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Objective:To analyze the development trend of global diabetes health management from the perspective of patent bibliometrics.Methods:Data from 4 804 global diabetes health management patents were retrieved from the Derwent Innovation patent database, and after data cleaning and merging of patent families, a total of 857 patents were used in Excel and big data analysis tool Derwent Data Analysis tool to analyze patent application trends and technology sources. Quantitative analysis of country and market layout, distribution and types of patent holders, technology research and development hotspots, visual display of quantitative analysis data using bubble charts, technical function matrices, and word cloud graphs and other methods were performed to compare the layout of domestic and foreign diabetes health management patent technologies, as well as status and development characteristics.Results:The filling of global diabetes health management patent application began in 1980, and the Chinese diabetes health management patent application began in 2003, showing a slow-growth trend. The United States had the most effective patents for diabetes health management, followed by China, South Korea, Switzerland, and Japan, with 153, 89, 50, 31, and 14 patents respectively. These five countries account for approximately 95% of effective patents. The main market areas for effective patents on global diabetes health management were the United States and China, followed by South Korea, the European Patent Office, Japan, and Canada. Approximately 98% of China′s patents were located in the country, and the proportion of companies in China′s patent applications was much lower than that of the United States, Japan, and Switzerland (49% vs 90% or more). The research and development hotspots of China′s and global diabetes health management patents were consistent with the various systems, including health management systems, diabetes management systems, blood sugar management systems, glucose monitoring systems, and health management equipment.Conclusions:The United States and China were the top two major technology sources and market distribution countries for diabetes health management patents; however, China′s patent application internationalization strategy has not yet been launched, and the degree of patent industrialization requires improvement. In the future, global diabetes health management patent research and development will continue to show a development trend dominated by information systems, equipment, and tools.
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Objective:To analyze the similarities and differences between obesity and diabetes in discipline development from the perspective of bibliometrics.Methods:Relevant literatures of guidelines and expert consensus in the field of obesity and diabetes were retrieved and collected from the China National Knowledge Infrastructure (CNKI) and Wanfang Knowledge Service Platform. The literature publication trend, the country and region distribution of guideline and consensus, as well as the distribution of citation frequency were further analyzed from the perspective of bibliometrics.Results:The research of guidelines and consensus of obesity started later than the diabetes. Its related research was still in its infancy, while the field of diabetes was in its mature stage. The corresponding guidelines and expert consensus in the United States were the major concerns in whatever fields of obesity or diabetes. The total number of citations for representative guidelines in the field of obesity was much lower than the representative guidelines in the field of diabetes （3 479 vs. 11 678）. Conclusion:As a type of chronic disease, the obesity shows far inferior to diabetes in the development of professional disciplines in China.
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Autoantibodies are related to occurrence of some types of severe hypertriglyceridemia. Resear-ches showed that autoantibodies of lipoprotein lipase, glycosylphosphatidylinositol-anchored high-density lipo-protein binding protein 1 and apolipoprotein C-Ⅱcould induce hypertriglyceridemia. This review focused on hy-pertriglyceridemia induced by autoantibodies and its treatment.
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Objective To explore the difference of gut microbiota between type 2 diabetes mellitus (T2DM) and non-diabetic population in Beijing. Methods 83 T2DM patients were selected as T2DM group and 64 non-diabetic subjects were selected as control group. Fecal samples were collected from all the subjects. The intestinal flora was detected by metagenome sequencing technology. Results 11 bacterialphyla were detec-ted in the two groups, there were significant differences in species diversity of Actinobacteria (P=0. 013), Firmicutes (P=0. 005), Fusobacteria (P=0. 001), Proteobacteria (P<0. 001) between the two groups. Actinobacteria, Fusobacteria and Proteobacteria were all enriched in the T2DM group, Firmicutes were enriched in the control group. 152 bacterial genera were detected in the two groups with 31 bacterial genera ofsignificant differences. In T2DM group, the levels of Roseburia, Eubacterium and Faecalibacterium decreased, while the levels of Bifidobacterium, Lactobacillus and Escherichia increased. Conclusion There are significant differ-ences in the composition of gut microbiota between T2DM patients and non-diabetic population. Regulation of gut microbiota in T2DM patients may be helpful to improve the condition of T2DM.
