Detection rates of adenomas, advanced adenomas, and colorectal cancers among the opportunistic colonoscopy screening population: a single-center, retrospective study / 中华医学杂志(英文版)

BACKGROUND@#Colorectal cancer (CRC) screening is effective in reducing CRC incidence and mortality. The aim of this study was to retrospectively determine and compare the detection rate of adenomas, advanced adenomas (AAs) and CRCs, and the number needed to screen (NNS) of individuals in an average-risk Chinese population of different ages and genders.@*METHODS@#This was a retrospective study performed at the Institute of Health Management, Chinese People's Liberation Army General Hospital. Colonoscopy results were analyzed for 53,152 individuals finally enrolled from January 2013 to December 2019. The detection rate of adenomas, AAs, or CRCs was computed and the characteristics between men and women were compared using chi-squared test.@*RESULTS@#The average age was 48.8 years (standard deviation [SD], 8.5 years) for men and 50.0 years (SD, 9.0 years) for women, and the gender rate was 66.27% (35,226) vs . 33.73% (17,926). The detection rates of adenomas, AAs, serrated adenomas, and CRCs were 14.58% (7750), 3.09% (1641), 1.23% (653), and 0.59% (313), respectively. Men were statistically significantly associated with higher detection rates than women in adenomas (17.20% [6058/35,226], 95% confidence interval [CI] 16.74-17.53% vs . 9.44% [1692/17,926], 95% CI 8.94-9.79%, P  < 0.001), AAs (3.72% [1309], 95% CI 3.47-3.87% vs . 1.85% [332], 95% CI 1.61-2.00%, P  < 0.001), and serrated adenomas (1.56% [548], 95% CI 1.43-1.69% vs . 0.59% [105], 95% CI 0.47-0.70%, P  < 0.001). The detection rate of AAs in individuals aged 45 to 49 years was 3.17% (270/8510, 95% CI 2.80-3.55%) in men and 1.69% (69/4091, 95% CI 1.12-1.86%) in women, and their NNS was 31.55 (95% CI 28.17-35.71) in men and 67.11 (95% CI 53.76-89.29) in women. The NNS for AAs in men aged 45 to 49 years was close to that in women aged 65 to 69 years (29.07 [95% CI 21.05-46.73]).@*CONCLUSIONS@#The detection rates of adenomas, AAs, and serrated adenomas are high in the asymptomatic population undergoing a physical examination and are associated with gender and age. Our findings will provide important references for effective population-based CRC screening strategies in the future.

Relationship between the blood test results of thyroid function and intolerance to 14 kinds of foods in physical examination population / 中华健康管理学杂志

Objective:To investigate the relationship between the blood test results of seven items of thyroid function and intolerance to 14 kinds of foods in physical examination population.Methods:Total of 45 764 participants who received physical examination and accepted 14-kind food intolerance and 7-item thyroid function detection from August 2016 to September 2019 in Chinese People′s Liberation Army General Hospital were included in this study. The data were analyzed based on age, gender, body mass index, smoking and drinking status, and laboratory test indexes. Chi square test and univariate or multivariate logistic regression were applied to analyze the correlation between food intolerance and thyroid function in the physical examination population.Results:In the subjects, there were 29 361 cases (64.16%) with at least intolerance to one kind of food, and 15 011 (32.80%) were in Grade 1, 9 037 (19.75%) in grade 2 and 5 313 (11.61%) in grade 3. The positive rate of egg intolerance was the highest (34.06%), and that of beef intolerance was the lowest (1.24%). Of the participants, 11 337 (24.77%) had at least one item thyroid dysfunction, among them, the highest abnormal rate was found in thyroid stimulating hormone (TSH), followed by anti-thyroglobulin antibodies and anti-thyroid peroxidase antibodies. The proportion (26.32%) of abnormal thyroid function in the participants with at least intolerance to one kind of food was significantly higher than that (22.00%) in the participants without intolerance to the 14 kinds of foods ( χ2=105.78, P<0.001). After adjusting for other significantly related factors, the positive results of intolerance to 14 kinds of foods was still the significant influencing factor of thyroid function abnormalities ( OR=1.14, Z=5.68, 95% CI: 1.09-1.20, P<0.001). Further analysis showed that, after adjusted for age, gender, smoking and drinking status, intolerance to four kinds of foods (egg, soybean, crab and pork) were the significant influencing factors of abnormal thyroid function. Conclusions:Food intolerance is an independent risk factor of thyroid dysfunction. Among them, egg, soybean, crab and pork may be the most important food varieties should be paid more attention to.

