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>

Exogenous H₂O₂ regulated secondary metabolism of Scutellaria baicalensis and enhanced drug quality / 中国中药杂志

The increasing demand of Chinese materia medica could not be supplied by wild resource, and the cultivated medicinal materials become popular, which led to decreased quality of many medicinal materials due to the difference of the circumstance between the wild and the cultivated. How to improve quality becomes key points of Chinese medicine resource. The leaves of Scutellaria baicalensis were sprayed with H₂O₂, the activities of superoxide dismutase (SOD) and catalase (CAT) changed little, but there had been a marked decrease of peroxidase (POD) and ascorbic oxidase (APX), which showed that the antioxidase system declined. Meanwhile, H₂O₂, as enhanced the expression of phenylalnine ammonialyase (PAL) and β-glucuronidase (GUS) as well as activity of PAL, promoted the biosynthesis and biotransformation of flavonoids. At the day 2 after treated, H₂O₂ of 0.004 μmol·L⁻¹ the contents of the baicalin and the wogonoside decreased slightly, but the contents of the baicalein and the wogonin increased significantly, the baicalein from 0.094% to 0.324%, the wogonin from 0.060% to 0.110%, i. e. increased 246% and 83.3%, respectively.

Establishment of reference ranges of sex hormones for healthy children in Shenzhen, China based on chemiluminescence / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the reference ranges of six sex hormones, i.e., luteinizing hormone, follicle-stimulating hormone, progesterone, prolactin, estradiol, and testosterone, for healthy children aged 0-18 years in Shenzhen, China.</p><p><b>METHODS</b>Stratified cluster sampling was performed to select 2 178 healthy children aged 0-18 years in the districts of Futian, Luohu, Nanshan, Bao'an, and Longgang in Shenzhen between September 2015 and September 2016. There were 1 219 boys and 959 girls, including 81 neonates, 335 infants, 346 young children, 469 preschool children, 419 school-aged children, and 528 adolescents. The American Beckman DXI800 chemiluminescence meter was used to measure the levels of luteinizing hormone, follicle-stimulating hormone, progesterone, prolactin, estradiol, and testosterone.</p><p><b>RESULTS</b>There were significant differences in the levels of luteinizing hormone, follicle-stimulating hormone, progesterone, prolactin, estradiol, and testosterone between different age groups (P<0.05). There were also significant differences in the levels of these sex hormones between boys and girls in the same age group (P<0.05). The reference ranges of six sex hormones were established for healthy children aged 0-18 years in Shenzhen based on the levels of these hormones in different age groups.</p><p><b>CONCLUSIONS</b>There are significant differences in sex hormones between different age groups or sex groups. The reference ranges of six sex hormones established for different sexes or ages have great significance in the diagnosis and treatment of endocrine diseases in children.</p>

Effect of different dietary loads on glucose-dependent insulinotropic polypeptide in subjects with normal glucose tolerance / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the secretion patterns of glucose-dependent insulinotropic polypeptide (GIP) after different dietary loads in subjects with normal glucose tolerance (NGT) and their relation to insulin secretion and plasma glucose levels.</p><p><b>METHODS</b>Fourteen subjects with normal glucose tolerance underwent 75 g glucose tolerance test(OGTT) followed by mixed meal tolerance test(MMT) one week later. Blood glucose, insulin, and GIP were measured in the fasting state and at 0, 15, 30, 60, 90 and 120 min after glucose load or mixed meal load.</p><p><b>RESULTS</b>The first peak value of GIP after glucose load occurred at 15 min (45.09∓4.67 pmol/L). After a brief decline, GIP continued to increase till reaching 59.66∓11.73 pmol/L at 120 min after the load. After the mixed meal load, GIP secretion presented with two peaks: the first peak appeared at 15 min (71.69∓14.19 pmol/L) with a level significantly higher than that at 15 min following glucose load (P<0.05), and the second occurred at 90 min (55.35∓13.19 pmol/L). The area under curve of GIP showed no significant difference between the two loads (P>0.05). Compared with glucose load, mixed meal load resulted in an increase of the first GIP peak and an earlier insulin peak (30 min vs 60 min), but a significant decrease of blood glucose at 15 min (P<0.05).</p><p><b>CONCLUSION</b>Compared with glucose load, mixed meal (containing fat) can strongly stimulate GIP release and cause earlier occurrence of the insulin peak, which might be an important reason for the lower blood glucose after mixed meal.</p>

Clinical study on combination of acupuncture, cupping and medicine for treatment of fibromyalgia syndrome / 中国针灸

<p><b>OBJECTIVE</b>To observe the therapeutic effect of acupuncture at five mental points and moving cupping on the Hechelu of the back on fibromyalgia syndrome (FS).</p><p><b>METHODS</b>Sixty-six cases who conformed to the criteria were randomly divided into the treatment group treated with acupuncture at five mental points, moving cupping on the Hechelu of the back and amitriptyline, and the control group treated with amitriptyline. Clinical therapeutic effects were assessed with McGill Pain Questionnaire (MPQ) and HAMD depression scale.</p><p><b>RESULTS</b>The therapeutic effect of the treatment group was better than that of the control group with a significant difference between the two groups (P < 0.01).</p><p><b>CONCLUSION</b>Combination of acupuncture with cupping therapy is an effective therapy for fibromyalgia syndrome.</p>

