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Xu Y.-P.,Zhejiang University | Liang L.,Zhejiang University | Wang C.-L.,Zhejiang University | Fu J.-F.,Zhejiang University | And 3 more authors.
World Journal of Gastroenterology | Year: 2013

Aim: To confirm the hypothesis that polymorphisms of the uncoupling protein 3 (UCP3) gene are associated with the occurrence of nonalcoholic fatty liver disease (NAFLD). Methods: A total of 250 NAFLD patients (147 males and 103 females) and 200 healthy individuals who served as controls (control, 109 males and 91 females), aged between 6 and 16 years were enrolled in this study. The four non-synonymous single nucleotide polymorphisms (SNPs) in the UCP3 gene polymorphisms of rs1726745, rs3781907, rs11235972 and rs1800849, were genotyped using MassArray. Body mass index (BMI), waist and hip circumference, blood pressure (BP), fasting blood glucose (FBG), insulin and lipid profiles were measured and B-ultrasound examination was performed in all subjects. Results: NAFLD patients showed risk factors for metabolic syndrome: elevated BMI, waist-to-hip ratio, BP, FBG, homeostasis model assessment-estimated insulin resistance, total triglyceride, total cholesterol and low-density lipoprotein-cholesterol, while decreased high-density lipoprotein-cholesterol level compared with the control group. The GG genotype distributions of rs11235972 in the NAFLD group differed significantly from that in the control group. We found that waist circumference between CC (58.76 ± 6.45 cm) and CT+TT (57.00 ± 5.59 cm), and hip circumference between CC (71.28 ± 7.84 cm) and CT+TT genotypes (69.06 ± 7.75 cm) were significantly different with and without rs1800849 variation (P < 0.05). Conclusion: A higher prevalence of rs11235972 GG genotype was observed in the NAFLD group compared with the control group. No differences were observed for the other SNPs. However, there was a significant difference in body height in addition to waist and hip circumference between the CC (mutant type group) and CT+TT group with and without rs1800849 variation. © 2013 Baishideng. All rights reserved.

Zhong H.,Ningbo Women and Childrens Hospital | Wang F.,Ningbo Women and Childrens Hospital
Journal of Laparoendoscopic and Advanced Surgical Techniques | Year: 2014

Objective: To conduct a meta-analysis of contralateral metachronous inguinal hernia (CMIH) that originated from negative laparoscopic evaluation for contralateral patent processus vaginalis (CPPV) in children who presented with a unilateral inguinal hernia and to determine the incidence of and factors associated with such a CMIH. Materials and Methods: A PubMed search was performed for all studies concerning laparoscopic repair or evaluation of inguinal hernia in children. The search strategy was as follows: (laparoscop* OR coelioscop* OR peritoneoscop* OR laparoendoscop* OR minilaparoscop*) AND ("inguinal hernia" OR "metachronous hernia") AND child*. Inclusion criteria included unilateral inguinal hernia in children, negative laparoscopic evaluation of CPPV, without history of contralateral inguinal surgery previously, and clearly reporting CMIH development or not. Editorials, letters, review articles, case reports, animal studies, and duplicate patient series were excluded. Results: Twenty-three studies comprising 6091 children with negative CPPV fulfilled the inclusion criteria and were included in the final analysis, of whom 80 (1.31%) subsequently presented with a CMIH. Subgroup analysis showed that CMIH incidence was lower through an umbilical approach than via an inguinal one (0.85% versus 1.78%, P=.009). As for the transinguinal approach, there was a CMIH incidence of 0.78% and 2.05%, respectively, for laparoscopy with a small angle (30 and 70), whereas there was no CMIH development for that with a large angle (110, 120, and flexible). A high pneumoperitoneum pressure (>10 mm Hg, >12 mm Hg, and >14 mm Hg) was usually associated with a slightly higher CMIH incidence than a low one (≤10 mm Hg, ≤12 mm Hg, and ≤14 mm Hg), all without significant difference. CMIH incidence was slightly lower for using a broad CPPV definition than for using a narrow one (0.64% versus 1.35%, P=.183). Conclusions: CMIH following negative laparoscopic evaluation for CPPV was a rare but possible phenomenon. Choosing the transumbilical approach, transinguinal laparoscopy with a large angle, low-pressure pneumoperitoneum, and broad CPPV definition would probably reduce the occurrence of such CMIHs. © 2014, Mary Ann Liebert, Inc.