Comparative clinical study of laparoscopic versus open liver resection in elderly patients with hepatocellular carcinoma / 中华老年医学杂志

Objective To evaluate the feasibility and efficacy of laparoscopic liver resection (LLR) in elderly patients with hepatocellular carcinoma (HCC). Methods Twenty-nine elderly patients undergoing laparoscopic liver resection (LLR) and 58 elderly patients receiving open liver resection (OLR) for HCC were included from January 2013 to December 2015 in our department of Fujian Medical University. Two groups were 1:2 matched for gender ,tumor numbers ,and operative procedure.Besides ,general clinical data ,intraoperative data ,postoperative recovery ,and postoperative survival were compared. Results The postoperative hospital stay was shorter in the LLR group [(9.1±3.8)days]thanintheOLRgroup[(11.8±5.1)days](t= -2.66,P<0.05).Theincidence of portal triad clamping was lower in the LLR group than in the OLR group (34.5％ vs.60.3％ ,χ2 =5.18 ,P<0.05). The removal time of abdominal drainage tube was earlier in the LLR group (4.18 ± 1.94)days than in the OLR group (5.4 ± 2.1)days (t= -2.48 ,P<0.05). The overall survival (OS) showed no difference (37.08 months vs.38.72 months ,t=0.72 ,P=0.789). The disease-free survival (DFS) showed no difference (29.00 months vs.27.49 months ,t=0.53 ,P=0.467). Conclusions LLR in elderly patients with HCC can achieve the same long-term outcome as the conventional open hepatectomy ,and LLR has better short-term outcomes with obvious advantages of minimal invasion.

Investigation on ideal cardiovascular health status in 37664 health checkup subjects / 中华健康管理学杂志

Objective To investigate the distribution of ideal cardiovascular health status in Chinese health checkup population. Methods Subjects were enrolled from a health checkup population coming to the PLA health management center from Sept 2009 to Mar 2016. Modified with China's specifications, lifestyle and checkup data were collected and analyzed according to the American ideal cardiovascular health standard. Results A total of 37664 people were included in the study, of whom 72.88%were male and 27.12%were female. Comprehensive analysis showed that, among 7 health indicators including smoking, physical activity, diet, fasting blood glucose, blood pressure, total cholesterol and body mass index, there were only 43 subjects (0.11%) whose lifestyle reached the ideal cardiovascular health status, 11 subjects were in the poor cardiovascular health status, accounting for 0.03%. The rest of the subjects were in the intermediate levels of cardiovascular health status. There was a large gap between the daily diet intake and the dietary recommendation, and there was also a large gap between the actual level physical activity and the ideal level of physical activity recommended by related guidelines, indicating that unhealthy diet and inadequate physical activity are two bottleneck factors. Dairy product intake has the lowest satisfaction ratio, followed by vegetable and fruit intake. Most subjects (94.10%) showed insufficient physical activity. The percentage of three status of cardiovascular health among young, middle-aged and elderly subjects differed significantly (χ2=1200, P=0.000), and presented an increasing trend of ideal cardiovascular health and a declining trend of poor cardiovascular health status with age from youth to middle age, to the elderly, which reflected insufficient physical activity especially among the young people, and then the middle-aged. Meanwhile, the proportion of ideal cardiovascular health in men was higher than that in women. Conclusion The rate of ideal cardiovascular health is relatively low in the study population, unhealthy diet and inadequate physical activity are two bottleneck factors. Encouraging people to develop good eating and exercise habits might be the most effective method to improve population's ideal cardiovascular health status.

