Objective To assess the association of obesity, serum lipid levels and insulin resistance with leptin in Nanjing population. Methods One hundred and eighty eight subjects aged 22～81 years in Nanjing were divided into three groups according to BMI and dignosis criteria of diabetes: normal group, obese group and diabetes group. Their weight, height, waist, abdomen and hip circumferences were measured. Total cholesterol, triglycerides, low density lipoprotein cholesterol, high density lipoprotein cholesterol, apoA, apoB, fasting plasma glucose (FPG), true insulin (TI), immunoreactive insulin (IRI) and leptin were also measured. ISI 1=1/(FPG?TI) and ISI 2=1/(FPG?IRI) as insulin sensitivity indexes were used to analyse the relation between leptin and insulin resistance. Results Fasting serum leptin level was associated with sex (four fold as high in women as that in men). BMI was the second strongest determinant of leptin. Leptin was positively correlated with TI (r=0.32, P

Objectives: To explore the epidemiological distribution of body mass index(BMI),waist to hip ratio(WHR) and abdominal circumference in population of Nanjing,Jiangsu Province. Methods: BMI, WHR and abdominal circumference were measured on 3 445 healthy cases aged 18～90 of Nanjing. Epidemiological distribution of BMI,WHR and abdominal circumference were analyzed according to sex and age. Results:The total mean BMI was( 23.28 ?3.49)kg/m 2, and the BMI in male was higher〔(23.80?3.36)kg/m 2〕 than that in female 〔(22.25? 3.49)kg/m 2〕( t =12.75, P

Low-triiodothyronine syndrome is a condition characterized by decreased total serum T 3 and free T3 , along with in-creased serum reverse triiodothyronine but normal levels of thyroxine and thyrotropin .However , it is not caused by the thyroid gland diseases.The latest research progress of mechanisms , diagnosis and clinical significance , and therapy strategy of low T 3 syndrome is reviewed in this paper .

So far, the major therapeutic drugs of diabetes are western medicine , but side effects of hypoglycemic western med-icine are large and not easy to take for a long time .In recent years , we found the side effects of some kind of hypoglycemic Chinese herbal medicine were small , much easier to be accepted by the patients .Thus, the clinical treatment of diabetes may have new meth-ods.According to the mechanisms of Traditional Chinese Medicine for protection of islet function , this review will discuss them from re-ducing oxidative stress , increasing the number of islet cells and promoting βcells to secrete, relieving insulin resistance , increasing in-sulin sensitivity and so on .All of these aspects reflect the unique role of Traditional Chinese Medicine in the treatment of diabetes and protection of islet function .

1-(2,6-Dimethylphenoxy)-2-(3,4-dimethoxyphenylethylamino) propane hydrochloride(DDPH) caused parallel rightward shifts of the phenylephrine(Phe) concentration-contractile response curves and did not suppress the maximal contractile response to Phe (pA2=7.24) in isolated rabbit urinary bladder smooth muscle. DDPH decreased the parameters of cystometry in urethane-anesthetized rats. Thirty minutes after DDPH (25 and 50 mg*kg-1 ig) administration, bladder capacity, voiding pressure, voiding threshold pressure were significantly decreased. With the observation of light-microscope and electron-microscope technique, DDPH (25 and 50 mg*kg-1*d-1 ig for 4 weeks) also inhibited the development of testosterone propionate-induced benign prostatic hyperplasia in rats. The results indicate that DDPH may inhibit benign prostatic hyperplasia and improve the urinary flow.

The hospital grade assessment is an effective approach to measure the comprehensive strength and the overall level of a hospital, and it is also an effective carrier which can promote the standardized management , improve the quality of connotation and accelerate the development of the hospital .This article aims to expound the effective and concrete methods for preparation in the hospi -tal grade assessment by introducing the practice and experience of Jinling Hospital in grade assessement .It also points out that:defi-ning the purpose of the assessment is the fundation , having a thorough grasp of the assessment criteria is the basis , having a compre-hensive knowledge of the hospital is the premise , establishing and implementing the plan strictly is the crux .All these might be helpful to promote the hospital grade assessment .

The construction of harmonious doctor-patient relationship is an important project in social medicine .The influen-cing factors about doctor-patient relationship are analyzed from three aspects which are responsibility ethics , bottom-line ethics and clin-ic ethics.Based on the discussion , certain countermeasures are proposed to reconstruct harmonious doctor -patient relationship .

Dioxin,one of the persistent organic pollutants,persistently exists in the environment and does serious harm to the ecological environment as well as to the human body because of its reproductive toxicity,carcinogenicity,immune toxicity,skin toxicity and toxicity to other systems and organs.This paper reviewed the toxicities of dioxins to the human body,especially to the endocrine and immune systems.

