Objective To understand the prevalence and Influencing factors of Metabolic Syndrome(MS) of 40～74 year-old non-diabetes population in Minhang District.Methods A population-based sample(diabetes screening of Minhang District in 2007) of 3 947 individuals aged 40～74 years was investigated by cluster random sampling.They completed a questionnaire and underwent triglyceride,high density lipoprotein measured cholesterol and an oral glucose tolerance test.Results The standardized prevalence rate of MS,overweight,diabetes,impaired glucose regulation(IGR),hypertension,high triglyceride and low HDL were 15.67%,2.45%,5.60%,17.72%,16.47% and 2.00%.The male with MS,overweight or obese,diabetes and hypertension were higher than the female in terms of incidence.The prevalence of MS was increased with age,the highest rate at the ages of 50 years and above.There was no significant difference between male and female at the ages of 45 years and above.The incidence of MS in people with BMI or hypertension or abnormal blood glucose or hige TG or low HDL-C was obviously higher than that of normal population.The OR value were 15.71,28.21,10.09,30.31 and 3.14 respectively.The prevalence of diabetes,coronary heart disease and stroke in people with MS was higher than that of people with out MS.The OR value were 10.09,9.94 and 2.40.Multiple factor analysis showed that the factors related to MS were male,the aged,family history of diabetes and having no physical activity.Conclusions MS and realated diseases are a serious threat to population of 40 years old and above in Minhang District.

Objective To assess the long-term survival and prognosfie factors in a series of patients with distal bile duet carcinoma. Methods A retrospective clinical analysis was made on 76 cases of distal bile duct cancer who were admitted into our hospital from January 1996 to December 2006. Clinicopathologic factors with possible prognostic significanees were selected and analyzed. Survival was calculated with the Kaplan-Meier method. A multivariate analysis of these individuals was performed using the Cox proportional Hazards Model. Results There were 46 males and 30 females. The age ranged from 21 to 88 years with a mean of 65.21 patients received palliative surgery including, bypass procedure, intraoperative biliary stenting, or percutaneous transhepatie biliary drainage. Radical resection was performed on 42 cases and the 1-, 3- and 5-yeur survival rates were 88.0%, 41.3% and 29.2% respectively. 38 cases died of liver metastasis or recurrence. In multivariate analysis, surgical procedure (P = 0.006) and liver metastasis (P = 0.008), but not sex, age, invasion of pancreas, invasion of duodenum, diameter or differentiation of tumor, were significant independent prognostic factors. Conclusions Radical resection is only curative treatment modality. Prevention on postoperative liver metastasis is essential for improving survival.

The chemical constituents from Euphorbia lunulata was investigated in this paper. Fourteen compounds were isolated and purified by column chromatographies on silica gel and preparative HPLC. Their structures were identified by physiochemical properties and NMR data analysis as lupeol (1), euphol (2), cassipourol(3) , 24-methylenecycloartan-3beta-ol (4), 24-hydroperoxycycloart-25-en-3beta-ol (5), 25-hydroperoxycycloart-23-en-3beta-ol (6), betulin (7), uvaol (8), (23E) -25-methoxycycloart-23-en-3beta-ol (9), (23E) -cycloart-23,25-dien-3beta-ol (10), 24-methylenecycloartan-3beta, 28-diol (11), salicinolide (12), 2alpha, 3beta, 5alpha, 9alpha, 15beta-pentaacetoxy-11,12-epoxy-7beta, 8alpha-diisobutyryloxyjatropha-6 (17) -en-14-one (13) and 3beta, 5alpha, 15beta-triacetoxy-7beta-isobutyryloxy-9alpha-nicotinoyloxyjatropha-6 (17), 11(E)-dien-14-one (14). Among them, compounds 1-11 were isolated from E. lunulata for the first time.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Euphorbia ; chemistry ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Spectrometry, Mass, Electrospray Ionization ; Stereoisomerism

