Objective To investigate the prevalence and associated risk factors of diabetes and prediabetes in Blang ethnic adults in Menghai county. Methods A cross-sectional survey including 3 365 Blang ethnic adults (aged 18 and above from 5 administrative villages) was conducted from February 2017 to March 2017 in Menghai county. A questionnaire, physical examination, and blood assays were included in the survey. Finally,a total of 3 237 adults with complete data were selected into this analysis. Results The standardized prevalence of diabetes and prediabetes in Blang ethnic adults were estimated based on the sixth national census in 2010. According to the 1999 WHO criteria, the overall standardized prevalence of diabetes and prediabetes were 8.5% (men: 10.2%, women: 6.8%) and 16.1% (men: 18.0%, women: 14.1%), in which the standardized prevalence of newly diagnosed diabetes among the total population was 7.3% (men: 8.7%, women: 5.8%). Multivariable multinominal logistic regression analyses showed that age, hypertension, hypertriglyceridemia, and central obesity were significantly positively associated with both diabetes and prediabetes, with the corresponding odds ratios of 1.74 and 1.37, 2.39 and 2.02, 2.30 and 1.34, 2.55 and 1.73, respectively. Conclusion The prevalence of diabetes is relatively high in Blang ethnic adults in Menghai county. Improving knowledge of diabetes among the local population is one of key steps in the prevention of diabetes.

OBJECTIVE: To analyze the detection rate of the inferior pyloric artery (IPA) in patients with gastric cancer by computed tomography arteriography (CTA). MATERIALS AND METHODS: Fifty-four patients (48 males and 6 females; mean age, 59.0 ± 1.5 years) who had undergone radical gastrectomy for gastric cancer from September 2016 to July 2017 at our institution were recruited prospectively. Patients underwent abdominal contrast-enhanced CT scans and CTA imaging reconstruction before the operation. The origin of the IPA in all cases was determined by a radiologist based on CTA images and verified by the surgeon. The accuracy of CTA in diagnosing the origin of the IPA was calculated. Dominant vessels of the origin were analyzed. RESULTS: IPAs were detected by CTA in 51 patients (94.4%). Among these, IPAs originated from the right gastroepiploic artery (RGEA) (24 cases), the gastroduodenal artery (GDA) (4 cases), and the anterior superior pancreaticoduodenal artery (ASPDA) (20 cases). In the remaining 3 cases, the IPAs contained two branches originating from the RGEA and ASPDA, respectively. During surgery, in 2 (3.7%) of the 54 cases of gastric cancer, IPAs could not be detected; the IPAs originated from the RGEA (22 cases), GDA (5 cases), and ASPDA (24 cases). One case had an IPA originating from both the RGEA and the GDA. Finally, the accuracy of CTA in diagnosing the origin artery of the IPA was 85.2% (46/54). CONCLUSION: CTA can detect the origin of the IPA accurately, which can aid surgeons while performing pylorus-preserving operations.
Angiography ; Arteries ; Female ; Gastrectomy ; Gastroepiploic Artery ; Humans ; Male ; Prospective Studies ; Stomach Neoplasms ; Surgeons ; Tomography, X-Ray Computed

Purpose To investigate the role of MYB in adenoid cystic carcinoma (ACC) of different origins and grades.Methods A total of 103 specimens of salivary gland tumors with complete pathologic data were collected from the Department of Pathology, Affiliated Hospital of Inner Mongolia Medical University. 64 cases of ACC of the salivary gland, which included 19 cases of grade I, 27 cases of grade Ⅱ, and 18 cases of grade Ⅲ were selected as experimental group. 7 cases of exrras-alivary ACC and 32 cases of non-ACC benign and malignant tumor of salivary gland were served as control group. The MYB protein expression was detected by MYB immunohistochemical En Vision two-step staining for both experimental and control group. Results The positive expression rates of MYB in 64 cases of salivary ACC and 7 cases of extrasalivary ACC were 54.69％ (35/64) and 57.14％ (4/7), respectively, with no statistically significant difference (P> 0.05). The positive expression rates of MYB in 64 cases of salivary ACC and 32 cases of non-ACC salivary benign and malignant tumors were 54.69％ (35/64) and 6.25％ (2/32), respectively, which showed statistically significant difference (P < 0.05). The positive expression rates of MYB were 68.42％ (13/19), 66.67％ (18/27) and 14.29％ (4/18) in 64 cases of salivary ACC Ⅰ, Ⅱ and Ⅲ, respectively, and the difference was significant (P <0.05). The difference between grade Ⅰ and Ⅱ was not statistically significant (P> 0.016 7), while compared with grade Ⅲ, there was a statistical increase of positive expression rate of MYB in both grade Ⅰ and Ⅱ (P < 0.016 7). Conclusion MYB is highly expressed in grade I and Ⅱ of the salivary ACC and low expressed in grade Ⅲ. It is speculated that there may be other fusion gene mutation in salivary ACC grade Ⅲ. MYB is lowly expressed in non-ACC benign and malignant tumors of salivary gland, suggesting that MYB protein expression has a certain diagnostic value for the diagnosis of salivary ACC.

