A total of 127 type 2 diabetic patients were divided into low glycemic index meal replacements (intervention) group and standard food-based diet (reference) group in an experiment for 12 weeks.The results showed that fasting plasma glucose,postprandial 2 h plasma glucose,fasting insulin,and homeostasis model assessment insulin resistance(HOMA-IR) in the intervention group decreased significantly after 12 weeks trial ( P＜0.05 or P＜0.01 ).However,there were no significant changes in lipid profile and HbA1C in intervention group.In addition,percentage of body fatty,visceral fatty area,and waist-hip ratio also decreased in intervention group( all P＜0.01 ).Superoxide dismutase and glutathione levels increased significantly in intervention group by the end of trial (both P＜0.01 ),while malondialdehyde was decreased (P＜0.01 ).There were no significant changes in the aforementioned indices in the reference group.Weight,body mass index,and waist circumferences were decreased in both groups,but without significant difference between the two groups.

OBJECTIVETo investigate the clinical, endoscopic and pathological features in primary colorectal non-Hodgkin lymphoma.

METHODSTwenty-four cases of primary colorectal non-Hodgkin lymphoma were studied retrospectively.

RESULTSThe main clinical symptoms were abdominal pain, abdominal mass, loss of weight, fever, bloody stools and altered bowel habits. There were 6 cases (25.0%) involving two or more lesion sites, including three cases showing continuous skip-distribution from sigmoid colon to ascending colon, one case showing the homologous manifestation from rectum to cecum, one case involving ascending colon and rectum, and the last one involving sigmoid colon and rectum. There were 18 cases involving single lesion site and the caecum was the most frequently affected site (44.4%, 8 cases). The major endoscopic phenotypes were ulcer (39.1%), bossing (43.5%) and infiltrating (17.4%). The major pathology types were diffuse large B-cell lymphoma (11/24, 45.8%), intestinal T-cell lymphoma (8/24, 33.3%), and mucosa-associated lymphoid tissue lymphoma (MALT) (3/24, 12.5%). 2 of 24 cases (8.3%) were not decided. Twenty-one patients were treated surgically, containing fifteen radical excisions, one local excision, four palliative excisions and one exploratory laparotomy. Sixteen postoperative patients accepted CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) or COP (cyclophosphamide, vincristine, prednisone) chemotherapy, and three patients abandoned treatment. Twenty-one patients were followed up and the 5-year survival rate was 37.7%.

CONCLUSIONThe clinical features of primary colorectal non-Hodgkin's lymphoma have no specificity. Ulcer and bossing are the two major morphologic manifestations of endoscopic. Diffuse large B-cell lymphoma and intestinal T-cell lymphoma are the main pathological types. Comprehensive treatment of surgery and chemotherapy are effective methods for primary colorectal non-Hodgkin lymphoma.

Adult ; Aged ; Biopsy ; Colorectal Neoplasms ; diagnosis ; pathology ; Endoscopy ; Female ; Follow-Up Studies ; Humans ; Lymphoma, Non-Hodgkin ; diagnosis ; pathology ; Lymphoma, T-Cell ; diagnosis ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Retrospective Studies ; Young Adult

Health self-management group adopts the mode of chronic disease self-management and offers a series of courses for community residents in order to help them carry out health self-management. For healthy people, the program aims at disease prevention by means of improving health literacy, acquiring health knowledge and skills, and developing a healthy lifestyle.While for patients, the program aims to prevent or slow the progression of diseases by means of helping them deal with their condition, achieving disease self-management. By nearly ten years of exploration and practice in Shanghai communities, with the program a working system had been established which was dominated by patriotic health campaign committee office at the levels of city and district, and technologically supported by centers for disease control and prevention with support and cooperation of the town government.The program was implemented by community health service centers and neighborhood ( village ) committee.A large-scale and whole-society promotion had been really achieved in community residents with health self-management. By the end of 2015, health self-management groups had covered all of the city's streets ( town ) and neighborhood ( village ) committee, 26 thousand groups set up and nearly 440 thousand community residents participated in group activities.