Objective To evaluate the effects of assisted reproduction technology ( ART) on gestational weight gain ( GWG) and glucose metabolism .Methods The study was performed in ART women with single-ton and full-term delivery .Age-and pre-pregnancy body mass index matched healthy women with spontaneous pregnancy, singleton, and full-term delivery were recruited as controls .Maternal characteristics (height, age, education level , pre-pregnancy body mass , pre-delivery body mass , medical history , history of abortion , fasting plasma glucose , triglyceride , total cholesterol , and glucose tolerance ) and fetal data ( delivery mode , gender , birth body mass , birth body length ) were collected by a trained nutritionist .Results A total of 200 women were recruited into this study (53 ART women and 147 controls).There was no significant difference in number of previous abortion ( the ratio between the women who had ≥3 abortions to those who had <3 abortions was 6∶47 in the ART group , and 10∶137 in the control group , χ2 =1.080 , P=0.299 ) .Compared with the control group, the ART group had higher education level (33 in the ART and 85 in the control group with un-dergraduate or higher education , 20 in the ART group and 62 in the control group with a college degree or lower education ,χ2 =6.303 , P=0.012 ) .There were no statistically significantly differences between the ART and the control groups in pre-pregnancy body mass index [ (22.00 ±3.05 ) kg/m2 vs.(21.81 ±2.62 ) kg/m2 , P=0.661] and average GWG [ (13.89 ±5.33) kg vs.(14.78 ±4.60) kg, P=0.247].GWG was appro-priate in 22 ART women, excess in 18, and inadequate in 13;in the control group, GWG was appropriate in 66 women, excess in 54, and inadequate in 27.The distribution of GWG showed no significant difference be-tween the two groups (χ2 =1.162 , P=0.247 ) .Oral glucose tolerance test in 24-28 gestational weeks showed no significant difference in fasting blood glucose between the ART and the control groups [ (4.66 ±0.39) mmol/L vs.(4.66 ±0.52) mmol/L, P=0.996], but 1-hour and 2-hour blood glucose levels were significantly in-creased in the ART women [ ( 7.87 ±1.83 ) mmol/L vs.( 7.31 ±1.51 ) mmol/L, P=0.034; ( 7.49 ± 1.29) mmol/L vs.(6.69 ±1.30) mmol/L, P=0.029].The overall prevalence of gestational diabetes melli-tus was 13.5%(27/200), with no significant difference between the ART and the control groups (18.9%vs. 11.6%, P=0.182 ) .Conclusion ART may not affect GWG , but it may cause changes of glucose metabo-lism during pregnancy .

Objective To evaluate the significance of tumor markers CEA and CA15-3,and biochemical markers of bone turnover (total procol]agen type Ⅰ amino-terminal propeptide (TP I NP),β-isomerized carboxyterminal propeptide (β-CTx),ALP and PTH) in the diagnosis of bone metastasis from breast cancer.Methods A total of 78 patients (all females) with mean age (56.72 ± 10.76) years,who were diagnosed with breast cancer,were included in this study.The patients were divided into two groups based on radionuclide bone imaging:with bone metastasis (n =32) and without bone metastasis (n =46).The serum concentrations of CEA,CA15-3,TP I NP,[β-CTx,PTH,ALP were measured.Gleason scores were evaluated.The diagnostic value was evaluated by ROC curve.The two groups were compared using two-sample t test.The correlations between bone metastasis and tumor markers,bone metastasis and biochemical markers of bone turnover were analyzed with Pearson correlation and logistic analysis.Results The serum levels of CEA,CA15-3,TPINP,β-CTx,PTH and ALP were significantly higher in the group with bone metastasis than those in the group without bone metastasis (t:4.16-7.56,all P ＜ 0.05).For the diagnosis of bone metastasis from breast cancer,the AUC of CEA,CA15-3,TPINP,[β-CTx,PTH and ALP was 0.815,0.887,0.869,0.852,0.844,0.731,respectively.Using the cut-off values of 4.18 μg/L for CEA,0.04 U/L for CA15-3,49.70 μg/L for TP I NP,0.47 pg/L for β-CTx,54.90 ng/L for PTH and 49.90 U/L for ALP,the sensitivities were 56.3％ (18/32),75.0％ (24/32),78.1％ (25/32),81.3％ (26/32),78.1％ (25/32),68.8％ (22/32) and the specificities were 80.4％ (37/46),84.8％ (39/46),76.1％ (35/46),78.3％ (36/46),69.6％ (32/46),58.7％ (27/46),respectively.CEA,CA15-3,TPINP,β-CTx,PTH,ALP and Gleason score were positively correlated with the presence of bone metastasis (r:0.267-0.636,all P ＜ 0.05).CEA,CA15-3,TP I NP,β-CTx,PTH and Gleason score were independent predictors for bone metastasis of breast cancer (odds ratios:2.45,3.44,1.24,1.54,1.11,2.22,all P ＜0.05).The total coincidence rate of regression model was 81.3％ (26/32) in patients with bone metastasis.Conclusions The diagnostic values of CEA,CA15-3,TP I NP,β-CTx and PTH are comparable.Combined use of these parameters may be helpful for the early diagnosis of bone metastasis from breast cancer.

