Cardiometabolic disease patterns among elderly patients with colorectal cancer in China / 中华肿瘤杂志

Objective: To explore the distribution patterns of cardiometabolic diseases (CMD) in elderly patients with colorectal cancer, and provide a reference for the prevention and treatment of cardiovascular metabolic diseases in these patients. Methods: Clinical data of 3 894 elderly patients with colorectal cancer from January 2008 to March 2018 admitted in the Chinese PLA General Hospital were recruited and the incidence rate of CMD was retrospectively analyzed. The influence factors of elderly patients with colorectal cancer combined with CMD were analyzed by multivariate Logistic regression model. Results: The morbidity rate of CMD in elderly patients with colorectal cancer is 33.4% (1 301/3 894), among them, the morbidity rate of the male was 31.9% (768/2 409), and that of the female was 35.9% (533/1 485). There was not significant difference between these two sex (P=0.074). The morbidity rates of CMD in patients of 65-74 years, 75-84 years and ≥85 years were 30.6% (754/2 462), 37.0% (479/1 294) and 49.3% (68/138), respectively, with significant differences (P<0.001). Multiple Logistic regression analysis revealed that female (OR=1.213, 95%CI: 1.056-1.394), age (75-84 years group: OR=1.344, 95%CI: 1.164-1.552; ≥85 years group: OR=2.345, 95%CI: 1.651-3.331) and body mass index (BMI 18.5-24.9 kg/m(2) group: OR=1.319, 95%CI: 1.065-1.638; ≥25 kg/m(2) group: OR=2.041, 95%CI: 1.627-2.561) were independent risk factors for elderly colorectal cancer patients with CMD. Conclusion: The morbidity rate of CMD in elderly patients with colorectal cancer increases with age and it is urgent to strengthen multidisciplinary cooperation and develop reasonable treatment plans to extend the survival and life quality of these patients.

Role of blood pressure on stroke-related mortality: a 45-year follow-up study in China / 中华医学杂志(英文版)

BACKGROUND@#Hypertension is associated with stroke-related mortality. However, the long-term association of blood pressure (BP) and the risk of stroke-related mortality and the influence path of BP on stroke-related death remain unknown. The current study aimed to estimate the long-term causal associations between BP and stroke-related mortality and the potential mediating and moderated mediating model of the associations.@*METHODS@#This is a 45-year follow-up cohort study and a total of 1696 subjects were enrolled in 1976 and 1081 participants died by the latest follow-up in 2020. COX proportional hazard model was used to explore the associations of stroke-related death with baseline systolic blood pressure (SBP)/diastolic blood pressure (DBP) categories and BP changes from 1976 to 1994. The mediating and moderated mediating effects were performed to detect the possible influencing path from BP to stroke-related deaths. E value was calculated in the sensitivity analysis.@*RESULTS@#Among 1696 participants, the average age was 44.38 ± 6.10 years, and 1124 were men (66.3%). After a 45-year follow-up, a total of 201 (11.9%) stroke-related deaths occurred. After the adjustment, the COX proportional hazard model showed that among the participants with SBP ≥ 160 mmHg or DBP ≥ 100 mmHg in 1976, the risk of stroke-related death increased by 217.5% (hazard ratio [HR] = 3.175, 95% confidence interval [CI]: 2.297-4.388), and the adjusted HRs were higher in male participants. Among the participants with hypertension in 1976 and 1994, the risk of stroke-related death increased by 110.4% (HR = 2.104, 95% CI: 1.632-2.713), and the adjusted HRs of the BP changes were higher in male participants. Body mass index (BMI) significantly mediated the association of SBP and stroke-related deaths and this mediating effect was moderated by gender.@*CONCLUSIONS@#In a 45-year follow-up, high BP and persistent hypertension are associated with stroke-related death, and these associations were even more pronounced in male participants. The paths of association are mediated by BMI and moderated by gender.