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Objective To analyze the effect of health check-up feedback style (HCFS) on the blood glucose level and weight of type 2 diabetes patients aged 75 years and older.Methods 120 consecutive patients with type 2 diabetes and aged 75 and older who were taking annual health check-up and receiving paper-based medical examination reports at Peking Union Medical College Hospital were enrolled into this study.The patients were randomly divided into two groups (control group and study group).All patients received annual health check-up between November 2014 and October 2015 (baseline health check-up).Patients in control group were given paperbased feedback as usual,while those in study group received feedback via face-to-face or telephone conversations.All patients received their second annual health check-up between November 2015 and October 2016.The patients' blood glucose and weight at the second health check-up were compared between the two groups.Results In baseline health check-up,the levels of HbA1c and BMI showed no difference between the two groups.In the second health check-up,HbA1c and BMI of study group were lower than control group [(7.17±0.58)％ vs.(7.44±0.72)％,P=0.027;(24.3±3.8) kg/m2 vs.(25.0±4.2) kg/m2,P=0.049].Fast blood glucose and waist circumference showed no difference between the two groups.Conclusions Combination of paper-based reports and face-to-face or telephone conversations to feedback on health check-up results led to better blood glucose and BMI control in old aged type 2 diabetes patients.HCFS is of vital importance.
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Glucocorticoids are widely used in clinical practice,and abnormal glucose metabolism due to the use of glucocorticoids is prevalent.There has been progress in studies evaluating post-glucocorticoid changes in blood glucose levels using continuous glucose monitoring.This paper reviews glycemic patterns and protocols for insulin treatment of abnormal glucose metabolism following the use of glucocorticoids as shown by continuous glucose monitoring.
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Objective: To determine whether microtubule-associated protein 2 (MAP2) and microtubule-associated protein 1B (MAP1B) could be prognostic biomarkers for patients with pancreatic neuroendocrine tumors (PNETs). Methods:With immunohisto-chemical staining, the expressions of MAP2 and MAP1B were examined in 193 and 120 primary tumors and peritumoral tissues, re-spectively. Then, the relationship between the expression of each protein and clinicopathological characteristics, including prognosis was analyzed. Results:MAP2 and MAP1B were expressed in 88 of 193 (45.6%) and 77 of 120 (64.2%) tumors, respectively. The expres-sion of MAP2 was significantly associated with the favorable overall survival of patients with PNETs (P=0.012). Moreover, MAP2 expres-sion was associated with the improved overall survival in a subset of patients with stageⅡand stageⅢtumors (P=0.017). The MAP1B expression did not correlate with other clinicopathological features and prognosis. Conclusion:MAP2 could be a novel, independent prognostcbiomarker for PNETs.
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Objective To investigate clinical and pathological characteristics of insulin-induced localized lipoatrophy and treatment.Methods We retrospectively analyzed clinical manifestation, skin biopsy pathology, treatment regimen and follow-up of 6 diabetic patients with insulin-induced localized lipoatrophy in Peking Union Medical College Hospital from January, 2010 to March, 2016, with systemic review of related literatures.Results Among 6 cases with insulin-induced localized lipoatrophy, 5 patients were with insulin allergy.5 patients were with positive insulin-autoimmune antibody, which was similar to the ratio reported in the systematic review (18 out of 19).Insulin-induced lipoatrophy could be caused by various types of preparations of insulin and insulin analogs.Subcutaneous biopsy, performed on the atrophied area, revealed the decrease of the number and volume of adipocytes and tissue fibrosis, probably accompanied with lymphocytes, eosinophils or mast cells infiltration.Lipoatrophy could sometimes be relieved by changing injection sites, types of insulin preparations or drug-delivery way, sometimes by application of systemic/local glucocorticoid or local cromolyn sodium.Conclusions Insulin-induced localized lipoatrophy is a rare adverse reaction of insulin preparations.It might be related to immune response of local tissue and heterogeneous pathological manifestations.The lipoatrophy might be improved by changing injection sites, changing the type of insulin preparations or drug-delivery way, and with possibility to carry out targeted immunosuppressive therapy according to the biopsy pathology in the future.
