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Objective@#To investigate the relationship between urinary monohydroxylated metabolites of hydroxyl polycyclic aromatic hydrocarbons (OH-PAHs) and lung function, as well as the role of oxidative stress in these associations, so as to provide a scientific basis for air pollution control and policy formulation.@*Methods@#A panel study was carried out among 45 young healthy adults. Four follow up surveys and health examinations were conducted from November 2017 to October 2018 to measure lung function parameters [forced vital capacity (FVC), second forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), FEV1/FVC, and forced expiratory flow between 25% and 75% vital capacity (FEF 25%~75% )], markers of exposure to 7OHPAHs [∑ 7OH PAHs], and markers of oxidative stress[8 hydroxy 2 deoxyguanosine (8 OHdG) and 8 isoprostaglandin F 2α (8 iso PGF 2α )]. The relationship between urinary PAH metabolites and lung function was quantified by linear mixed effects models. Mediation analysis was performed to assess the role of oxidative stress in the relationship between OH PAHs and lung function.@*Results@#The median values of FVC, FEV1, FEVI/FVC, PEF, and FEF 25%-75% were 4.37 L, 3.58 L, 83.00%, 4.38 L/s, and 3.32 L/s, respectively. The results showed that each 1 unit increase in log transformed value of 2 Hydroxyfluorene (2 OHFlu) was associated with a 5.05% decrease ( β %=-5.05%，95% CI =-8.85%--1.09%) in FVC, 4.15% decrease ( β %=-4.15%，95% CI =-7.94%- -0.22% ) in FEV1 and 5.87% decrease ( β %=-5.87%，95% CI =-11.35%--0.05%) in FEF 25%-75% , respectively. Each 1 unit increase in log transformed values of 2 OHFlu and 9 Phenanthrol (9 OHPhe) was associated with a 7.03% decrease ( β %=-7.03%，95% CI =-12.60%--1.11%) and a 7.08% decrease ( β%=-7.08%，95% CI =-13.50%--0.17%) in PEF, respectively. Additionally, urinary ∑ 7OH PAHs had a positive correlation with the levels of urinary 8 OHdG and 8 iso PGF 2α ( r =0.64, 0.69, P <0.01). Meanwhile, the levels of 8 OHdG mediated 17.06% and 15.71% of the association between 2 OHFlu with FVC and FEV1.@*Conclusion@#The finding reveales a negative relationship between urinary OH PAHs and lung function among young healthy adults. The 8 OHdG plays a mediated role in the correlation of 2 OHFlu with FVC and FEV1. Active relevant policies are needed to control air pollution and maintain the healthy living conditions of young people.
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Objective:To observe the influence of shared medical appointments on health-related quality of life and quality of sleep in patients after liver transplantation.Methods:By randomized controlled study, a total of 124 patients after liver transplantation were included from our hospital from January 2018 to January 2019, and according to the lottery method, all subjects were divided into the routine management group ( n=64) who received routine outpatient intervention and the shared medical management group ( n=60) who received shared medical appointments management. The health-related quality of life and quality of sleep were investigated and compared by post-liver transplant quality of life questionnaire (pLTQ) and Pittsburgh sleep quality index (PSQI) before intervention (the day of discharge) and after intervention (the end of the last shared outpatient service). Results:After intervention, the dimension scores of worry, economics, body function, emotional function, health service, complication and total score of pLTQ were improved in tow groups than before intervention [the routine management group: (41.90±7.61), (18.13±4.22), (22.22±5.10), (14.92±3.28), (20.39±4.87), (14.63±3.99), and (132.19±37.09) vs (32.25±5.55), (12.77±3.47), (17.58±4.72), (9.23±1.38), (15.17±4.81), (10.89±1.51) and (98.00±29.03) score, t=8.20, 7.85, 3.58, 12.79, 6.10, 7.01, 5.81, all P<0.001; shared medical management group: (46.12±7.92), (24.16±5.34), (25.55±5.42), (17.90±3.60), (24.81±5.12), (17.93±3.60) and (155.47±41.00) vs (32.57±5.69), (12.81±3.82), (17.00±4.70), (9.60±1.39), (15.39±4.84), (11.00±3.52) and (98.37±28.96) score, t=10.76, 13.39, 9.23, 16.66, 10.36, 10.66, 8.81, all P<0.001], and those in the shared medical management group