Objective To investigate the clinical diagnostic value of circulating tumor cells (CTCs)and circulating cell-free DNA (cfDNA) in peripheral blood samples in breast cancer. Methods From July 2017 to April 2018, 47 patients with BMC (7 in stage Ⅱ, 19 in stage Ⅲ and 21 in stage Ⅳ), 24 patients with benign breast diseases and 28 healthy people were selected. After collecting peripheral blood samples, serum and blood cells were separated. The size-based high-throughput microfluidic chip was used to capture CTCs. The real-time fluorescent quantitative PCR based on Alu sequence was used to detect the length of cfDNA(247 bp, 115 bp)in the serum, and the ratio of amplified products of long and short fragments was used as the index of DNA integrity. The Mann-Whitney U test or Kruskal-Wallis H test was used to compare the differences between the groups and analyze the relationship between CTCs and cfDNA and clinical parameters of breast cancer. The ROC curve was drawn and the area under the curve (AUC) was used to evaluate the feasibility of blood cell CTCs and plasma cfDNA detection as diagnostic criteria. Results The CTCs and cfDNA of 47 BMC patients were analyzed. The CTCs and cfDNA integrity index (Alu 247/115) of BMC patients were significantly higher than those of physical examination patients[(13.98± 12.36)cells / ml vs (1.14 ± 1.35) cells / ml; 0.7687 ± 0.3868 vs 0.5094 ± 0.2456], and the difference was statistically significant(the U value was 126.5,359.0;P<0.001), the area under ROC curve of CTCs was 0.885 (95％CI: 0.805-0.965), cut-off value was 7.68/ml, sensitivity was 80.4％, specificity was 96.4％. The area under ROC curve of Alu 247/115 was 0.727(95％CI: 0.608-0.847), cut-off value was 0.431, sensitivity was 71.7％, specificity was 71.4％. The AUC of CTCs and Alu 247/115 was 0.919 (95％CI 0.854-0.984), which was higher than the single test of each indicator. Conclusions CTCs and cfDNA may be the potential biological indicators for breast cancer diagnosis. The combined detection of CTCs and cfDNA maybe improve the diagnosis rate of breast cancer patients.

Objective To analyze the risk factors and pathogen distribution of nosocomial infection in adult patients undergoing extracorporeal membrane oxygenation (ECMO) after cardiac surgery.Methods The clinical data of 325 patients who underwent ECMO support in the Department of Adult Cardiac Surgery of Beijing Anzhen Hospital from January 2012 to December 2017 were retrospectively analyzed.There were 132 patients with nosocomial infection (infected group) and 193 patients without nosocomial infection (noninfected group).Multivariate logistic analysis was used to analyze the risk factors of nosocomial infection,and the distribution of pathogens in infected patients was also analyzed.Results Among 132 infected patients,67 cases (50.76％) had respiratory infection,40 cases (30.30％) had blood infection,15 cases (11.36％) had surgical wound infection,and 10 cases (7.58％) had urinary tract infection.The case fatality rates of the infected group and non-infected group were 61.37％ (81/132) and 52.85％ (102/ 193),respectively (x2 =6.356,P ＜ 0.05).Univariate analysis showed that long operation time,application of extracorporeal circulation and long-term ECMO support were associated with nosocomial infection.Multivariate logistic regression analysis found that ECMO time (OR =5.565,95％ CI =2.868-10.799,P ＜0.01) was an independent risk factor for nosocomial infection after ECMO treatment in adult patients after cardiac surgery.Among the 132 infected patients,364 strains of pathogens were detected,of which 233 were Gram-negative bacteria,including 79 strains of Acinetobacter Baumann (33.9％) and 32 strains of K.pneumoniae (13.73％);101 strains were Gram-positive bacteria,including Streptococcus aureus (14.85％),Micrococcus (14.85％) and catarrhal bacteria (14.85％);30 strains were fungi and Candida albicans accounted for 70％ of fungi infections.Conclusion The long ECMO support time is an independent risk factor for ECMO-related hospital infections in adult patients undergoing cardiac surgery,and the pathogens are mainly Gram-negative bacteria.

