Latest incidence and electrocardiographic predictors of atrial fibrillation: a prospective study from China / 中华医学杂志(英文版)

BACKGROUND@#China bears the biggest atrial fibrillation (AF) burden in the world. However, little is known about the incidence and predictors of AF. This study aimed to investigate the current incidence of AF and its electrocardiographic (ECG) predictors in general community individuals aged over 60 years in China.@*METHODS@#This was a prospective cohort study, recruiting subjects who were aged over 60 years and underwent annual health checkups from April to July 2015 in four community health centers in Songjiang District, Shanghai, China. The subjects were then followed up from 2015 to 2019 annually. Data on sociodemographic characteristics, medical history, and the resting 12-lead ECG were collected. Kaplan-Meier curve was used for showing the trends in AF incidence and calculating the predictors of AF. Associations of ECG abnormalities and AF incidence were examined using Cox proportional hazard models.@*RESULTS@#This study recruited 18,738 subjects, and 351 (1.87%) developed AF. The overall incidence rate of AF was 5.2/1000 person-years during an observation period of 67,704 person-years. Multivariable Cox regression analysis indicated age (hazard ratio [HR], 1.07; 95% confidence interval [CI]: 1.06-1.09; P < 0.001), male (HR, 1.30; 95% CI: 1.05-1.62; P = 0.018), a history of hypertension (HR, 1.55; 95% CI: 1.23-1.95; P < 0.001), a history of cardiac diseases (HR, 3.23; 95% CI: 2.34-4.45; P < 0.001), atrial premature complex (APC) (HR, 2.82; 95% CI: 2.17-3.68; P < 0.001), atrial flutter (HR, 18.68; 95% CI: 7.37-47.31; P < 0.001), junctional premature complex (JPC) (HR, 3.57; 95% CI: 1.59-8.02; P = 0.002), junctional rhythm (HR, 18.24; 95% CI: 5.83-57.07; P < 0.001), ventricular premature complex (VPC) (HR, 1.76; 95% CI: 1.13-2.75, P = 0.012), short PR interval (HR, 5.49; 95% CI: 1.36-22.19; P = 0.017), right atrial enlargement (HR, 6.22; 95% CI: 1.54-25.14; P = 0.010), and pacing rhythm (HR, 3.99; 95% CI: 1.57-10.14; P = 0.004) were independently associated with the incidence of AF.@*CONCLUSIONS@#The present incidence of AF was 5.2/1000 person-years in the studied population aged over 60 years in China. Among various ECG abnormalities, only APC, atrial flutter, JPC, junctional rhythm, short PR interval, VPC, right atrial enlargement, and pacing rhythm were independently associated with AF incidence.

Management and prognosis of primary retroperitoneal tumors / 中华普通外科杂志

Objective:To summarize the clinical characteristics of primary retroperitoneal tumors (PRT).Methods:All PRT cases undergoing surgical resection during recent 10 years at our center were retrospectively analyzed.Results:Tumors in all 92 cases were of malignant in 64 cases, borderline in 10 and benign PRT in 18, among which liposarcoma and leiomyosarcoma were the most common types. The tumor size and Ki-67 was significantly higher in malignant compared to borderline or benign PRT. The multifocal rate was 50%, en-bloc resection rate was 72%, R 0 rate was 61%, and combined organ resection rate was 41% in malignant PRTs. Small intestine and the colon were the most frequently resected organs. During 9.3 years of follow-up period, the 1-, 3- and 5-year cumulative reoperation rate of malignant PRT was 10.6%, 44.7% and 62.9%, respectively, and the median re-operation period was 4.0 years. The 1-, 3- and 5-year cumulative survival rate was 90.1%, 73.0% and 64.2%, respectively, and the median survival period was 6.1 years. None of postoperative borderline or benign PRT recurred or needed re-operation or deceased. Conclusion:Most of PRTs were malignant, presenting themsehies as a challenge to surgery with unfaror prognosis.

