Prediabetes Progression and Regression on Objectively- Measured Physical Function: A Prospective Cohort Study

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.

Association of Perceived Stress With Depression Among Vaccinated Healthcare Workers During the SARS-CoV-2 Variant Outbreak: The Mediating Role of Compassion Fatigue

Objective@#Depression was common during coronavirus disease-2019 (COVID-19) pandemic, while the association of perceived stress with depression among vaccinated healthcare workers has not been investigated. This study aimed to address this issue. @*Methods@#We included a total of 898 fully vaccinated healthcare workers during the outbreak of severe acute respiratory syndrome coronavirus 2 Delta variant in Nanjing, 2021. Depression was ascertained by Patient Health Questionnaire-9, with a cut-off score of ≥5 indicative of mild-to-severe depression. Perceived stress, resilience, and compassion fatigue were assessed by Perceived Stress Scale-10, Resilience Scale-25, and Professional Quality of Life Scale version-5, respectively. Logistic regression analyses were used to estimate the odds ratio (OR) and 95% confidence interval (CI), along with subgroup and mediation analyses. @*Results@#The prevalence of mild-to-severe depression was 41.1% in vaccinated healthcare workers. The odd of mild-to-severe depression was increased with higher perceived stress. Compared with vaccinated healthcare workers with the lowest tertile of perceived stress, those with the highest tertile had increased odds of mild-to-severe depression by 120% (OR 2.20, 95% CI 1.46 to 3.31) after multivariable-adjustment. However, perceived stress was not associated with mild-to-severe depression in vaccinated healthcare workers with strong resilience, but was in those with weak resilience (pinteraction=0.004). Further analysis showed that compassion fatigue mediated the relationship between perceived stress and mild-to-severe depression, with a mediating effect of 49.7%. @*Conclusion@#Perceived stress was related to an increased odd of mild-to-severe depression in vaccinated healthcare workers during COVID-19 pandemic, and this relationship might be explained by compassion fatigue.

Complete Box Fusion based on Ensemble Networks for rib fracture detection and localization / 解剖学报

Objective To propose a new rib fracture detection network Rib-Net to automatically and accurately detect and locate rib fracture and address the issue of missed diagnosis of rib fractures. Methods The public data set RibFrac Dataset was used to evaluate the performance of the Rib-Net, and the data set was divided into training set (420 cases), validation set (80 cases), and test set (160 cases). The Rib-Net was composed of the object detection integrated network Ensemble Detection Net (ED-Ne), Complete Box Fusion (CBF) module and the segmentation network 3D Unet. Firstly, Retina Unet, UFRCNN+ and Mask RCNN were integrated to form ED-Net to predict rib fracture candidate boxes. Secondly, a new CBF module was designed to fuse overlapping fracture candidate boxes to generate candidate boxes with accurate positioning and accurate confidence. Finally, Unet was used for rib fracture segmentation to achieve further precise localization of rib fractures. Results On the “MICCAI 2020 RibFrac Challenge: Rib Fracture Detection and Classification challenge”, our proposed Rib-Net’s detection results reached the best performance, and its recall rate, free-response receiver operating characteristic curve(FROC) value and Dice were 92.3%, 0.859 and 0.61, respectively. Conclusion The Rib-Net network can efficiently and accurately detect and locate rib fractures on chest CT images, effectively assisting doctors in making accurate diagnosis.

Four-year changes in central fatness, risk of diabetes, and metabolic control in older adults: a cohort study with mediation analysis

Background/Aims@#Older adults are vulnerable to central obesity, while the association of changes in central fatness with risk of diabetes and metabolic control has not been investigated among this particular population. This study was aimed to address these issues. @*Methods@#A total of 1,815 adults aged ≥ 60 years without diabetes at baseline were followed for 4 years. Incident diabetes was ascertained based on plasma glucose, hemoglobin A1c, medical history, and/or the use of anti-diabetic drugs. Central fatness was assessed by waist circumference (WC), waist-height ratio (WHtR), and body roundness index (BRI). Logistic regression analyses were used to assess the association of changes in central fatness with risk of diabetes, along with dose-response and mediation analyses. @*Results@#During the 4-year follow-up, 177 participants developed diabetes. The risk of diabetes was increased by 42%, 41%, and 40% per 1 standard deviation increases in WC, WHtR, and BRI, respectively, in multivariable-adjusted models (all p < 0.01). Moreover, these relationships were all linearly-shaped (all pnonlinearity ≥ 0.11). Increases in WC, WHtR, and BRI correlated with increases in hemoglobin A1c, triglycerides-and-glucose index, triglycerides, white blood cell, and C-reactive protein (all p ≤ 0.04). Yet only changes in hemoglobin A1c and triglycerides-and-glucose index were identified as the possible mediators for risk of diabetes, with their mediating effect being about 35% and 21%, respectively. @*Conclusions@#Increases in central fatness were related to elevated risk of diabetes, and this association might be partly explained by the worsening of glycemic control and insulin resistance in older adults.

