Research advances in abnormal gluconeogenesis in hepatocellular carcinoma / 临床肝胆病杂志

Tumors still perform glycolysis in the aerobic environment to accelerate the uptake of glucose and produce a large amount of lactic acid in tumor microenvironment, provide biomolecular precursors of nucleotides, lipids, and proteins for tumor cell proliferation, and inhibit the function of immune cells and promote the metastasis of tumor cells in acidic environment. Gluconeogenesis, as the reverse reaction of glycolysis, is inhibited in hepatocellular carcinoma, especially the downregulated expression of the four key rate-limiting enzymes pyruvate carboxylase, phosphoenolpyruvate carboxykinase, fructose-1, 6-diphosphate 1, and glucose-6-phosphatase 4, which promotes the growth and proliferation of hepatocellular carcinoma by promoting aerobic glycolysis and its branched pathways, and meanwhile, it is also associated with the overall survival time and prognosis of patients with hepatocellular carcinoma and is considered an inhibitor for hepatocellular carcinoma. Therefore, this review summarizes the changes and mechanism of action of the key enzymes of gluconeogenesis in the development and progression of hepatocellular carcinoma and analyzes the shortcomings and future directions of related research in hepatocellular carcinoma, so as to provide new ideas for the treatment of hepatocellular carcinoma.

Fasting Blood Glucose, Cholesterol, and Risk of Primary Liver Cancer: The Kailuan Study / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#The influence of fasting blood glucose (FBG) and cholesterolemia primary liver cancer (PLC) in china was analyzed via a large prospective cohort study based on a community population, and the combined effects between them were investigated. @*Materials and Methods@#Overall, 98,936 staff from the Kailuan Group who participated in and finished physical examinations between 2006 and 2007 were included in the cohort study. Their medical information was collected and they were followed up after examination. The correlations of serum FBG or TC with PLC were analyzed. Then, we categorized all staff into four groups: normal FBG/ non-hypocholesterolemia, normal FBG/hypocholesterolemia, elevated FBGon-hypocholesterolemia, elevated FBG/hypocholesterolemia and normal FBG/ non-hypocholesterolemia was used as a control group. The combined effects of elevated FBG and hypocholesterolemia with PLC were analyzed using the Age-scale Cox proportional hazard regression model. @*Results@#During 1,134,843.68 person*years follow up, a total of 388 PLC cases occured. We found the elevated FBG and hypocholesterolemia increases the risk for PLC, respectively. Compared with the non-hypocholesterolemiaormal FBG group, the risk of PLC was significantly increased in the non-hypocholesterolemia/elevated FBG group (HR=1.19,95%CI 0.88–1.62) and hypocholesterolemiaormal FBG group (HR=1.53,95%CI 1.19–1.97), and in the hypocholesterolemia/elevated FBG group (HR=3.16 95%CI2.13-4.69). And, a significant interaction effect was found of FBG and TC on PLC. All results were independent from the influence of liver disease. @*Conclusion@#Elevated serum FBG and hypocholesterolemia are risk factors for PLC, especially when combined. Thus, for the prevention and treatment of PLC, serum FBG and TC levels should be investigated.

Risk factors of surgical incision infection in patients with gastrointestinal perforation / 中华全科医师杂志

The clinical data of 288 patients with gastrointestinal perforation undergoing surgical treatment from Jul 2014 to Jul 2017 were retrospectively analyzed,among whom the surgical incision infection occurred in 112 patients(38.9％).The risk factors of the incision infections were examined with logistic regression analysis.The univariate analysis showed that preoperative albumin level (≤30 g/L),body mass index (＞24.0 kg/m2),duration of abdominal pain(＞24 h),extension of incision,preoperative shock,colostomy,preoperative antibiotic use and the operation time were associated with incision infections(P＜0.05),while the gender,age,preoperative hemoglobin level,diabetes,incision length were not associated with the incision infections(P＞0.05).The multivariate logistic regression analysis showed that the body mass index(OR=1.61,P＜0.01),gastrointestinal perforation site(colon and rectum,OR=5.60,P＜0.01),extension of incision (OR=3.94,P＜0.01) and operation time(OR=1.04,P=0.02)were independent risk factors of theincision infection.The results suggest that the full preoperative preparation,intensive treatment of underlying diseases,avoiding incision extension and shortening operation time may be able to reduce the surgical incision infections for patients with the gastrointestinal perforation.

