Adipocytokines included adiponectin,leptin,omentin and visfatin are secreted by adipocytes and closely associated with obesity and insulin resistance.Many studies find that these adipocytokines are correlated with the occurrence and development of colorectal cancer,and may be promising biomarkers with respect to clinical diagnosis and prognosis of colorectal cancer.At present,the occurrence mechanisms of colorectal cancer induced by adipocytokines are unclear and needed to be extensively explored.

Mefformin is the first-line oral medicine used to treat type 2 diabetes.Besides its glucose-lowering effect,Mefformin can inhibit the proliferation of cancer cells,especially colorectal cancer cells.In recent years,there is mounting evidence that mefformin could reduce the risk and mortality of colorectal cancer, and its mechanism includes activating AMP activated protein kinase pathway,interfering with cell cycle,redu-cing insulin resistance,inhibiting the inflammatory response and killing colorectal cancer stem cells,etc.

Objective To explore the risk factors for the development of delayed neuropsychologic sequelae (DNS)and to characterize the clinical course following the development of DNS in acute CO poisoning cases. Methods This study included 79 cases of acute CO poisoning,and they were divided into two groups consisting of 13 cases who developed DNS and 66 cases who did not.The generally conditions of the two groups [including age, gender,exposure environment,the time of coma,whether through referral,the severity of disturbance of consciousness, computed tomography(CT)abnormal,first time to see a doctor if hyperbaric oxygen therapy]and laboratory index [carbon oxygen hemoglobin(COHb),WBC,creatine kinase (CK),creatine kinase isoenzyme (CK -MB),lactate dehydrogenase(LDH),hospitalization time,HBO]were analyzed by single factor variance analysis,Chi -square test and Mann Whitney U test.Results Compared with the non DNS group,in the DNS group,JCS score was significantly higher[(200.4 ±107.24)points vs.(94.55 ±52.71 )points,U =8.373,P <0.01 ],CT abnormal skull increased (76.9% vs.6.2%,χ2 =9.548,P <0.01),CK[(5976.33 ±4 371.92)IU /L vs.(2 384.67 ±650.86)IU /L,F =6.877],CK -MB[(51.22 ±33.28)IU /L vs.(23.47 ±15.66)IU /L,F =4.329],LDH[(395.80 ±270.04)IU /L vs.(221.87 ±101.95)IU /L,F =1.012]increased,there were statistically significant differences between the two groups by single factor analysis(all P <0.01 ).The patients with DNS had longer hospitalized time [(283.27 ± 251.08)d vs.(37.93 ±37.18)d,F =2.283]and HBO time[(51.62 ±16.69)d vs.(7.70 ±5.38)d,F =6.428], there were statistically significant differences between the two groups by single factor analysis (all P <0.01 ). Conclusion In patients with the characteristics identified in this study,administration of HBO therapy should be proactively considered after informing their family at initial stage,thus to decrease the risk of developing DNS.

Objective To evaluate the clinical value of fibrinogen and D-dimer(D-D)in the diagnosis of patients with acute pulmonary embolism.Methods A retrospective study was conducted.74 patients with acute pulmonary embolism were retrospectively analyzed.The general clinical data were gathered,and the patients were divided into high-risk group(n=20),moderate-risk group(n=32),and low-risk group(n=22)according to the 2008 ESC Guidelines on the diagnosis and management of acute pulmonary embolism.25 patients with physical examination were randomly recruited as control group.The plasma levels of fibrinogen and D-D were detected and compared between these groups.Receiver operating characteristic curve(ROC)was used to evaluate diagnostic biomarker performance.Results In acute pulmonary embolism patients,with the risk degree increased,the level of fibrinogen decreased[(4.20±0.82)g/L,(4.16±0.83)g/L,(3.62±0.74)g/L,(2.83±0.62)g/L](compared with control group,P=0.183,moderate-risk group,P=0.046,high-risk group,P=0.033;compared with low-risk group,moderate-risk group,P=0.041,high-risk group,P=0.037;compared with moderate-risk group,P=0.044),and the level of D-D increased[(1 845.20±3 939.56)μg/L,(4 405.27±2 356.68)μg/L,(4 360.63±2 675.40)μg/L,(16 817.00±6 878.66)μg/L](compared with the control group,low-risk group,P=0.392,moderate-risk group,P=0.042,high-risk group,P=0.027;compared with low-risk group,P=0.136,P=0.016;compared with moderate-risk group,P=0.035).The ROC curve showed that the AUC of D-D in each group were 0.865,0.834 and 0.974,respectively.AUC of FIB were 0.459,0.253 and 0.277,respectively,which were below or even significantly lower than predicted line area.Conclusion The performance of fibrinogen in the diagnosis of acute pulmonary embolism and the classification of the risk degree is very low.

