Objective:To systematically assess the efficacy and safety of bevacizumab (BEV) plus chemotherapeutic agents as first-line therapy for metastatic colorectal cancer (mCRC). Methods:We retrieved randomized controlled clinical trials (RCTs) of BEV plus chemotherapeutic agents as first-line therapy for mCRC from the databases of PubMed (1966 to August 2009), Embase (1974 to August 2009), Cochrane Library (Issue 3, 2009), China Journal Full Text Database (CJFD, 1994 to August 2009), Chinese Bio-medical Literature Database(CBM, 1978 to August 2009) and Chinese Scientific Journals Full Text Database (CSJD, 1989 to August 2009). Then we evaluated the methodological quality of included studies. Meta-analysis was performed using RevMan 5.0 software developed by the Cochrane Collaboration. Results:Only 6 clinical studies were selected and 2 646 eligible patients were included in the systematic review. Meta-analysis showed that BEV plus chemotherapy increased the overall response rate (complete response+partial response) compared with chemotherapy alone. The relative risk was 1.27 (95%CI: 1.00-1.61, P=0.05), and the median survival time and progression-free survival (PFS) were longer. In terms of safety, there was a significant difference in the frequency of grade 3/4 adverse events, grade 3/4 hypertension, adverse events-induced study discontinuation and gastrointestinal perforation between the two groups. The relative risk was 1.12 (95%CI: 1.07-1.61), 4.51 (95%CI: 2.81-7.23), 1.37 (95%CI: 1.16-1.63)and 4.32(95% CI:1.24-15.05), respectively. There was no statistical difference between the two groups in the incidence of grade 3/4 bleeding, 60-day all-cause mortality, grade 3/4 proteinuria, grade 3/4 diarrhea, grade 3/4 leukopenia and pulmonary embolism. The relative risk was 1.50(95%CI: 0.87-2.57), 0.71(95%CI: 0.45-1.11), 2.26(95%CI: 0.69-7.33), 1.18(95%CI: 0.99-1.41), 1.17 (95%CI: 0.97-1.42)and 0.84(95%CI: 0.46-1.53), respectively. Conclusion:BEV plus chemotherapeutic agents as first-line the-rapy increases the response rate and prolongs PFS and median survival time of mCRC patients, but results in a higher incidence of any grade 3/4 adverse event, grade 3/4 hypertension and gastrointestinal perforation.

Objective To find out parental locus of control and mental health affecting students test anxiety. Methods The samples were from 5 middle schools including 1000 students,and their parents. They were investigated with the general life scales, Sarason's test anxiety scale, Symptom checklist 90 (SCL-90)and Parenting Locus of Control Scale(PLOC). Results The ratio of test anxiety: the mild was 28.8%, moderate was 45.0%, severe was 26.2% ,and felt anxiety was 55.8%. Ratio of test anxiety was higher in the boy students (X2=9.284, P =0.010) ,and heavier(F:16.42±6.70; M:15.18 ±6.51, t=2.716, P=0.007). Student test anxiety was significantly positively correlated with their parental mental health (r fatherl～11=0.166～0.272, Pfather l～11= 0.000;r mother 1～11=0.182～0.242, P mother 1～11= 0.000); Student test anxiety positively correlated with the effectiveness cof parents education, father's belief on the fate, eontrol of fathers for their children, locus of control from fathers (r1～5=0.075～0.143; P1-5=0.000～0.030);felt anxiety positively correlated with self-expect ,pressure from their mothers,over take care attitude from their parents,self-pressure from their parents( r1～6=0.068～0.230; P1-6=0.000～0.050) ,and negatively correlated with respect attitude of parents for their child, Marital relations,Communication time between the students and their parents,attitude of mother for learning( r1-7=-0.074～-0.140;P1～7=0.000～0.034). Felting test anxiety was served as a dependent factor, some factors enter the regression equation,and they were somatization of father, psychotic mother, the pressure from parents, mother over expectations, self-expectations ,the child control from student's father by Logistic regression analysis ( OR1～16=0.675～3.029;P1-6=0.000～0.007). Conclusion Students test anxiety is a common problem in male and female students. Mental health and locus of control from students' parents show test anxiety has somatization of father, psychotic mother, the pressure from parents, mother' expectations,self-expectations, the control of father for the child 6 risk factors.

