Objective: To prospectively investigate the feasibility of shear wave elastography (SWE) as a new quantitative and objective method for evaluating the stiffness of the gastrocnemius medialis (GM) muscle during passive stretching in patients with Parkinson’s disease (PD). Materials and Methods: SWE of the GM muscle was performed in 28 patients with PD [13 female and 15 male; mean age ± standard deviation (SD): 63.0 ± 8.5 years] and 12 healthy controls (5 female and 7 male; mean age ± SD: 59.3 ± 6.4 years) during passive ankle rotation. A Young’s modulus-ankle angle curve was constructed. The GM slack angle and baseline Young’s modulus (E 0) were compared between the markedly symptomatic and mildly symptomatic sides of patients with PD, and healthy controls. Additionally, the correlation between the GM slack angle and the severity of rigidity, and the observer reproducibility of SWE in determining the GM slack angle were evaluated. Results: The GM slack angle was smaller on both the markedly and mildly symptomatic sides in patients with PD than in healthy controls (mean ± SD of -29.13° ± 3.79° and -25.65° ± 3.39°, respectively, vs. -21.22° ± 3.52°; p < 0.001 and p = 0.006, respectively). Additionally, in patients with PD, the GM slack angle on the markedly symptomatic side was smaller than that on the mildly symptomatic side (p = 0.003). The E 0 value was lower on both the markedly and mildly symptomatic sides in patients with PD than in healthy controls (mean ± SD of 10.11 ± 2.85 kPa and 10.08 ± 1.88 kPa, respectively, vs. 12.23 ± 1.02 kPa; p = 0.012 and p < 0.001, respectively). However, no significant difference was found between the markedly and mildly symptomatic sides in patients with PD (p = 0.634). A negative linear relationship was observed between the GM slack angle and lower limb rigidity score on the markedly symptomatic side in patients with PD (r = -0.719; p < 0.001). The intraclass correlation coefficients for observer reproducibility of SWE ranged from 0.880 to 0.951. Conclusion The slack angle determined by SWE may be a useful quantitative and reproducible method for evaluating muscle stiffness in patients with PD.

Objective To investigate the changes aad possible role of estrogen and its receptor ERα、ERβ、GPR30 in the pathogenesis of asymptomatic hyperuricemia.Methods The peripheral blood of 62 asymptomatic hyperuricemia patients (AH) and 68 healthy controls (HC) were collected.The expression of estradial (E2) in serum was detected by the chemilluminescent microparticle immunoassay (CMIA).The expression of ERα,ERβ,GPR30 mRNA in peripheral blood mononuclear cells (PBMCs) was measured using Real time quantitative polymerase chain reaction (RT-qPCR).Statistical Package form Soci-science (SPSS) 17.0 statistical software was used for data analysis.The measurement data were compared by t test,rank sum test or one factor analysis of variance test.The correlation between variables was used by Spearman correlation analysis.Results ① The expression of E2 in serum of the HC group was higher than that in the AH group [(38.7±10.2) pg/ml vs (33.7±8.6) pg/ml,Z=-0.356,P＜0.05].② The expression of ERα,GPR30 mRNA in PBMCs of HC group was increased,compared with that in the AH group (0.000 17±0.000 23 vs 0.000 12± 0.000 12,0.002 0±0.002 1 vs 0.001 5±0.000 8,Z=-2.112,-2.147,P＜0.05,respectively).No significant difference in PBMCs ERβ mRNA levels was found between HC group and AH group,while a slight but not significant increase was observed in HC group.③ The Spearman correlation analysis found that the expression of ERα and ERβ mRNA,E2 and GR,ERβ and GLU in the AH group were positively related (r=0.259,0.251,0.260,P＜0.05,respectively).Conclusion The expression of E2,ERα,ERβ,GPR30 mRNA in the peripheral blood of patients with AH is decreased,suggesting that the estrogen and its receptor may be involved in the patho-genesis of hyperuricemia.

Objective: To investigate the causes and impacts of unplanned reoperations (UO) in patients underwent colorectal cancer surgery, and its effect on the length of hospital stays and hospitalization fees of these patients. Methods: we retrospectively analyzed the data of colorectal tumor patients underwent resection and UO from January 2014 to November 2017 in Cancer Hospital, Chinese Academy of Medical Sciences (CAMS). Student t tests, ANOVA analysis and chi-square test were used to compare the paired data and data of multiple groups, respectively. Results: There were 5 923 cases who underwent colorectal cancer surgery from 2014 to 2017. Among them, 75 cases further accepted UO, the incidence rate of UO was 1.27%. Among the 75 patients of UO, 60 were male and 15 were female, 21 patients underwent colonic operation and 54 patients underwent rectal operation. The average length of hospital stays were 25.8 days and the average hospitalization fees were 110 647.04 yuan. The gender construction, surgical site, average length of hospital stays and hospitalization fees of UO were significantly different from those of operative colorectal tumor patients during this period (all P<0.01). There were 40 patients underwent anastomotic fistula, 11 patients underwent stoma complications and 10 patients underwent bowel obstruction, respectively, which accounts for the three most common causes of UO after colorectal cancer surgery, and the total incidence was 81.3%. The interval of reoperation and the first operation significantly impacted the average length of hospital stays of UO patients (P=0.003), while marginally affected the hospitalization fees (P=0.847). Conclusions UO are more possible to occur to the male patients who undergo rectal operation. The length of hospital stays and hospitalization fees of UO are significantly increased when compare to those of operative colorectal cancer patients. The time of reoperation significantly impacts the length of hospital stays but has little effect on the hospitalization fees of UO patients.

Objective: To investigate the risk factors of prolonged postoperative length of stay (LOS) in patients with gastric cancer. Methods: A retrospective study was performed on 2033 patients who underwent curative surgery in Department of Pancreatic-gastric, Cancer Hospital, Chinese Academy of Medical Sciences. Eightieth percentile of postoperative hospital stay for all patients was taken as the cutoff, the patients were divided into the normal group (1 532 patients) and the extended group (501 patients). Logistic regression model was used to determine the risk factors related to prolonged postoperative LOS in gastric cancer. Results: A total of 417 cases with postoperative complications were recruited in extended group. The five highest complications accounting for prolonged LOS were: abdominal infection in 69 cases (13.77%), pleural effusion in 60 cases (11.98%), anastomotic leakage in 43 cases (8.58%), poor wound healing in 34 cases (6.79%), and bleeding in 25 cases (4.99%). Logistic regression analysis showed that age (OR=1.348, P=0.013), surgical procedure (OR=2.712, P<0.001), extent of resection (OR=2.035, P<0.001), degree of incision healing(OR=4.867, P<0.001), and perioperative blood transfusion (OR=1.711, P<0.001) were independent risk factors for prolonged postoperative LOS. Conclusions The most common complication associated with prolonged postoperative LOS for gastric cancer patients is abdominal infection. Age, surgical procedure, extent of resection, degree of incision healing, and perioperative blood transfusion are the independent risk factors for prolonged postoperative LOS.