Objective To explore the relationship of serum leptin concentration,body mass index (BMI) and esophageal squamous cell carcinoma.Methods Blood samples were collected from 47 patients with esophageal squamous cell carcinoma and 20 healthy controls in Shanxi Cancer Hospital.Serum leptin was measured by ELISA.Results Serum leptin concentration in patients group was significantly higher than control group[(13.09±5.94) ng/ml vs (7.58±4.16) ng/ml,(t =3.76,P =0.001)].In 47 patients,BMI,albumin and lymphocytes were (25.20±3.14) kg/m2,(43.58±2.15) g/L and (2.02±0.55)×109/L,respectively.The serum leptin concentration of all patients (47 cases) were positive correlation with BMI (r =0.561,P =0.006),not with blood albumin and lymphocytes (r =0.206,P =0.242; r =0.122,P =0.412).Multiple logistic regressionanalysis reveal statistically significant association between serum leptin and esophageal squamous cell carcinoma incidence (OR =1.442,95 ％ CI 1.094-1.848,P=0.09).Conclusion Higher serum leptin levels seem to represent an additional and independent risk factor for esophageal squamous cell carcinoma.

Objectiveto investigate serum leptin concentration and lipdid levels in patients with esophageal squamous cell carcinoma and their clinical significance. MethodsBlood samples were collected from 47 patients with esophageal cancer, 20 healthy control subjects. Serum leptin was measured by ELISA and serum lipids was measured by biochemistry auto-analyzer. ResultsThe serum leptin concentration and LP α levels in patients group were significantly higher than those in control group[(13.09±5.94) ng/ml vs (7.584±4.15) ng/ml,(216.50±752.52) ng/ml vs(87.85±10.73) mg/L](P=0.001).However,the TG concentration was significantly lower than control group [(1.23±0.46) mmol/L vs (1.58±0.07) mmol/L]( P=0.001 ).Multiple logistic regression analysis revealed statistically significant association between serum leptin levels and esophageal squamous cell carcinoma incident(ORLeptm =1.442,95％ CI 1.094-1.848). ConclusionThe increased serum leptin levels maybe the risk factors of esophageal cancer,elevated LP α levels in patients might be a compensatory reactions.

Objective To explore the relationship of leptin,leptin receptor and esophageal squamous cell carcinoma,and provide a scientific basis for prevention and treatment of esophageal cancer.Methods Samples were collected from 32 patients with esophageal squamous cell carcinoma,20 healthy control subjects in Shanxi Tumor Hospital.ELISA and immunohistochemistry were used to analyze leptin and leptin receptor,respectively.The correlation between their expression and clinicopathologieal parameters was also analysized.Results Patients with esophageal squamous cell carcinoma had significandy(t =4.64,P ＜ 0.001)higher leptin levels [(4.7 ±1.9)ng/ml] compared with normal [(2.54±1.01)ng/ml] oesophagus tissues.The expression rate of leptin receptor in esophageal carcinoma and normal esophagus was 81.25 ％ and 75.00 ％ respectively,not differ significantly.The expression levels of leptin was associated with position,(l)ymphatic metastasis.Conclusion Higher leptin levels seem to represent an additional,independent risk factor for esophageal squamous cell carcinoma,leptin receptor expression on oesophageal epithelial cells provides a pathway for leptin-mediated signal transduction.

