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Objective To analyze the effect of intervention programs and influencing factors regarding the community “5 + 1” staged diabetes target management on patients with type 2 diabetes mellitus (T2DM) and to provide evidence for improving the quality of life (QOL).Methods A total of 12 community health service centers from Shanxi province,Jiangsu province,and Ningxia Hui autonomous region were selected as intervention group and control group,by stratified cluster sampling method.“5 + 1” model was used in intervention groups and basic public health services model was applied in control groups for this two-year follow-up.Data was collected through a questionnaire on demographic and disease-related information,while the QOL was measured with SF-36.Multiple linear regression and conducted by SAS 9.4.Results A total of 2 467 subjects were included at baseline and 1 924 had completed a two-year-long management service.After intervention programs being implemented,the net effect of PCS score between the intervention and the control groups was 13.6,with the net effect of MCS score as 29.8.Results from the multiple linear regression showed that the main factors affecting PCS scores included age,type of medical insurance,baseline PCS score and regions of residency.Main factors related to MCS score included age,type of medical insurance,baseline MCS score,hypertension,and region of residency.Conclusion Community “5 + 1” staged diabetes target management model presented favorable effect of improving the QOL on T2DM patients.
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Objective To analyze the effect of intervention programs and influencing factors regarding the community “5 + 1” staged diabetes target management on patients with type 2 diabetes mellitus (T2DM) and to provide evidence for improving the quality of life (QOL).Methods A total of 12 community health service centers from Shanxi province,Jiangsu province,and Ningxia Hui autonomous region were selected as intervention group and control group,by stratified cluster sampling method.“5 + 1” model was used in intervention groups and basic public health services model was applied in control groups for this two-year follow-up.Data was collected through a questionnaire on demographic and disease-related information,while the QOL was measured with SF-36.Multiple linear regression and conducted by SAS 9.4.Results A total of 2 467 subjects were included at baseline and 1 924 had completed a two-year-long management service.After intervention programs being implemented,the net effect of PCS score between the intervention and the control groups was 13.6,with the net effect of MCS score as 29.8.Results from the multiple linear regression showed that the main factors affecting PCS scores included age,type of medical insurance,baseline PCS score and regions of residency.Main factors related to MCS score included age,type of medical insurance,baseline MCS score,hypertension,and region of residency.Conclusion Community “5 + 1” staged diabetes target management model presented favorable effect of improving the QOL on T2DM patients.
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This study was conducted to evaluate the relationship between serum insulin levels and the production of insulin antibody (IA) in type 2 diabetes (T2DM).A total of 647 T2DM were included.Among them,20.9％ patients were IA positive,who were elder and had a longer duration,lower BMI,a higher positive rate of glutamic acid decarboxylase antibody(GADAb) and higher serum insulin levels during an insulin secretion test.More patients were treated with insulin in IA positive group than in IA negative group (65.9％ vs 41.0％,P =0.000).Fasting serum insulin level was associated with occurrence of IA in all patients (OR =1.02,P =0.001) and insulin treated patients (OR =1.033,P =0.002).The cut-off point of fasting serum insulin level for predicting IA positive was 17.87 mIU/L (sensitivity 55.1％,specificity 89.0％).Exogenous insulin use is associated with the presence of IA.Fasting serum insulin level can be used as a predictor for the production of IA in insulin-treated patients.
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Objective To observe the effect of electroacupuncture (EA) on intestinal vitamin D receptor (VDR) mRNA and protein expression in ovariectomized rat model,and to explore the possible mechanism of acupuncture treatment for postmenopausal osteoporosis.Methods Sixty 3-month-old female SD rats were randomly divided into operation group and sham group.3 months after osteoporosis model was successfully produced,rats in operation group were randomly divided into model group,EA sham group,EA group and drug group.12 weeks after intervention,bone mineral density (BMD) of lumbar spine and femur were detected,then rats were all sacrificed to extract the small intestinal mucosa.VDR mRNA and protein expressions were determined by real-time quantitative PCR and Western blotting.Results The model of postmenopausal osteoporosis was successfully established.The bone mineral density was significantly improved in EA group and drug group as compared with the model group at 12 weeks after intervention.Western blotting and realtime quantitative PCR showed that small intestinal VDR mRNA and protein expressions were increased in EA group and drug group,but the increment of VDR mRNA expression was less in EA group than in drug group.Conclusions One of the mechanisms of acupuncture treatment for postmenopausal osteoporosis may be related with increasing the intestinal VDR mRNA and protein expression levels and enhancing the bioactivity of vitamin D.
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Objective To observe the effect of acupuncture on ghrelin,estradiol (E2) and bone mineral density (BMD) in postmenopausal osteoporosis rats.Methods According to the random number table method,60 female Sprague-Dawley rats aged 3 months,were randomly divided into surgery group (40 rats) and sham group (20 rats).The osteoporosis model was established by bilateral ovariectomy.Three months after the operation,a significant decrease in BMD of lumbar vertebrae and femur of the model rats as measured by dual energy X-ray absorptionmetry against the sham group indicated successful establishment of the osteoporosis model.Then surgery group was randomly divided into a model subgroup,a acupuncture subgroup and an estrogen subgroup,with 10 rats in each subgroup.The acupuncture subgroup was treated with electroacupuncture,estrogen subgroup with subcutaneous injection of estradiol benzoate,sham group and model subgroup without any treatment.After 3 months of intervention all the rats were sacrificed,BMD of the lumbar vertebrae and femur was measured,ghrelin and E2 were determined.Results Serum ghrelin in acupuncture subgroup (399 pg/ml) and estrogen subgroup (276 pg/ml) were significantly lower (P ＜ 0.01) than that in model subgroup (546 pg/ml); serum E2 in acupuncture subgroup (128.02 pg/ml) and estrogen subgroup (182.89 pg/ml) increased significantly (P ＜ 0.05) than that in model subgroup (72.10 pg/ml) ;lumbar vertebrae BMD in acupuncture subgroup (0.212 g/cm2) and estrogen subgroup (0.231 g/cm2) increased significantly (P ＜ 0.05) than that in model subgroup (0.191 g/cm2),but in acupuncture subgroup the effect on improving the level of E2,ghrelin and lumbar vertebrae BMD was less than that in estrogen subgroup (P ＜ 0.05).Conclusions Acupuncture intervention can improve lumbar vertebrae BMD and serum E2 level of postmenopausal osteoporosis rat model,down regulate serum ghrelin level,but the overall effect of acupuncture is less than estrogen.
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To analyse the familial aggregation and genetic predisposition of Shen-yin deficiency syndrome (SYDS) in families with diabetes mellitus type 2 (DM2). Methods One hundred and forty-one DM2 patients were collected from 32 family lines in Nanjin area, in which the probands were differentiated as DM2 with SYDS. On them, genetic analysis on the characteristics of SYDS was conducted using pedigree analysis, morbidity and heritability of the first-degree relatives of the probands were calculated, and the action of familial SYDS factor on the genesis of the syndrome was assessed by multiple factors regression analysis. Results The morbidity rate of SYDS in the first-degree relatives of the probands was 33.71%, and the heritability, calculated by Falconer formula, was 80.6%. The fitting result of regression analysis showed that familial factor played an important role in SYDS genesis (OR = 5.61, P = 0.001), but DM2 itself is not an independent risk factor for it. Conclusion DM2 with SYDS shows the tendency of familial aggregation and genetic predisposition, genetic factor is associated with the genesis of the syndrome. Pedigree research is a good method for exploring the relationship between syndrome and genetic factor.