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Objective:To investigate the relationship of pks gene islands with virulence genes, capsular serotypes and biofilm formation in Klebsiella pneumoniae ( Kp). Methods:A total of 113 Kp clinical isolates were collected in the First Affiliated Hospital of Fujian Medical University and divided into two groups based on the presence of pks gene islands: pks+ and pks- groups. The hypermucoviscous (HM) phenotype was detected by string test. Five virulence genes ( peg-344, rmpA, rmpA2, iucA, iroB) and six common capsular serotypes (K1, K2, K5, K20, K54, K57) were detected by polymerase chain reaction (PCR). The biofilm formation ability was measured by crystal violet staining. Results:Among the 113 Kp isolates, 46 were pks+ strains and 67 were pks- strains. The detection rate of HM phenotype was higher in the pks+ group than in the pks- group [87.0% (40/46) vs 43.3% (29/67)]. The detection rates of virulence genes ( peg-344, rmpA, rmpA2, iucA, iroB) and K1 serotype in the pks+ group were also higher than those in the pks- group ( P<0.05). The biofilm formation ability of the pks+ strains was higher than the pks- strains ( P<0.05). Conclusions:Kp strains carrying pks gene islands were likely to display a HM phenotype and mainly belonged to the K1 serotype. Most of the pks+Kp strains carried the virulence genes of peg-344, rmpA, rmpA2, iucA and iroB, and had a greater ability to form biofilms.
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To explore the relationship between sleep duration and brachial-ankle pulse wave velocity(baPWV) in patients with type 2 diabetes mellitus(T2DM). A total of 1 755 patients with T2DM received standardized management of metabolic disease from March 1, 2018 to February 29, 2020 were included. All patients were classified into three groups according to the sleep duration: short(≤6 h), medium(>6 h to 8 h) and long(>8 h). Increased arterial stiffness was defined as baPWV≥1 600 cm/s. The prevalence of baPWV≥1 600 cm/s was 39.7%, 30.8% and 38.6% in short, medium and long sleep duration group, respectively( P<0.01). Multivariate logistic regression analysis showed that patients with long sleep duration( OR=1.317, P<0.05) but not short sleep duration( OR=1.169, P>0.05) had a higher risk for baPWV≥1 600 cm/s compared with the reference group with medium sleep duration. Stratified analyses by sex showed that the OR were 1.735( P<0.05) among female and 1.131( P>0.05) among male respectively for baPWV≥1 600 cm/s in long sleep duration group when compared with medium sleep duration group. Sleep duration>8 h was found to be associated with elevated baPWV in patients with T2DM. There were gender differences in the correlation between long sleep duration and baPWV.
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Objective:To explore the association between thyroid hormones and visceral fat area(VFA) in the patients with type 2 diabetes.Methods:A total of 729 patients with type 2 diabetes, who joined National Metabolic Management Center(MMC) through Ningbo First Hospital from March, 2018 to July, 2019, were enrolled in this study. Blood tests were taken to assess their thyroid hormones and biochemical indexes. VFA and subcutaneous fat area(SFA) were obtained through bioelectrical impedance analysis. Statistics were later analyzed by Spearman correlation analysis and multivariate linear regression. Results:Spearman correlation analysis showed that VFA were positively correlated with T 3、FT 3( r=0.225 and 0.211, P<0.01), and VFA were inversely correlated with FT 4( r=-0.112, P<0.01). No correlation was found between VFA and either of T 4 or TSH( P>0.05). Multivariate linear regression analysis indicated that VFA was independently correlated with FT 4 and FT 3( P<0.01). An increment of 1 pmol/L in FT 4 was associated with 1.759 cm 2 increase in VFA, and increment of 1 pmol/L in FT 3 was associated with 3.256 cm 2 decrease in VFA. Conclusion:VFA in patients with type 2 diabetes are correlated with FT 3 and FT 4.