Evaluating continence recovery time after robot-assisted radical prostatectomy / 北京大学学报(医学版)

OBJECTIVE@#To evaluate urinary continence recovery time and risk factors of urinary continence recovery after robot-assisted laparoscopic radical prostatectomy (RARP).@*METHODS@#From January 2019 to January 2021, a consecutive series of patients with localized prostate cancer (cT1-T3, cN0, cM0) were prospectively collected. RARP with total anatomical reconstruction was performed in all the cases by an experienced surgeon. Lymph node dissection was performed if the patient was in high-risk group according to the D'Amico risk classification. The primary endpoint was urinary continence recovery time after catheter removal. Postoperative and pathological variables were analyzed. Continence was rigo-rously analyzed 48 hours, 1 week, 4 weeks, 12 weeks, and 24 weeks after catheter removal. Continence was evaluated by recording diaper pads used per day, and all the patients were instructed to perform the 24-hour pad weight test until full recovery of urinary continence. The patient was defined as continent if no more than one safety pad were needed per day, or no more than 20-gram urine leakage on the 24-hour pad weight test. Time from catheter removal to full recovery of urinary continence was recorded, and risk factors influencing continence recovery time evaluated.@*RESULTS@#In total, 166 patients were analyzed. The mean age of the enrolled patients was 66.2 years, and the median prostate specific antigen (PSA) was 8.51 μg/L. A total of 59 patients (35.5%) had bilateral lymphatic dissection, and 28 (16.9%) underwent neurovascular bundle (NVB) preservation surgery. Postoperative pathology results showed that stage pT1 in 1 case (0.6%), stage pT2 in 77 cases (46.4%), stage pT3 in 86 cases (51.8%), and positive margins in 28 patients (16.9%). Among patients who underwent lymph node dissection, lymph node metastasis was found in 7 cases (11.9%). Median continence recovery time was one week. The number of the continent patients at the end of 48 hours, 1 week, 4 weeks, 12 weeks, and 24 weeks were 65 (39.2%), 32 (19.3%), 34 (20.5%), 24 (14.5%), and 9 (5.4%). Two patients remained incontinent 24 weeks after catheter removal. The continence rates after catheter removal at the end of 48 hours, 1 week, 4 weeks, 12 weeks, and 24 weeks were 39.2%, 58.4%, 78.9%, 93.4%, and 98.8%, respectively. Univariate COX analysis revealed that diabetes appeared to influence continence recovery time (OR=1.589, 95%CI: 1.025-2.462, P=0.038). At the end of 48 hours, 4 weeks, 12 weeks, and 24 weeks after catheter removal, the mean OABSS score of the continent group was significantly lower than that of the incontinent group.@*CONCLUSION@#RARP showed promising results in the recovery of urinary continence. Diabetes was a risk factor influencing continence recovery time. Bladder overactive symptoms play an important role in the recovery of continence after RARP.

The expression of pre-B-cell leukemia homeobox 3and phosphatase and tensin homology deleted on chromosome 10in cervical cancer and its relationship with clinicopathologic features and prognosis / 中国医师进修杂志

