A cross-sectional study was conducted on 1619 youngsters aged 13-15.They were divided into two groups:one with family history of diabetes (FHD~+) and another without a family history of diabetes (FHD~-).Measurements included height,weight,waist circumference (WC) and hip.FHD~+ group had significantly higher WC measurement,waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) when compared with FHD~-group (P ＜0.01).The abdominal obesity rate defined by WC measurement in FHD+ group was higher than that in FHD~-group (P＜0.01).The rate of overweight and obesity defined by body mass index (BMI) were no significant difference between two groups.After adjusting the gender and age,logistic regression analysis showed that the odds ratios of WC alone and BMI+WC for FHD~+ were 2.029 and 1.364 (95% CI:1.211-3.400,1.043-1.784,P＜0.05) respectively.Our data suggest that teenage with a family history of type 2 diabetes has a tendency of overweight characterized by the abdominal obesity.

ObjectiveTo investigate the relation of obesity parameters,including body mass index (BMI),waist-to-height ratio(WHR),waist circumference,and waist-to-hip ratio(WHR),with hypertension in adolescents.MethodsA cross-section study was conducted among 3953 adolescents aged 12 to 18 years old,who were assigned to the normal blood pressure group (3724) or hypertension group(229).Measurements were height,weight,waist circumference,systolic blood pressure (SBP),and diastolic blood pressure (DBP).ResultsThe data showed that mean BMI,WHR,waist circumference,WHR,SBP,and DBP in the hypertension group Was significantly higher than those in the normal blood pressure group(all P<0.05).In partial correlation analysis,BMI,WHR,waist circumference,and WHR were positively correlated with both SBP and DBP after gender or age were adjusted(r'=0.3228 and 0.2358,both P<0.05).For alias under the receiver operating curve(ROC),the BMI was obserred to strongly predict hypertension in male (0.715;95%CI0.659-0.771)and female (0.702;95%CI0.646-0.757).BMI was also entered into the multiple linear regression modeL ConclusionBMI could be an effective predictive factor of hypertension in adolescents.

A total of 1507 children aged 7 ～ 12 years in Qinhuangdao were incruited to evaluate the diagnostic accuracy of different obesity indices in screening hypertension.Blood pressure and obesity indices were positively correlated(P＜0.01).Area under the receiver operating characteristic (ROC) curve were 0.744 ～ 0.835 in boys and 0.704 ～ 0.796 in girls (P＜0.01).Obesity indices could be used as parameters for detecting hypertension in children.

Objective To explore the best cut-point of waist-to-heisht ratio (WHtR) for identifying metabolic syndrome(MS)in adolescents.Methods A cross-sectional study was conducted in 4 507 adolescents aged 13-18 years in Qinhuangdao.Receiver operating characteristic (ROC) curve analysis was employed to determine the optimal WHtR cut-point for detecting MS.Results The prevalences of MS were higher among higher WHtR in both boys and girls.Odds ratios for MS significantly increased from the WHtR≥0.45 in boys(OR =13.85,95%CI 4.08-46.97)and in girls (OR=12.42,95%CI 2.62-58.96,P<0.01).The ROC curve analysis showed that the optimal WHtR cut-point was 0.45 in boys with the sensitivity of 89.4%and specificity of 81.4%.and in girls with sensitivity of 90.3%and specificity of 86.5%.Conclusion There is a significant correlation between WHtR and MS.Optimal WHtR cut-point for predicting MS is 0.45.

Objective To evaluate the relationship between obesity and serum soluble intercellular adhesion molectde-1 (sICAM-1) in adolescents. Methods Totally, 158 adolescents aged 13-15 years were divided into three groups based on their body mass index (BMI) , 80 in control group, 44 in overweight group and 34 in obesity group. Height, weight, waist circumference (WC) and blood pressure were measured for all of them and sICAM-1 was assayed from fasting venous blood collected. Results BMI, WC and systolic blood pressure were significantly higher in overweight group than those in control group (P < 0. 01). BMI, WC, systolic blood pressure and diastolic blood pressure were significantly higher in obesity group than those in overweight group (P<0. 05). Level of sICAM-1 was significantly higher in obesity group than that in control group (P <0.05). Their sICAM-1 showed positive correlation with BMI (r = 0.168, P=0.035) and WC (r=0. 179, P =0.025). Multiple linear regression analysis using sICAM-1 as a dependent variable showed that WC (β= 0.009, 95% CI 0. 001-0.018, P=0.025) was an independent predictors for sICAM-1 adjusted for age, sex, BMI and blood pressure. Conclusions Results mentioned above suggest that endothelial dysfunction associates with obesity, particularly with abdominal obesity. sICAM-1 can be used as an early marker of atherosclerosis in adolescents.

accumulation and endothelial dysfunction are associated with insulin resistance.