Clinical efficacy of laparoscopic liver resection versus open liver resection for hepato-cellular carcinoma / 中国肿瘤临床

Objective:To compare the short-and long-term outcomes of laparoscopic liver resection (LLR) with those of open liver re-section (OLR) for hepatocellular carcinoma (HCC). Methods:Clinical data from patients who suffered from HCC and received LLR or OLR from January 2013 to May 2016 in The First Affiliated Hospital of Fujian Medical University were analyzed restrospectively. To over-come selection bias, a 1:1 match was performed via a case-control study. After case-control matching was completed, 105 patients were included in each group. Short-term outcomes of operation and postoperation as well as long-term outcomes, including disease-free survival and overall survival rates, were evaluated. Relevant statistical methods were used for statistical analysis. Results: The postoperative hospital stay of the laparoscopic group was shorter (8.68 ± 2.82 vs. 10.61 ± 2.95 days, P<0.01) and its use of portal triad clamping was less (20.0%vs. 41.0%, P<0.01) than those of the open group. The abdominal drainage tube of the laparoscopic group was also removed at an earlier time than that of the open group (4.45±2.53 vs. 5.40±2.43 days, P<0.01). The 1-, 2-, and 3-year overall survival rates of the laparoscopic group were 96.88%, 87.54%, and 79.50%, respectively. By comparison, the 1-, 2-, and 3-year overall survival rates of the open group were 94.91%, 86.29%, and 76.37%, respectively (P=0.670). The 1-, 2-, and 3-year disease-free survival rates of the laparoscopic group were 72.09%, 60.16%, and 52.08%, respectively, while the 1-, 2-, and 3-year disease-free survival rates of the open group were 69.48%, 56.50%, 48.13%, respectively (P=0.388). Conclusion:LLR is a safe and feasible procedure. LLR in the selected patients with HCC showed similar long-term outcomes to those of OLR. The postoperative hospital stay of these patients who underwent LLR was shorter and their use of portal triad clamping was less than those of the patients who received OLR. The abdomi-nal drainage tube of the former was also removed at an earlier time than that of the latter. Therefore, the short-term outcomes of LLR were better than those of OLR.

A cross sectional survey on the prevalence of food intolerance and its determinants through physical checkup programs in the elderly / 中华流行病学杂志

Objective To explore the prevalence of food intolerance and its determinants in healthcare elderly in China.Methods A cross sectional survey was carried out from August 1st,2008 to June 30th,2009,that including 736 60-year-olds from a Health Management Research Institute,Chinese PLA General Hospital.Data was double entried in computer and organized by EpiData 3.0.Non conditional logistic regression model was used for odd ratio (OR)and 95％CI,with the use of SPSS 13.0.Results The three leading foodstuff on intolerance were crab,egg and shrimp,with the prevalence rates as 35.9％,28.8％ and 15.1％ respectively.Results from the multiple regression analysis showed that the crab intolerance was associated with Helicobacter pylori infections (P＜0.05).The OR (95％CI) of Helicobacterpylori infections (DOB≥4) was 1.544 (1.139-2.091).Conclusion The three leading intolerance foods were egg,crab and shrimp.Crab intolerance was associated with Helicobacter pylori infections.To reduce the risk of crab intolerance,it was necessary to control the infection caused by Helicobacter pylori.

Predictive equations of lung function for adults in north China urban areas / 南方医科大学学报

<p><b>OBJECTIVE</b>To establish predictive equations of lung function for adults in urban areas in north China.</p><p><b>METHODS</b>A survey was conducted in 600 male and 600 female healthy adults in the urban areas in north China. Five flow-volume test parameters were measured including forced vital capacity (FVC) and forced expiratory volume in one second (FEV1). Stepwise multiple regression was carried out to establish the predicative equations for the parameters for male and female adults separately. The predicted values from these equations and those from other commonly used equations (such as ECCS equation and Knudson equation) were compared with the actual measurements in pulmonary function tests.</p><p><b>RESULTS</b>Four flow-volume test parameters, namely FVC, FEV1, 25% forced expiratory flow (FEF25%), and FEF75%, showed obvious differences between the male and female adults, while FEV1/FVC was not correlated with gender. Multiple regression analysis showed that FVC, FEV1, FEF25% and FEF75% were positively correlated with height and negatively with age, and FEV1/FVC was negatively correlated with both height and age. The parameters were not affected by body weight. The predicted values from our equations were closer to the actual measurements than those calculated from other equations.</p><p><b>CONCLUSION</b>The equations we established are more appropriate than the generally used equations for predicting lung functions in adults in north China urban areas.</p>

