OBJECTIVETo investigate the prognostic factors of young, middle-age and old-age colorectal cancer patients in order to improve the treatment in the future.

METHODSColorectal cancer patients (n = 842) who had undergon curative resection were divided into three groups according their age: young group (< or = 40 years), middle-age group (41 to 64 years) and old group (> o = 65 years). Thirty-five clinical factors in the three groups were analyzed and compared by univariate survival and multivariate analysis. Cox proportional hazards regression model was used with SPSS statistic software.

RESULTSThe overall 5-, 10- and 15-year survival rates were 66.3%, 54.2% and 48.5% respectively. The 5- and 10-year survival rates were 53.0% and 42.7% in the young group, which were lower than those in the other two groups. Cox proportional hazards regression model demonstrated that Dukes stage and family history of cancer were common prognostic factors in both young and middle-age groups; chronic constipation was an independent prognostic factor in middle-age group; bowel obstruction, length of operating time and number of metastatic lymph nodes were prognostic factors in the older group. In the young group, the symptomatic duration was not demonstrated as a prognostic factor. The 5- and 10-year survival rates were 82.6% and 64.5% in Dukes A stage; 73.3% and 67.4% in B stage; 37.3% and 27.0% in C stage; 33.3% and 22.2% in D stage. The survival rates in Dukes A and B stages were similar, but in Dukes C and D stages they were lower than those of the middle-age and older groups if the patient had the same stage of disease. In the young colorectal cancer patients with family cancer history, the 5- and 10-year survival rates were 73.1% and 64.5%, which were better than those of patients without it (48.1% and 37.3%).

CONCLUSIONIn young colorectal cancer patients, the survival rate is lower than those in the middle-age and old patients. Family cancer history and/or advanced Dukes stage are poor prognostic factors, whereas the symptomatic duration is not demonstrated as a poor prognostic factor. The prognostic factors affecting the survival after surgical treatment may be different in different age groups of colorectal cancer patients.

Adult ; Age Factors ; Aged ; China ; epidemiology ; Colorectal Neoplasms ; epidemiology ; mortality ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Survival Rate

Objective To observe the efficacy difference between ZHU Lian's acupuncture plusWen Ren Tiao Shu method (warming the Conception Vessel and regulating back-Shu points) and ovulation drugs in treating anovulatory infertility.Method Seventy patients were randomized into an observation group and a control group, 40 cases each. The control group was given ovulation triggering medications; the observation group was intervened by ZHU Lian's acupuncture plusWen Ren Tiao Shu method, with Tianshu (ST25), Zigong (EX-CA 1), Guanyuan (CV4), Xuehai (SP10), Zusanli (ST36), Sanyinjiao (SP6), Ganshu (BL18), Pishu (BL20), Sanjiaoshu (BL22) and Shenshu (BL23) selected, once per day, 10 sessions as a course of treatment. The two groups were observed for 3 menstrual cycles. The symptoms score of traditional Chinese medicine (TCM), menstruation score, basal body temperature (BBT), and ovulation rate by gynecological scanning were compared before and after the treatment, and the clinical efficacies were compared between the two groups.Result The TCM symptoms score changed significantly after the intervention in the observation group (P<0.05); the TCM symptoms score didn't show significant change after the treatment in the control group (P>0.05); after the treatment, there was a significant difference in comparing the symptoms score between the two groups (P<0.01); there was a significant difference in comparing the BBT between the two groups after the intervention (P<0.05); according to Chi-square test, after the treatment, the difference in ovulation rate between the two groups was statistically significant (P<0.05); the total effective rate was 94.3% in the observation group, higher than 82.9% in control group.ConclusionZHU Lian's acupuncture plusWen Ren Tiao Shu method can improve the symptoms of anovulatory fertility, increase the conception rate, and reduce adverse reactions; this method can produce a more significant efficacy than oral administration of Western medications in treating anovulatory fertility.

Objective To develop the method of 16S rRNA gene clone library for tick bacterial flora analysis, and to analyze the detection effective of pathogens in tick and capacity of bacterial flora diversity. Methods Primers were designed according to the specific gene of Borrelia burgdorferi, Bartonella henselae, Anaplasma phagocytophilum, Ehrlichia chaffeensis and templates were choosen by positive PCR result to amplify the DNA extracted from the ticks. One set of primers targeting 16S rRNA gene conserved region were chosen to amplify certain fragments, DNA extraction, PCR reaction, cloning and sequencing. Nucleotide sequences were compared with GenBank database. Calculated Coverage values of clone library and Shannon-Wiener diversity index. Results Sixteen defined genus-or species-bacteria were detected in 103 valid sequences. Eight species were edge type (Clone No. > 5). Three kinds of pathogens were identified (Borrelia burgdorferi, Bartonella henselae and Rickettsia sp). Three kinds of pathogens were not edge type(Clone No. < 5). Coverage value was 96.11%, and Shannon-Wiener index was 2.40. Analysis results of cloning sequence showed that tick-parasitic bacteria mainly were α and γ deformation mycetes which accounted for 56.25% (9/16). Conclusions The 16S rRNA gene sequences technology could make relative quantitative of bacterial flora, and detect many kinds of pathogens in tick. It's a good method for detection of pathogens and bacterial flora analysis.

