Objective To investigate the relationship between metabolic syndrome (MS) and education level in Su-Xi-Chang area to provide evidence for healthcare policy making. Methods A clustered sampling of 6798 subjects from Su-Xi-Chang areas of Jiangsu Province was included. Questionnaires and physical examinations were completed to collect clinical data. Logistic regression was used to analyze weather education level could be an independent risk factor of MS. Results Significant differences were found in waist circumstance (WC) ,systolic blood pressure (SBP) and fasting blood glucose (FBG) among participants with different education level. Significant differences were also existed in triglyceride and diastolic blood pressure (DBP) between subjects with higher and lower education level ( P＜0. 05 ). In single-factor or multivariate analysis, education level was negatively correlated with the prevalence of MS (P＜0. 05 ). Conclusions Education level may be an independent risk factor of MS. People with low and moderate education level have higher risk of MS. Therefore,it is recommended that health-related information should become an integral part of the compulsory education system.

Objective To investigate the relationship between metabolic syndrome (MS) and diet style in the elderly. Methods The 781 old people were consecutively selected. Related data were collected by means of questionnaires and physical examinations. And logistic regression was performed to analyze if moderate and high fat diet were risk factors of MS. Results The total prevalence rate of MS in old people was 40. 7%, with 36.7% in old males and 55.4% in old females,and the prevalence rate of MS was higher in old women than in old men (P=0. 000). The significant differences in waist circumferences among three groups of low, moderate and high-fat diet [(86.0±9.3) cm vs. (88.8±8.5) cm vs. (90. 0±7.9) cm, respectively (all P＜0.05)]were found. Fasting blood glucose showed a significant difference between two groups of low and high-fat diet, with the results of (5.78 ± 0.98) mmol/L and (6.27 ± 1.80) mmol/L, respectively ( P＜0. 05 ). The logistic regression analysis showed that odds ratio for people with moderate and high-fat diets were 1. 541 ( 1. 092-2. 174) and 2. 293 ( 1. 317-3. 994), respectively (P＜0.05), which indicated that moderate and high-fat diet was independent risk factors for MS in old people. Conclusions Both moderate and high-fat diets are risk factors of MS in old population, low fat diet with food balance is recommended to old population in order to decrease the prevalence of MS.

Objective To explore the effects of lifestyle intervention on index of early artery diseases in nondiabetic patients with metabolic syndrome (MS). Methods Eighty-seven nondiabetic patients with MS were randomly assigned to the intervention group ( n =47) and the control group ( n =40).The patients in the intervention group received health education,diet control,regular physical exercises,and unhealthy habit correction; however,the control group did not receive any intervention.All the patients were followed up for 9 months.Body mass index (BMI),waist circumference (WC),systolic blood pressure (SBP),diastolic blood pressure (DBP),triglyceride (TG),total cholesterol (TC),high-density lipoprotein cholesterol ( HDL-C ),low-density lipoprotein cholesterol ( LDL-C ),fasting blood glucose (FBG),HbAlc,fasting insulin (FINS),HOMA-IR,high sensitivity C-reactive protein (hs-CRP),carotid intima-media thickness (IMT),brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index(ABI) were measured at baseline and at 9 months.ResultsAfter 6 or 9 months' intervention,BMI,WC,SBP,TG,HDL-C,FPG,HbAlc,FINS,HOMA-IR and hs-CRP of the intervention group were improved (all P ＜ 0.05). HDL-C,FPG,HbAlc,FINS,HOMA-IR and hs-CRP of the intervention group were further improved at 9 months when compared to 6 months ( all P ＜ 0.05 ). In comparison with the control group,BMI,WC,HDL-C,FPG,HbA1 c,FINS,HOMA-IR and hs-CRP were significantly improved in the intervention group at 9 months ( all P ＜ 0.05 ).After 6 or 9 months' intervention,baPWV and ABI were significantly changed ( both P ＜ 0.05 ) in the intervention group although IMT of the carotid did not changed (P ＞0.05). BaPWV and ABI were significantly changed in the intervention group when compared with those in the control group at 9 months ( both P ＜ 0.05).The abnormal rate of baPWV in the intervention group at 9 months was 44.68％. BaPWV and ABI were associated with hs-CRP and HOMA-IR.ConclusionsIn nondiabetic MS patients, health management could significantly improve insulin resistance,modify metabolic disorders,and prevent the development of atherosclerosis.

