Metabolism-related risk factors of cholelithiasis among Beijing residents: a case-control study / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the metabolism-related risk factors of cholelithiasis among residents in Beijing.</p><p><b>METHODS</b>The clinical data including previous disease history, findings of physical examination, and results of cholecystosonography of 2270 patients with cholelithiasis identified in the Health Screening Center of Peking Union Medical College Hospital between August 2007 and August 2010 were retrospectively reviewed (the case group). Meanwhile, 4336 healthy individuals during the same period were randomly chosen as the control group.</p><p><b>RESULTS</b>Total cholesterol, triglyceride, low-density lipoprotein cholesterol, fasting blood glucose, body mass index, and systolic blood pressure were positively correlated with the incidence of cholelithiasis (P < 0.05), while high-density lipoprotein cholesterol was negatively correlated (P < 0.05). Diastolic blood pressure showed no association with cholelithiasis (P > 0.05).</p><p><b>CONCLUSION</b>Cholelithiasis is resulted from multiple factors including elevated blood lipids, blood glucose, and systolic blood pressure among residents in Beijing.</p>

Comprehensive analysis of relevant factors on colorectal cancer-related anemia / 中国医学科学院学报

<p><b>OBJECTIVE</b>To analyze the risk factors of colorectal cancer-related anemia.</p><p><b>METHOD</b>The clinical data of 319 patients with colorectal cancer were retrospectively analyzed for the possible risk factors of tumor-related anemia including tumor location, clinical stage, clinical symptoms, pathology, gender, and age.</p><p><b>RESULTS</b>Of these 319 cases, 141 (44.20%) had anemia. The incidence of anemia was 62.20% among patients with right hemicolon cancers (including caecum cancer), and was 23.82% among patients with rectal cancer and 36.23% among those with transverse descending or sigmoid colon cancer. Cardia insufficiency, melena, tumor location, T staging, hypoproteinemia were also found to be related with anemia. Anemia and hypoproteinemia were the risk factors for perioperative blood transfusion (odds ratio = 3.004, odds ratio = 8.356, respectively).</p><p><b>CONCLUSIONS</b>The colorectal cancer-related anemia is not associated with the clinical stage of the tumor, while cardiac insufficiency, melena, tumor location, tumor stage, and hypoproteinemia constitute the possible risk factors. Anemia and hypoproteinemia are the risk factors of perioperative blood transfusion.</p>

Mechanisms of gastrointestinal surgery in treatment of type 2 diabetes / 中国医学科学院学报

Type 2 diabetes can be treated by gastrointestinal surgery, but the underlying mechanism is unclear. This review summarizes the possible mechanisms which include weight loss, gastrointestinal hormones, foregut hypothesis, hindgut hypothesis, adipocytokines, and inflammatory factors.

Application of laparoscopic adjustable gastric banding and a multi-disciplinary team approach in treatment of morbid obesity and its complications / 中国医学科学院学报

<p><b>OBJECTIVE</b>To assess the safety and feasibility of laparoscopic adjustable gastric banding (LAGB) and a multi-disciplinary team (MDT) approach in the treatment of morbid obesity and its complications.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 16 patients who underwent LAGB and MDT approach in Peking Union Medical College Hospital from October 2009 to February 2011.</p><p><b>RESULTS</b>Of these 16 patients, 15 patients completed the 3 month follow up; their body weight and body mass index (BMI) decreased significantly after treatment (both P=0.000), with an percentage of excess weight loss (%EWL) of (25.7±7.4)%. Thirteen patients completed 6 month follow up; their body weight and BMI were significantly lower than the preoperative levels (both P=0.001), while there were no significant difference between the third and sixth month measurements (P=0.103 and P=0.053, respectively); %EWL of 6 months after operation was significantly higher than that of 3 months after operation [(37.0±14.7)% vs. (29.1±6.8)%,P=0.042]. Six patients completed 12 month follow up; their body weight and BMI decreased significantly at the first 3 months after operation (P=0.007 and P=0.005,respectively) and at the second 6 postoperative months (P=0.007 and P=0.013,respectively); the BMI of 6 months after operation was significantly lower than that of 3 months after operation (P=0.045), but there was no significant difference of body weight between the third and sixth month after operation (P=0.065); meanwhile, the %EWL increased significantly within the second 3 postoperative months from (29.6±6.8é% to(42.4±14.0é%(P=0.028), and also within the second 6 postoperative months (60.4±12.6é%(P=0.001). In 9 patients with pre-operative obstructive sleep apnea hypopnea syndrome, the symptom was remarkably resolved in all these 9 patients 3 months after the treatment. Of 16 patients with preoperative metabolic syndrome, the condition was obviously improved after treatment in 10 patients. Of 9 patients with hypertension preoperatively, the blood pressure returned to normal level after the withdrawal of antihypertensive agents in 7 patients; in addition, one patient had his dose decreased and one patient switched to a milder antihypertensive agent. Of 8 patients accompanied with type 2 diabetes, 7 had their antidiabetic drugs withdrawn after the blood sugar returned normal and one patient had his dose decreased.</p><p><b>CONCLUSION</b>LAGB combined with MDT approach is effective, safe, and feasible for treating morbid obesity and its complications.</p>