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Objective:“Food addiction” may be one of the drivers of the obesity epidemic. Bariatric surgery-induced weight loss can significantly alleviate food addiction in overweight or obese people. Appetite regulation is part of the feedback control system for energy balance. The purpose of this study was to investigate the effects of mobile application-based dietary intervention on weight-loss and food addiction in overweight and obese adults.Methods:A total of 101 overweight or obese people aged over 18 years, who were admitted to the obese multidisciplinary clinic of Ningbo First Hospital from August 2015 to January 2018 were enrolled. All subjects received health education and dietary guidance, and submitted their diet log through the weight management application of their smartphone. Over 12 weeks, a dietitian guided and corrected the subjects who did not meet the diet standards. Interviews, physical examinations, laboratory tests, and the Yale Food Addiction Scale Questionnaire survey were administered before and after the intervention (12 weeks) comparing subjects’ weight, food addiction symptom count, and the proportion of food addiction before and after intervention. Statistical analysis of body composition measurements, blood biochemical parameters, and symptom count scores was performed using paired data t-test, McNemar chi-square test, and Fisher’s exact test. Results:A total of 101 overweight and obese subjects were enrolled, including 31 males and 70 females, with an average age of (30.4±7.3) years, mean body mass index of (32.76±4.46) kg/m 2, and average body weight of (89.95±17.12) kg. The proportion of food addiction was 26.73%. After 12 weeks of dietary intervention with the mobile application, the number of people with food addiction decreased from 27 to 14, the proportion of food addiction decreased by 12.87%, the proportion of symptom counts ≥3 decreased from 41.58% to 19.80%.（χ2 =5.17， 11.26, all P <0.01), and the symptom count decreased from 2.25 ±1.61 to 1.50±1.31 ( t=3.64, P<0.001). Simultaneously, body weight, BMI, and waist circumference decreased by (6.54±1.03) kg, (2.35±0.36) kg/m 2, and (6.50±0.86) cm ( t=6.36, 5.62 and 3.78, all P<0.001), respectively, compared with those before the intervention. Metabolic indicators such as fasting glucose, insulin resistance index, and LDL-C cholesterol also significantly improved, with a decrease of (0.38±0.10) mmol/L, 1.83±0.46, (0.22±0.75) mmol/L ( t=3.67, 3.59, 2.97, all P<0.01). Conclusion:The smartphone application-based dietary intervention can effectively improve blood glucose and lipid levels in overweight and obese people, reduce visceral fat accumulation and reduce insulin resistance, and improve the food addiction status of overweight and obese people.
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Objective@#To explore the association between thyroid hormones and visceral fat area(VFA) in the patients with type 2 diabetes.@*Methods@#A total of 729 patients with type 2 diabetes, who joined National Metabolic Management Center(MMC) through Ningbo First Hospital from March, 2018 to July, 2019, were enrolled in this study. Blood tests were taken to assess their thyroid hormones and biochemical indexes. VFA and subcutaneous fat area(SFA) were obtained through bioelectrical impedance analysis. Statistics were later analyzed by Spearman correlation analysis and multivariate linear regression.@*Results@#Spearman correlation analysis showed that VFA were positively correlated with T3、FT3(r=0.225 and 0.211, P<0.01), and VFA were inversely correlated with FT4(r=-0.112, P<0.01). No correlation was found between VFA and either of T4 or TSH(P>0.05). Multivariate linear regression analysis indicated that VFA was independently correlated with FT4 and FT3(P<0.01). An increment of 1 pmol/L in FT4 was associated with 1.759 cm2 increase in VFA, and increment of 1 pmol/L in FT3 was associated with 3.256 cm2 decrease in VFA.@*Conclusion@#VFA in patients with type 2 diabetes are correlated with FT3 and FT4.