Objective To investigate the expressions of P53,topoisomeraseⅡ(TopoⅡ)and multidrug resistance associated protein(MRP)in tissues of colorectal cancer of patients combined with chronic schistosomiasis.Method The retrospective case-control study was adopted.The clinicopathological data of 338 colorectal cancer patients who were admitted to the Zhejiang Cancer Hospital between January 2008 and December 2010 were collected.Cancer tissue specimens from surgical resection were collected.Among 338 patients,80 were combined with chronic schistosomiasis and 258 were combined with non-chronic schistosomiasis.The expressions of P53,TopoⅡand MRP were dectected using immunohistochemistry(IHC).Ranked data were presented as percentage and analyzed using the non-parametric test.Results The negative,weak positive,positive and strong positive expressions of P53 were respectively 5.00％(4/80),87.50％(70/80),3.75％(3/80),3.75％(3/80)in tissues of colorectal cancer of patients combined with chronic schistosomiasis and 28.68％(74/258),19.38％(50/258),16.67％(43/258),35.27％(91/258)in tissues of colorectal cancer of patients combined with non-chronic schistosomiasis,with a statistically significant difference(Z=-2.962,P＜0.05).The negative,weak positive,positive and strong positive expressions of TopoⅡwere respectively 8.75％(7/80),51.25％(41/80),22.50％(18/80),17.50％(14/80)in tissues of colorectal cancer of patients combined with chronic schistosomiasis and 12.01％(31/258),55.43％(143/258),22.48％(58/258),10.08％(26/258)in tissues of colorectal cancer of patients combined with non-chronic schistosomiasis,with no statistically significant difference(Z=-1.551,P＞0.05).The negative,weak positive,positive and strong positive expressions of MRP were respectively 7.50％(6/80),40.00％(32/80),28.75％(23/80),23.75％(19/80)in issues of colorectal cancer of patients combined with chronic schistosomiasis and 24.42％(63/258),38.37％(99/258),24.03％(62/258),13.18％(34/258)in tissues of colorectal cancer of patients combined with non-chronic schistosomiasis,with a statistically significant difference(Z=-3.408,P＜0.05).Conclusion There are abnormal expressions of P53 and MRP in tissues of colorectal cancer of patients combined with chronic schistosomiasis,which may be involved in the hypothetical mechanism of chronic schistosomiasis inducing carcinogenesis of colorectal cancer.

ObjectiveRetrospectively investigate the characteristics of neoplasma of health checkup participants to find ways to improve cancer detection rate.Methods A total of 186 confirmed cancer patients were enrolled in this study.Personal information,including age,gender,andlocation were collected.The contribution of clinical symptoms,physical examination and laboratory test to cancer detection was investigated.ResultsBiopsy confirmed cancers accounted for 0.133％( 186/140 127 ).Lung (0.036％ ),liver ( 0.017％ ),kidney ( 0.014％ ),colorectal ( 0.013％ ) and gastric cancer ( 0.011％ )were the most commonly found neoplasma.Detection rate of liver cancer in male was significantly higher than that in female (x2 =6.181,P＜0.05 ).Asymptomatic cancer was found in 158 adults (84.9％ ).Ultrasound showed a significantly higher sensitivity to liver,kidney and thyroid cancer than tumor biomarkers.The detection of lung cancer was improved with the combination of X ray,tumor marker( TM ),clinical symptom and low-dose chest CT scan.In 2008,the detection rate for digest system carcinoma (0.083％ ) and lung cancer (x2 =8.538,P＜0.05) was significantly increased (x2 =11.792,P＜0.05).ConclusionsHealth check-up plays an important role in early detection of cancer.The combined use of physical examination,chest X ray,ultrasound test,TM and CT may improve the detection of cancer.