Methodological analysis of sequential sector scan through oral fissure for fetal cleft palate screening / 中华围产医学杂志

Objective:To explore the method of sequential sector scan with 2D ultrasound through oral fissure (SSTOF) and its utilization in the cleft palate screening.Methods:Based on features of oral anatomy and ultrasonic beam, SSTOF was designed to screen cleft palate and the accuracy had been verified using specimens of aborted fetuses. This study recruited 7 154 women with singleton pregnancy who were screened for fetal malformations during 20-28 gestational weeks in the First Affiliated Hospital of Anhui Medical University from May 2020 to October 2020. In medical addition to routine screening, these subjects also underwent SSTOF to further verify its feasibility and imaging performance. Follow-up was performed by telephone and medical record review.Results:Clear images of the upper palate were acquired in five specimens of induced fetuses using SSTOF. Except for 56 cases lost to follow-up, a total of 7 098 fetuses were finally enrolled, of which 6 885 acquired satisfactory images using SSTOF, 213 did not due to inappropriate position, with a success image rate of 97%. SSTOF found cleft palate in 31cases, which were all confirmed after birth or induction, noting an accuracy rate of 100%.Conclusion:Sequential sector scan through oral fissure has a high clinical value on cleft palate screening in the second trimester with advantages of clear image, easy operation, and access to section views.

The reliability and validity of multi-dimensional, quantitative video evaluation of the hand function of stroke survivors / 中华物理医学与康复杂志

Objective:To test the reliability and validity of a multi-dimensional, quantitative video evaluation system (the Multi-dimensional system) for evaluating hand dysfunction among stroke survivors so as to provide an objective basis for its clinical application.Methods:Sixty stroke survivors with single dysfunctional hand were evaluated using the Multi-dimensional system and also using the Fugl-Meyer Upper Extremity Assessment (FMA-UE) and the Action Research Arm Test (ARAT) and in terms of their active range of hand motion (AROM-H). The Multi-dimensional system′s internal consistency, composite reliability, split-half reliability, parallel-forms reliability as well as intra- and inter-observer reliability were quantified. Its validity was tested in terms of content validity, structural validity, convergent validity and criterion validity.Results:The system′s Cronbach′s α was determined to be 0.86. Its one-dimension composite reliability was 0.939, its split-half reliability coefficient was 0.88 and its parallel-forms reliability was 0.922. The inter-evaluator reliability was between 0.965 and 0.998 [95%CI= (0.919, 0.999)], and the single evaluator ICC value was 0.973 to 0.998 [95%CI= (0.937, 0.999)]. The validity test produced a content validity index of 1, and the Pearson correlation coefficients between each sub-item and the total score were all greater than 0.60. The KMO value for structural validity was 0.882, and there was a common factor in the component matrix which reflected 60.9% of the information in the original variables. The system′s convergent validity AVE was 0.609 with Pearson correlation coefficients between the multidimensional system and the FMA-UE and ARAT both > 0.70.Conclusion:The multi-dimensional quantitative video evaluation system has good reliability and validity in the evaluation of stroke survivors with hand dysfunction.

Preparation and application of a PDGFRβ-targeted near-infrared fluorescent probe for molecular optical imaging of lung cancer / 中国胸心血管外科临床杂志

@#Objective    To prepare platelet-derived growth factor receptor β (PDGFRβ)-targeted near-infrared molecular probe and evaluate its potential in optical molecular imaging of lung cancer. Methods    PDGFRβ-specific affibody Z-tri was recombinantly expressed in Escherichia coli (E. coli) and purified using affinity chromatography. In vitro cell-binding of Z-tri was analyzed by flow cytometry. Cellular distribution of Z-tri in tumor grafts was determined by protein-tracing. The molecular probe CF750-Z-tri was prepared by conjugating near-infrared fluorescent dye CF750 to Z-tri. The optical images of xenografts of lung cancer were obtained by using CF750-Z-tri combined with optical imaging system. Results    PDGFRβ-specific affibody Z-tri was highly expressed in E. coli and purified to homogeneity. Z-tri could bind PDGFRβ-positive cells but not PDGFRβ-negative cells cultured in vitro. In the tumor xenografts of human lung cancer, intravenously injected Z-tri was predominantly distributed on cells overexpressing PDGFRβ. The near infrared fluorescent dye CF750 was efficiently conjugated to Z-tri. Optical images with high contrast of lung cancer xenografts were produced by using the near-infrared fluorescent probe CF750-Z-tri combined with optical imaging system. Conclusion    The near-infrared fluorescent probe CF750-Z-tri can be used for optical imaging of human lung cancer, which takes great potential in optical imaging-guided surgery of lung cancer.