OBJECTIVETo investigate the status of male reproductive health among middle-aged and older men in the urban area of Nanjing.

METHODSWe collected the laboratory results of 884 middle-aged and older men aged 55 - 89 years from the Xuanwu District of Nanjing present for routine physical examinations, including those of blood routine tests, liver and kidney function, blood glucose, blood lipid, and total prostate specific antigen (TPSA), as well as such reproductive hormone indexes as total serum testosterone (TT), free serum testosterone (fT), and sex hormone binding globulin (SHBG). We also obtained the above reproductive hormone indexes from 119 young and middle-aged men aged 20 - 39 years as controls.

RESULTSAging-related changes were found in the 50 percentiles of all the reproductive hormones and relevant parameters but those of TT and E2, with gradual increases in LH, FSH and SHBG and decreases in fT, TSI and fTI. Comparison of reproductive hormones and relevant parameters by Mann-Whitney U test did not show any statistically significant differences in the TT level between any two of the five age groups (20 - 39, 55 - 59, 60 - 69, 70 - 79, and > or = 80 yr) (P > 0.05) except between the control and > or = 80 yr groups and the 60 - 69 and > or = 80 yr groups (P < 0.05), nor in the E2 level between any two groups, nor in the levels of LH and FSH except between the 55 - 59 and 60 - 69 yr groups and the 70 - 79 and > or = 80 yr groups, and nor in the levels of fT and TSI except between the 55 - 59 and 60 - 69 yr groups. However, there were significant differences in the levels of SHBG and fTI between any two age groups. Spearman correlation analysis revealed that fT, TSI, and fTI were correlated negatively with aging and LH (P < 0.05, I r I > 0.5) but weakly positively with cholesterol, blood glucose and hemoglobin (P < 0.05, /r/ < 0.5), SHBG and LH positively with aging, SHBG weakly negatively with blood glucose and hemoglobin, LH weakly negatively with hemoglobin, and TT weakly negatively with aging but positively with hemoglobin.

CONCLUSIONThe levels of serum testosterone, particularly that of fT, declined with aging in middle-aged and older men in the urban area of Nanjing, which may contribute to abnormal lipid metabolism, low hemoglobin and high blood glucose.

Aged ; Aged, 80 and over ; Aging ; blood ; Blood Glucose ; analysis ; Case-Control Studies ; China ; Follicle Stimulating Hormone ; blood ; Humans ; Luteinizing Hormone ; blood ; Male ; Middle Aged ; Prostate-Specific Antigen ; blood ; Sex Hormone-Binding Globulin ; analysis ; Statistics, Nonparametric ; Testosterone ; blood

Objeetive To study the public health emergent events(PHEE)in Fujian province，from 2004 to 2007.Methods Descriptive and analytic methods were Used to analyze the PHEE in Fujian province aecording to the internet.based surveillance reports.Results From 2004 to 2007.there were 304 emergency events being surveyed.Of all the events，there were 7(2.30％)belonged to serious-degree of grade II，57(18.75％)to gradeⅢand 240(78.95％)t0 gradeⅣ，but with no grade I.Results showed that the attack rate in affected population WaS 25.82‰.the mortality rate was 0.08‰and the fatalky rate Was 0.32％.The numbers of emergency events decreased 2.82％on average.each year.A total number of 169(55.60％)events occurred in schools with 71(23.36％)in the countryside.Numbers due to infectious disease-born Was 233(76.64％)including avian flu，cholera and dengue fever were predominant pathogens of the grade II and grade emergency events.57(18.75％)of the events was due to food poisoning.The epi.garph showed that there were two peaks.I.e.in Mar-Apr and Sep.contributed 43.1％to the total number of events.Conclusion Emergency events showed a stable decrease in FujJan province with communicable disease and food poisoning the two major sources and more commonly seen in schools and countryside.We suggest that the government and community pay more attention to the emergency events of avian flu,cholera and dengue fever.

OBJECTIVETo screen out specifically-expressed serum protein markers in familial adenomatous polyposis (FAP) and to establish a serum protein fingerprint diagnostic model for distinguishing FAP from sporadic colorectal adenomas.