OBJECTIVETo investigate the expression difference of DNA mismatch repair gene hMLH1 and hMSH2 between schistosomiasis-associated colorectal cancer and sporadic colorectal cancer.

METHODClinical and pathological data of colorectal cancer patients receiving operations in Zhejiang Cancer Hospital between January 2008 and December 2010 were retrospectively analyzed. Patients were divided into schistosomiasis group(n=80) and sporadic group (n=258) according to the preoperative history and pathologic results. Pathological specimens were collected and tissue chips were made to analyze the expression of hMLH1 and hMSH2 by immunohistochemistr.

RESULTSCompared with sporadic group, older age [(62.2 ± 9.6) year vs. (57.2 ± 11.7) year, P=0.000)], lower platelet level [(197.0 ± 59.6) × 10(9)/L vs. (217.0 ± 84.3) × 10(9)/L, P=0.02] and lower WBC level [(5.9 ± 1.9) × 10(9)/L vs. (6.6 ± 2.8) × 10(9)/L, P=0.02] were found in schistosomiasis group. Ratio of low differentiation-undifferentiation tumor was significantly higher in schistosomiasis group [44.2% (34/77) vs. 4.9% (12/247), P<0.05]. Lower positive rate of hMLH1 expression [77.5% (62/80) vs. 98.1% (253/258), P=0.000] and hMSH2 expression [75.0% (60/80) vs. 95.3% (246/258), P=0.000] was found in schistosomiasis group compared with sporadic group. Concurrent schistosomiasis was one of the risk factors of hMLH1/hMSH2 deficiency (RR: 0.913, 95% CI: 0.836-0.997, P=0.043), but not an independent factor (RR: 0.951, 95% CI: 0.867-1.043, P=0.286).

CONCLUSIONSchistosomiasis is associated with lower positive expression of hMLH1 and hMSH2, which indicates that hMLH1/hMSH2 deficiency may be a potential mechanism of schistosomiasis inducing carcinogenesis of colorectal cancer.

Adaptor Proteins, Signal Transducing ; Colorectal Neoplasms ; DNA Mismatch Repair ; Humans ; MutL Protein Homolog 1 ; MutS Homolog 2 Protein ; Nuclear Proteins ; Polymerase Chain Reaction ; Schistosomiasis

Objective:To explore the correlation between different smoking status and serum uric acid(SUA)in a middle-aged male in health check-up population.Methods:In this cross-sectional study, a total of 26701 middle-aged men who underwent health check-up in Taihu Sanatorium of Jiangsu Province from January 2014 to June 2015 were studied.The correlation between smoking status and SUA was analyzed by questionnaires, physical examination and serum biochemical assay.Smoking state was divided into no smoking, a occasional smoking and smoking groups.Results:With the increase of age, there was a downward trend of SUA( F=7.38, P=0.000). Among the three smoking groups, the group with occasional smoking had the highest level of SUA.The smoking group had lower level of SUA than the non-smoking group and occasional smoking group( P=0.000 and 0.005). In the non-smoking group, the fourth quartile of SUA(41.5%)had a higher percentage than that in first quartile of SUA(38.4%)( χ2=12.266, P=0.000). In the smoking group, the fourth quartile of SUA(54.9%)had lower percentage than that in the first quartile of SUA(58.4%)( χ2=7.049, P=0.008). Compared with the non-smoking group, the prevalence of hyperuricemia(HUA)in smoking group was lower( OR=0.872, 95% CI: 0.821~0.927, P=0.000), the prevalence of HUA in occasional smoking group was higher( OR=1.194, 95% CI: 1.013~1.408, P=0.035). Conclusions:As compared with the non-smoking group, the prevalence of HUA is lower in smoking group and is higher in occasional smoking group.

