Objective To systematically assess the relationship between oral administration of aspirin and survival benefit for patients with colorec?tal cancer(CRC)by meta?analysis. Methods Relevant studies were identified through searching PubMed and EMBASE. Random?effects model was derived to composite the pooled hazard ratio for overall mortality and CRC?specific mortality. The subgroup analysis was conducted for included data,and the bias analysis was reported. Results Thirteen studies on aspirin therapy were finally included in this meta?analysis. The overall surviv?al benefit associated with oral administration of aspirin represented an HR of 0.83(95%CI:0.71?0.96). Oral administration of aspirin was also asso?ciated with CRC?specific survival(HR=0.77,95%CI:0.64?0.93). No evidence was observed of an association between prediagnostic aspirin use and CRC overall survival(HR=1.00,95%CI:0.85?1.18)or CRC?specific survival(HR=0.97,95%CI:0.83?1.13). Conclusion These findings provide further indication that post?diagnostic aspirin therapy can improve CRC prognosis.

Objective To compare the difficult degree,differences in gastric pouch volume,the complications,and postoperative weight loss effect of two gastric pouch practices in laparoscopic gastric bypass for bariatrics.Methods We retrospectively analyzed laparoscopic gastric bypass surgery in 76 bariatrics cases from May 2010 to May 2012.Two methods were used to create gastric pouch,among which 39 cases were operated with the dissection landmark method (called dissection),and 37 cases with bougie airbags 30 ml (called the bougie).Parameters were compared between the 2 groups including operation time for gastric pouch,the amount of staple cartridges,intraoperative complications,blood loss,and postoperative excess weight loss percentage (EWL ％),the postoperative bleeding,obstruction,fistula and other complications.Results All patients were followed up for more than one month.The dissection group used longer time in creating gastric pouch than that in the bougie group [(58 ± 27) min,(42 ±21) min,P ＜ 0.01].The number of staple cartridges used were significantly different between the two groups [(6.2 ±3.0),(4.3 ± 2.0),P ＜ 0.01].There were 10 cases of complications in the dissection group (26％),and 3 cases in the bougie group (8％) (P ＜0.05).One month after the surgery,one each patient had transient hematochezia.There was no gastric pouch-related complications in the two groups postoperation.There was no difference in excess weight loss (P ＞ 0.05).Conclusions The two methods can achieve the same effect on excess weight loss.The bougie method used less time in creating the gastric pouch,less consumable materials,and less complications occurred in creating gastric pouch.

Objective To investigate the efficacies of laparoscopic sleeve gastrectomy + duodenojejunal bypass (DJB) and laparoscopic gastric bypass in the treatment of patients with non-obese type 2 diabetes mellitus (T2DM).Methods The clinical data of 42 patients with type 2 diabetes mellitus and body mass index (BMI) ＜ 30 kg/m2 received surgical treatment at the First Affiliated Hospital of Nanjing Medical University from January 2012 to June 2013 were retrospectively analyzed.Fifteen patients received laparoscopic sleeve gastrectomy + DJB (Sleeve + DJB group),and 27 received Roux-en-Y gastric bypass (RYGB group).The follow-up time for all the patients was more than 6 months.The decrease of BMI,complete remission of T2DM,decrease of fasting glycemia and glycosylated hemoglobin (HbAlc),postoperative nutritional condition and the incidence of complications of the 2 groups were compared.The measurement data were analyzed using the t test and the repeated measurement chi-square test.Results The operation time of the Sleeve + DJB group and the RYGB group were (137 ± 61)minutes and (89 ± 43) minutes,with significant difference between the 2 groups (t =6.158,P ＜ 0.05).No mortality and hemorrhage,bowel obstruction and anastomotic stenosis were detected.One patient was complicated with bile leakage in the Sleeve + DJB group,and was cured by conservative treatment 5 days later.The levels of fasting glucose before operation and at postoperative month 1,3,6 were (8.9 ± 0.7) mmol/L,(5.8 ± 1.3) mmoL/L,(5.6 ±1.8) mmol/L and (5.7 ± 0.3) mmol/L in the Sleeve + DJB group,and (9.9 ± 1.2) mmol/L,(6.9 ± 0.8) mmol/L,(6.6 ± 2.2) mmol/L and (5.6 ± 0.8) mmol/L,with no significant difference between the 2 groups (F =1.670,2.932,0.444,0.158,P ＞ 0.05).The levels of HbAle before operation and at postoperative months 1,3,6 were 7.4％± 1.4％,6.5％ ±0.6％,5.7％±0.5％,5.9％ ±0.6％ in the Sleeve + DJB group,and 7.7％± 2.0％,6.8％ ± 1.3％,5.7％±0.8％,5.6％ ± 1.1％ in the RYGB group,with no significant difference between the 2 groups (F =0.055,0.125,0.005,0.286,P ＞ 0.05).The remission rates of T2DM of the Sleeve + DJB group and the RYGB group were 14/15 and 74.1％ (20/27) at postoperative month 6,with no significant difference between the 2 groups (x2 =2.320,P ＞ 0.05).The decrease rate of BMI of the Sleeve + DJB group and the RYGB group were 18.2％±9.5％ and 21.2％ ± 4.9％,with no significant difference between the 2 groups (t =0.982,P ＞0.05).The numbers of patients with postoperative anaemia,avitaminosis and diarrhea were 0,0,2 in the Sleeve + DJB group and 3,2,6 in the RYGB group,with no significant difference between the 2 groups (x2=1.795,1.167,0.908,P ＞0.05).The BMIs of all the patients were above 19 kg/m2.Conclusion The effects and incidence of postoperative complications of Sleeve + DJB for the treatment of T2DM are comparable to those of RYGB.Sleeve + DJB has less interference on the nutritional condition of patients compared with RYGB.

