Objective To investigate the correlation between body mass index ( BMI) , type Ⅱ diabetes and colorectal neoplastic lesions including adenoma and adenocarcinoma. Methods A total of 971 subjects, aged 20-86, who underwent colonoscopy from July 2008 to July 2009 were included. The body height and weight were measured, and history of type Ⅱ diabetes was recorded. Based on the results of colonoscopy and pathology, the subjects were divided into study group (with confirmed adenoma or adenocarcinoma; n =471) and normal control group (n = 500). All data were analyzed by using logistic multi-factors regression. Results With adjustment for some potential mixed factors, obesity group run 2. 55 times of risk of colorectal adenoma or adencarcinoma compared with the normal weight group (OR = 2.55, 95% CI: 1.26-3.05, P =0.027), among which obese male's risk was 3. 32 (OR =3.32, 95% CI: 1. 50-6. 86, P = 0.007) times of that in normal weight males. There was no correlation between female's BMI and incidence of colorectal adenoma & adencarcinoma. Patients with type Ⅱ diabetes ran 2. 10 times of risk of developing colorectal neoplastic lesions compared with those without ( OR = 2.10, 95% CI: 1. 25 - 3. 57, P = 0.010). Incidence of colorectal adenoma & adencarcinoma was 3 times higher in those with type II diabetes less than 6 years, compared with those with history more than 6 years ( OR = 3.00, 95% CI: 1.05 - 10. 86, P =0. 040), which was not correlated with gender of diabetic patients. Those with both type Ⅱ diabetes and obesity had 3.05 times of risk of colorectal adenoma & adencarcinoma, compared with non-obese diabetic patients (OR = 3.05,95% CI: 1.08 - 18.41, P - 0.041). Conclusion Obesity is positively correlated with colorectal adenoma and adencarcinoma, and obese males run higher risk than females. Type Ⅱ diabetes also leads to a higher incidence of colorectal neoplastic lesions, which will run even higher when combined with o-besity.

Objective To investigate the retinoic acid incubation effect on proliferation of U251 cell line and effect on MAPK signal pathway. Methods ATRA solution of different concentration on the U25 1 glioma cells were incubated,the influence of ATRA on the proliferation of U25 1 cells were detected,and the proteins of MKPs and MAPK signaling pathways were detected by qRT-PCR and Western blot.Using Graph Prism 5 software for quantitative analysis of experimental results.Results Compared with control group,ATRA could effectively inhibit the proliferation of U25 1 glioma cells, in a concentration dependent manner.QRT-PCR results showed that,different concentrations of ATRA after incubation for 48 hours,the expression of MKPs mRNA changed,but the changes of MKP-5 and expression of 67LR was different,explained the main differences between the two methods of the MAPK signaling pathway was the regulation of MKP-5.Western blot results showed that the ATRA,after 48 hours of incubation,the protein MAPK pathway had changed in phosphorylation, which showed that ATRA protein in the MAPK signaling pathway through control of the degree of phosphorylation on U25 1 cell line regulation.Conclusion Retinoic acid and retinoic acid receptor play its physiological effects and regulate human glioma cell line U25 1 proliferation through different combination.Retinoic acid could not only reduce the expression of phosphorylated ERK1/2 to inhibit tumor proliferation,but also regulate three kinds of protein phosphorylation,therefore its mechanism will be more complex,at the same time that the MAPK signaling pathway plays a crucial role in tumor proliferation process.

Objective To study the relationship between Cardiac allograft vasculopathy (CAV) and donor heart ischemia time. Methods The rat model of retroperitioneal heterotopic heart transplantation was used. Seventy Wistar rats were divided into 4 groups: group 1 receiving CsA after sham operation; group 2 receiving transplantation directly; group 3 having 3 h-ischemia before transplantation; group 4 having 6?h ischemia before transplantation. After transplantation, all rats in each group were subjected to the gastric lavage of CsA for 20?days. At 20?days after transplantation, the donor heart was removed for observation of changes in pathological lesions and ultrastructues of coronary artery. Results With ischemia time being prolonged, cardiac capillary endothelial cell swelling and coronary intimal proliferation were observed which were similar to the CAV histopathological changes. Conclusion The prolongation of ischemia time can lead to intimal proliferation and hyperplasia which can promote CAV development. So ischemia time is a vital reason for the CAV.