Objective To investigate the protective effect and mechanism of active vitamin D3 on podocyte injury in type 1 diabetic rats.Methods Animals were randomly divided into normal control group (NC group),diabetic nephropathy group (DN group),diabetes nephropathy plus active vitamin D3 group (DN + VD group).Random tail vein blood glucose was measured and 24 hours of urine was collected every 3 weeks to observe the dynamic changes of blood glucose and 24-hour urine volume and urinary albumin.Rats were sacrificed at the end of 18th week,the kidney weight to body weight ratio,serum creatinine,blood urea nitrogen,serum calcium,and serum phosphorus levels were measured.Pathological in glomeruli were observed by PAS staining.Immunohistochemistry and Western blotting were used to observe the expression of slit diaphragms proteins including Nephrin,Podocin,and vitamin D receptor protein VDR.The mRNA level of autophagy-related protein P62 was detected by realtime quantitative PCR,and expression of autophagy-related protein including LC3B/A,Beclin1,and P62 were detected by Western blotting.Ultrastructure of podocytes and autopbagosomes in podocytes were observed by electron microscopy.Results Levels of serum creatinine,blood urea nitrogen,and blood glucose in diabetic rats were higher than those in NC group (P＜0.05),but without significant difference between DN and DN+VD groups (P＞0.05).Compared with the DN group,the urinary protein and kidney weight to body weight ratio in the DN +VD group were significantly lower (P＜ 0.05).Mesangial matrix hyperplasia and basement membrane thickening were improved,and podocyte fusion and shedding were partially reversed.The expressions of Nephrin,Podocin,VDR,LC3B/A and Beclin1 were increased,and P62 mRNA and protein were down-regulated (P ＜ 0.05).The number of autophagosomes in podocytes increased.Besides,positive correlations were found between Nephrin and Beclin 1 (r =0.939 8,P＜0.05),as well as Nephrin and VDR (r=0.948 3,P＜0.05),and Beclin1 andVDR (r=0.9093,P＜0.05).Conclusion Active vitamin D3 inhibits the injury of diabetic nephropathy podocytes by up-regulating VDR expression and enhancing autophagy activity,thereby reducing proteinuria and delaying the development of diabetic nephropathy.

BACKGROUND: Type l diabetes mellitus is a T cell-mediated autoimmune disease resulting in pancreatic islet cell damage. In this study, immunotherapy was used to deal with type l diabetes mellitus and stem cell transplantation was used to repair damaged islet p cells, attempting to explore a new treatment for type l diabetes mellitus. OBJECTIVE: To observe the efficacy of human umbilical cord mesenchymal stem cells combined with immunotherapy for the treatment of type l diabetic mice. METHODS: Fifty BALB/c Foxp3-DTR-EGFP positive mice were selected, six of which were randomly selected as normal control group and the remaining of which were intraperitoneally injected with streptozotocin and diphtheria toxin to prepare an animal model of type l diabetes mellitus. After successful modeling, randomization was performed in model mice and there were four groups: model group (normal saline), immunotherapy group (subcutaneous injection of dexamethasone (10 μg) and insulin (10 μg) mixture), cell transplantation group (injection of human umbilical cord mesenchymal stem cells (1 X106 cells per mouse) through the tail vein, and combined treatment group (the combination of immunotherapy and cell transplantation as described above). At 4 weeks after treatment, changes in blood glucose, C-peptide, body mass, pancreatic histopathology and insulin-positive area were observed in each group. RESULTS AND CONCLUSION: (1) Compared with the normal control group, the blood glucose level of the model group increased (P < 0.01) the C peptide level and body mass decreased (P < 0.01), and the islet was severely atrophied, with decreased number of islet cells and reduced insulin-positive area. (2) Compared with the model group, the blood glucose level of the immunotherapy group decreased (P > 0.05), the C-peptide level and body mass did not change significantly (P > 0.05), the islet cells increased in number, and the insulin-positive area increased. (3) Compared with the model group, the blood glucose level of the cell transplantation group and the combined treatment group decreased (P > 0.05), the C peptide level and body mass increased (P < 0.05), the islet cells increased in number, and the insulin-positive area increased. These findings reveal that either human umbilical cord mesenchymal stem cells or immunotherapy can improve the islet function of type l diabetic mice, and the combination treatment has better outcomes.