Investigation of tumor related anemia in 10,218 patients with cancer in the digestive system / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the prevalence of tumor related anemia in patients with cancer in the digestive system.</p><p><b>METHODS</b>A total of of 10 218 inpatients were diagnosed with cancer in the digestive system at the Peking Union Hospital from January 2000 to June 2009, which included esophageal cancer(n=1118), gastric cancer(n=2418), carcinoma of duodenum(n=134), carcinoma of small intestine(n=85), hepatocellular cancer(n=1508), cholangiocarcinoma(n=546), pancreatic cancer (n=1242), colon cancer(n=1582), and rectal cancer(n=1585). Patients with hemolytic anemia or hepatorenal dysfunction were excluded. Data pertaining to sex, age and hemoglobin were obtained by chart review.</p><p><b>RESULTS</b>According to the China criteria of anemia, the overall anemia rate was 27.5% (2813/10 218). The prevalence of anemia was 64.7% for small bowel cancer, 60.5% for duodenal cancer, 42.6% for colon cancer, 36.6% for cholangiocarcinoma, 33.3% for gastric cancer, 22.6% for pancreatic cancer, 20.4% for rectal cancer, 18.7% for hepatocellular cancer, and 10.0% for esophageal cancer. Anemia was more common in older patients in those with gastric cancer, cholangiocarcinoma, pancreatic cancer, colon cancer and rectal cancer. There were more male anemic patients in those with cancer in the small intestine or cholangiocarcinoma. However, females were more commonly seen in those with hepatocellular cancer or pancreatic cancer.</p><p><b>CONCLUSIONS</b>Anemia is common in patients with cancer in the digestive system. The prevalence of anemia is higher in patients with cancer in the duodenum carcinoma or small intestine, followed by colon cancer and gastric cancer, and then esophageal cancer. Anemia may be associated with age or gender in some types of cancer in the digestive system.</p>

Prevalence of metabolic syndrome and its associations with other metabolic disorders and cardiovascular changes in health examination population in Beijing / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the prevalence of metabolic syndrome (MS) and its associations with other metabolic disorders and cardiovascular changes in health examination population in Beijing.</p><p><b>METHODS</b>Totally, 10,916 individuals who received health examination in Health Examination Center of Peking Union Medical College Hospital were enrolled. The height, weight, blood pressure, serum levels of triglyceride, high-density lipoprotein cholesterol (HDL-C), and fasting blood glucose were recorded. MS was diagnosed based on the working criteria of Chinese Diabetes Society 2004 (CDS2004). Meanwhile, other metabolic disorders, including fatty liver and hyperuricemia, were recorded. The cardiovascular changes were reflected by the reports of electrocardiogram (ECG) ST-T changes and atherosclerosis of retinal arteries.</p><p><b>RESULTS</b>The overall prevalence rate of MS was 6.1% (666/10,916) in the population. The prevalence rate of MS in male was much higher than that in female (9.0% vs. 2.7%, P=0.000). For individuals with MS, the prevalence rates of fatty liver and hyperuricemia were significantly higher than those without MS, respectively (70.4% vs. 35.4%, P=0.000; 29.9% vs. 17.7%, P=0.000). As for cardiovascular changes, the prevalence rates of ECG ST-T changes and atherosclerosis of retinal arteries were significantly higher in individuals with MS than those without MS, respectively (13.8% vs. 11.7%, P=0.012; 12.0% vs. 6.8%, P=0.000).</p><p><b>CONCLUSIONS</b>The prevalence of MS in Beijing population is high. The individuals with MS have a higher risk for other metabolic disorders and cardiovascular changes.</p>