September 2017, Volume 20, No.27 Abstracts

 Recent Developments in Neutrophil Gelatinase-Associated Lipocalin and Cardiovascular Disease

CHEN Wen,ZHU Ji-hong*

Department of Emergency,Peking University People's Hospital,Beijing 100044,China

*Corresponding author:ZHU Ji-hong,Professor,Chief physician;

    Abstract  Cardiovascular diseaseCVDseriously endangers public health.Therefore,it is of great significance to study the predictive markers of CVD.Recent studies showed that neutrophil gelatinase-associated lipocalin (NGAL) is an important marker for CVD.NGAL is directly involved in the pathogensis of CVD,and it also can independently predict the prognosis of acute myocardial infarctionAMIand heart failure (HF).In this paper,the recent studies on NGAL and coronary heart disease (CHD)NGAL and AMINGAL and HF were respectively summarized and analyzed.We concluded that NGAL has clinical value in evaluating the severity of CVD and predicting the prognosis of CVD.

    Key words  Cardiovascular diseases;Neutrophil gelatinase-associated lipocalin;Coronary disease;Myocardial infarction;Heart failure


1Impact of Smoking on Cardiovascular Disease and Its Recent Progress

GUO Jian-jun1,GUO Hang-yuan2,CHI Ju-fang2,PAN Sun-lei2,YU Yu2*

1.Medical Research Center,Shaoxing People's Hospital,Shaoxing 312000,China

2.Department of Cardiovascular,Shaoxing People's Hospital,Shaoxing 312000,China

*Corresponding author:YU Yu,Nurse-in-charge;

    Abstract  In recent years,the prevalence of cardiovascular disease has been increased gradually in China.Smoking,obesity,hypertension,dyslipidemia and abnormal glucose metabolism are risk factors for cardiovascular disease.We introduced the nicotine in tobacco and carbon monoxide that play an important role in the development of cardiovascular diseases,described their effects on cardiovascular diseases such as hypertension,coronary heart disease,heart failure,cardiomyopathy,arrhythmia,summarized the harm of smoking to cardiovascular diseases,put forward that stop smoking can effectively reduce the occurrence rate of cardiovascular disease,and called on the whole society to stop smoking and to create a smoke-free environment.

    Key words  SmokingCardiovascular diseasesReview


Recent Developments in Mechanical Thrombectomy for the Treatment of Acute Cerebral Infarction

ZHANG Feng*,LI PengJING Shan-quanGAO Jin-ling

Department of Neurosurgerythe First Hospital of Hebei Medical UniversityShijiazhuang 050031China

*Corresponding author:ZHANG FengAssociate chief physicianAssociate

    Abstract  With the change of people's lifestyle and dietary structure,acute cerebral infarction has become an important cause of death and disability in elderly patients,and it is very easy to cause a series of complications such as paralysis,which not only increases the patient's financial burden,but also brings harm to their body and mind.The current clinical treatments are mainly intra arterial thrombolysis,mechanical thrombectomy and intravenous thrombolysis.This paper mainly introduces the research status of mechanical thrombectomy in the treatment of acute cerebral infarction,and analyzes the therapeutic effect of mechanical thrombectomy and intra arterial thrombolysis,the results showed that compared with intra arterial thrombolysis,the therapetutic effect of mechanical thrombectomy was better,and the possibility of the occurrence of secondary cerebral embolism,postoperative cerebral hemorrhage and cerebral vasospasm and other complications was reduced greatly,especially for better patients with acute cerebral infarction.

    Key words    Brain Infarction;Stent;Mechanical thrombolysisTreatment outcome


Effect of Intervention on Type 2 Diabetic Patients with Central Obesity in the Community through Joint Management Mode between the Community Health Service Center and the Tertiary Grade A Hospital

WANG Hong-xiu1,ZHAO Hai1,YANG Xue-yun1,GAO Li-wei1,ZHANG Xue-lian2*,ZHU Liang-xiang2,WAN Gang3,YUAN Shen-yuan2

1.Yuyuantan Community Health Service Center,Beijing 100142,China

2.Department of Endocrinology,Beijing Tongren Hospital,CMU,Beijing 100730,China

3.Medical Records and Statistics Department,Beijing Ditan Hospital Capital Medical University,Beijing 100015,China