were higher than those in routine management group ( t=3.03, 6.95, 3.53, 4.82, 4.93, 4.83, 3.32, all P<0.05). After intervention, the total score of PSQI scale were lower than before intervention in the routine management group [(10.48±2.14) vs (11.89±2.45) score, t=3.47, P=0.001], and the dimensions score of sleep quality, full-sleep time, sleep time, sleep efficiency, sleep disorders, daytime function, hypnotic and total score of PSQI were lower than before intervention in the shared medical management group [(1.41±0.32), (0.54±0.13), (1.17±0.26), (1.11±0.35), (1.21±0.27), (1.30±0.33), (1.08±0.21) and (8.05±1.75) vs (1.88±0.53), (0.86±0.37), (1.84±0.41), (2.05±0.56), (1.39±0.33), (1.47±0.43), (1.22±0.32) and (11.71±2.43) score, t=-5.88, -6.32, -10.69, -11.03, -3.27, -2.43, -3.65, -9.47, all P<0.05], and those in the shared medical management group were lower than those in routine management group ( t=-6.68, -6.39, -10.43, -10.97, -2.62, -2.12, -3.54, -6.90, all P<0.05). Conclusion:Shared medical appointments model can improve the health-related quality of life and quality of sleep in patients after liver transplantation, and improve the effectiveness of outpatient intervention.
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Objective To investigate the therapeutic effects and adverse drug reactions of different doses of rosuvastatin in patients with acute ST segment elevation myocardial infarction (STEMI). Methods A total of 115 patients with STEMI were collected from Department of Cardiology, the Second Hospital of Tianjin Medical University. According to different oral doses of rosuvastatin, patients were divided into two groups including 5 mg/d rosuvastatin treatment group (low-dose group, n=44) and 10 mg/d Rosuvastatin treatment group (moderate-dose group, n=71). Patients of two groups were treated with Rosuvastatin at least 1 month after discharge. Data of total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were analyzed and compared before and after treatment between two groups. The major cardiovascular adverse events (MACE) and adverse reactions were recorded in two groups of patients. Results There were no significant differences in blood lipid and liver function levels before and after one month treatment between the two groups. After one month treatment, levels of TC, LDL-C, ALT and AST were significantly decreased in both groups of patients compared with those before treatment (P<0.05). There were no significant differences in levels of TG, and HDL-C before and after treatment between two groups. The incidence of MACE (heart failure and angina pectoris) was significantly lower in moderate-dose group than that in low-dose group (P<0.05). There was no significant difference in the proportion of malignant arrhythmia between the moderate-dose group and the low-dose group (P<0.05). No target vessel repair and death were found in the two groups. No obvious adverse drug reactions were found during the follow-up period. Conclusion The hypolipidemic effects are epuivalent between 5 mg/d rosuvastatin and 10 mg/d on the basis of conventional treatment for STEMI patients, but the moderate dose can reduce the incidence of MACE and improve prognosis.
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Objective:To determine the content of self-manufactured and imported lurasidone hydrochloride tablets in order to e-valuate their internal qualities. Methods:The determination of lurasidone hydrochloride tablets was performed by HPLC. The HPLC system consisted of a Waters C8 column (250 mm × 4. 6 mm, 3. 5 μm) and the mobile phase of 0. 05 mol·L-1 phosphate buffer solu-tion (pH 3. 0)-acetonitrile(60∶40), the detection wavelength was 230 nm, the flow rate was 1. 2 ml·min-1 and the column tempera-ture was 40℃, and the injection volume was 20μl. Results:The linear range of lurasidone hydrochloride was 0. 100 8-0. 806 4 mg· ml-1(r=0. 999 5). The average recovery was 99. 95% with RSD of 0. 31%(n=9). Conclusion:The method is simple, rapid, ac-curate, and reliable. The method can determine lurasidone hydrochloride tablets satisfactorily. According to the results, there are few differences among the self-manufactured and imported lurasidone hydrochloride tablets.
