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OBJECTIVE To evaluate the risk of hypoglycemia caused by sodium-glucose co-transporter protein 2 （SGLT-2） inhibitors in type 2 diabetes （T2DM） patients. METHODS Retrieved from PubMed， Web of Science， Cochrane Library， CNKI， VIP， Wanfang Data and CBM， randomized controlled trials （RCTs） about SGLT-2 inhibitors in the treatment of T2DM were collected from the inception to Oct. 15th， 2022. After literature screening， data extraction and quality evaluation of included literature with bias risk assessment tool recommended by the Cochrane system evaluator handbook 5.1.0， Stata 15.1 software was used for network meta-analysis and publication bias analysis. RESULTS A total of 22 RCTs were included， with a total of 18 734 patients. The results of meta-analysis showed that compared with ertugliflozin 15 mg [RR＝3.26， 95%CI （1.13， 8.11）， P＜0.05] and ertugliflozin 25 mg [RR＝3.08， 95%CI （1.12， 6.34）， P＜0.05]， the incidence of hypoglycemia was significantly increased in patients using canagliflozin 300 mg. Compared with ertugliflozin 15 mg [RR＝1.48， 95%CI （1.24， 6.93）， P＜0.05] and ertugliflozin 25 mg [RR＝6.74， 95%CI （1.33， 9.34）， P＜0.05]， the incidence of hypoglycemia in patients treated with canagliflozin 100 mg was significantly increased. There was no statistically significant difference between other groups （P＞0.05）. The ranking results of the network meta-analysis showed that the incidence of hypoglycemia was from low to high， ie. ertugliflozin 15 mg＞placebo＞ertugliflozin 25 mg＞empgaliflozin 25 mg＞empgaliflozin 10 mg＞empgaliflozin 1 mg＞dapagliflozin 5 mg＞ dapagliflozin 10 mg＞dapagliflozin 2.5 mg＞canagliflozin 300 mg＞ertugliflozin 10 mg＞ertugliflozin 5 mg＞empgaliflozin 50 mg＞canagliflozin 200 mg＞canagliflozin 100 mg＞canag-liflozin 50 mg＞ertugliflozin 1 mg＞empgaliflozin 5 mg. Results of publication bias analysis showed that there was little possibility of publication bias in this study. CONCLUSIONS When SGLT-2 inhibitors are used in patients with T2DM， the incidence of hypoglycemia is the lowest when using ertugliflozin 15 mg， and the incidence of hypoglycemia is the highest when using empagliflozin 5 mg.
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Objective:Using lasso regression analysis to screen out the blood lipid indexes closely related to coronary heart diseaseMethods:The clinical data of 3 062 patients with coronary heart disease who were hospitalized in the Department of Cardiology, Affiliated Hospital of Jining Medical College from May 2013 to November 2015 were retrospectively analyzed.They were divided into control group ( n=2 427) and coronary angiography group ( n=635). R language was used for statistical analysis.Multiple logistic regression models were established for indicators of blood lipid related to CAD, and their multicollinearity severity was assessed.LASSO regression was used to screen out the representative lipid parameters in the CAD prediction model. Results:A total of 3 062 patients were enrolled, including 2 427 patients in coronary heart disease group and 635 patients in control group.The inclusion of lipid parameters into multiple logistic regression model leads to serious multicollinearity.Stepwise regression can only partially reduce multicollinearity severity, while LASSO regression model significantly reduces multicollinearity severity.Low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and non-high density lipoprotein cholesterol (non-HDL-C) were found to be the representative lipid indexes for predicting coronary heart disease by LASSO regression analysis.Conclusion:LASSO regression has advantages in processing multicollinearity data.LASSO regression showed that LDL-C, HDL-C and non-HDL-C were representative lipid indicators for predicting coronary heart disease..