*Corresponding author:ZHANG Xue-lian,Associate chief

    Abstract  Objective  To investigate the effect of intervention on type 2 diabetic patients with central obesity in the community through joint management mode between the Yuyuantan Community Health Service Center(YCHSC) and Beijing Tongren Hospital,CMU(hereafter referred to as a tertiary grade A hospital),which might be of great significance for the delivery of community health services.Methods  This study is a sub-project of the Beijing Community Diabetes Study(BCDS).Totaled 119 subjects with type 2 diabetes mellitus were recruited from YCHSC between October 2012 and February 2013.Based on body mass index(BMI) and waist to height ratio(WHtR),central obesity was found in 74 cases of them(diabetes with central obesity group),but not in other 45 cases(diabetes without central obesity group).The study was implemented under the instructions of the endocrinology chief physicians of a tertiary grade A from the beginning to the end.Patient management standards were formulated by endocrinology chief physicians of a tertiary grade A and general practitioners(GPs) of YCHSC based on China Guideline for Type 2 Diabetes(2010 edition).All the participants received a 36-month multifactorial intervention delivered by the appointed chief general practitioner.The physical measurements and biochemical indicatorsbody weight,systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),triacylglycerol(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),and uric acid were measured before and after intervention.And prognostic endpoints occurred after intervention were recorded.The effect of the intervention was assessed after the intervention by evaluating and comparing the improvement achieved in both groups and between the groups,and comparing the incidence of prognostic endpoints between the groups.Results  Before the intervention,body weight,SBP and TG in diabetes with central obesity group were higher than those in diabetes without central obesity group(P0.05),while there were no significant differences in DBP,FPG,HbA1c,TC,HDL-C,LDL-C,and uric acid between the two groupsP0.05.However,after the intervention,except the average value of FPG was higher in the diabetes with central obesity group(P0.05),other indicators were similar in both groups(P0.05).After the intervention,SBP,FPG and LDL-C were found to be decreased significantly but the average value of HDL-C increased obviously in the diabetes without central obesity group(P0.05);in the diabetes with central obesity group,body weight,SBP were identified to be declined substantially but the average value of HDL-C increased notably(P0.05).There were no significant differences in the incidence of stroke,coronary heart disease,diabetic nephropathy,diabetic retinopathy,and carotid plaque between the two groups after intervention(P0.05).Conclusion  Bad control of blood pressure and lipid profiles could be seen in type 2 diabetic patients with central obesity.Joint management mode between the community health service center and the tertiary grade A hospital for these patients can effectively improve the values of metabolic markers,and reduce the incidence of prognostic endpoints.

    Key words  Diabetes mellitustype 2;Community health servicesObesity,abdominal


Impact of Community Nurse-led New Team Model of Community-based Chronic Disease Management on the Medication Adherence Self-efficacy and Medication Adherence in Hypertensive Patients

WANG Sha1,YANG Hong-hua2,WANG Xiu-hua3*LIU Dan3

1.No.1(31ward)General Surgery Departmentthe Third Xiangya Hospital of Central South University,Changsha 410013,China

2.Geriatrics Cardiology DepartmentXiangya Hospital Central South University,Changsha 410008,China

3.Nursing SchoolXiangya School of MedicineCentral South UniversityChangsha 410013,China

*Corresponding author:WANG Xiu-hua,Professor;

