[Association between obesity and risk for colorectal advanced adenoma].

Objectives: To understand the association between obesity and the risk for colorectal advanced adenoma. Methods: Community residents aged 45 to 74 who had participated in the Shanghai community-based colorectal cancer (CRC) screening project in 2008 were included in our study. Anthropometries information including body weight, height and risk factors for colorectal advanced adenoma were collected. Results on colonoscopic diagnosis and personal health records were used for supplementary outcome information retrieval. Multivariate Cox proportional hazard regression models were used to evaluate the hazard ratio (HR) and 95%CI of obesity on the risk for colorectal advanced adenoma. Results: 20 811 residents were followed up for 122 739.36 person-years, with a median follow-up time of 5.87 years. A total of 657 cases of advanced adenomas were identified. After adjusting for potential confounding risk factors such as age, sex, family history of CRC, level of education, marriage, cigarette smoking, alcohol drinking, foods intake including fat, fried or pickled, vegetables and fruits etc., the HR was 1.25 (95%CI: 1.04-1.51) for obese people when compared with the normal weight persons. Further stratified analysis by age, gender and family history of CRC, results showed that obese people had a much higher risk of colorectal advanced adenoma than those with normal weight (male: HR=1.57, 95%CI: 1.20-2.04; more than 60- year-old: HR=1.63, 95%CI: 1.23-2.16). Conclusion: Data from this large scale population-based study revealed that obesity might be an independent risk factor for colorectal advanced adenoma and the risk increases along with the increase of BMI in China.

[Comparison of results between fenestration discectomy associated with annulus repair and fenestration discectomy for lumbar disc herniation in the adolescents].

OBJECTIVE: To compare the preliminary clinical outcomes of fenestration discectomy associated with annulus repair (FDAR) and fenestration discectomy (FD) for lumbar disc herniation in the adolescents. METHODS: The data of 26 adolescent patients with single segment lumbar disc herniation who were admitted to the Department of Orthopedics, Xuzhou Central Hospital from October 2012 to October 2014 were retrospectively studied. All patients were divided into 2 groups, including 12 patients undergoing FDAR and 14 patients undergoing FD respectively. The factors including the length of skin incision, amount of intraoperative bleeding, operation time and duration of hospitalization were compared. The indentation of dura were measured from MRI. Pfirrmann grading system was used for assessment of lumbar disc degeneration preoperatively and 1 year later. The visual analogue scale (VAS), the oswestry disability index (ODI) and Japanese Orthopedic Association (JOA) scores were used to measure the clinical outcomes. Simultaneously, surgical complications, and postoperative recurrence of lumbar disc herniation were recorded. RESULTS: There were no significant differences in the observational factors such as the skin incision length, amount of intraoperative bleeding, operation time, and duration of hospitalization between the FDAR and FD groups (P>0.05). The indentation of the dura significantly reduced after surgery in each group [FDAR: (7.3±2.6) vs (1.3±0.8) mm; FD: (7.4±3.1) vs (2.9±0.7) mm; both P<0.05]. The postoperative lumbar disc degeneration in FDAR group was the same as that of in FD group. The postoperative VAS scores and ODI scores at each follow-up time point in both groups were significantly improved when compared with the preoperative ones (P<0.05). There were no statistically significant differences between the 2 groups in the JOA score improvement rate (FDAR: 88.5%, FD: 87.2%; P>0.05). According to the modified MacNab criteria, there were no statistically significant differences between the 2 groups in the excellent and good rate (FDAR: 89.3%, FD: 88.5%; P>0.05). There were no dural tears, disc space infection, hematoma formation in the spinal canal and other serious complications in both groups. But there was one patient regaining the back and leg pain in the FD group, whereas recovering by conservative treatment. CONCLUSION: The preliminary clinical efficacy of both FDAR and FD in the treatment of single segment lumbar disc herniation in the adolescents is satisfactory.

Causes of anorexia in untreated hyperthyroidism: a prospective study.