Objective:To investigate the expression of pre-B-cell leukemia homeobox 3 (PBX3) and the phosphatase and tensin homology deleted on chromosome 10 (PTEN) in cervical cancer and its relationship with the clinicopathologic characteristics and prognosis.Methods:Cervical cancer tissues and adjacent tissues of 85 patients with cervical cancer admitted to Xianlin Gulou Hospital from June 2014 to December 2018 were collected and the expression levels of PBX3 and PTEN were detected by immunohistochemistry. The univariate analysis and Logistic regression model were used to analyze the relationship between the expression levels of PBX3, PTEN and clinicopathologic features. Kaplan-Meier survival curve was used to analyze the relationship between the expression levels of PBX3, PTEN and prognosis.Results:The positive expression rate of PBX3 protein in cervical cancer tissues was higher than that in adjacent tissues: 38.82%(33/85) vs. 25.53%(20/85); the positive expression rate of PTEN protein was lower than that in adjacent tissues: 36.47%(31/85) vs. 98.82%(84/85), and there were significant differences ( P<0.05). The univariate analysis showed that the expression levels of PBX3 and PTEN were associated with clinical stages, degree of tumor differentiation, lymph node metastasis, vascular invasion, and degree of tumor invasion ( P<0.05). The multiple Logistic regression model showed that the clinical stages, tumor differentiation and lymph node metastasis were independent influencing factors for the positive expression of PBX3 or PTEN in cervical cancer tissues ( P<0.05). While 45.45%(15/33) of patients with positive PBX3 expression died, with a median survival of 31 months, and 25.00% (13/52)of patients with negative expression died, with a median survival of 38 months. Kaplan-rank test showed that the survival time in the patients with positive PBX3 expression and in the patients with negative expression had significant difference ( P=0.025). While 22.58%(7/31) of patients with positive PTEN expression died, with a median survival of 39 months, and 38.89%(21/54) of the patients with negative expression died, with a median survival time of 33 months. Kaplan-rank test showed that the survival time in the patients with positive PTEN expression and in the patients with negative expression had significant difference ( P=0.035). Conclusions:The expression of PBX3 is up-regulated and PTEN is down-regulated in cervical cancer. The expression levels of PBX3 and PTEN are related to clinical stage, tumor differentiation and lymph node metastasis. The prognosis of the patients with positive PBX3 expression is worse than that of the patients with negative expression, and the prognosis of the patients with positive PTEN expression is better than that of the patients with negative expression.

Olecranon osteotomy vs. triceps-sparing for open reduction and internal fixation in treatment of distal humerus intercondylar fracture: a systematic review and meta-analysis / 中华医学杂志(英文版)

BACKGROUND@#The open reduction and internal fixation (ORIF) was a standard treatment approach for fracture at distal humerus intercondylar, whereas the optimal way before ORIF remains inconclusive. We, therefore, performed a systematic review and meta-analysis to assess the efficacy and safety of olecranon osteotomy vs. triceps-sparing approach for patients with distal humerus intercondylar fracture.@*METHODS@#The electronic searches were systematically performed in PubMed, EmBase, Cochrane library, and Chinese National Knowledge Infrastructure from initial inception till December 2019. The primary endpoint was the incidence of excellent/good elbow function, and the secondary endpoints included Mayo elbow performance score, duration of operation, blood loss, and complications.@*RESULTS@#Nine studies involving a total of 637 patients were selected for meta-analysis. There were no significant differences between olecranon osteotomy and triceps-sparing approach for the incidence of excellent/good elbow function (odds ratio [OR]: 1.37; 95% confidence interval [CI]: 0.69-2.75; P = 0.371), Mayo elbow performance score (weight mean difference [WMD]: 0.17; 95% CI: -2.56 to 2.89; P = 0.904), duration of operation (WMD: 4.04; 95% CI: -28.60 to 36.69; P = 0.808), blood loss (WMD: 33.61; 95% CI: -18.35 to 85.58; P = 0.205), and complications (OR: 1.93; 95% CI: 0.49-7.60; P = 0.349). Sensitivity analyses found olecranon osteotomy might be associated with higher incidence of excellent/good elbow function, longer duration of operation, greater blood loss, and higher incidence of complications as compared with triceps-sparing approach.@*CONCLUSIONS@#This study found olecranon osteotomy did not yield additional benefit on the incidence of excellent/good elbow function, while the duration of operation, blood loss, and complications in patients treated with olecranon osteotomy might be inferior than triceps-sparing approach.

