Analysis of mortality trend and related factors for aged in-patients with diabetes mellitus / 中国实用内科杂志

OBJECTIVE: To find out the mortality trend and related factors in aged hospitalized patients with diabetes mellitus(DM). METHODS: The case information diabetic in patients who died during the period from 2005 to 2014 were collected and the mortality and causes of death were analyzed. RESULTS: From 2005 to 2014, 1297 diabetic patients died, and the mortality of elderly DM inpatients was 4.44%(1162 cases), significantly higher than that of the non-elderly of 0.94%(P<0.001). The death rate of elderly diabetic patients was significantly higher in males than in females(5.22% vs. 3.47%, P<0.001). The mortality of the aged diabetic patients decreased within 10 years(P<0.001), decreasing from 4.75% in 2005 to 3.01% in 2009(P<0.001) in the year of 2005-2009, while there were no differences in the year of 2010-2014. The main death causes of the aged diabetic in-patients were as follows: infections(27.71%), cardiovascular diseases(25.22%), tumor(21.34%), cerebral vascular diseases(10.41%) and diabetic complications(5.51%). The first death cause in the 60-79 yrs group was cardiovascular diseases, while in the ≥80 yrs group, it was infections. The constituent ratio of infection as death cause in the aged during 2010-2014 significantly increased(22.60% vs. 32.50%, P<0.001), increasing by 43.81%, and it became the first cause of death in 2010. CONCLUSION: The death rate of the elderly DM in-patients has decreased significantly within 10 years, from 2005 to 2014, while the rate has kept steady from 2010. Infections and cardiovascular diseases are the main cause of death. So it's important to prevent the elderly hospitalized DM patients from infection, in addition to cardiovascular diseases, and to control in time.

Assessment of hypoglycemic status among hospitalized elderly patients with type 2 diabetes / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the hypoglycemic characteristics of hospitalized elderly patients with type 2 diabetes mellitus (T2DM).</p><p><b>METHODS</b>From January, 2014 to December, 2015, the data of 58 565 blood measurements using a standard blood glucose monitoring system (BGMS) were collected from 1187 cases of patients with type 2 diabetes during hospitalization in the Department of Endocrinology, Guangdong General Hospital (Guangzhou, China). Stratified analyses were conducted by dividing the patients into 3 age groups, namely <45 years group (128 cases), 45-64 years group (594 cases), and ≥65 years group (465 cases). The incidence and time distribution of hypoglycemia in these patients were compared among the 3 age groups.</p><p><b>RESULTS</b>The risk of hypoglycemia increased with age. Compared with those below 45 years of age, the patients beyond or equal to 65 years had a significantly increased hypoglycemic density (0.95% vs 0.40%, P<0.001), a higher proportion of patients with hypoglycemia (28.17% vs 10.94%, P<0.001), and greater patient-days with hypoglycemia (4.48% vs 1.76%, P<0.001). In the elderly patients, hypoglycemia occurred most frequently before dawn, at which time the hypoglycemic density was 2.66% in patients ≥65 years of age, significantly higher than that in patients below 45 years (1.09%, P<0.05) and between 45 and 64 years (1.90%, P<0.05); the proportion of patients with hypoglycemia was also significantly higher in the elderly patients (14.57%) than in those below 45 years (3.77%, P<0.02) and between 45 and 64 years (9.42%, P<0.02). The proportion of patients with recurrent hypoglycemia (≥2 times) was significantly higher in patients ≥65 years (13.33%) than in younger patients (2.34% in <45 years group and 9.43% in 45-64 years group, P<0.05).</p><p><b>CONCLUSION</b>The hypoglycemic risk in hospitalized elderly patients with T2DM is significantly higher than that in younger patients, especially before dawn and in terms of recurrent hypoglycemia. Clinicians should develop differential blood glucose monitoring and management strategies for these elderly patients to improve the clinical safety.</p>

Clinical study of exercise rehabilitation and gait analysis during the perioperative period of lumbar percutaneous transforaminal endoscopic discectomy / 中国骨伤