METHODSSerum samples were collected from 19 FAP cases and 16 sporadic colorectal adenomas with informed consent. Serum protein fingerprint profiles were detected by SELDI-TOF-MS with CM 10 protein chip to screen out FAP adenoma-related serum protein markers, and support vector machine (SVG) technique was used to establish the diagnostic model to distinguish FAP from sporadic colorectal adenomas.

RESULTSSix differently-expressed protein peaks (P < 0.01) were detected. Among them proteins of 5640, 3160, 4180 and 4290 m/z were highly expressed in FAP adenomas, and proteins of 3940 and 3400 m/z were highly expressed in sporadic colorectal adenomas. The accuracy of diagnostic model established with SVG to distinguish FAP adenomas and sporadic colorectal adenomas was 94.7% and 93.7%, respectively.

CONCLUSIONSELDI-TOF-MS can be effectively used to screen out the differentially expressed serum protein markers in FAP adenomas and sporadic colorectal adenomas, and a diagnostic model build by SVG to distinguish them has been successfully established. Therefore, a useful breakthrough point for research on molecular mechanisms of FAP pathogenesis is provided.

Adenoma ; genetics ; metabolism ; Adenomatous Polyposis Coli ; genetics ; metabolism ; Adult ; Aged ; Biomarkers, Tumor ; metabolism ; Colorectal Neoplasms ; genetics ; metabolism ; Diagnosis, Differential ; Female ; Gene Expression Profiling ; Humans ; Male ; Middle Aged ; Protein Array Analysis ; Proteomics ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

OBJECTIVETo analyze the adenomatous polyposis coli (APC) gene mutations in familial adenomatous polyposis (FAP) in Chinese.

METHODSDNA was extracted from blood samples taken from 31 FAP families, and all exons of the APC gene were amplified with touch-down PCR. APC gene mutations were screened by denaturing high performance liquid chromatography followed by sequencing if abnormal profile was detected.

RESULTSTwelve categories of APC gene mutations were found in 15 FAP families (48.39%) including 4 novel mutations in coding region and 3 mutations in introns. The 4 novel mutations in coding region were frameshift mutations and located in codons 255, 677, 1192 and 1403 respectively. Most mutations were clustered in exon 15 of APC gene leading to frameshift and accounted for 86.67%. Others were nonsense mutations (13.33%).

CONCLUSIONThe mutation rate of the APC gene in this group of Chinese FAP families was about 48.39%, and 4 novel mutations were detected. Frameshift mutation was the major mutation type in Chinese FAP and mainly located in exon 15.

Adenomatous Polyposis Coli ; genetics ; Chromatography, High Pressure Liquid ; methods ; Exons ; genetics ; Female ; Frameshift Mutation ; genetics ; Genes, APC ; physiology ; Humans ; Introns ; genetics ; Male ; Mutation ; Polymerase Chain Reaction

OBJECTIVETo characterize the clinical features of Chinese hereditary nonpolyposis colorectal cancer (HNPCC) families and to evaluate the value of Chinese HNPCC criteria.

METHODSTwenty-six families were involved in this study. Eight families fulfilled both the Amsterdam criteria and the Chinese HNPCC criteria (named group A), while the other 18 families fulfilled the Chinese HNPCC criteria only (named group B). The clinical features of these HNPCC families were compared with those of 509 sporadic colorectal cancers (CRC) cases. Features of families in group A and in group B were also compared and analyzed.

RESULTSA total of 86 colorectal carcinomas developed in 77 patients in these 26 families. Synchronous or metachronous colorectal cancers developed in seven (9.1%) patients. Thirty-nine percent of colorectal carcinomas were developed in the proximal colon. Fifty-one out of 71 patients (71.8%) were diagnosed before the age of 50. A total of 24 extracolonic malignancies were identified in these families. Gastric carcinoma was the most common type of extracolonic malignancy (37.5%). Compared with sporadic CRCs, HNPCC patients were significantly younger at the age of diagnosis, namely, higher proportion of patients less than 50 years old, and more frequent development of multiple colorectal cancers. Except for the average number of colorectal carcinomas developed per family (4.5:2.3, P = 0.022), there was no significant difference between group A and B regarding the age of diagnosis, the location of colorectal cancer, the development of multiple colorectal cancers and the distribution of extra-colonic malignancies.

CONCLUSIONChinese HNPCC families have certain specific clinico-pathological features. Families in accord with the Chinese HNPCC criteria have similar clinical features as those with the Amsterdam criteria. The Chinese criteria are, however, more suitable for the diagnosis of patients from small families.

