Analysis of the prevalence of anemia and its influencing factors in the urban communities-dwelling elderly population in Beijing / 中华老年医学杂志

Objective:To analyze the prevalence of anemia and its influencing factors in the elderly population dwelling in urban communities in Beijing.Methods:A random cluster sampling method was adopted to select the elderly people of communities in Beijing, and cross-sectional research was conducted through questionnaire surveys, field tests and blood sample collection.The criteria for diagnosing anemia were from WHO standards, and the health evaluation indicators in the questionnaire survey included demographic data and eating habits, socio-economic information, information on enjoying health services, health and physical fitness and other information.Blood samples were drawn for routine blood tests and biochemical tests.Results:A total of 1 947 elderly people aged 65 years and above were investigated, including 789 males(40.5%)and 1 158 females(59.5%). Among the 1 947 survey subjects, 288 elderly people had anemia, with the prevalence of anemia of 14.79%(288/1 947). The prevalence of anemia was 16.35%(129/789)in males and 13.73%(159/1 158)in females.There was no statistically significant difference in the prevalence of anemia between male and female( χ2=2.760, P=0.097). Logistic regression analysis was used to analyze the factors affecting anemia.The results showed that the higher age( OR=1.055, P=0.000), the higher frequency of meat-eating( OR=1.353, P=0.046), the lower frequency of fruit-eating( OR=0.759, P=0.048), the worse health status of cohabitants( OR=0.757, P=0.037), the lower BMI( OR=0.905, P=0.001)and the lower exercise frequency( OR=0.769, P=0.012)were correlated to the higher anemia risk in the elderly population dwelling in urban communities in Beijing. Conclusions:The prevalence of anemia is relatively high in the elderly in Beijing communities.According to our findings, older people should reduce the frequency of eating meat, while ensuring nutritional intake, increase the intake of fruits and take appropriate exercises to reduce the prevalence of anemia.

Significance of changes of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in neoadjuvant therapy for rectal cancer / 肿瘤研究与临床

Objective:To investigate the significance of changes of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in neoadjuvant therapy for rectal cancer.Methods:The data of 86 patients with rectal cancer who received neoadjuvant therapy from November 2013 to January 2015 in Shanxi Provincial Cancer Hospital were retrospectively analyzed, and the correlations of NLR and PLR changes with the patients' clinicopathological characteristics and therapeutic effects were also analyzed.Results:There were 43 cases of increased NLR and 43 cases of increased PLR after treatment. NLR and PLR changes before and after neoadjuvant therapy in patients with rectal cancer were not associated with age, gender, TNM stage, lymph node metastasis, number of cancer nodules, and tumor diameter (all P > 0.05). The increasing proportion of NLR and PLR after treatment in patients with the distance from the tumor to anus < 6 cm was higher than that in those with the distance≥6 cm [60.00% (30/50) vs. 36. 11% (13/36), χ2 = 4.778, P = 0.029; 64.00% (32/50) vs. 30.56% (11/36), χ2 = 9.364, P = 0.002]. The increasing proportion of NLR and PLR after treatment in patients with the body mass index (BMI) ≥28 kg/m 2 was higher than that in those with BMI < 28 kg/m 2 [81.82% (9/11) vs. 45.33% (34/75), χ2 = 5.108, P = 0.024; 90.91% (10/11) vs. 44.00% (33/75), χ2 = 8.444, P = 0.004]. The remission rate of patients in NLR reduction group after treatment was higher than that in NLR increase group [72.09% (31/43) vs. 51.16% (31/43), χ2 = 3.983, P = 0.046]. PLR changes were not associated with the therapeutic effects of neoadjuvant therapy before and after treatment ( P > 0.05). Conclusion:NLR changes are associated with therapeutic efficacy before and after neoadjuvant therapy for patients with rectal cancer.