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Objective To evaluate the effects of a traditional Chinese medicine Rubia cordifolia L.aqueous extract (RCAE) on body weight, fat mass and parameters of glucose and lipid metabolism in high fat diet (HFD)-induced obese rats and its mechanism.Methods pGL3-Enhancer-PPARγ2 (625 bp)-Luc plasmid, a luciferase reportergene expression plasmid containing PPARγ2 promoter was constructed and stably transfected 3T3-L1 preadipocytes were established.PPARγ2 promoter`s activities in these cells were detected after administration with different concentration (0.1 mg/L~1 000 mg/L) of RCAE or with 100 mg/L RCAE for different action time.PPARγ2 mRNA expression in human adipocytes were detected after administration with 100 mg/L RCAE.Meanwhile, HFD-induced obese rats were administrated with low or high dose RCAE to investigate the effects of RCAE on serum glucose, lipid and insulin levels, body weight, visceral fat mass and so on.Results 10 mg/L RCAE could increase luciferase expression in 3T3-L1 cells to 1.43 folds of that in control group (P<0.01) and it reached 3.24 folds of that in control group when the concentration of RCAE was 1000 mg/L (P<0.01).With the administration with 100 mg/L RCAE, the luciferase activity of 3T3-L1 cells peaked at 28 h where it was 2.72 folds of that in control group (P<0.01), and the expression of PPARγ2 mRNA in human adipocytes increased to 2.27 folds of that in control group (P<0.01).Compared with HFD group, low dose RCAE significantly reduced the fasting insulin level, HOMA-IR and visceral fat mass (P<0.05).Conclusions Low dose RCAE significantly reduces the visceral fat mass and ameliorates insulin resistance in HFD-induced obese rats.The potential mechanism may be explained by the stimulation of PPARγ2 promoter activities and the increased expression of PPARγ2 gene.
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Objective To explore the fasting blood glucose (FBG) variation trends and the prevalence of impaired fasting blood glucose(IFG)among medical staff in Beijing, 2009-2015.Methods A prospective cohort study, using seven years of follow-up data, was conducted in a large-scale tertiary hospital in Beijing.A total of 1 284 medical staff aged 35 to 60 years were recruited.We divided them into 4 groups according to age and occupational categories,and the level of FBG was tested at the same time each year. Results The number of medical staff who completed all 7 annual FBG tests was 403. There was a stepwise increase in the levels of FBG (4.92 mmol/L, 5.26 mmol/L, and 5.60 mmol/L in the years 2009, 2012,and 2015,respectively;F=100.643,P<0.001).An increasing trend in the prevalence of IFG was also evident (3.7%, 7.7%, and 13.4% in the years 2009, 2012, and 2015, respectively; χ2=39.099, P<0.001). Compared with baseline levels(in 2009),the average levels of FBG and the prevalence of IFG in men and women, as well as in all occupational classes (doctors, nurses, technicians, and other medical employees), were significantly elevated by the year 2015 (all P<0.05). The levels of FBG in male medical staff were higher than that in female medical staff,in both 2009 and 2015(both P<0.001).Conclusion The trend of increasing FBG levels and IFG cases in medical staff,especially in men,has been a problem for hospitals. Health policy action is urgently needed to deflate the IFG bubbles.
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Proprotein convertase subtilisin/kexin type 9 (PCSK9) plays an important role in lipid reg-ulation through interaction with low-density lipoprotein cholesterol receptors , and several types of PCSK 9 inhibi-tors are gradually becoming research hotspots due to their lipid lowering effect .Among them PCSK9 monoclonal antibodies are the closest to clinical application , and a number of phase Ⅲclinical trials in PCSK9 monoclonal antibodies have been completed in recent years .We systemically reviewed the current clinical research on PC-SK9 monoclonal antibodies in this paper , in order to understand their efficacy and long-term safety in reducing the risk of cardiovascular diseases .