Objective To observe the efficacy and safety of the cocktail therapy to treat patients with Parkinson's disease with dementia ( PDD) . Methods Sixty patients with PDD were randomly divided into treatment group(30 cases)and control group(30 cases). The dose 10 mg of donepezil hydrochloride was taken 1 time a day in the control group;on the basis,the dose 0. 2 g of butylphthalide soft capsules was taken pre-dinner, 3 times a day,the dose 0. 8 g of oxiracetam was taken 3 times a day and 2 Ginkgo Biloba Leaves Extract tablets was taken 3 times a day in the treatment group,period of treatment was 6 months. The curative effect was measured by using Montreal cognitive assessment scale (MoCA),Blessed-Roth dementia table,severity of clinical dementia rating scale (WMS) rating, respectively before treatment and on the 3th, 6th month after treatment,and monitored the adverse reactions. Results There were no statistically significant differences on the scores of MoCA, WMS and Blessed-Roth dementia table between treatment group and control group before treatment ( all P>0. 05 ) . The scores of MoCA, WMS in the treatment group and control group on 6 months after treatment were significantly higher than those before treatment and 3 months after treatment, and the scores of Blessed-Roth dementia table in the treatment group and control group on 6 months after treatment were significantly lower than those before treatment and 3 months after treatment ( P<0. 05-0. 01). Compared with control group,the scores of MoCA, WMS increased obviously and the scores of Blessed-Roth dementia table decreased significantly in the treatment group on 6 months after treatment (P<0. 05-0. 01). There was no statistically significant difference on the rates of abnormal liver function after treatment betweenin the treatment group (16. 67%) and the control group (13. 33%) (P>0. 05). Conclusion The curative effect of cocktail therapy is better than traditional remedies for treating patients with PDD, and it is high safety.

BACKGROUND: Traditional anterior release followed by posterior correction and fusion is frequently used to treat severe and rigid adolescent idiopathic scoliosis, which is considered as Cobb angle of the major curve > 65° and flexibility < 34.5%; however, there are a great majority of complications. Whether isolated posterior correction using pedicle screw fixation combining with bone grafting and fusion may provide better effects on severe and rigid adolescent idiopathic scoliosis needs to be further studied.OBJECTIVE: To evaluate isolated posterior correction using pedicle screw fixation combining with bone grafting and fusion for the treatment of severe and rigid adolescent idiopathic scoliosis. DESIGN: Case analysis.SETTING: Department of Orthopaedics, Renji Hospital, Medical College of Shanghai Jiao Tong University.PARTICIPANTS: Twenty patients with severe and rigid adolescent idiopathic scoliosis, including 8 males and 12 females, were selected from Department of Orthopaedics, Renji Hospital, Medical College of Shanghai Jiaotong University from June 1999 to August 2005. They were 12-18 years old, and the mean age was 14.6 years. All patients were finally diagnosed as X-ray of whole spine. According to King-Moe criteria, patients were classified into type Ⅰ(n =4), type Ⅱ(n =6), type Ⅲ (n =5), type Ⅳ(n =3) and type Ⅴ(n =2). Before surgery, mean Cobb angle of the major curve was 82° (75°-92°), mean flexibility was 30% (20%-40%), and mean shoulder height difference was 15 mm (5-35 mm). Moreover, according to Risser syndrome, patients were classified into degree 1 (n =3), degree 2 (n =5), degree 3 (n =6), degree 4 (n =5) and degree 5 (n =1). All patients and their relatives provided the informed consents, and the experiment was approved by the local ethical committee. Artificial bone was Osteoset provided by Wright Company, USA.METHODS: Patients underwent isolated posterior correction using pedicle screw fixation combining with bone grafting and fusion, and spinous process, lamina of vertebra, zygapophysial joints and transverse process were exposed in a preconcerted fusion area. Pedicle screw was inserted into strategy vertebra using free hand technique according to the anatomic landmark of entry point. Six patients underwent fixation with TSRH system, and the other patients with CDH M8 system. Operative time and blood loss were evaluated after surgery. At 7 days after operation, Cobb angle was measured with X-ray, and correction rate of major curve was calculated. While shoulder height difference and admission duration were evaluated simultaneously. Complications and recovery states were followed up in the next 4 years.MAIN OUTCOME MEASURES: ① Operative time and blood loss; ② Cobb angle and correction rate of major curve; ③ shoulder height difference and admission duration; ④ follow-up results.RESULTS: All 20 patients were included in the final analysis. ① Operative time and blood loss: Operative time lasted from 3.2 to 4.3 hours, and the mean time was 3.5 hours. Blood loss ranged from 660 to 1 070 mL, and the mean loss was 865 mL. ② Cobb angle and correction rate of major curve: Cobb angle of the major curve ranged from 82° (75°-92°) before surgery to 31° (22°-37°) after surgery, and the mean correction rate was 62%. ③ Shoulder height difference and admission duration: Mean should height difference before surgery was 15 mm (5-35 mm). Postoperative lateral film of spine indicated that thoracic and lumbar vertebra generally suffered from normal posterior and anterior convexity, and mean shoulder height difference after surgery was 7.5 mm (0-11 mm). The admission duration lasted from 8 to 11 days, and the mean duration was 9 days. ④ Follow-up results: All patients were followed up in the next 4 years after surgery. The cobb angle correction of major curve remained unchanged, and the instrumented segments were completely fused without instrumentation failure.CONCLUSION: Isolated posterior correction using pedicle screw fixation combining with bone grafting and fusion may effectively cure severe and rigid adolescent idiopathic scoliosis, which is considered as Cobb angle of the major curve between 75° and 92° and flexibility ≥ 20%.