Objective To approach the efficiency and feasibility of preserving the fertility for patients with placental site trophoblastic tumor ( PSTT ).Methods Totally 2 086 cases of gestational trophoblastic neoplasm ( GTN) patients registered in Peking Union Medical College Hospital between 1998 and 2013.Fifty-seven of them were PSTT patients , 40 cases of which suffered hysterectomy , the rest 17 PSTT patients who preserved their fertility were analyzed retrospectively.The computerized database of clinical and pathological reports was reviewed in this cohort.Results The clinical manifestation of PSTT was not specific compared to other types of GTN.The average age of the 17 patients was 29.5 years old (range 22-39 years).The most common antecedent pregnancy was term birth (8 cases), the others were spontaneous abortion in 4 case, artificial abortion in 3 cases and molar pregnancy in 2 cases.The baseline serum β-hCG was slightly elevated and 12 patients (12/15) were less than 1 000 U/L.In this cohort, nine of the patients were in stage Ⅰ, while the other eight cases were in stage Ⅲ .The patients suffered conservative surgery, including dilation and curettage of uterus in 7 cases, open abdomen uterine lesion excision in 4 cases, laparoscopic uterine lesion excision in 3 cases, hysteroscopic uterine lesion excision in 1 case, and pulmonary lobectomy in 2 cases.Two of the patients didn′t received chemotherapy , while the other 15 cases suffered combination chemotherapy.Compared with 40 patients who suffered hysterectomy during the same interval , fertility preservation group did not result in poor outcomes or high risk of relapse rate.Six subsequent pregnancies happened after the therapy , two of them were during their second-trimester, while four patients had healthy babies by vaginal delivery in two and cesarean section in two .The scar of the uterus was fairly well during the cesarean sections.Conclusions Reservation of fertility therapy could be considered in highly-selected patients for young women who strongly desired to preserve their fertility and with localized lesion.Exactitude follow-up after therapy should be recommended.Contraception should also be recommended for at least one year after the chemotherapy.Vaginal delivery could be an option for the future pregnancies.

Objectives To investigate the relationship between atherosclerotic acute myocardial infarction (AMI),acute cerebral infarction (ACI)and homocysteine (Hcy). Methods Three hundred and twenty consecutive patients with primary acute myocardial infarction (AMI)(group A)were admitted to the Department of Cardiology,310 patients with primary large artery atherosclerotic cerebral infarction (group B)were admitted to the Department of Neurology,and 327 healthy individuals without cardiovascular and cerebrovascular diseases (group C)at the Department of Physical Examination,Xuanwu Hospital, Capital Medical University were enrolled retrospectively from March 2010 to October 2011. The age and sex were matched in the 3 groups. All the clinical data of subjects were colleted in detail and then were compared and analyzed. Results (1)The Hcy levels (μmol/L)of group A,B,and C were 15. 10 (12. 43, 19.47),15. 80 (13. 10,20. 83),and 13. 20 (11. 00,16. 50;median [interquartile range]),respectively. There were significant differences among the 3 groups (P<0. 05). The incidences of hyperhomocysteinemia (HHcy)were 92. 8%(n=297),97. 1%(n=301),and 84. 7%(n=277)(P<0. 05). (2)Multivariate Logistic regression analysis showed that the independent risk factors for ACI were HHcy (OR 8. 97,95% CI 3. 01-26. 71),hypertension,diabetes,hyperlipidemia and blood ureanitrogen;the independent risk factors for AMI were HHcy (OR 4. 36,95% CI 1. 70-11. 21),hypertension,diabetes,hyperlipidemia,and total blood cholesterol. Conclusion HHcy is an independent factor for ACI and AMI,which have closer relationship with ACI. ACI and AMI have some common risk factors,but their degrees of action are different.