OBJECTIVETo describe the prevalence of smoking, quitting smoke, and passive smoking in different populations by education status, occupation and geographic distribution.

METHODSSurveillance on risk behaviors in 145 disease surveillance points (DSP) was carried out in 2002 by multi-steps random sampling through questionnaires. 16,407 records had been completed with 16 056 used for analysis. Indicators as smoking, current smoking, average cigarettes smoked and the cost per day, etc., were calculated by weight on age proportions from the 2000 census.

RESULTSEver-smoking rates in males and females aged 15 and over were 66.0% and 3.1%, respectively with ever-smoking rate dropped 1.8% in whole population, but increased in people aged 15-24. The number of total smokers was about 350 million, 30 million more than that in 1996. There were no obvious geographic differences seen among male, but big difference was seen in female smokers. Higher smoking rates were seen in the northeast and northern parts of the country. Rate of quitting smoking was increasing, from 9.42% in 1996 to 11.5% in 2002, referring to an increase of 10 million quitters. However, the rate of no intention to quit among smokers was still very high--74%. The average cigarettes consumption per person-day was the same as that in 1996--14.8 cigarettes/day, which cost 2.73 RBM/day. The cost was various in different groups of population with a 15 times difference. The level of exposure for passive smokers was not improved. The prevalence of passive smoking in nonsmokers were 53% in 1996 and 52% in 2002. Knowledge on smoking and health condition in population had been greatly improved, but still poor in the western areas. 60% of the people claimed in supporting banning of smoking in public places, 45% supporting the banning of all cigarettes ads, but big difference was seen in different geographic areas.

CONCLUSIONThe prevalence of smoking in Chinese males had reached its peak, leveling but had not yet obvious dropped. Communication on the knowledge of harm in smoking remained weak since people did not understand or support the strategies on tobacco control, especially in the western areas. Data indicated that the prevalence of tobacco use would not decrease over in short period and the disease burden caused by tobacco use would still be heavy in the next 30-50 years. The government and public health authorities should develop effective tobacco control in no time to decrease disease burden caused by smoking and passive smoking.

Adolescent ; Adult ; Attitude to Health ; China ; epidemiology ; Female ; Humans ; Male ; Prevalence ; Smoking ; epidemiology ; Smoking Cessation ; statistics & numerical data ; Surveys and Questionnaires ; Tobacco Smoke Pollution ; statistics & numerical data ; Tobacco Use Disorder

Objective To investigate the expression of Toll-like receptor(TLR) 9 of circulating plasmacytoid dendritic cell (pDC) and analyze the frequency and interferon (IFN)-?production of circulating pDC during hepatitis B virus(HBV) infection.Methods Peripheral blood was collected from 69 HBV-infected patients,including 14 cases of asymptomatie HBV infection,30 cases of chro- nic hepatitis B(CHB),25 cases of HBV-related liver cirrhosis,and 21 healthy blood donors as con- trols.Flow cytometry was used to analyze the frequency of circulating pDC and the mean fluorescence intensity(MFI) of TLR9.Fresh peripheral blood mononuclear cells(PBMC) were stimulated by CpG ODN 2216 for 24 h in vitro.IFN-?in the supernatant was measured using enzyme-linked immunosorbent assay(ELISA) to analyze the frequency and IFN-?production of pDC during HBV in- fection.Data were analyzed with SPSS 13.0 for windows.Results Compared with healthy controls (62.6?10.7),the MFI of TLR9 of patients with asymptomatic HBV infection,those of CHB and HBV-related cirrhosis were significantly reduced (P