Normalized Creatinine-to-Cystatin C Ratio and Risk of Diabetes in Middle-Aged and Older Adults: The China Health and Retirement Longitudinal Study

Background@#Creatinine-to-cystatin C ratio is recently suggested to be a surrogate marker for sarcopenia. However, little is known about its association with diabetes. This study aimed to fill in this gap based on a large-scale prospective cohort. @*Methods@#A population-based representative sample of 5,055 participants aged ≥45 years from the China Health and Retirement Longitudinal Study was enrolled between 2011 and 2012 and followed at least once during the subsequent surveys at 2013, 2015, or 2018. Creatinine-to-cystatin C ratio was calculated and normalized by body weight. Incident diabetes was ascertained by plasma glucose, glycosylated hemoglobin, self-reported history, or use of anti-diabetic drugs. Logistic regression analysis and mediation analysis were employed. @*Results@#During follow-up, 634 participants developed diabetes. The risk of diabetes was gradually and significantly decreased with increased normalized creatinine–cystatin C ratio. The multivariable-adjusted odds ratio for diabetes was 0.91 (95% confidence interval, 0.83 to 0.99) per 1 standard deviation higher of normalized creatinine-to-cystatin C ratio, and this relationship remained significant after controlling for muscle strength. The risk reduction in diabetes was significantly larger in participants with normal-weight and high normalized creatinine-to-cystatin C ratio compared with those with overweight/obesity and high normalized creatinine-to-cystatin C ratio (Pinteraction=0.01). Insulin resistance and inflammation appeared to be key mediators accounting for the observed relationship between normalized creatinine-to-cystatin C ratio and risk of diabetes, with their mediating effect being 93.1% and 22.0%, respectively. @*Conclusion@#High normalized creatinine-to-cystatin C ratio is associated with reduced risk of diabetes in middle-aged and older adults.

Cichoric acid from extracted Echinacea purpurea induces the proliferation and apoptosis of peripheral blood mononuclear cells from yaks

BACKGROUND: Cichoric acid (CA) is extracted from Echinacea purpurea. It is well known and widely used for its immunological function. However, the effect of CA on peripheral blood mononuclear cells (PBMCs) from yaks is still unclear. This study investigated the potential influences of CA on the proliferation, cytokine induction, and apoptosis of PBMCs from Datong yak in vivo, and aimed to provide a basis for exploring the pharmacological activities of CA on yaks. RESULTS: In this study, CA promoted PBMCs proliferation by combining concanavalin A (Con A) and exhibited a dose-dependent effect as demonstrated by a Cell Counting Kit-8. The concentration of 60 µg/ml CA was the best and promoted the transformation from the G0/G1 phase to the S and G2/M phases with Con A. Furthermore, 60 µg/ml CA significantly increased IL-2, IL-6, and IFN-γ levels and PCNA, CDK4 and Bcl-2 expression levels, but it significantly inhibited the TP53, Bax, and Caspase-3 expression levels. Transcriptome analysis revealed a total of 6807 differentially expressed genes (DEGs) between the CA treatment and control groups. Of these genes, 3788 were significantly upregulated and 3019 were downregulated. Gene Ontology and pathway analysis revealed that DEGs were enriched in cell proliferation and immune function signaling pathways. The expression level of some transcription factors (BTB, Ras, RRM_1, and zf-C2H2) and genes (CCNF, CCND1, and CDK4) related to PBMCs proliferation in yaks were significantly promoted after CA treatment. By contrast, anti-proliferation-associated genes (TP53 and CDKN1A) were inhibited. CONCLUSIONS: In summary, CA could regulate the immune function of yaks by promoting proliferation and inhibiting inflammation and apoptosis of PBMCs.