Wang F.,Ningbo Women and Childrens Hospital | Xu Y.,Ningbo Women and Childrens Hospital | Zhong H.,Ningbo Women and Childrens Hospital
Scandinavian Journal of Urology | Year: 2013

Objective.The aim of this study was to perform an updated systematic review and meta-analysis to compare robot-assisted pyeloplasty (RP) with laparoscopic pyeloplasty (LP) with regard to perioperative results. Material and methods. A search was performed for all available studies comparing the effect of RP versus LP for ureteropelvic junction obstruction (UPJO), published up to August 2012 in PubMed, Embase, Cochrane Library and Science Direct. Three reviewers independently conducted the determination of eligibility, quality assessment and data extraction for each study. All analyses were performed with Review Manager software. Results.In total, 12 studies meeting the eligibility criteria were identified for meta-analysis data extraction, including 347 cases of RP and 299 cases of LP. Meta-analysis showed that RP was associated with a 18.76 min reduction in suturing time [weighted mean difference (WMD) = -18.7 6 min, 95% confidence interval (CI) -28.76 to -8.76, p = 0.0002] and a 0.75 day decrease in mean length of hospital stay (WMD = -0.75 days, 95% CI -1.10 to -0.40, p < 0.0001) compared with LP. There were no obvious differences between the approaches in operative time (WMD = -19.44 min, 95% CI -40.20 to 1.31, p = 0.07), complication rate [odds ratio (OR) = 0.65, 95% CI 0.38 to 1.12, p = 0.12] or success rate (OR = 1.32, 95% CI 0.42 to 4.12, p = 0.64). Conclusion. For patients with UPJO, RP appears to achieve equivalent perioperative results to LP, except that RP has a shorter suturing time and shorter length of hospital stay. Given the significant heterogeneity, inevitable selection bias and limited number of studies, more high-quality clinical studies are needed. © 2013 Informa Healthcare.

Xu Y.,Ningbo Women And Childrens Hospital | Wang Q.,Ningbo Women And Childrens Hospital | Wang F.,Ningbo Women And Childrens Hospital
International Urogynecology Journal and Pelvic Floor Dysfunction | Year: 2015

Introduction and hypothesis: Today laparoscopic hysterectomy (LH) can be performed safely and effectively, even for women with a previous history of cesarean section (CS). However, it is unclear whether the risk of urinary tract injury increases with previous CS during LH. Methods: PubMed and Embase databases were searched for all studies on previous history of CS and risk of urinary tract injuries during and after LH. Reference lists of the identified studies, reviews, and other relevant publications were also searched. Urinary tract injuries or related complications were the outcomes of interest. Meta-analysis was conducted using an inverse-variance weighted random-effects model. Results: A total of 7 studies including 3,191 patients were identified in the meta-analysis. Overall, the pooled relative risk (RR) and the corresponding 95 % confidence interval (CI) of urinary tract injury were 3.48 (1.86–6.50) for previous CS compared with no previous CS. However, only two studies reported sufficient data on ureteral injury, and the combined RR was 1.83 (95 % CI 0.19–17.26). All seven studies reported the outcomes of bladder injury, and the pooled RR was 3.75 (95 % CI 1.96–7.17). Stratified analyses showed a basically consistent result with the overall analysis except for that by 1–2 times of previous CS (RR 2.32, 95 % CI 0.56–9.56). Conclusions: Previous CS is significantly associated with development of bladder injury during LH. No significant association was found yet between previous CS and risk of ureteral injury. Given the limited number of studies, more future studies are required to confirm the associations. © 2015, The International Urogynecological Association.

Feng Y.Y.,Zhejiang University | Feng Y.Y.,Ningbo Women and Childrens Hospital | Xu X.Q.,Zhejiang University | Ji C.B.,Nanjing Medical University | And 3 more authors.
Cellular Physiology and Biochemistry | Year: 2014

