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Objective:To explore the associations of urinary retinol binding protein (RBP) and β 2-microglobulin (β 2-MG) with urinary albumin to creatinine ratio (UACR) and renal function in hospitalized patients with type 2 diabetes mellitus (T2DM). Methods:A total of 1 030 Chinese patients with T2DM were included in this study. The subjects were divided into the UACR normal group (<30 mg/g), microalbuminuria group (30-300 mg/g) and macroalbuminuria group (>300 mg/g). Patients with normal UACR were further divided into two groups according to the estimated glomerular filtration rate (eGFR): the eGFR low group (<90 ml·min -1·1.73m -2) and the normal eGFR group (≥90 ml·min -1·1.73m -2). Urine RBP and β 2-MG levels among the groups were compared. Multiple linear regression analyses were applied to evaluate risk factors of urine RBP and β 2-MG. Results:In all patients ( n=1 030), urine RBP and β 2-MG increased gradually with the increase of UACR across the three groups, the proportions of abnormal urine RBP (>0.7 mg/L) and β 2-MG (>370 μg/L) in these groups were 3.8%, 8.5%, 39.0% ( P<0.001), and 12.9%, 26.7%, 46.8% ( P<0.001), respectively. In the UACR normal group ( n=788), 12.2% of the patients were with eGFR<90 ml·min -1·1.73m -2. The proportion of abnormal β 2-MG (>370 μg/L) was higher in the eGFR low group than that in the eGFR normal group (29.2% vs. 10.7%, P<0.001). Multivariate linear stepwise regression analyses were performed using natural logarithm of urine RBP or β 2-MG as dependent variable, and showed that urine RBP was independently associated with UACR ( β=0.0005, P<0.001), serum creatinine ( β=0.006, P<0.001) and glycosylated hemoglobin A1c ( β=0.050, P=0.001), and β 2-MG was independently correlated with UACR ( β=0.000 4, P<0.001), serum creatinine ( β=0.011, P<0.001), systolic blood pressure ( β=0.005, P=0.031) and fasting blood-glucose ( β=0.027, P=0.046). Conclusions:Urine RBP and β 2-MG are positively associated with high UACR and impaired renal function in T2DM patients, and these changes could occur before UACR and eGFR turned out to be abnormal. It is recommended that urine RBP and β 2-MG be detected as early as possible to identify diabetic kidney disease in patients with normal UACR and eGFR.
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In order to evaluate the efficacy and side effects of the non-insulin antidiabetes medications as an adjunct treatment in type 1 diabetes mellitus (T1DM), we conducted systematic searches in MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials for randomized controlled trials published between the date of inception and March 2020 to produce a systematic review and meta-analysis. Overall, 57 studies were included. Compared with placebo, antidiabetes agents in adjunct to insulin treatment resulted in significant reduction in glycosylated hemoglobin (weighted mean difference [WMD], –0.30%; 95% confidence interval [CI], –0.34 to –0.25%; P<0.01) and body weight (WMD, –2.15 kg; 95% CI, –2.77 to –1.53 kg; P<0.01), and required a significantly lower dosage of insulin (WMD, –5.17 unit/day; 95% CI, –6.77 to –3.57 unit/day; P<0.01). Compared with placebo, antidiabetes agents in adjunct to insulin treatment increased the risk of hypoglycemia (relative risk [RR], 1.04; 95% CI, 1.01 to 1.08; P=0.02) and gastrointestinal side effects (RR, 1.99; 95% CI, 1.61 to 2.46; P<0.01) in patients with T1DM. Compared with placebo, the use of non-insulin antidiabetes agents in addition to insulin could lead to glycemic improvement, weight control and lower insulin dosage, while they might be associated with increased risks of hypoglycemia and gastrointestinal side effects in patients with T1DM.
