Objective To investigate the regulations of lymphatic metastasis of rectal carcinoma which can provide help of clinical diagnosis and treatments.Methods A retrospective analysis was performed of 222 patients with rectal carcinoma who underwent surgical resection from November 2006 to January 2012.Summarize the relevance of each factor and lymph node metastasis by logistic regression analysis.Results (1) Gender and lymph node metastasis has no significant correlation (x2 =0.000,P ＞ 0.05).(2) Lymph node metastasis rate reduced with increasing age and the difference was statistically significant (x2 =5.001,P ＜ 0.05).(3) There is no significant difference between tumor location and lymph node metastasis rate (x2 =0.052,P ＞ 0.05),when the distance between anal rectal cancer and the anus was closer,the tendency of lymph node metastasis was higher,and there has the obvious correlation with lymph node metastasis rate of its size,2.5 to 5.5 cm group and more than 5.5 cm lymph node metastasis rate was significantly higher than less than 2.5 cm group with a significant difference (x2 =2.267,P ＜ 0.05).(4) Tumor invasion of the intestinal circumference was closely related with lymph node metastasis rate (x2 =2.323,P ＜0.01).(5) Lymph node metastasis rate was closely related to the depth of invasion,metastasis rate increased with the depth of invasion increasing(x2 =2.277,P ＜0.05).(6) Lymph node metastasis was significantly higher with the decrease of the degree of tumor differentiation (x2 =4.322,P ＜ 0.01).Logistic regression analysis showed that the degree of tumor differentiation,infiltration and invasion of intestinal circumference diameter lymph node metastasis influential,OR (95 ％ CI) was 5.562 (0.105-0.444),2.178 (0.144-0.971),1.563 (0.038-8.613) respectively (P ＜0.01).Conclusion The lymphatic metastasis of rectal carcinoma is related to age,tumor size,intestinal circumference invasion,depth of tumor invasion and the differentiating degree of the tumor,and the differentiating degree is the major factor.

Objective:To evaluate the effects of rosiglitazone (ROS) on the expression of adiponectin receptors (AdipoR1 and AdipoR2) mRNA in gingival tissue and inflammatory factors,and on the potential of bone loss in the rats with experimental periodontitis.Methods:10 male Sprague-Dawley rats without treatment were used as the controls;40 were used for the creation of periodontis models and then treated by rosiglitazone at 0(periodontitis control),1,3,10 mg/kg(low,median and high dose groups) respectively 1/d for 4 weeks.RT-PCR was used to examine the expression of AdipoR1 and AdipoR2 mRNA in gingiva tissue.Levels of gingival TNF-α,MMP-9 and plasma adiponectin was measured by ELISA.CEJ-A was measured for the evaluation of alveolar bone loss by standard digital photographs.Results:The expression levels of gingival AdipoRl and AdipoR2 mRNA in periodontitis group is lower than that in the control group(P ＜ 0.01).The concentration of plasma adiponectin had no significant difference between control group and periodontitis group(P ＞ 0.05).The concentration of gingival TNF-α,MMP-9 in periodontitis group was significantly higher than that in control group (P ＜ 0.01).Compared with periodontitis group,ROS treatment increased the expression levels of AdipoR1 mRNA(P ＜ 0.05)and decreased the concentration of TNF-α in gingival tissue.Median and high dose treatment increased the expression levels of AdipoR2 (P ＜ 0.01) and the concentration of plasma adiponectin(P ＜ 0.05),decreased the concentration of MMP-9 in gingival tissue (P ＜ 0.01)and the alveolar bone loss(P ＜ 0.01).Conclusion:Rosiglitazone treatment may reduce inflammatory response and suppress the bone resorption probably through up-regulation of the expression of adiponectin receptors and decrease of the concentration of TNF-α,MMP-9 in gingival tissue.

