Diabetes, hypertension, and dyslipidemia, collectively referred to the " Three Highs, " represent increasingly prevalent metabolic risk factors in China. Many individuals experience all three conditions concurrently, significantly heightening the risk of cardiovascular disease and mortality. Although the National Metabolic Management Center(MMC) has been established for over eight years and has its unique features, the awareness, treatment, and control rates of these diseases in China remain low, and the efficiency of community management is insufficient. According to the previous two editions of management guidelines and the most recent domestic and international diagnostic and treatment guidelines, this paper conducts an in-depth analysis of the operational experience and management strategies of the MMC. Its aim is to improve the efficiency of grassroots MMC mode management for " Three Highs" patients and ensure that patients receive more standardized management.

Diabetes, hypertension, and dyslipidemia, collectively referred to the " Three Highs, " represent increasingly prevalent metabolic risk factors in China. Many individuals experience all three conditions concurrently, significantly heightening the risk of cardiovascular disease and mortality. Although the National Metabolic Management Center(MMC) has been established for over eight years and has its unique features, the awareness, treatment, and control rates of these diseases in China remain low, and the efficiency of community management is insufficient. According to the previous two editions of management guidelines and the most recent domestic and international diagnostic and treatment guidelines, this paper conducts an in-depth analysis of the operational experience and management strategies of the MMC. Its aim is to improve the efficiency of grassroots MMC mode management for " Three Highs" patients and ensure that patients receive more standardized management.

The latest epidemiological data suggests that the situation of adult diabetes in China is severe, and metabolic diseases have become significant chronic illnesses that have a serious impact on public health and social development. After more than six years of practice, the National Metabolic Management Center(MMC) has developed distinctive approaches to manage metabolic patients and has achieved a series of positive outcomes, continuously advancing the standardized diagnosis and treatment model. In order to further improve the efficiency, based on the first edition, the second edition guideline was composed by incorporating experience of the past six years in conjunction with the latest international and domestic guidelines.

Five patients with mediastinal bronchogenic cyst (MBC) were treated with endoscopic submucosal tunnel dissection (ESTD) between January 2018 and October 2019 at the Department of Gastroenterology in Henan Provincial People′s Hospital. Lesions were located in the middle or lower esophageal level, with diameters≤3.5 cm. The tunnel establishment time was 13-18 min, and the tumor stripping time was 30-51 min. The number of titanium clips used for tunnel closure was 5-8. The tumors were completely resected. No major bleeding or hypoxemia occurred during the operation and no serious adverse reactions occurred after the operation. Postoperative pain scores were all ≤3. The hospital stay was 4-7 days. There was no tumor residue and recurrence during 4-23 months of follow-up.It is suggested that ESTD for MBC which derived from post mediastinum and located at the lower or middle level esophagus is safe and effective.

Objective To investigate the effects of submucosal resection by guidance under esophageal endoscopic ultrasound. Methods 79 cases ofsuspected upper gastrointestinal submucosal tumors were found by endoscopic ultrasonography,transesophageal endoscopic ultra-sound showed lesions under muscularis mucosa,after informed consent,they were underwent endoscopic mucosal resection. Pathological diag-nose of the lesions were found out after resection. Results Compared with pathological results showed that endoscopic ultrasound accurately determine tumor location in the hierarchy;through endoscopic mucosal resection to remove all lesions,5 patients were found bleeding postop-erative,6 patients were found esophageal stricture,the prognosis was good after treatment. Conclusion Endoscopic ultrasonography can accu-rately determine submucosal myoma,it can be used to guide resection of submucosal myoma.

OBJECTIVETo evaluate the efficacy and safety of autologous cytokine-induced killer (CIK) cell t combined with XELOX regimen in treatment of senile advanced gastric cancer.

METHODSForty-six cases of senile advanced gastric cancer patients with a mean age of 70 years were prospectively divided into two groups according to individual acceptance of CIK cells: 25 patients receiving autologous CIK cell treatment combined with XELOX regimen (trial group) and 21 patients receiving simple chemotherapy (control group). Patients in CIK group were matched to those in control group by sex, ages, KPS ranking scores, histological type, pathological grade, and clinical stage. Immune reaction, adverse reaction, time to progression (TTP) and overall survival (OS) were evaluated.