Objective To investigate clinical characteristics of patients with ST-elevation myocardial infarction (STEMI) and hypokalemia and the effects of hypokalemia on prognosis. Methods Consecutive 216 cases with STEMI who underwent emergency PCI were divided into group A (serum potassium ＜ 3.5 mmol/L) and group B (serum potassium＞3.5 mmol/L). Infarct site, infarct interrelated artery, peak level of CK-MB and cTnT were compared between two groups. Post-infarctional angina pectoris, arrhythmia, heart failure and cardiac death were compared. Results (1 )The percentage of anterior wall myocardial infarction , left anterior descending artery (LAD) lesions in group A were significantly higher than those in group B [61.2%(41/67) vs. 44.3%(66/149),55.2%(37/67)vs. 38.9%(58/149),P = 0.022,0.026]. The peak levels of CK-MB and cTnT in group A were significantly higher than those in group B [(194.39 ± 101.27) μg/L vs. (115.35 ±78.62)μg/L,(19.16 ±11.48)μg/L vs. (9.07 ±7.65) μg/L,P = 0.004,0.002].(2)Left ventricular ejection fraction in group A was significant lower than that in group B (P - 0.003). The incidence rates of post-infarctional angina pectoris, ventricular tachycardia, ventricular fibrillation and heart failure were significantly higher in group A [43.3%(29/67),32.8%(22/67), 11.9%(8/67),37.3%(25/67)] than those in group B [24.8%(37/149),18.1%(27/149),4.0%(6/149),20.8%(31/149)](P = 0.006, 0.017, 0.029, 0.010). Conclusions Hypokalemia is associated with infarct site and infarct interrelated artery. Hypokalemia has bad effect on prognosis of STEMI.

Objective To explore the differences between the minority nationality and Han recruits in army occupational adaptability.Methods 3 213 recruited youths coming from 29 autonomous counties of minority nationalities,Yunnan Province were tested by 2011 Chinese enrollment psychological test system to explore the differences of the intelligence adaptability and character trait adaptability between the minority nationality and Han recruits.Results There were obvious differences in the eligible rates of intelligence and character trait between minority nationality and Han recruits ( x2 =13.3,9.0; P ＜ 0.01 ).The intelligence eligible rates of Yi,Hani,Wa recruits (78.1％,76.8％,68.2％,respectively) were significantly lower than those of Han recruits (84.0％) (P＜0.01 ),and time used in three intelligence test was all significantly longer than Han recruits(P ＜ 0.05 ).Naxi and Dai recruits' time used in word reasoning ( ( 109.2 ± 20.9) s; ( 123.9 ± 32.5 ) s,respectively) was both longer than Han recruits' (P＜0.01).In the fact of character trait,the eligible rates of Hani,Wa recruits (67.8％,64.3％,respectively) were significantly lower than that of Han recruits (78.1％) (P ＜ 0.01 ).The Hani average score of T dimension (57.9 ± 17.5) was obviously higher than the Han's score (52.2 ± 16.5) (P ＜ 0.05 ).All dimensions average scores except T and D dimension of Wa recruits were all significantly higher than those in Han recruits(P ＜ 0.05 ).Conclusion Every minority nationality has its unique differences in armyoccupational adaptability from Han.Ethnic factor may be an important reference for new recruits' selection,education and management.

Prostaglandin E_2(PGE_2)is one of the major metabolic products of arachidonic acid.PGE_2 plays important roles in various important physiological processes by binding to its G protein-coupled receptors designated EP1,EP2,EP3,and EP4,respectively.EP receptors are highly expressed in the kidney and cardiovascular system,and PGE2-mediated activation of EP receptors plays important roles in the regulation of blood pressure.The abnormal expression of EP receptors in the kidney and cardiovascular system is associated with some blood pressure disease such as salt-sensitive hypertension,renal hypertension,and myocardial hypertrophy.

