Intensified Antiplatelet Treatment Reduces Major Cardiac Events in Patients with Clopidogrel Low Response: A Meta-analysis of Randomized Controlled Trials / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Clopidogrel low response (CLR) is an independent risk factor of adverse outcomes in patients undergoing percutaneous coronary intervention (PCI), and intensified antiplatelet treatments (IAT) guided by platelet function assays might overcome laboratory CLR. However, whether IAT improves clinical outcomes is controversial.</p><p><b>METHODS</b>Relevant trials were identified in PubMed, the Cochrane Library, and the Chinese Medical Journal Network databases from their establishment to September 9, 2014. Trials were screened using predefined inclusion criteria. Conventional meta-analysis and cumulative meta-analysis were performed using the Review Manager 5.0 and STATA 12.0 software programs.</p><p><b>RESULTS</b>Thirteen randomized controlled trials involving 5111 patients with CLR were recruited. During a follow-up period of 1-12 months, the incidences of cardiovascular (CV) death, nonfatal myocardial infarction (MI), and stent thrombosis were significantly lower in the IAT arm than in the conventional antiplatelet treatment arm (relative risk [RR] = 0.45, 95% confidence interval [CI]: 0.36-0.57, P < 0.000,01), whereas bleeding was similar between the two arms (RR = 1.05, 95% CI: 0.86-1.27, P = 0.65).</p><p><b>CONCLUSIONS</b>IAT guided by platelet function assays reduces the risk of CV death, nonfatal MI, and stent thrombosis (ST) without an increased risk of bleeding in patients undergoing PCI and with CLR.</p>

Accuracy of a continuous glucose monitoring system in detection of blood glucose during oral glucose tolerance test / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the accuracy of continuous glucose monitoring system (CGMS) during oral glucose tolerance test (OGTT) in the detection of blood glucose changes in glucose stress condition.</p><p><b>METHODS</b>Forty-nine out-patients with fasting plasma glucose of 3.9-11.0 mmol/L underwent continuous blood glucose monitoring using CGMS for 3 days, and OGTT was conducted on the third day. The venous blood glucose was measured at 0, 30, 60, 90, and 120 min after oral glucose intake, and the accuracy of CGMS during OGTT was evaluated.</p><p><b>RESULTS</b>The correlation indices between CGMS values and the venous blood glucose values during the entire OGTT and in phases of stable, rapidly rising and falling glucose levels were 0.928, 0.901, 0.924 and 0.902, respectively (P<0.001). Clarke error-grid analysis showed that more than 95% of the measured results fell into the A and B zones.</p><p><b>CONCLUSION</b>CGMS values show good consistency with venous blood glucose values measured during OGTT. CGMS is accurate in detection of rapidly changing blood glucose during OGTT.</p>

Epidemiological investigation of diabetes and prediabetes in community residents in the suburbs of Guangzhou / 南方医科大学学报

<p><b>OBJECTIVE</b>To identify the prevalence and risk factors of diabetes and prediabetes in the community residents above 18 years old in the suburbs of Guangzhou.</p><p><b>METHODS</b>Between April and May in 2008, the residents above 18 years living in 6 communities of Guangzhou for 5 or more years were sampled with multistage clustering sampling. The sampled residents were surveyed by questionnaires, and physical examination and glucose determination were carried out.</p><p><b>RESULTS</b>A total of 1532 residents were sampled. The incidence of diabetes mellitus in these community residents was 8.46%, and that of impaired glucose regulation was 6.59%. Age, body mass index, family history of diabetes mellitus, case history of hypertension, hyperlipidemia, hypertension and smoking were all the independent risk factors for impaired glucose regulation and diabetes mellitus.</p><p><b>CONCLUSION</b>Diabetes and prediabetes are prevalent in the community residents in Guangzhou. Controlling the risk factors such as obesity, hypertension, lipid metabolism disorder among the residents above 40 years with a family history of diabetes mellitus and hypertension is key to prevention of impaired glucose regulation and diabetes mellitus.</p>

Association of blood glucose fluctuation with the pain sensation in patients with painful diabetic neuropathy / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the relationship between blood glucose fluctuation and the pain sensation in patients with painful diabetic neuropathy.</p><p><b>METHODS</b>The severity of pain in 16 patients with painful diabetic neuropathy was assessed using visual analog scale (VAS), and according to the results, the patients were divided into mild to moderate pain group and severe pain group. The blood glucose of the patients were monitored continuously for 72 h using a continuous glucose monitoring system, and the MBG, SD, DMMG, MAGE, and AUCPG were obtained with the FBG and HbA1C tested.</p><p><b>RESULTS</b>The SD, DMMG, and MAGE of the severe pain group were all significantly higher than those of the mild to moderate pain group (P<0.05), and no significant difference was found in MBG, FBG or HbA1c between the two groups.</p><p><b>CONCLUSION</b>The blood glucose fluctuation is associated with the severity of the pain degree, and effective control of the blood glucose fluctuation helps prevent and treat painful diabetic neuropathy.</p>

Sweat function evaluation for early diagnosis of diabetic peripheral neuropathy / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the clinical value of sweat function examination in early diagnosis of diabetic peripheral neuropathy (DPN).</p><p><b>METHODS</b>Ninety-eight hospitalized type 2 diabetic patients with or without DPN (DN and DC groups) according to Michigan Diabetic Neruopathy Score (DNS) and 40 healthy volunteers (NC group) were evaluated for their sweat function of the feet in relation to the peripheral autonomic nerve with sweat printing method using Neuropad. The Neuropad color-changing time was recorded to assess the sensitivity and specificity of sweat printing methods relative to DNS for DNP evaluation, and the correlation of the Neuropad color-changing time to DNS score was analyzed.</p><p><b>RESULTS</b>The average Neuropad color-changing time was 4.0-/+0.6, 4.3-/+1.2 and 23.0-/+6.1 min in NC, DC, and DN groups, respectively, showing significant differences between the 3 groups (P<0.05). The morbidity rate detected by sweat printing method was 62.2%, similar to that detected by DNS (57.1%, P>0.05). The sensitivity of the sweat printing method for DPN diagnosis was 92.8%, with specificity of 78.5%, positive predictive value of 93.2%, and negative predictive value of 78.6%. DNS showed significant positive correlation with the Neuropad color-changing time (r=0.46, P<0.05).</p><p><b>CONCLUSION</b>Sweat printing method provides an objective, simple and reliable method for sweat function evaluation of the feet of type 2 diabetic patients to help in early DPN diagnosis, and quantification of the results of sweat printing method can be indicative of the DPN severity.</p>