Objective To assess the clinical significance of ankle-brachial index (ABI)in the diagnosis of peripheral arterial disease and its relationship with some interfering factors in type 2 diabetes mellitus. Methods One hundred and ten type 2 diabetes mellitus patients were selected.The systolic blood pressure and blood flow waveform in brachial artery,dorsal artery of foot or posterior tibial artery were surveyed with Doppler flow imaging survey meter ES-1000 SPM.ABI was calculated and the patients were divided into peripheral arterial disease group (group A) and non-peripheral arterial disease group (group B).Clinical data and risk factors were analyzed.Results In 110 patients,there were 20 cases (18.2%) with ABI<0.9.Age,TC,LDL-C,24 hours urinary microalbumin (24hUMA) and the prevalence of coronary heart disease were all higher in group A than those in group B (P＜0.05).LDL-C and the prevalence of coronary heart disease were independent risks variable for peripheral arterial disease. Conclusions ABI can assess objectively peripheral arterial disease in type 2 diabetes mellitus.which offers reliable base to active therapy.Advanced age,hypercholesteremia and hyper 24hUMA are the main factors of peripheral arterial disease.

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.

accumulation and endothelial dysfunction are associated with insulin resistance.

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.

Objective To investigate the optimal initial concentration of microRNA22 agomir in epilepsy model induced by lithium chloride-pilocarpine after single injection of lateral ventricle.Methods 36 rats with acute temporal lobe epilepsy were randomly divided into 6 groups:the control group and the other five groups were the experimental group.All epilepsy rats were selected for right lateral ventricle injection.The control group was given negative control reagent,while the experimental group were given 0.1 mmol/L,2.5 mmol/L,5 mmol/L,10 mmol/L,20 mmol/L different concentrations of miRNA22agomir reagent.6 rats in each group were randomly selected for acute phase experiment after 3 days of administration.The expression of P2X7 in hippocampus of epilepsy rats was determined by Western blot and quantitative real-time polymerase chain reaction (qRT-PCR).Results Compared with control group,the protein and mRNA expression of P2X7 reduced in all of the model group.The protein and mRNA expression level of P2X7 protein in hippocampus of rats injected with 2.5 mmol/L,5 mmol/L and 10 mmol/L in each experimental group were significantly lower than that in the other two groups (P ＜ 0.05).Moreover,the protein and mRNA expression level of P2X7 were the lowest at 2.5 mmol/L injection and 10 mmol/L,and there was no significant difference between the two groups (P ＞ 0.05).Conclusions The optimal onset concentration for unilateral lateral ventricle injection miRNA22 agomir treatment of temporal lobe epilepsy is 2.5 mmol/L.

Objective To investigate the effect of early glucose metabolism abnormality on skeletal muscle content of young men.Methods 88 males who underwent physical examinations in our hospital from September 2020 to September 2021 were divided into normal blood glucose group(NGT,n=47)and IGR group(n=41),according to their FPG and 2 hPG levels.FPG,FIns and visceral fat area(VFA)were measured.HOMA-IR,HOMA-β,skeletal muscle index(SMI)and body fat ratio(BFR)were calculated.Results Compared with NGT group,the males in IGR group showed elevated BMI,WC,FPG,2 hPG,HOMA-IR and VFA(P＜0.05),but decreased HDL-C and SMI(P＜0.05).Pearson correlation analysis showed that SMI was negatively correlated with BMI,WC,FPG,2 hPG,HOMA-IR,VFA and BFR in young men(P＜0.05 or P＜0.01).Logistic regression analysis showed that BMI was the influencing factor of FPG,while SMI was the influencing factor of 2 hPG.Conclusions In young men with abnormal glucose metabolism,the postprandial blood glucose significantly increase with the decrease of skeletal muscle content,and fasting blood glucose is mainly affected by BMI.