Clinical value of preoperative 18F-FDG PET-CT imaging in staging of colorectal cancer / 肿瘤研究与临床

Objective To discuss the value of preoperative 18F-FDG PET-CT imaging in the staging of colorectal cancer. Methods Eighty-three patients with colorectal cancer were studied who underwent 18F-FDG PET-CT examinations without any previous treatment and subsequent operations within one week. The results of PET-CT and pathology were analyzed with chi-square test and Kappa consistency test. Results The diagnostic accuracy of primary colorectal lesions was 100 %, the average of maximum standardized uptake value(SUVmax) was 14.54±8.10(4.43-48.19). The diagnostic accuracy of local infiltration depth, lymph node metastasis, distant metastasis and TNM staging before operation were 73.49 %(61/83), 90.36 %(75/83), 97.59 % (81/83) and 85.54 % (71/83), respectively, and the Kappa values were 0.481, 0.797, 0.950, 0.788 (P <0.05).The diagnostic sensibility of staging with T1-2,T3and T4were 30.00 %(3/10),68.42 %(13/19) and 83.33 % (45/54), respectively, the diagnostic accuracy of staging with T1-2, T3and T4were 91.57 % (76/83), 74.70 % (62/83) and 80.72 % (67/83). Conclusion Preoperative 18F-FDG PET-CT imaging is an effective staging method for colorectal cancer, and has high accuracy in the detection of primary colorectal lesions, lymph node metastasis, distant metastasis and T4stage lesions, but it is difficult for diagnosing of the T1-2and T3lesions.

Colorectal lipoma: clinical analysis of 9 cases / 中华全科医师杂志

Nine cases of colorectal lipoma who were admitted from January 2005 to December 2016 were reported.The pathological diagnosis was confirmed after surgery,and all 9 cases were cured and discharged.All patients were followed up and were alive by January 2017.

Association between hemoglobin level and health status in elderly people living in communities in Beijing / 中华老年医学杂志

Objective To investigate the correlation between hemoglobin level and health status of the elderly living in communities in Beijing.Methods A random cluster sampling method was used to select residents living in communities of Beijing city,and a cross-sectional study was carried out by questionnaires,scene testing and blood sample collection.WHO-formulated criteria were applied for diagnosing anemia.The health indicators in questionnaires included visual impairment,physical disability,decreased health,self-care,fatigue,anorexia,independent walking distance,exercise frequency,intelligence status and computing power.Results Complete information was obtained in a total of 1 948 elderly people,including 790 cases of male and 1 158 cases of female,with an average age of(73.9±6.1)years and a median age of 74 years(65-100).The mean level of hemoglobin in the 1 948 people was(135.65 ± 14.48) g/L,with (142.56 ± 15.56) g/L in male and (130.95 ± 11.53) g/L in female.Hemoglobin level was significantly lower in female than in men (t =54.739,P＜ 0.01).Hemoglobin level was decreased with aging,and negatively associated with appetite,physical strength,walk assistance,visual acuity and physical ability(r=-0.055,-0.067,-0.071,-0.114,-0.095;P =0.022,0.005,0.004,0.000,0.000),while positively associated with health status,activities in daily life,athletic ability,exercise frequency and intelligence (r =0.073,0.126,0.122,0.066,0.124;P =0.002,0.000,0.000,0.006,0.000).Conclusions The hemoglobin level of the elderly decreases with aging and is associated with health status and quality of life in the elderly,which should be taken care seriously.

Clinical efficacy of ladder neoadjuvant therapy in treatment of advanced mid-low rectal cancer / 中华肿瘤杂志