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Objective Glucose metabolism trend was dynamicly mornitored following liver transplantation, and its affecting factors were assessed. Methods The glucose metabolism status were assessed at four time points respectively after liver transplants, then they were divided into two groups:normal glucose metabolism (NGM) and abnormal glucose metabolism (AGM). The clinical data were univariate analyzed and multivariate analyzed to screen the risk factors. Results At 1 month, 3 months, 1 year and 3 years post-transplantation, the incidence of AGM were 74.0%, 43.9%, 29.4%, 24.1% respectively Between these two groups, age > 45 y had a significant difference at 1 month, 3 months, 1 year and 3years post-transplantation; the use of tacrolimus had a significant difference at 3 months, 1 year and 3years post-transplantation, but the dose of tacrolimus or tacrolimus blood concentration showed no significant difference; high dose of glucocorticoid had significant difference at 1 month , 3 months post-transplantation; high BMI and acute rejection had significant difference at 1 month post-transplantation. Conclusions There is a high incidence of abnormal glucose metabolism (AGM) in the early stage post-transplantation, and a considerable number of patients' glucose metabolism improved in the later period. Age>45 y and tacrolimus affect glucose metabolism for a longer period post-transplants. High BMI and acute rejection have an impact on glucose metabolism only in the early stage post-transplantation. Large dose of glucocorticoid affect glucose metabolism for at least 3 months post-transplantation , and there is no significant difference after 1 year.
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Objective:To establish the determination method for four lurasidone hydrochloride enantiomers by HPLC. Methods:Lurasidone hydrochloride enantiomers were separated on a CHIRALPAK AD-H column (250 mm × 4. 6 mm, 5μm). The mobile phase consisted of hexane-ethanol-diethylamine ( 90∶10∶0. 1) at a flow rate of 1. 0 ml·min-1 and the column temperature was at 40℃. The detection wavelength was 230nm. Results:The resolution of lurasidone hydrochloride enantiomers was above 2. 0. The linear calibra-tion curves were obtained over the range of 5-120 μg· ml-1 for all the enantiomers (r=0. 999 9). The recovery was above 99. 0%with RSD below 0. 5%. The detection limits were 5ng. Conclusion:The method is simple, accurate and rapid, and suitable for the de-termination and quality control.
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Objective To investigate the relationship between serum cystatin C and coronary artery disease in type 2 diabetes mellitus (T2DM) patients with normal uric protein.Methods According to the coronary artery lesion diagnosed by 320-dynamic volume CT,the 126 T2DM patients with normal uric protein were divided into three groups:no coronary stenosis group (group A,32 cases),coronary atherosclerosis group(group B,38 cases),coronary heart disease group (group C,56 cases).Then the serum cystatin C etc were compared among the three groups.Results The levels of serum cystatin C in group A,B,C were (0.89 ± 0.27),(1.31 ± 0.53),(1.54 ± 0.62) mg/L.With the increase of coronary artery lesions,it gradually increased,there was significant difference among the three groups (P ＜ 0.05).The patients were divided into three groups according to the level of serum cystatin C quartile.The incidence of coronary artery lesion in creased with the increased levels of serum cystatin C.The level of serum cystatin C increased from 75th percentile to 100th percentile,the incidence of coronary heart disease increased significantly (OR =8.32,P ＜0.05).The result of multiple Logistic regression analysis showed that history of hypertension (regression coefficient 4.135,P =0.000),glycosylated hemoglobin (regression coefficient 1.257,P =0.002),low density lipoprotein-cholesterol (regression coefficient 3.381,P =0.015),cystatin C (regression coefficient 2.046,P =0.030) were the independent risks of coronary heart disease in patients with T2DM.Conclusion The level of serum cystatin C may be a predictor for coronary heart disease in T2DM patients with normal uric protein.