    Abstract  Objective  To explore the impact of community nurse-led team model of community-based chronic disease management on the medication adherence self-efficacy and medication adherence in hypertensive patients,in order to offer support for community-based management of chronic disease in the future.Methods  We carried out this study between December 2014 and December 2015.The study sample comprised 180 participants who were divided equally into two groups:90 from the Wangyuehu Community Health Service Center(intervention group) and other 90 from the Hexinyuan Community Health Service Center(control group).All of them were selected from those hypertensive patients whose medical records were established and maintained in the above centers by systematic random sampling.Patients in the intervention group received nurse-led team model of community-based chronic disease management services,and those in the control group received the conventional community-based health services.The medication adherence self-efficacy was assessed by Medication Adherence Self-efficacy Scale(MASES),and medication adherence was assessed by Eight-Item Morisky Medication Adherence Scale(MMAS-8) before intervention,at the end of 6-month intervention,and at the end of 1-year intervention,respectively.And the results of the three assessments of medication adherence self-efficacy and medication adherence were compared between the two groups.Results  Total 175 cases(88 in the intervention group,and 87 in the control group) completed the intervention,the other 5 cases were lost to follow up.The method and duration of intervention exerted interaction effects on the scores of MASES and MMAS-8(P0.05).Moreover,they produced significant main effects on the scores of MASES and MMAS-8(P0.05).Before intervention,both groups had similar scores of MASES and MMAS-8(P0.05).However,the scores of MASES and MMAS-8 were much higher in the intervention group at the end of 6-month intervention and 1-year intervention(P0.05).The score of MASES in the intervention group before intervention was lower than that the end of 6-month intervention,and the end of 1-year intervention(P0.05);and the score of MASES in the 1 years after the intervention was higher than that in the end of 6-month intervention(P0.05).With view to the scores of MMAS-8 for the intervention group,the latter two assessment results were both higher than the first assessment result(P0.05),but the third assessment result was lower than the second assessment result(P0.05).Conclusion  The nurse-led team model of community-based chronic disease management can significantly improve the medication adherence self-efficacy and medication adherence in patients with essential hypertension.However,the intervention effect on the medication adherence of these patients could decrease over time.

    Key words  HypertensionCommunity medicineNursesGroup managementSelf-efficacyMedication adherence


Role of Family Doctor Service Team in Community-based Integrated Management of Diabetes

WEI Xue-juan1,WU Hao1,YU Hai-yang1,CUI Shu-qi2,GE Cai-ying1,JIA Hong-yan1,WANG Li1,GAO Wen-juan2,HUANG Wen3,LIANG Wan-nian2*

1.Fangzhuang Community Health Service Center,Capital Medical University,Beijing 100078,China

2.School of General Practice and Continuing EducationCapital Medical University,Beijing 100069China

3.Beijing Tongren Hospital,CMU,Beijing 100730China

*Corresponding author:LIANG Wan-nianProfessorDoctoral

    Abstract  We elaborated the role of the family doctor service team built by Fangzhuang Community Health Service Center in Fangzhuang District,Beijing in community-based integrated management of diabetes from the aspects of its building,service pattern,service contents,and service effect assessed from the rate of signing a contract with a family doctor,rate of blood glucose under control,rate of standardized health management,and health-seeking behavior in diabetic patients.Based on this,we explored and developed a service pattern that is suitable for the integrated management of type 2 diabetic patients in urban communities,which is contribute to the community-based chronic disease management,prevention and treatment in China.

    Key words  Community health servicesDiabetes mellitus,type 2 Family physicians' service teamIntegrated management


Prognosis Analysis of Colorectal Cancer by Three Predictive Models Based on Clinical and Pathological Indexes

YIN Ming-ming1,2,QIN Huan-long1,2*

1.Shanghai Clinical College of Anhui Medical University,Shanghai 200072,China

2.Department of Gastroenterological Surgery,Shanghai Tenth People's Hospital,Shanghai 200072,China

*Corresponding author:QIN Huan-long,Professor,Doctoral supervisor;