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In order to evaluate the efficacy and side effects of the non-insulin antidiabetes medications as an adjunct treatment in type 1 diabetes mellitus (T1DM), we conducted systematic searches in MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials for randomized controlled trials published between the date of inception and March 2020 to produce a systematic review and meta-analysis. Overall, 57 studies were included. Compared with placebo, antidiabetes agents in adjunct to insulin treatment resulted in significant reduction in glycosylated hemoglobin (weighted mean difference [WMD], –0.30%; 95% confidence interval [CI], –0.34 to –0.25%; P<0.01) and body weight (WMD, –2.15 kg; 95% CI, –2.77 to –1.53 kg; P<0.01), and required a significantly lower dosage of insulin (WMD, –5.17 unit/day; 95% CI, –6.77 to –3.57 unit/day; P<0.01). Compared with placebo, antidiabetes agents in adjunct to insulin treatment increased the risk of hypoglycemia (relative risk [RR], 1.04; 95% CI, 1.01 to 1.08; P=0.02) and gastrointestinal side effects (RR, 1.99; 95% CI, 1.61 to 2.46; P<0.01) in patients with T1DM. Compared with placebo, the use of non-insulin antidiabetes agents in addition to insulin could lead to glycemic improvement, weight control and lower insulin dosage, while they might be associated with increased risks of hypoglycemia and gastrointestinal side effects in patients with T1DM.
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BACKGROUND@#Cardiovascular (CV) disease is the leading cause of morbidity and mortality in adults with type 2 diabetes (T2D). The aim of this study was to determine the CV risk in Chinese patients with T2D based on the 2019 European Society of Cardiology (ESC) and the European Association for the Study of Diabetes (EASD) guidelines on diabetes, pre-diabetes, and CV diseases.@*METHODS@#A total of 25,411 patients with T2D, who participated in the study of China Cardiometabolic Registries 3B study, were included in our analysis. We assessed the proportions of patients in each CV risk category according to 2019 ESC/EASD guidelines.@*RESULTS@#Based on the 2019 ESC/EASD guidelines, 16,663 (65.6%), 1895 (7.5%), and 152 (0.6%) of patients were included in "very high risk," "high risk," and "moderate risk" categories, respectively. The proportions of patients in each category varied based on age, sex, body mass index, and duration. While 58.7% (9786/16,663) of elderly patients were classified to "very high risk" group, 89.6% (3732/4165) of patients with obesity were divided into "very high risk" group. Almost all patients with a duration of diabetes >10 years had "very high risk" or "high risk." However, 6701 (26.4%) of Chinese T2D patients, who had shorter duration, and one or two risk factors, could not be included in any category (the "unclear risk" category).@*CONCLUSIONS@#In China, most patients with T2D have "very high" or "high" CV risk based on 2019 ESC/EASD guidelines. However, the risk of patients in "unclear risk" group needs to be further classified.
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Adult , Aged , Humans , Cardiovascular Diseases/epidemiology , Cross-Sectional Studies , Diabetes Mellitus, Type 2 , Heart Disease Risk Factors , Risk FactorsABSTRACT
Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer, and its mortality ranks fourth in global malignant tumors. Early diagnosis of HCC has an important impact on the survival rate of patients. Exosomal microRNA (miRNA) is closely related to the occurrence and development of HCC. It can be secreted and transferred to recipient cells through the corresponding target genes, and play a role of regulating cancer progression. Exosomal miRNAs have great differences in the expression of HCC patients and in vitro cell lines, and it has the advantages of high content, specificity and stability relative to circulating miRNAs. It not only can better distinguish between HCC and healthy patients, but also can be further differentiated from hepatitis or cirrhosis, and it also has certain value in the diagnosis of recurrent HCC.