Comparison of four different metabolic syndrome diagnostic criteria among the elderly in Nanjing / 中华疾病控制杂志

Objective To compare the application of the 2013 Chinese Diabetes Society (CDS 2013) criteria, the 2009 joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention(JIS)criteria, the 2005 International Diabetes Federation(IDF)criteria and the 2005 US National Cholesterol Education Program Adult Treatment PanelⅢ (ATPⅢ) criteria among the elderly in Nanjing. Methods A total of 1 832 elderly (≥60 years old) were recruited in Nanjing using cluster random sampling and were surveyed with questionnaires, physical examination, and laboratory test between March and December 2013. The different prevalence under CDS 2013, JIS, IDF and ATPⅢ criteria were calculated respectively. SPSS 19.0 was used to conduct t test, chi-square test and kappa test to compare the prevalence of metabolic syndrome and the consistency of four diagnostic criteria in the elderly. Results According to CDS 2013, JIS, IDF, and ATPIII, prevalence of MS in the elderly in Nanjing was 39.9%, 58.2%, 46.5%, and 54.5%, respectively. The highest value of kappa was 0.920 between JIS and ATPⅢ, with a compliance rate of 96.1%．The value of kappa was 0.841 between ATPⅢ and IDF, with a compliance rate of 92.0%. Conclusions The prevalence of metabolic syndrome among the elderly in Nanjing is relatively high under different criteria. The higher detection rate of MS by the JIS standard and ATPIII standard can help to find MS earlier and reduce the cardiovascular damage.

A new polyketide from marine-derived Streptomyces sp.MDW-06 / 中国中药杂志

To isolate and identify secondary metabolites of marine-derived Streptomyces sp.MDW-06,the isolations and purifications of compounds were performed by means of column chromatography over silica gel. And their structures were elucidated through the spectroscopic analysis of MS,NMR and specific rotations. The bioactivities were assayed by paper diffusion and DPPH method. From the fermentation broth of marine-derived Streptomyces sp.MDW-06,five compounds( 1-5) were isolated and identified as streptopentanoic acid( 1),germicidin A( 2),germicidin B( 3),isogermicidin A( 4),isogermicidin B( 5) and oxohygrolidin( 6),respectively. Compound 1 is a new compound. Compound 1 shows DPPH radical scavenging activity with 36. 4% at 100 mg·L~(-1).

Nursing care of 5 patients with atrial fibrillation treated with left atrial appendage occlusion combined with his bundle up pacing / 中国实用护理杂志

Objective To summarize the nursing experience of left atrial appendage occlusion combined with his bundle lifting pacing in the treatment of atrial fibrillation. Methods The heart center of our hospital was first created with left atrial appendage combined with hirson bundle pacing, and 5 cases were completed from January 1, 2017 to January 1, 2018, and the nursing points were summed up in combination with the perioperative and postoperative follow-up nursing. Results All 5 patients were successfully performed with combined operation, and no serious complications occurred during the perioperative period and follow-up period. Conclusions Because the process of innovation is more complicated, it is necessary for the nursing team to carry out strict auxiliary nursing and monitoring of the disease in different stages so as to ensure the operation safety and improve the quality of life of the patients.

Analysis of Risk Factors for Mortality from Acute Paraquat Poisoning / 中国医科大学学报

Objective To analyze risk factors for mortality from acute paraquat poisoning. Methods A retrospective study was performed that included 162 patients with acute paraquat poisoning who visited the emergency room between January 2016 and July 2017. The patients were divided into survival and non-survival groups, and paraquat doses and regular laboratory test results were recorded. The significantly different parameters (P ＜ 0. 05) that were identified between the two groups were included in logistic regression analyses to identify independent risk factors of mortality, and receiver-operating characteristic curves were generated to evaluate the prognostic ability of each risk factor. Results Paraquat dose, hemoperfusion, blood lactic acid level, serum creatinine level, and urine paraquat concentration were independent risk factors for mortality from acute paraquat poisoning (P ＜ 0. 05). Conclusion Paraquat dose, hemoperfusion, blood lactic acid, serum creatinine, and urine paraquat concentration can be used to determine the prognosis of acute paraquat poisoning.