Objective:To investigate the risk factors of Crohn′s disease (CD)-related gastrointestinal stenosis, and to summarize and analyze the corresponding treatments.Methods:From January 2010 to December 2018, 122 patients diagnosed with CD and hospitalized in the Seventh Medical Center, PLA General Hospital were selected including 72 patients in gastrointestinal stenosis group and 50 patients in non-gastrointestinal stenosis group. The gender, age of onset, course of disease, location of lesions involved (Montreal classification), disease activity, extraintestinal manifestations, application of therapeutic drugs, and complications were compared between the two groups. The treatment of CD patients with gastrointestinal stenosis was analyzed. Multivariate logistic regression was used to analyze the risk factors of CD patients with gastrointestinal stenosis. The independent sample t test, Mann-Whitney U test and chi-square test were used for statistical analysis. Results:The age of onset of patients in gastrointestinal stenosis group was older than that in non-gastrointestinal stenosis group ((37.6±15.1) years old vs. (30.8±14.7) years old), and course of disease was longer than that of non-gastrointestinal stenosis group (72 months, 11 to 492 months vs. 45 months, 3 to 240 months); and the differences were statistically significant ( t=-2.044, Z=-2.770; P=0.018, 0.006). The proportion of patients with ileum involvement of the gastrointestinal stenosis group was lower than that of the non-gastrointestinal stenosis group (69.4%, 50/72 vs. 86.0%, 43/50), and the proportion of severe patients was higher than that of the non-gastrointestinal stenosis group (15.3%, 11/72 vs. 4.0%, 2/50); and the differences were statistically significant ( χ2=4.463 and 3.942, P=0.035 and 0.047). There were no significant differences in gender, use of therapeutic drugs, extraintestinal manifestations, application of therapeutic drugs or the incidence of complications between the patients of two groups (all P>0.05). The results of multivariate logistic regression showed that the age of onset and course of disease were risk factors of CD-related gastrointestinal stenosis ( β=0.028, odds ratio ( OR)=1.028, 95% confidence interval ( CI) 1.000 to 1.056, P=0.046; β=0.008, OR=1.008, 95% CI 1.002 to 1.015, P=0.013). Further stratified analysis revealed that the incidence rates of CD-related gastrointestinal stenosis in patients with age of onset over 40 years old and course of disease more than five years were higher than those of patients with age of onset less than 40 years old and course of disease less than five years (76.3%, 29/38 vs. 51.2%, 43/84; 68.4%, 39/57 vs. 50.8%, 33/65), and the differences were statistically significant ( OR=3.072, 95% CI 1.298 to 7.272, P=0.009; OR=2.101, 95% CI 1.002 to 4.406, P=0.048). Among the 72 CD patients with gastrointestinal stenosis, 15 cases (20.8%) were treated with medicine and nutrition, without endoscopic or surgical treatment. Fifty-two patients (72.2%) underwent surgical treatment, among them six patients (11.5%) received twice surgery, the interval between the two operations was 46 months (1 to 204 months), and eight patients (15.4%) had postoperative complications. Twenty-one patients (29.2%) were treated with endoscopic dilatation, and no complications occurred after surgery. Five patients (23.8%) underwent surgical treatment during the follow-up period. Conclusions:The age of onset over 40 years old and the course of disease more than five years are the risk factors of CD-related gastrointestinal stenosis. Individualized medical treatment is the basis for the treatment of CD-related gastrointestinal stenosis. Surgery is still the main treatment. The endoscopic treatment is safety and can delay or avoid surgery to a certain extent.

Objective: To explore the valuable indicators for differential diagnosis by comparing the clinical features of Crohn′s disease (CD) with primary intestinal lymphoma (PIL). Methods: From 2010 to 2017, at The Seventh Medical Center of PLA General Hospital, a total of 91 patients diagnosed with CD or PIL were enrolled, including 76 cases of CD, 14 cases of PIL and one case of CD with secondary lymphoma. The clinical data of enrolled patients were retrospectively analyzed. T-test, non-parametric test and chi-square test were used for statistical analysis. Results: The average age at diagnosis of CD patients was (37.7±16.0) years, which was younger than that of PIL patients (52.6±19.6) years, and the difference was statistically significant (t=-3.085, P=0.003). The median duration of CD was 36.0 months, which was longer than that of PIL (3.5 months), and the difference was statistically significant (Z=-3.616, P<0.01). Abdominal pain and extra-intestinal manifestations (oral ulcers, joint injuries, erythema nodosum and perianal lesions) were more common in CD patients, and the differences were all statistically significant (χ²=9.427 and 5.173, both P<0.05). CD patients were not diagnosed by colonoscopic biopsy alone. Totally 13 of 14 patients were diagnosed by colonoscopic biopsy and immunohistochemisty and one patient was diagnosed after surgery. The diagnostic rate of pathological biopsy in PIL group was significantly higher than that in CD group (χ²=82.584, P<0.01). One patient was initially clinically diagnosed as CD, and then developed secondary lymphoma after five times of infliximab treatment. Conclusions The diagnosis of CD is generally supported by young age, long course of disease, abdominal pain and extra-intestinal manifestations. The diagnostic rate of colonoscopic biospsy in PIL patients is higher than that in CD patients.