    Abstract  Objective  To investigate the value of clinical and pathological indexes integrated with support vector machine model(SVM) in the prediction of the prognosis of patients with colorectal cancer(CRC).Methods  We enrolled 2 951 patients undergoing resection of colorectal cancer in Department of Gastroenterological Surgery of Shanghai Tenth People's Hospital from 2002 to 2011,and collected their clinical indexes(sex,age,tumor size,tumor site,histopathological type,T stage,N stage,M stage,G stage) and pathological indexes(CEA,PCNA,P53,CD34,S-100,NM23,CerB-b2,P21,and Ki-67).We divided the patients into 2 groups according to whether they lacked follow-up information.Group 1 had sufficient clinical data but lacked follow-up information,with a total of 2 747 cases.Group 2 had complete clinical data and follow-up information,with a total of 204 cases.The survival situation of the patients was recorded.In group 1,if a patient had more than 4 indicators missing,the patient was eliminated;among the remaining patients,if any index had a loss rate of 30.0%,the index was excluded;further,patients with fewer pathological types were excluded.The association of clinical indicators and pathological indicators was calculated,and then the resulting association was verified in patients in group 2.If the association was present in group 2,the patients of group 2 would be included in group 3 directly;if the association did not exist in group 2,the SVM internal algorithm was used to remove some patients until the association was established and the remaining patients of group 2 were included in group 3.The pathological indexes of group 2 were statistically analyzed,if the missing rate of an index was 50.0%,the index was eliminated.Based on SVM,data of group 3 was processed,and 3 prediction models were established:SVM1 based on clinical indexes,SVM2 based on pathological indexes,SVM3 based on clinical and pathological indexes.Results  In group 1,a total of 834 patients had missing indexes 4.The loss rates of 9 indexes(sex,age,tumor site,histopathological type,P53,CD34,S-100,CerB-b2 and Ki-67) were less than 30.0%,and they were remained.After excluding 5 patients with rare tumors,a total of 829 patients remained in group 1.There was a correlation between age and expression of CerB-b2 in group 1(P0.05).After eliminating 105 patients,the age of the 99 remaining patients was related to the expression of CerB-b2(P0.05),and the 99 patients were included in group 2,the loss rates of 5 indexes(PCNA,P53,CD34,S-100,CerB-b2) were less than 50.0%,and they were remained.Age correlated with the expression of S-100 as well as with the expression of CerB-b2 in group 3(P0.05);there was correlation between the M staging and the expression of PCNA in group 3(P0.05).The survival curve of the patients in group 3 significantly varied by T stage and N stage(P0.05).SVM1 included 9 clinical indicators(sex,age,tumor size,tumor location,histopathological type,T stage,N stage,M stage,G stage),the accuracy rate was 83.4%.SVM2 included 5 pathological indexes(PCNA,P53,CD34,S-100,CerB-b2),the accuracy rate was 78.8%.The initial SVM3 included the above 9 clinical indicators and 5 pathological indicators,the accuracy rate was 74.8%.The index was further screened by MRMR method to obtain the final SVM3,which included 4 clinical indexes(tumor location,histopathological type,T stage,N stage) and 2 pathological indexes(CD34,CerB-b2),and the accuracy rate was 81.8%.The survival curves of patients with different risk SVM1,SVM2 and SVM3 were statistically significant(P0.05).Conclusion  There was a certain correlation between pathological indexes such as CerB-b2,S-100 and PCNA and clinical indexes such as age and M stage;SVM model can be used to integrate the pathological and clinical indexes and to effectively predict the prognosis of patients with colorectal cancer.

    Key words  Colorectal neoplasms;Prognosis;Prediction model


Correlation of the Expressions of E-cadherin and Vimentin with the Clinicopathological Factors and Prognosis of Colon Cancer

ZENG Xiang-yue1,SUN Zhen-qiang2WANG Qi-san1,GE Lei1,WANG Hai-jiang1*

1.Department of Gastrointestinal Surgery,Affiliated Tumor Hospital of Xinjiang Medical University,Urumqi 830011,China

2.Department of Anorectal Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China

*Corresponding author:WANG Hai-jiang,Professor,Chief physician;

    Abstract  Objective  The development of tumor is a complex pathophysiological process involving many interrelated factors.The purpose of this study was to investigate the correlation of the expressions of epithelial mesenchymal transition(EMT) markers(E-cadherin and Vimentin) with the clinicopathological factors and prognosis of colon cancer.Methods  Immunohistochemistry with SP method was performed to detect the expressions of E-cadherin and Vimentin in the colon cancer and adjacent tissue specimens taken from 116 stage colon cancer patients who underwent radical resection of colon cancer in Department of Gastrointestinal Surgery of Affiliated Tumor Hospital of Xinjiang Medical University from January 1,2009 to January 1,2014 and pathologically diagnosed as colon cancer postoperatively.The patients were followed up by outpatient or ward review,telephone and so on with a deadline of January 1st 2015.Totaled 92.2% of the participants(107/116) were followed up for 4.1-63.0 months with a median follow-up of 46.0 months.Overall survival(OS) and disease-free survival(DFS) of patients were recored.Multivariate Logistic regression analysis was performed to investigate the correlation of the expressions of E-cadherin and Vimentin with the clinicopathological factors of colon cancer.Kaplan-Meier survival analysis was conducted to estimate the survival function.Survival rate was compared with the Log-rank test.Results  The positive rate of E-cadherin and Vimentin expressions in all the participants was 79.3%(92/116),15.5%(18/116),respectively.The positive rates of E-cadherin of carcinoembryonic antigen(CEA),tumor diameter,vascular invasion,differentiation degree of colon cancer cells,lymphatic metastasis showed significant differencesP0.05.The positive rates of Vimentin of tumor diameter,vascular invasion,perineural invasion,differentiation degree of colon cancer cells,lymphatic metastasis showed significant differencesP0.05.Multivariate Logistic regression analysis found that CEA,vascular invasion and differentiation degree of colon cancer cells were significantly associated with the expression of E-cadherin(P0.05).Vascular invasion,nerve invasion and differentiation degree of colon cancer cells were significantly associated with the expression of vimentin(P0.05).Notable differences were found in the cumulative OS and DFS between E-cadherin positive group and negative group(P0.05).The cumulative OS and DFS differed significantly between Vimentin positive group and negative group(P0.05).Conclusion  CEA,vascular invasion and the differentiation degree of colon cancer cells are the associated factors for the expression of E-cadherin.Vascular invasion,nerve invasion and the differentiation degree of colon cancer cells are the associated factors for the expression of Vimentin.E-cadherin and Vimentin are important adverse prognostic factors in colon cancer.