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BACKGROUND@#Few studies have reported brain function differences in drug-naïve first-episode schizophrenia patients who had auditory verbal hallucinations (AVH) with insight vs. those without insight. This study aimed to investigate brain function differences between drug-naïve first-episode AVH-schizophrenia patients with and without insight.@*METHODS@#Forty first-episode drug-naïve AVH-schizophrenia patients with or without insight and 40 healthy controls between December 2016 and December 2018 were recruited in this study. The auditory hallucinations rating scale (AHRS) was used to assess AVH severity, while the insight and treatment attitudes questionnaire was used to distinguish insight. The global functional connectivity density (gFCD) between different groups was compared using a voxel-wise one-way analysis of covariance. The relationship between gFCD and AHRS total scores were analyzed using voxel-wise multiple regression.@*RESULTS@#Finally, 13 first-episode drug-naïve AVH-schizophrenia patients with insight, 15 AVH-schizophrenia patients without insight, and 20 healthy controls were included for analysis. Except for global assessment of functioning scores, there were no significant differences in sociodemographic information between the AVH-schizophrenia and healthy groups (P > 0.05). Compared to the healthy controls, AVH-schizophrenia patients with insight demonstrated a decreased gFCD in the supra-marginal gyrus within the primary auditory cortex, while those without insight demonstrated an increased gFCD in the inferior frontal gyrus and superior temporal gyrus and decreased gFCD in the supplemental motor area. Compared to the AVH-schizophrenia patients with insight, those without insight demonstrated an increased gFCD in the supra-marginal gyrus and posterior superior temporal lobule and a decreased gFCD in the frontal lobe. No significant correlation between gFCD and AVH severity (AHRS total score: r = 0.23, P = 0.590; and frequency: r = 0.42, P = 0.820) was found in both AVH-schizophrenia groups.@*CONCLUSIONS@#The gFCD-aberrant brain regions in the AVH-schizophrenia patients without insight were wider compared to those with insight, although the AHRS scores were not significantly different. The AVH-schizophrenia patients without insight had wide functional impairment in the frontal lobule, which may underlie the lack of insight and the abnormal hyperactivity in the inferior frontal gurus and temporal lobe related to the AVH symptoms.
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Background@#Few studies have reported brain function differences in drug-naïve first-episode schizophrenia patients who had auditory verbal hallucinations (AVH) with insight vs. those without insight. This study aimed to investigate brain function differences between drug-naïve first-episode AVH-schizophrenia patients with and without insight.@*Methods@#Forty first-episode drug-naïve AVH-schizophrenia patients with or without insight and 40 healthy controls between December 2016 and December 2018 were recruited in this study. The auditory hallucinations rating scale (AHRS) was used to assess AVH severity, while the insight and treatment attitudes questionnaire was used to distinguish insight. The global functional connectivity density (gFCD) between different groups was compared using a voxel-wise one-way analysis of covariance. The relationship between gFCD and AHRS total scores were analyzed using voxel-wise multiple regression.@*Results@#Finally, 13 first-episode drug-naïve AVH-schizophrenia patients with insight, 15 AVH-schizophrenia patients without insight, and 20 healthy controls were included for analysis. Except for global assessment of functioning scores, there were no significant differences in sociodemographic information between the AVH-schizophrenia and healthy groups (P > 0.05). Compared to the healthy controls, AVH-schizophrenia patients with insight demonstrated a decreased gFCD in the supramarginal gyrus within the primary auditory cortex, while those without insight demonstrated an increased gFCD in the inferior frontal gyrus and superior temporal gyrus and decreased gFCD in the supplemental motor area. Compared to the AVH-schizophrenia patients with insight, those without insight demonstrated an increased gFCD in the supra-marginal gyrus and posterior superior temporal lobule and a decreased gFCD in the frontal lobe. No significant correlation between gFCD and AVH severity (AHRS total score: r = 0.23, P = 0.590; and frequency: r = 0.42, P = 0.820) was found in both AVH-schizophrenia groups.@*Conclusions@#The gFCD-aberrant brain regions in the AVH-schizophrenia patients without insight were wider compared to those with insight, although the AHRS scores were not significantly different. The AVH-schizophrenia patients without insight had wide functional impairment in the frontal lobule, which may underlie the lack of insight and the abnormal hyperactivity in the inferior frontal gurus and temporal lobe related to the AVH symptoms.