Preliminary application of three dimensional printing surgical guide plate in orthognathic surgery for partial mandibular deformities / 中华医学美学美容杂志

Objective To evaluate the effectiveness of computer aided design (CAD) and three bit printing in the management of orthognathic surgery.Methods A total of 5 cases of patients with jaw deformity were involved in this study;jaw teeth and CT scanning laser scanning hefore surgery,virtual surgery design of 3D reconstruction and fusion data were analyzed,according to the design scheme of double jaw surgery combined with genioplasty;design and 3D printing of maxillary Le Fort Ⅰ osteotomy,genioplasty titanium alloy resin osteotomy and positioning guide,sagittal split ramus osteotomy by 3D printing and plate technology were used in this approach.The postoperative results were compared with the surgical planning by three-dimensional measurement and statistical analysis.Results When the operation guide plate was applied smoothly,the maximum error for maxilla was 1.2 mm (0.3-1.2 mm),and the maximum error for genioplasty was 1.7 mm,(0.5-1.7 mm),and the mean error was less than 1 mm.Follow-up for 12 months showed no adverse reaction.Conclusions Three dimensional printing surgical guide plate can accurately provide the osteotomy information,effectively control the jaw movement,and improve the orthognathic surgery accuracy of patients with partial jaw deformity.

Research progress of anxiety and depression in adult patients undergoing cardiac surgery / 中国胸心血管外科临床杂志

@#Anxiety is a strong behavioral and psychological reaction with fear components, while depression is a mental disorder dominated by high or low mood, both of which are accompanied by cognitive and behavioral changes, and are common comorbidities in patients with heart disease. Cardiac surgery is one of the important factors which trigger specific emotional and physiological reactions of patients. Persistent or initial depression and anxiety after surgery will not only increase surgical complications, short- or long-term mortality and medical costs, but also seriously affect patients' social function and quality of life. With the transformation of bio-psycho-social medical model, it is necessary to evaluate the perioperative psychological state and biological risk of patients undergoing cardiac surgery. This article reviews the characteristics, related mechanisms and therapeutic interventions of anxiety and depression in patients undergoing cardiac surgery.

Minor Sesquiterpenoid and Steroid Constitutes from Azadirachta indica A. Juss and Their Cytotoxic Activity

Background Neem (Azadirachta indica A. Juss) is a plant belonging to the meliaceae family. It was used widely asherbal medicine in ancient India and Burma. It possesses a variety of chemical constitutes. Recent studies showedthat some of major constitutes have remarkable anticancer activities. However, the minor constitutes in neem arestill studied insufficiently.Aim The aim of the study is to identify the minor constitutes in neem, and investigate their cytotoxic activity.Material & methods The dry seeds of neem were extracted with 95% ethanol. The ethyl acetate fraction of theextract was systematically separated by silica gel, Sephadex LH-20, High Performance Liquid Chromatography(HPLC) and other chromatographic techniques. The structures of the resulting isolates were elucidated byspectroscopic methods, such as mass spectrum (MS), nuclear magnetic resonance spectrum (NMR), etc.Results A sesquiterpenoid, 11,13-dihydroqinghaosu V (1), together with two known steroids, (24R)-ergosta5,7,22E-trien-3β-ol (2) and 5α,8α-epidioxiergosta-6,22-dien-3β-ol (3), was isolated from the dry seeds of neem. 1is a compound which is isolated from nature for the first time. In vitro cytotoxic bioassays showed that compound1 selectively inhibited the growth of Hela cell lines, with an IC50 value of 37.26 ±6.02 µM.Conclusion The study indicated that besides some major constituents of neem possessing anticancer activity, itsminor metabolites may also inhibit growth of cancer cells

