Risk factors of nonalcoholic fatty liver disease with a normal visceral adipose tissue area / 临床肝胆病杂志

ObjectiveTo investigate the risk factors and insulin resistance (IR) of nonalcoholic fatty liver disease (NAFLD) with a normal visceral adipose tissue (VAT) area. MethodsA total of 45 NAFLD persons with a normal VAT area who were admitted to Quanzhou First Hospital Affiliated to Fujian Medical University from June 2017 to May 2018 were enrolled as observation group, and 27 non-NAFLD patients with a normal VAT area were enrolled as control group. VAT area, waist circumference, fasting blood glucose (FBG), and fasting insulin (FINS) were measured for both groups, homeostasis model assessment of insulin resistance (HOMA-IR) was calculated, and the correlation of IR with the indices including waist circumference was analyzed. The independent samples t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between groups. Pearson correlation analysis and Spearman correlation analysis were used to investigate the correlation of normally and non-normally distributed continuous data. A forward logistic regression analysis was used to identify related risk factors. ResultsThe NAFLD group had a significantly higher level of IR than the control group, and there was a significant difference in HOMA-IR between the two groups (2.66(1.59-4.06) vs 1.84(125-2.47), Z=364.000, P=0005). IR was positively correlated with FBG (r=0.412, P=0.005), FINS (r=0.789, P＜0001), and TG (r=0.306, P=0041). IR was negatively correlated with HDL(r=-9398,P=0007). The multivariate regression analysis showed that waist circumference was an independent risk factor for NAFLD with a normal VAT area (regression coefficient = 0.181, odds ratio = 1.198, 95% confidence interval: 1.099-1.306, P＜0.001). ConclusionThere is a certain degree of IR in NAFLD patients with a normal VAT, and waist circumference is an independent risk for NAFLD with a normal VAT.

Clinical application of pancreatic cancer nomogram / 中华肝胆外科杂志

Pancreatic cancer is one of the gastrointerstinal tumors with high malignancy and poor prognosis,so analyzing the prognosis of the patients based on the clinical data may provide an important reference for the formulation of individualized treatment plan and clinical decision making.The nomogram model can quantify various risk factors to analyze the risk value of related clinical events.At present,the nomogram in pancreatic cancer is mainly used for predicting the postoperative survival of patients with pancreatic ductal adenocarcinoma (PDAC),the cancerization risk and the chemotherapy effect evaluation of patients with intraductal papillary mucinous neoplasms (IPMN),meanwhile,these three aspects are also evaluated by a series of indexes such as predictive factors,prediction accuracy and so on.This article will summarize the latest research progress about pancreatic cancer related nomogram model.

The hyperplantarflexion ankle fracture variant / 中华创伤骨科杂志

Objective To investigate the characteristics,trauma mechanism and treatment of the hyperplantarflexion ankle fracture variant.Methods Between January 2013 and June 2015,125 consecutive patients with ankle fracture received operative treatment.In 18 of them,the ankle joint had been subjected to excessive violence of plantarflexion.They were 6 males and 12 females,aged from 15 to 67 years (average,47.6 years).Their pre-operative ankle radiographs showed sagittal ankle instability and posterior ankle dislocation or subluxation.The injury was complicated with medial malleolus fracture and fibular fracture.Posterolateral approach or posterolateral and posteromedial approach was adopted to treat the patients.Lag screws and anti-glide plates were applied.Results All the 18 patients were followed up for 10 to 25 months (average,16.8 months).All their fractures healed after 11 to 16 weeks (average,13 weeks).Superficial skin necrosis occurred in one patient undergoing dual-plate fixation of the dual malleoli but responded to change of dressing 3 weeks later.No screw loosening,fixation breakage or failure,nonunion or malunion happened.Their final follow-ups showed an average American Orthopedic Foot Ankle Society score of 94.8 ponits (from 76 to 100 points),yielding 13 excellent and 5 good cases (an excellent to good rate of 100％).Conclusions The hyperplantarflextion ankle fracture variant is caused by excessive violence of planter flexion to the ankle joint,with the force on the sagittal plane going from anteriorly to posteriorly,resulting in posterior talar displacement.Its treatment should vary from that for other ankle fractures because it has its own characteristics.Appropriate treatment may lead to satisfactory outcomes.

Clinical application of pancreatic cancer nomogram / 中华肝胆外科杂志

Pancreatic cancer is one of the gastrointerstinal tumors with high malignancy and poor prognosis,so analyzing the prognosis of the patients based on the clinical data may provide an important reference for the formulation of individualized treatment plan and clinical decision making.The nomogram model can quantify various risk factors to analyze the risk value of related clinical events.At present,the nomogram in pancreatic cancer is mainly used for predicting the postoperative survival of patients with pancreatic ductal adenocarcinoma (PDAC),the cancerization risk and the chemotherapy effect evaluation of patients with intraductal papillary mucinous neoplasms (IPMN),meanwhile,these three aspects are also evaluated by a series of indexes such as predictive factors,prediction accuracy and so on.This article will summarize the latest research progress about pancreatic cancer related nomogram model.

The analysis of the relationship between the severity of non-alcoholic fatty liver disease and metabolic syndrome / 中国综合临床

Objective To investigate the relationships between the severity of non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MS).Methods One hundred and twenty-seven cases of NAFLD patients were selected from March 2011 to August 2012 in the First Hospital Affiliated to Fujian Medical University,of them,61 patients with mild NAFLD,45 patients with moderate and 21 patients with severe.And 21 cases without NAFLD were selected as control group during the same hospitalized period.All objects received the measures of height,body weight,waist circumference (WC),blood pressure; Liver ultrasonic examination,the examination of fasting plasma glucose,blood fat and hepatic function detections were also handed by special people.Results The proportion of overweight in the control group and the three NAFLD subgroups were 57.1％ (12/21),88.5％ (54/61),95.6％ (43/45) and 100％ (21/21) respectively (x2 =18.376,P ＜0.001) ;The proportion of the obesity in control group and the three NAFLD subgroups were 19.0％ (4/21),44.3％ (27/61),64.4％ (29/45) and 71.4％ (15/21) respectively(x2 =16.440,P =0.001).The proportion of the metabolic syndrome of the control group and the three NAFLD subgroups were 14.3％ (3/21),45.9％(28/61),71.1％ (32/45) and 71.4％ (15/21) respectively (x2 =22.637,P ＜ 0.05).All three subgroups of NAFLD were higher than the control group (x2 =6.641,P ＜ 0.05 ; x2 =18.562,P ＜ 0.05 ; x2 =14.000,P ＜0.05,respectively).The severity of NAFLD was positively correlated with BMI,WC,TG,FBG,SBP,and DBP (r =0.467,0.503,0.386,0.369,0.279,0.295,P ＜ 0.01),and negatively correlated with HDL-C (r =-0.209,P ＜0.05).Conclusion The severity of NAFLD had significant correlations with metabolic syndrome's components.