<p><b>OBJECTIVE</b>To explore the clinical effect of exercise rehabilitation during perioperative period on residual pain, gait and activities of daily living (ADL) in patients with lumbar spinal stenosis (LSS) after lumbar percutaneous transforaminal endoscopic discectomy(PTED).</p><p><b>METHODS</b>The clinical data of 48 patients with LSS underwent PTED from December 2015 to December 2016 were retrospectively analyzed. Patients were divided into observation group and control group according to different rehabilitation patterns, being 24 cases in each group. The patients of observation group received exercise rehabilitation and the patients of control group received conventional rehabilitation. Visual analogue scale(VAS), Oswestry Disability Index (ODI) and the ratio of supporting phase were recorded before operation and 12 days, 6 months after operation. The correlation between the ratio of supporting phase and VAS, ODI was analyzed.</p><p><b>RESULTS</b>The ratio of supporting phase of observation group was significantly higher than that of control group at 12 days after operation(<0.05). The VAS and ODI in observation group were significantly lower than that of control group at 6 months after operation(<0.01). There was no correlation between the ratio of supporting phase and ODI or VAS in two groups (>0.05).</p><p><b>CONCLUSIONS</b>Lumbar percutaneous transforaminal endoscopic discectomy combined with exercise rehabilitation during the perioperative period can release or eliminate postoperative residual pain, improve gait balance, enable activities of daily living, and has a positive effect in patients with lumbar spinal stenosis.</p>

Application of Real-time Quantitative PCR in Detecting Atypical BCR/ABL mRNA Transcripts in Chronic Myelocytic Leukemia / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To detect atypical BCR/ABL mRNA transcript by real-time quantitative PCR in CML patients without e13a2/e14a2,e19a2 or e1a2 transcripts, and investigate its value of clinical application.</p><p><b>METHODS</b>Twelve cases of CML with positive for t(9;22) translocation, but negative for common major and minor breakpoint cluster regions comfirmed by chromosome karyotyping or FISH analysis, were collected from July 2012 to December 2015. These 12 cases were then detected for b2a3(e13a3), b3a3(e14a3), e6a2, e8a2 and e1a3 fusion variants by real-time quantitative PCR.</p><p><b>RESULTS</b>Among 12 cases 4 variant transcripts were detected, including e1a3 in 1 case (8.33%), e8a2 in 2 cases (16.67%), b2a3 in 5 cases (41.67%) and b3a3 in 4 cases (33.33%), with total positivity of 100%, moreover b2a3 and b3a3 were predominant.</p><p><b>CONCLUSION</b>The detecting atypical BCR/ABL mRNA transcripts by real-time quantitative PCR is suitable for the diagnosis of CML negative for P210, P190 and P230 by standard real-time PCR test, and this detection is still the standard and economic method for monitoring minimal residual disease in CML patients with variants of BCR/ABL fusion gene.</p>

Correlation between ectopic fat accumulation and insulin sensitivity in obese individuals with different glucose tolerance levels / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the correlation between liver and skeletal muscle fat contents and insulin resistance in obese individuals with different levels of glucose tolerance.</p><p><b>METHODS</b>RESULTS: Ten non-obese individuals with normal glucose tolerance (NGT), 9 obese individuals with NGT, and 7 obese individuals with impaired glucose tolerance (IGT) were enrolled in this study. All the participants were examined for insulin sensitivity by hyperinsulinemic-euglycemic clamp and for liver and skeletal muscle fat accumulation quantified by proton magnetic resonance spectroscopy (1H MRS). The data were collected from the subjects including somatometric measurements, fasting plasma glucose, 2-h plasma glucose (2hPG), fasting insulin, and blood biochemistry. Linear correlation analysis and multiple linear stepwise regression analysis were used to analyze the relationship between ectopic fat accumulation and insulin resistance.</p><p><b>RESULTS</b>The glucose infusion rates (GIR, presented as the M value) differed significantly among IGT-obese (3.95∓1.66 mg·kg·min), NGT-obese (6.14∓1.90 mg·kg·min) and NGT-non-obese (8.78∓2.46 mg·kg·min) groups (P<0.05). The 3 groups also showed significant differences in liver fat contents [(15.23∓3.09)%, (6.25∓0.38)%, and (1.89∓0.90)%, respectively, P<0.05] and intramyocellular lipids in the tibialis anterior (2.69∓0.95, 2.61∓1.45, and 1.54∓0.66 mmol/kg, respectively, P<0.05). Linear analysis revealed that liver fat content, but not skeletal muscle fat content, was significantly correlated with the M value. Multiple linear stepwise regression analysis using M value as the dependent variable (Y) revealed that liver fat content (X) was an independent factor inversely correlated with the M value (regression equation: Y=-30.562X+9.007, R=0.717, P<0.01).</p><p><b>CONCLUSIONS</b>Liver fat accumulation, but not skeletal muscle fat accumulation, is correlated with insulin resistance and impaired glucose metabolism.</p>