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Persistent bacteria is a microbial subpopulation which can survive from lethal concentration of antimicrobial agents. Unlike the resistant bacteria which usually acquire the resistance from heritable gene mutations, persisters are genetically identical to regular cells in genome but show a distinct antibiotic tolerant phenotype through a state of dormancy. Once the antimicrobial therapy is removed,the persisters can regrow to a new population and cause the recurrent infectious diseases. The increased threats due to the in-fections and drug tolerance caused by persistent bacteria promote the interests of preventing bacterial persistence. This review discusses the harmfulness of persistent infections, the mechanisms of bacterial persistence and summarizes the different control and eradication strategies,aiming to provide ideas and references for further research.
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Objective To investigate the correlation between morphological abnormalities and abnormal myelodysplastic syn-dromes(MDS)cloning.Methods 82 cases of MDS were collected with complete FISH and morphological abnormalities. The relationship between MDS cell morphology and chromosome abnormality was investigated.Results 45 cases of chromo-somal abnormalities were found,and +8 were the most frequent chromosomal abnormalities.8 cases were +8,-5 and 5q-were 6,20q-were 7,-7 and 7q-were 5,complex karyotypes(>3 abnormalities)were 6.There were statistically significant differences in the proportion of primordial cells,megakaryocyte dysplasia,megakaryocyte abnormalities between karyotype abnormal group and karyotype normal group(P<0.05).There were statistically significant differences in the proportion of abnormal karyotype among high risk group and low risk group,the low risk group and medium risk group(P<0.05).Con-clusion The chromosomal abnormalities of MDS patients would be related to morphological changes.
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<p><b>BACKGROUND</b>Electroconvulsive therapy (ECT) can alleviate the symptoms of treatment-resistant depression (TRD). Functional network connectivity (FNC) is a newly developed method to investigate the brain's functional connectivity patterns. The first aim of this study was to investigate FNC alterations between TRD patients and healthy controls. The second aim was to explore the relationship between the ECT treatment response and pre-ECT treatment FNC alterations in individual TRD patients.</p><p><b>METHODS</b>This study included 82 TRD patients and 41 controls. Patients were screened at baseline and after 2 weeks of treatment with a combination of ECT and antidepressants. Group information guided-independent component analysis (GIG-ICA) was used to compute subject-specific functional networks (FNs). Grassmann manifold and step-wise forward component selection using support vector machines were adopted to perform the FNC measure and extract the functional networks' connectivity patterns (FCP). Pearson's correlation analysis was used to calculate the correlations between the FCP and ECT response.</p><p><b>RESULTS</b>A total of 82 TRD patients in the ECT group were successfully treated. On an average, 8.50 ± 2.00 ECT sessions were conducted. After ECT treatment, only 42 TRD patients had an improved response to ECT (the Hamilton scores reduction rate was more than 50%), response rate 51%. 8 FNs (anterior and posterior default mode network, bilateral frontoparietal network, audio network, visual network, dorsal attention network, and sensorimotor network) were obtained using GIG-ICA. We did not found that FCPs were significantly different between TRD patients and healthy controls. Moreover, the baseline FCP was unrelated to the ECT treatment response.</p><p><b>CONCLUSIONS</b>The FNC was not significantly different between the TRD patients and healthy controls, and the baseline FCP was unrelated to the ECT treatment response. These findings will necessitate that we modify the experimental scheme to explore the mechanisms underlying ECT's effects on depression and explore the specific predictors of the effects of ECT based on the pre-ECT treatment magnetic resonance imaging.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Brain , Pathology , Depression , Therapeutics , Depressive Disorder, Treatment-Resistant , Therapeutics , Electroconvulsive Therapy , Methods , Magnetic Resonance ImagingABSTRACT