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ObjectiveTo investigate the clinical significance of inflammatory factors and adiponectin in type 2 diabetes milletus complicated with non-alcoholic fatty liver disease.Methods Two hundred and ten subjects aging from 25.0 to 65.0 years old,including 106 men and 104 women,were recruited into this study.They were divided into four groups: Forty cases of healthy control (NC),60 cases with newly-diagnosed type 2 diabetes (T2DM),65 cases with simple non-alcoholic fatty liver disease (NAFLD) and other 45 cases with newly-diagnosed T2DM complicated with NAFLD.The physical examination was performed for each patient.Serum levels of alanine aminotransferase (ALT),gamma-glutamyl transpeptidase (GGT),fasting plasma glucose (FPG),glycation hemoglobin A 1 c ( GHbA1c ),creatinine ( Cr),uric acid ( UA ),2 hours postprandic plasma glucose (2hPG),fasting insulin (FINS),lipid profiles were measured.Insulin resistance index (HOMAIR) was calculated.Tumor necrosis factor-α (TNF-α),high sensitive C-reactive protein (hs-CRP) and adiponectin were also detected.Results The serum levels of ALT and GGT,body mass index and waist/hip ratio were higher in the NAFLD,T2DM with NAFLD patient groups than that in T2DM and NC group ( P ＜0.05or P ＜0.01 ).The serum levels of TG and LDL-C were significantly higher in T2DM,NAFLD and T2DM with NAFLD groups than that of NC group.And serum TG levels in T2DM with NAFLD group were higher than that of T2DM group (P ＜ 0.05).FPG and GHbAl c were higher in T2DM and T2DM with NAFLD groups than that of NAFLD and NC groups.The serum levels of TNF-α,hs-CRP and HOMA-IR were higher in T2DM,NAFLD and T2DM with NAFLD groups than that of NC group.T2DM with NAFLD group had higher levels of TNF-α,hs-CRP and HOMA-IR compared with T2DM group.However,serum adiponectin levels of T2DM,NAFLD and T2DM with NAFLD groups were lower than that of NC group.And it was lower in T2DM with NAFLD group when compared with NC group ( P ＜ 0.05 ).Adiponectin was negatively associated with TNF-α,hs-CRP and HOMA-IR (r =-0.635,-0.668,-0.752 respectively,P ＜ 0.0l ).But HOMA-IR was positively associated with TNF-α,hs-CRP( r =0.667,0.706 respectively,P ＜ 0.01 ).ConclusionInflammatory factors and adiponectin may play important roles in the pathophysiology and progression of T2DM and NAFLD.The protective effects of adiponectin may come from its anti-inflammatory activity to relieve insulin resistance for NAFLD.
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Objective To investigate the relationship between dyslipidemia,obesity,insulin resistance (IR)and various degrees of non.alcoholic fatty liver disease(NAFLD)in patients with type 2 diabetes mellitus (T2DM), and the risk factors of NAFLD.Methods Two hundred and sixty-eight patients were divided into three groups(non-NAFLD group,mild NAFLD group,moderate and severe NAFLD group)by liver ultrasonography.Body height(H),weight(W),waist circumference(WC),hip circumference(H)were measured.The levels of fasting blood glucose (FBG),glycosylated hemoglobin A_1c(GHbA_1C),serum total cholesterol(TC),serunl high density lipoprotein(HDL-C),serum low density lipoprotein(LDL-C),serum triglyceride (TG),alanine aminotransferase (ALT)and fasting serum insulin(FINS)were measured.Body mass index(BMI),the waist to hip ratio(WHR)and insulin resistance index(HOMA-IR)were calculated.Unconditional logistic regression model was used to test for the risk factors of NAFLD.Results BMI、WC、WHR、HNS、HOMA.IR、TC、LDL-C、TG and ALT in NAFLD group were significantly higher than those in non-NAFLD group (P<0.05).The levels of BMI、WC、WHR、HNS、HOMA-IR、 TG and ALT increased significantly in moderate and severe NAFLD group compared with mild NAFLD group(P<0.05).TG、WHR and HOMA.IR were the risk factors of NAFLD(P<0.05,OR=2.394,3.273,5.256).Conclusions NAFLD in patients with T2DM had remarkable dyslipidemia,overweight,central obesity and insulin resistance.TG、WHR and HOMA.IR were risk factors of NAFLD.
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Objective To study the effects of sulodexide on islet B-cell function in streptozocin induced di-abetic rats. Methods Sprague-Dawley(SD) rats were randomly divided into normal control group (group C), dia-betic group without treatment(group D), and suledexide treatment group(group S), a single dose of streptozotocin were abdominally injected to establish the diabetic rat models. Each animal in sulodexide treated group was addition-ally fed with sulodexide of 10 mg/(kg·d) for 12 weeks,while the remained group (group C and D) were given normal water in the same period. After 12 weeks of treatment, fasting plasma glucose(FPG),fasting plasma insulin (FINS), activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), triglyceride (TG), Low-density lipoprotein cholesterol (LDL-C), serum creatinine rates (SCr) and alanine aminotransferase (ALT) were measured. Insulin sensitivity index(ISI) and insulin resistant index (HOMA-IR) were calculated. Results After 12 weeks, the levels of TG, LDL-C and ALT had no significant difference between group D and group S, but were higher than those in group C (P <0.05);There were no significant difference of SCr levels among the three groups. Compared with the group C, APTT, PT, TT and ISI in group D and S were significantly decreased, HOMA-IR were significantly increased (P < 0.05). APTT, PT, TT and ISI in group S had significantly increased compared with that in group D, HOMA-IR was significantly decreased in group S compared with that in group D (P < 0.01). Conclusions Sulodexide can reduce insulin resistant, improve hypercoagulability and insulin sensitiv-ity in streptozocin induced diabetic rats. The effects to blood lipid, liver and renal functions in diabetic rats are not obvious.