One-step treatment of low anal fistula plus mixed hemorrhoids with automatic ligation / 中华全科医师杂志

Sixty two patients with low anal fistula were treated by anal fistulectomy (fistula group) and 82 patients with mixed hemorrhoids were treated by automatic ligation of hemorrhoids (RPH group) and 38 patients with anal fistula plus mixed hemorrhoids were treated by the RPH and anal fistulectomy (fistula plus RPH group),the clinical data of patients were retrospectively analyzed.The complication rate,the degree of pain and,the urination disorders,the postoperative recurrent rate,scar area and the anal functions were observed and compared.There were no differences in pain degree at d1 and d3 among three groups(P ＞ 0.05).There was significant difference in urination disorders between the fistula group and anal fistula plus RPH group (8％ vs.32％,P ＜ 0.05),but no differences between the RPH group and anal fistula plus RPH group (11％ vs.32％,P ＞ 0.05).There were significant differences in scar area and the anal functions between anal fistula group and anal fistula plus RPH group(P ＜ 0.05).There were no postoperative massive hemorrhage,proctenclisis and infection in all three groups.

Predictive value of serum uric acid on new-onset cholelithiasis (a report of 97 469 cases) / 中华消化外科杂志

Objective To explore the predictive value of serum uric acid on new-onset cholelithiasis.Methods The retrospective cohort study was conducted.The data of 97 469 subjects who participated health examination at the Kailuan General Hospital Affiliated to the North China University of Science and Technology,Kailuan Linxi Hospital,Kailuan Zhaogezhuang Hospital,Kailuan Tangjiazhuang Hospital,Kailuan Fan'gezhuang Hospital,Kailuan Lyujiatuo Hospital,Kailuan Jinggezhuang Hospital,Kailuan Linnancang Hospital,Kailuan Qianjiaying Hospital,Kailuan Majiagou Hospital and Kailuan Branch Hospital from June 2006 to December 2015 were collected.Epidemiological investigation,anthropometric parameters and biochemical indicators were collected.All the subjects were allocated into 4 groups according to squartiles of serum uric acid:24 140 with serum uric acid ＜232 μmol/L in the Q1 group,24 473 with 232 μmol/L≤ serum uric acid ＜282 μmol/L in the Q2 group,24 382 with 282 μmol/L≤ serum uric acid ＜338 μmol/L in the Q3 group and 24 474 with serum uric acid ≥ 338 μmol/L in the Q4 group.Observation indicators:(1) comparisons of clinical characteristics among the 4 groups;(2) incidence of cholelithiasis in the 4 groups;(3) effects of serum uric acid on the new-onset cholelithiasis:① the dose-response relationship between serum uric acid and the risk of cholelithiasis,② comparisons of the fitting degree of serum uric acid on the cholelithiasis model,③ effects of different serum uric acid levels on incidence of cholelithiasis after stratification by sex,④ serum uric acid of different gender on the boxplots,⑤ effects of different serum uric acid levels on the incidence of cholelithiasis after stratification by age.Measurement data with normal distribution were expressed as (x)±s,and comparisons among groups were analyzed using the one-way ANOVA.Measurement data with skewed distribution is expressed by M (Q),and comparisons among groups were analyzed using the nonparametric Krustal-willis test.Count data were represented by percentage,and comparisons among groups were analyzed using chi-square test.The incidences of cholethiasis in 4 groups of different serum uric acid were calculated by person-year incidence.Restrictive cubic spline regression was used to calculate the dose-response relation between the continuous variable and the risks of new-onset cholelithiasis and 95％ confidence interval (CI).COX regression model was used to analyze the hazard ratio (HR) and 95％ CI of different serum uric acid levels on new-onset cholelithiasis.Likelihood ratio test and akaike information criterion (AIC) were used to calculate the fitting degree of serum uric acid on new-onset cholelithiasis model.Boxplots were used to describe serum uric acid in different genders.Results (1) comparisons of clinical characteristics among the 4 groups:sex (male),age,body mass index (BMI),systolic pressure,diastolic pressure,fasting plasma glucose (FPG),total cholesterol (TC),triglyceride (TG),high sensitive C-reactive protein,diabetes,hypertension,smoking,drinking and physical exercise were 15 162,(50± 11) years,(24±3)kg/m2,(123±21)mmHg (1 mmHg=0.133 kPa),(82± 12)mmHg,(5.6±2.0) mmol/L,(4.8±1.2) mmol/L,1.14 mmol/L (range,0.81-1.63 mmol/L),0.70 