Analysis on protein expression of ferritin light chain in alveolar macrophages of patients with occupational silicosis / 中国职业医学

OBJECTIVE: To observe the protein expression of ferritin light chain(FTL) in alveolar macrophages(AM) of patients with occupational silicosis(hereinafter referred to as silicosis). METHODS: The male patients with silicosis at stage Ⅰ, Ⅱ, and Ⅲ were separately selected as the silicosis groupⅠ, Ⅱ, and Ⅲ using judgment sampling method, with 15 patients in each group. Meanwhile, 15 male silicon dust workers with small lung shadows but not diagnosed as silicosis were selected as the control group. Bronchoalveolar lavage fluid was collected from the four groups, and AM was separated and purified, and protein was extracted after lysis of the AM. Western blotting was used to detect the relative expression of FTL protein in the AM. RESULTS: The relative expression of FTL protein in AM of silicosis groupⅠ, Ⅱ, and Ⅲ was lower than that in the control group(all P<0.05). The relative expression of FTL protein in AM decreased with the increase of silicosis stage(P<0.05).CONCLUSION: The expression of FTL protein in AM was down-regulated in patients with silicosis in a dose-response manner. It is speculated that FTL may have a negative regulatory effect in the progress of silicosis fibrosis.

Association between polymorphisms of interleukin-17 genes and pneumoconiosis susceptibility / 中华劳动卫生职业病杂志

Objective@#To explore the relationship between polymorphisms of interleukin 17(IL-17) gene (rs4711998, rs763780) and the susceptibility of pneumoconiosis, and to provide a basis for prevention of high-risk groups of pneumoconiosis.@*Methods@#A total of 219 pneumoconiosis patients and 242 workers without pneumoconiosis were enrolled in the study. All subjects were photographed with high undulating X-rays anterior chest radiographs, diagnosed according to diagnostic criteria for pneumoconiosis. We collected 3 ml of peripheral venous blood of the study subjects. Polymorphism in IL-17A rs4711998 and IL-17F rs763780 locus were evaluated by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).@*Results@#The IL-17A rs4711998 locus has AA, AG and GG genotypes, there was no the significant difference between case and control groups (P>0.05). IL-17F rs763780 had AA, AG and GG genotypes, there was a significant difference between case and control groups (P<0.05). Allele A and allele G were statistically significant difference between the case group and the control group (P<0.05).@*Conclusion@#No relationship was found between IL-17A gene polymorphisms at rs4711998 and silicosis. IL-17F rs763780 locus gene polymorphism is associated with susceptibility to pneumoconiosis. AG genotype and G allele may have a protective effect.

Progress on diagnosis and treatment of low transcondylar fractures of distal humerus / 中国骨伤

Low transcondylar fractures of the distal humerus in adults is rarely seen and reported in literatures. It has a bimodal distribution in terms of age, affecting the elderly and younger patients. The fracture is characterized by a very low transverse intra-capsular and extra-articular fracture lines extending from the level of lateral epicondyle to medial epicondyle. Standard elbow plain films and CT scans are crucial and indispensable for diagnosis. Conservative treatment is suitable for undisplaced fractures, patients who are intolerant of anesthesia, or people with advanced dementia. Open reduction and internal fixation (ORIF) is preferred. Parallel and orthogonal plate fixation are widely adopted while some researchers preferred crisscross-type screw fixation or bicolumnar 90-90 plating. In addition, some customized posterolateral plates are specially designed to be able to insert a transverse screw, functioning as lateral support. However, most of the recent researches conducted on low transcondylar fractures of the distal humerus are retrospective studies with relatively lower level of evidence compared to prospective and randomized controlled ones which remain a vacancy in this field. Therefore, further studies comparing the biomechanical properties and clinical prognosis of different configurations of internal fixation or total elbow arthroplasty for the treatment of low transcondylar fractures are needed in the future.

