factors influencing this in the community-embedded elderly care service complex.Methods:Stratified variable ratio sampling was used to select 500 elderly people from a certain community in Guangzhou. A self-developed questionnaire regarding willingness to choose retirement care in the community-embedded elderly care service complex was administered. Data were analyzed by multi-category logistic regression analysis.Results:Among the services involved in the community-embedded elderly care service complex, 57.6%, 31.2%, and 11.2% of the elderly selected family, community home, and institution care, respectively. Logistic regression analysis showed that seniors with college degrees or above ( OR=2.514), who were cared for by family ( OR=3.345), with a monthly income of 3 000-5 000 yuan ( OR=1.891), with monthly pension payments of 1 000-3 000 yuan ( OR=2.572), or with average health status ( OR=3.716) were more willing to choose community based retirement services (all P<0.05). Meanwhile, seniors with a better occupation before retirement ( OR=9.813), a monthly income of 3 000-5 000 yuan ( OR=3.222), monthly pension payment above 3 000 yuan ( OR=6.902), poor health status ( OR=1.000), or who were unattended ( OR=4.386) were more inclined to choose community institution care (all P<0.05). Conclusion:The elderly still rely mainly on family based retirement life, but their willingness to use socialized retirement is more prevalent. Educational level, occupation, economic status, caregivers, and health status are the main factors affecting the elderly′s choice of different pension methods in the community-embedded elderly care service complex.
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Objective:To explore the related factors of poor ovarian response (POR) in patients receiving controlled ovarian stimulation (COS) and to establish the nomogram for predicting POR in patients who received in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI).Methods:In this retrospective research, clinical data of 17 164 cycles of patients who received IVF/ICSI treatment at Henan Provincial People′s Hospital from September 1st, 2016 to September 1st, 2020 were analyzed. Independent correlative factors affecting the occurrence of POR were screened by logistic regression, which were the model enrollment variables in the prediction model. Totally 13 266 cycles with well-record of enrollment variables were screened, and these data were randomly divided into model group (9 896 patients) and validation group (3 370 patients) according to 3∶1. The nomogram was established according to the regression coefficient of the relevant variables. The prediction accuracy of the nomogram was evaluated by calculating area under the receiver operating characteristic curve (AUC).Results:Multivariate logistic regression analysis showed age, infertility type, body mass index, anti-Müllerian hormone, basal follicle stimulating hormone, basal estrogen, antral follicle number, previous times of POR, history of ovarian surgery, ovulation stimulation protocol and average amount of gonadotropin were independent correlative factors affecting the occurrence of POR (all P<0.05). In the model group, according to the above factors, the prediction model and nomogram of POR risk were constructed and the validation group verified the model. The AUC of the model group was 0.893 (95% CI: 0.885-0.900), and the AUC of the validation group was 0.890 (95% CI: 0.878-0.903). Conclusion:The influencing factors of POR after COS in patients treated by IVF/ICSI are screened, and the nomogram for predicting POR established in this study is proved to be effective, simple, intuitive and clear in predicting the occurrence of POR.
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OBJECTIVE:To improve the quality standard for Qiwei maqianzi pills.METHODS:TLC was used for the qualitative identification of Chebulae Fmctus and Aucklandiae Radix in the preparation.HPLC method was used for the content determination of hydroxy safflor yellow A,brucine and strychnine in preparation.The determination was performed on Phenomenex Prodigy C18 column with mobile phase consisted of methanol-acetonitrile-0.7％ phosphoric acid soulution(26 ∶ 2 ∶ 72,V/V/V,for hydroxy safflor yellow A),acetonitrile-0.01 mol/L sodium heptanesulfonate mixed with same quantity of 0.02 mol/L potassium dihydrogen phosphate (pH adjusted to 2.8 using 10％ phosphoric acid,21 ∶ 79,V/V,for brucine and strychnine) at the flow rate of 1.0 mL/min.The detection wavelengths were 403 nm (for hydroxy safflor yellow A) and 260 nm (for brucine and strychnine).The column temperature was 25 ℃C,and the injection volume was 10 μL.RESULTS:TLC spots of Chebulae Fructus and Aucklandiae Radix were clear and well-separated without interference from negative control.The linear range was 6.29-62.94 μg/mL for hydroxy safflor yellow A(r=0.999 3),1.83-18.30 μg/mL for brucine(r=0.999 4) and 2.11-21.11 μg/mL for strychnine (r=0.999 6).RSDs of precision,stability and reproducibility tests were lower than 2.0％.The recoveries were 101.66％-104.91％(RSD=1.14％,n=6),99.58％-104.55％ (RSD=1.75％,n=6) and 101.22％-104.04％ (RSD=0.99％,n=6),respectively.CONCLUSIONS:Improved standard can be better used for quality control of Qiwei maqianzi pills.
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Eighty-two newly-diagnosed type 2 diabetic patients with poor glycemic control were treated by mitiglinide calcium for 16 weeks.Plasma fibroblast growth factor-21 ( FGF-21 ) level were evaluated.The relationship of plasma FGF-21 levels with body mass index,body fat,waist-to-hip ratio,lipid,blood glucose,HbA1c,and free fatty-acid were analyzed.Plasma FGF-21 was decreased significantly by treatment with mitiglinide calcium in type 2 diabetic patients,and it may play a role in the pathogenesis of type 2 diabetes mellitus.
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<p><b>OBJECTIVE</b>To investigate the expression variation of RAR-β2, RASSF1A, and CDKN2A gene in the process of nickel-induced carcinogenesis.</p><p><b>METHODS</b>Nickel subsulfide (Ni(3)S(2)) at dose of 10 mg was given to Wistar rats by intramuscular injection. The mRNA expression of the three genes in induced tumors and their lung metastasis were examined by Real-time PCR. The methylation status of the 5' region of these genes were detected by Quantitative Real-time methylation specific PCR.</p><p><b>RESULTS</b>The mRNA expressions of the three genes both in muscle and lung tumor were decreased distinctly in comparison with normal tissue. But hypermethylation was found only in muscle tumor.</p><p><b>CONCLUSION</b>These findings suggest that loss of function or decrease of RAR-β2, RASSF1A, and CDKN2A, as well as the hypermethylation of 5' region of these genes, are related with nickel exposure.</p>