mmol/L (range,0.23-2.23 mmol/L),2 537,9 415,4575,2380,2 649 in the Q1 group,19 079,(51±12) years,(25±3)kg/m2,(130±21)mmHg,(83±12) mmHg,(5.5 ± 1.7) mmol/L,(4.9 ± 1.2) mmol/L,1.20 mmol/L (range,0.86-1.76 mmol/L),0.71 mmol/L (range,0.28-1.98 mmol/L),2 287,10 124,6 918,3 649,3 288 in the Q2 group,21 132,(52±13)years,(25±3)kg/m2,(132±21)mmHg,(84±12)mmHg,(5.5±1.6)mmol/L,(5.0±1.2) mmol/L,1.29 mmol/L (range,0.91-1.94 mmol/L),0.80 mmol/L (range,0.30-2.06 mmol/L),2 027,10 755,8 259,4 730,3 958 in the Q3 group,22 651,(53± 14) years,(26± 3) kg/m2,(134± 21) mmHg,(85±12)mmHg,(5.4±1.5)mmol/L,(5.1±1.2)mmol/L,1.54 mmol/L (range,1.05-2.35 mmol/L),1.02 mmol/L (range,0.43-2.50 mmol/L),1 981,12 082,9 562,6 209,4 758 in the Q4 group,respectively,with statistically significant differences among the 4 groups (x2 =7 624.63,F=279.93,961.91,330.84,271.40,38.25,353.18,H =3 406.30,912.23,x2 =108.15,590.49,2567.07,2 209.21,760.15,P＜0.05).(2)Incidence of cholelithiasis in the 4 groups:97 469 participants were followed up for 592 922 person-year,4 270 participants had new-onset cholelithiasis,with a total person-year incidence of 7.20 thousand person / year.The person-year incidence were respectively 6.34 (971/153 205 * 1 000),6.91 (1 034/149 686 * 1 000),7.44 (1 090/146 549 * 1 000),8.19 (1 175/143 482 * 1 000) thousand person / year in Q1,Q2,Q3 and Q4 group.(3) Effects of serum uric acid on the new-onset cholelithiasis.① The dose-response relationship between serum uric acid and the risk of cholelithiasis:restricted cubic spline regression showed a linear relationship between continuous serum uric acid,logarithmic transformated serum uric acid and the risk of cholelithiasis (x2 =11.74,8.01,P＜0.05).② Comparisons of the fitting degree of serum uric acid on the cholelithiasis model:adjusted for sex,age,BMI,TC,TG,diabetes,hypertension,smoking,drinking and physical exercise,risks of new-onset cholelithiasis increased in Q3 and Q4 groups compared with Q1 group (HR=1.10,1.12,95％CI:1.01-1.20,1.03-1.23,P＜0.05).The-2Log L and AIC value of multivariate model,serum uric acid+multivariate model were 92 532.39,92 550.39 and 92 525.35,92 549.35,respectively,with a statistically significant difference (x2=7.04,P ＜ 0.05).③ Effects of different serum uric acid levels on incidence of cholelithiasis after stratification by sex:in female participants,adjusted for age,BMI,TC,TG,diabetes,hypertension,smoking,drinking and physical exercise,risk of new-onset cholelithiasis in Q1 group was not statistically significant different from that in Q2,Q3,Q4 group (HR=1.06,1.15,1.09,95％CI:0.88-1.28,0.93-1.34,0.91-1.31,P＞0.05).In male participants,adjusted for age,BMI,TC,TG,diabetes,hypertension,smoking,drinking and physical exercise,risks of new-onset cholelithiasis in Q2,Q3 and Q4 groups were increased compared with Q1 group (HR=1.17,1.24,1.30,95％CI:1.06-1.30,1.12-1.37,1.18-1.44,P＜0.05).④ Serum uric acid of different gender on the boxplots:in female participants,the level of serum uric acid was (249 ± 61) μmol/L,(235±50)μmol/L,(231±56) μmol/L,(250±66) μmol/L,(266±75) μmol/L,(281±81) μmol/L,(298±76) μmol/L,(379±86)μmol/L respectively in the group of 18-27 years old,28-37 years old,38-47 years old,48-57 years old,58-67 years old,68-77 years old,78-87 years old,88-97 years old after stratified by 10 years old.In male participants,the level of serum uric acid was respectively (310±76)μmol/L,(298 ±75) μmol/L,(298±74) μmol/L,(294±74) μmol/L,(302±78) μmol/L,(311 ±80) μmol/L,(322±80) μmol/Land (330±75)μmol/L after participants stratified by 10 years old.⑤ Effects of different serum uric acid levels on the incidence of cholelithiasis after stratification by age:in participants with age ≤ 60 years old,adjusted for sex,BMI,TC,TG,diabetes,hypertension,smoking,drinking and physical exercise,risk of new-onset cholelithiasis in the Q2 and Q3 groups were not increased compared with Q1 group (HR=1.05,1.10,95％CI:0.94-1.17,0.99-1.23,P＞0.05),however,risk of new-onset cholelithiasis was increased in the Q4 group (HR =1.15,95％CI:1.02-1.28,P＜0.05).In participants with age ＞ 60 years old,adjusted for sex,BMI,TC,TG,diabetes,hypertension,smoking,drinking and physical exercise,risk of new-onset cholelithiasis in the Q2 groups was not increased compared with Q1 group (HR=1.16,95％CI:0.99-1.36,P＞0.05),however,risks of new-onset cholelithiasis were increased in the Q3 and Q4 groups (HR =1.19,1.21,95％CI:1.02-1.40,1.04-1.41,P＜ 0.05).Conclusion Elevated serum uric acid is an independent risk factor for the new-onset cholelithiasis.