BACKGROUND: The formation mechanism of biliary cast syndrome following liver transplantation has not been thoroughly illuminated, and it is unclear that whether some proteins correlated to the formation mechanism of biliary cast or prewarning to the formation of biliary cast.OBJECTIVE: To investigate the holoprotein expression in biliary cast syndrome patients following liver transplantation. METHODS: Four patients underwent liver transplantation at Liver Transplantation Institute, General Hospital of Chinese People's Armed Police Force. Three months later, 10 g biliary cast was harvested. Four kinds of biliary cast specimens at different colors and textures were preserved at deep hypothermia, followed by protein abstraction and restriction enzyme digestion, the total protein abstraction solution of biliary cast were analyzed by high definition mass spectrometry and query on MASCOT database. All protein name of biliary cast were list, the conjunct protein was found by comparing 4 specimens. RESULTS AND CONCLUSION: There were totally 208 proteins in 4 biliary cast specimens, 82, 44, 56 and 65, respectively. By comparison, 5 proteins were found to overlay in 2 biliary cast specimens, 7 proteins in 3 specimens and 13 proteins in 4 specimens. Among the latter 13 proteins, 5 unnamed-proteins, as well as 8 named-proteins (termed alpha-fibrinogen precursor, beta-fibrinogen precursor, fibrinogen gamma chain, proapolipoprotein, Chain A of Human Cathepsin G, S100 calcium-binding protein A9, lactoferrin) were included. The proteins exists in biliary cast, the common proteins of 4 biliary cast specimens imply a correlation between the formation of biliary cast and the exudative inflammation following the damage of biliary tract epithelium; Some proteins might be considered as a marker of prewarning the presence of biliary cast syndrome, judging the inflammation severity following the damage of biliary tract epithelium and the prognosis of biliary cast syndrome.

BACKGROUND: With further understanding of deep venous thrombosis(DVT)following total hip replacement,reduction and prevention of DVT has become hot topic in clinical studies.The reports of DVT formation factors remain controversial due to small samples,little statistical significance,confusion of basic experimental and clinical results and lacks of science.OBJECTIVE: To explore the causes and factors for the early DVT following total hip replacement and summarize measures to prevent and treat early DVT to reduce incidence of complications.METHODS: A total of 1780 cases of primary total hip replacement operation were analyzed retrospectively.The statistical indexes included sex,age,body mass,other system disease,previous hip joint operation,anesthesia,operative time,prosthetic fixation,blood transfusion,postoperative functional exercise,antithrombotics,and complication.Standardized database was built and analyzed by SPSS(version 13).Regression analysis was performed using Binary Logistic Regression.RESULTS AND CONCLUSION: Of 1780 cases,136 had DVT.Age,other system diseases,anesthesia,prosthetic fixation,blood transfusion,postoperative functional exercise and antithrombotics were correlated with early DVT(P < 0.05).Old age,hypertension or diabetes,general anesthesia,fixation of bone cement,whole blood transfusion were the risk factors for early DVT following total hip replacement,while postoperative functional exercise and antithrombotics were the protective factors for DVT.The incidence rate of early complications can be reduced by the methods such as dealing with perioperative treatment carefully,effectively controlling the chronic diseases,efficient evaluation before surgery,precise manipulation,and the postoperative prophylactic treatment and nursing.