Taxus chinensis ameliorates diabetic nephropathy through down-regulating TGF-β1/Smad pathway / 中国天然药物

Diabetic nephropathy (DN) is one of the common microvascular complications of diabetes mellitus. Renal fibrosis is closely related to the deterioration of renal function. The present study aimed to investigate protective effect of Taxus chinensis on high-fat diet/streptozotocin-induced DN in rats and explore the underlying mechanism of action. The rat DN model was established via feeding high fat diet for 4 weeks and subsequently injecting streptozotocin (30 mg·kg body weight) intraperitoneally. The rats with blood glucose levels higher than 16.8 mmol·L were selected for experiments. The DN rats were treated with Taxus chinensis orally (0.32, 0.64, and 1.28 g·kg) once a day for 8 weeks. Taxus chinensis significantly improved the renal damage, which was indicated by the decreases in 24-h urinary albumin excretion rate, blood serum creatinine, and blood urea nitrogen. Histopathological examination confirmed the protective effect of Taxus chinensis. The thickness of glomerular basement membrane was reduced, and proliferation of mesangial cells and podocytes cells and increase in mesangial matrix were attenuated. Further experiments showed that Taxus chinensis treatment down-regulated the expression of TGF-β1 and α-SMA, inhibited phosphorylation of Smad2 and Smad3. These results demonstrated that Taxus chinensis alleviated renal injuries in DN rats, which may be associated with suppressing TGF-β1/Smad signaling pathway.

Effects of Xingbi Wenmin Gel on Serum Levels of IL-4, TGF-β1 and Nasal Mucosa Eosinophils in Allergic Rhinitis Rats / 中国中医药信息杂志

Objective To observe the effects of Xingbi Wenmin Gel on serum levels of IL-4, TGF-β1 and nasal mucosa eosinophils (EOS) in allergic rhinitis (AR) rats; To discuss its mechanism of action. Methods Intraperitoneal injection of egg albumin and aluminum hydroxide based sensitized to ovalbumin challenge 2％ local AR model was established successfully. The experimental rats were randomly divided into normal group, model group, positive control group, and Xingbi Gel low-, medium-, and high-dosage groups. Each medication group was given relevant medicine for intervention. The rat symptom scores in each group were compared, and serum IL-4, TGF-β1, and nasal mucosa EOS counts were detected. Results Compared with the normal group, the serum levels of IL-4 and TGF-β1 in model group increased significantly (P<0.01), and the nasal mucosa EOS counts increased significantly (P<0.05). Compared with model group, the serum levels of IL-4 and TGF-β1 in Xingbi Gel medium-dosage group and positive control group decreased significantly (P<0.01), and the nasal mucosa EOS counts decreased significantly (P<0.05). Conclusion Xingbi Wenmin Gel may be effective through down-regulation of IL-4, TGF-β1 levels of inflammatory factors, and reduction of EOS infiltration in nasal mucosa.

Taxus chinensis ameliorates diabetic nephropathy through down-regulating TGF-β1/Smad pathway / 中国天然药物

Diabetic nephropathy (DN) is one of the common microvascular complications of diabetes mellitus. Renal fibrosis is closely related to the deterioration of renal function. The present study aimed to investigate protective effect of Taxus chinensis on high-fat diet/streptozotocin-induced DN in rats and explore the underlying mechanism of action. The rat DN model was established via feeding high fat diet for 4 weeks and subsequently injecting streptozotocin (30 mg·kg body weight) intraperitoneally. The rats with blood glucose levels higher than 16.8 mmol·L were selected for experiments. The DN rats were treated with Taxus chinensis orally (0.32, 0.64, and 1.28 g·kg) once a day for 8 weeks. Taxus chinensis significantly improved the renal damage, which was indicated by the decreases in 24-h urinary albumin excretion rate, blood serum creatinine, and blood urea nitrogen. Histopathological examination confirmed the protective effect of Taxus chinensis. The thickness of glomerular basement membrane was reduced, and proliferation of mesangial cells and podocytes cells and increase in mesangial matrix were attenuated. Further experiments showed that Taxus chinensis treatment down-regulated the expression of TGF-β1 and α-SMA, inhibited phosphorylation of Smad2 and Smad3. These results demonstrated that Taxus chinensis alleviated renal injuries in DN rats, which may be associated with suppressing TGF-β1/Smad signaling pathway.