Objective To explore the efficacy and clinical value of texture analysis of conventional MRI image for the preoperative classification of meningiomas. Methods The MR images of 101 meningioma cases were retrospectively analyzed, all of them underwent routine MRI before operation, and confirmed by surgery and pathology,of whom 81 cases in WHO Ⅰ,19 cases in Ⅱand 1 case in Ⅲ.The maximum diameter of the tumor in MRI images was outlined as ROI by the Image J software.The histograms and grey-level co-occurrence matrix(GLCM)were used to measure the texture parameters,such as maximum value,minimum value,standard deviation(SD),skewness,kurtosis,angular second moment,contrast,inverse different moment, entropy, correlation and so on, and compared with postoperative pathological grading results.The independent sample t test or the Mann-Whitney U test was used to compare the difference of the histogram and the gray level co-occurrence matrix parameter of the MRI images between low-grade and high-grade meningiomas. ROC curves for statistically significant parameters were used to confirm their efficacy in predicting the preoperative grade of meningiomas.Results (1)In histogram parameters,the SDs of T2WI,FLAIR,ADC(SDT2WI,SDFLAIR,SDADC)of low grade meningioma were 14.764(10.928,17.932),9.753 (7.385,13.618) and 12.171 (9.138,19.691), the high grade meningiomas were 19.252 (13.580,25.715), 13.568 (8.936,17.108) and 16.636 (13.166,21.498), respectively. The difference between the two groups was statistically significant(Z values were-2.863,-2.250,-2.247,P respectively 0.004,0.024,0.025).The skewness values (SkeADC, SkeFLAIR) of ADC sequence and FLAIR sequence of low-grade meningiomas were 1.377 ± 1.172 and-1.327 ± 0.930, respectively, and the high-grade meningiomas were 2.503 ± 1.613 and-0.827±0.834,respectively.The differences between the two groups were statistically significant (t values were-2.196,-3.129, P values were 0.002,0.030, respectively). (2) In the GLCM parameters, entropy (EntT1WI, EntT2WI, EntFLAIR, EntADC) of the enhanced T1WI, T2WI, FLAIR and ADC sequences of low grade meningiomas were 6.881(6.174,7.305),6.534±0.598,6.019±0.588,6.040±0.588,high-grade meningiomas were 7.079 (6.742,7.739), 7.014 ± 0.514,6.370 ± 0.703,6.576 ± 0.450, respectively. And the difference between the two groups was statistically significant (Z=-2.007, t values were-3.294,-2.327,-3.245, P values were 0.045,0.001,0.022,0.002,respectively).(3)The ROC curves of EntADCand SkeADCwere plotted, and the area under the curve(AUC)was 0.768 and 0.710,respectively.Combined EntADC,SkeADCand EntT2WI were the best for the classification of meningiomas,and AUC was 0.799.Conclusion Texture analysis can provide more quantification information, which can be more accurately distinguishing high grade meningiomas and low grade meningiomas before surgery.

Objective:To introduce the stereotactic cardiac radioablation (SCRA) based on the stereotactic body radiotherapy (SBRT), and comprehensively evaluate the new approach by short-term effectiveness and safety.Methods:Patients with ventricular arrhythmia (VA) were evaluated and included in this clinical trial, who were immobilized by vacuum bag and performed simulation with 4-dimensional computed tomography (4DCT). In this study, the planning target volume (PTV) was set as the target to design a SBRT plan using volumetric modulated arc therapy (VMAT), which was evaluated by dose parameters such as R 50%, homogeneity index and conformity index, etc. The results of Holter and echocardiography were monitored during the follow-up and compared with the data before treatment. Results:Three subjects with ventricular tachycardia (VT) and one with premature ventricular contraction (PVC) received the same prescription of 25 Gy in a single fraction. The average volume of PTV was 71.4 cm 3(60.3-89.4 cm 3). The average time of beam delivery was 12.0 min (4.5-21.0 min). And the short-term follow-up lasted for an average of 18 weeks (14-25 weeks), which showed significant decrease in both VT and PVC load without complications. Conclusion:This study reports the implementation method of SCRA and proves its short-term effectiveness and safety, but the effects and standards of the key radiotherapy techniques still need to be explored.