Objective:To explore the relative factors of hospitalized schizophrenics with metabolic syndrome. Methods: Patients data were collected by the way of face-to-face questionnaire to patients or their guardians, consulting patients medical record, checking physical or laboratory examination. Information include age, duration of the disease, the classification of antipsychotics and dosage, fast plasma glucose, plasma lipids, blood pressure, etc of hospitalized schizophrenics. The relative factors of metabolic syndrome were analyzed. Results; Among 797 schizophrenics, there were 153 cases (19. 2% ) suffered from metabolic syndrome. Single-factor analysis showed that the patients with longer duration of the disease, taking clozapine, etc, were at high risk of metabolic syndrome, and sex didnt relate to metabolic syndrome; Logistic regression analysis appeared that metabolic syndrome correlated with age, clozapine, CRP concentration, etc. Conclusion: The possible risk factors causing metabolic syndrome in schizophrenia include, duration of the disease, etc.

The fibrinolytic function of 98 patients with SLE were determined by spectrophotometric assay and immunodiffusion, 19 patients were observed before treatment, 1 month after treatment and 3 months after the disappearance of clinical symptoms. The results showed that the low level of fibrinolytic function correlated to the severity and the refractoriness of the disease, the activity of plasminogen activator inhibitor (PAI) was significantly increased in all patients. The activity ratio of tissue-type plasminogen activator (t-PA): PAI was significantly lower than normal level in the patients with lupus nephritis, not only the activity of PAI increased significantly, but also the activity of t-PA was significantly decreased, so the activity ratio of t-PA: PAI became much lower, the result suggested that it was related to the refractoriness of the disease. In patients in clinical remission, although the activity of PAI was still higher than normal level, the activity of t-PA was also significantly increased, therefore, the activity ratio of t-PA: PAI was nearly normal.

Objective To explore the influence of modified radical gastrectomy on glycometabolism in patients with gastric carcinoma and non-obese T2DM.Methods The retrospective study was carried out to analyze the changes of glycometabolism between preoperative and postoperative follow-up in 25 patients with gastric carcinoma and non-obese T2DM.The above parameters included fasting plasma glucose (FPG),2-hour postprandial blood glucose (2 h PBG),glycosylated hemoglobin A1c (HbA1c),fasting insulin (FINS),homeostasis model assessment-insulin resistance (HOMA-IR),fasting glucagon-like peptide-1 (GLP-1),and glucose-dependent insulinotropic polypeptide (GIP).Results At the 6th and 12th month after operation,the related parameters such as FPG,2 h PBG,HbA1c,FINS and HOMA-IR were (7.54±1.44) mmo]/L and (7.17±1.35) mmol/L,(9.97±1.59)mmol/L and (9.47±1.23) mmol/L,(6.46±0.74)％ and (6.31±0.97)％,(7.73±0.98) μIU/ml and (7.44±0.96) μIU/ml,1.10±0.15 and 1.04±0.14 respectively.The above indexes were significantly improved compared with those before operation (P＜O.05).The levels of fasting GLP-1 at 6th and 12th month after operation were (2.27±0.25) pmol/ml and (2.33±0.27) pmol/ml respectively,and there was no significant change compared with those before operation (P＞0.05).On the contrary,the levels of GIP at 6th and 12th month after operation are significantly decreased compared with that before operation,which were (7.23±1.33) pmol/ml and (6.40±1.20) pmol/ml respectively.Conclusion The modified radical gastrectomy can improve T2DM in patients with gastric carcinoma markedly,even curing some patients,which may be related to the decrease of fasting GIP after operation.

Objective To research the changes of bile dynamics and plasma levels of cholecystokinin ( CCK ) and vasoactive intestinal peptide ( VIP ) in post-cholecystectomy patients. Methods Twenty-nine post-cholecystectomy patients were selected as observation group, including 14 patients combined with bile duct dilatation and 15 without bile duct dilatation. Another 17 healthy subjects were enrolled as the control group. They were assessed with quantitative 99mTc-EHIDA hepatobiliary scintigraphy to determine bile dynamics. Plasma levels of CCK and VIP were measured by enzyme-linked immunosorbent assay. Results Scintigraphic analysis demonstrated that the time to maximum counts and half excretion of liver were no significantly different among the three groups ( all P＞0. 05). The developing time of common hepatic duct, time of maximum counts of common bile duct, half excretion of common bile duct, developing time of duodenum, hepatic portal and duodenum transit time significantly increased in the bile duct dilatation group compared with those of the control group ( all P＜0. 05). Development time of duodenum, hepatic portal and duodenum transit time were significantly less in the non-bile duct dilatation group compared with those in the bile duct dilatation group and control group (all P＜0. 05). Fasting plasma levels of CCK and VIP were no significantly different among the three groups ( all P＞0. 05 ), while postprandial plasma levels of CCK and VIP were significantly higher in the bile duct dilatation group compared to those in the other two groups ( P＜0. 05). Conclusion After cholecystectomy, the flow and velocity of bile in bile duct and intestine increases during the interdigestive period for patients without bile duct dilatation, while for patients with bile duct dilatation, bile remains in common bile duct and is blocked from intestine, with gastrointestinal hormone regulation disorder.