Objective To investigate the effects of life-style intervention on obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods A number of 168 cases with OSAHS were randomized into intervention group ( n =81 ) and control group ( n =87 ).In the interventional group,the patients received uvulopalatopharyngoplasty and life-style intervention,including cognition guide,proper diet,weight control,stopping smoking or drinking,and exercise.The control group received uvulopalatopharyngoplasty only and their living was just as usual.polysomography,body mass index ( BMI ),and symptom assessment were monitored Imonth,6months,12months and 24months after operation.The patients were followed up for more than 2 years.Results There was no statistical differences in life style between the two groups prior to intervention(P ＞0.05).The proportion of a healthy diet manner,cessation in alcohol and smoking,weight loss or good control in weight,moderate exercise between the two groups (93.8％,86.4％,69.1％,81.5％,87.7％ in intervention group,and 11.5％,36.8％,21.8％,17.2％,9.2％ in control group) showed statistical differences after intervention(x2=113.80,43.33,37.97,69.33,103.70,respectively;P ＜0.01 ).Compared to the control group,patients in intervention group had a significant improved in lowest oxygen saturation( LSa02 ),apnea hypopnea index(AHI),snoring index and BMI at 6,12,24 months after intervention(t =2.51,4.13,7.88;2.10,2.66,3.68;3.42,4.17,9.34 ;5.92,12.78,9.37 ; respectively; P ＜ 0.01 ).The observational index in intervention group before and after intervention showed statistical differences (P ＜ 0.01 ) while no difference in control group(P ＞ 0.05).Conclusions It can improve the clinical symptoms and improve the long-term efficacy of surgical treatment to reduce cardiovascular and cerebrovascular complications for uvulopalatopharyngoplasty and life-style intervention on the patients with obstructive sleep apnea-hypopnea syndrome,which not only improves the life quality of the patients,but also reduce their economic burden.It is worthy of clinical application.

OBJECTIVETo determine the magnetic resonance (MR) imaging findings of an ovarian mass which are most predictive of malignancy and assess the value of intravenous gadolinium administration in the characterization of an ovarian mass.

METHODSTotally 74 consecutive patients with a clinically or sonographically indeterminate adnexal mass underwent MR imaging, of whom 59 had subsequent surgical resection of 70 adnexal masses. These 59 patients formed the study population. MR imaging studies were prospectively and independently reviewed by a senior and a junior radiologist. The senior radiologist also reevaluated the studies in a blind fashion after a minimum 6 months interval. The sensitivity, specificity, positive predictive value, and negative predictive value of contrast-enhanced and unenhanced MR imaging were evaluated.

RESULTSThe most predictive MR imaging findings for malignancy were presence of vegetations in a cystic lesion and presence of necrosis in a solid lesion. The odds ratio was even higher when the ancillary finding of peritoneal metastasis or ascites was present. Contrast media contributed significantly to lesion characterization. Total 70 ovarian masses were detected by contrast-enhanced MR imaging including 37 malignant ovarian masses and 33 benign ovarian masses with 87% (61/70) accuracy, 86% (32/37) sensitivity, 88% (29/33) specificity, 89% (32/36) positive predictive value, and 85% (29/34) negative predictive value, whereas 70 ovarian masses were detected by unenhanced MR imaging with 74% (52/70) accuracy, 73% (27/37) sensitivity, 76% (25/33) specificity, 77% (27/35) positive predictive value, and 71% (25/35) negative predictive value. There were significant differences in accuracy (P < 0.01), sensitivity (P < 0.01), specificity (P < 0.01) between contrast-enhanced and unenhanced MR imaging.

CONCLUSIONContrast-enhanced MR imaging is highly accurate in detection and characterization of complex adnexal masses.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cystadenocarcinoma, Serous ; diagnosis ; pathology ; Cystadenoma, Mucinous ; diagnosis ; pathology ; Female ; Humans ; Image Enhancement ; Magnetic Resonance Imaging ; methods ; Middle Aged ; Ovarian Neoplasms ; diagnosis ; pathology ; Sensitivity and Specificity ; Teratoma ; diagnosis ; pathology