Objective The risk of current pancreaticojejunostomy is carefully considered from the perspective of the morphology of remnant pancreas,and we aimed to discuss the clinical outcomes of selecting different pancreaticojejunostomy techniques based on pancreatic morphology.Methods This was a prospective cohort study.The histopathology of remnant pancreatic tissues was categorized into four types based on preoperative radiological images and intraoperative palpation:Type Ⅰ:pancreas with hard texture in palpation,pancreatic atrophy,dilated pancreatic duct larger than 5 mm and remnant pancreatic surface ＜3 cm;Type Ⅱ:pancreas with hard texture in palpation,pancreatic atrophy and mild dilatation of pancreatic duct with the diameter of 3-5 mm and remnant pancreatic surface ＜3 cm;Type Ⅲ:pancreas with slightly hard texture,no atrophy,and normal or slightly dilated pancreatic duct with the diameter of 3-5 mm and remnant pancreatic surface ≥3 cm;Type Ⅳ:pancreas with soft texture,normal morphology and pancreatic duct.Results From January 2008 to August 2017,116 consecutive patients underwent pancreaticoduodenectomy in our center.Among them,10 patients with type Ⅰ underwent classic pancreatic ductal mucosa to mucosa anastomosis.19 patients with type Ⅱ underwent classic end to end invaginated pancreaticojejunostomy.45 patients with type Ⅲ underwent classic end to end invaginated pancreaticojejunostomy with overlapping U sutures;42 patients with type Ⅵ underwent total invaginated pancreaticojejunostomy.The post-operative pancreatic fistula occurred in 6 patients (5.2％) with one patient died.Postoperative bleeding occurred in 10 patients (8.6％),and gastroparesis occurred in 22 patients (19.0％).Overall complication rate was 33.6％.Conclusions Classification of pancreatic morphology based on preoperative radiological images and intraoperative palpation and the selection of corresponding pancreaticojejunostomy technique is theoretically rational and has the advantage of potentially reducing the risk of remnant pancreatic tissue.

Objective To investigate the effect of open surgical drainage approach for the treatment of walled-off pancreatic necrosis ( WOPN) in severe acute pancreatitis. Methods Clinical data of 154 WOPN patients admitted in the First Affiliated Hospital of Xinjiang Medical University from January 2005 to October 2016 were retrospectively analyzed. Traditional open debridement necrosectomy was performed in 83 patients from January 2005 to October 2012 ( debridement group) , and small abdominal incision with low-position open surgical drainage was performed in 71 patients from October 2012 to October 2016 ( drainage group ) . The clinical outcomes of two groups were analyzed and compared. Results 43 cases (51. 8％) in debridement group had postoperative intraperitoneal reinfection, while there were only 13 cases with postoperative intraperitoneal reinfection (18. 3％) in drainage group;18 cases (21. 7％) in debridement group had surgery-related digestive tract fistula, while there were only 4 cases with surgery-related digestive tract fistula (5. 6％) in drainage group; the differences were statistically significant (χ2 = 18. 55, P=0. 001; χ2 = 11. 35, P=0. 002). 15 patients (18. 1％) in debridement group and only 2 patients (2. 8％) in drainage group died. The mortality in drainage group were obviously lower than that in debridement group, and the difference was statistically significant (χ2 = 9. 07, P<0. 05 ). 62 cases ( 74. 7％) in debridement group and 55 cases (77. 5％) in drainage group were cured directly, respectively. No significant difference was found between two groups. However, 3 cases (3. 6％) in debridement group and 12 cases (16. 9％) in drainage group were cured by the way of small intestinal fistula in the late stage of intubation, and the latter was higher than the former with statistically significant(χ2 =5. 989,P=0. 014). Conclusions Compared with open debridement necrosectomy, the abdominal infection rate, digestive tract fistula rate and mortality of open surgical drainage were all significantly reduced , which may be a better treatment for WOPN.

