BACKGROUND: Membrane CD36 is a fatty acid transporter implicated in the pathogenesis of metabolic disease. We aimed to evaluate the association between plasma CD36 levels and diabetes risk and to examine if the association was independent of adiposity among Danish population. METHODS: We conducted a case-cohort study nested within the Danish Diet, Cancer and Health study among participants free of cardiovascular disease, diabetes and cancer and with blood samples and anthropometric measurements (height, weight, waist circumference, and body fat percentage) at baseline (1993 to 1997). CD36 levels were measured in 647 incident diabetes cases that occurred before December 2011 and a total of 3,515 case-cohort participants (236 cases overlap). RESULTS: Higher plasma CD36 levels were associated with higher diabetes risk after adjusting for age, sex and other lifestyle factors. The hazard ratio (HR) comparing high versus low tertile of plasma CD36 levels was 1.36 (95% confidence interval [CI], 1.00 to 1.86). However, the association lost its significance after further adjustment for different adiposity indices such as body mass index (HR, 1.23; 95% CI, 0.87 to 1.73), waist circumference (HR, 1.21; 95% CI, 0.88 to 1.68) or body fat percentage (HR, 1.20; 95% CI, 0.86 to 1.66). Moreover, raised plasma CD36 levels were moderately associated with diabetes risk among lean participants, but the association was not present among overweight/obese individuals. CONCLUSION Higher plasma CD36 levels were associated with higher diabetes risk, but the association was not independent of adiposity. In this Danish population, the association of CD36 with diabetes risk could be either mediated or confounded by adiposity.

Objective To evaluate laparoscopic right hepatectomy through the right incisura or the right groove for hepatic benign disease.Methods This study enrolled 32 patients of hepatic benign lesions within the right lobe of the liver including hepatic hemangioma (n =7),hepatic focal nodular hyperplasia (n =2),right intra-hepatic bile duct stones (n =23) with concomitant extra-hepatic bile duct stones in 19 cases.Results Laparoscopic procedures were successful in 28 patients,while 4 patients were converted to laparotomy.Time of operation was 235 to 405 min,time for right hemihepatectomy was (305 ±41) min on average.Time for right hemihepatectomy and biliary tract exploration and removal of stones was (326 ± 48)min on average.The intraoperative blood loss was (573 ±219) ml on average.On postoperative follow-up,patients with hepatic hemangioma and focal nodular hyperplasia had no residual lesions.2 cases suffered calculus residue,residual stones were removed by repeat choledochoscopy with primary stones clearence rate of 91.3％ (21/23).Bile leakage occurred in 3 cases and pleural effusion in 7 cases.The gastrointestinal function recovered (2.8 ± 0.71) days after surgery.The hospital stay was (11.5 ± 2.98) days.28 patients were followed up for (32 ± 8) months.Conclusion The laparoscopic anatomical right hemihepatectomy through the right incisura or the right groove is a satisfactory surgical procedure.

Objective To explore the sedation and analgesia effect of dexmedetomidine (DEX) in patients with multiple trauma during mechanical ventilation.Methods Eighty cases of multiple trauma patients under mechanical ventilation treated from September 2016 to March 2017 were analyzed by retrospective case-control study.There were 58 males and 22 females with an age range of 18-60 years (mean,41.87 years).The injury severity score (ISS) was (18.45 ±4.53)points.The patients were treated with sedation and analgesia,and they were divided into two groups according to the sedative drugs.DEX composite tartaric acid butorphanol were used in 40 patients as DEX group.Midazolam composite tartaric acid butorphanol were used in 40 patients as Midazolam group.The degree of sedation score (Ramsay score) were compared between groups.The time from initial drug use to effective sedation achievement,daily wake-up time,mechanical ventilation duration,emergency intensive care unit (EICU) time,dosage of tartaric acid butorphanol,heart rate,blood pressure changes,and incidence of delirium were compared.Results (1) Two groups could both reach the target of sedation.DEX group had shorter daily wake-up time,shorter mechanical ventilation time and shorter length of EICU stay compared with Midazolam group (P ＜ 0.05).(2) The time to achieve satisfied sedation after initial usage in Midazolam group was shorter than that in DEX group (P ＜ 0.05).(3) DEX group had smaller tartaric dosage of acid butorphanol,and lower incidence of delirium compared those in Midazolam group (P ＜ 0.05).(4) The comparison of systolic blood pressure,diastolic blood pressure,heart rate within either group showed significant difference before and after sedation (P ＜ 0.05),but had no significant difference between two groups (P ＞ 0.05).Conclusions For multiple trauma patients with mechanical ventilation,DEX can attain sedation and analgesia and shorten daily wake-up time,mechanical ventilation time,and length of hospital stay.DEX can reduce the dosage of analgesic (butorphanol) and the incidence of delirium.Blood pressure and heart rate are associated with small variations before and after sedation.