Objective@#To explore the clinical efficacy of ladder neoadjuvant therapy in treatment of advanced mid-low rectal cancer.@*Methods@#We performed a retrospective study of one hundred and eighty mid and low rectal cancer patients who underwent ladder neoadjuvant therapy(neoadjuvant chemotherapy followed by surgery if neoadjuvant chemotherapy was effective; neoadjuvant chemotherapy followed by neoadjuvant chemoradiotherapy if neoadjuvant chemotherapy was ineffective)(n=90) or neoadjuvant chemoradiotherapy (n=90).@*Results@#In the ladder neoadjuvant therapy group, the descent stage rate was 85.6% (77/90), the anastomosis rate was 50.0% (45/90), the pre-sacral infection rate was 4.4% (4/90), the pathological complete remission (pCR) was 13.3%(12/90), R0 resection rate was 85.6% (77/90), the 2-year disease control rate was 76.7% (69/90), and the 2-year survival rate was 90.0% (81/90). In the control group, the descent stage rate was 88.9% (80/90), The anastomosis rate was 45.6% (41/90), the rate of pre-sacral infection was 11.1% (10/90), pCR was 16.7% 15/90), R0 resection rate was 88.9% (80/90), the 2-year disease control rate was 78.9% (71/90), and the 2-year survival rate was 87.8% (79/90). The difference was not statistically significant (P>0.05). The ladder neoadjuvant therapy group had lower prophylactic transverse colostomyrate(10.0% vs 34.4%), lower radiation injury rate (6.7% vs 27.8%), and lower sexual dysfunction rate (38.9% vs 87.8)compared to the control group.@*Conclusions@#The ladder neoadjuvant therapy might reduce side injury caused by radiotherapy, improve compliance of patients, and reduce treatment costs. Moreover, the RO resection rate, 2-year local control rate and 2-year survival rate of ladder neoadjuvant therapy group was comparable with neoadjuvant chemoradiotherapy.

Preoperative Diagnosis of 18F-FDG PET/CT on Regional Lymph Node Metastasis in Colorectal Cancer / 中国医学影像学杂志

Purpose To discuss the diagnostic value and the optimal diagnostic threshold of preoperative 18F-FDG PET/CT imaging on regional lymph node metastasis in colorectal cancer.Materials and Methods Seventy-six patients with newly diagnosed colorectal cancer underwent radical resection of colorectal cancer within one week after PET/CT examination.All lymph nodes matching PET/CT were divided into proximal and distal lymph nodes on the basis of their location relative to the primary tumor.Meanwhile,the receiver operating characteristic (ROC) curves of the lymph node short diameter and maximum standardized uptake value (SUVmax) were created according to the pathological findings which were considered as the gold standard,and the diagnostic efficacies were analyzed.Results The proximal and distal lymph node ROC curves showed that the optimum thresholds of lymph node short diameter,SUVmax were 6.5 mm,1.9 and 5.5 mm,1.81.The sensitivity,specificity and accuracy of the diagnosis of proximal lymph node metastasis under the optimum threshold of lymph node short diameter were 84.85％,73.02％ and 77.52％,respectively;and those of distal lymph node metastasis were 97.62％,65.45％ and 79.38％,respectively.The sensitivity,specificity and accuracy of the diagnosis of proximal lymph node metastasis under the optimum threshold of SUVmax were 84.85％,95.81％ and 91.64％,respectively;those of distal lymph node metastasis were 92.86％,94.55％ and 93.81％,respectively.The specificity and accuracy of the optimum threshold of SUVmax were higher than those of the optimum threshold of lymph node short diameter (P＜0.01).The homogeneity of optimum threshold of SUVmax was excellent in comparison with the pathological results (Kappa=0.813 and 0.874,P＜0.01).Conclusion Optimum threshold method improves the diagnostic efficacy of 18F-FDG PET/CT in regional lymph node metastasis of colorectal cancer.Moreover,the SUVmax standard is superior to lymph node short diameter standard.