    Key words  Colonic neoplasms;Epithelial-mesenchymal transition;Cadherins;Vimentin;Prognosis


1Value of POSSUM,P-POSSUM,Cr-POSSUM and E-PASS Scoring System in Predicting Postoperative Mortality Risk of Colorectal Cancer Patients

LIU Ting-ting,ZHANG Ao,HU Fang*

Department of General SurgeryTianjin Medical University General Hospital,Tianjin 300052,China

*Corresponding author:HU FangAssociate chief superintendent

    Abstract  Objective  To evaluate the value of POSSUM,P-POSSUM,Cr-POSSUM and E-PASS scoring systems in predicting postoperative mortality risk of colorectal cancer patients.Methods  The clinical data of 550 patients with colorectal cancer treated in Tianjin Medical University General Hospital from 2010 to 2015 were retrospectively analyzed.The relevant indicators were collected according to Physiological and Operative Severity Score for Enumeration of Mortality and morbidityPOSSUM,Portsmouth-POSSUMP-POSSUM,Colorectal POSSUMCr-POSSUMand Estimation of physiologic ability and surgical stressE-PASSscoring systems andresearchneeds.The POSSUM,P-POSSUM,Cr-POSSUM and E-PASS scoring systems were used to predict the postoperative mortality rate of 30 days in patients with colorectal cancer.The predictive value of the scoring system was evaluated by receiver operating characteristic(ROC) curve and observed to expected ratio(O/E).Results  The best cutoff value of POSSUM,P-POSSUM,Cr-POSSUM and E-PASSscoring systems were 54.29%,55.39%,31.68% and 56.31%,respectively.The sensitivity of POSSUM,P-POSSUM,Cr-POSSUM and E-PASS scoring systems were 83.3%,83.3%,33.3% and 83.3%,respectively.The specificity of POSSUM,P-POSSUM,Cr-POSSUM and E-PASSscoring systems were 29.0%,27.9%,1.6% and 27.0%,respectively.The area under ROC curve of POSSUM,P-POSSUM,Cr-POSSUM and E-PASS scoring systems were 0.73395%CI(0.500,0.966),0.71395%CI(0.479,0.948),0.75195%CI(0.570,0.932),and 0.78195%CI(0.607,0.955),respectively.The O/E were 0.128,0.414,0.248,0.712,respectively.Conclusion  POSSUM,P-POSSUM,Cr-POSSUM and E-PASS scoring systems all have an overestimation of the postoperative mortality of colorectal cancer.E-PASS scoring system has a good consistency in the predicting postoperative mortality and actual mortality.

    Key words  Colorectal neoplasm;Mortality;Forecasting


Serum Protein Expression in Tibetan and Han Chinese College Students with Unwell Symptoms after Migration to the Inland Region of China from Tibet

LI Wen-huaLI Yu-xiang*ZHANG Xin-longGUO Yi-jiao

School of Medicine,Xizang Minzu University,Xianyang 712082,China

*Corresponding author:LI Yu-xiangAssociate


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