Associations of Plasma Glucagon Levels with Estimated Glomerular Filtration Rate, Albuminuria and Diabetic Kidney Disease in Patients with Type 2 Diabetes Mellitus

Background@#Type 2 diabetes mellitus (T2DM) is characterized by elevated fasting glucagon and impaired suppression of postprandial glucagon secretion, which may participate in diabetic complications. Therefore, we investigated the associations of plasma glucagon with estimated glomerular filtration rate (eGFR), albuminuria and diabetic kidney disease (DKD) in T2DM patients. @*Methods@#Fasting glucagon and postchallenge glucagon (assessed by area under the glucagon curve [AUCgla]) levels were determined during oral glucose tolerance tests. Patients with an eGFR <60 mL/min/1.73 m2 and/or a urinary albumin-to-creatinine ratio (UACR) ≥30 mg/g who presented with diabetic retinopathy were identified as having DKD. @*Results@#Of the 2,436 recruited patients, fasting glucagon was correlated with eGFR and UACR (r=–0.112 and r=0.157, respectively; P<0.001), and AUCgla was also correlated with eGFR and UACR (r=–0.267 and r=0.234, respectively; P<0.001). Moreover, 31.7% (n=771) presented with DKD; the prevalence of DKD was 27.3%, 27.6%, 32.5%, and 39.2% in the first (Q1), second (Q2), third (Q3), and fourth quartile (Q4) of fasting glucagon, respectively; and the corresponding prevalence for AUCgla was 25.9%, 22.7%, 33.7%, and 44.4%, respectively. Furthermore, after adjusting for other clinical covariates, the adjusted odds ratios (ORs; 95% confidence intervals) for DKD in Q2, Q3, and Q4 versus Q1 of fasting glucagon were 0.946 (0.697 to 1.284), 1.209 (0.895 to 1.634), and 1.521 (1.129 to 2.049), respectively; the corresponding ORs of AUCgla were 0.825 (0.611 to 1.114), 1.323 (0.989 to 1.769), and 2.066 (1.546 to 2.760), respectively. Additionally, when we restricted our analysis in patients with glycosylated hemoglobin <7.0% (n=471), we found fasting glucagon and AUCgla were still independently associated with DKD. @*Conclusion@#Both increased fasting and postchallenge glucagon levels were independently associated with DKD in T2DM patients.

Influential factors of leisure exercise among patients with type 2 diabetes mellitus based on the planned behavior theory / 中华疾病控制杂志

Objective This study applied the theory of planned behavior to investigate the leisure exercise situation among patients with type 2 diabetes mellitus (T2DM) and its influencing factors. Methods The questionnaire was self-designed based on the theory of planned behavior, which had good reliability and validity. Structural equation modeling was used to estimate the determinants of leisure exercise and the potential intermediate effect. Results 774 patients with T2DM were enrolled in this study. 52.6% were over 60 years old. The median amount of leisure exercise was 0.0 thousand-step equivalent with quartile of (0.0, 2.0). Structural equation modeling showed that the effects of attitude (β=0.080) and intention (β=0.277) on leisure exercise were significant. Besides, perceived behavioral control (β=0.180) had an indirect effect on exercise through intention. Conclusions In general, most patients with type 2 diabetes have insufficient amount of exercise. Improving attitude, control and intention to exercise would be one crucial part of exercise health education among patients with T2DM.

Correlation between the expression of JARID1B/KDM5B in breast cancer tissues and the circulating tumor cells / 基础医学与临床

Objective To investigate the relation between expression of JARID1B/KDM5B in invasive breast cancer tissue and circulating tumor cells of invasive breast patients. Methods The S-P immunohistochemical method was used to observe the expression of JARID1B/KDM5B in lesions.imFISH method was used to detect circulation tumor cells. Results Twenty-seven cases of patients showed CTC positive(the number of CTC was more than or equal to 2) in 35 invasive breast cancer cases,The results of JARID1B/KDM5B expression were as follows:(-) (n=0) and (+) in 1 case,(++) in 3 cases,(+++) in 23 cases,8 cases of negative cases (the number of CTC < 2), JARID1B/KDM5B immune group of results:(-) (n=2),(+) in 2 cases,(++) in 1 case,(+++) in 3 cases, The positive relation was found in expression of JARID1B/KDM5B and circulating tumor cells(P<0.05). Conclu-sions JARID1B/KDM5B positive expression in tumor tissues has a certain significance in predicting the recurrence and metastasis of tumor.