Background/Aim: Emerging evidence suggests that microRNA (miRNA) mediated gene regulation influences the maintenance of metabolic homeostasis, particularly the states of obesity and insulin resistance, thereby providing a potential link between miRNAs and nonalcoholic fatty liver disease (NAFLD). Methods: Sprague-Dawley rats fed a high-fat diet (HFD) were used to establish a rat model of NAFLD. The miRNA expression profile of liver tissues was evaluated using Illumina HiSeq deep sequencing. Selected miRNAs were then validated by real-time PCR at both 4- and 12-week time points. Furthermore, the expression levels of these miRNAs were assessed in HepG2 cells and human hepatocytes treated with free fatty acids (FFAs) and proinflammatory factors (tumour necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6). Results: Our results showed that consumption of a HFD for 4 weeks caused simple steatosis, which progressed to steatohepatitis at 12 weeks. miRNA deep sequencing analysis identified 44 known up-regulated miRNAs (fold change >1.5) and 12 down-regulated miRNAs (fold change <0.5). Among the abnormally expressed miRNAs, miR-200a, miR-200b, miR-200c, miR-146a, miR-146b and miR-152 were up-regulated both in vitro and vivo. Interestingly, the expression levels of these six miRNAs were increased in HepG2 cells and human hepatocytes after treatment with FFAs and proinflammatory factors. Conclusion: These findings suggest a critical role for miRNAs in the pathogenesis of NAFLD. © 2015 S. Karger AG, Basel.

Zhou J.,Zhejiang University | Wang Y.,Zhejiang University | Wang Y.,Ningbo Women and Childrens Hospital | Fei J.,Zhejiang University | Zhang W.,Zhejiang University
Oncology Letters | Year: 2012

The aim of this study was to examine the correlation between cofilin 1 expression and differentiation of epithelial ovarian cancer in patients. We immunohistochemically analyzed 30 patients with primary ovarian epithelial carcinomas, 14 patients with borderline epithelial ovarian tumors, 13 patients with benign epithelial ovarian tumors and 10 normal ovarian tissues. All ovarian cancer patients received the standard therapy, including staging laparotomy and adjuvant chemotherapy consisting of carboplatin and paclitaxel. Cofilin 1 expression gradually increased in normal ovarian tissues, benign tumors, borderline tumors and carcinomas, respectively, and there were significant differences among them (r=0.94, P<0.05). This suggests a positive correlation between the expression of cofilin 1 and tumor differentiation (r=0.97, P<0.05). The expression of cofilin 1 may predict the development of ovarian cancer and may be involved in the progression of patients with ovarian carcinoma.

Wang F.,Ningbo Women and Childrens Hospital | Xu Y.,Ningbo Women and Childrens Hospital
International Journal of Cancer | Year: 2014

Obesity is accepted as one of the major risk factors for renal cell cancer (RCC). However, conflicting results persist for the pooled risks based on the results from case-control and cohort studies combined, and the exact shape of the dose-response relationship has not been clearly defined yet. To help elucidate the role of obesity, PubMed and Embase databases were searched for published cohort studies on associations between body mass index (BMI) and risk of RCC. Random-effects models and dose-response meta-analyses were used to pool study results. Subgroup analyses were conducted by the available characteristics of studies and participants. Cohort studies (21) with 15,144 cases and 9,080,052 participants were identified. Compared to normal weight, the pooled relative risks and the corresponding 95% confidence intervals of RCC were 1.28(1.24-1.33) for preobesity and 1.77(1.68-1.87) for obesity, respectively. A nonlinear dose-response relationship was also found for RCC risk with BMI (p = 0.000), and the risk increased by 4% for each 1 kg/m2 increment in BMI. There was no significant between-study heterogeneity among studies (I 2 = 35.6% for preobesity and I2 = 44.2% for obesity, respectively). Subgroup analysis showed a basically consistent result with the overall analysis. These results suggest that increased BMI are associated with increased risk of RCC both for men and women. What's new? Obesity is known to be a major risk factor for renal-cell cancer (RCC). However, various studies have yielded conflicting results regarding the exact impact of increasing body mass index (BMI) on RCC risk. In this study, the authors conducted a dose-response meta-analysis of all published cohort studies involving BMI and risk of RCC. They found that, compared to normal weight, obesity conferred a relative risk of 1.77 for RCC, and that risk increased by 4% for each 1kg/m2 increment in BMI. © 2014 UICC.