Objective:To investigate the correlation between serum 25-hydroxyvitamin D [25(OH)D], Essen Stroke Risk Scale (ESRS) and the incidence of coronary atherosclerotic heart disease.Methods:From July 2016 to January 2019, 186 patients who underwent coronary angiography (CAG) in the Department of Geriatric Cardiology at the Second Affiliated Hospital of Anhui Medical University were included.Among them, 117 patients were diagnosed with coronary heart disease, 69 cases without coronary heart disease.The serum 25(OH)D values and ESRS scores of the two groups were collected to analyze the relationship between 25(OH)D, and ESRS scores, coronary heart disease.At the same time, multivariate logistic regression was used to analyze the correlation between serum 25(OH)D and ESRS scores.Results:The serum level of 25(OH)D in the coronary heart disease group was (38.19±16.35)nmol/L, which in the non-coronary heart disease group was (45.37±19.01)nmol/L, the difference was statistically significant difference ( t=2.722, P<0.05). The ESRS scores in the coronary heart disease group was (2.32±1.38)points, which of the non-coronary heart disease group was (1.42±1.32)points, the difference was statistically significant ( t=-4.394, P<0.05). Multivariate logistic regression analysis showed that 25(OH)D was independently associated with coronary heart disease ( OR=0.944, 95% CI: 0.902-0.989, P=0.015), ESRS score was independently associated with coronary heart disease ( OR=1.716, 95% CI: 1.314-2.240, P<0.001). Conclusion:25(OH)D is a protective factor for coronary heart disease, ESRS score is an independent risk factor for coronary heart disease.

Objective:To evaluate the diagnostic value of Essen stroke risk score(ESRS) combined with neutrophil lymphocyte ratio(NLR) in coronary heart disease(CHD).Methods:From July 1, 2015 to June 30, 2019, patients who were hospitalized in the Second Affiliated Hospital of Anhui Medical University for suspected CHD and underwent coronary angiography were selected as the study objects.According to the results of coronary angiography, these patients were divided into CHD group (stenosis rate ≥ 50%) and control group(stenosis rate<50%). The clinical, laboratory and angiographic data of the two groups were collected, including NLR, ESRS and coronary narrow degree integral(Gensini integral method). Logistic regression model and receiver operator characteristic(ROC) were used to evaluate the diagnostic value of ESRS combined with NLR in CHD.Results:During the study period, 325 patients were enrolled, including 219 CHD patients and 106 controls.The age, hypertension, diabetes mellitus, peripheral artery disease, ESRS, NLR and fasting blood glucose levels in the CHD group were significantly higher than those in the control group(all P<0.05). Spearman correlation analysis showed that ESRS( r=0.515, P<0.001) and NLR( r=0.250, P<0.001) were positively correlated with coronary Gensini score.Two logistic regression models were established, where model 1 was logit(P1)=-2.072+ 0.566×ESRS+ 0.299×NLR+ 0.173×fasting blood glucose(the diagnostic accuracy rate was 71.7%) and model 2 was logit(P2)=-1.169+ 0.594×ESRS+ 0.302×NLR(the diagnostic accuracy rate was 70.8%). There was no significant difference in the diagnostic accuracy between the two models( P=0.499). Finally, logistic regression model 2 was selected as the joint diagnostic model.The area under curve of ESRS, NLR and logistic regression model 2 was 0.713, 0.634 and 0.736, respectively, and the difference was statistically significant(all P<0.05). The diagnostic threshold of ESRS was 2, and the diagnostic threshold of NLR was 2.74.The 95% CI of the joint diagnostic model 2 was (0.684, 0.783), which showed a sensitivity of 60.27% and a specificity of 78.30%.This model was superior to the diagnostic efficacy of ESRS( P=0.047) and NLR( P<0.001). Conclusion:The joint diagnostic model of ESRS combined with NLR is superior to the single index in the diagnosis of CHD, which may thus be used to predict the occurrence of CHD.

Atrial fibrillation is one of the important risk factors for ischemic stroke, which can lead to the cardioembolic stroke. On the contrary, ischemic stroke can also result in atrial fibrillation, namely, atrial fibrillation detected after stroke (AFDAS). Studies have shown that the pathophysiological mechanism and prognosis of AFDAS may be different from those of atrial fibrillation known before stroke. The monitoring of AFDAS and its effect on prognosis has become a hot research topic. This article reviews the definition, pathophysiological mechanism, monitoring methods and prognosis of AFDAS.