Diagnostic Value of Cerebrospinal Fluid T-SPOT.TB for Tuberculousis Meningitis in China / 生物医学与环境科学（英文）

The aim of this study was to evaluate the diagnostic value of the cerebrospinal fluid (CSF) T-SPOT.TB test for the diagnosis of TB meningitis (TBM). A retrospective analysis of 96 patients with manifested meningitis was conducted; T-SPOT.TB test was performed for diagnosing TBM to determine the diagnostic sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). A receiver operating characteristic (ROC) curve was also drawn to assess the diagnostic accuracy. The sensitivity, specificity, PPV, and NPV of CSF T-SPOT.TB test were 97.8%, 78.0%, 80.3%, and 97.5%, respectively, for 52 patients (54.2%) of the 96 enrolled patients. The area under the curve (AUC) was 0.910, and the sensitivities of CSF T-SPOT.TB for patients with stages I, II, and III of TBM were 96.7%, 97.2%, and 98.9%, respectively. CSF T-SPOT.TB test is a rapid and accurate diagnostic method with higher sensitivity and specificity for diagnosing TBM.

Efficacy of ultrasound-guided lauromacrogol sclerotherapy for benign thyroid cysts and factors affecting the therapeutic effect / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of ultrasound-guided lauromacrogol sclerotherapy for benign thyroid cysts and analyze the factors affecting the efficacy.</p><p><b>METHODS</b>Ultrasound-guided lauromacrogol sclerotherapy was performed in 97 patients with a total of 99 benign thyroid cysts. The changes in cystic volume and other thyroid parameters were evaluated at 1, 3, 6, and 12 months after sclerotherapy. According to changes in the cystic volume, the efficacy of sclerotherapy was defined as therapeutic failure (with a volume reduction <50%), treatment success (volume reduction ≥50%) and cure (volume reduction ≥90%). The factors of affecting the efficacy of sclerotherapy was analyzed using COX regression.</p><p><b>RESULTS</b>The mean cystic volume at 1, 3, 6 and 12 months after sclerotherapy were reduced from the baseline volume of 12.08∓11.56 cmto 5.63∓8.51 cm, 5.96∓8.42 cm, 3.80∓5.50 cmand 2.85∓3.98 cm, respectively, with an average cystic volume reduction rate of (70.02∓33.72)%. Therapeutic success was achieved 82 of the 99 cysts (82.83%) and cure was achieved 63cysts (63.64%) at 12 months after the procedure. A second sclerotherapy was performed for 13 cysts which did not show a volume reduction at 1-3 months after the initial procedure. A disease course of over 12 months was an independent risk factor for a second sclerotherapy (23.7% [9/38] vs 6.6% [4/61], OR=4.473 [1.238-16.169], P=0.022). The efficacy of sclerotherapy was related to cystic cavity separation, cystic fluid viscosity, cystic/solid ratio and cystic wall thickness. COX regression analysis revealed that cystic cavity separation (HR=2.25, 95%CI: 1.19-4.25) and cystic fluid viscosity (HR=2.02, 95%CI: 1.19-3.43) were the major factors affecting the treatment efficacy.</p><p><b>CONCLUSION</b>Ultrasound-guided lauromacrogol sclerotherapy is effective and safe for treatment of benign thyroid cysts, and the maximal treatment effect can be achieved at 6 months after sclerotherapy and in cases of uncomplicated cysts with non-viscous cystic fluid, no solid cystic cavity separation and a disease course of less than 12 months.</p>