Fang J.,Ningbo Women and Childrens Hospital | Zhang J.P.,Ningbo Women and Childrens Hospital | Luo C.X.,Ningbo Women and Childrens Hospital | Yu X.M.,Ningbo Women and Childrens Hospital | Lv L.Q.,Ningbo Women and Childrens Hospital
International Journal of Medical Sciences | Year: 2010

Aim: To investigate risk factors which impact on common carotid artery intima media thickness (IMT). Methods: A total of 86 obese children and adolescents and 22 healthy children and adolescents with normal weight were enrolled. Moreover, 23 of 86 obese children and adolescents were diagnosed with metabolic syndrome (MetS). The clinical, biochemical data and the IMT of the common carotid artery were measured in all subjects. Results: Obese and obese with MetS subjects demonstrated a significantly (p < 0.01) thicker intima media (0.69mm, 0.66mm) as compared to the control group (0.38mm), but there was no significant difference of IMT between obese and MetS group. IMT was correlated to body weight, body mass index, waist circumference, waist to hip ratio, systolic blood pressure, diastolic blood pressure, fasting insulin, homoeostasis model assessment-insulin resistance, triglyceride, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, alanine aminotransferase, aspartate aminotransferase and fatty liver. Waist circumference, waist to hip ratio, triglyceride and homoeostasis model assessment-insulin resistance were independent determinants of mean IMT level. Conclusion: Obesity especially abdominal obesity, high TG and insulin resistance may be the main risk predictors of increased IMT. © Ivyspring International Publisher.

Zhou L.M.,Ningbo Women and Childrens Hospital
Zhonghua fu chan ke za zhi | Year: 2013

To study clinical efficacy of leuprorelin acetate in treatment of uterine adenomyosis with infertility. From January 1,2011 to March 31,2012, 166 cycles in 166 infertile patients combined with uterine adenomyosis undergoing in vitro fertilization embryo transplant (IVF-ET) with long protocol ovum induction by leuprorelin acetate in centre of medical reproduction, ningbo women and children's hospital were studied retrospectively. In the mean time, 200 cycles in 200 infertile patients with tubal factors were enrolled as control group.The volume of uterus and outcome of IVF-ET were compared and studied between two groups. (1) Volume of uterus:in adenomyosis group, after 2-6 cycles of injecting leuprorelin acetate (3.75 mg/28 days), the mean uterine volume was shrinked from (180 ± 73) cm(3) to (86 ± 67) cm(3) (P < 0.05). (2) Outcome of IVF-ET:the rate of embryo implantation was 39.1% in adenomyosis group and 35.8% in control group. The rate of clinical pregnancy was 54.2% in adenomyosis group and 53.7% in control group. The rate of abortion was 4.7% in adenomyosis group and 4.2% in control group. They all did not show statistical differences (P > 0.05). (3) In adenomyosis group, the rate of fertilization, two pronuclear (2PN) and superior embryo were 67.2%(319/475), 60.8% (289/475) and 52.9% (162/306) in patients with failed pregnancy and 74.2% (423/570), 67.7% (386/570) and 62.1% (256/412) in patients with successful pregnancy after IVF-ET, which reached significant difference (P < 0.05). Leuprorelin acetate could improve volume of uterine adenomyosis and outcome of pregnancy in patients undergoing IVF-ET.

Wang F.,Ningbo Women and Childrens Hospital | Xu Y.,Ningbo Women and Childrens Hospital | Zhong H.,Ningbo Women and Childrens Hospital
Pediatric Surgery International | Year: 2013

Purpose: To conduct a systematic review and meta-analysis of studies comparing the perimeatal-based flap (PBF) and tubularized incised-plate (TIP) techniques for primary hypospadias repair and determine whether the two techniques had similar reported outcomes. Methods: The PubMed, Embase and Cochrane databases were searched using the terms: hypospadias, Snodgrass, TIP*, tubularized incised plate, tubularized incised-plate, Mathieu*, perimeatal-based flap, perimeatal flap, meatal-based flap and meatal based flap. No other limits were used. Inclusion criteria included: primary hypospadias repair only; both including the PBF and TIP techniques; at least one of the quantitative outcomes obtainable from study; comparative studies. Results: Twelve studies fulfilled the inclusion criteria and were included in the final analysis. Meta-analysis showed that there were no significant differences between the two techniques when comparing fistula (OR = 1.47; 95 % CI: 0.82-2.63; P = 0.20), meatal stenosis (OR = 0.53; 95 % CI: 0.24-1.16; P = 0.11), and wound dehiscence (OR = 0.82; 95 % CI: 0.24-2.84; P = 0.76). Both the studies which assessed cosmesis objectively showed a consistent better cosmetic result of the TIP technique (P < 0.05). Conclusion: There were no significant differences of complication rates between the two techniques, and the TIP technique was usually of better cosmesis. Given the large clinical heterogeneity among studies, future more well-designed studies with full data and uniform criterion were awaited. © 2013 Springer-Verlag Berlin Heidelberg.

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