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[Objective] To investigate the clinical characteristics and risk factors of lower-extremity arterial disease in the patients with newly diagnosed type 2 diabetes mellitus combined with nonalcoholic fatty liver disease (NAFLD). [Methods] One hundred fifty-one patients were investigated respectively. The patients were divided into two groups (NAFLD-Group and non-NAFLD group) by liver ultrasonography and disease history, then their clinical data were collected and compared in order to find the differences of biochemical indicators and the morbidity of lower-extremity arterial disease between two groups. [Results] Ninety-two cases (60.93%) were complicated with NAFLD. NAFLD group had higher levels of fast insulin and C peptide level, postprandial insulin and C peptide level, uric acid, body mass index (BMI), homeostasis model assessment (HOMA-IR) and lower level of high-density lipoprotein cholesterol and insulin sensitive index than those of without NAFLD (P<0.05). One hundred and one cases(66.89%) were complicated with lower-extremity arterial disease. The morbidity of lower-extremity arterial diseases was higher in NAFLD group than that of without NAFLD group (75% vs. 54.24%, P<0.01). [Conclusion] Both lower-extremity arterial disease and NAFLD are common complicated with type 2 diabetes. The morbidity of lower-extremity arterial diseases was higher in NAFLD group than that of without NAFLD group.
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Objective To compare the excursion of blood glucose (BG) in the type 2 diabetes mellitus treated with oral antidiabetic drugs (OADs) plus glargine or human isophane insulin (HII). Methods A 1 : 1 randomization schedule assigned 30 type 2 diabetics inadequately controlled on OADs (fasting BG>9.0 mmol/L and HbA1C > 8.5%) to 2 groups additionally treated with glargine or HII. The insulin dose was titrated to achieve fasting capillary BG<6.0 mmol/L. Montoring BG with continuous glucose monitoring system, then the standard deviation of BG (SDBG), maximal excursion of BG (LAGE) and coefficient of variation (CV) of fasting plasma glucose (FPG) were calculated. Results SDBG (1.49±0.35 vs 1.73±0.46), LAGE (3.23±0.76 vs 3.73± 1.00) and CV-FPG (17.26±2.24 vs 20.33±3.21) were lower in glargine group than those in HII group (P< 0.05). No difference could be found in hypoglycaemia between two groups. Conclusion OADs plus glargine could make blood glucose more stable than OADs plus HII without increasing the incidence of hypoglycaemia.
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Objective To evaluate the value of Microparticle Enzyme Immunoassay(MEIA),a quantitative assay, in the diagnosis and treatment of chronic hepatitis B (CHB). Methods MEIA, Enzyme linked immunoabsorbent assay (ELISA), and quantitative PCR were used to detect e antigen, hepatitis B serum markers, and the quantity of HBV DNA in 249 CHB patients and 32 non CHB patients respectively. Expression of HBcAg in Liver tissue was detected by using S P method. These measures were used to illuminate the relationships among serum e antigen quantity, hepatitis B serum markers, the quantity of HBV DNA, the quantity of HBcAg in hepatocytes, and pathologic diagnosis of liver tissues. Results 1. The sensitivity of MEIA (80.28%) to detect serum e antigen is higher than that of ELISA (69.01%)( ? 2=9.312, P =0.002).2. The serum e antigen quantity is positively correlated with the logarithm of the quantity of HBV DNA ( r =0.411, P =0.000). 3. The level of serum e antigen is positively correlated with the semi quantitative of HBcAg in hepatocytes ( r =0.646, P =0.000). 4. The serum e antigen quantity is negatively correlated with pathologic degree of liver tissues ( r =-0.172, P =0.006). Conclusions MEIA is a sensitive, stable, and reliable method to assay the serum e antigen quantity which could be used to evaluate the replication of HBV and the degree of liver damage.