Objective To provide basis for routine fetal cardiac screening by comparing the ultrasound detection rate of fetal heart defects between the high-risk and low-risk population.Methods According to the questionnaire about maternal risk factors,all 7165 pregnant women were divided into two groups.The high-risk group included 2147 cases and the remained 5018 were considered as low-risk population.Routine fetal heart screening was performed by the four-chamber view,left and right outflow tract views.If some cardiac malformations were found,the detailed fetal echocardiography would be performed.Both the detection rate of fetal cardiac defects and distribution of the relevant risk factors were analyzed.Results Ninty-five(1.33%)cases of congenital heart disease were found in our study,32(1.49%)cases from highrisk group and 63(1.26%)cases from low-risk group.No significant was found between the two groups (X2=0.635,P＞0.05).Karyotyping were performed prenatally in 23 of 95 fetal congenital defects cases by cordocentesis and chorionbiopsy,and 11(47.83%)cases of concomitant chromosomal abnormality were found.Conclusions Routine fetal screening for congenital fetal diseases should be performed in non-selected population for the similar detection rate of fetal defect in high-risk and low-risk group.

Objective To evaluate the effects of health management of stomatology on the marginal bone resorption of minimally invasive implant in the elderly.Method Tottally 54 implants were placed in 37 elderly patients of missing teeth in maxillary molar areas and the patients were randomly divided into health management group and control group.Patients in the group of health management were guided to master the proper techniques of oral hygiene practices before and after the implantation and periodontal maintenance were carried out carefully until 1 year after loading of restoration.In the control group, oral hygiene was applied. X-ray and CBCT examinations were made and implant marginal alveolar bone loss (MBL) was measured 3, 6, 9, 12 months after loading with Planmeca PROMAX3D software. Besides, 3, 6, 9, 12 months after loading, improved plaque index (iPLI), modified bleeding index (mBI) and probing depth (PD) were also recorded. SPSS 15.0 was applied to analyze the data. Result Differences in diastolic and systolic blood pressure and changes in heart rate in patients during the intraoperative period were (8.86 ± 0.31) mmHg(1 mmHg=0.133 kPa), (19.18 ± 0.22) mmHg, (20.19 ± 1.84) times/min, which were significantly lower than those of the control group values [(16.55±1.08) mmHg, (28.31±2.30) mmHg, (20.19±1.84) times/min] (P<0.05 or 0.01);at 12 months after the load around the implant in oral health management group, the values of MBL and mSBI were 2.6 (2, 4), 2.1 (2, 4), which were significantly better than control group [4.3(3, 7), 4.3(3, 7)] (P<0.01);simultaneously, there was significant difference in the values of MBL and PD between experimental group (1.42 ± 0.03, 0.77 ± 0.24) and control group (1.59 ± 0.04, 0.54 ± 0.17) (P<0.01). Conclusion Well-performed health management of peri-implant could reduce the MBL and keep healthy soft tissue environment around implants.

Clinical data of 23 patients with T2a bladder cancer admitted from March 2008 to August 2013 were retrospectively analyzed.Among 23 patients,11 cases were treated with transurethral resection (TURBT) plus arterial catheterization chemotherapy (study group) and 12 cases were treated with radical cystectomy (control group).The overall survival time and recurrence free survival time of two groups were compared.Patients in study group were followed up for 20-68 months,recurrence occurred in 5 cases (5/11),including 4 cases of invasive recurrence;patients in control group were followed up for 2 ～86 months,1 case had superficial recurrent and underwent TURBT,2 cases dead due to bladder tumor.During the course of chemotherapy,the main adverse effects were digestive reaction (7/11),fever (4/11),bone marrow suppression (2/11),symptomatic treatment was given,which was tolerated.There were no significant differences in overall survival time and recurrence free survival time between two groups (P ＞ 0.05).The quality of life of study group was better than that of control group (P ＜ 0.05).It is suggested that the arterial interventional chemotherapy combined with transurethral resection for T2a stage invasive bladder cancer has a certain curative effect with the advantage of preservation of bladder function and higher quality of life.