Objective To understand the changing trends of immune-related diseases.Disease patterns from both pre-and post-immunization plan and after the immunization program were described,in order to provide evidence for the formulation and revision of immunization program and policy,in Ningxia Hui Autonomous Region.Methods According to the time order descriptive method was used to analyze and compare the reported data on infectious diseases in Ningxia,between 1958 and 2014.Results From 1958 to 2014,both incidence and mortality of infectious diseases and four diseases related to the immunization programs,in Ningxia appeared significantly low.Since the implementation of the immunization plan,the incidence and mortality of the 4 diseases declined significantly,with the average annual total incidence as 176.12/100 000 before the immunization plan dropped to 2.56/100 000 when the expanded immunization plan was put into practice.The incidence also showed a downward trend.Among diseases that under the immunization program,the incidence of measles appeared the highest,followed by pertussis.However,none of the case on diphtheria or polio appeared which was caused by the wild strains,in 1983 and 1994.Conclusion After the implementation of the immunization plan,the immune-related diseases seemed to have been under well controlled.and with remarkable social benefit.Immunization programs appeared the most effective measures to control and eliminate the acute infectious diseases in the region.

Objective To evaluate left liver anatomical resection via left vertical groove by laparoscope.Method Among 103 patients with left intrahepatic biliary calculi,39 cases underwent left lateral hepatectomy,20 cases did left liver anatomical resection via left vertical groove by laparoscope,29 cases underwent left lateral hepatectomy via left liver diaphragmatic surface,15 cases did left liver anatomical resection via the first porta.Result In the 103 cases of laparoscopic left liver anatomical resection,101 cases were successful and two cases were conversed to open surgery.In the success group,total laparoscopic anatomical left lateral lobectomy was performed (Ⅱ,Ⅲ section) in 68 cases.Compared with the approach via left liver falciform ligament diaphragmatic surface,the operatve time via left vertical groove was significantly shorter(t =-2.723,P =0.008,intraoperative blood loss was significantly smaller (t =-5.399,P =0.000),while the differences in postoperative hospital stay (t =-0.168,P =0.867) and postoperative complications (x2 =0.664,P =0.415) were of no statistical significance between the 2 groups.In the 33 cases of left hemihepatectomy (Ⅱ,Ⅲ,Ⅳ section),those performed via left vertical groove compared with through the first porta hepatic,used shorter operation time(t =-3.144,P =0.004),while blood loss was similar(t =-1.049,P =0.302),as well as the length of hospital stay(t =0.784,P =0.439).There was no postoperative bleeding and intractable bile leakage,nor postoperative air embolism.Flatus on an average of (2.5 ± 1.2) days.Patients were discharged from hospital 5-17 (9.98 ±2.98) days post-op.96 cases were followed up in the 101 cases undergoing successful total laparoscopic left hemihepatectomy.The followed-up time were 3-52 (32.6 ± 5.7) months.Postoperative review found no residue stone.One case in first porta hepatis group,caudate lobe atrophy was found by postoperative CT.Conclusions Left liver anatomical resection via left vertical groove by laparoscope is less traumatic,quick recovery with satisfactory clinical curative effect for the treatment of left hepatolithiasis.

