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ObjectiveTo investigate the association between estimated glucose disposal rate （eGDR） and the severity of coronary heart disease. MethodsWe conducted a hospital-based cross-sectional study that included 1258 patients （mean age： 62（53-68） years） who underwent coronary angiography for suspected coronary artery disease （53.9% were male）. Insulin resistance level （IR） was calculated according to eGDR formula： eGDR = 21.158 - （0.09 × WC） - （3.407 × hypertension） - （0.551 × HbA1c） ［hypertension （yes = 1 / no = 0）， HbA1c = HbA1c （%）］. Subjects were grouped according to the eGDR quantile. CAD severity was determined by the number of narrowed vessels： no-obstructive CAD group （all coronary stenosis were<50%， n=704）， Single-vessel CAD group （only one involved major coronary artery stenosis≥50%， n=205）， Multi-vessel CAD group （two or more involved major coronary arteries stenosis≥50%， n=349）； Multivariate logistic regression model was used to analyze the association between eGDR and CAD severity. The linear relationship between eGDR and CAD in the whole range of eGDR was analyzed using restricted cubic spline. Subgroup analyses were used to assess the association between eGDR and CAD severity in different diabetic states. Receiver operating characteristic （ROC） curve analysis were used to evaluate the value of eGDR in improving CAD recognition. ResultsA decrease in the eGDR index was significantly associated with an increased risk of CAD severity （OR： 2.79； 95%CI： 1.72~4.55； P<0.001）. In multivariate logistic regression models， individuals with the lowest quantile of eGDR （T1） were 2.79 times more likely to develop multi-vessel CAD than those with the highest quantile of eGDR （T3） （OR： 2.79； 95%CI： 1.72~4.55； P<0.001）. Multivariate restricted cubic spline analysis showed that eGDR was negatively associated with CAD and multi-vessel CAD （P-nonlinear>0.05）. In non-diabetic patients， compared with the reference group （T3）， the T1 group had a significantly increased risk of CAD （OR： 1.42； 95% CI： 1.00~2.01； P<0.05） and multi-vessel CAD （OR： 1.86； 95%CI： 1.21~2.86； P<0.05）. No statistical association was found between eGDR and CAD in diabetic patients. In ROC curve analysis， when eGDR was added to traditional model for CAD， significant improvements were observed in the model's recognition of CAD and multi-vessel CAD. ConclusionOur study shows eGDR levels are inversely associated with CAD and CAD severity. eGDR， as a non-insulin measure to assess IR， could be a valuable indicator of CAD severity for population.
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Secondary hyperparathyroidism (SHPT) is a common and serious complication in long-term dialysis patients, who often experience multiple symptoms and a poor quality of life. Parathyroidectomy (PTX) is the best choice for severe SHPT patients with poor drug treatment. At present, the follow-up after PTX has not received sufficient attention, and the assessment of patients' clinical symptoms and quality of life is not yet adequate. In view of this, we systematically combed the changes and influencing factors of patients' quality of life and related symptoms after surgery, in order to provide reference for the practice and research of symptom management of such patients in the future.
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<p><b>OBJECTIVE</b>To study the effects of exposed to different concentrations of carbon disulfide on neurological signs of workers.</p><p><b>METHODS</b>Collection the information of concentration of carbon disulfide in the workplace or workers individuals exposed of a chemical fiber industry from 2004 to 2011, a total of 3 537 workers exposed to carbon disulfide were detected muscle strength and muscle tone, knee reflex, Achilles tendon reflex, trembling limbs, sensory function, and three chatter. Chi-square test was used for statistical analysis on abnormal neurological signs of workers.</p><p><b>RESULTS</b>Eight hours time-weighted average concentration range of workers exposed to carbon disulfide in this chemical fiber industry was 0.2-41.0 mg/m(3), geometric mean was 2.38 mg/m(3). Concentration of carbon disulfide exposure of 1 771 workers was from 0.2 to 2.5 mg/m3( ≤ 2.5 mg/m(3)), 642 workers was 2.6-4.8 mg/m(3) (< 5.0 mg/m(3)), other 1 051 workers was from 5.1 to 41.0 mg/m(3) ( > 5.0 mg/m(3)) in all subjects. The different detection rates of knee reflex were 3.0% (31/1 045), 3.7% (21/574), 4.8% (16/331), 3.3% (10/305), 5.9% (11/187), 6.7% (68/1 022), the different detection rates of Achilles tendon reflex were 2.2% (23/1 045), 3.7% (21/574), 2.7% (9/331), 2.3% (7/305), 2.1% (4/187), 5.6% (57/1 022), the different detection rates of sensory dysfunction were 0.4% (4/1 045), 0.5% (3/574), 0.6% (2/331), 0.0% (0/305), 2.1% (4/187), 1.7% (17/1 022) in different cumulative amount of contact groups ( ≤ 10.0, 10.1-20.0, 20.1-30.0, 30.1-40.0, 40.1-50.0, >50.0 mg/m(3) per year), and the differences were statistically significant (χ(2) = 19.53, 21.27 and 15.89, all P values were <0.01) . Stratified according to age and gender, in addition to the ≤ 25 years group the difference of detection rate analysis on Achilles tendon reflex was statistically significant in the different concentration group (the ratio of on Achilles tendon reflex in the different groups of concentration of carbon disulfide exposure of 2.5, 2.6-5.0, ≥ 5.0 mg/m(3) were 0.4% (2/511), 1.0% (1/98), 2.1% (7/327), χ(2) = 5.59, P = 0.045) , the difference of detection rate analysis on neurological sign was not statistically significant in the different concentration group on the rest of the age and gender groups (P > 0.05).</p><p><b>CONCLUSION</b>Within the concentration range of the object of study contact actual, different concentrations of carbon disulfide in addition to individual neurological signs of individual ages influential, it has no significant effect on the various signs of nervous system of workers of most age and gender groups, expect the age below the 25 years old group.</p>
Subject(s)
Adult , Humans , Middle Aged , Age Factors , Carbon Disulfide , Chemical Industry , China , Neurotoxicity Syndromes , Occupational Exposure , WorkplaceABSTRACT
<p><b>OBJECTIVE</b>To make a system review of the effects of Bushenhuoxue (kidney-tonifying and blood-activating prescription), a category of compound Chinese medicines, on benign prostatic hyperplasia (BPH) and its side effects.</p><p><b>METHODS</b>All the research articles about Chinese medicines treating BPH from January 1978 to February 2003 were retrieved using the methods of international evidence-based medicine (EBM), and their qualities were evaluated based on JADAD standard and concealment of research allocation. Then the included articles went through META-analysis with Revman 4.2 software.</p><p><b>RESULTS</b>The efficacy of Bushenhuoxue on BPH was better than Qianliekang but not statistically different from finasteride. The combined use of Bushenhuoxue with surgery had no statistical difference from mere surgical treatment. Four articles reported the side effects of this compound Chinese medicine including upset and pain in the abdomen, nausea, diarrhea and dryness of the nose.</p><p><b>CONCLUSION</b>Massive, multi-center and randomized controlled clinical trials should be conducted to find out more effective methods for treating BPH with Chinese medicines based on the improvement of measurable symptom evaluation method and for evaluating their side effects.</p>