Relationship between CD4⁺CD25(High)CD127(low) regularly T cells in the peripheral blood and tumor regression after neoadjuvant therapy in patients with rectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To observe the proportion change of immune cells in the peripheral blood of patients with rectal cancer after neoadjuvant therapy and to explore the relationship between tumor regression and CD4⁺CD25(High)CD127(low) regularly T cells(Treg cells).</p><p><b>METHODS</b>Patients with rectal cancer who underwent the neoadjuvant therapy before surgery at the Shanxi Cancer Hospital Colorectal Surgery Department from January to December 2013 were prospectively enrolled. These patients were divided into down-staging group and non-down-staging group according to the change of staging in accordance with TNM classification for rectal cancer after neoadjuvant therapy. Flow cytometry was used to analyze the proportions of Treg cells, CD4+T cells, CD8+T cells, NK cells, B cells, and CD4+/CD8+ ratio in the peripheral blood from these patients before and after neoadjuvant therapy.</p><p><b>RESULTS</b>A total of 108 patients were enrolled, including 76 cases in the down staging group and 32 cases in the non-down-staging group. Differences of immune cells proportions between two groups before neoadjuvant therapy were not statistically significant(all P>0.05). In the down-staging group, the proportions of Treg cells, B cells and CD4+/CD8+ ratio were decreased while the proportion of NK cells did not change obviously after the neoadjuvant therapy. Interestingly, in the non-down-staging group, the proportions of B cells and CD4+/CD8+ ratio were decreased while the proportions of Treg cells and NK cells did not change obviously after the neoadjuvant therapy. In addition, after neoadjunvat therapy, the proportion of Treg cells in down-staging group was significantly lower than that in non-down-staging group [(4.4 ± 1.7)% vs. (6.2 ± 1.9)%, P=0.001].</p><p><b>CONCLUSION</b>For patients in the down-staging group after neoadjuvant therapy, the proportion of Treg cells in peripheral blood decreases, suggesting that Treg cells may be a valuable biomarker for assessing tumor regression.</p>

Investigation of operational timing and manner for the digestive tract reconstruction after Hartmann procedure in the patients with left colorectal cancer / 肿瘤研究与临床

Objective To investigate the operational timing and manner for the digestive tract reconstruction after Hartmann procedure and the prevention for the postoperative complications in the patients with left colorectal cancer.Methods The data of twenty-four cases with digestive tract reconstruction were analysed retrospectively containing the cause of Hartmann procedure for left colorectal cancer,preoperative evaluation of the digestive tract reconstruction,operation timing,operation manner,postoperative complications and length of hospital stay and so on.Results Three of 24 patients gave up the digestive tract reconstruction due to the results of their distant metastasis detection in the preoperative evaluation.As a commonly manner of digestive tract reconstruction,rectum-sigmoid colon or sigmoid-descending colon end-end anastomosis was used for 17 patients.Meanwhile,ascending colon-sigmoid colon end-side anastomosis was used for 4 patients.The incidence of postoperative complications was 14.29 ％ (3/21),and the mean time of postoperative hospital stay was 10.5 days.Conclusions In patients undergoing Hartmann procedure for left colorectal cancer,adequate assessment of the tumor recurrence and metastasis is necessary.In addition,the optimal timing of surgery should be selected after completion of chemotherapy,and operational manner should be determined by the situation of intraoperative exploration.

Levels and clinical significance of serum SP-D and MBL in infants with cytomegalovirus pneumonia / 国际儿科学杂志

Objective To investigate the levels of serum surfactant protein D (SP-D) and mannosebinding lectin (MBL) in infants with cytomegalovirus (CMV) pneumonia with the severity of disease.Methods A total of 101 hospitalized infants with CMV pneumonia were enrolled from January 2011 to December 2012.These patients were divided as the severe pneumonia group (n =48) and the mild pneumonia group (n =53) according to physical sign of lung and complication.Another 55 infants who were hospitalized in the same period with non-infectious diseases were used as the control group.Serum levels of SP-D and MBL were detected by enzyme-linked immunosorbent assay.Blood gas analyzer was used to measure arterial partial pressure of oxygen (PaO2) of the blood in severe patients.Results The mean serum SP-D levels in the severe pneumonia group [(150.08 ±52.59)ng/ml] and the mild pneumonia group [(109.67 ±31.39)ng/ml] were significantly higher than those in control group [(41.33 ± 16.42) ng/ml] (P ＜ 0.01), and higher in the severe pneumonia group than in the mild pneumonia group (P ＜ 0.01).However, there was no significant difference in serum MBL between all groups (P ＞ 0.05).In severe patients, serum SP-D levels were negatively correlated with PaO2 (r =-0.565, P ＜ 0.01).Conclusion Serum SP-D is associated with the severity of CMV pneumonia, but MBL shows no relation.The serum SP-D levels has an important clinical significance in judgment the sererity of infants with CMV pneumonia.

