Purpose To investigate the imaging features of lumbar spinal epidural angiolipoma, and to improve the imaging diagnostic capability of the disease. Materials and Methods Four patients with lumbar spinal epidural angiolipoma confirmed by pathology were recruited in the study. CT and MRI images were reviewed and the imaging characteristics including the shape, size, location, density, and signal intensity were analyzed. Results The lesions located at the right front of the spinal canal in two cases, at the left front in one case, and the residual one case located directly behind the spinal canal. The longitudinal axis of the lesions paralleled to the longitudinal axis of the spine. The dura mater spinalis was compressed and inward shifted. All of the four cases showed homogeneous iso- or hypo-density on CT without calcification or necrosis in the lesions. The maximum diameter was 3 to 5 cm. The boundary was clear and smooth. Three lesions showed dumbbell-shaped and crossed foramen, but the adjacent bone were not absorbed or destructed. One lesion showed scallop-like. On MRI, four cases displayed slightly hypointense on T1WI and hyperintense on T2WI. On STIR images, the lesions showed hyperintense with patchy low signal intensity in it. The boundary of the lesions was clear. After administration of contrast media, two lesions presented remarkably homogeneous enhancement, one lesion showed dual tail sign, and one lesion displayed pen-tip-like at the both ends. Conclusion MRI plays an important role in locating the lesion and distinguishing internal tissue components of spinal angiolipoma, which is the gold standard for the diagnosis of the tumor. CT provides excellent supplement. The Combination of CT and MRI will improve the diagnostic accuracy of the spinal angiolipoma.

Objective To study the epidemiological characteristics of diabetes,and to provide effective prevention and intervention strategies for diabetes in Zhejiang Province.Methods Descriptive epidemiological method was used to analyze the surveillance data of diabetes from 2007 to 2012.Results 272 534 cases of new on-set diabetes were reported through the noncommunicable disease surveillance system in Zhejiang Province from 2007 to 2012,and the annual incidence was 277.08/100 000.According to different types of diabetes,the proportions of type 1,type 2,gestational,and other types diabetes were 0.69％,96.04％,2.23％,and 1.03％,respectively.The incidence was higher in urban and female population.The diabetes incidence was increased with 20.18％ per year and the growing speed of incidence in rural area and males were faster than those in urban area and females,respectively.The incidence in 70-year group was the highest and the growth speed in 20-year group was the fastest one.11.89％ of diabetes patients were diagnosed with complications simultaneously and the proportion of diabetic neuropathy,vasculopathy,and nephropathy was accounted for 82.81％.The incidence of diabetic complications was increased at first and then decreased from 2007 to 2012.Conclusion With the aging trends in Zhejiang province,the incidence will be increased rapidly,and the rural,male,and adolescence populations should be the focus objectives for the diabetes prevention and control in the future.Although the trend of diabetic complications incidence was tended to decline,the result should be confirmed by further researches.

Objective To investigate the incidence of occult pancreatobiliary reflux and to evaluate its relation to gallbladder epithelial dysplasia and cancer. Methods From July 2006 to Feb 2008,956 cases underwent selective biliary procedure or preoperative endoscopic retrograde cholangiopanereatography (ERCP), bile was collected and amylase was measured. All removed gallbladders were pathologically examined for dysplasia and cancer. Results Occult pancreatobihary reflux was found in 75 of 754 patients in this study, with an incidence of 9. 9%. The biliary amylase values in the patients with occult pancreatobiliary reflux and in controls were 7701±20 378 IU/L and 16±51 IU/L, respectively ( P <0. 01 ).Gallbladder dysplasia and cancer were found in 31.0% and 3.4% of the patients with occult pancreatobiliaryreflux, respectively, and both were higher than those in the patients without pancreatobiliary reflux ( P <0. 05). In the patients with occult pancreatobiliary reflux, the biliary amylase level with gallbladder dysplasia or cancer was 2388 ± 2745 IU/L and was higher than those without gallbladder dysplasia or cancer (P < 0. 01 ). Conclusions With an incidence of 9.9% in patients of normal pancreatobiliary junction,the occult pancreatobihary reflux may contribute to the pathogenesis of gallbladder epithelial dysplasia and cancer.