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Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer, and its mortality ranks fourth in global malignant tumors. Early diagnosis of HCC has an important impact on the survival rate of patients. Exosomal microRNA (miRNA) is closely related to the occurrence and development of HCC. It can be secreted and transferred to recipient cells through the corresponding target genes, and play a role of regulating cancer progression. Exosomal miRNAs have great differences in the expression of HCC patients and in vitro cell lines, and it has the advantages of high content, specificity and stability relative to circulating miRNAs. It not only can better distinguish between HCC and healthy patients, but also can be further differentiated from hepatitis or cirrhosis, and it also has certain value in the diagnosis of recurrent HCC.
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Objective@#To investigate the protective effects and mechanism of keratinocyte growth factor (KGF) combined with hypoxia inducible factor-1α (HIF-1α) on intestinal crypt epithelial cells (IEC-6) of rats with hypoxia stress.@*Methods@#(1) The routinely cultured IEC-6 of rats were collected and divided into normoxia blank group, normoxia KGF group, normoxia HIF-1α group, and normoxia combine group, according to the random number table, and then the previous mediums were respectively replaced with dulbecco′s modified eagle medium (DMEM), medium with 0.5 ng/mL KGF, medium with 10.0 ng/mL HIF-1α, and medium with 0.5 ng/mL KGF and 30.0 ng/mL HIF-1α. And the cells were cultured in cell incubator with oxygen volume fraction of 21% for 24 hours. (2) Another batch of routinely cultured IEC-6 were collected and divided into normoxia control group, hypoxia control group, hypoxia KGF group, hypoxia HIF-1α group, and hypoxia combine group, according to the random number table. The previous mediums were replaced with DMEM, DMEM, medium with 0.5 ng/mL KGF, medium with 10.0 ng/mL HIF-1α, and medium with 0.5 ng/mL KGF and 30.0 ng/mL HIF-1α respectively. And then, the cells in normoxia control group were cultured routinely for 24 hours, and cells in the other 4 groups were cultured in cells incubator of 3 gases, with oxygen volume fraction of 5% for 24 hours. Cells cultured in normoxic and hypoxic incubators were collected, with 3 samples in each group, and morphological changes of cells were observed with optical microscope. Cells cultured in normoxic and hypoxic incubators were collected, with 3 samples in each group, and survival rates of cells were detected by cell count kit 8. Cells in normoxia control group and cells cultured in hypoxic incubator were collected, with 3 samples in each group. The cell cycle changes and apoptosis rates were detected by flow cytometer, the content of adenosine triphosphate (ATP) was detected by ultraviolet spectrophotometer, and protein expression of p53 was detected by Western blotting. Data were processed with one-way analysis of variance and least significant difference test.@*Results@#(1) After being cultured for 24 h, cells cultured in normoxic incubator grew well with oval or round shapes and clear cytoplasm, and cells cultured in hypoxic incubator showed irregular shapes such as fusiform or starlike shape, with black particle in cytoplasm. (2) After being cultured for 24 h, cell survival rates of normoxia blank group, normoxia KGF group, normoxia HIF-1α group, and normoxia combine group were (107.4±8.7)%, (109.8±2.9)%, (115.8±7.4)%, and (112.8±10.6)% respectively. There was no significantly statistical difference in general comparison of cell survival rates among the above groups (F=0.685, P=0.586). After being cultured for 24 h, cell survival rates of hypoxia control group, hypoxia KGF group, hypoxia HIF-1α group, and hypoxia combine group were (35.1±4.6)%, (52.9±6.8)%, (56.2±3.1)%, and (71.2±9.6)% respectively, which were significantly lower than (106.3±12.3)% of normoxia control group (P<0.001). Survival rates of cells in hypoxia KGF group, hypoxia HIF-1α group, and hypoxia combine group were significantly higher than the rate of cells in hypoxia control group (P=0.023, 0.009, <0.001). Survival rate of cells in hypoxia combine group was significantly higher than the rates of cells in hypoxia KGF group and hypoxia HIF-1α group (P=0.017, 