H-type hypertension in health check-up populations / 中华健康管理学杂志

Objective To explore clinical characteristics of H-type hypertension in health check-up populations so as to provide evidence for stroke prevention.Methods A total of 42 251 health check-up individuals (male 27 746,female 14 505,average age (46 ± 9) years) who visited our center during May,2009 and February,2012 were enrolled and responded to the investigation.In face to face interview,their age,gender,cigarette smoking and alcohol consumption were recorded.Height,body weight and blood pressures were measured.Serum lipid profiles,blood glucose,uric acid (UA),creatinine (Cr),homocysteine and urine albumin creatinine ratio (ACR) were tested.The subjects were then assigned to the H-type hypertension group,common hypertension group,high homocysteine group and control group.Analysis of Variance was used for data analysis.Results Of 42 251 participants,7748 were found to have H-type hypertension (18.34％ in whole subjects and 63.95％ in hypertensive subjects).Serum level of homocysteine and prevalence of common hypertension and H-type hypertension were significantly higher in males (P ＜ 0.05).Age and body mass index of the H-type hypertension group were significantly increased (P ＜ 0.05).The highest incidence of cigarette smoking and alcohol drinking was found in the homocysteine group (P ＜ 0.05),while the highest serum levels of Hb,UA,high sensitivity-C reactive protein (hs-CRP),and Cr occurred in the H-type hypertension group.Moreover,total cholesterol,triglycide,low-density lipoprotein cholesterol,and microalbumin/creatinine were not significantly different between the common hypertension group and the H-type hypertension group (P ＞ 0.05),although were significantly different between the controls and the H-type hypertensive patients (P ＜ 0.05).Conclusion The prevalence of Htype hypertension may be increased with the increasing serum levels of biological markers for nutritional metabolism.Higher level of homocysteine dose not seem to aggregate lipid disorders and early renal damage.

Difference in blood pressure in left and right extremities / 中华健康管理学杂志

Objective To explore if there is a difference in blood pressure in left and right extremities.Methods A total of 20164 adults who took part in health check-up at Health Examination Center of Chinese PLA General Hospital between December 2009 and August 2011were enrolled in this study.Age,height and body weight were recorded,and blood pressure in extremities was measured in synchronous way by using an arteriosclerosis detector.Results (1) Blood pressure in upper left extremity was slightly higher than that in upper and lower right extremity ( all P =0.0001).( 2 ) Difference in diastolic blood pressure in upper left and right limbs in females (2.1±6.7) mm Hg(1mm Hg =0.133 kPa) was more significant than that in males (1.4 +6.5 ) mm Hg ( P =0.0000).In males,difference in systolic blood pressure between two lower extremities ( 2.3 ± 9.6 )mm Hg was more significant than that in females (1.9 ±13.4) mm Hg ( P =0.0225 ).( 3 ) The above mentioned differences were found in low or normal weight and over-weight/obesity populations,which was not correlated with body mess index.(4) The difference of diastolic blood pressure in left and right limbs of relatively taller adults ( ＞170 cm) was more significant than that in shorter populations ( ＜170 cm ) (P =0.001).Conclusion The differences in blood pressure in left and right extremities do exist.

Bone mineral density-related factors of adult health checkup receivers / 中华健康管理学杂志

Objective To investigate bone mineral density-related factors to decrease the prevalence of osteoporosis. Methods This croas-sectional survey enrolled 46 219 adults less than 60 years old. Anthropometry, blood pressure, serum lipid, glucose, electrolytes, uric acid and homocysteine were detected. Bone mineral density (BMD) of distal forearm was measured by using peripheral dual energy-ray detector (MestriscanTM). Our data were analyzed by Pearson's correlation analysis and stepwise multiple regression analysis. Results All BMD-related factors except age showed significant difference between male and female. BMD of female subjects was lower than that of male participants (0.50±0. 15 vs 0. 54 ±0. 15,t = 22. 38 ,P < 0. 05 ). The prevalence of osteoporosis in female was higher ( 29. 51% vs 26. 48%, χ2 =47.90,P <0. 05). BMD increased with age before 40-year old, and then decreased more rapidly in female after 50-year old. Conclusion BMD of male is higher. Cigarette smoking, waist-hip ratio, systolic blood pressure, serum sodium, total cholesterol, and ALP were negatively correlated with BMD.