Objective:To evaluate the safety of double and a half layered esophagojejunal anastomosis in radical gastrectomy.Methods:This prospective, multi-center, single-arm study was initiated by the Affiliated Cancer Hospital of Zhengzhou University in June 2021 (CRAFT Study, NCT05282563). Participating institutions included Nanyang Central Hospital, Zhumadian Central Hospital, Luoyang Central Hospital, First Affiliated Hospital of Henan Polytechnic University, First Affiliated Hospital of Henan University, Luohe Central Hospital, the People's Hospital of Hebi, First People's Hospital of Shangqiu, Anyang Tumor Hospital, First People's Hospital of Pingdingshan, and Zhengzhou Central Hospital Affiliated to Zhengzhou University. Inclusion criteria were as follows: (1) gastric adenocarcinoma confirmed by preoperative gastroscopy;(2) preoperative imaging assessment indicated that R0 resection was feasible; (3) preoperative assessment showed no contraindications to surgery;(4) esophagojejunostomy planned during the procedure; (5) patients volunteered to participate in this study and gave their written informed consent; (6) ECOG score 0–1; and (7) ASA score I–III. Exclusion criteria were as follows: (1) history of upper abdominal surgery (except laparoscopic cholecystectomy);(2) history of gastric surgery (except endoscopic submucosal dissection and endoscopic mucosal resection); (3) pregnancy or lactation;(4) emergency surgery for gastric cancer-related complications (perforation, hemorrhage, obstruction); (5) other malignant tumors within 5 years or coexisting malignant tumors;(6) arterial embolism within 6 months, such as angina pectoris, myocardial infarction, and cerebrovascular accident; and (7) comorbidities or mental health abnormalities that could affect patients' participation in the study. Patients were eliminated from the study if: (1) radical gastrectomy could not be completed; (2) end-to-side esophagojejunal anastomosis was not performed during the procedure; or (3) esophagojejunal anastomosis reinforcement was not possible. Double and a half layered esophagojejunal anastomosis was performed as follows: (1) Open surgery: the full thickness of the anastomosis is continuously sutured, followed by embedding the seromuscular layer with barbed or 3-0 absorbable sutures. The anastomosis is sutured with an average of six to eight stitches. (2) Laparoscopic surgery: the anastomosis is strengthened by counterclockwise full-layer sutures. Once the anastomosis has been sutured to the right posterior aspect of the anastomosis, the jejunum stump is pulled to the right and the anastomosis turned over to continue to complete reinforcement of the posterior wall. The suture interval is approximately 5 mm. After completing the full-thickness suture, the anastomosis is embedded in the seromuscular layer. Relevant data of patients who had undergone radical gastrectomy in the above 12 centers from June 2021 were collected and analyzed. The primary outcome was safety (e.g., postoperative complications, and treatment). Other studied variables included details of surgery (e.g., surgery time, intraoperative bleeding), postoperative recovery (postoperative time to passing flatus and oral intake, length of hospital stay), and follow-up conditions (quality of life as assessed by Visick scores).Result:[1] From June 2021 to September 2022,457 patients were enrolled, including 355 men and 102 women of median age 60.8±10.1 years and BMI 23.7±3.2 kg/m2. The tumors were located in the upper stomach in 294 patients, mid stomach in 139; and lower stomach in 24. The surgical procedures comprised 48 proximal gastrectomies and 409 total gastrectomies. Neoadjuvant chemotherapy was administered to 85 patients. Other organs were resected in 85 patients. The maximum tumor diameter was 4.3±2.2 cm, number of excised lymph nodes 28.3±15.2, and number of positive lymph nodes five (range one to four. As to pathological stage,83 patients had Stage I disease, 128 Stage II, 237 Stage III, and nine Stage IV. [2] The studied surgery-related variables were as follows: The operation was successfully completed in all patients, 352 via a transabdominal approach, 25 via a transhiatus approach, and 80 via a transthoracoabdominal approach. The whole procedure was performed laparoscopically in 53 patients (11.6%), 189 (41.4%) underwent laparoscopic-assisted surgery, and 215 (47.0%) underwent open surgery. The median intraoperative blood loss was 200 (range, 10–1 350) mL, and the operating time 215.6±66.7 minutes. The anastomotic reinforcement time was 2 (7.3±3.9) minutes for laparoscopic-assisted surgery, 17.6±1.7 minutes for total laparoscopy, and 6.0±1.2 minutes for open surgery. [3] The studied postoperative variables were as follows: The median time to postoperative passage of flatus was 3.1±1.1 days and the postoperative gastrointestinal angiography time 6 (range, 4–13) days. The median time to postoperative oral intake was 7 (range, 2–14) days, and the postoperative hospitalization time 15.8±6.7 days. [4] The safety-related variables were as follows: In total, there were 184 (40.3%) postoperative complications. These comprised esophagojejunal anastomosis complications in 10 patients (2.2%), four (0.9%) being anastomotic leakage (including two cases of subclinical leakage and two of clinical leakage; all resolved with conservative treatment); and six patients (1.3%) with anastomotic stenosis (two who underwent endoscopic balloon dilation 21 and 46 days after surgery, the others improved after a change in diet). There was no anastomotic bleeding. Non-anastomotic complications occurred in 174 patients (38.1%). All patients attended for follow-up at least once, the median follow-up time being 10 (3–18) months. Visick grades were as follows: Class I, 89.1% (407/457); Class II, 7.9% (36/457); Class III, 2.6% (12/457); and Class IV 0.4% (2/457).Conclusion:Double and a half layered esophagojejunal anastomosis in radical gastrectomy is safe and feasible.