0.045). (3) After being cultured for 24 h, percentage of cells in G1 phase in hypoxia control group was significantly higher than that of cells in normoxia control group (P=0.030), percentages of cells in S phase in hypoxia control group, hypoxia KGF group, and hypoxia HIF-1α group were obviously lower than the percentage of cells in normoxia control group (P=0.020, 0.031, 0.026), and percentages of cells in different phases in other groups were close to those of cells in normoxia control group (P=0.516, 0.107, 0.052, 0.985, 0.637, 0.465, 0.314, 0.591). After being cultured for 24 h, percentages of cells in G1 phase in hypoxia control group, hypoxia KGF group, and hypoxia HIF-1α group were obviously higher than the percentage of cells in hypoxia combine group (P=0.001, 0.030, 0.014), and percentages of cells in S phase in the above 3 groups were obviously lower than the percentage of cells in hypoxia combine group (P=0.001, 0.012, 0.010). (4) After being cultured for 24 h, compared with that of cells in normoxia control group, apoptosis rate of cells in hypoxia control group obviously increased (P=0.018), and apoptosis rate of cells in hypoxia combine group obviously decreased (P=0.008). After being cultured for 24 h, compared with that of cells in hypoxia control group, apoptosis rates of cells in hypoxia KGF group and hypoxia combine group obviously decreased (P=0.004, 0.001). Apoptosis rate of cells in hypoxia combine group was obviously lower than those of cells in hypoxia KGF group and hypoxia HIF-1α group (P=0.032, 0.002). (5) After being cultured for 24 h, compared with that of cells in normoxia control group, the content of ATP of cells in hypoxia combine group changed unobviously (P=0.209), and content of ATP of cells in the other groups obviously decreased (P= <0.001, 0.001, 0.002). Content of ATP of cells in hypoxia HIF-1α group and hypoxia combine group was obviously higher than that of cells in hypoxia control group (P=0.044, 0.001). Content of ATP of cells in hypoxia combine group was obviously higher than that of cells in hypoxia KGF group and hypoxia HIF-1α group (P=0.011, 0.020). (6) After being cultured for 24 h, protein expressions of p53 of cells in hypoxia control group, hypoxia KGF group, and hypoxia HIF-1α group were obviously higher than that of cells in normoxia control group (P<0.001), and protein expression of p53 of cells in hypoxia combine group was obviously lower than those of cells in hypoxia control group, hypoxia KGF group, and hypoxia HIF-1α group (P=0.001, 0.001, 0.002).@*Conclusions@#KGF combined with HIF-1α have significant protective effects on IEC-6 of rats with hypoxia stress, and can improve its survival in hypoxic environment by inhibiting cell cycle arrest, reducing the level of apoptosis, and increasing level of energy metabolism.
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<p><b>OBJECTIVE</b>To explore the clinicopathological and bronchoscopic characteristics of CT-occult lung cancer.</p><p><b>METHODS</b>Clinical data of 11 patients who were diagnosed with CT-occult lung cancer by bronchoscopy were analyzed retrospectively.</p><p><b>RESULTS</b>Seven out of eleven patients had bloody sputum. The median disease course was 3 months. Nine patients were in stage I or II, among them 5 cases underwent surgery, with a 5-year survival rate of 80.0%. The upper lobes were predilection areas, and all of the 11 patients had direct sign by bronchoscopy. The most common histopathology was squamous cell carcinoma, which had proliferative changes.</p><p><b>CONCLUSIONS</b>Patients with symptoms of persistent bloody sputum should undergo a bronchoscopy to make sure whether there is an occult lung cancer or not, even if the chest CT scan is negative at first visit.</p>
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Humans , Bronchoscopy , Carcinoma, Squamous Cell , Diagnosis , Lung Neoplasms , Diagnosis , Retrospective Studies , Survival Rate , Tomography, X-Ray ComputedABSTRACT
