Obesity is a risk factor for colorectal cancer,but the underlying mechanism remains unclear.Adiponectin as an adipocyte-derived protein might play an important role between obesity and colorectal cancer.Here we review the current progress on molecular characteristics of adiponectin,the association of adiponectin with colorectal cancer,and the possible anti-tumor mechanism.

The resistance of anti-VEGF therapy which casually occurs during the course of tumor therapy by using anti-VEGF drugs may be associated with alternative angiogenesis signaling activation, bone marrowderived stem cells recruitment, pericyte coverage, perivascular invasion and so on. Thus, to investigate the mechanisms of drug resistance will guide us to understand deeply the relationship among normal tissues, tumors and drugs and to find out new therapeutic targets for anti-tumor therapy.

The morbidity of colorectal cancer has been increasing year by year in China.Screening test of colorectal cancer can effectively decrease the morbidity and mortality of it.However,the current screening technique has obvious defect.Screening of exfoliated colonocytes isolated from human stool for early detection of colorectal cancer is noninvasive and well tolerated by patients;it has a potential for colorectal cancer screening.

Objective To investigate the effect of trastuzumab,a special blocker of epidermal growth factor receptor-2(HER-2) on proliferation and apoptosis of human umbilical vein endothelial cells(HUVECs) exposed to tumor conditioned medium(TCM).Methods HUVECs were cultured and exposed to TCM and trastuzumab was used as an intervention approach.Their proliferation,apoptosis and cell cycle distribution were measured by MTT and flow cytometery(FCM).Intra-tumor microvessel density(MVD) and HER-2 expression were tested by immunohistochemistry(IHC).Results Following the stimulation of MDA-CM,HUVECs showed higher proliferating and anti-apoptotic ability(P

Objective To report outcomes of patients with PSA ≥ 30 μg/L with initial negative transperineal template-guided saturation biopsy (TTSB). Methods From 2003 to 2010,a total of 1824 patients underwent transperineal saturation biopsies with the prostate template at the Peking Union Medical College Hospital.44 of them had initial negative biopsy with PSA ≥ 30 μg/L were reviewed in this study.The mean age was 68 years old (range,51 to 80).The mean biopsy cores were 28.7 (range,11 to 44).The median PSA level was 40 μg/L (range,30 to 128),and the median prostate volume was 73 ml (range,30 to 190).They were divided into four groups:TURP group,chronic prostatitis group,repeat biopsy group and miscellaneous group. Results Patients were followed up for a mean of 49 months (range,12 to 91).All patients of TURP group (15 cases) were identified as prostatic hyperplasia by postoperative pathology.2 of them had a second TTSB for PSA ＞ 10 μg/L after TURP,which were negative.5 patients of chronic prostatitis group had a declining PSA level after antibiotic therapy for 3 to 4 weeks.One patient took a second biopsy,which was identified as prostatitis.All patients of repeat biopsy group (18 cases) showed no significant decrease in PSA level during follow-up and undertook biopsies 2 to 4 times,6 of which were proved to be prostate cancer.All patients of the miscellaneous group (6 cases) had a declining PSA and didn't take a second biopsy. Conclusions Close follow-up and regular PSA testing for patients who had a high PSA level with initial negative biopsy would be help to avoid both false negative of prostate cancer and unnecessary biopsy.

Objective To establish a predictive model and to find the preoperative predictors for the nature of lesion in the setting of chronic pancreatitis. Methods The 121 patients from 7 tertiary medical centers in Shanghai from July 1998 to April 2007 with focal mass lesions in the setting of chronic pancreatitis were selected as the study population. The final diagnosis had to be confirmed histologically by surgical specimens (n =97) or by follow-up (n = 24). A case control study was conducted; the patients were divided into pancreatic cancer group and chronic pancreatitis group. The age, sex, past history, initial clinical presentations, lab results and imaging exams were collected by reviewing the medical records of these patients. χ~2 test and t test was used for univariate analysis, then the factors with P≤0. 25 were selected for further multivariate analysis, and multivariate logistic regression model was used to estimate odds ratio and 95% CI. Results Of 121 , 21 patients had a final diagnosis of pancreatic cancer and other 90 patients had a final diagnosis of chronic pancreatitis. Abdominal tenderness, direct bilirubin, CA19-9 and CEA were independent predictors of cancer in patients with focal mass lesions. Their odds ratios (95% CI) were 5. 691 (1.468, 22.070) , 1.011 (1.001 , 1.021) , 1.003 (1.001, 1.005) , 101.9 (0.988, 1.051) , respectively. Their P values were 0. 012, 0. 030, 0.003 and 0. 23 , respectively. Conclusions The logistic regression model may accurately predict the nature of lesion in the setting of chronic pancreatitis and may have certain clinical implication.

Objective To evaluate angiogenesis of the benign and malignant solid thyroid nodules with color Doppler ultrasound and immunohistochemistry staining. Methods Fifty-six solid thyroid nodules in 55 patients (28 papillary thyroid cancer, 23 goiter, 4 adenoma, 1 Hashimoto' s disease) were observed before surgery with color Doppler ultrasound. Pathological specimens of paraffin-embedded were immunohistochemically stained with CD34 and VEGF antibody. Results There were significant differences between the benign and malignant thyroid nodules in vascular morphology and regional rich blood flow. The irregular or less irregular vessels were found in 75 % of the malignant nodules. Regional rich blood flow or suspicious regional rich blood flow were found in 64. 3% of malignant nodules. The regular vessels were found in 89. 3% of the benign nodules, non-regional rich blood flow was found in 71.4% of the benign nodules. The number of CD34 in malignant lesions [(37.31 ± 11.55)/HP] was significantly higher than benign lesions [(29. 02 ± 8.32)/HP, P = 0.04]. There was a significantly difference of VEGF expression between the benign and malignant nodules which was higher in malignant nodules than in benign nodules(P ＜ 0.01). Conclusions Compared with the benign nodules, the vessles in malignant thyroid nodules were irregular,the distribution of vessles was asymmetry and angiogenesis was active.