Objective To analyze the prevalence rate of diabetic nephropathy (DN) and the related factors on DN among type 2 diabetic patients.Methods A total number of 1758 type 2 diabetic patients who were hospitalized in the Beijing Hospital from 2003 to 2010 were analyzed retrospectively.Three groups were divided according to the rate of urinary albumin excretion (UAER).Patients whose UAER＜20 μg/min belonged to normal albuminuria (NA) group.The ones whose UAER from 20 to 200 μ g/min belonged to microalbuminuria (MA) group,and the others whose UAER≥200 μg/min belonged to large albuminuia (LA) group.The clinical characteristics were then compared.The related factors of DN were analyzed.Results (1)There were 1246 patients in NA group,408 patients in MA group,and 104 patients in LA group.The constituent ratio of nephropathy was 29.1％ (2) The ages of NA group,MA group and LA group were (59.87± 12.77,62.52± 12.74,64.44 ± 12.74) years old,respectively,with body mass index ( BMI ) as (24.90 ± 3.42,25.53 ± 4.00,25.53 ± 3.91 )kg/m2 respectively; duration of diabetes as (8.39 ± 7.12,10.77 ± 8.02,12.84 ± 7.97)years; systolic blood pressure (SBP) as (133.42 ± 18.19,142.72 ± 20.21,151.12 ± 21.91 )mm Hg;diastolic blood pressure as (78.75 ± 10.66,80.79 ±12.21,83.33 ±13.61 )mm Hg; fasting blood suger (FBS) as (8.25±3.43,9.02±3.72,9.22±4.62)mmol/L; glycated hemoglobin(HbAlc) as (8.88±2.10,9.34 ± 2.36,9.10 ± 2.36)％ ; uric acid (UA) as (288.04 ± 90.41,307.23 ± 96.96,374.28 ±105.47) mmol/L; triglyceride as (1.72 ± 1.51,2.06 ± 1.88,1.94 ± 1.42) mmol/L,high density lipoprotein cholesterol as ( 1.08 ± 0.30,1.02 ± 0.29,1.07 ± 0.28) mmol/L; fasting insulin as (9.24 ±9.02,11.24 ± 9.74,11.06 ± 9.29) μU/ml; fasting C peptide as (462.31 ± 289.94,510.02 ± 350.08,595.93 ± 445.86) pmol/L.There were significant differences between NA,MA and LA groups in all above items ( P ＜ 0.01 or P＜ 0.05 ).( 3 ) Logistic regression analysis showed that DN were related with duration of diabetes,BMI,SBP,HbAlc,FBS,UA (OR values were 1.041,1.055,1.028,1.116,1.100,1.004 respectively,P＜0.05 or P＜0.01 ).Conclusion It would be helpful to prevent and retard progression of DN that comprehensively controlling high blood glucose,hypertension,hyperuricemia and body weight of type 2 diabetic patients.

Objective To investigate the mechanisms of four and a half LIM protein 1 (FHL1) on paclitaxel resistance of hepatocellular carcinoma cells.Methods According to the expression of FHL1,two groups were set up:test group (hepatocellular carcinoma cell lines with knockdown of FHL-1) and control group (hepatocellular carcinoma cell lines expressing FHL-1).Both groups were treated with paclitaxel.In addition,oxaliplatin was used as a reference experiment.The antitumor effects of paclitaxel were detected by in vitro activity assay.The effects of paclitaxel on cell colony formation were analyzed by colony formation assay.The cell clones of both test group and contol group were inoculated in nude mice and then treated with paclitaxel.The situation of tumor growth and the effect of paclitaxel were observed.Meanwhile,the activity of Caspase-3 was determinated.Results The cell activity of the test group and the control group (HepG2 cells) was 0.41 ±0.02 and 0.70 ±0.02,respectively.The cell activity of the test group and the control group (SMMC 7721 cells) was 0.44 ± 0.02 and 0.63 ± 0.03,respectively.The difference was statistically significant.There was no significant difference in cell activity after the treatment of oxaliplatin(P ＞0.05).In cell colony formation,the numbers of clone formation were 93.52 ± 14.58 and 302.48 ±21.56 in HepG2 ceils.The numbers of clone formation were 55.14 ± 10.82 and 192.28 ± 19.47 in SMMC cells.The difference was statistically significant(P ＜ 0.05).There was no significant difference in cell activity after the treatment of oxaliplatin (P ＞ 0.05).In xenograft test,the tumor volume of the test group and the control group was 0.02 ± 0.02 and 1.89 ±0.51,respectively.The difference was statistically significant (P ＜ 0.05).Besides,the expression of Caspase-3 in the test group and the control group was 10.27 ± 0.47 and 26.72 ± 0.54,respectively.The difference was statistically significant (P ＜ 0.05).After being treated by the inhibitor of Caspase-3 (z-VAD-FMK),the expression of Caspase-3 in the test group and the control group was 8.87 ± 0.36 and 29.96 ± 0.68,respectively.The difference was statistically significant (P ＜ 0.05).Conclusion FHL1 is a paclitaxel resistance gene.After knockdown of FHL1,the antitumor effect of paclitaxel will be enhanced.Meanwhile,the activation of Caspase-3 is promoted,causing apoptosis induced by paclitaxel.

OBJECTIVETo investigate the status of genital infection as well as distribution of types of human papillomavirus (HPV) in women in Shenzhen and provide population data for the future vaccine intervention on cervical cancer.