<p><b>BACKGROUND</b>Given the pace with which standards of care have changed, timely assessment of their impact on routine clinical practice and patient outcomes is needed. In coordination with the Chinese Diabetes Society (CDS), we developed a quantitative survey to explore the implementation of standards of care for type 2 diabetes (T2D) in China.</p><p><b>METHODS</b>A national online survey of physicians involved in the management of T2D in China was conducted over a 4-week period in 2012. Completed responses were obtained from 1 028 physicians. Participants responded to 52 questions designed to capture information relating to their demographic and clinical practice profiles. The questionnaire was divided into three sections: basic information, diagnosis practices and screening methods on main complications, and treatment and control practices. The questionnaire was developed in conjunction with the CDS.</p><p><b>RESULTS</b>Overall, 83% of surveyed physicians were at least "aware" of the CDS guidelines on standards of care for T2D. Level of awareness was directly related to hospital grade, specialty, geographic location, professional rank and participation in CDS training. The 2-hour oral glucose tolerance test was reported as the most ever-used approach across all three hospital grades and physician specialties, with a usage rate of 97%. Respondents selected their choice of primary treatment for newly diagnosed T2D patients. Just over half (52%) indicated the use of oral anti-diabetic drugs (OAD) monotherapy, in line with CDS recommendations. However, OAD use varied considerably between different regions and city tiers. Despite hemoglobin A1c being defined as the gold standard for glucose control, it was not universally measured, with more physicians indicating routine use of glucose before fasting and glucose non-fasting.</p><p><b>CONCLUSION</b>The standards-of-care analysis has provided important insights into the current management of T2D among physicians in China across different geographical regions, hospital grades, specialties, professional statuses, and levels of CDS guideline awareness and training.</p>
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Adult , Female , Humans , Male , Middle Aged , China , Data Collection , Diabetes Mellitus, Type 2 , Glucose Tolerance Test , Standard of CareABSTRACT
<p><b>OBJECTIVE</b>To study the root canal curvatures of adolescents' maxillary first premolars in Guangdong province and the differences between male and female were studied.</p><p><b>METHODS</b>200 maxillary first premolars among adolescents in Guangdong Province (100 males and 100 females) were numbered in proper. After access preparation, a K-file was inserted into the canal until the tip of the file was just seen at the apical foramen. Then standardized periapical images were taken from mesial-distal and buccal-lingual directions with radio visio graphy. The angle of canal curvature (CCA) was determined according to the method described by Schneider. Then the curved canals whose angle were more than 5 degrees were chosen, and the canal access angle (CAA), curvature height (X) and curvature distance (Y) were determined according to the method described by Günday. Linear correlations of the measurements were analyzed.</p><p><b>RESULTS</b>59.21% of the total roots were curved in buccal-lingual directions. The incidence rates of males' and females' were 49.74% and 68.98%, respectively. 41.05% of the total roots were curved in mesial-distal directions. The incidence rates of males' and females' were 36.27% and 45.99%, respectively. 6.84% of the total roots were S-shaped curves. 4.15% and 9.63% of canals from male and female were S-shaped curves, respectively. The curvatures of single root canals between male and female had statistical differences in buccal-lingual directions (P<0.05). The curvatures of the lingual root canals from females in buccal-lingual directions and mesial-distal directions was higher than males' (P<0.05). The Y of buccal root canals in buccal-lingual directions and mesial-distal directions and the CCA of lingual root canals in buccal-lingual directions between male and female had statistical differences (P<0.05). The CAA of curved buccal canals and curved palatal canals from female and female had positive correlation with CCA and X (P<0.01), while negative correlation with Y (P<0.05).</p><p><b>CONCLUSION</b>There are curved root canals in buccal-lingual and mesial-distal directions in the maxillary first premolars, and some curved root canals were S-shaped. The curved canals incidence rate of females was higher than males.</p>