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Objective To investigate prevalence of nutritional status of children and adolescents of school age in the poor region with many ethnic groups of Western regions of China. Methods In September 2006, we performed a health check?up for 2 475 students of a primary school and a middle school from many ethnic groups in Rongshui, Guangxi; 1 163 boys (46.99%) and 1 362 girls (53.01%) participated in this study, including 4 main ethnic groups: Han (848 participants, 34.26%), Miao (736 participants, 29.74%), Zhuang (415 participants, 16.77%) and Dong (341 participants, 13.78%), and prevalence of obesity and malnutrition for the population were surveyed. Results The prevalence rates of overweight among male and female children/adolescents of school age were 3.01%and 3.66%, respectively;and the prevalence rates of obesity were 1.55%and 0.76%, respectively. In 4 main ethnic groups of Han, Miao, Zhuang and Dong, the prevalence rates of overweight were 2.59%, 4.76%, 2.89% and 2.93%, respectively; while the prevalence rates of obesity were 1.89%, 0.27%, 0.96%and 1.17%, respectively. The prevalence rates of malnutrition among male and female children/adolescents of school age were 5.59%and 3.35%, respectively;while the prevalence rates of malnutrition in 4 main ethnic groups of Han, Miao, Zhuang and Dong were 6.96%, 2.17%, 5.54% and 2.64%, respectively. Conclusion The prevalence rates of overweight and obesity of children and adolescents of school age in Rongshui were relatively low, while the prevalence rates of malnutrition is similar to the average level of China.
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Objective To investigate how to improve safety of insulin injection in type 2 diabetes patients by“insulin pen”through the rotating insulin weekly abdominal injection card. Method All the inpatients with type 2 diabetes in the Department of 3rd Internal Medicine from January to September, 2013 were enrolled in this study. Insulin Injection Card group was composed of 66 type 2 diabetes patients who were admitted from June to September, while control group was composed of 62 type 2 diabetes patients admitted from January to April. The difference between Insulin Injection Card group and control group was that the former group used the rotating insulin abdominal injection card weekly which was designed by ourselves, while the control group patients did not use the card. Every participant of both groups was evaluated at 2 weeks of treatment by percentage of patients having absence of Safety standard of insulin injection, and at the end of 3 months of treatment by percentage of patients attaining the therapeutic targets and incidence of adverse events. Result Compared with the control group, patients in Insulin Injection Card group had lower proportion of absence of Safety standard for insulin injection. The scores of rotation injection site in the two groups was 0.59±0.14 and 2.67±0.21(P<0.01). The rate of FPG target achievement of patients in Insulin Injection Card group (84.9%) was higher than that of the control group (61.3%)(P<0.01), the rate of HbA1c target achievement of patients in Insulin Injection Card group (78.8%) was higher than that of the control group (56.5%)(P<0.01). Patients in Insulin Injection Card group had lower incidence of local adverse events (1.5%) compared with the control group (12.9%)(P<0.05). Conclusion Use of the rotating insulin weekly abdominal injection card that was designed by the diabetes health management Quality Control Group in our department showed good effect in achieving therapeutic targets (including HBA1C) and decreasing safety standard deficiency of insulin injection and adverse events.
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Malignant islet cell tumor, a rare type of neuroendocrine carcinoma, biologically behaves in an aggressive way and is difficulty to be treated. Sunitinib malate, a novel tyrosine kinase inhibitor, demonstrates a high efficacy in treating malignant islet cell tumor as shown by promising results in recent trials.
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Objective To evaluate the values of continuous subcutaneous insulin/rapid insulin analoguc infusion in desensitization for allergy to recombinant human insulin. Methods Two patients allergic to recombinant human insulin received desensitization therapy by continuous subcutaneous insulin lispro infusion. The diluted insulin lispro solution was pumped with initial basal rate of O. O1 U/h, and the basal rate and insulin lispro concentration increased gradually until the insulin dosage for clinical treatment was reached. After that, continuous subcutaneous insulin lispro infusion was replaced by regimen of insulin lispro subcutaneous injection plus oral hypoglycemic agents. Results Local wheals were not observed in both two patients during continuous subcutaneous insulin lispro infusion or during bolus subcutaneous injection of insulin lispro after desensitization. Conclusion The desensitization therapy by continuous subcutaneous insulin/rapid insulin analogue infusion can be applied for allergy to recombinant human insulin.
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Objective We have summarized the clinical characteristics of inappropriate antidiuresis(SIAD).Methods We adopted retrospective analysis to analyze the clinical and lab data of 40 cases.Results The most common causes of SIAD were malignant tumor,lung disease,and central nervous system disease.The five major abnormal lab data were:hypochloraemia,hypouricemia,hyponitremia,hypocalcemia,and low hematocrit.Conclusion It is important to diagnose SIAD as soon as possible,and patient presented hyponatremia combined with hypouricemia must be suspected to have SIAD.