Objective:To investigate the epidemiological characteristics, diagnosis, treat-ment and prognosis of gallbladder cancer in China from 2010 to 2017.Methods:The single disease retrospective registration cohort study was conducted. Based on the concept of the real world study, the clinicopathological data, from multicenter retrospective clinical data database of gallbladder cancer of Chinese Research Group of Gallbladder Cancer (CRGGC), of 6 159 patients with gallbladder cancer who were admitted to 42 hospitals from January 2010 to December 2017 were collected. Observation indicators: (1) case resources; (2) age and sex distribution; (3) diagnosis; (4) surgical treatment and prognosis; (5) multimodality therapy and prognosis. The follow-up data of the 42 hospitals were collected and analyzed by the CRGGC. The main outcome indicator was the overall survival time from date of operation for surgical patients or date of diagnosis for non-surgical patients to the end of outcome event or the last follow-up. Measurement data with normal distribu-tion were represented as Mean±SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M( Q1, Q3) or M(range), and com-parison between groups was conducted using the U test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Univariate analysis was performed using the Logistic forced regression model, and variables with P<0.1 in the univariate analysis were included for multivariate analysis. Multivariate analysis was performed using the Logistic stepwise regression model. The life table method was used to calculate survival rates and the Kaplan-Meier method was used to draw survival curves. Log-rank test was used for survival analysis. Results:(1) Case resources: of the 42 hospitals, there were 35 class A of tertiary hospitals and 7 class B of tertiary hospitals, 16 hospitals with high admission of gallbladder cancer and 26 hospitals with low admission of gallbladder cancer, respectively. Geographical distribution of the 42 hospitals: there were 9 hospitals in central China, 5 hospitals in northeast China, 22 hospitals in eastern China and 6 hospitals in western China. Geographical distribution of the 6 159 patients: there were 2 154 cases(34.973%) from central China, 705 cases(11.447%) from northeast China, 1 969 cases(31.969%) from eastern China and 1 331 cases(21.611%) from western China. The total average number of cases undergoing diagnosis and treatment in hospitals of the 6 159 patients was 18.3±4.5 per year, in which the average number of cases undergoing diagnosis and treatment in hospitals of 4 974 patients(80.760%) from hospitals with high admission of gallbladder cancer was 38.8±8.9 per year and the average number of cases undergoing diagnosis and treatment in hospitals of 1 185 patients(19.240%) from hospitals with low admission of gallbladder cancer was 5.7±1.9 per year. (2) Age and sex distribution: the age of 6 159 patients diagnosed as gallbladder cancer was 64(56,71) years, in which the age of 2 247 male patients(36.483%) diagnosed as gallbladder cancer was 64(58,71)years and the age of 3 912 female patients(63.517%) diagnosed as gallbladder cancer was 63(55,71)years. The sex ratio of female to male was 1.74:1. Of 6 159 patients, 3 886 cases(63.095%) were diagnosed as gallbladder cancer at 56 to 75 years old. There was a significant difference on age at diagnosis between male and female patients ( Z=-3.99, P<0.001). (3) Diagnosis: of 6 159 patients, 2 503 cases(40.640%) were initially diagnosed as gallbladder cancer and 3 656 cases(59.360%) were initially diagnosed as non-gallbladder cancer. There were 2 110 patients(34.259%) not undergoing surgical treatment, of which 200 cases(9.479%) were initially diagnosed as gallbladder cancer and 1 910 cases(90.521%) were initially diagnosed as non-gallbladder cancer. There were 4 049 patients(65.741%) undergoing surgical treatment, of which 2 303 cases(56.878%) were initially diagnosed as gallbladder cancer and 1 746 cases(43.122%) were initial diagnosed as non-gallbladder cancer. Of the 1 746 patients who were initially diagnosed as non-gallbladder cancer, there were 774 cases(19.116%) diagnosed as gallbladder cancer during operation and 972 cases(24.006%) diagnosed as gallbladder cancer after operation. Of 6 159 patients, there were 2 521 cases(40.932%), 2 335 cases(37.912%) and 1 114 cases(18.087%) undergoing ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) examination before initial diagnosis, respec-tively, and there were 3 259 cases(52.914%), 3 172 cases(51.502%) and 4 016 cases(65.205%) undergoing serum carcinoembryonic antigen, CA19-9 or CA125 examination before initially diagnosis, respectively. One patient may underwent multiple examinations. Results of univariate analysis showed that geographical distribution of hospitals (eastern China or western China), age ≥72 years, gallbladder cancer annual admission of hospitals, whether undergoing ultrasound, CT, MRI, serum carcinoembryonic antigen, CA19-9 or CA125 examination