ObjectiveTo détect in the tissue of primary bronchogenic carcinoma(PBC) and discuss its significance. Methods was assessed by immunohistochemical method ot SP in paraffin tissue sections of 40 PBC and paratumor normal lung tissue. Results The positive rate of TNF-a in cytoplasm of carcinoma cells was 47.5 % (19/40), and it was not found in all paratumor normal lung tissue(P< 0.05). ConclusionTNF-a gene expressed in some patients with broncho genic carcinoma. The growth of bronchogenic carcinoma is related to TNF-a gene.

Objective To explore the impact of family history of hypertension and diabetes mellitus on the phenotype of insulin resistance and the ?-cell function in normoglycemic subjects. Methods 275 normoglycemic subjects were divided into four groups according to family history of hypertension and diabetes,namely group combined with family history of hypertension and diabetes (H+D+group),group without family history of hypertension and diabetes (H-D-group),group without family history of hypertension but with diabetes (H-D+group),group with family history of hypertension but without diabetes (H+D-group). The homeostasis model assessment of insulin resistance(HOMA-IR) and the function of insulin secretion (HOMA-?) was used to estimate insulin resistance and ?-cell function. Results The mean body mass index,waist to hip ratio,blood pressure,triglycerides,cholesterol and HOMA-IR were significantly higher in H+D+group than those in H-D-group,but HDL,HOMA-? were significantly lower in H+D+group than those in H-D-group (all P

Objective To explore the relationships of serum levels of leptin,TNF-?,FFA and resistin with IR and between themselves. Methods 48 T2DM patients and 47 non-diabetic controls were selected.Levels of leptin,TNF-?,FFA and resistin were measured.FPG,insulin,blood lipid,blood pressure,BMI and WHR were measured.Results The levels of leptin,TNF-?,FFA and resistin were correlated positively with HOMA-IR(P

Objective To study the change of B-cell function after reduction in plasma free fatty acid(FFA)concentration.Methods All 38 normoglycemic first-degree relatives of type 2 diabetes received a 75 g oral glucose tolerance test(OGTT),before and after acipimox,250 mg orally tid for 5 days.Results Acipimox significantly reduced fasting plasma FFA,HOMA-IR,the incremental glucose area under the curve(AUCg)and the incremental FFA area under the curve(AUCf)during OGTT(P0.05).The increment in ?I30/?G30、?I30??G30-1?HOMA-IR-1 correlated negatively with the decrement in fasting FFA,AUCf(r=-0.39~-0.49,P

Objective To investigate the difference in EMG peroneal nerve conduction velocity between patients with diabetic foot ulcers and T2DM patients without diabetic foot and its influencing factors.Methods Retrospective analysis was performed on clinical data of a total of 108 patients, including 54 inpatients with diabetic foot and 54 T2DM patients without diabetic foot ulcers, so as to investigate the difference in EMG peroneal nerve conduction velocity between these two groups of patients and its influencing factors.Results Compared with the control group, EMG peroneal nerve conduction velocity was slower in the diabetic foot group, with statistically significant difference (P<0.05).There were significant differences in education attainment, WBC count, neutrophil ratio, hemoglobin, albumin, and ABI between the two groups (P<0.05).Peroneal sensory nerve conduction velocity presented negative correlation with HbA1C, WBC count, and neutrophil ratio(P<0.05), and positive correlation with fasting C-peptide level, hemoglobin, albumin, and ABI (P<0.05).Peroneal motor nerve conduction velocity presented negative correlation with smoking duration, HbA1C, and neutrophil ratio (P<0.05), and positive correlation with hemoglobin and albumin (P<0.05).Conclusion Diabetic perineuropathy is an important risk factor for diabetic foot ulcers.Poor blood glucose control, infection, smoking, poor pancreatic islet function, anemia, hypoproteinemia, and poor lower limb blood supply may contribute to the development or progression of diabetic perineuropathy.In preventing and treating diabetic foot, it is therefore desirable to lay stress on blood glucose control, give active anti-infective treatment, improve or protect pancreatic islet function, and correct anemia and hypoproteinemia;attention should also be paid to patient education on diabetes and foot diseases.

OBJECTIVE To discuss the diagnosis and treatment of Burkholderia cepacia(BCE) pneumonia. METHODS The 31 cases of inpatients and outpatients in our hospital were analyzed from Jul 2005 to Dec 2007. RESULTS From them 11 cases were with community-acquired pneumonia and 20 cases with hospital-acquired pneumonia,the underlying diseases in 27 cases.Of these cases,19 cases were kidney transplant recipients,four cases with chronic obstructive pulmonary disease,seven cases with non-insulin dependent diabetes,three cases with cerebral vascular diseases,and two cases were with malignant tumors.All cases were diagnosed by bronchoscopy,bronchial lavage,and BCE positive in douche liquid.At last there were 24(77.4%) cases cured,2 cases discharged(6.5%) and 5 cases deceased(16.1%). CONCLUSIONS BCE is a multi-drug resistant bacteria.BCE pneumonia often appears severe.It appears non-specific clinical symptoms in early stage and higher mortality.It should be treated as soon as possible by using piperacillin /tazobactam-based combined anti-infection treatment.