D-dimer is useful in assessing the vulnerable blood in elderly patients with coronary disease / 老年心脏病学杂志（英文版）

Background and objective The value of D-dimer in the risk stratification of patients with coronary artery diseas(CAD)and the relationship between D-dimer and the diseased coronary arteries remains controversial or unclear.especially in the elderly.Thisstudy was to evaluate the usefulness of D-djmer as a biomarker in assessing the vuinerable blood in the elderly patients with coronarydisease.Methods Sixty elderly (≥60 years old)male patients with suspected CAD were enrolled in this prospective study.Patients were divided into CAD group(n=41,10 with stable angina and 31 with unstable angina)and control group(n=19)according to their coronary angiography Results Clinicalinformation including age,body mass index(BMI),smoking index,and thecomplications of Primary hypertension or diabetes.and CAD family history was collected.Venous blood was sampled serially for thedetermination of total cholesterol,HDL cholesterol,LDL cholesterol,triglycerides,apoAl,apoB,glucose,uric acid,homocysteine(Hey),hs-CRP,soluble thrombomodulin(sTM),and marker of fibrinolytic system and hypercoagulability,such as D-dimer,fibrinogen,etc.The extent of coronary atherosclerosis was assessed.using the Gensini scoring system on the basis of coronary angiography.Results Compared with the controls.the patients with CAD had significantly higher levels of D-dimer.D-dimer level wassignificantly correlated to age.hs-CR P.Hcy,and PAI-1.Patients with D-dimer levels in the top triplicate of D-dimer level hadsignificantly higher prevalence of unstable angina compared with patients in the lowest triplicate(OR=4.8,Z=3.28,P=0.001).In anordinal logistic regression.the OR value ofdeveloping more serious CAD augmented 3.1-foid with each increasing triplicate of D-dimer.Patients with unstable angina had a significantly higher level of D-dimer than the controls(P=0.005),and an increasing trend comparedwith patients with stable angina (P=0.059).whereas there was no difference between the patients with stable angina and the controls(P=0.885).D-dimer was significantly correlated with Gensini scores(r=0.3930,P=0.0019).Ordinal logistic regression showed that theOR value ofincreasing one or two triplicates of Gensini's scores augmented 1.44.fold with each increasing triplicate of D-dimer(OR=2.44,Z=2.87,P=0.004). Conclusions D-dimer may be a helpful biomarker in identifying the severity of vulnerable blood in elderlypatients with CAD.

Expression and its clinical significance of RhoC mRNA in human primary hepatocellular carcinoma / 中国普通外科杂志

Objective To study the expression of RhoC mRNA in human primary hepatocellular carcinoma(PHCC) and paracarcinoma liver(PCL) tissues .Method Reverse transcription polymerase chain reaction(RT-PCR) was used to detect the expression of RhoC mRNA in the PHCC and PCL tissue of 30 patients with PHCC. Results The opacity density (OD)of RhoC mRNA expression in PHCC tissues was significantly higher than that in PCL tissures(P

The relationship between the level of serum homocysteine and the diseased coronary arteries / 解放军医学杂志

Objective To investigate the relationship between of the serum homocysteine (Hcy) level and the occurrence and severity of diseased coronary arteries in patients. Methods The total serum Hcy content was determined in sixty-seven patients with diseased coronary arteries and forty-three normal subjects. They were all subjected to coronary artery angiography for evaluation. Using the Gensini's scoring system the degree of severity of of pathology the coronary arteries were assessed. Other risk factors were analyzed in addition to Hcy and Gemini's scores. Results The total serum level of Hcy in patients with diseased coronary artery was significantly higher compared with the normal controls (P

A Comparison Study between Cardiac Syndrome X and Cardiac Neurosis / 中国医师杂志

0 05). The levels of TC, LDL-C and apoB in the patients with CSX were significantly higher than those in the patients with CN(P

Effect of γ-interferon on the expresson of Fas, Bcl-2 on Hep-G2 hepatocellular carcinoma cells / 中国普通外科杂志

Objective　To investigate the influence of γ-interferon (γ-IFN) on liver cancer cell line (Hep-G2). Methods　Observing the expression of Fas and Bcl-2 by γ-IFN-pretreated Hep-G2 cells via immunohistochemical stain; subsequently treating these cells with adrimysin, and observing the cell death rate and apoptosis of these cell by MTT and electroscopy. Results　(1) γ-IFN up-regulating the expression of Fas protein and down-regulating Bcl-2 protein (P<0.05), and the sensitivity of pretreated hep-G2 cell to adrimysin was increased. Conclusions　γ-IFN can rise the sensitivity of Hep-G2 to adrimysin via regulating the expression of Fas and Bcl-2.