<p><b>BACKGROUND</b>This study aimed to observe the differences in brain gray matter volume in drug-naive female patients after the first episode of major depression with and without stressful life events (SLEs) before the onset of depression.</p><p><b>METHODS</b>Forty-three drug-naive female patients voluntarily participated in the present study after the first major depressive episode. The life event scale was used to evaluate the severity of the impact of SLEs during 6 months before the onset of the major depressive episode. High-field magnetic resonance imaging (MRI) scans were obtained, and the VBM and SPM8 software process were used to process and analyze the MRI.</p><p><b>RESULTS</b>Compared to that in patients without SLEs, the volume of brain gray matter was lower in the bilateral temporal lobe, right occipital lobe, and right limbic lobe in the SLE group. However, the gray matter volume did not differ significantly between the two groups after the application of false discovery rate (FDR) correction.</p><p><b>CONCLUSIONS</b>Although the results of the present study suggest the absence of significant differences in brain gray matter volume between female drug-naive patients after the first episode of major depression with and without SLEs after FDR correction, the study provides useful information for exploring the definitive role of stress in the onset of depression.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Middle Aged , Young Adult , Depression , Gray Matter , Magnetic Resonance Imaging , Software , Stress, Physiological , PhysiologyABSTRACT
<p><b>BACKGROUND</b>Previous studies have demonstrated interhemispheric functional connectivity alterations in schizophrenia. However, the relationship between these alterations and the disease state of schizophrenia is largely unknown. Therefore, we aimed to investigate this relationship using voxel-mirrored homotopic connectivity (VMHC) method.</p><p><b>METHODS</b>This study enrolled 36 schizophrenia patients with complete remission, 58 schizophrenia patients with incomplete remission and 55 healthy controls. The VMHC was calculated based on resting-state functional magnetic resonance imaging data. Differences in VMHC among three groups were compared using one-way analysis of variance. A brain region with a significant difference in VMHC was defined as a region of interest (ROI), and the mean VMHC value in the ROI was extracted for the post hoc analysis, i.e., pair-wise comparisons across the three groups.</p><p><b>RESULTS</b>VMHC in the visual region (inferior occipital and fusiform gyri) and the sensorimotor region (paracentral lobule) showed significant differences among the three groups (P < 0.05, a false discovery rate method corrected). Pair-wise comparisons in the post hoc analysis showed that VMHC of the visual and sensorimotor regions in schizophrenia patients with complete remission and incomplete remission was lower than that in healthy controls (P < 0.05, Bonferroni corrected); however, there was no significant difference between the two patient subgroups.</p><p><b>CONCLUSIONS</b>Interhemispheric functional connectivity in the sensorimotor and visual processing pathways was reduced in patients with schizophrenia, but this reduction was unrelated to the disease state; thus, this reduction may serve as a trait marker of schizophrenia.</p>
Subject(s)
Adult , Female , Humans , Male , Brain , Physiology , Brain Mapping , Image Processing, Computer-Assisted , Magnetic Resonance Imaging , Schizophrenia , Sensorimotor Cortex , Physiology , Visual Pathways , PhysiologyABSTRACT
<p><b>BACKGROUND</b>Auditory verbal hallucinations (AVHs) of schizophrenia have been associated with structural and functional alterations of some brain regions. However, the brain regional homogeneity (ReHo) alterations specific to AVHs of schizophrenia remain unclear. In the current study, we aimed to investigate ReHo alterations specific to schizophrenic AVHs.</p><p><b>METHODS</b>Thirty-five schizophrenic patients with AVH, 41 schizophrenic patients without AVHs, and fifty healthy subjects underwent resting-state functional magnetic resonance imaging. ReHo differences across the three groups were tested using a voxel-wise analysis.</p><p><b>RESULTS</b>Compared with the healthy control group, the two schizophrenia groups showed significantly increased ReHo in the right caudate and inferior temporal gyrus and decreased ReHo in the bilateral postcentral gyrus and thalamus and the right inferior occipital gyrus (false discovery rate corrected, P < 0.05). More importantly, the AVH group exhibited significantly increased ReHo in the left precuneus compared with the non-AVH group. However, using correlation analysis, we did not find any correlation between the auditory hallucination rating scale score and the ReHo of brain regions.</p><p><b>CONCLUSIONS</b>Our results suggest that increased ReHo in the left precuneus may be a pathological feature exclusive to schizophrenic AVHs.</p>