Objective:To retrospectively analyze the correlation between blood lipoprotein levels and the risk of osteoporosis (OP) development in postmenopausal patients with RA and its influencing factors.Methods:Patients hospitalized with a definite diagnosis of RA from July 2017 to May 2020 were retrospectively collected and analyzed by bone mineral density (BMD) in subgroups, using correlation analysis, di-chotomous Logistic regression to quantify independent associations between laboratory test results and out-comes, and restrictive cubic spline (RCS) to fit the relationship of OP risk occurrence.Results:Six hundred and sixty-six eligible RA patients were included according to inclusion criteria, including 253 RA-OP and 413 RA-non-OP patients. After exclusion of relevant influencing factors by comparing demographic characteristics, a significant correlation was found between blood HDL-C ( r=-0.11, P=0.006) LDL-C ( r=0.12, P=0.003) levels and RA-OP( P<0.05), and dichotomous Logistic regression showed that as BMI ( OR(95% CI)=0.81(0.77, 0.86), P<0.001], calcium [ OR(95% CI)=0.24(0.10, 0.63), P<0.001], HDL-C[ OR(95% CI)=0.38(0.22, 0.66), P<0.001] increased, the risk of developing OP in RA patients decreased. In contrast, the risk of developing OP increased with increasing age [ OR(95% CI)=1.10(1.07, 1.21), P<0.001), disease duration [ OR(95% CI)=1.00(1.00, 1.00), P=0.020], and LDL-C[ OR(95% CI)=1.71(1.38, 2.12), P<0.001]. Conclusion:Blood HDL-C and LDL-C levels are significantly correlated with the development of RA-OP, and can be used as predictors of OP development and good indicators for disease monitoring in RA patients.

OBJECTIVETo explore the expressions of P33ING1, P53 and their relationships with apoptosis in anal canal carcinoma (ACC).

METHODSThe expressions of P33ING1, P53 proteins were measured by immunohistochemistry method (SP method), and apoptosis was detected in 42 cases with ACC, 36 cases with anal canal adenoma (ACA) or anal canal papilloma (ACP), and 40 cases with paraanal inflammatory mass(PAIM).

RESULTSThe positive expression rates of P33ING1 and P53 proteins were 40.5% (17/42), 97.2% (35/36) and 97.5% (39/40), 50.0% (21/42), 22.2% (8/36) and 27.5% (11/40) respectively, and the average apoptosis indexes(AI) were (10.27+/- 1.23) per thousand, (42.75+/- 0.98) per thousand and (42.67+/- 1.04) per thousand respectively in ACC, ACA or ACP and PAIM. There were significant differences in the positive expression rates of P33ING1, P53 and apoptosis index between ACC and the other two groups respectively (P< 0.05). Among 21 cases of ACC with positive expression of P53 protein,there were 18 cases with P33ING1 negative expression.

CONCLUSIONSP33ING1 expression decrease in ACC, which may play an important role in the carcinogenesis and progression of ACC. P33ING1 and P53 may have an synergistic effect of suppressing cell growth and accelerating cell apoptosis.

Adult ; Aged ; Aged, 80 and over ; Anus Neoplasms ; metabolism ; pathology ; Apoptosis ; Carcinoma ; metabolism ; pathology ; Female ; Humans ; Immunohistochemistry ; Inhibitor of Growth Protein 1 ; Intracellular Signaling Peptides and Proteins ; metabolism ; Male ; Middle Aged ; Neoplasm Staging ; Nuclear Proteins ; metabolism ; Tumor Suppressor Protein p53 ; metabolism ; Tumor Suppressor Proteins ; metabolism

OBJECTIVETo study the clinical characters, treatment modalities and prognosis of patients with maxillary squamous cell carcinoma.

METHODSThe clinical data of 60 patients with maxillary squamous cell carcinoma treatment between January 1994 and December 2004 were analyzed retrospectively. The patients were treated with three therapy modalities including radiotherapy alone (22 cases), radiotherapy and surgery (R + S, 29 cases) and concurrent chemo-radio-therapy adjuvant surgery (CCR + S, 9 cases).

RESULTSThe five year survival rate were 18.2%, 51.7% and 33.3% for patients in the radiotherapy alone group, the R + S group and the CCR + S group, respectively. Patients receiving R + S combined modality therapy had a significantly higher five year survival rate than the patients who were treated radiotherapy alone (χ(2) = 15.62, P < 0.01). The five year survival rate (51.7%) of patients in R + S group was significantly higher than that (33.3%) of patients in CCR + S group (χ(2) = 4.28, P < 0.05), and also higher than that (18.2%) of patients in radiotherapy group (χ(2) = 9.49, P < 0.01).