Cancer of the nasal cavity / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyze the factors affecting prognosis of patients with nasal carcinoma.</p><p><b>METHODS</b>163 patients treated from 1985 to 1998 were analyzed. The survival analysis was performed by Kaplan-Meier estimate and the comparison between groups by Log-rank test. Multivariate analysis was carried out by Cox proportional hazard model.</p><p><b>RESULTS</b>The overall 5-year survival rate was 58.2%. The 5-year survival rate was 55.8% in squamous-cell carcinoma, 44.0% in adenocarcinoma, 59.7% in undifferentiated carcinoma, 76.3% in adenoid cystic carcinoma, 71.4% in mucoepidermoid carcinoma, 25.0% in rhabdomyosarcoma, 26.7% in malignant melanoma, 50.0% in neuroblastoma (P > 0.05). Patients with cervical metastasis gave a 5-year survival of 53.5% while those without gave 58.9% (P > 0.05). Patients with involvement of sphenoidal sinus or maxillary sinus gave the worse survival. The 5-year survival rate was 73.8% in patients whose cancer completely disappeared after treatment. It was 41.6% in patients whose cancer incompletely disappeared, and 34.3% in patients whose cancer remained refractory (P < 0.01). The 5-year survival was 78.3% in stage I disease, 56.4% in stage II disease, 54.2% in stage III and 35.9% in stage IV (P < 0.05). The 5-year survival rate of patients who were treated with radiotherapy only was 56.9%. That of patients who were treated with surgery only was 56.6%. That with chemotherapy only was 25.0% whereas that of patients treated with combination treatment was 61.8% (P > 0.05). So far, 85 patients have died up to writing this report, 57.6% (49 patients) of recurrence or uncontrolled.</p><p><b>CONCLUSION</b>Clinical stage, immediate therapeutic response and involvement of sphenoidal or maxillary sinus; but not the pathologic type, the presence of cervical metastasis nor the method of treatment, are the factors affecting the prognosis of patients with nasal carcinoma. Recurrence and uncontrolled disease are the cause of death.</p>

Relationship between biologic behavior and morphologic features of invasive micropapillary carcinoma of the breast / 中华病理学杂志

<p><b>OBJECTIVE</b>To clarify the relationship between biologic behavior and morphologic features of invasive micropapillary carcinoma (IMPC) of the breast.</p><p><b>METHODS</b>Two thousand and eighty-eight cases of clinically defined monocentric breast cancer without pre-operative biopsy (except fine needle aspiration procedure) were examined by whole mammary gland serial sectioning. The clinicopathologic and morphologic features (including microscopic and ultrastructural) of IMPC were analyzed.</p><p><b>RESULTS</b>One hundred and seventeen cases of IMPC (6.2%, 117/1 880) were diagnosed during the period of study. The incidence of lymphovascular invasion (54.7%, 58/106) and nodal metastases (76.4%, 81/106) was significantly higher in IMPC, as well as the number of metastatic node (on average 9.6) was significantly more in IMPC, as compared with that of the invasive ductal carcinoma. Microscopically, the tumor was characterized by morula-like clusters and small papillae of malignant cells floating within irregular interstitial spaces and separated by fibrous septa. Ultrastructurally, microvilli were observed on the neoplastic cell surface at the periphery of the micropapillae. There were also numerous fine intermediate filaments in the cytoplasm. Newly formed capillaries were noted in the interstitium and some tumor cells were directly in contact with endothelial cells.</p><p><b>CONCLUSIONS</b>A predominant component of IMPC in breast carcinoma is associated with a higher risk of lymphovascular invasion and nodal metastasis. The aggressive behavior of IMPC can be attributed to the proliferative activity of the tumor cells, and its associated angiogenesis.</p>

Clinicopathological characteristics of atypical cystic duct (ACD) of the breast: assessment of ACD as a precancerous lesion / 中华病理学杂志

<p><b>OBJECTIVE</b>To assess the clinicopathological features of atypical cystic duct (ACD) as a precancerous lesion of the breast.</p><p><b>METHODS</b>Whole mammary gland serial sections were performed on 200 cases of breast cancer without pre-operative biopsy (prior operation, fine needle aspiration or needle biopsy were routinely performed in each case). The clinicopathological findings and immunohistochemical features of ACD were investigated.</p><p><b>RESULTS</b>Forty-four (22%) of the 200 breast cancer patients had ACD breast lesions. The frequency of patients with ACD increased in premenopausal women (P=0.001). A number of ACD lesions displayed a histological transition to adjacent ductal carcinoma in-situ. In 16 of 44 (36%) patients with ACD, carcinoma cells stained positive for p53. In 12 of these 16 cases (75%), ACD cells also stained positive for p53 protein (P=0.001). Myoepithelial cells of ACD appeared attenuated and stained strongly for alpha-smooth muscle actin. There was no correlation between the ACD-present group and the ACD-absent group in tumor size, nodal metastasis, and immunostaining patterns of estrogen receptor (ER), progesterone receptor (PR), p53, c-erbB-2 and Ki-67 labeling index of cancerous tissues. All 44 ACD lesions showed a negative staining of c-erbB-2, regardless of the staining result in their corresponding carcinomas. The mean Ki-67 labeling index of ACD lesions was low.</p><p><b>CONCLUSIONS</b>ACD is frequently associated with breast cancer. It may represent a precancerous mammary lesion, supported by the frequent histological continuum between ACD and malignancy, and simultaneous p53 over-expression present in both ACD and its corresponding breast carcinoma.</p>