OBJECTIVE:To explore the optimal steaming time of Carapax trionycis during cleansing period,and to optimize and improve production technology of Carapax trionycis recorded by current Chinese Pharmacopoeia. METHODS:The mechanical processing replaced the artificial processing method in Chinese Pharmacopoeia. The content of protein and the appearance of Cara-pax trionycis were investigated after steaming for 30,60,90,120,180,240 min during cleansing period. The extract,decoction, ash content,appearance and property of Carapax trionycis decoction piece processed with vinegar were also investigated after cleansed Carapax trionycis decoction piece was processed by sand scalding and vinegar quenching method. RESULTS:The differ-ent steaming time obtained different quality of cleansed Carapax trionycis decoction piece and Carapax trionycis decoction piece pro-cessed with vinegar. Compared with decoction piece steamed for other duration,when the steaming time was 90 min,the content of protein in cleansed Carapax trionycis decoction piece was higher(31.16%),and its appearance was up to the requirement. Cara-pax trionycis decoction piece processed with vinegar had higher contents of extract and decoction(9.13%,11.39%)and lower con-tent of ash(66.29%),and its appearance was up to the requirement. CONCLUSIONS:Different steaming time have certain effect on the quality of cleansed Carapax trionycis and Carapax trionycis processed with vinegar,the optimal steaming time of Carapax tri-onycis is about 90 min during cleansing. The mechanical processing method maybe replace the artificial processing on Carapax tri-onycis for improving its production efficiency.

Objective To explore the serum levels of growth differentiation factor-15 (GDF-15) in patients with acute exacerbation of chronic heart failure (CHF) and its correlation with other common indexes,to provide reference for its clinical diagnosis,treatment and prognosis.Methods Two hundred patients with acute exacerbation of CHF were selected as CHF group,and 100 matched healthy volunteers were selected as control group.Serum levels of GDF-15 and N-terminal pronatriuretic peptide (NT-proBNP) were detected,and left ventricular end diastolic diameter (LVESD),left ventricular end diastolic diameter (LVEDD),and left ventricular ejection fraction (LVEF) were measured by echocardiography within 2 hours after admitted to hospital,and after the symptoms improved of CHF group,and on health examination day of control group.Patients in CHF group were followed up to record CHF related adverse events.Correlations between GDF-15 and other indicators were analyzed by Spearman correlation analysis,and the clinical value of serum GDF-15 on diagnosing CHF was analyzed by the receiver operating characteristic curve (ROC) and the area under the curve (AUC).Results The serum levels of GDF-15 and NT-proBNP in each time-point of CHF group were all higher than those of control group (t =4.70 ～ 7.11,P ＜ 0.05 orP ＜ 0.01).The serum levels of GDF-15 and NT-proBNP had negative correlation with LVEF (r =-0.539,-0.572,P ＜ 0.01),and had positive correlation with LVESD,LVEDD,and NYHA cardiac functional grading (r =0.505 ～ 0.861,P ＜ 0.01).Serum GDF-15 had positive correlation with serum NT-proBNP (r =0.528,P ＜0.01).With the increase of serum GDF-15 level,CHF group's readmission (rate) and death (rate) were both increased (x2 =36.86,26.59,P ＜0.01).AUC of predicting readmission risk by serum GDF-15 was 0.822 (95％ CI:0.719 ～0.890,P ＜0.01),and the best predictive cutoff point was 2 876.30 ng/L (sensitivity was 91.86％,specificity was 73.27％).AUC of predicting mortality risk was 0.816 (95％ CI:0.715 ～ 0.885,P ＜ 0.01),and the best predictive cutoff point was 3 487.05 ng/L (sensitivity was 91.72％,specificity was 69.05％).Conclusions Serum GDF-15 level in patients with acute exacerbation of CHF is higher,decreases with symptoms improvement,has positive correlation with LVESD,LVEDD,and NYHA cardiac functional grading,and has negative correlation with LVEF,has higher sensitivity on predicting CHF-related adverse events,and the mechanism may be related to the activation of SMAD pathway.Therefore,it may be a promising biomarker for clinical diagnosis and prognosis of cardiovascular diseases.

Objective In the two division methods which are GDP per capita gathering and administrative level division of the state, which method can more reflect regional economy on teenagers psychological characteristics influence. Methods 10684 recruited youths were tested by Chinese enrollment psychological test system,and the division method of GDP per capita gathering and administrative level division of the state was adopted.Results By the method of GDP gathering, the percent of pass from digital operation was higher in second class region to first class region(P＜ 0.05 ). The percent of pass from digital search was higher in first and second class of region compared to third class of region(P ＜0.05). For the Net dimension, the average value of third class region (52.28 ±10. 53 ) was obviously higher than that of first class region (50. 64 ±- 10. 17)and second class region (51.53 ± 10.28 ) (P＜0. 05 ). For the Dit dimension, the average value of third class region (52.83 ± 11.03 ) was obviously higher than that of first class region (50. 56 ± 10. 56 ) and second class region (51.80 ± 10. 81 ) (P ＜0.05 ). The average value of Set dimension of second class region (51.81 ± 10.72)and third class region (52.44±- 10.94) was evidently higher than that of first class region (49.90 ± 10.76 ) (P ＜ 0. 05 ). While through the administrative level division of the state, the percent of pass was apparently higher in city than in country for digital searching and words reasoning; Set dimension was distinctly higher in country ( 52.30± 10. 85 ) than in city (51.07 ±10.90)(P＜0.05). Conclusion The GDP per capita clustering method can better reflect the regional economy on teenagers psychological characteristics influence.