Plasma CD36 and Incident Diabetes: A Case-Cohort Study in Danish Men and Women

BACKGROUND: Membrane CD36 is a fatty acid transporter implicated in the pathogenesis of metabolic disease. We aimed to evaluate the association between plasma CD36 levels and diabetes risk and to examine if the association was independent of adiposity among Danish population.METHODS: We conducted a case-cohort study nested within the Danish Diet, Cancer and Health study among participants free of cardiovascular disease, diabetes and cancer and with blood samples and anthropometric measurements (height, weight, waist circumference, and body fat percentage) at baseline (1993 to 1997). CD36 levels were measured in 647 incident diabetes cases that occurred before December 2011 and a total of 3,515 case-cohort participants (236 cases overlap).RESULTS: Higher plasma CD36 levels were associated with higher diabetes risk after adjusting for age, sex and other lifestyle factors. The hazard ratio (HR) comparing high versus low tertile of plasma CD36 levels was 1.36 (95% confidence interval [CI], 1.00 to 1.86). However, the association lost its significance after further adjustment for different adiposity indices such as body mass index (HR, 1.23; 95% CI, 0.87 to 1.73), waist circumference (HR, 1.21; 95% CI, 0.88 to 1.68) or body fat percentage (HR, 1.20; 95% CI, 0.86 to 1.66). Moreover, raised plasma CD36 levels were moderately associated with diabetes risk among lean participants, but the association was not present among overweight/obese individuals.CONCLUSION: Higher plasma CD36 levels were associated with higher diabetes risk, but the association was not independent of adiposity. In this Danish population, the association of CD36 with diabetes risk could be either mediated or confounded by adiposity.

Multiple Biomarkers Improved Prediction for the Risk of Type 2 Diabetes Mellitus in Singapore Chinese Men and Women

Background@#Multiple biomarkers have performed well in predicting type 2 diabetes mellitus (T2DM) risk in Western populations. However, evidence is scarce among Asian populations. @*Methods@#Plasma triglyceride-to-high density lipoprotein (TG-to-HDL) ratio, alanine transaminase (ALT), high-sensitivity Creactive protein (hs-CRP), ferritin, adiponectin, fetuin-A, and retinol-binding protein 4 were measured in 485 T2DM cases and 485 age-and-sex matched controls nested within the prospective Singapore Chinese Health Study cohort. Participants were free of T2DM at blood collection (1999 to 2004), and T2DM cases were identified at the subsequent follow-up interviews (2006 to 2010). A weighted biomarker score was created based on the strengths of associations between these biomarkers and T2DM risks. The predictive utility of the biomarker score was assessed by the area under receiver operating characteristics curve (AUC). @*Results@#The biomarker score that comprised of four biomarkers (TG-to-HDL ratio, ALT, ferritin, and adiponectin) was positively associated with T2DM risk (P trend <0.001). Compared to the lowest quartile of the score, the odds ratio was 12.0 (95% confidence interval [CI], 5.43 to 26.6) for those in the highest quartile. Adding the biomarker score to a base model that included smoking, history of hypertension, body mass index, and levels of random glucose and insulin improved AUC significantly from 0.81 (95% CI, 0.78 to 0.83) to 0.83 (95% CI, 0.81 to 0.86; P=0.002). When substituting the random glucose levels with glycosylated hemoglobin in the base model, adding the biomarker score improved AUC from 0.85 (95% CI, 0.83 to 0.88) to 0.86 (95% CI, 0.84 to 0.89; P=0.032). @*Conclusion@#A composite score of blood biomarkers improved T2DM risk prediction among Chinese.

Plasma Fetuin-A Levels and Risk of Type 2 Diabetes Mellitus in A Chinese Population: A Nested Case-Control Study