Feasibility of Multi-dimensional Visual Hand Function Rehabilitation Quantitative Assessment System in Assessing Hand Function for Stroke Patients / 中国康复理论与实践

@#Objective To investigate the feasibility of Multi-dimensional Visual Hand Function Rehabilitation Quantitative Assessment System in the assessment of hand function for stroke patients. Methods From November, 2017 to July, 2018, 17 stroke inpatients were assessed with Fugl-Meyer Assessment-upper extremities (FMA-UE) and the Multi-dimensional Assessment System. Results The results of Multi-dimensional Assessment System positively correlated with the score of FMA-UE (r = 0.609, P = 0.010). Conclusion The Multi-dimensional Visual Hand Function Rehabilitation Quantitative Assessment System can be used to assess the hand function for stroke patients quantitatively.

Two cases about mesh adhesion to intra-abdominal cavity tissue after using mesh to repair an incisional hernia

Abdominal incisional hernia is a common postoperative complication. With the development of a new type of surgical anti-adhesion mesh, mesh repair has become a widely-adopted procedure, particularly in the laparoscopic era. However, there were few reports about use of these new meshes to repair incisional hernia in the abdominal cavity. In this report, we present two cases: one a 72-year-old male and the other a 62-year-old female. Both of those patients suffered incisional hernias during abdominal operations, and therefore underwent open incisional hernia anti-adhesion mesh repair operations. Both of them had recurrent incisional hernias after the first repair operation. During the second hernia repair operation via laparoscopy, tissue from the intestine and omentum were found to have adhered seriously to the old meshes, which could cause many serious problems. We need to pay more attention to the issue of adhesion, try to determine possible reasons and improve in our future work

Effects of blood lead level on the occupational health examination index in workers with lead exposure / 中国职业医学

OBJECTIVE: To investigate the effects of blood lead level on the occupational health examination index in workers with lead exposure. METHODS: Using judgment sampling method,412 workers exposed to lead from a lead acid battery factory were selected. According to the blood lead levels,the participants were divided into 5 groups( < 100. 0,100. 0-,200. 0-,300. 0- and 400. 0- μg / L). The effects of blood lead level on the health status of the workers such as clinical symptoms,electrocardiogram( ECG),routine urine and blood pressure,liver function and blood routine were analyzed.RESULTS: The median( the 25 th and 75 th percentiles) of the blood lead level was 169. 0( 76. 6,320. 4) μg / L in the 412 workers,and over standard rate was 12. 6%. Male workers 'blood lead level was higher than that of female workers[225. 8( 91. 3,351. 2) vs 131. 0( 64. 6,248. 9) μg/L,P < 0. 01]. In the female workers,the abnormal rate of ECG in the < 100. 0 μg / L group was lower than those of the 400- μg / L group( 6. 7% vs 41. 2%,P < 0. 005); the level of diastolic pressure in the < 100. 0 μg / L group was lower than that of the 300. 0- μg / L group [( 78. 4 ± 11. 7) vs( 72. 6 ±5. 6) mm Hg,P < 0. 01]. It was no correlation between blood lead level and urine β2-microglobulin( rS=- 0. 044,P =0. 82),while it was positive correlation between blood lead level and 24 hours urine lead content( rS= 0. 657,P < 0. 01).CONCLUSION: Lead exposed could cause the increase of cardiovascular abnormalities in female workers than that of male workers. Routine blood index,liver function index and routine urine index( urine protein) could not early reflect the blood,liver and kidney toxicity of lead.