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Objective@#“Food addiction” may be one of the drivers of the obesity epidemic. Bariatric surgery-induced weight loss can significantly alleviate food addiction in overweight or obese people. Appetite regulation is part of the feedback control system for energy balance. The purpose of this study was to investigate the effects of mobile application-based dietary intervention on weight-loss and food addiction in overweight and obese adults.@*Methods@#A total of 101 overweight or obese people aged over 18 years, who were admitted to the obese multidisciplinary clinic of Ningbo First Hospital from August 2015 to January 2018 were enrolled. All subjects received health education and dietary guidance, and submitted their diet log through the weight management application of their smartphone. Over 12 weeks, a dietitian guided and corrected the subjects who did not meet the diet standards. Interviews, physical examinations, laboratory tests, and the Yale Food Addiction Scale Questionnaire survey were administered before and after the intervention (12 weeks) comparing subjects’ weight, food addiction symptom count, and the proportion of food addiction before and after intervention. Statistical analysis of body composition measurements, blood biochemical parameters, and symptom count scores was performed using paired data t-test, McNemar chi-square test, and Fisher’s exact test.@*Results@#A total of 101 overweight and obese subjects were enrolled, including 31 males and 70 females, with an average age of (30.4±7.3) years, mean body mass index of (32.76±4.46) kg/m2, and average body weight of (89.95±17.12) kg. The proportion of food addiction was 26.73%. After 12 weeks of dietary intervention with the mobile application, the number of people with food addiction decreased from 27 to 14, the proportion of food addiction decreased by 12.87%, the proportion of symptom counts ≥3 decreased from 41.58% to 19.80%.（χ²=5.17， 11.26, all P <0.01), and the symptom count decreased from 2.25 ±1.61 to 1.50±1.31 (t=3.64, P<0.001). Simultaneously, body weight, BMI, and waist circumference decreased by (6.54±1.03) kg, (2.35±0.36) kg/m2, and (6.50±0.86) cm (t=6.36, 5.62 and 3.78, all P<0.001), respectively, compared with those before the intervention. Metabolic indicators such as fasting glucose, insulin resistance index, and LDL-C cholesterol also significantly improved, with a decrease of (0.38±0.10) mmol/L, 1.83±0.46, (0.22±0.75) mmol/L (t=3.67, 3.59, 2.97, all P<0.01).@*Conclusion@#The smartphone application-based dietary intervention can effectively improve blood glucose and lipid levels in overweight and obese people, reduce visceral fat accumulation and reduce insulin resistance, and improve the food addiction status of overweight and obese people.
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Objective@#To explore the association of the glycosylated hemoglobin (HbA1c) level at admission with 90 days functional outcome in patients with spontaneous intracerebral hemorrhage (ICH).@*Methods@#Patients admitted to the Department of Neurology, Tongji Hospital from January to December 2017 were prospectively and continuously enrolled in this study. Clinical data were collected at admission and functional outcomes 90 days after ICH were assessed by using the modified RANKIN scale. Univariate and multivariate conditional logistic regression models were constructed. Patients were divided into four groups according to the quartile of HbA1c values. The median value of HbA1c in each group was taken as the substitute value and P for trend was calculated. The logistic regression model was fitted by restricted cubic splines to investigate the association between HbA1c level and outcome of ICH.@*Results@#A total of 345 patients with ICH were enrolled, including 214 with favorable outcomes and 131 with poor outcomes (99 severe disability cases and 32 deaths). The risk of poor 90 days outcomes was significantly associated with HbA1c level at admission indicated by multivariate logistic regression analysis, and the P for trend test was <0.001 (middle-level group vs. low-level group: OR=2.33, 95%CI: 1.07-5.07; high-level group vs. low-level group: OR=2.52, 95%CI: 1.12-5.64; extremely high-level group vs. low-level group: OR=6.80, 95%CI: 3.01-15.34). Results from the restricted cubic spline showed that there was a linear correlation between HbA1c level at admission and poor 90 days outcomes of ICH (χ2=14.81, P<0.001; non- linear test: P=0.118). Compared with patients with HbA1c level of 6.5%, the risk of poor outcomes in patients with HbA1c level of <6.5% decreased linearly with the decrease in HbA1c level at admission, and the risk in patients with HbA1c level >6.5% was higher but not significantly.@*Conclusion@#There was correlation between high HbA1c level at admission and 90 days poor outcome of ICH. High HbA1c level is an independent prediction indicator for ICH.