BACKGROUND: Fetuin-A is a hepatokine that involved in the pathogenesis of insulin resistance. Previous epidemiological studies have found a positive association between blood fetuin-A and type 2 diabetes mellitus (T2DM) risk among Caucasians and African Americans. We aimed to investigate the prospective relationship between fetuin-A and T2DM in an Asian population for the first time. METHODS: A nested case-control study was established within a prospective cohort of Chinese living in Singapore. At blood collection (1999 to 2004), all participants were free of diagnosed T2DM and aged 50 to 79 years. At subsequent follow-up (2006 to 2010), 558 people reported to have T2DM and were classified as incident cases, and 558 controls were randomly chosen from the participants who did not develop T2DM to match with cases on age, sex, dialect group, and date of blood collection. Plasma fetuin-A levels were measured retrospectively in cases and controls using samples collected at baseline. Conditional logistic regression models were used to compute the odds ratio (OR) and 95% confidence interval (CI). Restricted cubic spline analysis was used to examine a potential non-linear association between fetuin-A levels and T2DM risk. RESULTS: Compared with those in the lowest fetuin-A quintile, participants in the highest quintile had a two-fold increased risk of developing T2DM (OR, 2.06; 95% CI, 1.21 to 3.51). A non-linear association was observed (P nonlinearity=0.005), where the association between fetuin-A levels and T2DM risk plateaued at plasma concentrations around 830 µg/mL. CONCLUSION: There is a positive association between plasma fetuin-A levels and risk of developing T2DM in this Chinese population.

Status Quo of Cost Estimation and Systematic Review in Pharmacy Intravenous Admixture Services in China / 中国药房

OBJECTIVE： To systematically evaluate the status quo of cost estimation in pharmacy intravenous admixture services （PIVAS）， and to provide cost basis for the construction of PIVAS in China. METHODS： Retrieved from PubMed， Embase， Cochrane library， CBM， CNKI， CSJD and Wanfang database from database establishment to Jan. 2019， the studies about the status quo of cost estimation in PIVAS of China were included. The descriptive analysis was conducted for content and method of cost estimation， infection to hospital. RESULTS： A total of 17 literatures were included， involving 8 before and after control studies， 6 experience sharing studies and 3 reviews. Existing reports showed that the estimation contents and methods of PIVAS cost were roughly the same. The cost included manpower， medical and health materials， fixed asset purchase， depreciation， repair costs， medicine cost and indirect costs. At the same time， the infection to hospital were reported， such as in manpower adopting， formulating detailed management measures and systems， concurrent allocation of the same kind of drugs， shortening infusion preparation and replacement time， in order to save manpower cost. CONCLUSIONS： PIVAS cost calculation method is roughly the same in some hospitals， but there is no uniform standard. It is necessary to further improve the PIVAS cost measurement standard and provide a basis for the construction and development of PIVAS in China.

Systematic Evaluation of Current Status of Charges in PIVAS of China / 中国药房

OBJECTIVE： To systematically evaluate current status of charges in pharmacy intravenous admixture services （PIVAS）， and to provide reference for the formulation of China’s pharmacy intravenous admixture services （PIVAS） charging standards. METHODS： Retrieved from PubMed， Embase， Cochrane library， CBM， CNKI， VIP， Wanfang database and related goverment websets， the literatures about current status evaluation of charges in PIVAS of China were collected during the establishment of database to Jan. 2019. Cost estimation， charge standard， influential factors and other indicators were collected， and the results were presented by descriptive analysis. RESULTS： A total of 5 literatures were included， all of which were reviewed. According to the existing literatures， except for Shandong， Guangdong and Yunnan provinces， there were no regional charge standards in other provinces （districts and cities）. The cost estimation methods of PIVAS in these three provinces were basically the same. The cost could be obtained by adding up the business fees， labor fees， fees of medical instruments purchase and use， indirect fees etc. Dispensing charges in PIVAS were 3-5 yuan per piece for general drug， 5 yuan per piece for antibiotics and 8-12 yuan per piece for cancer chemotherapeutics， 20-35 yuan per piece for TPN. The charging level was mainly affected by local prices， PIVAS scale， hardware investment， management and other factors. CONCLUSIONS： There is no unified charging standard for PIVAS in most provinces （districts， cities） of China. The cost estimation methods of the hospitals from the included literatures are basically the same. It is necessary to construct national PIVAS charging standard and cost estimation method， which could provide a basis for formulating the price of medical and health services.