miR-27b inhibits gastric cancer metastasis by targeting NR2F2

Increasing attention is focused on the down-regulation of miRNAs in cancer process. Nuclear receptor subfamily 2 (NR2F2, also known as COUP-TFII) is involved in the development of many types of cancers, but its role in gastric cancer remains elusive. In this experiment, oncomine and Kaplan-meier database revealed that NR2F2 was up-regulated in gastric cancer and that the high NR2F2 expression contributed to poor survival. MicroRNA-27b was targeted and down-regulated by NR2F2 in human gastric cancer tissues and cells. The ectopic expression of miR-27b inhibited gastric cancer cell proliferation and tumor growth in vitro and in vivo. Assays suggested that the overexpression of miR-27b could promote MGC-803 cells' migration and invasion and retard their metastasis to the liver. In addition, down-regulation of miR-27b enhanced GES-1 cells' proliferation and metastasis in vitro. These findings reveal that miR-27b is a tumor suppressor in gastric cancer and a biomarker for improving patients' survival.

The clinical effect of debridement in the treatment of Kashin-Beck disease under an ankle arthroscopy / 中华地方病学杂志

Objective To analyze the clinical effect of debridement in the treatment of Kashin-Beck disease under an ankle arthroscopy.Methods Totally 40 patients with ankle Kashin-Beck disease who had underwent surgery in the Fifth Hospital of Daqing from January 2015 to October 2016 were selected as the research subjects.All patients were treated with cleaning treatment under arthroscopy,evaluated via the visual analogue scale method,and compared pain before and 6,12 month after the treatment.Walking function and ankle motion of the patients were evaluated via an ankle-scoring system,and the quality of life of patients was investigated before and after the treatment through a questionnaire survey.Results The visual analogue scale of before and 6,12 months after the treatment was (6.2 ± 1.0),(2.3 ± 1.2) and (1.6 ± 0.4) scores,respectively;ankle foot score (53.3 ± 6.8),(86.6 ± 5.1) and (88.7 ± 6.2) scores,respectively;ankle activity score (15.9 ± 4.1),(36.9 ± 4.9) and (41.8 ± 6.4) scores,respectively;and life quality score (53.1 ± 4.0),(75.4 ± 6.6) and (88.7 ± 10.5) scores,respectively.The differences between groups were statistically significant (F =2.1,2.6,2.3,2.5,P ＜ 0.05).Visual analogue scale of 6 and 12 months after the treatment was significantly lower than that before the treatment,ankle foot score and ankle activity score and life quality score were significantly higher than those before the treatment (P ＜ 0.05).Conclusion The debridement under an ankle arthroscopy can effectively reduce the pain of patients with Kashin-Beck disease,and improve the walking function of the patients obviously,significantly improve the patients' life quality,and the method should be widely applied in clinical treatment.

Recombinant expression and characterization of CD2-binding domain of Macaca mulatta lymphocyte function-associated antigen 3 in Pichia pastoris / 生物医学工程学杂志

Human lymphocyte function-associated antigen 3 (hLFA3) has been identified as an important T cell accessory molecule. Rhesus monkeys (Macaca mulatta) have been widely used as animal models for human immune disorders. Due to the species-specificity of immune system, it is necessary to study M. mulatta LFA3 (mmLFA3). In this study, the gene encoding mmLFA3 CD2-binding domain (mmLFA3Sh) was amplified by polymerase chain reaction (PCR) and genetically fused to human IgG1 Fc fragment in pPIC9K to construct the expression plasmid pPIC9K-mmLFA3Sh-Ig. Approximately 3-4 mg mmLFA3Sh-Ig protein was recovered from 1 L of inductive media, and mmLFA3Sh-Ig produced by the P. pastoris can bind to the CD2 positive cells, and suppress the monkey and human lymphocytes proliferation induced by Con A and alloantigen in a dose-dependent manner. These results suggested that mmLFA3Sh-Ig might be used as a novel tool for pathogenesis and experimental immunotherapy of Rhesus monkey immune disorders.