Therapeutic Efficacy of Multigly-Cosidorum Tripterygium Combined with rhIL-11 for Immune Thrombocytopenia / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To study the therapeutic efficacy of multigly-cosidorum Tripterygium combined with rhIL-11 for treating patients with immune thrombocytopenia (ITP).</p><p><b>METHODS</b>A total of 75 patients with ITP were divided into 2 group: experimental group and control group. The experimental group included 40 patients who had been treated with multigly-cosidorum Tripterygium combined with rhIL-11. Multigly-cosidorum Tripterygium was given at a dose of 1mg/kg·d for 2 months and rhIL-11 was injected at a dose of 16,000,000 units per day. Control group included 35 patients who had been treated with prednisone at a dose of 1 mg/kg·d. Platelet counts were performed every day before platelet counts >30 × 10⁹/L. Peripheral blood T cells were collected before and after treated for 2 months. The ratios of CD4⁺, CD8⁺ T cells in peripheral blood T cells were analyzed by flow cytometry.</p><p><b>RESULTS</b>Totally effective rate in experimental group was 77.5%. Totally effective rate in control group was 82.9%. Totally effective rate showed no statistical difference between these two groups (P > 0.05). The average time of platelet count 30 × 10⁹/L in experimental and control groups were 13.06 ± 6.10 days and 9.76 ± 5.71 days respectively; in experimental group, the ratio of CD4⁺ T cells in peripheral blood was 21.03% before treatment, then rised to 34.49% after treatment for 2 months (P < 0.01); The ratio of CD8⁺ T cells in peripheral blood was 26.35% before treatment, then decreased to 20.18% (P < 0.01). In control group, the ratio of CD4⁺ T cells was 22.30% before treatment, then rised to 25.11% after treatment for 2 months (P < 0.05); The ratio of CD8⁺ T cells in peripheral blood was 27.24% before treatment, then decreased to 21.35% (P < 0.01).</p><p><b>CONCLUSION</b>Multigly-cosidorum tripterygium can correct disorder of T lymphocytes, the combination of multigly-cosidorum triptergium and rhIL-11 can accelerate therapeutic efficacy for treating ITP and with less adverse reaction, so this combination may be effective and safe for treating patients with ITP.</p>

Sequence comparison of the hemagglutinin gene of the duck-origin H9N2 subtype avian influenza viruses / 病毒学报

To demonstrate the phylogenetic evolution, the molecular characteristics of the motif of HA protein cleavage site and the varieties at the receptor binding sites of the hemagglutinin gene of the duck-origin H9N2 subtype avian influenza viruses, sequence alignment and phylogenetic analysis were performed by MEGA 4.1 Neighbor-Joining method.. The results revealed that the duck-origin H9N2 AIV viruses originated from CK/BJ/1/94-like and North-Ame-like, all the duck-origin H9N2 AIV viruses from mainland China belonged to CK/BJ/1/94-like and formed multiple genotypes through complicated re-assortment, while other duck-origin H9N2 AIV, isolated from other countries in Aisa, American and European such as Korea, Japan, Alberta, Austria, Switzerland, Iran, belonged to the North-Ame-like phylogenetic lineage. The amino acids at positions 183, 190, and 226 of the receptor binding sites of North-Ame-like group isolates had highly conserved H, E and Q respectively. In contrast with duck-origin H9N2 AIV viruses isolates from mainland China, the amino acids had N at positions 183, A, T, or V at 190, L or Q at 226, which was the same as the chicken-origin H9N2 AIV from mainland China. Most newly isolated chicken-origin H9N2 AIV in Fujian Province in Southern China had L at position 226 emphasized the higher risk of cross-infection between the chicken-origin and duck-origin H9N2 AIV in China.

In vivo biological stability of chemically pretreated silicone gel inserts intended for use in keratoprostheses / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Pretreatment with chemical agents could alter the surface chemistry of the silicone gel, which makes it suitable for epithelial migration onto its surface and thus enhances the cytobiocompatibility. This study aimed to evaluate the biological response of the corneal stroma to porous silicone gel pretreated with different chemical agents in vivo.</p><p><b>METHODS</b>The porous silicone gels were treated with a mixed acid solution containing 23.2% H2SO4 and 0.8% K2Cr2O7 for 10 or 15 minutes or with 30% H2O2 for 15 minutes. Discs (4 mm in diameter) were inserted into interlamellar stromal pockets of New Zealand white rabbits and followed up for a period of 3 months. Clinical evaluations such as corneal infiltration, edema and neovascularization were performed daily. At 3 months, the fibroplasias and collagen deposition were examined under light and scanning electron microscopy (SEM) and by immunohistochemical analysis.</p><p><b>RESULTS</b>Pretreatment of the discs obviously decreased conjunctival congestion, discharge, cornea edema, and the extent of neovascularization. More fibroblasts migrated into the pretreated discs than into the control, and collagen was deposited, indicating that the biocompatibility of the corneal replacements was enhanced by the chemical pretreatments. From immunohistochemical analysis, Type I collagen deposition in the pretreated silicone discs was greater than in the control.</p><p><b>CONCLUSIONS</b>Chemical treatment of silicone gel is effective in decreasing rabbit corneal inflammation, encouraging fibroblast in-growth, and enhancing tissue compatibility. Pretreated gels show good biological stability when used as a skirt material in Keratoprosthesis (Kpros).</p>