Comparison research of transcutaneous bilirubin measurement and serum bilirubin measurement during phototherapy in neonates / 中华护理杂志

Objective To compare the correlation between transcutaneous bilirubin(TcB) measurement and serum bilirubin (TSB) measurement at covered and exposed skin sites during phototherapy in neonates.Methods Two sites of exposed skin and two sites of covered skin were chosen to measure the transcutaneous bilirubin.The serum bilirubin was monitored at admission and during phototherapy,while the transcutaneous bilirubin was tested and recorded at the same time of monitoring the serum bilirubin.Results A total of 112 cases were included from January 29th to April 15th in 2016.At the four monitoring points during phototherapy,the differences between the transcutaneous bilirubin of the two exposed sites and the serum bilirubin were statistically significant (P＜0.01).For the covered site 4,there were no significant differences between transcutaneous bilirubin and serum bilirubin at every test point (P＞0.05).When the serum bilirubin was higher than 307.8 μmol/L (18mg/dl),the serum bilirubin measurement was larger than the transcutaneous bilirubin measurement.Conclusion The transcutaneous bilirubin level of covered skin was more close to serum bilirubin,especially when the covered median skin of the second rib was chosen to monitor the transcutaneous bilirubin.When the serum bilirubin was greater than 307.8 μmol/L(18mg/dl),the transcutaneous bilirubin couldn't represent serum bilirubin quite well.

Clinicopathologic characteristics of sporadic renal hemangioblastoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathological characteristics of sporadic renal hemangioblastoma.</p><p><b>METHODS</b>Two cases of sporadic renal hemangioblastoma were studied by histological and immunohistochemical staining, along with review of the literature.</p><p><b>RESULTS</b>Both cases were presented with a renal mass during annual physical examination with an age of 40 and 45 years, respectively. The lesions located in the middle portion of the kidney with a sharp tumor border. Histopathologically, the tumors were characterized by two major components: capillary and stromal cells. Immunohistochemically, the stromal cells were positive for vimentin, NSE, S-100 protein and inhibin-α, and negative for CK, HMB45, Melan A, EMA, CD56 and syn. Both tumors showed a very low level of Ki-67 labeling. The endothelial cells were positive for CD34.</p><p><b>CONCLUSION</b>Sporadic renal hemangioblastoma is a rare benign neoplasm, the diagnosis of which is based on the characteristic follicular architecture and an exclusion of other carcinomas of the kidney.</p>

Immune tolerance induced by exosomes derived from regulatory dendritic cells of mice / 中国实验血液学杂志

The study was aimed to explore the roles of exosomes derived from regulatory dendritic cells of mice in the induction of immune tolerance. Immature DC (iDC) from mouse bone marrow cells and regulatory DCs (rDC) were induced by treating iDC with TGF-beta1 and IL-10. The phenotype of regulatory DCs and normal DCs were assayed by flow cytometry. Exosomes from immature DCs (iDex) and regulatory DCs (rDex) were isolated by ultracentrifugation and ultrafiltration. A skin transplantation model was established with the recipients BALB/c mice and the donor C57BL/6 mice. Recipients were divided into PBS control group, iDex group (injection 10 microg iDex of donor C57BL/6 mice via tail vein at days 7 and 3 before skin transplantation), rDex group (injection 10 microg rDex of donor C57BL/6 mice via tail vein at days 7 and 3 before skin transplantation). The capacity of the donor mice and the unrelated allogeneic donor mice to stimulate allogeneic T lymphocyte proliferation was examined by mixed lymphocyte culture (MLR). The results showed that TGF-beta1 and IL-10 could down-regulate the expressions of costimulatory molecules, including CD80, CD86 and CD40. The graft mean survival time (MST) in control group, iDex group and rDex group was 7.8, 10.7 and 18.8 days, respectively. There was significant difference in MST between iDex group and control group (p<0.05), and between rDex group and iDex group (p<0.01). The results of MLR assays indicated donor-specific hyporeactivity especially in rDex group, while the tolerant B/C mice were still immunocompetent to unrelated allogeneic DBA mouse. It is concluded that injection iDex or rDex of donor mice via tail vein before skin transplantation induces immunotolerance, and the effect of rDex is more significant.