Expression and significance of STK15 gene in parpillary thyroid carcinoma / 实用医学杂志

Objective To explore the expression of serine/threonine kinase 15 (STK15) gene and its significance for papillary thyroid carcinoma. Methods SP immunohistochemical method was used to detect the expression of STK15 gene in 71 cases of papillary thyroid carcinoma and 45 cases nodular goiter tissue. Results The positive expression rates of STK15 gene in 71 cases of papillary thyroid carcinoma were 100%, and the adjacent of papillary thyroid carcinoma expressions of STK15 gene 8.5%, nodular goiter tissue of STK15 gene expression rates 24.4%. The expression of STK15 gene was positively correlated with that of STK15 gene in papillary thyroid carcinoma (P < 0.01). Conclusion High expression of STK15 gene is confirmed in papillary thyroid carcinoma. The detection of STK15 gene can provide valuable evidence for diagnosis of papillary thyroid carcinoma and evaluation of the malignant potential of nodular goiter.

Molecular Cloning, Recombinant Expression and Functional Characterization of the Soluble Tumor Necrosis Factor-related Apoptosis-inducing Ligand for the Macaca mulatta / 生物医学工程学杂志

Human tumor necrosis factor-related apoptosis-inducing ligand (hTRAIL) might be developed as a novel anti-tumor drug due to its selective cytotoxicity in tumor cells. The predicted Macaca mulatta TRAIL (mmTRAIL) is highly homologous to hTRAIL in nucleotide acid as well as amino acid sequence, suggesting that mmTRAIL might induce apoptosis of human cancer cells. However, the cytotoxicity of mmTRAIL in human cancer cells has not been investigated. In this paper, it is reported that the gene encoding mmTRAIL has been cloned by using reverse-transcriptase polymerase chain reaction (RT-PCR) from monkey peripheral blood mononuclear cells (PBMCs) in our laboratory. Subsequently, an expression plasmid was constructed by inserting mmTRAIL gene into pQE30 plasmid. After induction by addition of Isopropyl β-D-1-Thiogalactopyranoside (IPTG), mmTRAIL was expressed. MmTRAIL was recovered from supernatant of sonicated bacteria by Ni-NTA agarose affinity chromatography. SDS-PAGE and gel filtration chromatography demonstrated that mmTRAIL forms trimer in solution. In vitro assays indicated that mmTRAIL was cytotoxic to human COLO205 tumor cells but not to normal cells at low concentration of nanomole. In addition, antitumor effect of mmTRAIL was evaluated in mice bearing human COLO205 tumor xenografts. Intratumorally injected mmTRAIL significantly inhibited growth of tumor grafts. These results suggested that mmTRAIL was valuable as candidate drug for cancer-targeted therapy.

Diagnosis and treatments of craniomaxillofacial deformities with OSDB / 临床耳鼻咽喉头颈外科杂志

Obstructive sleep disordered breathing (USDB) is a common diseases which caused by upper airway(UA) occlusion, muscle tone problems and collapse of upper airway etc. The article introduces how to select surgical treatment protocol. First, it is necessary of PSG and upper airway evaluation. Then, it is key to master surgical indications. For the children with hypertrophy of tonsillectomy or adenoidectomy, it may first step of tonsillectomy or adenoidectomy, they needed followed up by orthodontic doctor or orthognathic surgeon for tooth and maxillomandibular malformation. For the adult OSDB patients, there are two method, soft tissue reduction/mass excision around UA or maxillomandibular advancement(MMA), and MMA is recommended to the patients such as failure from UPPP and other surgical treatment, but for severe obesity patients, bariatric surgery is commended, it is very effective for soft tissue reduction around UA and weigh loss. For the OSDB patients with craniaomaxillomandibular deformities, such as craniosynostosis syndrome/micrognathia. Finally, it is important of the UA management for the surgical patients around perioperative period. All in all, it is necessary of the multidisciplinary cooperation for the OSDB patients, surgical treatment is useful method but it is not commend to all OSDB patients.