A Photoelecteochemical Sensor Based on CdS Sensitized Fe:TiO2Nanosheets for Determination of Cu2+ / 分析化学

Iron-doped titanium dioxide nanosheets was prepared by hydrothermal method using tetrabutyl titanate (C16H36O4Ti) and iron trifluoride (FeF3) and modified on ITO electrode.ITO/Fe : TiO2/CdS photoelectrochemical sensor was fabricated by successive ionic layer absorption and reaction(SILAR) method for determination of copper ion.The band gap of electode material was narrowed by iron doped TiO2 nanosheets,which made its absorption red-shifted and its response range of light was magnified.Based on the sensitization effect of CdS,the absorption and utilization of visible light of sensor was significantly enhanced and the photoelectric signal was amplified via reducing the recombination of electrons and holes.The sensor displayed excellent analytical performance for detection of copper ion with linear range of 0.2-4.0 μmol/L and 4.0-80.0 μmol/L and with the detection limit of 85 nmol/L.The sensor was used to detect copper ion in tap water,drinking water and Yongjiang river water with recoveries ranging from 94% to 111%.

Study on root number and root canal morphology in maxillary third molars by cone-beam computed tomography / 重庆医学

Objective To use the cone-beam computed tomography(CBCT) to analyze the root number and root canal morphology of maxillary third molars in Luzhou area.Methods A total of 321 maxillary third molars in 200 outpatients in the stomatological hospital of Southwest Medical University from September 2016 to February 2017 were collected.The age,gender,root number,canal morphology and CBCT imaging data were recorded.The difference in root number of maxillary third molars between left and right sides and between genders were analyzed.Results In included 321 maxillary third molars,the root number was mainly fused root teeth(56.70％),followed by three roots teeth(26.48％);the number of root canal was mainly three root canals (38.94 ％),followed by single root canal(30.84 ％).According to the Vertucci root canal classification,65.73 ％ of root canals were type Ⅰ and 10.60％ were type Ⅴ.There was no statistical differences between left and right sides(P＞0.05),wherease there was statistically difference between genders(P＜0.05).Conclusion The root number of maxillary third molars is variable,the root canal morphology has large variability and the root canal system is complex.

An observation on the long-term efficacy of recombinant hepatitis B vaccines among the newborns / 预防医学

Objective evaluate the long-term efficacy of the recombinant hepatitis B vaccines (HBV) among the newbornswith vaccination at birth. Methods During 1996-1997, 135 newborns were selected from Deqing according to the inclusioncriterion. They were divided into 2 groups: a group of 35 newborns whose mother was HBsAg positive) and a group of 100newbornswhose mother was HBsAg negative. All 135 newborns routinely received 3 doses of yeast -derived hepatitis Bvaccines (i.e. the first dose at birth, the second dose at 1 month old, and the third dose at 6 months old) . Serologicalmarkers to HBV were repeatedly assessed at 3 follow-up stages (i.e. the first follow-up at 12 months, the second follow-upat 2010, the third follow-up at 2012) . Results Participants remained in the study at 3 follow-upstages were 123(91.11%), 95(70.37%) and 46(34.07%) respectively. Participants' serum HBsAg were negative at all 3 follow-upstages. Among participants whose mothers were HBsAg positive, 3 participants were found to be HBcAb positive in 2010,and no new HBcAb positive participants were found in 2012. The rates of HBsAb positive at 3 follow-up stages were 88.89%, 81.48%, and 80.00% respectively. The HBsAb geometric mean concentrations (GMCs) of participants at their 12 monthsold were significantly positively associated with those in 2010 and those in 2012(P<0.05) . Among participants whosemothers were HBsAg negative, no HBcAb positive participants were found. The rates of HBsAb positive at 3 follow-up stageswere 91.18%, 54.41%, and 52.78% respectively. No correlation was found among HBsAb GMCs of participants at 12 monthsold, in 2010 and in 2012. No correlation was found between boost vaccination and the rate of HBsAg positive, afteradjustment of the HBsAg status of their mothers. Conclusion The efficacy of the yeast-derived HBV could sustain for at least13-15 years, and the general population do not need booster immunization. After the 3-dose immunization, the HBsAblevels of the healthy mothers' 12-months-old children were related to those of their adolescence.