An epidemiological investigation of cholelithiasis in employees of Kailuan Corporation in Tangshan of Hebei Province, China / 临床肝胆病杂志

ObjectiveTo investigate the prevalence of cholelithiasis in the employees of Kailuan Corporation and to provide a reference for effective preventive measures. MethodsA total of 101 510 in-service or retired employees of Kailuan Corporation were recruited. All of them completed checkups organized by Kailuan Corporation from June 2006 to October 2007. The cholelithiasis examination data of 1133 employees were lost and the data of 100 377 employees were finally included in the statistical analysis. Questionnaire survey, blood biochemical examination, and ultrasound examination of the gallbladder were carried out. According to the ultrasound examination results, the subjects were divided into cholelithiasis group and non-cholelithiasis group. Comparison of the means between the two groups was made by t-test and comparison of the incidence rates between the two groups was made by chi-square test. The risk factors for cholelithiasis were assessed using multiple logistic regression analysis. ResultsThere were 80 129 males and 20 248 females in the 100 377 subjects. Their ages ranged from 18 to 98 years (mean, 51.89±12.66 years). There were 98 109 subjects without cholelithiasis and 2268 subjects (2.3%) with cholelithiasis. The females had a significantly higher incidence of cholelithiasis compared with the males (2.5% vs 2.2%, χ2=4.60, P=0033). The incidence rate of cholelithiasis increased with age in both men and women. According to the result of logistic regression analysis, sex, age, body mass index, occupation, fasting plasma glucose, high-sensitivity C-reactive protein (hs-CRP), and cholecystitis were all risk factors for cholelithiasis and the odds ratios (95% confidence interval) of them were 0.765(0.687-0.853), 1.439(1.388-1493), 1.403(1.282-1.535), 0.821(0.706-0.955), 1.234(1.075-1.416), 1.080(1.022-1.142), and 12.519(10678-14678), respectively. ConclusionPeople with advanced age, female sex, obesity, hyperglycemia, high hs-CRP, cholecystitis, or unhealthy lifestyle have high risk of cholelithiasis.

