Predicting value of serum CEA and CA19-9 in neoadjuvant chemotherapy for advanced gastric carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the predictive value of CEA and CA19-9 in tumor progression, prognosis and neoadjuvant chemotherapy of advanced gastric cancer.</p><p><b>METHODS</b>Clinical data of 322 patients with advanced gastric cancer(54 cases undergoing neoadjuvant chemotherapy) from the Affiliated Oncologic Hospital of Guangzhou Medical College were reviewed. Serum CEA and CA19-9 levels were detected by electrochemiluminescence immunoassay, while the expression of CEA and CA19-9 protein in 54 pairs of tumor tissues and matched biopsies neoadjuvant chemotherapy were determined by immunohistochemistry.</p><p><b>RESULTS</b>The expression levels of serum CEA and CA19-9 were closely related to tumor invasion, lymph node metastasis and TNM stage(all P<0.05). The 5-year cumulative survival rates of patients with serum CEA-positive and CA19-9-positive were 17.0% and 11.9%, compared with 34.6% and 34.8% of the patients with serum CEA-negative and CA19-9-negative respectively (both P<0.05). Neoadjuvant chemotherapy could down-regulate CEA and CA19-9 expressions in tumor tissues(P<0.05), while there was no significantly difference in serum level(P>0.05).</p><p><b>CONCLUSIONS</b>The expressions of serum CEA and CA19-9 are closely associated with tumor progression and prognosis in advanced gastric cancer. However, further study should be done to evaluate their value in selecting patients to receive neoadjuvant chemotherapy.</p>

Association of transforming growth factor-β1 gene +869T/C polymorphism with autoimmune thyroid disease / 中国地方病学杂志

Objective To clarify whether the +869T/C polymorphism in the transforming growth factor-β1 (TGF-β1) gene is associated with TGF-β1 expression,and involved in the severity of Graves disease(GD) and Hashimoto's thyroiditis(HT).Methods The TGF-β1+869T/C polymorphism was genotyped by using PCR-sequence specific primers(PCR-SSP) in genomic DNA samples in blood from 158 patients with HT who developed hypothyroidism before they were 45 years old (severe HT) and 125 untreated,euthyroid patients with HT who were older than 45(mild HT).Using the same method,129 euthyroid patients with GD who had been under treatment and were still positive for anti-thyrotropin receptor antibodies (intractable GD) and 130 euthyroid patients with GD in remission and 144 healthy controls were examined.Results It had no difference between GD,HT groups and control group (x2 =1.488,0.439; 0.626,0.005; all P ＞ 0.05 ).The frequency of the TT genotype and the T allele were higher in group with severe HT[34.81％(55/158),58.86％( 186/316)] than in those with mild HT[ 17.60％ (22/125),43.60％ (109/250); x2 =14.040,13.026,all P ＜ 0.05].In contrast,the frequency of the CC genotype was higher in group with intractable GD[ (21.03％(31/129),51.16％(132/258)] than in group with GD in remission[ 13.85％ (18/130),40.38％( 105/260); x2 =12.225,6.061,all P ＜ 0.05 ].TGF-β1 +869 T/C genotype had the correlation with severe groups of HT and GD.C allele would increase in severity of GD(OR =1.546,95％ CI =0.192 - 2.190),and T allele would increase in severity of HT(OR =1.851,95％ CI =1.323 - 2.589).Conclusion The +869T/C polymorphism in the TGF-β1 gene is associated with the severity and intractability of autoimmune thyroid disease.

Reasons for the upsetting cholesterol level during the community investigation from residents, physicians, and social aspects: the China Cholesterol Education Program (CCEP) / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The community medical center is the first barrier for lipid control. We aimed to survey the residents' cholesterol condition in the community, and pursue the reasons for the upsetting results from various aspects.</p><p><b>METHODS</b>Residents and physicians were recruited from four community centers. Residents completed questionnaires and a physical examination as well as biochemical analysis. Physicians were also asked to complete a questionnaire, some of which were about basic knowledge of lipids.</p><p><b>RESULTS</b>About 37.0% male and 48.1% female had elevated cholesterol levels. Residents' blood pressure (BP), fasting glucose (FG), body mass index (BMI), and waist circumference (WC) were positively associated with their low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC). Framingham risk scoring (FRS) was strongly related to cholesterol (P < 0.001 for LDL-C and TC). Residents' higher education grade was positively related to a normal cholesterol condition (P < 0.001), while personal income was negatively related to it. Rural residents had higher percent of population with normal cholesterol level (normal cholesterol rate) than their city counterpart (P < 0.001). Although physicians with college education had a much higher lipid knowledge level themselves, the physicians' factors had almost no relationship with the residents' cholesterol levels.</p><p><b>CONCLUSIONS</b>Management of hypercholesterolemia should be an important component of health strategy in Beijing. Education is imperative for residents as well as for physicians.</p>

