ABSTRACT
Background@#Prediabetes leads to declines in physical function in older adults, but the impact of prediabetes progression or regression on physical function is unknown. This study assessed this longitudinal association, with physical function objectivelymeasured by grip strength, walking speed, and standing balance, based on the Health and Retirement Study enrolling United States adults aged >50 years. @*Methods@#Participants with prediabetes were followed-up for 4-year to ascertain prediabetes status alteration (maintained, regressed, or progressed), and another 4-year to assess their impacts on physical function. Weak grip strength was defined as <26 kg for men and <16 kg for women, slow walking speed was as <0.8 m/sec, and poor standing balance was as an uncompleted fulltandem standing testing. Logistic and linear regression analyses were performed. @*Results@#Of the included 1,511 participants with prediabetes, 700 maintained as prediabetes, 306 progressed to diabetes, and 505 regressed to normoglycemia over 4 years. Grip strength and walking speed were declined from baseline during the 4-year followup, regardless of prediabetes status alteration. Compared with prediabetes maintenance, prediabetes progression increased the odds of developing weak grip strength by 89% (95% confidence interval [CI], 0.04 to 2.44) and exhibited larger declines in grip strength by 0.85 kg (95% CI, –1.65 to –0.04). However, prediabetes progression was not related to impairments in walking speed or standing balance. Prediabetes regression also did not affect any measures of physical function. @*Conclusion@#Prediabetes progression accelerates grip strength decline in aging population, while prediabetes regression may not prevent physical function decline due to aging.
ABSTRACT
Acute kidney injury (AKI) and hepatorenal syndrome (HRS) are serious complications in patients with end-stage liver disease, with renal injury as the main manifestation. They are interrelated, but also different from each other. There are several types of AKI, i.e., prerenal AKI, intrarenal or intrinsic AKI, and post-renal AKI, and type 1 HRS is considered a special type of AKI. There are different therapies for different types of AKI. With the improvement in the diagnostic criteria for AKI and chronic kidney disease in recent years, the diagnostic criteria and classification of HRS have also been updated. As for pathogenesis, systemic inflammation caused by intestinal bacterial translocation is attracting more and more attention. HRS was considered functional renal injury in the past, but recent evidence suggests the existence of structural injury. Vasoconstrictor combined with albumin is the main therapeutic drug for HRS. This article reviews the diagnosis and treatment of AKI in end-stage liver disease and the recent advances in the diagnostic criteria, classification, pathology, pathogenesis, and treatment of HRS.
ABSTRACT
TCM and psychiatry are two different medical systems,but they diagnose and treat diseases through clinical symptoms observation.Both have the characteristics of entity,variety and flexibility on medical thoughts,basic theory and diagnosis and treatment.The difference lies in that TCM has unified medical thought easy for learning,the psychiatry has unified diagnosis standard easy for operation.The two’s mutual supplementation will have great meaning in their development.