High glucose up-regulates GRK2 gene expression in H9C2 cardiomyoblasts in vitro / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the effect of high glucose on GRK2 gene expression in H9C2 cardiomyoblasts in vitro.</p><p><b>METHODS</b>H9C2 cardiomyoblasts were cultured for 72 h in the presence of 0, 5.5, 12.5, 25 or 33 mmol/L glucose (with the osmotic pressure adjusted with monnitol). Semi-quantitative detection of GRK2 gene expression in H9C2 cardiomyoblasts was carried out using RT-PCR and phosph-Akt (Ser473) protein level was measured by Western blotting.</p><p><b>RESULTS</b>Glucose in the culture medium (5.5 to 33 mmol/L) concentration-dependently increased the mRNA expression of GRK2 concentration and decreased phosphorylation Akt (ser473) level in in H9C2 cardiomyoblasts.</p><p><b>CONCLUSION</b>Increased GRK2 gene expression may play an important role in cardiac dysfunction in diabetes.</p>

Genome cloning and sequence analysis of duck circovirus / 病毒学报

To reveal the molecular biological characteristics of genome of circovirus in infected ducks, two nucleotide fragments were amplified by overlapping PCRs using DNA extracted from various tissues of ducks. After they had been assembled together, the nucleotide components, the genome organization and the phylogenetic scale of the sequence were analyzed. The results showed that the obtained sequence is a circular DNA with a total length of 1995nt. It contains 6 open reading frames (ORFs), and shares a high identity of 97.4% with the MuDCV circovirus sequence presented in GenBank (AY228555). These results indicate that the amplified product stems from duck circovirus sequence.

Research Progress on Insect-resistant Genes From Plants / 中国生物工程杂志

Plant insect-resistantgenetic engineering hasopened a new way to prevent and cure against the insect pest incrop and wood productions. With the progresses instudies, many insect-resistantgeneswere cloned and characterized. The classification of most insect-resistantgenes from plant, the functionalmechanism and the applications of theplantinsect-resistantgenes, the problems and prospectsforusing the plant insect-resistant genes in genetic engineering was described.

Evaluation on reducing effect of eye drop on herpes simplex virus-I in vitro / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To observe the effect of herbal eye drop Reduqing (clearing toxic heat) on herpes simplex virus (HSV) on the cytopathic effect in cell culture in vitro.</p><p><b>METHODS</b>The maximal non-toxic Reduqing eye drop concentration added to cell culture infected with 100 and 10TCID50 of herpes simplex virus? (HSV-1) to observe the inhibitory effect of the medicine on HSV-I induced cytopathic effect.</p><p><b>RESULTS</b>The Reduqing eye drop at maximal non-toxic concentration could obviously inhibit the cytopatic effect induced by 100TCID50 and 10TCID50 HSV-I. No statistically significant difference was found when compared with 0.1% acyclovir eye drop (P>0.05), on cytopathic effect occurred with boty eye drops. However, there was significant difference when compared with control group(P<0.05). The inhibitory effect of concentrations of Reduqing at 500,000 and 63,000 microg/L was stronger than that of 2,000,000 and 1,000,000 microg/L (P 0.01). The maximal tolerable concentration of Reduqing eye drop by the cell was 2,000,000 microg/L (1:80 dilution), which was higher than that of 5,000 microg/L(1:400 dilution) acyclovir eye drop.</p><p><b>CONCLUSIONS</b>These results suggest that Reduqing eye drop could markedly inhibit the cytopathic effects caused by HSV-I. The Reduqing eye drop showed remarkably low toxic effect to the cells as compared to acyclovir eye drop.</p>