CONCLUSIONSThe combined therapy of radiation and surgery was a good choice of treatment for the patients with maxillary sinus squamous cell carcinoma. The role of concurrent chemo-radiotherapy adjuvant surgery in the treatment of maxillary sinus squamous cell carcinoma needs further to research.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; diagnosis ; therapy ; Combined Modality Therapy ; Female ; Humans ; Lymphatic Metastasis ; Male ; Maxillary Sinus Neoplasms ; diagnosis ; therapy ; Middle Aged ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Young Adult

OBJECTIVETo evaluate the treatment outcome of different therapeutic modalities for squamous cell carcinoma of the nose and ethmoid sinus and prognostic factors.

METHODSOne hundred and forty-six cases of squamous cell carcinoma of the nose and ethmoid sinus treated from 1990 to 2007 were reviewed. Of the 146 cases, 28 were at stage I or II; 46 stage III; 72 stage IV. Forty-one patients were treated with preoperative radiation plus surgery (R + S), 22 patients with surgery plus postoperative radiation (S + R), 5 patients with surgery alone (SA), 78 patients with radiotherapy alone (RA).

RESULTSThe overall 5 year survival rate of 146 patients with squamous cell carcinoma of the nose and ethmoid sinus was 49.1%. The 5 year survival rate of the patients at stage I and II was 95.7%, while the rate was 59.8% in the patients at stage III and 28.2% in the patients at stage IV (χ(2) = 24.15, P < 0.05). The 5 year survival rate was 57.7% in R + S group, 60.4% in S + R group, 100% in SA group, and 38.8% in RA group, respectively (P > 0.05). The 5 years survival rate of N+ patients was lower than that of N0 (χ(2) = 12.326, P < 0.05). Local recurrence and distant metastasis were main causes of death. Cox analysis showed TNM stage and differentiation of tumor were independent significant prognostic factors.

CONCLUSIONSThe higher survival rate of patients with squamous cell carcinoma of the nose and ethmoid sinus was obtained from combined therapy R + S or S + R. SA gave ideal results for early lesions (stage I and II).

Adolescent ; Adult ; Aged ; Carcinoma, Squamous Cell ; pathology ; therapy ; Child ; Ethmoid Sinus ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Paranasal Sinus Neoplasms ; pathology ; therapy ; Prognosis ; Young Adult

OBJECTIVETo summarize the clinicopathological characteristics of primary anorectal malignant melanoma (AMM).

METHODSClinical data of nine patients with AMM were reviewed retrospectively from January 1999 to March 2005.

RESULTSAnorectal malignant melanoma had a female predominance. The average age was 56 years old and average course of disease was 5.8 months. The onset of symptom was hematochezia, then anus prolapses. 94.7% of patients had AMM within 5 cm from anus margin; the average tumor size was (3.3+/- 2.1) cm. The polyp and ulcer were most common types. More than a half (54.5%) of the tumor was movable, 19.1% smooth surfaced, 6.6% soft textured. Synchronous metastasis was found in 14.0% of the patients, the first common metastasis was found in liver, the secondary was superficial inguinal lymph node metastasis. Half of the patients were misdiagnosed,and over 50% of patients were misdiagnosed as benign disease. Mile's operation was performed in most of patients (63%), while anal resection was performed in 30% of the patients.

CONCLUSIONSAnorectal malignant melanoma is often misdiagnosed,surgical procedure is the first choice for patients with AMM.

Adult ; Aged ; Aged, 80 and over ; Anus Neoplasms ; diagnosis ; pathology ; surgery ; Female ; Humans ; Male ; Melanoma ; diagnosis ; pathology ; surgery ; Middle Aged ; Rectal Neoplasms ; diagnosis ; pathology ; surgery ; Retrospective Studies

OBJECTIVETo study the clinical characteristics, the surgical treatments and the prognostic factors of medullary thyroid carcinoma.