Objective To investigate the clinical and pathological features of eosinophilic diseases with cardiac involvement Methods We analyzed the clinical and cardiac pathological data of 7 patients with eosinophilic diseases with cardiac involvement under endomyocardial biopsy or autopsy.Results Seven patients (5 male, average age 51 years) were enrolled.Four patients were diagnosed as idiopathic hypereosinophilic syndrome and three were Churg-Strauss syndrome.Peripheral blood eosinophila count increased significantly in all patients.Cardiac involvement included angina pectoris, myocardial infarction, heart failure, presyncope and sudden death.Electrocardiogram showed cardiac ischemia, bundle branch block and third degree atrioventricular block.Echocardiography suggested ventricular and atrial enlargement, decreased ventricular systolic function, pulmonary hypertension, valvular prolapse and insufficiency and endocarditis.Pathology displayed infiltration of eosinophils, formation of granulomata, necrotizing vasculitis, myocardial necrosis and endomyocardial fibrosis in heart.Coronary artery could be also affected and led to myocardial infarction.Conclusions Cardiovascular complications of eocinophilic diseases are a major source of morbidity and mortality in these disorders.The manifestations are multiple and early recognition and treatment with steroid and immunosuppressant can improve prognosis.

Objective To develop a scoring system to determine peptic ulcer risks and to evaluate its screening efficiency.Methods A total of 862 people who underwent gastroscopy for the first time ranging from 18 to 45 years old were enrolled in this study.They were divided into two cohorts with the method of simple random sampling,514 in the original cohort and 348 in the validation cohort.Information such as demographic characteristics,dietary intake,lifestyle,symptoms relating to peptic ulcer was obtained.A multivariable logistic regression method was used to determine independent predictors of peptic ulcer.Based on the logistic regression model,a scoring system was developed with a regression coefficient-based scoring method.Then the scoring system was internally and externally validated.Each value of calibration,discrimination and accuracy were computed and then compared with those of original cohort to assess its screening efficiency.Results Three variables (gender,smoking and melena) composed the scoring system with scores ranging from 0 to 4 points.It had good calibration (P =0.956) and discrimination (area under the ROC =0.70,95％CI:0.65-0.76).With 2.5 points as the screening cutoff value,the sensitivity,specificity,accuracy rate,positive predictive value,negative predictive value,positive likelihood ratio and negative likelihood ratio were 49.5％,82.2％,75.5％,41.6％,86.4％,2.78 and 0.61,respectively.In the validation cohort,the sensitivity,specificity,accuracy rate,positive predictive value,negative predictive value,positive likelihood ratio and negative likelihood ratio were 27.2％,92.7％,71.3％,64.6％,72.3％,3.89 and 0.79.The results above indicated that the screening efficiency of the scoring system in the original cohort was similar to that in the validation cohort.Conclusion The scoring system to determine peptic ulcer risks,containing gender,smoking and melena,has good screening efficiency and can be applied to predict the risks of peptic ulcer.

BACKGROUND:Deep vein thrombosis is a common postoperative complication after spinal surgery in clinical department of neurosurgery anddepartment of orthopedics. Deep vein thrombosis is mostly related to vein intima injury, stasis and activation of blood coagulation factor. Early effective prediction can effectively avoid the adverse effects on the prognosis of patients with deep vein thrombosis. D-dimer used in the prediction of deep venous thrombosis has high sensitivity and specificity, andcan be used as a sensitive predictor for deep vein thrombosis. OBJECTIVE:To explore the relationship between plasma D-dimer mass concentration and deep vein thrombosis after spinal surgery. METHODS:A total of 83 patients treated with spinal surgery colected fromDepartment of Neurosurgery, First Affiliated Hospital of Xinjiang Medical University from April 2014 to August 2015 were retrospectively analyzed. They were divided into two groups according to postoperative plasma D-dimer mass concentration:D-dimer positive group (n=48) and D-dimer negative group (n=35). We monitored D-dimer mass concentration in both groups preoperatively and postoperatively 1, 3, 5, 9 and 14 days, and analyzed the relationship between D-dimer mass concentration and deep vein thrombosis. RESULTS AND CONCLUSION:(1) No significant difference in D-dimer mass concentration was determined between the two groups (P> 0.05). D-dimer mass concentration was significantly higher in the D-dimer positive group than in the D-dimer negative group 1, 3, 5, 9, and 14 days postoperatively (P<0.05). (2) After operation, plasma D-dimer of 28 cases was positive, with persistent increasing. Double lower limb deep vein color Doppler ultrasound demonstrated that seven patients experienced deep vein thrombosis and four patients suffered from pulmonary embolism in D-dimer positive group. There was no deep vein thrombosis and pulmonary embolism in the D-dimer negative group. (3) These results indicate that positive D-dimer concentration of patientsafter spinal surgery suggests the possibility of deep vein thrombosis. If the concentration of D-dimer is persistently high, we should highly alert to the occurrence of deep vein thrombosis.