METHODSWomen with age between 15 and 59 years were selected in cluster stratified sampling from Huaqiaocheng community, Nanshan district, Shenzhen and received a population-based cervical cancer screening. After consent, every woman was interviewed by using questionnaire and tested by liquid-based cytology and HPV DNA (hybrid capture 2 and gene chips typing) separately.

RESULTSTotally 1 137 women were screened. The rate of high risk HPV of hybrid capture 2 test (14. 0% ) was higher than gene chips typing test (9. 8%) (chi(2) = 27. 198, P < 0. 001) ; the consistency of the two tests was acceptable ( kappa = 0. 498, P < 0. 001). The rates of low risk HPV types and other types of gene chips typing test in this population were 1. 9% and 0. 2% respectively. The percentages of HPV 16, 18 and 58 in HPV positive women were 29. 7% , 18. 9% and 18. 9%. The rates of different age group of low risk HPV were 1. 4% (17-34), 1. 7% (35-44) and 3. 2% (45-59) , respectively.

CONCLUSIONSHPV 16, 18, and 58 are the most popular types in the study population. The differences of infection rates of high risk HPV are due primarily to the variation of HPV16 distribution among age-specific population. The chances of being affected by low risk HPV will increase with age.

Adolescent ; Adult ; Alphapapillomavirus ; classification ; isolation & purification ; China ; epidemiology ; Female ; Humans ; Middle Aged ; Papillomavirus Infections ; epidemiology ; virology ; Tumor Virus Infections ; epidemiology ; virology ; Uterine Cervical Diseases ; epidemiology ; virology

BACKGROUNDThe hypothalamus plays a central role in the regulation of metabolism by sensing metabolic demands and releasing regulatory neurotransmitters. This study investigated the response of the hypothalamus to glucose ingestion in rats by blood oxygen level-dependent functional magnetic resonance imaging (BOLD-fMRI) and immunohistochemical techniques to determine the role of the hypothalamus in glyco-regulation during disturbances in carbohydrate metabolism.

METHODSThe signal intensity of the hypothalamus was monitored by fMRI for 60 minutes after oral glucose intake in 48 healthy rats (age 14 months), which included 24 normal weight rats (weighing (365 +/- 76.5) g) and 24 overweight rats (weighing (714 +/- 83.5) g). Then, 12 rats (6 normal, 6 overweight) underwent a repeat fMRI scan after consuming an equivalent amount of water without glucose on a separate day. The procedure for fMRI with water intake was the same as for glucose ingestion. fMRI data was processed using time cluster analysis and intensity averaging method. After fMRI, the expression of neuropeptide Y (NPY) and 5-hydroxytryptamine (5-HT) in the hypothalamus of all rats was determined by immunohistochemistry. Positive cells for NPY or 5-HT were counted.

RESULTSThere was a transient, but significant, decrease in fMRI signal intensity in all rats (mean (3.12 +/- 0.78)%) in the hypothalamus within 19.5 - 25.5 minutes of oral glucose ingestion. In overweight rats, the decrease in signal intensity in response to the glucose ingestion was more markedly attenuated than that observed in normal weight rats ((2.2 +/- 1.5)% vs (4.2 +/- 0.7)% inhibition, t = 2.12, P < 0.05). There was no significant response in the hypothalamus after oral water ingestion. The percentage of NPY positive cells in obese rats were slightly lower than those in control group (21% vs 23%, t = 0.71, P > 0.05); but there was no significant difference between the two groups; the percentage of 5-HT positive cells in obese rats were significantly lower than those in the control group (22% vs 31%, t = 3.25, P < 0.01).

CONCLUSIONSThere is a transient, but significant, decrease in BOLD signal intensity in the hypothalamus following glucose ingestion, which is similar to that observed in humans. The response of the hypothalamus to glucose ingestion was different in overweight and normal weight rats. The percentage of NPY positive cells in obese rats were lower than those in the control group, although this difference was not statistically significant. The percentage of 5-HT positive cells in obese rats was significantly lower than those in the control group.

Animals ; Glucose ; metabolism ; Hypothalamus ; physiology ; Immunohistochemistry ; Magnetic Resonance Imaging ; methods ; Neuropeptide Y ; analysis ; Obesity ; metabolism ; Oxygen ; blood ; Rats ; Serotonin ; analysis