Objective: To assess the relationship between hemoglobin A₁c (HbA₁c) and hemorrhagic cerebral infarction (HI) in patients with acute cerebral infarction. Methods: From January 2014 to June 2016, in the Lianyungang Hospital Affiliated to Xuzhou Medical University, 426 patients with acute anterior circulation infarction were included. The blood sugar status before stroke was expressed by HbA₁c. HbA₁c and fasting blood glucose (FBG) were measured on the second day after admission. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the severity of neurological function at admission. The modified Rankin scale (mRS) was used to evaluate the prognosis at discharge. CT or MRI/SWI examination was performed to determine whether there was HT. Logistic regression was used to evaluate the risk factors for HT and short-term prognosis after cerebral infarction. Results: Of the 426 patients enrolled, 93 (21.8%) appeared HT, 60 (14.1%) had hemorrhagic cerebral infarction (HI) and 33 (7.7%) had parenchymal hemorrhage (PH). Multivariate analysis showed that HbA₁c and infarct volume were independent predictor of HT. When patients were grouped according to fasting blood glucose (FBG<7.8 mmol/L or ≥ 7.8 mmol/L), the predictive effect of HbA₁c on HT was found in both groups. In multiple Logistic regression analysis, HbA₁c was also a predictor of poor prognosis after stroke (OR=1.482, 95% CI 1.228 -1.788). Conclusions In patients with ischemic stroke, elevated HbA₁c is independently associated with post-infarction HT, and this result doesn′t change even in patients with well-controlled blood glucose. HbA₁c is also a predictor of poor prognosis after stroke. These findings are important for blood glucose management in patients with diabetes and acute anterior circulation infarction.

OBJECTIVETo conduct a survival analysis of gastric cancer patients according to the data of population-based cancer registry during 2005-2010 in Zhejiang Province in order to provide information for prognosis assessment and control of this disease.

METHODSThe deadline of the last follow-up of 26, 536 patients was December 31st, 2012. Cumulative observed survival rate (OSR) and expected survival rate were calculated by life table and Hakulinen method.

RESULTSthe 1-, 3-, and 5-year OSR were 58.51%, 39.07%, and 33.08%, and the 1-, 3-, and 5-year relative survival rates (RSR) were 60.24%, 42.90%, and 39.03%, respectively. The 1-, 3-, and 5-year relative survival rates of males vs. females were 60.49% vs. 59.65%, 42.88% vs. 42.96%, and 38.76% vs. 39.64%, respectively, statistically with non-significant differences (χ(2) = 0.13, P > 0.05) between them. The 5-year OSR and RSR of urban patients were 39.15% and 46.30%, and the 5-year OSR and RSR of rural patients were 30.81% and 36.32%, with statistically significant differences between them (P < 0.05). The 15-44 age group had a better relative survival rate.

CONCLUSIONSThe survival rate of gastric cancer patients in Zhejiang Province is low. Work of cancer prevention and control should be strengthened. The wide variation in gastric cancer survival rates between urban and rural patients indicates that priority should be given to rural areas in allocating medical and public health resources.

China ; epidemiology ; Female ; Humans ; Male ; Prognosis ; Rural Population ; Stomach Neoplasms ; epidemiology ; Survival Analysis ; Survival Rate

Objective To describe the survival status and to analyze the factors associated with mortality on first-ever stroke patients.Methods The first-ever stroke patients registered in 2009 were collected from "Zhejiang provincial information system for NCDs' surveillance and management".Survival status and the cause of death through active and passive follow-up programs,were collected.Kaplan-Meier methods were used for survival description.Monovariant and multivariant Cox' s proportional hazard regression models were used to analyze risk factors on mortality.Results A total of 78 189 patients,who suffered from cerebral infarctions (ICD-10:I63),intracerebral haemorrhages (I61),subarachnoid haemorrhages (I60) and unspecified strokes (I64),accounted for 61.65％,30.42％,2.32％ and 5.62％,were recruited.33 265 cases died during the period of this study.27 147 cases were stroke related,accounted for 81.61％.6 122 cases died on the same day,with one-day case fatality as 7.83％ and the overall 28-day case fatality as 21.01％.The survival rates from one-year to four-year were 72.04％,68.92％,66.27％ and 64.29％,respectively.The four-year survival rates of I63,I61,I60 and I64 were 80.06％,50.15％,71.80％ and 21.41％,respectively.Effect of the model showed that the risk factors associated with mortality were age,gender,educational level,the diagnosis and quality of the hospitals on treatment,hypertension and the types of stroke incidences.Age had interacted with gender (P＜0.001).Results from the ‘single effect’ showed that males had higher risk than females in those younger than 75 years old,but vice versa in those older than 75 of age.Conclusion Patients appeared very high risk of death in both acute and sub-acute phases.Factors including age,gender,educational level,both quality on diagnosis and treatment of the hospitals,clinical types of hypertension and stroke etc.were at risk,associated with prognosis of the disease.