Objective:To compare the prognosis of pancreatic head cancer, uncinate process cancer and pancreatic neck cancer patients after undergoing pancreatoduodenectomy.Methods:The clinical data and follow-up data of 71 pancreatic cancer patients undergoing pancreatoduodenectomy in the First Affiliated Hospital of Xinjiang Medical University were analyzed retrospectively, Kaplan Meier method was used to compare the survival of postoperative patients. COX proportional risk model was used to analyze the survival of three groups of tumor.Results:In pancreatic cancer patients, uncinate process cancer and pancreatic neck cancer had more frequent vascular invasion, higher lymph node metastasis rate and lower R 0 resection rate than pancreatic head cancer (all P<0.05). Multivariate COX suggested that vascular invasion ( P=0.018), lymph node metastasis ( P=0.001), tumor site ( P=0.022 in uncinate process, P=0.000 in pancreatic neck) and R 0 resection ( P=0.000) were independent risk factors for prognosis. For pancreatic head cancer the 1-year recurrence rate was 43.8%, 3-year survival rate was 28.1%, median survival time was 20.0 months (95% CI 15.565-24.435). For uncinate process cancer 1-year recurrence rate was 61.5%, 3-year survival rate was 15.4%, median survival time was 14.0 months (95% CI 9.003-18.997) respectively.That was 69.2%, 7.7% and 10.0 months (95% CI 5.303-14.697) respectively for pancreatic neck cancer. Conclusion:Compared with pancreatic head cancer, uncinate process cancer and pancreatic neck cancer are associated with poorer prognosis because of frequent early vascular invasion, low R 0 resection rate and early local recurrence.

Objective:To investigate the epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with maintenance hemodialysis (MHD) in Jiangsu province during SARS-CoV-2 pandemic in China from December 7, 2022 to January 27, 2023, and to analyze the influencing factors of all-cause death.Methods:It was a multi-center cross-sectional investigation. Structured questionnaire was used to collect patient information by medical staff of each hemodialysis center (room) as investigators. Part of the demography data and laboratory examination data came from the Jiangsu Province Hemodialysis Data Information System. MHD patients from hemodialysis centers (rooms) at all levels of medical institutions and independent hemodialysis institutions in Jiangsu province during the outbreak of SARS-CoV-2 infection were included, and the clinical characteristics and all-cause mortality of confirmed and suspected cases of SARS-CoV-2 infection were analyzed.Results:Questionnaire surveys and data analysis on 57 278 patients in 407 hemodialysis centers (rooms) were completed, accounting for 90.41% of the total number of MHD patients (63 357 cases) in Jiangsu province during the same period. There were 24 038 cases (41.97%) of SARS-CoV-2 infection and 14 805 cases (25.85%) of suspected infection, which were widely distributed in all dialysis centers in Jiangsu province. After clinical classification of 38 843 confirmed and suspected SARS-CoV-2 infection cases, 3 662 cases were severe and critical cases, accounting for 9.43% of the infected and suspected cases. Among the patients who had completed the questionnaires, there were 1 812 all-cause deaths, with an all-cause mortality rate of 3.16%. Multivariate logistic regression analysis showed that elderly (taking ≤50 years as a reference, 51-59 years: OR=1.583, 95% CI 1.279-1.933, P=0.001; 60-69 years: OR=3.972, 95% CI 3.271-4.858, P<0.001; 70-79 years: OR=7.236, 95% CI 5.917-8.698, P<0.001; ≥80 years: OR=11.738, 95% CI 9.459-14.663, P<0.001), male ( OR=1.371, 95% CI 1.229-1.529, P<0.001), and co-infection with hepatitis B virus (HBV) (positive serum HBV surface antigen, OR=0.629, 95% CI 0.484-0.817, P<0.001) were independent influencing factors for all cause mortality. Receiver-operating characteristic curve analysis showed that the area under the curve for male, age and current HBV infection prediction of all-cause death was 0.529 ( P<0.001), 0.724 ( P<0.001) and 0.514 ( P=0.042), respectively, and the cut-off value for age prediction of all-cause death was 65.5 years old. Compared with patients without HBV infection, MHD patients with HBV infection significantly reduced the proportion of severe and critically ill patients, all-cause hospitalizations and all cause deaths when infected with SARS-CoV-2 (4.99% vs. 6.41%, χ2=6.136, P=0.013; 8.90% vs. 11.44%, χ2=11.662, P<0.001; 2.01% vs. 3.37%, χ2=10.713, P=0.001, respectively). Conclusion:The MHD patients in Jiangsu province are susceptible to SARS-CoV-2. Elderly age and male gender are independent risk factors for death in MHD patients during the epidemic, while the HBV infection may be a protective factor for death of MHD patients infected with SARS-CoV-2.