Prognostic factors of combined small cell lung cancer after surgical resection / 中国肿瘤临床

Objective:To investigate the prognostic factors and survival of patients with combined small cell lung cancer (C-SCLC) after they underwent complete resection. Methods:The clinical records of C-SCLC patients who were subjected to complete resection and systematic nodal dissection in one institution between January 2010 and December 2014 were retrospectively reviewed. Results:Sev-enty-eight patients with histologically diagnosed C-SCLC were identified. The most common combined component was large cell neuro-endocrine carcinoma (LCNEC) (n=42), followed by squamous cell carcinoma (SCC) (n=18), adenocarcinoma (AC) (n=10), and adenosqua-mous carcinoma (ASC) (n=8). The overall survival (OS) rate of the entire cohort was 39.1%. Multivariate analyses using Cox's propor-tional hazard models revealed that size [3 cm;hazard ratio (HR)=0.406;95%confidence interval (CI)=0.202-0.816;P=0.011], performance status (2;HR=0.113;95%CI=0.202-0.631;P=0.013), combined non-small cell lung cancer (NSCLC) components (LCNEC vs. non-LCNEC, HR=3.00;95%CI=0.096-0.483;P<0.001), stage Ⅲ A vs.Ⅰ;HR=0.195, 95%CI:0.063-0.602;P=0.004) and adju-vant therapy (yes vs. no, HR=0.402;95%CI=0.195-0.831;P=0.014) were significant prognostic factors of OS. Conclusion:The mixed NSCLC components within C-SCLC significantly influence survival. Adjuvant therapy is beneficial for patients with complete resection of C-SCLC.

A rare case of spontaneous coronary artery dissection after emotional stress in a postmenopausal woman / 南方医科大学学报

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction. While its etiology and pathogenesis remain not fully understood, SCAD occurs most frequently in patients at a young age and of a female gender. We report a case of SCAD in a 52-year-old healthy postmenopausal woman who developed acute myocardial infarction and subsequent ventricular aneurysm after emotional stress. This case may provide valuable insight into this rare disease and highlights the importance of psychological factors as contributing factors of SCAD in postmenopausal women with acute onset of chest pain.

Role of postoperative chemotherapy in patients with early-stage pulmonary large-cell neuroendocrine carcinoma after resection / 中国肿瘤临床

Objective:To investigate the efficacy of postoperative chemotherapy in patients with early-stage pulmonary large cell neu-roendocrine carcinoma (LCNEC) after resection. Methods:A cohort of 50 patients who underwent resection and systematic nodal dissection for LCNEC between January 2008 and December 2014 in our institution was retrospectively reviewed. The patients were divided into adjuvant chemotherapy group (32 cases) and non-chemotherapy group (18 cases). Follow-up information was investigated. Results:The median survival and the 5-year survival rate were 48 months and 72.5%for the adjuvant chemotherapy group whereas 29 months and 35.6%for the non-adjuvant chemotherapy group, respectively. Univariate and multivariate analyses using Cox's proportional hazard models showed that postoperative chemotherapy was a signifi cant prognostic factor for OS (P=0.005;hazard ratio=0.281, P=0.008, respectively). Conclusion:Postoperative chemotherapy is beneficial to patients with early-stage pulmonary LCNEC after complete resection.

Clinical outcomes of epidermal growth factor receptor tyrosine kinase inhibitors in re-current adenosquamous carcinoma of the lung after resection / 中国肿瘤临床