An epidemiological investigation of cholelithiasis in employees of Kailuan Corporation in Tangshan of Hebei Province, China / 临床肝胆病杂志

ObjectiveTo investigate the prevalence of cholelithiasis in the employees of Kailuan Corporation and to provide a reference for effective preventive measures. MethodsA total of 101 510 in-service or retired employees of Kailuan Corporation were recruited. All of them completed checkups organized by Kailuan Corporation from June 2006 to October 2007. The cholelithiasis examination data of 1133 employees were lost and the data of 100 377 employees were finally included in the statistical analysis. Questionnaire survey, blood biochemical examination, and ultrasound examination of the gallbladder were carried out. According to the ultrasound examination results, the subjects were divided into cholelithiasis group and non-cholelithiasis group. Comparison of the means between the two groups was made by t-test and comparison of the incidence rates between the two groups was made by chi-square test. The risk factors for cholelithiasis were assessed using multiple logistic regression analysis. ResultsThere were 80 129 males and 20 248 females in the 100 377 subjects. Their ages ranged from 18 to 98 years (mean, 51.89±12.66 years). There were 98 109 subjects without cholelithiasis and 2268 subjects (2.3%) with cholelithiasis. The females had a significantly higher incidence of cholelithiasis compared with the males (2.5% vs 2.2%, χ2=4.60, P=0033). The incidence rate of cholelithiasis increased with age in both men and women. According to the result of logistic regression analysis, sex, age, body mass index, occupation, fasting plasma glucose, high-sensitivity C-reactive protein (hs-CRP), and cholecystitis were all risk factors for cholelithiasis and the odds ratios (95% confidence interval) of them were 0.765(0.687-0.853), 1.439(1.388-1493), 1.403(1.282-1.535), 0.821(0.706-0.955), 1.234(1.075-1.416), 1.080(1.022-1.142), and 12.519(10678-14678), respectively. ConclusionPeople with advanced age, female sex, obesity, hyperglycemia, high hs-CRP, cholecystitis, or unhealthy lifestyle have high risk of cholelithiasis.

Etiology and treatment strategies for pediatric cholecystolithiasis / 中华全科医师杂志

A total of 55 children aged under 14 years with cholecystolithiasis were treated at our hospital between January 2005 to December 2011.Their clinical data were collected and analyzed.The etiologies included pseudolithiasis (n =36),chronic hemolytic disease (n =2),obesity (n =9) and unknown (n =8).Among 50 cases on conservative treatment,42 cases were cured.Four cases underwent laparoscopic cholecystectomy.During a follow-up period of 2-4 years,there was no occurrence of significant complications.The removal of gallbladder stone was performed via laparoscopy plus choledochoscope in 1 case.There was no recurrence during a follow-up period of 2 years.Ceftriaxone sodium and obesity were the major cause of pediatric cholecystolithiasis.A proper selection of treatment regimens should be based upon the considerations of etiologies and symptoms.

Observation on Therapeutic Effects of Acupuncture and Moxibustion for Primary Dysmenorrhea / 针灸推拿医学（英文版）

Objective: To assess the clinical effects of acupuncture treatment for primary dysmenorrhea. Methods: 80 cases of the patients were randomly divided into two groups by single blind to 40 cases in the acupuncture group were treated with acupuncture plus ginger-partitioned moxibustion. 40 cases in the medication group were treated with oral administration of Ibuprofen sustained release capsules. The therapeutic effects were observed after continuous treatment for 3 months. Results: The total effective rate was 85.0% in the acupuncture group and 70.0% in the medication group, with statistical significance in comparison of differences between the two groups (P<0.05) Conclusion: Acupuncture plus ginger-partitioned moxibustion is better than Ibuprofen sustained release capsules in treating dysmenorrhea.