BackgroundAlthough an elevated hemoglobin A1c (HbAc1) level is an independent predictor of worse survival in patients with both digestive cancer and diabetes mellitus, its relationship to short-term prognosis in these patients has not been addressed. This study assessed this relationship in gastrointestinal cancer (GIC) patients with type 2 diabetes mellitus (T2DM).MethodsA retrospective review of patients with GIC with or without T2DM from 2004 to 2014 was performed. Patients with T2DM were grouped according to HbA1c level, either normal (mean < 7.0%) or elevated (mean ≥ 7.0%). Age- and sex-matched GIC patients without T2DM served as controls.ResultsOne hundred and eighteen patients aged 33 - 81 years with T2DM met the study eligibility criteria; 51 were in the normal HbA1c group, and 67 were in the elevated HbA1c group. The 91 patients in the non-T2DM group were randomly selected and matched to the T2DM group in terms of admittance date, age, and sex. There was a trend toward a higher 180-day mortality rate in the T2DM group compared with the non-T2DM group (15.3% vs. 7.7%, P = 0.095) and in the elevated HbA1c group compared with the normal HbA1c group (19.4% vs. 9.8%, P = 0.151); however, the differences were not significant. The duration of the hospital stay was longer in patients with T2DM than in those without T2DM (13.2 vs. 8.9 days, P < 0.05) and in patients with elevated versus normal HbA1c levels (14.5 vs. 11.4 days, P < 0.05). Diabetic GIC patients with elevated HbA1c levels had significantly more total postoperative complications than those with normal HbA1c levels (25.4% vs. 9.8%, P < 0.05). In multivariate regression analyses, short-term adverse outcomes were strongly associated with elevated HbA1c levels (odds ratio (OR): 5.276; 95% confidence level (CI): 1.73 - 16.095; P < 0.05) and no strict antidiabetic treatment (OR: 7.65; 95% CI: 2.49 - 23.54; P < 0.001).ConclusionAn elevated level of HbA1c significantly correlated with and was an independent predictor of short-term adverse outcomes in GIC patients with T2DM.

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We report on the use of fluorescence in situ hybridization (FISH) with specific chromosome 8 arm painting to characterize further small supernumerary chromosome 8-derived markers/rings (SMC/SRC) identified in three patients. Two patients (patients 1 and 2) who carried the marker (SMC) were evaluated because of mental retardation and minor facial anomalies. The patient (patient 3) who carried the ring (SRC) had ventriculomegaly. Parental blood chromosomes of patients 2 and 3 were normal and unavailable on patient 1. The identification of the SMC/SRC was first characterized by FISH specific alpha-repeat centromeric probes, second by FISH whole chromosome painting (WCP), and finally by FISH chromosome arm painting (CAP). The latter showed involvement of only the short arm of chromosome 8 in all three SMC/SRC cases, suggesting a U-type exchange mechanism.

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Background and Aims: Malnutrition is a common and critical problem that greatly influences the clinical outcomes of hospitalized patients. Nutrition support therapy and food intake, in addition to disease-related factors, are also important to maintain the nutrition status of patients. In light of this, we aimed to examine the risk factors associated with malnutrition in 3 hospitals in China. Methods: This project was part of the NutritionDay audit, an international daylong cross-sectional audit investigating the nutritional intervention profiles of hospitalized patients. Seven standardized questionnaires were used, and malnutrition was defined as a body mass index <18.5 kg/m² or unintentional weight loss >5% in last 3 months. Results: A total of 842 hospitalized patients from 9 units in 3 Chinese hospitals participated in the project on November 19, 2015. Among them, 825 were included in the analyses. Malnutrition was identified in 29.3% of the patients and oral nutrition was the primary nutrition support therapy administered (n = 623, 75.6%). Age, nutrition support, and food intake during the past week were independent risk factors for malnutrition. Furthermore, nutrition status, nutrition support therapy, and food intake during the past week were associated with prolonged length of stay. Conclusions: The prevalence of malnutrition in Chinese hospitals was similar to that in European hospitals. Nutrition status was associated with age, nutrition support, and food intake, which was closely related to patients' clinical outcome, such as prolonged hospital stays as confirmed in this study. More studies are needed to determine why nutrition intake is often inadequate and to determine efficient methods for correcting the nutrition status of patients.