This study was aimed to investigate the association between dyslipidemia and thyroid associated ophthalmopathy (TAO). We evaluated the relationship between dyslipidemia and TAO in 218 patients with Graves′ disease (GD) and found that the serum total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) in the GD subjects with TAO (n=110) were significantly increased [(5.32±1.39) mmol/L vs. (3.18±2.12) mmol/L, (2.98±0.75) mmol/L vs. (1.25±0.98) mmol/L] than those in the GD subjects without TAO (n=108). TC and LDL-C were positively correlated with the Clinical disease activity score (CAS) [TC (r=0.7, P=0.03),LDL-C (r=0.82, P=0.03)], and the levels of TC (OR=2.56, P=0.02) and LDL-C(OR=2.01, P=0.015) were positively associated with TAO. These suggested that high serum cholesterol level is a novel risk factor for TAO, and management of blood lipids should be included in the treatment of TAO.

OBJECTIVETo compare the safety and efficacy between three-field lymphadenectomy and normative Ivor-Lewis two-field lymphadenectomy for thoracic esophageal squamous cell carcinoma METHODS: Clinical data of 375 patients with thoracic esophageal squamous cell carcinoma who underwent three-field lymphadenectomy(3FL) or Ivor-Lewis two-field lymphadenectomy(2FL, Ivor-Lewis) in Fudan University Shanghai Cancer Center during 2013 were retrieved and collected from electronic medical record system. Ninety-one patients received three-field lymphadenectomy (3FL group), including 16 cases of intra-cervical gastro-esophageal anastomosis and 75 cases of intra-thoracic gastro-esophageal anastomosis, while 284 patients received Ivor-Lewis two-field lymphadenectomy (2FL group) with all intra-thoracic gastro-esophageal anastomosis. Short-term outcomes were compared between two groups, including postoperative anastomotic leakage, pneumonia and respiratory failure, chylothorax, reoperation and 90-day death. Total harvested lymph nodes and positive lymph nodes in each group were also compared. A total of 338 patients were enrolled into survival analysis. Survival curve was presented by Kaplan-Meier method.

RESULTSAs compared to 2FL group, the 3FL group had significantly higher ratio of N3 patients [19.8% (18/91) vs. 5.3% (15/284), P=0.000], stageIII( patients [58.2%(53/91) vs. 43.0%(122/284), P=0.007], and upper thoracic cancer patients [12.1%(11/91) vs. 3.5%(10/284), P=0.027]; also the 3FL group had more harvested lymph nodes (40.1±14.6 vs. 25.3±9.4, P=0.000) and more positive lymph nodes (3.3±4.0 vs. 1.7±3.2, P=0.000). With respect to pneumonia and respiratory failure, chylothorax, reoperation and 90-day death, no significant differences were found between the group (P=0.447, P=0.751, P=0.678, P=0.685). The 3FL group had a significantly higher incidence of anastomotic leakage than 2FL group [7.7% (7/91) vs. 1.8% (5/284), P=0.011], while its incidence of intrathoracic anastomosis leakage was 4.0% (3/75), which was not significantly different with 1.8%(5/284) of 2FL group (P=0.372). Median follow-up was 33 months. Overall 1-, 2-, 3-year survival rates were 94%, 81% and 70%, while 1-, 2-, 3-year survival rates of 3FL group were 90%, 73% and 66%, of 2FL group were 95%, 84% and 72%, respectively, without significant differences between the two group(P=0.135). Further subgroup analysis showed that no significant differences of postoperative survival in stage I(, II( and III( patients were observed between the two groups (P=0.541, P=0.511, P=0.402), meanwhile no significant differences of postoperative survival in patients with metastasis and without metastasis were found between the two groups as well (P=0.985, P=0.233).

CONCLUSIONSThree-field lymphadenectomy can be performed with acceptable perioperative morbidity and mortality. The prognosis value of three field lymphadenectomy needs further investigation. Patients with thoracic esophageal squamous cell carcinoma may have favorable survival through normative Ivor-Lewis two-field lymphadenectomy.

Anastomotic Leak ; etiology ; Antineoplastic Protocols ; Carcinoma, Squamous Cell ; mortality ; surgery ; China ; Esophageal Neoplasms ; mortality ; surgery ; Esophagectomy ; adverse effects ; methods ; mortality ; Humans ; Incidence ; Lymph Node Excision ; adverse effects ; methods ; mortality ; Lymph Nodes ; Lymphatic Metastasis ; Neoplasm Staging ; Prognosis ; Survival Analysis ; Survival Rate ; Thoracic Neoplasms ; mortality ; surgery ; Treatment Outcome