Objective To discussed application effect of modified flowchart of preoperational articles in the operating room. Methods A group for the reconstructed flowchart was set up to look into the problems of traditional flowchart for articles preparation and then have the flowchart modified upon the found problems. The duration for article preparation and the flaw rate were compared between pre-and post-modification. Result The duration for preparation after modification was significantly shorter than that before modification and the flaw rate was significantly lower as well (P<0.001). Conclusion The modified flowchart for article preparation in the operation room can reduce the flaw rate and shorten the duration for article preparation, thus ensuring smooth operation.

OBJECTIVETo investigate the clinical application of diffusion weighted imaging (DWI) in uterine cervical cancer and the apparent diffusion coefficient (ADC) value in diagnosis and predicting treatment response.

METHODSTwenty-eight patients with advanced primary cervical cancer confirmed by pathology and 10 cases of normal uterine cervix as control were recruited in this prospective clinical trial. To analyze the correlation between tumor volume measured in DWI and tumor maximum diameter measured according to the RECIST criteria. To compare the ADC value differences among the uterine cervical cancer, uterine myometrium, and normal uterine cervix. To compare the ADC values in 17 cancer patients before and after treatment.

RESULTSThe illustration of tumor boundary in DWI was superior to conventional T2WI and post-enhancement T1WI. The DWI with higher b value (2000 s/mm(2)) had a better signal-to-noise ratio. The tumor volume measured in DWI has good correlation with tumor maximum diameter according to RECIST criteria (r = 0.759, P < 0.01). When b = 800 s/mm(2), the ADC values of the uterine cervical cancer, uterine myometrium, and normal uterine cervix were (9.85 ± 1.55)×10(-3) mm(2)/s, (14.20 ± 2.80)×10(-3) mm(2)/s, and (14.14 ± 0.45) ×10(-3) mm(2)/s. When b = 2000 s/mm(2), the ADC values of the uterine cervical cancer, uterine myometrium and normal uterine cervix were (7.38 ± 0.98)×10(-3) mm(2)/s, (8.52 ± 2.38)×10(-3) mm(2)/s, and (8.60 ± 0.63)×10(-3) mm(2)/s, respectively. There were significant differences between the cervical cancer and normal cervix or uterine myometrium (P < 0.001 for both). When b = 800 s/mm(2), the ADC value was (9.85 ± 1.55)×110(-3) mm(2)/s before and (13.41 ± 2.93)×10(-3) mm(2)/s after treatment (P < 0.001). When b = 2000 s/mm(2), the ADC value was (7.38 ± 0.98)×10(-3) mm(2)/s before and (8.93 ± 1.92)×10(-3) mm(2)/s after treatment (P = 0.008). Univariate logistic regression analysis showed that 25% ADC, 50%ADC, and 75%ADC in the tumor ADC value histogram before treatment were significantly correlated to the treatment outcome of cervical cancer (P < 0.05 for all). Multivariate regression analysis showed that 25%ADC, 50%ADC, and 75%ADC in the tumor ADC value histogram before treatment were not significantly correlated to the treatment outcome of cervical cancer (P > 0.05 for all). The values of ROC curves were 25%ADC = 0.818, 50%ADC = 0.775, and 75%ADC = 0.716 (P > 0.05), however, the 25% ADC showed a relatively stronger statistical power.

CONCLUSIONSDWI helps to confirm the morphology and exact target zone of the tumor for radiotherapy. DWI volume measurement is well correlated with RECIST criteria, particularly in volume measurement of irregular tumors. ADC value has a potential in quantitatively monitoring treatment response and predicting outcome of cervical cancers.