Effect of early enteral nutrition on postoperative recovery in patients with colon cancer / 肿瘤研究与临床

Objective To investigate the clinical application of early postoperative enteral nutrition in patients undergoing colon cancer operation.Methods 90 patients suffering from colon cancer were randomly divided into the enteral nutrition group,indwelling stomach tube group and the control group.The control group was given conventional treatment and the indwelling gastric tube group was received postoperative intermittent clamping of stomach tube and enteral nutrition.Moreover,patients in the enteral nutrition group were pulled out the tube on the first postoperative day while giving enteral nutrition.All patients were observed for exhaust defecation time,length of hospital stay postoperative and nutrition indicators.Results Exhaust defecation time,length of hospital stay postoperative had significant difference among three groups.Indwelling stomach tube group set minimum length of stay and first passage of flatus and defecation in the three groups [the enteral nutrition group:(50.07±11.59) h,(76.75±27.37) h,(10.1 1±1.57) d,the control group:(62.03±12.31) h,(90.67±25.64) h,(11.80±1.83) d,indwelling stomach tube group:(43.53±11.94) h,(61.17± 22.67) h,(8.70±1.53) d (P ＜ 0.05)].The levels of hemoglobin and plasma albumin one week after operation were statistically lower than pre-operation,while that the level of these nutrition indicators were higher in indwelling stomach tube group compare to control group (all P ＜ 0.05).The same result was observed between enteral nutrition group and control group.Whereas,the change of nutrition indicators between the enteral nutrition group and the control group was not statistical significant (P ＞ 0.05).Conclusion Indwelling stomach tube combined with enteral nutrition is a reasonable choice for patients after colonic cancer surgery.

Effective evaluation of short peptide enteral nutrition powder in advanced digestive tract cancer / 肿瘤研究与临床

Objective To study the effective evaluation of short peptide enteral nutrition powder in advanced digestive tract cancer. Methods 50 cases of advanced digestive tract cancer were randomly divided into two groups: experimental group(short peptide enteral nutrition powder) and control group(routine treatment). Results Data regarding to nutritional status and immune function (WT/IBW, TSF, MANC, ALB, TRF, PA, lgG, lgM, IgA, C3, CD3, CD4, CD8, CD4/CD8) showed a significant difference between experimental group and control group after two weeks's treatment,as well as between before and after two weeks's treatment in experimental group(P <0.05). Conclusion Short peptide enteral nutrition powder maintenance is beneficial to improve the nutritional status and the immune function of patients with advanced cancer and to promote their life quality.

Influence of Qingchangyukui Gel on Activity of SOD and Contents of MDA in Rats with Experimental Ulcerative Colitisbstract / 浙江中医药大学学报

[Objective] To observe the curative effects and the influence of activity of Superoxide dismutase(SOD) and contents of Maleic dialdehyde(MDA) of Qingchangyukui Gel in Rats with Experimental Ulcerative Colitis. [Method]Ulcerative Colitis model was established in Wistar rats by injecting trinitro-benzene-sulfonic acid (TNBS)into anus, and then treated with Qingchangyukui Gel and salisy-lazosulfa-pyridine(SASP) respectively. Isolating the colon and measuring the SOD and MDA after treating for two weeks. [Results]Colon mucous membrane in the model group had serious erosion, ulcer, damaging of glandular organ, high inflammation grade; activity of SOD in model group was significantly lower than in normal group and contents of MDA increased. The other groups, especially in Qingchangyukui Gel group, had different levels of inflammation repairing, ulcer healing, increasing of SOD and reducing of MDA. [Conclusion]TNBS can cause Colon mucous membrane inflammation and ulcer, reducing of SOD and increasing of MDA , which are the typical pathological change of Ulcerative Colitis; the Qingchangyukui Gel has the effects of increasing the activity of SOD and reducing contents of MDA, therefore it can effectively treat the UC rat.