Objective Admission hyperglycemia is thought to be related to poor neurological function and high mortality in patients with spontaneous intracerebral hemorrhage (sICH).However, it is not known whether preictal glycemic status affects functional outcome of sICH.The study is aimed to disclose the association between preictal glycemic status and neurological outcomes in patients with acute sICH.Methods Three hundred and thirty-two patients with sICH, admitted to our hospital from January 2011 to September 2013 (within 24 h of onset), were chosen in our study.Pre-stroke glycemic status, represented by hemoglobin A1c (HbA1c), was determined the next day after admission.Patients were categorized into four groups according to HbA1c values (＜6％, 6.1％-7％, 7.1％-8％ and ≥8％).The correlations of HbA1c in the four groups with different variables (NIHSS scores, hematoma volume, modified Rankin scale [mRS] scores) were analyzed using Spearman correlation test.Patients were also categorized into two groups according to hematoma volume (≤25 mL or ＞25 mL) or mRS scores (≤2 or ＞2).Logistic regression analyses were used to determine the relative independent risk factors for both hematoma volume and mRS scores.Results The hematoma volume, NIHSS scores, mRS scores, and number of patients with diabetes mellitus were significantly different among the four groups (P＜0.05).Blood glucose at admission and HbA1c level were significantly correlated with hematoma volume (r=0.085, P=0.027;r=0.164, P=0.014).Age and HbA1c level were significantly correlated with mRS scores (r=0.027, P=0.019;r=0.199, P=0.003).Conclusion HbA1C alone could serve as a better predictor of poor outcome after sICH than glucose at admission;HbA 1 C is the independent risk factor of poor prognosis for sICH.

Objective To evaluate the impact of diabetes prevalence and mortality on health life expectancy (HLE).Methods A cause-excluded health adjusted life expectancy method was used to quantitatively analyze the impact of diabetes on HLE and the composition of health life losses (HLL),using the integrated data on population mortality,self-assessed health status and diabetes prevalence.Results The HLE for people aged 15 was 55.80 in Zhejiang,in 2013.After removing the diabetes morbidity and mortality,the HLE for men aged 15 increased by 0.86 and 1.13,respectively,with an increase of 1.04 and 0.66 for urban and rural residents.Substantial increase of HLE was observed in women and urban residents than those for men and rural residents.HLL caused by diabetes mortality and morbidity appeared as 0.10 and 0.79,with a ratio of 7.92.Conclusion HLL caused by diabetes mortality was much greater than those caused by diabetes mortality,suggesting the most effective measure in reducing the diabetes-related HLL is to promote the healthy lifestyle in urban areas and especially for women.