Evidenced-based Evaluation of Personnel Training Mode in Pharmacy Intravenous Admixture Services in China / 中国药房

OBJECTIVE： To systematically evaluate the mode of personnel training in pharmacy intravenous admixture services （PIVAS） in China， and to provide reference for the comprehensive training of pharmacist in PIVAS in China. METHODS： PubMed， Embase， Cochrane Library， CBM， CJFD， VIP and Wanfang database were searched from the establishment of database to Sept. 2018. Studies which evaluated the training mode of PIVAS in China were included， and the results were presented by descriptive analysis in respects of training objects， training objectives， contents and evaluation indicators. RESULTS： A total of 5 literatures were included. The research types were 2 before-after control studies， 2 experience sharing studies and 1 review. 3 subjects were pharmacists， 1 subject was clinical pharmacists， and 1 subject was nurses. The training objectives were comprehensive quality training， clinical rational drug use level， pharmacy personnel training path and professional service ability. The specific training content of the training mode varied greatly， including professional theoretical knowledge， practical operation ability， pre-job training， professional psychological quality， professional ethics and laws and regulations， continuing education learning ability， career development planning and teaching ability. There were great differences in the evaluation indicators of training effectiveness， which were mainly reflected in team execution motivation and creativity， discoveny rate of unreasonable doctor’s advice， work efficiency， service quality， drug treatment level and satisfaction of PIVAS， etc. CONCLUSIONS： There are certain differences in the training objectives， training targets， specific contents and evaluation indicators of the PIVAS pharmacist training model in China. It is necessary to use the evidence- based method to construct the training mode for PIVAS pharmacist to provide support for clinical intravenous drug use.

Clinical Observation on Rhubarb Enema and Glauber's Salt Topical Treating Acute Pancreatitis / 浙江中医药大学学报

[Objective]To discuss the clinical efficacy of Rhubarb Enema and Glauber's salt Topical on acute pancreatitis.[Methods]Select in our hospital from April 2010 to April 2014 60 AP patients were randomly divided into two groups,n=30 for each.The treatment one was treated with Rhubarb Enema and Glauber's salt Topical on the basis of western medicine,the control group only received conventional western treatment.After 7 days,observe clinical symptoms and laboratory parameters changes,e.g.exhaust defecation, bowel sounds, serum amylase and C-reactive protein,and compare the two groups before and after the treatment of APACHEⅡand BISAP score. [Result] The clinical effective rate was 90% in treatment group and was better than the control group 73.33%,the difference was obvious(P0.05). [Conclusion]Rhubarb Enema and Glauber's salt topical treatment for acute pancreatitis have a significant effect.

Progress on effect and mechanism of Danhong injection in treatment of coronary heart disease / 中国生化药物杂志

Coronary heart disease is a kind of serious heart disease, which is caused by the disease of the coronary artery, which leads to the stenosis or obstruction of the coronary vessels.Danhong injection is made of Salvia miltiorrhiza, safflower extract, chemical composition of two drugs is the key to play a role in treatment.Numerous clinical studies show that the red injection can effectively expand the coronary artery, increase the coronary blood flow, relieve the clinical symptoms of coronary heart disease, improve the ECG and improve the clinical effect.In this paper, the pharmacological properties, clinical research and treatment of CHD were reviewed,In this paper, the pharmacological properties, clinical research and treatment of CHD are reviewed, to provide theoretical basis for the treatment of CHD molecular mechanism and clinical application.

Impacts of bicyclo-monoterpene enhancers on transdermal delivery of ligustrazine / 药学学报

The purpose of this study is to investigate the impacts of bicyclo-monoterpene promoters (i.e., borneol and camphor) on the in vitro permeation of ligustrazine (LGT) through the hairless porcine dorsal skin. Fourier transform-infrared (FT-IR), scanning electron microscope (SEM) and transdermal delivery kinetics in vitro were performed to investigate the effect of the promoters on the biophysical changes to the stratum corneum (SC), the surface changes to porcine skin and the in vitro percutaneous fluxes of ligustrazine through procine skin. FT-IR results revealed that the peak shift and the decrease in the peak area with borneol were higher than those with camphor. SEM studies demonstrated that the morphological change to SC was related to the chosen enhancer. It was observed that the SC lipid extraction with borneol and camphor led to disruption of the SC and the scutella desquamation. Apparent density (AD) was utilized to describe the desquamation extent of the scutella. Percutaneous fluxes of ligustrazine through porcine skin were evaluated in vitro by the Franz-type diffusion cells. Use of borneol led to greater penetration of ligustrazine across porcine skin. It was shown that the permeation enhancement mechanism of bicyclo-monoterpenes to ligustrazine included extracting and disordering lipids which involved the shift changes in C-H stretching and H-bonding action between enhancers and cermaide. The penetration capability of the hydroxy groups in bicyclo-monoterpenes was better than that of the ketone groups.