Prevalence of dyslipidemia and borderline dyslipidemia and other risk factors of coronary heart disease in residents from Beijing communities / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the prevalence of dyslipidemia and borderline dyslipidemia and other coronary heart disease (CHD) risk factors in residents from Beijing communities.</p><p><b>METHODS</b>Resident samples were selected by random cluster multistage method. Serum lipid level and CHD factors were obtained through questionnaire, physical examination and biochemical analysis during June 2007 to August 2007 from 10 054 residents.</p><p><b>RESULTS</b>Age- and sex-adjusted standardized prevalence of hypercholesterolemia, high low-density lipoprotein cholesterolemia, low high-density lipoprotein cholesterolemia, and triglyceridemia were 9.3%, 2.56%, 18.79% and 16.84%, respectively. Incidence of borderline hypercholesterolemia was 23.96%. Incidence of dyslipidemia and borderline dyslipidemia was 31.23% and 23.30% respectively, 71.17% residents have at least 1 CHD major risk factor and 20.23% residents were in borderline CHD risks. Prevalence of hypertension, diabetes, smoking and obese was 41.57%, 11.08%, 35.81% and 22.89%, respectively. The odds ratio for dyslipidemia (95% confidence interval) in residents having 1 borderline CHD risk factor (RF), 2 RF, and 3 RF versus none RF was 1.668, (95%CI: 1.319 - 2.110), 2.537 (95%CI: 1.989 - 3.235), and 3.203 (95%CI: 2.007 - 5.114).</p><p><b>CONCLUSIONS</b>The prevalence of dyslipidemia of residents from Beijing communities is higher the average level of China (25.1%). Over 1 out of 5 residents were in increased risk for borderline dyslipidemia or CHD risks. Intensive control of dyslipidemia and CHD risk factors are warranted in Beijing residents.</p>

Community-wide survey of physicians' knowledge of cholesterol management / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>An elevated serum lipid is one of the major risk factors for coronary heart disease (CHD). Physicians' awareness contributes to successful adoption of practice guidelines. Community medical centers are the primary defense against chronic disease. This study aimed to investigate community physicians' awareness of cholesterol guidelines and their utilization.</p><p><b>METHODS</b>Six hundred and one community physicians were randomly selected from four different regions, and completed a confidential and semi-structured questionnaire. Four hundred and ninety-one completed the questionnaire, and 486 valid questionnaires were available.</p><p><b>RESULTS</b>The physicians' fundamental knowledge of lipids was astonishingly poor, while the awareness of cholesterol guidelines was low. Only 24% and 14% of the physicians reported the right optimal low-density lipoprotein cholesterol (LDL-C) level for CHD and diabetes patients respectively. More than half of the physicians (55.8%) mistakenly considered elevated transaminases to be the lethal side effect of statins. More than half of the physicians (51.9%) would give up statin treatment in the case of transaminase elevation.</p><p><b>CONCLUSION</b>Educational interventions to improve cholesterol knowledge and to publicize standard treatment are needed among Chinese community physicians.</p>

Prevalence and awareness of dyslipidemia among overweight and obese population in Beijing community / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the prevalence and percentage of dyslipidemia awareness among overweight and obese residents in Beijing community.</p><p><b>METHOD</b>Cross-sectional data of 9786 subjects from capital cholesterol education and intervention program (CCEIP) were analyzed. Participants were divided into 3 groups (Normal, overweight and obese) based on body mass index (BMI). Blood lipid levels were determined from overnight fasting plasma samples. Questionnaires were collected to estimate awareness of dyslipidemia.</p><p><b>RESULT</b>(1) Blood lipids levels were positively correlated with BMI (r = 0.17, 0.18, -0.26 and 0.35 between total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride and BMI, respectively, all P < 0.01). (2) Prevalence of dyslipidemia increased in proportion with increase of BMI. The age-standardized prevalence of dyslipidemia of normal, overweight and obese population was 23. 9%, 43.3% and 65.4% in men and 17.9%, 29.2% and 42.3% in women. Dyslipidemia was more frequent in obese men than obese women (65.4% vs. 42.3%, P < 0.01). However, this gender difference decreased gradually with the increase of age. Risk of hypercholesterolemia, high LDL-C, low HDL-C and hypertriglyceridemia in obese men was 1.6, 2.9, 2.4, and 2.7 folders higher than in the normal body weight men and was 1.3, 1.9, 1.7 and 2.1 folders higher in obese women than in normal body weight women. (3) Unexpectedly, the percentage of dyslipidemia awareness in overweight and obese population was not significantly higher than in the normal body weight group (P > 0.05).</p><p><b>CONCLUSION</b>The prevalence of dyslipidemia was high while the percentage of dyslipidemia awareness was rather low in obese population. Aggressive intervention should be taken in obese population, especially in the young obese men, to effectively reduce dyslipidemia.</p>

Expression of wild type and variant estrogen receptors in human hepatocellular carcinoma / 北京大学学报(医学版)

Objective:To investigate the expression of wild type estrogen receptor(wER)and the ex-on-5 deleted ER(variant ER,vER)in human hepatocellular carcinoma(HCC)samples,and thereafteranalyze the possibility of HCC treatment by endocrine therapy.Methods:The mRNA expressions of wERand vER were analysed from 28 cases of HCC by RT-PCR.The expression of ER at the protein level wasdetected by immunohistochemistry(IHC).Results:IHC results showed that 39.3% of the HCC speci-mens expressed ER.The mRNA of wER was detected in 89.3%(25/28)of the HCC specimens whilethat of vER was detected in 96.4%(27/28).Twenty four out of 28 HCC cases(85.7%)expressedboth wER and vER.One out of 28 patients(3.5%)expressed only wER whereas 3 patients out of 28(10.7%)expressed vER only.Conclusion:Ninety six percent(27/28)of the HCC patients expressedvER,which suggests that the expression of vER is an important event in the development of HCC.