Correlation between carotid intima-media thickness and glucose fluctuation in type 2 diabetic patients / 中华全科医师杂志

Objective To investigate the correlation between carotid intima-media thickness (CIMT) and glucose fluctuation in patients with type 2 diabetes mellitus (T2DM).Methods Sixty-eight T2DM patients admitted to Beijing Military General Hospital from March to August 2012 were enrolled in the study,including 32 cases with CIMT thickening (CIMT ≥ 0.9 mm) and 32 cases with normal CIMT (CIMT ＜0.9 mm).The 72 h continuous blood glucose levels were monitored from the day of admission.Results There were no significant differences in the gender,age,body mass index (BMI),systolic and diastolic blood pressure,HDL-C,LDL-C,CHO,TG,glycosylate hemoglobin (HbA1c),fasting blood glucose(FBG) and postprandial average blood glucose (MPBG) between two groups (P ＞ 0.05).The atherosclerosis (AS) score and mean amplitude of glycemic excursion (MAGE),glucose standard deviation,frequency of glycemic excursion (FGE) and absolute mean of daily differences (MODD) in patients with thickening CIMT were (11 ± 7) years,(6.9 ± 3.0) mmol/L,(2.8 ± 1.2) mmol/L,(3.4 ± 1.5) times/d,(2.8 ± 1.3) mmol/L,(4.5 ± 1.0) score,respectively ; while those in patients with normal CIMT were (8 ±6) years,(4.2 ± 1.1) mmol/L,(1.6 ± 0.5) mmol/L,(2.2 ± 0.8) times/d,(2.0 ± 1.0) mmol/L,(3.3 ±0.6) score,respectively.There were significant differences between two groups (all P ＜ 0.05).Pearson correlation showed that CIMT was positively correlated with MAGE,FGE,MODD,course of disease,diastolic blood pressure,LDL-C,MPBG and AS score (P ＜ 0.05).Multiple stepwise regression analysis showed that MAGE,MBPG were the influencing factors of CIMT.Conclusions The CIMT of patients with T2DM is closely correlated with glucose fluctuation,indicating that reduction of blood glucose fluctuation and MAGE,MPBG levels may delay the occurrence of diabetic macroangiopathy.

The effect of insulin intensive therapy on serum level of oxidative stress in patients with first diagnosed type 2 diabetes mellitus / 中国医师进修杂志

Objective To observe the difference in serum level of oxidative stress between first diagnosed type 2 diabetes mellitus (T2DM) patients and healthy person with normal glucose,compare the difference in serum level of oxidative stress between T2DM patients with continuous subcutaneous insulin injection (CSII) and multiple subcutaneous insulin injection (MSII),and further explore the possible mechanism of CSII superior to MSII.Methods Sixty patients with first diagnosed T2DM were divided into CSII group and MSII group by random digits table,with 30 patients in each group and given 14 days treatment of CSII and MSII respectively.Thirty healthy person were selected with age and sex matched in same period as control group,then fasting plasma glucose (FPG),2-hour postprandial blood glucose (2 h PG),glycosylated serum protein (GA),fasting insulin (FINS),superoxide dismutase (SOD),reduced glutathione (rGSH) and malondialdehyde (MDA) before and after treatment was measured and analyzed.Results The FPG,2 h PG,GA,HOMA model of insulin resistance (HOMA-IR) and MDA before treatment in CSII group and MSII group was higher than that in control group [FPG:(13.81 ± 3.14),(13.58 ±2.10) mmol/L vs.(5.21±0.42) mmol/L; 2 h PG:(21.72 ±4.43),(22.07 ±3.86) mmol/L vs.(6.19 ± 0.47) mmol/L;GA:(28.74 ± 4.40),(28.83 ± 5.01) mmol/L vs.(13.24± 1.26) mmol/L;HOMA-IR:0.45 ±0.13,0.43 ±0.12 vs.0.20 ±0.15;MDA:(4.37 ± 1.13),(4.44 ± 1.07) mmol/L vs.(2.37 ±0.58) mmol/L] (P ＜ 0.01),and the HOMA model 3 cell function index (HOMA-β),SOD and rGSH was lower than that in control group [HOMA-β:0.98 ±0.17,0.96 ±0.12 vs.1.91 ±0.19;SOD:(29.63 ±9.29),(28.07 ±9.62) mU/L vs.(41.00 ± 12.89) mU/L;rGSH:(157.03 ±46.58),(165.23 ±45.66) ng/L vs.(212.00 ± 61.67) ng/L] (P ＜ 0.01).There was no significant difference between CSII group and MSII group (P ＞ 0.05).The FPG,HOMA-β,SOD and MDA after treatment in CSII group was no significant difference compared with that in control group (P ＞ 0.05).But the FPG and MDA after treatment in MSII group was higher than that in control group(P＜ 0.01 or ＜ 0.05),and the HOMA-β and SOD was lower than that in control group (P ＜ 0.01).The FPG,2 h PG,GA and MDA after treatment in CSII group was lower than that in MSII group (P ＜ 0.01 or ＜ 0.05).The HOMA-β was higher than that in MSII group (P ＜ 0.01).Multi-factor analysis results showed that the HOMA-β and FPG (r =-0.919,P ＜ 0.01),2 h PG (r =-0.904,P ＜ 0.01),GA (r =-0.830,P ＜ 0.01) and MDA (r =-0.653,P ＜ 0.01) was negatively correlated,and SOD (r =0.454,P ＜ 0.01) and rGSH (r =0.394,P ＜ 0.01) was positively correlated.Conclusions Oxidative stress level of first diagnosed T2DM is significantly higher than that of healthy people.Two intensive insulin treatment for first diagnosed T2DM can reduce blood glucose level,oxidative stress levels and improve insulin resistance and β cell function.CSII can effectively reduce blood glucose,reduce the level of lipid peroxidation and improve β-cell function compared with MSII.