before initially diagnosis were related factors influencing initial diagnosis of gallbladder cancer patients ( odds ratio=1.45, 1.98, 0.69, 0.68, 2.43, 0.41, 1.63, 0.41, 0.39, 0.42, 95% confidence interval as 1.21-1.74, 1.64-2.40, 0.59-0.80, 0.60-0.78, 2.19-2.70, 0.37-0.45, 1.43-1.86, 0.37-0.45, 0.35-0.43, 0.38-0.47, P<0.05). Results of multivariate analysis showed that geographical distribution of hospitals (eastern China or western China), sex, age ≥72 years, gallbladder cancer annual admission of hospitals and cases undergoing ultrasound, CT, serum CA19-9 examination before initially diagnosis were indepen-dent influencing factors influencing initial diagnosis of gallbladder cancer patients ( odds ratio=1.36, 1.42, 0.89, 0.67, 1.85, 1.56, 1.57, 0.39, 95% confidence interval as 1.13-1.64, 1.16-1.73, 0.79-0.99, 0.57-0.78, 1.60-2.14, 1.38-1.77, 1.38-1.79, 0.35-0.43, P<0.05). (4) Surgical treatment and prognosis. Of the 4 049 patients undergoing surgical treatment, there were 2 447 cases(60.435%) with complete pathological staging data and follow-up data. Cases with pathological staging as stage 0, stage Ⅰ, stage Ⅱ, stage Ⅲa, stage Ⅲb, stage Ⅳa and stage Ⅳb were 85(3.474%), 201(8.214%), 71(2.902%), 890(36.371%), 382(15.611%), 33(1.348%) and 785(32.080%), respectively. The median follow-up time and median postoperative overall survival time of the 2 447 cases were 55.75 months (95% confidence interval as 52.78-58.35) and 23.46 months (95% confidence interval as 21.23-25.71), respectively. There was a significant difference in the overall survival between cases with pathological staging as stage 0, stage Ⅰ, stage Ⅱ, stage Ⅲa, stage Ⅲb, stage Ⅳa and stage Ⅳb ( χ2=512.47, P<0.001). Of the 4 049 patients undergoing surgical treatment, there were 2 988 cases(73.796%) with resectable tumor, 177 cases(4.371%) with unresectable tumor and 884 cases(21.833%) with tumor unassessable for resectabi-lity. Of the 2 988 cases with resectable tumor, there were 2 036 cases(68.139%) undergoing radical resection, 504 cases(16.867%) undergoing non-radical resection and 448 cases(14.994%) with operation unassessable for curative effect. Of the 2 447 cases with complete pathological staging data and follow-up data who underwent surgical treatment, there were 53 cases(2.166%) with unresectable tumor, 300 cases(12.260%) with resectable tumor and receiving non-radical resection, 1 441 cases(58.888%) with resectable tumor and receiving radical resection, 653 cases(26.686%) with resectable tumor and receiving operation unassessable for curative effect. There were 733 cases not undergoing surgical treatment with complete pathological staging data and follow-up data. There was a significant difference in the overall survival between cases not undergoing surgical treatment, cases undergoing surgical treatment for unresectable tumor, cases undergoing non-radical resection for resectable tumor and cases undergoing radical resection for resectable tumor ( χ2=121.04, P<0.001). (5) Multimodality therapy and prognosis: of 6 159 patients, there were 541 cases(8.784%) under-going postoperative adjuvant chemotherapy and advanced chemotherapy, 76 cases(1.234%) under-going radiotherapy. There were 1 170 advanced gallbladder cancer (pathological staging ≥stage Ⅲa) patients undergoing radical resection, including 126 cases(10.769%) with post-operative adjuvant chemotherapy and 1 044 cases(89.231%) without postoperative adjuvant chemo-therapy. There was no significant difference in the overall survival between cases with post-operative adjuvant chemotherapy and cases without postoperative adjuvant chemotherapy ( χ2=0.23, P=0.629). There were 658 patients with pathological staging as stage Ⅲa who underwent radical resection, including 66 cases(10.030%) with postoperative adjuvant chemotherapy and 592 cases(89.970%) without postoperative adjuvant chemotherapy. There was no significant difference in the overall survival between cases with postoperative adjuvant chemotherapy and cases without postoperative adjuvant chemotherapy ( χ2=0.05, P=0.817). There were 512 patients with pathological staging ≥stage Ⅲb who underwent radical resection, including 60 cases(11.719%) with postoperative adjuvant chemotherapy and 452 cases(88.281%) without postoperative adjuvant chemotherapy. There was no significant difference in the overall survival between cases with postoperative adjuvant chemo-therapy and cases without post-operative adjuvant chemo-therapy ( χ2=1.50, P=0.220). Conclusions:There are more women than men with gallbladder cancer in China and more than half of patients are diagnosed at the age of 56 to 75 years. Cases undergoing ultrasound, CT, serum CA19-9 examination before initial diagnosis are independent influencing factors influencing initial diagnosis of gallbladder cancer patients. Preoperative resectability evaluation can improve the therapy strategy and patient prognosis. Adjuvant chemotherapy for gallbladder cancer is not standardized and in low proportion in China.