Objective To investigate the relationship of lymph node metastasis rate (LNR) with prognosis of esophageal squamous cell carcinoma after radical resection and postoperative adjuvant chemotherapy.Methods The retrospective case-control study was conducted.The clinicopathological data of 121 patients who underwent radical resection of esophageal squamous cell carcinoma in the Peking University Cancer Hospital from January 2012 to September 2016 were collected.There were 105 males and 16 females,aged from 42 to 76 years,with a median age of 58 years.All patients underwent radical resection of esophageal cancer with at least two-field lymph nodes dissection.Some patients underwent corresponding chemotherapy and radiotherapy.The thoracic and abdominal lymph nodes were grouped according to the 7th edition standard of Americau Joint Committee on Cancer (AJCC).The lymph nodes dissected were labeled in groups,and all the lymph nodes were examined by pathology test.Observation indicators:(1) follow-up;(2) effects of LNR on prognosis of patients in different AJCC N staging;(3) relationship between LNR and postoperative adjuvant chemotherapy.Follow-up was conducted by outpatient examination,telephone interview and hospital statistical office to detect postoperative survival of patients up to February 2017.The disease-free survival time was from surgery date to date of confirmation of tumor recurrence,and the overall survival time was from surgery date to death of the patient or the last follow-up date.Measurement data with skewed distribution were expressed by M (range).The Kaplan-Meier method was used to calculate the survival rate and draw the survival curve.The Log-rank test was used for survival analysis.Results (1) Follow-up:121 patients were followed up for 3.0-94.2 months,with a median follow-up time of 27.1 months.During the follow-up,98 of 121 patients had tumor recurrence and metastasis (including 64 deaths),22 had no metastasis,and 1 had unknown tumor metastasis.The mean overall survival time of patients was 30.8 months.The 1-,3-,5-year disease-free survival rates were 47.1％,20.3％,and 5.9％,respectively.The 1-,3-,5-year overall survival rates were 93.1％,48.7％,and 35.3％,respectively.(2) Effects of LNR on prognosis of patients in different AJCC N staging:of 121 patients,46 were in N0 stage,42 were in N1 stage,28 were in N2 stage,and 5 were in N3 stage.Of 42 patients in N1 stage,35 with 0 ＜ LNR ≤ 0.15 had a disease-free survival time of 12.2 months (range,1.2-82.3 months),and 7 with LNR ＞ 0.15 had a disease-free survival time of 6.9 months (range,2.1-23.1 months);the difference between the two groups was statistically significant (x2 =3.888,P＜0.05).Of the 28 patients in N2 stage,12 with 0 ＜ LNR ≤ 0.15 had a disease-free survival time of 8.5 months (range,1.2-38.8 months),and 16 with LNR ＞ 0.15 had a disease-free survival time of 4.4 months (range,1.0-52.7 months);the difference was not statistically significant (x2 =0.007,P＞0.05).Forty-six patients in N0 stage were detected no lymph node metastasis,and only 5 cases were in N3 stage,with no analysis.(3) Relationship between LNR and postoperative adjuvant chemotherapy:of the 121 patients,56 underwent postoperative adjuvant chemotherapy,which was mainly constituted by pactitaxel,platinum,and 5-fluorouracilbased regimens,58 didn't undergo postoperative adjuvant chemotherapy,and 7 had unknown data of postoperative adjuvant chemotherapy.Of 121 patients,46 had LNR =0,47 had 0 ＜ LNR ≤ 0.15,28 had LNR ＞ 0.15.Of the 46 patients with LNR =0,17 who underwent postoperative adjuvant chemotherapy had a disease-free survival time of 8.1 months (range,3.9-66.7 months) and a overall survival time of 34.0 months (range,4.7-76.0 months);29 who didn't undergo postoperative adjuvant chemotherapy had a disease-free survival time of 18.8 months (range,1.6-53.2 months),and a overall survival time of 48.6 months (range,8.3-94.2 months);there was no significant difference in the disease-free survival time and overall survival time between the two groups (x2=0.311,0.858,P＞0.05).Of the 47 patients with 0 ＜ LNR ≤ 0.15,27 who underwent postoperative adjuvant chemotherapy had a disease-free survival time of 13.3 months (range,5.0-82.3 months),and a overall survival time of 53.1 months (range,5.7-82.3 months);20 without postoperative adjuvant chemotherapy had a disease-free survival time of 8.4 months (range,1.2-39.2 months),and a overall survival time of 26.5 months (range,5.9-52.6 months).There were significant differences in the disease-free survival time and overall survival time between the two groups (x2 =10.322,4.971,P＜0.05).Of the 28 patients with LNR ＞ 0.15 (7 had unknown data of postoperative adjuvant chemotherapy),12 who underwent adjuvant chemotherapy had a diseasefree survival time of 10.3 months (range,2.9-52.7 months),and a overall survival time of 29.5 months (range,11.2-58.5 months);9 without postoperative adjuvant chemotherapy had a disease-free survival time of 2.9 months (range,1.4-35.7 months),and a overall survival time of 14.5 months (range,3.0-62.3 months);there was a significant difference in the disease-free survival time between the two groups (x2 =6.687,P＜0.05),and no significant difference in the overall survival time between the two groups (x2=2.938,P＞ 0.05).Conclusions LNR can be used as a supplementation of AJCC N staging system.In patients with 0＜ LNR ≤ 0.15,postoperative adjuvant chemotherapy can improve disease-free survival time and overall survival time.