Assessment of the accuracy of real-time continuous glucose monitoring system and its correlated factors / 中华内分泌代谢杂志

Objective To assess the factors that influence the accuracy of real-time continuous glucose monitoring system (RT-CGM).Methods A total of 79 diabetic patients wore RT-CGM for three days continuously while calibrating by interphalangeal glucose values 4-8 times a day.We counted matching rate of interphalangeal glucose values and RT-CGM probe value,and analyzed correlation of the matching rate with MAGE,SDBG,MBG,AUC10,AUC3.9,and NGE by Pearson correlation analysis and multiple linear regression analysis.Then we grouped corresponding match rate by MAGE and MBG,compared the difference among groups.Furthermore,we analyzed correlation of RT-CGM probe values of all-day,fasting-postprandial,and nighttime and the corresponding interphalangeal glucose values by Pearson correlation analysis.Results Pearson correlation analysis showed that the matching rate was negatively correlated with the MAGE,SDBG,MBG,and AUC10.MAGE,MBG,and NGE were in the regression equation.MAGE ＜3.9 mmol/L,matching rate was 81％,3.9 ≤ MAGE＜7 mmol/L,matching rate was 67％,MAGE≥7 mmol/L,the matching rate was 52％,the difference among 3 groups was statistically significant (P＜0.01).MBG＜7.8 mmol/L,matching rate was 78％,7.8 ≤ MBG＜ 10 mmol/L,matching rate was 68％,MBG ≥10 mmol/L,the matching rate was 57％,the difference among 3 groups was statistically significant (P ＜ 0.01).When Youden index was 0.409 and MAGE was less than 3.745 mmol/L,the match rate was more than 75％.When Youden index was 0.369 and MBG was less than 8.38 mmol/L,the matching rate was more than 75％.The correlation coefficients of all day,fasting,postprandial and nighttime probe values and the corresponding interphalangeal glucose values were 0.958,0.963,0.944,and 0.965 (all P＜0.01).Conclusions The probe values show good consistency with the interphalangeal glucose values,are able to be used for blood glucose assessment.Blood glucose fluctuations influences accuracy of RT-CGM,the smaller the blood glucose fluctuations,the smaller the mean glucose concentration,the smaller the effective blood glucose fluctuations in frequency,the higher would be the accuracy.It seems to be more effective to do calibration during fasting and nighttime.