Objective:To observe the changes of the expression level of long non-coding RNA (lncRNA) KCNQ1OT1 and microRNA (miR)-146a-3p in placenta tissues of preeclampsia (PE) patients, as well as their effect and mechanism on the biological functions of trophoblast cells.Methods:A total of 45 cases of hospitalized PE patients in Hainan General Hospital from July 2017 to July 2018 were selected as the PE group, 55 normal pregnant women during the same period were chosed as the control group. The expression level of KCNQ1OT1 mRNA and miR-146a-3p in the placenta tissues between two groups were detected by using quantitative real time (qRT)-PCR. Pearson′s test was furtherly analyzed the correlation between them. Human trophoblast cell line (HTR8/SVneo) were randomly divided into control and lipopolysaccharide (LPS) groups, and then LPS group were divide into four sub-groups,included LPS group, short hairpin RNA (sh)-KCNQ1OT1 (after silencing the expression of KCNQ1OT1), miR-146a-3p inhibitor and sh-KCNQ1OT1+miR-146a-3p inhibitor. The targeting relationship between KCNQ1OT1 and miR-146a-3p were predicted by bioinformatics software and confirmed by luciferase assay. The cell proliferation and invasion capacities were respectively detected by cell counting kit-8 (CCK-8) and transwell assay. The expression level of KCNQ1OT1 mRNA and miR-146a-3p were detected by qRT-PCR and the protein expression level of CXC chemokine ligand 12 （CXCL12） and CXC chemokine receptor type 4 (CXCR4) were tested by western blot.Results:(1) The mRNA expression level of KCNQ1OT1 in the placenta of PE group was lower than that of control group (0.23±0.03 vs 0.51±0.04, P<0.05), and the miR-146a-3p expression level was higher than that of the control group (0.49±0.03 vs 0.31±0.03, P<0.05), there were statistical significant differences between the two groups. (2) Luciferase assay showed that there was a targeting relationship between KCNQ1OT1 and mir-146a-3p. Compared with the control group, the mRNA expression level of KCNQ1OT1 in the LPS group were significantly decreased (0.91±0.03 vs 0.35±0.03, P<0.05), and the expression level of miR-146a-3p were significantly increased (0.22±0.03 vs 0.63±0.04, P<0.05). The cell proliferation, invasion and migration capacities and the protein expression of CXCL12 and CXCR4 significantly reduced in the LPS group compared with control group (all P<0.05). The mRNA expression level of KCNQ1OT1 (0.23±0.03) in the sh-KCNQ1OT1 group were further decreased, the expression of miR-146a-3p (0.85±0.03) were further increased, and the cell proliferation, invasion and migration capacities and the protein expression of CXCL12 and CXCR4 were all further reduced compared with control group，there were significant difference between two groups (all P<0.05). Comparing the miR-146a-3p inhibitor group, and sh-KCNQ1OT1+miR-146a-3p inhibitor group with the sh-KCNQ1OT1 group, respectively, the expression level of KCNQ1OT1 mRNA (0.78±0.04 vs 0.50±0.03) increased, and the expression level of miR-146a-3p (0.42±0.03 vs 0.46±0.03) decreased, the cell proliferation, invasion and migration capacities and the protein expression of CXCL12 and CXCR4 were all increased ,there were statistically significant differences (all P<0.05). Conclusion:KCNQ1OT1 could target the regulation of miR-146a-3p through CXCL12/CXCR4 pathway in the proliferation, invasion an migration of HTR8/SVneo cells, which may be involved in the pathogenesis of PE.

OBJECTIVETo survey the incidence of acute coronary events (nonfatal acute myocardial infarction and death from coronary heart disease), and analyze the trend and distribution characteristics in permanent residents aged 25 years and more across 30 surveillance regions of Zhejiang province from 2010 to 2012.

METHODSThrough databases matching and duplicate checking, this study incorporated the register module of coronary disease and the cause of death register module in Zhejiang provincial information system for chronic non-communicable diseases surveillance and management. The distribution of incidence was calculated across gender, age groups, regions and times.

RESULTSA total of 31 872 person-time acute coronary events were identified. The gender- and age-standardized mean annual incidence was 81.56 per 100 000 people in overall population, with 94.33 in males and 68.27 in females. Age-standardized incidence was 87.90 and 77.36 per 100 000 people in urban and rural area, respectively. Urban area had higher incidence rate than rural in each of the three years, and had obvious trend of increasing (P < 0.001) compared with rural area (P = 0.331). Incidence rate also increased significantly with age (P < 0.001).In addition, compared with women, men had higher incidence in each age group (all P < 0.001). The incidence rate increased rapidly in population older than 75 years old. The highest incidence was observed in age group ≥ 85 years old, with 2 371.67 and 1 873.92 per 100 000 in males and females, respectively. Apparent seasonal trend was observed for acute coronary events, which was low in summer and high in winter.

CONCLUSIONSQuantity and incidence for acute coronary events in residents aged 25 years and more of Zhejiang surveillance regions increased during 2010 to 2012. Male had higher incidence than female, and the incidence in urban areas was higher compared with rural areas. Residents older than 75 years old were high risk population of events, and winter was the high-occurrence season.

Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Anterior Wall Myocardial Infarction ; China ; epidemiology ; Chronic Disease ; Coronary Artery Disease ; Coronary Disease ; diagnosis ; epidemiology ; Disease Management ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Rural Population