Objective:To evaluate the safety of double and a half layered esophagojejunal anastomosis in radical gastrectomy.Methods:This prospective, multi-center, single-arm study was initiated by the Affiliated Cancer Hospital of Zhengzhou University in June 2021 (CRAFT Study, NCT05282563). Participating institutions included Nanyang Central Hospital, Zhumadian Central Hospital, Luoyang Central Hospital, First Affiliated Hospital of Henan Polytechnic University, First Affiliated Hospital of Henan University, Luohe Central Hospital, the People's Hospital of Hebi, First People's Hospital of Shangqiu, Anyang Tumor Hospital, First People's Hospital of Pingdingshan, and Zhengzhou Central Hospital Affiliated to Zhengzhou University. Inclusion criteria were as follows: (1) gastric adenocarcinoma confirmed by preoperative gastroscopy;(2) preoperative imaging assessment indicated that R0 resection was feasible; (3) preoperative assessment showed no contraindications to surgery;(4) esophagojejunostomy planned during the procedure; (5) patients volunteered to participate in this study and gave their written informed consent; (6) ECOG score 0–1; and (7) ASA score I–III. Exclusion criteria were as follows: (1) history of upper abdominal surgery (except laparoscopic cholecystectomy);(2) history of gastric surgery (except endoscopic submucosal dissection and endoscopic mucosal resection); (3) pregnancy or lactation;(4) emergency surgery for gastric cancer-related complications (perforation, hemorrhage, obstruction); (5) other malignant tumors within 5 years or coexisting malignant tumors;(6) arterial embolism within 6 months, such as angina pectoris, myocardial infarction, and cerebrovascular accident; and (7) comorbidities or mental health abnormalities that could affect patients' participation in the study. Patients were eliminated from the study if: (1) radical gastrectomy could not be completed; (2) end-to-side esophagojejunal anastomosis was not performed during the procedure; or (3) esophagojejunal anastomosis reinforcement was not possible. Double and a half layered esophagojejunal anastomosis was performed as follows: (1) Open surgery: the full thickness of the anastomosis is continuously sutured, followed by embedding the seromuscular layer with barbed or 3-0 absorbable sutures. The anastomosis is sutured with an average of six to eight stitches. (2) Laparoscopic surgery: the anastomosis is strengthened by counterclockwise full-layer sutures. Once the anastomosis has been sutured to the right posterior aspect of the anastomosis, the jejunum stump is pulled to the right and the anastomosis turned over to continue to complete reinforcement of the posterior wall. The suture interval is approximately 5 mm. After completing the full-thickness suture, the anastomosis is embedded in the seromuscular layer. Relevant data of patients who had undergone radical gastrectomy in the above 12 centers from June 2021 were collected and analyzed. The primary outcome was safety (e.g., postoperative complications, and treatment). Other studied variables included details of surgery (e.g., surgery time, intraoperative bleeding), postoperative recovery (postoperative time to passing flatus and oral intake, length of hospital stay), and follow-up conditions (quality of life as assessed by Visick scores).Result:[1] From June 2021 to September 2022,457 patients were enrolled, including 355 men and 102 women of median age 60.8±10.1 years and BMI 23.7±3.2 kg/m2. The tumors were located in the upper stomach in 294 patients, mid stomach in 139; and lower stomach in 24. The surgical procedures comprised 48 proximal gastrectomies and 409 total gastrectomies. Neoadjuvant chemotherapy was administered to 85 patients. Other organs were resected in 85 patients. The maximum tumor diameter was 4.3±2.2 cm, number of excised lymph nodes 28.3±15.2, and number of positive lymph nodes five (range one to four. As to pathological stage,83 patients had Stage I disease, 128 Stage II, 237 Stage III, and nine Stage IV. [2] The studied surgery-related variables were as follows: The operation was successfully completed in all patients, 352 via a transabdominal approach, 25 via a transhiatus approach, and 80 via a transthoracoabdominal approach. The whole procedure was performed laparoscopically in 53 patients (11.6%), 189 (41.4%) underwent laparoscopic-assisted surgery, and 215 (47.0%) underwent open surgery. The median intraoperative blood loss was 200 (range, 10–1 350) mL, and the operating time 215.6±66.7 minutes. The anastomotic reinforcement time was 2 (7.3±3.9) minutes for laparoscopic-assisted surgery, 17.6±1.7 minutes for total laparoscopy, and 6.0±1.2 minutes for open surgery. [3] The studied postoperative variables were as follows: The median time to postoperative passage of flatus was 3.1±1.1 days and the postoperative gastrointestinal angiography time 6 (range, 4–13) days. The median time to postoperative oral intake was 7 (range, 2–14) days, and the postoperative hospitalization time 15.8±6.7 days. [4] The safety-related variables were as follows: In total, there were 184 (40.3%) postoperative complications. These comprised esophagojejunal anastomosis complications in 10 patients (2.2%), four (0.9%) being anastomotic leakage (including two cases of subclinical leakage and two of clinical leakage; all resolved with conservative treatment); and six patients (1.3%) with anastomotic stenosis (two who underwent endoscopic balloon dilation 21 and 46 days after surgery, the others improved after a change in diet). There was no anastomotic bleeding. Non-anastomotic complications occurred in 174 patients (38.1%). All patients attended for follow-up at least once, the median follow-up time being 10 (3–18) months. Visick grades were as follows: Class I, 89.1% (407/457); Class II, 7.9% (36/457); Class III, 2.6% (12/457); and Class IV 0.4% (2/457).Conclusion:Double and a half layered esophagojejunal anastomosis in radical gastrectomy is safe and feasible.