Adenocarcinoma ; diagnosis ; drug therapy ; pathology ; radiotherapy ; Antineoplastic Agents ; therapeutic use ; Carcinoma, Squamous Cell ; diagnosis ; drug therapy ; pathology ; radiotherapy ; Case-Control Studies ; Cervix Uteri ; pathology ; Cisplatin ; therapeutic use ; Diffusion Magnetic Resonance Imaging ; Female ; Humans ; Middle Aged ; Myometrium ; pathology ; Prospective Studies ; ROC Curve ; Radiotherapy, Conformal ; Treatment Outcome ; Tumor Burden ; Uterine Cervical Neoplasms ; diagnosis ; drug therapy ; pathology ; radiotherapy

Objective To explore the relationship between traditional Chinese medicine (TCM) syndromes of state of evil domination and clinical and laboratory indicators of IgA nephropathy. Methods A prospective study was used to collect data on clinical and laboratory examination of IgA nephropathy in multi clinical centers. Patients’ TCM syndrome types were determined according to the national diagnostic criteria at the same time. Totally 266 patients with IgA nephropathy were included in the study to establish a database for analyzing the relationship between TCM syndrome of state of evil domination and clinical and laboratory indicators. Results In the relationship between syndromes of state of evil domination distribution and clinical subtypes, patients of wind-heat syndrome had more macroscopic hematuria;patients of phlegm-damp syndrome had more nephrotic syndrome;patients of damp-heat syndrome had more chronic nephritis type Ⅰ;patients of blood stasis syndrome had more chronic nephritis type Ⅱ. In the relationship between syndrome of state of evil domination distribution and clinical manifestation, the incidence of hypertension was higher in patients of blood stasis syndrome than in other three types. It was more serious for hematuresis in the patients of wind-heat syndrome. For patients of phlegm-damp syndrome, the incidence of heave proteinuria was highest. In the relationship between syndrome of state of evil domination distribution and laboratory examination, 24-hour urinary protein quantification was higher than in patients of wind-heat and damp-heat syndrome, but the level of blood albumin was lowest. For patients of blood stasis syndrome, serum creatinine level was significantly higher than in other three types;the level of eGFR was just the opposite. The levels of blood cholesterol and triglyceride in patients of phlegm-damp syndrome were higher than in other three types. The activated partial thromboplastin time (APTT) levels in patients of blood stasis and phlegm-damp syndrome were lower than in other patients, but the FIB level was the exact opposite of APTT. In the relationship between syndrome of state of evil domination distribution and the stages of chronic kidney disease (CKD), patients of wind-heat syndrome were more in the first stage of CKD;patients of blood stasis syndrome were more in the third stage of CKD. Conclusion There is relative correlation between TCM syndromes of state of evil domination and clinical and laboratory indicators in IgA nephropathy, which would provide some reference to narrow the gap in the information of the four methods of TCM with clinical and laboratory indicators to enhance accurate diagnosis of TCM syndrome.

Papers on 1918 influenza virus published in 1995-2014 were retrieved from Web of Science.Institutional cooperation network, co-author network, and maps of hot key words, key word cluster, and reference co-citation were plotted using the VOSviewer.The study hot spots and their development trends were analyzed in an attempt to provide the key information for the prevention and control of influenza virus outbreak in the future.

Objective To study the feasibility and efficacy of intraoperative choledoscopy combined with laparoscopic left liver resection to treat intrahepatic lithiasis.Method In 49 patients with biliary stone,laparoscopic left lateral sectionectomy/left medial sectionectomy/left hepatectomy combined with intraoperative choledochoscopy and stone retrieval were carried out.Results Laparoscopic left lateral sectionectomy was carried out in 29 patients,left medial sectionectomy in 2 patients and left hepatectomy in 18 patients.In all the patients,combined choledoscopy and stone retrieval were carried out.A concomitant laparoscopic cholecystectomy (LC) was carried out in 11 patients.The average operative time was 226 min.When LC was carried out,the mean operative time was 243 min.The mean intraoperative blood loss was 378 ml.There was no bile leak or postoperative bleeding.Flatus was passed 1-3 days after surgery.The patients were discharged home 7-10 days after surgery.Postoperative MRI/MRCP did not reveal any residual stone.On a mean follow up of 16 months for 47 patients,the patients did well and there was no recurrent stone.Conclusion Choledochoscopy combined with laparoscopic left liver resection for bile duct stone resulted in minimal trauma to the patient.The recovery was quick and there was a high stone clearance rate.The treatment was safe,efficacious,and it is a viable minimally invasive treatment option.