METHODSEighty-two cases of medullary thyroid carcinoma undergoing surgeries between January 1999 and December 2004 were reviewed. There were 39 males and 43 females. Age ranged from 16 to 77 years old, with a median of 46 years old. The calcitonin, chromogranin A and neuron-specific enolase were analysed by immunohistochemistry in samples, and calcitonin was detected in 24 cases. Of them, 28 cases underwent lobectomy with isthmectomy, 24 for remained lobe dissection, 16 for total thyroidectomy, and 14 only for neck and upper mediastinal lymph node dissection. Of the 82 cases, 68 cases underwent trachea esophageal ditch dissection, 53 for unilateral neck dissection, 11 for bilateral neck dissection, 13 for upper mediastinal lymph node dissection through trans-cervical approach, and 5 for mediastinal lymph node dissection through inverted T-shaped incision.

RESULTSImmunohistochemical examination revealed that the expression rates of calcitonin, chromogranin A and neuron-specific enolase were 95.8%, 88.9% and 80.0% respectively. Total metastasis rate of neck lymph nodes was 68.8%, and the rates in level II, III, IV, V and VI were 27.3%, 47.7%, 59.1%, 11.4% and 52.3% respectively. The overall five-year survival rate was 87.8%. The recurrent rate of contralateral lobes was 5.8% and local recurrent rate was 7.3% respectively. Univariate analysis showed that gender, age and TNM stage were significant prognostic factors. Multivariate analysis revealed that distant metastasis was an independent prognostic factor.

CONCLUSIONSStandard radical surgery of the primary and metastatic lesion is key to the treatment of medullary thyroid carcinoma. Lobectomy with isthmectomy should be applied to sporadic medullary thyroid carcinoma, with regular postoperative follow-up, and total thyroidectomy to familial or bilateral medullary thyroid carcinoma. Therefore, detecting the calcitonin is very important for medullary thyroid carcinoma patients' prognosis.

Adolescent ; Adult ; Aged ; Calcitonin ; metabolism ; Carcinoma, Neuroendocrine ; Chromogranin A ; metabolism ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Phosphopyruvate Hydratase ; metabolism ; Prognosis ; Retrospective Studies ; Survival Rate ; Thyroid Neoplasms ; diagnosis ; surgery ; Young Adult

OBJECTIVETo evaluate the role of parathyroid hormone (PTH) and serum calcium in prediction for hypocalcaemia after total thyroidectomy.

METHODSOne hundred and sixty-five patients undergoing total or complete total thyroidectomy were reviewed retrospectively. The indications included bilateral carcinoma, undifferential carcinoma, surroundings invasion, distant metastasis and huge benign lesions. Preoperative and postoperative PTH, calcium concentrations and their decline levels were compared between Jan. 2005 and May 2009. The role of PTH value and decline level predicting for symptomatic hypocalcaemia were analyzed by receiver operator characteristics (ROC) curve.

RESULTSAfter total thyroidectomy, 85 patients (51.5%) developed hypocalcemia. Symptoms were reported by 36 patients (21.8%). The mean concentration of PTH for normocalcaemia (80 cases), asymptomatic hypocalcaemia (49 cases) and symptomatic patients (36 cases) were 31.0 ng/L, 19.6 ng/L and 11.9 ng/L, respectively. The mean decline level for the three groups were 28.6%, 52.6% and 78.0%, respectively. PTH value and its decline level had a poor predicting value for symptomatic hypocalcaemia and high negative predicting value for asymptomatic patients. The serum calcium concentration more than 2.0 mmol/L, PTH level higher than 15 ng/L and PTH decline less than 50% had the good negative predicting value of 97.6%, 90.3% and 96.5%, respectively.

CONCLUSIONSPostoperative PTH and its decline level were significantly correlated with postoperative serum calcium concentration but had a low accuracy for predicting symptomatic hypocalcaemia. The serum calcium concentration more than 2.0 mmol/L, PTH level higher than 15 ng/L and PTH decline less than 50% had the good predicting value for asymptomatic patients. Calcium should be routinely supplemented in the first 24 h after total thyroidectomy to reduce the rate of hypocalcemia and the severity of hypocalcemia symptoms.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Calcium ; blood ; Child ; Female ; Humans ; Hypocalcemia ; blood ; diagnosis ; Male ; Middle Aged ; Parathyroid Hormone ; analysis ; Postoperative Period ; Retrospective Studies ; Thyroid Neoplasms ; surgery ; Thyroidectomy ; adverse effects ; Young Adult