Seventeen consecutive patients (mean (SD) 46 (11) years) with untreated hyperthyroidism and anorexia and 29 patients (35 (9) years) with untreated hyperthyroidism without anorexia were studied. The study was conducted at the thyroid clinic of the PUMC Hospital, Beijing, China from March to August 1997. The patients' ages, serum free calcium, liver function and emotional state, specifically the level of anxiety (using the self anxiety scale, Chinese version), were compared before and/or after antithyroid drug treatment in the two groups. This prospective study suggested that the causes of anorexia in untreated hyperthyroidism are complicated. Older age, abnormal liver function, and the level of anxiety are significantly related to anorexia in untreated hyperthyroidism, but hypercalcaemia was not confirmed to be related to anorexia in the study.

Effect of acute water loading on plasma levels of antidiuretic hormone AVP aldosterone, ANP fractional excretion of sodium and plasma and urine osmolalities in myxedema.

We monitored the plasma and urine osmolalities, fractional excretion of sodium, fractional excretion of chloride, plasma levels of antidiuretic hormone (ADH, AVP), aldosterone and atrial natriuretic peptide (ANP) before and after acute water ingestion in 12 patients with overt hypothyroidism. The ability of the patients to dilute and concentrate urine was found impaired and the ability of excretion of water load decreased and delayed. Acute water load test was proved to be effective in evaluating the urinary excreting function for the patients. We hypothesize that inappropriate secretion of anti-diuretic hormone and elevated plasma ANP may be homeostatic factors for abnormal urinary excretion in patients with hypothyroidism.

Normal and leukemic lymphocyte membrane fluidity and response to stimulation with ConA and PHA.

In our experiment, lymphocyte membrane was labeled by DPH fluorescence probe. The rate of rotation of the probe can be measured from the value of fluorescence polarization (PDPH). With this method useful information could be provided about membrane fluidity of lymphocytes. It was found that the F value (unit of lipid fluidity of membrane) of leukemic lymphocytes was obviously higher than that of normal ones. Furthermore, the F value of cultured leukemic Ts lymphocytes was the highest. In contrast with normal spleen T-lymphocytes or mixed lymphocytes, the response of malignant lymphocytes to the stimulation with ConA or PHA was reflected in the decrease of PDPH value or the increase of F value. Unexpectedly, the F value of T-lymphocytes from "615" mouse not injected with tumour cells was also higher than that of the mixed. The possibility of using the membrane fluidity as a diagnostic criterion was also discussed.

The effect of high cholesterol, high fat diet on rabbit plasma beta-VLDL and its interaction with macrophage.

Rabbits were fed on 1% cholesterol and 10% rape seed oil (group A) or lard (group B). Plasma cholesterol and triglyceride level of group A was strikingly lower than that of group B. No difference was found in the lipid composition of beta-VLDLs between both groups. However, apo E content of beta-VLDL from group A was higher and apo B (higher molecular weight) was lower than that of group B respectively. beta-VLDL of group A caused greater accumulation of cholesterol in mouse peritoneal macrophage than that of group B. Therefore, we assume that the good effect of poly-unsaturated fatty acid on atherosclerosis results not from decreasing accumulation of cholesterol in macrophages but from enhancing elimination of beta-VLDL by the liver.

The assay for thyroid stimulating immunoglobulin using cultured human thyroid cells and its clinical application.

A new technique for the determination of the serum level of thyroid stimulating immunoglobulins (TSI) is described. TSI may be detected by measuring cyclic AMP increases in cultures of isolated thyroid epithelial cells in response to added normal or patient's serum. Our results showed that the serum level in the normal control group was mostly lower than 110%, however, in 9.1% of normal human sera, TSI showed a positive result. In abnormal position, activity of TSI was higher than 110% of the rate of the normal control group. The positive result was 86% and the serum TSI levels were 270 +/- 176.6% in patients with Graves' disease before receiving antithyroid drug. After treatment with antithyroid drugs from one to thirty months, the positive results dropped to 35% and the serum TSI level decreased to 117.0 +/- 113%, which was significantly lower than that in untreated patients. In conclusion, TSI can be detected in the majority of the sera in patients with Graves' disease using this technique. It is helpful to the diagnosis and treatment of the Graves' disease.