Adult ; Age of Onset ; Asian Continental Ancestry Group ; genetics ; Colorectal Neoplasms, Hereditary Nonpolyposis ; epidemiology ; genetics ; Family ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasms, Second Primary ; epidemiology ; genetics ; Pedigree ; Phenotype ; Stomach Neoplasms ; epidemiology ; genetics

OBJECTIVETo observe blood uric acid levels and Goldstein grading, as well as their correlation in Wilson's disease (WD) patients with different Chinese medical syndrome types.

METHODSTotally 906 WD patients in line with inclusive criteria were assigned to 6 groups, i.e., the heart spirit confused by phlegm group (HSCP, 26 cases), the phlegm-fire disturbing heart group (PFDH, 90 cases), the retention of damp-heat group (RDH, 113 cases), deficiency of qi and blood group (DQB, 168 cases), the deficiency of Gan-yin and Shen-yin group (DGYSY, 327 cases), the deficiency of Gan and Shen group (DGS, 182 cases) due to different Chinese medical syndrome types. Recruited were another 160 healthy subjects having similar ages and diet structures, who came for medical examinations, as the healthy control group. Venous blood was collected from the medial cubital vein of each-patient on an empty stomach in early mornings to detect blood uric acid levels. Results Blood uric acid levels were lower in each syndrome type group than in the healthy control group (146.08 +/- 67.24 micromol/L in the HSCP group; 157.08 +/- 69.77 micromol/L in the PFDH group; 162.58 +/- 97.72 micromol/L in the RDH group; 156.20 +/- 62.63 micromol/L in the DQB group; 161.83 +/- 111.23 micromol/L in the DGYSY group; 194.41 +/- 90.01 micromol/L in the DGS group; 242.39 +/- 87.55 micromol/L in the healthy control group, P < 0.01). Blood uric acid levels were higher in the DGYSY group than in the other 5 syndrome groups (P < 0.01). Correlation analyses between Goldstein grading and blood uric acid showed that, along with increased Goldstein grade (that was aggravating disease conditions), WD patients' blood uric acid levels decreased (P < 0.01).

CONCLUSIONSWD patient's blood uric acid levels decreased more. Blood uric acid levels and Goldstein grading were different in various Chinese medical syndrome types. Blood uric acid levels had certain value in assessing the severity of WD.

Asian Continental Ancestry Group ; Heart ; Hepatolenticular Degeneration ; blood ; classification ; diagnosis ; Humans ; Medicine, Chinese Traditional ; Syndrome ; Uric Acid ; blood

Objective To find out the data sources of respiratory syndromes and their components from the outpatients of general hospitals and to describe the time distribution and mutual relations of different respiratory syndromes. Feasibility of respiratory syndromes used for early warning surveillance on respiratory infectious disease was also under research. Methods Retrospective investigation on Hospital Information System (HIS) was implemented in a general hospital in Guangzhou, 2005, and data of outpatients was collected and classified into different syndromes. The respiratory syndromes with its time distribution similar to influenza like illness (ILI),were selected, and cross-correlation analyses were conducted to inveshgate the feasibility of respiratory syndromes for early warning surveillance on respiratory infection diseases (influenza as an example). Results Primary sub-classification of respiratory syndromes in outpatient department would include upper respiratory infection(URI)(51.20%), trachitis/bronchitis (18.80%), asthma ( 17.52% ), etc. Pulmonary infection accounted for only 2.26%. Time distributions of URI, trachitis/bronchitis, pulmonary infection, cough and asthma in outpatient department, X-ray tests and pneumonia/acute respiratory distress syndromes (ARDSs) in outpatient X-ray room were similar, with two peaks observed. Cross-correlation functions were calculated with the data sets of 1st-28th week.The most significant correlation was detected between the time series of outpatient pulmonary infections and ILIs moved 4 weeks backward (r＝0.739, P＜0.01 ), and that was detected between URIs and ILIs moved 5 weeks backward (r=0.714, P＜0.01 ). Correlation between X-ray tests,pneumonia/ARDSs in outpatient X-ray room and ILIs was the strongest when ILIs time series moved 1 week backward (r=0.858, P＜0.001; r=0.821, P＜0.001 ). Conclusion Outpatient data from HIS system in general hospital could be applied to syndromic surveillance on respiratory diseases. For early warning epidemics or outbreaks of influenza or other respiratory infectious diseases, data of outpatient pulmonary infection appeared to be the most feasible for its specificity and timeliness, followed by URI and cough. X-ray tests and pneumonia/ARDSs in outpatient X-ray findings were important supplementary to verify the respiratory disease epidemics or outbreaks for its good specificity, but with no advantage for early warning.