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Female , Humans , Male , Bicuspid , Dental Pulp Cavity , In Vitro Techniques , Root Canal Therapy , Tooth RootABSTRACT
Objective To investigate the insulin dosage and analyze the dosage-impacting factors of intensive insulin treatment in Chinese type 2 diabetic patients.Methods Totally 1025 patients with intensive insulin treatment were included,the insulin dosage and clinical characteristics were taken down and analyzed.Results The mean insulin dosage was 39.30U/day,the insulin dosage per kg of body weight was 0.61U/Kg,among which the dosage of intermediate-acting insulin was 9.79 U/day,occupying 25.24%,while the pre-meal one was 29.51 U/day,occupying 74.76%.According to the insulin dosage per kg of body weight,patients were divided into low dosage group and high dosage one.The result showed significant difference in period of diabetes,BMI,HbA1c,and the highest weight level between the two groups.Correlation analysis showed that the average insulin dosage per kg of body weight was positively correlated with period of diabetes,HbA1c,fasting glucose level and LDL-C,while negatively correlated with BMI,fasting and postprandial C-peptide,the highest body weight level and HDL-C.Conclusions The average insulin dosage for type 2 diabetic patients is 39.30U/day,among which the dosage of intermediate-acting insulin occupies 25% while the pre-meal one occupies 75%.The insulin dosage is positively correlated with period of diabetes and HbA1c,while negatively correlated with BMI and the highest body weight level
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OBJECTIVE: To establish RP-HPLC method for the content determination of chlorogenic acid in 3 kinds of dosage forms of Qingkailing preparation. METHODS: SinoChrom ODS-AP C18(250 mm?4.6 mm, 5 ?m) column was adopted and the mobile phase consisted of methnol-water-acetic acid (25 ∶ 75 ∶ 0.5) at the flow rate of 1.0 mL?min-1. Column temperature was set at 30 ℃ and the detection wavelength was set at 327 nm. RESULTS: The linear range of chlorogenic acid was 3.81～152.50 ?g?mL-1(r=0.999 8), and the average recoveries of the capsules, granules and dripping pills were 99.03%(RSD=2.02%), 99.35%(RSD=1.16%),98.11%(RSD=1.51%). CONCLUSION: The method is sensitive, simple and accurate for the quality control and content determination of 3 kinds of Qingkailing preparations.
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OBJECTIVE:To probe into the situation and trend of cardiovascular Chinese patent medicine in our hospital.METHODS:The utilization of 10 kinds of cardiovascular Chinese patent medicine in our hospital from 2007 to 2009 was analyzed statistically in respect of consumption sum,proportion of drug use and utilization frequency,etc.RESULTS:Consumption sum of 10 kinds of cardiovascular Chinese patent medicine increased year by year with capsule as main dosage form.The DDDs,DDC and sequence ratio of cardiovascular Chinese patent medicine indicated most of drugs were characterized with high utilization frequency and low price.CONCLUSION:The utilization of cardiovascular Chinese patent medicine is rational and widespread with great advantage.Pharmaceutical enterprises should develop more safe,effective and economical cardiovascular Chinese patent medicine.
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Objective To investigate the prevalence and risk factors of diabetic retinopathy(DR) in Chinese elderly diabetic patients. Methods One hundred and ninety patients with type 2 diabetic aged 60 years and over,including 93 males and 97 females were selected.The average age was 68.9 years and the average diabetic duration was 11.5 years.HbA1c,insulin,C-peptide and other clinical characteristics in all patients were tested.The retinopathy of the patients were examined by the retina-camera. Results There were 103 patients without deabetic retinopathy,59 patients carrying nonproliferative deabetic retinopathy and 28 patients carrying proliferative diabetic retinopathy.The above three groups had statistically different diabetic duration((121.1?93.2) vs(149.6?112.1) vs(182.2?83.5)months,P
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This paper reviewed some new types of skin whitening agents and their mechanisms of action from aspects of suppressing melanogenesis, reducing melanosome transference and enhancing desquamation of melanin pigment from the epidermis etc.