RESULTSHost immune function was increased (P<0.05) and the adverse reaction was decreased in patients of trial group as compared to control group. There were no significant differences in response rate (RR)(33.3% vs. 23.1%, P>0.05), disease control rate (DCR)(86.7% vs. 80.8%, P>0.05) between the two groups. TTP (4.8 months vs. 3.1 months, P<0.05) and OS (7.1 months vs. 5.9 months, P<0.05) in trial group were significantly improved as compared to control group.

CONCLUSIONAutologous CIK cells combined with XELOX regimen can increase immune function, improve clinical efficacy, decrease adverse reaction and prolong OS for senile patients with advanced gastric cancers.

Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cytokine-Induced Killer Cells ; immunology ; Deoxycytidine ; analogs & derivatives ; Fluorouracil ; analogs & derivatives ; Humans ; Immunotherapy, Adoptive ; Prospective Studies ; Stomach Neoplasms ; immunology ; therapy

ObjectiveTo evaluate the accuracy of the modalities in revealing the results by observing the radiofrequency ablated (RFA) lesions with contrast-enhanced ultrasonography (CEUS),magnetic resonance image (MRI) in comparison with histopathologic findings in normal rabbit kidney.Methods RFA was performed in the left kidneys of 10 rabbits.The ablated lesions were observed with conventional ultrasound(US),CEUS,MRI at 1 day,1 week after RFA.Then the rabbits subjected to postmortem and the kidney specimens were excised,stained and processed for conventional histologic study.The maximum lesion size as measured on US,CEUS and MRI was then correlated with the histopathologically determined lesion size.The utility of different imaging modalities were evaluated.ResultsIn a relatively short time (at 1 day and 1 week),CEUS and MRI may reveal the location,shape and extent of ablated lesion.And the lesion sizes with CEUS,MRI and kidney specimens were well correlated (P＞0.05).ConclusionsBoth CEUS and MRI are suitable for the accurate evaluation of the ablated lesions in the short time.CEUS can reveal the variation of flow perfusion in the ablated lesion dynamicly and in real time.

Objective To describe the characteristic endoscopic ultrasonography (EUS) features of gastric ectopic pancreas.Methods Totally 23 patients were diagnosed pathologically as having gastric ectopic pancreas.The EUS images of the lesions were retrospectively reviewed regarding layer of origin,size,growth pattern,margin,and internal echo pattern.Results The coincidence of EUS and pathologic diagnosis was 91%(21/23).EUS revealed that the lesions originated from the second,third,and/or fourth layers of the gastric wall.Most lesions were heterogenous,mainly isoechoic.The borders of the lesions were indistinct in 70%(16/23) patients. Anechoic cystic or tubular structures within the lesions appeared in 10 of the 23 lesions(43%).The mean longest/shortest diameter ratio of ectopic pancreas was 1.7.Conclusions Characteristic EUS features of gastric ectopic pancreases include:mural lateral growth pattern,third layer (submucosa) origin,indistinct margin,intermediate echogenecity,anechoic areas,and fourth-layer thickening.Careful assessment of the EUS findings may be a useful aid in the diagnosis of gastric ectopic pancreas.

Objective To afford an new effective imaging technique for the morphological observation of the normal male pelvic floor by observing the normal male puborectalis with transrectal ultrasound and magnetic resonance imaging (MRI). Methods Thirty-six normal males were examined by transrectal ultrasound and MRI,data of puborectalis were recorded and compared including starting point, end point,appearance, structure, thickness and the relationship with peripheral organs. Results The results including the appearance,direction and internal echo of puborectalis and the relationship with peripheral organs can be clearly displayed by transrectal ultrasound compared with MRI. The thickness of right and left puborectalis at rest measured in ultrasound and in MRI were (6.22±0.57)mm, (6.19±0.59) mm, (6.20±0.61) mm and (6.17±0.53) mm, respectively. The thickness by two methods and two sides had no significant differences (P>0.05). The thickness of puborectalis measured by two methods did not correlate with age,height,body weight,the volume of prostate and interspinal diameter respectively. Conclusions Transrectal ultrasound is a new imaging method to observe male puborectalis. Identification for nomal puborectalis sonography is the foundation of diagnosis pelvic floor disease.