Objective To distinguish choriocarcinoma from gestational or non-gestational choriocarcinoma and also identify the causative pregnancy of gestational choriocarcinoma by the genetic origin through molecular genetic analysis. Methods Twelve patients with choriocarcinoma, who had experienced surgery prior to chemotherapy were enrolled in this study. All 12 cases were diagnosed pathologically as choriocarcinoma. Peripheral venous blood samples and formalin-fixed paraffin-embedded blocks of choriocarcinoma tissue microdissected from haematoxylin and eosin-stained sections of tissue by microdissection method were available from the patient and (or) her husband. DNA was then prepared from the couples' blood samples and choriocarcinoma tissue by using standard techniques. PCR amplification and fluorescent microsatellite genotyping were performed by using DNA from the couples and captured choriocarcinoma tissues. The genetic contributions to the choriocarcinoma tissue were determined by comparing the fragments of genes from the choriocarcinoma tissue to those from blood samples of the couples. Results The primary lesion was ovary in 7 cases, but only 4 of them had the maternal contribution, indicating a non-gestational origin; the other three were gestational choriocarcinoma. The primary lesion was uterus in 5 cases, which were all gestational choriocarcinoma confirmed by genetic analyses. The causative pregnancies of the 8 cases with gestational choriocarcinoma were identified as androgenetic complete hydatidiform mole (AnCHM) in six cases and normal pregnancies in two cases, respectively. Conclusion Microsatellite polymorphism analysis is a molecular approach for distinguishing the non-gestational choriocarcinoma from the gestational one, and also be used to identify the causative pregnancy of gestational choriocarcinoma.

Objective To investigate the changes of pulmonary capillary wedge pressure(PCWP) before and after off-pump coronary artery bypass graft(OPCABG) using transesophageal echocardiography(TEE). Methods Mitral valve flow(MVF) and pulmonary veinous flow(PVF) were measured in 46 patients before and after OPCAB using TEE and PCWP was detected by cardiac catheter. The correlations between indices derived from TEE and catheterization-measured PCWP and the differences before and after OPCAB were studied. Results There were obvious differences in the indices derived from TEE and PCWP which could reflect the left ventricular function. The most indices measured in PVF and MVF correlated with PCWP(r=(0.30)-(0.76),P

Objective To investigate the effects of different doses of alcohol on the synthesis of testosterone and the expression of androgen binding protein(ABP)mRNA in rat testis.Methods Forty male Wistar rats were randomly divided into 4 groups(10 rats each group)and received either distilled water(control group)or alcohol(alcohol-fed groups)for 5 months.Alcohol was administered by garage with a single daily dose : 5 g/kg(large dose group),2.5 g/kg(middle dose group)and 0.5 g/kg(small dose group).Testosterone content was measured by ELISA.mRNA levels of peripheral-type benzodiazepine receptors(PBR),PPARct and ABP were assayed by RT-PCR.Results Compared with control group:(1)ethanol feeding with daily doses of 5 g/kg,2.5 g/kg and 0.5 g/kg significantly decreased testosterone levels by 31.13%(P0.05)respectively,indicating that ethanol might impair testosterone synthesis;(2) mRNA levels of PBR were decreased in all three ethanol-treated groups(all P