Objective:To investigate the efficacy of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in adenosqua-mous carcinoma (ASC) of the lung after resection. Methods:Clinical data of patients suffering from ASC and receiving EGFR-TKI treat-ment at one institution between January 2006 and December 2014 were retrospectively reviewed. Results:A total of 27 EGFR muta-tion-positive patients with ASC subjected to EGFR-TKI therapy were enrolled in this study. EGFR mutations included deletion in exon 19 in 15 cases and point mutation at codon 858 in exon 21 in 12 cases. Of the 27 ASC patients who received EGFR-TKI treatment, 9 exhibit-ed a partial response and 11 manifested a stable disease, and these patients accounted for a disease control rate of 74.1%(20/27). The median overall survival (OS), median progression-free survival, and median relapse OS of the EGFR mutation-positive patients who underwent TKI therapy were 39 months [95%confidence interval (CI)=25.6-52.4], 15 months (95%CI=12.9-17.1), and 19 months (95%CI=0.9-37.1), respectively. The 3-and 5-year survival rates of these patients after operation were 51.9%and 15.3%, respectively. Con-clusion:The survival of EGFR mutation-positive ASC patients treated with EGFR-TKIs was satisfactory. EGFR testing was recommended for ASCs and EGFR-TKI treatment was suitable for ASCs with EGFR-sensitizing mutation.

Clinical implications of the platelet test results about unstable angina patients with different conditions of blood glucose / 西安交通大学学报(医学版)

ABSTRACT:Objective To study the platelet changes in patients with unstable angina with different blood glucose ,and their related biochemical index changes ,and their relationship with global registry of acute coronary events (GRACE) score .Methods For this clinical study ,we enrolled 82 patients diagnosed with unstable angina , 47 of whom were male and 35 were female .Upon admission ,their random blood glucose was tested .According to different blood glucose values ,they were divided into normal blood glucose group (<6 .1 mmol/L) and high blood glucose (≥ 6 .1 mmol/L ) group . The following clinical data were compared between the two groups :age , hypertension ,diabetes ,smoking history ,and BMI .We detected EF (% ) ,HBA1C ,glucose ,LDL‐C ,HDL‐C ,TG , LPA ,CREA ,UA ,hsCRP ,BNP ,CKMB ,CTNI ,D‐Dimer ,and GRACE risk scores .We compared the platelet test results :PLT ,P‐LCR ,PDW ,and MPV .We also detected the relationship of MPV with hsCRP ,D‐Dimers and GRACE risk scores .Results MPV ,hsCRP ,and GRACE risk score differed significantly between normal blood glucose group and high blood glucose group (P<0 .05) .In the latter group ,MPV had significant correlation with hsCRP ,D‐Dimers and GRACE risk score ( r=0 .28 , r=0 .41 , r=0 .56 , P<0 .05) .Conclusion Hyperglycemia in patients with unstable angina causes the increase of MPV , change of the inflammatory marker hsCRP , and increase of clinical GRACE risk score .Abnormal MPV may predict the increased risk of unstable angina in patients with hyperglycemia upon hospitalization .

The prognostic analysis for non-small cell lung cancer with brain metastases in 107 cases / 肿瘤研究与临床

Objective To evaluate the clinical efficacy of different treatments on non-small cell lung cancer (NSCLC) patients with brain metastases and to explore the influential factors of the prognosis.Methods The NSCLC patients with brain metastases treated from Jan.2010 to Dec.2011 were follow-up.The survival time and influences resulted from the treatments were analyzed.Results The average survive time of these patients was (11.93±5.53) months,and the median survive time was 11 months.The 6-month,1-year and 2-year overall survival rates were 90.7 ％,41.1％ and 6.4 ％,respectively.Multivariate analysis showed that control of extracranial lesions,Kamofsky score,target therapy and age were independent predictive factors of survival,and the OR value were 0.358 (95 ％ CI0.217-0.593),0.302 (95 ％ CI 0.182-0.502),0.170 (95 ％ CI 0.098-0.296) and 1.635 (95 ％ CI 1.010-2.647),respectively (all P ＜ 0.01).Conclusions Radiation therapy is an effective treatment on non-small cell lung cancer with brain metastases.Biological target therapy can effectively improve survival.The survival time also is correlated with age,Karnofsky score and control of extracranial lesions.