Construction of RhoC gene vector and its expression in eucaryotic cells / 中国普通外科杂志

Objective To establish an experimental model for exploring the role of RhoC gene in the invasiveness and metastasis of hepatocellular carcinoma.Method The RhoC gene was digested with restricted enzyme Hind III and XbaI,and direct cloned to pcDNA3.1.The recombinant vector (pcDNA3.1 RhoC) and the vector alone (pcDNA3.1) were transfected into HEPG2 cells with LIPFECTAMINETMReagent.After selected with hygromycin,resistant cloneies was obtained.The transcription and translation of RhoC gene were analysed with the reverse transcription PCR and immunohistochemical stain.Results The recombinant vectort (pc DNA3.1 Rhoc) express steadily in HerpG2 cells.Conclusions The modified tumor cells(HEPG2 RhoC) could be used to study the effect of RhoC protein on the invasiveness and metastasis of hepatocellular carcinoma.

The influence of RhoC on the expression of angiogenic factors in HCC cells / 中国普通外科杂志

Objective To study the influence of pcDNA3.1-RhoC on the expression of endogenous angiogenic factors in HCC cells.Methods The reconstructed plasmid pcDNA3.1-RhoC was transfected into HepG2 cells, and expression of VEGF and bFGF was detected with the RT-PCR and immunohistochemical stain. HepG2 cells transfected with pcDNA3.1-RhoC or pcDNA3.1 were implanted into nude mice to observe the tumor occurrence rate.Results HepG2 cells transfected with pcDNA3.1/RhoC showed higher expression of RhoC . The expression of RhoC enhanced the expression of VEGF and bFGF(P

Effect of ?-interferon on the expresson of Fas, Bcl-2 on Hep-G2 hepatocellular carcinoma cells / 中国普通外科杂志

Objective To investigate the influence of ?-interferon (?-IFN) on liver cancer cell line (Hep-G2). Methods Observing the expression of Fas and Bcl-2 by ?-IFN-pretreated Hep-G2 cells via immunohistochemical stain; subsequently treating these cells with adrimysin, and observing the cell death rate and apoptosis of these cell by MTT and electroscopy. Results (1) ?-IFN up-regulating the expression of Fas protein and down-regulating Bcl-2 protein (P

Effect of homocysteine on expression and secretion of tissue factor pathway inhibitor in human endothelial ECV 304 cells / 解放军医学杂志

Objective The aim of this study was to elucidate the effects of homocysteine (Hcy) on the expression and secretion of tissue factor pathway inhibitor (TFPI) in endothelial cells (Ecs). Methods Cultured human umbilical vein endothelial cells (HUVECs) (ECV-304 strain) were incubated with homocysteine (Hcy) in different concentrations of 0, 25, 50, 100?mol/L, and 1,5,10mmol/L, respectively, for 24 hours. Cell viability was then determined by MTT assay, and lactate dehydrogenase (LDH) released into the culture medium was measured to assess cell damage. Antigen levels of the free form of TFPI after Hcy exposure were measured in culture media with ELISA (Diagnostica Stago, France). Furthermore, the total content of TFPI was assessed with cellular ELISA. Results Hcy in concentrations of 0～1mmol/L did not produce cell toxicity as shown by cell viability and LDH determination in culture media after 24 hours of incubation. When the endothelial cells were exposed to concentrations up to 5mmol/L, cell viability decreased, and a higher concentration of Hcy (10mmol/L) elicited a significant cytotoxic effect, as shown by a decreased cell viability and a higher amount of LDH in culture supernatants compared with the control cells. All the TFPI absorbance values in Hcy-treated cells and the free TFPI levels in culture supernatants were significantly increased, especially in the 50?mol/L group. Conclusion A lower concentration of Hcy did not show signs of cell toxicity but it could promote the expression and secretion of TFPI. The results can help us partly explain why the TFPI level was increased in some patients with hyperhomocysteinemia. They also suggested that Hcy could play an important role in the modulation of coagulation processes in blood circulation.