Effect of DPP-4 inhibitor on glucose fluctuation in patients with type 2 diabetes mellitus treated by insulin / 重庆医学

Objective To probe into the effect of sitagliptin on blood glucose fluctuation of the patients with type 2 diabetes mellitus(T2DM) and poor control by insulin aspart 30.Methods Ninety cases of T2DM and poor control by insulin aspart 30 in affiliated Zhongshan hospital from January 1,2014 to December 31,2014 were selected and randomly divided into three groups:simply continuous subcutaneous insulin injection(CSII),acarbose combined CSII group(CSII + Aca) and sitagliptincombined CSII group (CSII + Sig),30 cases in each group.Three groups received the intensive treatment for 2 weeks,and72-h continuous glucose monitoring was performed on last 3 d.The 24 h mean blood glucose(24 hMBG),largest amplitude of glycemic fluctuation(LAGE),mean amplitude of glycemic excursion(MAGE) within 1 d,postprandial blood glucose spike(PGS),postprandial glucose peak time(△t),postprandial glucose excursion(PPGE) and total T were observed within 24 h.The difference of insulin dose(△ insulin),hypoglycemia incidence,glucose-target rate,blood glucose profiles were compared at the end of treatment.Results After two-week treatment,intraday blood glucose variation indicators(24 hMBG,LAGE and MAGE) and postprandial blood glucose variation indicators (PGS,△t,PPGE and total T) in the CSII+Sig and CSII+-Aca groups were significantly lower than those in the CSII group(P＜ 0.05),while the differences in blood glucose variation indicators between the CSII+Sig group and CSII+-Aca group were not statistical significant(P＞ 0.05).In the comparison after treatment,△ insulin,hypoglycemia incidence and glucose-target rate in the CSI + Sig group were lower(P＜0.05).Conclusion The combined application of short-term CSII and sitagliptin will achieve a better effect than the combination with acarbose,can smoothly and steadily reduces the blood glucose level,relieves the whole day glucose fluctuations,effectively reduces △ insulin,and has lower hypoglycemia occurrence rate.

An evaluation on immunization effect and the influencing factors after revaccination with 60 μg hepatitis B vaccine among non-response adults / 预防医学

Objective To explore vaccine immune effects of 60μg hepatitis B on adults who have no response to hepatitis B vaccination.Methods A Total of 689 healthy adults who were HBsAg and anti -HBs negative were selected,and they were received 3 doses of hepatitis B vaccine at dosage 10 μg.Those with anti-HBs<10 IU/L detected after full series vaccination were given 1 dose of hepatitis B vaccine at dosage 60 μg.One month later,anti-HBs detection was conducted for them.Results The non -responsiveness rate was 17.71% after primary hepatitis B vaccination.The multivariate logistic regression analysis showed that risk factors for primary non-responsiveness were the history of surgical operation, immunization schedule and "anti-HBc alone".The anti-HBs positive rate was 95.5 1% in 89 re-vaccinated people, and the geometric mean titers of anti -HBs(GMT)was 585.39 IU/L.Conclusion Re -immunization of hepatitis B vaccine at dosage 60 μg has good immunogenicity in people who have no response to primary vaccination,and weight control may improve the effect of hepatitis B re-immunization.

Comparison clinical efficacy of 3% hypertonic saline solution with 20% mannitol in treatment of intracranial hypertension in patients with aneurysmal subarachnoid hemorrhage / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To compare the efficacy of 3% hypertonic saline solution with 20% mannitol in treatment of intracranial hypertension in patients with aneurysmal subarachnoid hemorrhage.</p><p><b>METHODS</b>An alternating treatment protocol was used to compare the efficacy of 160 mL 3% hypertonic saline solution (HSS) with 150 mL 20% mannitol for episodes of increased intracranial pressure (ICP) in patients with aneurysmal subarachnoid hemorrhage. The dependent variables were the extent and duration of reduction of increased ICP after each event.</p><p><b>RESULTS</b>Both 3% HSS and 20% mannitol rapidly decreased the ICP in patients with aneurysmal subarachnoid hemorrhage (P <0.01). No difference between two medications in the extent of duration of ICP and reduction of action (P >0.05).</p><p><b>CONCLUSION</b>3% HSS should be considered as the first-line osmotic drug in treatment of intracranial hypertension in patients with aneurysmal subarachnoid hemorrhage.</p>