Effects of different acupuncture depths of Lianquan (CV 23) for dysphagia after stroke: a randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To explore the effects of different acupuncture depths of Lianquan (CV 23) for dysphagia after stroke.</p><p><b>METHODS</b>Two hundred and fifty-one patients with dysphagia after stroke were randomly divided into a deep acupuncture group (group A, 85 cases) a shallow acupuncture group (group B, 83 cases) and a glossopharyngeum acupuncture group (group C, 83 cases). Based on the conventional treatment, the glossopharyngeum acupuncture which was pricking without needles retained at lingual surface, posterior pharyngeal wall of the affected side, Jinjin (EX-HN 12) and Yuye (EX-HN 13) was used in the three groups. After the glossopharyngeum acupuncture, Lianquan (CV 23) was acupunctured 60-70 mm in the group A and 30-40 mm in the group B. The needles were all retained for 30 min. The treatment was applied once a day for 30 days in the three groups. Water swallowing test evaluation scale was observed before and after treatment, and the efficacy was assessed in the three groups.</p><p><b>RESULTS</b>The total effective rate was 95.3% (81/85) in the group A, which was better than 85.5% (71/83) in the group B and 83.1% (69/83) in the group C (both P < 0.05). The water swallowing test scores were decreased apparently in the three groups (all P < 0.01), and scores in the group A were the most obvious decline (P < 0.01). The decrease of scores in the group A was more remarkable than those in the group B and the group C after two weeks of treatment (both P < 0.05).</p><p><b>CONCLUSION</b>Acupuncture at Lianquan (CV 23) can effectively improve the dysphagia after stroke. The acupuncture depth can affect efficacy and the effect of deep acupuncture is better.</p>

Effect of Electroacupuncture at Bilateral Points Quchi on Blood Pressure Variability in Hypertensive Disease Patients / 上海针灸杂志

Objective To investigate the effect of electroacupuncture at bilateral points Quchi on blood pressure variability in hypertensive disease patients.Methods One hundred and two patients were randomly allocated to treatment and control groups, 51 cases each. Methods The treatment group received electroacupuncture at bilateral points Quchi and the control group, no treatment as a blank control. Twenty-four-hour dynamic blood pressure and blood pressure variability were observed in the two groups of patients. Results There were statistically significant post-treatment differences in 24-hour systolic pressure standard deviation (24 hSSD), daytime systolic pressure standard deviation (dSSD) and night systolic pressure standard deviation (nSSD) between the treatment and control groups (P0.05).Conclusion Electroacupuncture at bilateral points Quchi can reduce systolic pressure variability in hypertensive disease patients.

Effects of different lymph node dissection methods on short-term clinical efficacy and complication of esophageal cancer patients / 中国医师进修杂志

Objective To investigate the short-term clinical efficacy and complication of esophageal cancer patients with two-field lymph node dissection by thoracolaparoscopic esophagectomy surgery and open surgery. Methods One hundred and fifty esophageal cancer patients with two-field lymph node dissection were selected, and they were divided into control group (using open surgery, 75 cases) and observation group (using thoracolaparoscopic esophagectomy surgery, 75 cases) by random digits table method. The operation time, bleeding amount, hospital staying time, number of lymph node dissection, reoperation rate, intensive care unit (ICU) transferring rate and postoperative complication were compared. Results There was no statistical difference in operation time between 2 groups ( P>0.05). The bleeding amount and hospital staying time in observation group were significantly lower than those in control group: (210.33 ± 30.71) ml vs. (254.59±35.28) ml and (8.45±1.52) d vs. (11.61±2.08) d, there were statistical differences (P0.05). There were no statistical differences in incidences of hoarseness and anastomotic stenosis between 2 groups ( P>0.05). The incidences of pulmonary infection and arrhythmia in observation group were significantly lower than those in control group:17.33%(13/75) vs. 30.67%(23/75) and 2.67%(2/75) vs. 14.67%(11/75), and there were statistical differences (P<0.05). Conclusion Compared with open surgery, thoracolaparoscopic esophagectomy surgery with two-field lymph node dissection for esophageal cancer patients can effectively reduce the degree of operative trauma, accelerate postoperative rehabilitation process, improve the effects of lymph node dissection, and reduce postoperative complication risk.