Effects of different cavosurface margins on color matching of the resin composite / 北京大学学报(医学版)

Objective: To evaluate effects of color matching of different cavosurface margins on the resin composites in vitro.Methods:Twenty extracted human premolars with an A 2 shade buccal surface were used in this study .Rectangular shaped cavities (3.0 mm depth, 2.0 mm width, 2.0 mm length) were prepared in the center of the buccal surfaces .The gingival and occlusal cavosurface margins were prepared to be either shoulder or bevel;the other cavosurface margins remained vertical .Ten teeth were filled with Clearfil AP-X (AP), the other ten with Clearfil Majesty (MJ) and light cured.The color difference at the cavosurface margin area was measured using a spectrophotometer ( CrystalEye ) and evaluated by 3 observers subjectively .The data were statistically analyzed using repeated measures ANOVA and Chi-square test .Results:When measured by CrystalEye , the color difference between the tooth and resin composite was reduced from the center of restoration to the cavosurface margin area .Both objective and subjective evaluations showed that for AP , the color difference at the cavosurface margin area had no statistical difference among 3 types of the margins; for MJ, the color difference at bevel margin area was significantly smaller than that at the vertical margin area .Conclusion: The resin com-posite restorations produced the color matching at marginal area .The color matching of resin composites with higher diffused light transmission property is more susceptible to the type of cavosurface margins . Preparing bevels may reduce the color difference between the restoration and tooth surface .

The long-term efficacy of recombinant hepatitis B vaccines for children / 预防医学

Objective To observe long-term efficacy of recombinant hepatitis B vaccines for children received fundamental immunization or booster dose. Methods 493 school students from Deqing county with complete information of immunization history were investigated and their serological markers were detected. 430 students received booster dose vaccines at 3-11 years old and were defined as booster group while the remaining 63 students were defined as fundamental group. Results All vaccines the 493 students received for fundamental immunization were recombinant. Compared with fundamental group(57. 14%),booster group had significantly higher Anti-HBs positive rate of 91. 40%(P<0. 01). And the Anti-HBs positive rate had a high level of 94. 99% when 0-5 years after booster immunization while it declined to 64. 71% after 8-15 years and showed no significant difference compared with fundamental group. Conclusion Anti-HBs level and anti -HBs positive rate can significantly increase for short periods after booster immunization,and may decline considerably for long-term. Immunologic amnesia rate is low when 3 -11 years after fundamental immunization among infants.

Prevalence of occult hepatitis B virus infection and its phylogenetic features among mother-teenager pairs / 中华流行病学杂志

Objective Prevalence of occult hepatitis B virus (HBV) infection (OBI) was investigated in a paired mother-teenager population and HBV S gene variation including overt and occult HBV,was determined.Methods A follow-up study based on an initial survey of 135 mother-teenager pairs was carried out through collection of questionnaires and blood samples HBsAg were detected by ELISA method,viral load by PCR amplification and HBV S gene by phylogenetic analysis.Results 102 pairs of subjects were followed-up.Blood samples from 94 mothers and 101children were collected.OBI prevalence in mothers was 10.0％ (6/60),significantly higher than 2.0％(2/101) in teenagers.Medians of viral load were 399.9 IU/ml and 247.6 IU/ml in overt and occult HBV strains,but without significant difference.1 occult HBV strain belonged to genotype B with serotype adw while the other 7 were genotype C with serotype adr.15 of the overt HBV strains belonged to genotype B with serotype adw and the other 8 were genotype C with serotype adr.Proportions of genotype-C strains were significantly higher in occult HBV strains than in overt HBV strains.Conclusion OBI was seen in teenage-mother population.

Improving Patients' Adherence to Physical Activity in Diabetes Mellitus: A Review

Regular physical activity (PA) is a key element in the prevention and management of type 2 diabetes mellitus (T2DM). Participation in regular PA improves blood glucose control and can prevent or delay T2DM and its complications, along with positively affecting lipids, blood pressure, cardiovascular events, mortality, and quality of life. However, most people with T2DM are not active and show poor adherence. This paper reviews the possible barriers to PA and strategies to improve the adherence to PA. Based on the currently available literature, it is concluded that self-efficacy and social support from family, friends, and health care providers play the important role in adoption and maintenance of regular PA. Here we also highlight some new modern and innovative interventions that facilitate exercise participation and improve the adherence.