Analysis of the results of percent free prostate specific antigen detection among the men without prostate diseases in Xi'an / 南方医科大学学报

<p><b>OBJECTIVE</b>To measure the percentage of free prostate specific antigen (fPSA) among the men without prostate diseases in Xi'an, and understand the age-related changes in percent fPSA and its association with the pathological grade and clinical stage of prostate cancer, so as to determine the reference range of percent fPSA in Chinese men.</p><p><b>METHODS</b>A total of 829 men (including 775 men without prostate disease and 54 with prostate cancer) were enrolled into the study and the serum PSA and fPSA levels were measured for calculating the percent fPSA. The 775 prostate disease-free subjects were divided into 5 age groups to study the relations of PSA, fPSA and percent fPSA with age. In the 54 patients with prostate cancer, the relations of pathological grade and clinical stage with percent fPSA were investigated with reference to the related data of the men without prostate disease to establish the appropriate reference range of percent fPSA for Chinese men.</p><p><b>RESULTS</b>Serum PSA or fPSA levels, but not the percent fPSA, were correlated to age. In patients with prostate cancer, the percent fPSA was also correlated to the pathological grade and clinical stage. Among the men without prostate disease we investigated, the percent fPSA was significantly lower than that reported in other countries. The reference range of percent fPSA for Chinese men was > or =15%.</p><p><b>CONCLUSION</b>The percent fPSA is not correlated to age and has greater clinical value than PSA measurement in the detection of prostate cancer. The percent fPSA decreases in prostate cancer patients with lowered pathological grade, advanced clinical stage, and therefore increased malignancy. The reference range of percent fPSA reported in other countries does not apply to Chinese men, and according to our investigation, the reference range of percent fPSA> or =15% is appropriate for Chinese men.</p>

Effects of warm needle moxibustion on bone mass density and biochemical indexes of bone metabolism in patients of postmenopausal osteoporosis / 中国针灸

<p><b>OBJECTIVE</b>To compare therapeutic effects of warm needle moxibustion and medication on osteoporosis and to study the mechanism.</p><p><b>METHODS</b>Forty cases were randomly divided into an acupuncture group and a medication group, 20 cases in each group. The acupuncture group was treated by warm needle moxibustion at Dazhu (BL 11), Ganshu (BL 18), Shenshu (BL 23), Zusanli (ST 36), Yanglingquan (GB 34) etc. once other day, for 3 months; and the medication group was treated by oral administration of tablet Caltrate with Vit D2 for 3 months. The changes of bone mass density (BMD), estradiol (E2), osteocalcin (bone growth protein, BGP), urine calcium/creatinine (Ca/Cr) in the two groups before and after treatment and therapeutic effects were investigated.</p><p><b>RESULTS</b>After treatment, BMD significantly increased (P<0.05, P<0.01) in the acupuncture group and did not signifi cantly changed in the medication group (P>0.05) with a significant difference between the two groups (P<0.05). After treatment E2 level significantly increased as compared with before treatment in both of groups (P<0.01); after treatment BGP significantly decreased as compared with before treatment in both of groups (P<0.01); after treatment Ca/Cr significantly decreased as compared with before treatment in the acupuncture group (P<0.05) ; af ter treatment, there were significant differences in BGP and Ca/Cr between the two groups (P<0.05 or P<0.01). The clinically controlled rate in the acupuncture group and in the medication group were 35.0%, 5.0%, respectively, the therapeutic effect of the acupuncture group being better than that of the medication group (P<0.01).</p><p><b>CONCLUSION</b>The therapeutic effect of warm needle moxibustion on osteoporosis is better than that of oral administration of tablet Caltrate with Vit D2 and it can increase levels of hormones and delay bone loss. It is an effective method for preventing and treating postmenopausal osteoporosis.</p>

Effect of hospice care on the quality of life and psychological state of aged mortal inpatients / 中南大学学报(医学版)

OBJECTIVE@#To investigate the influence of hospice care on the life quality and psychological state of aged mortal inpatients.@*METHODS@#Seventy-six aged patients were randomly divided into 2 groups (n=38). The research group was treated with hospice care, while the control group was treated with conventional nursing. Before and after more than one month of the interference, the quality of life, social support, satisfied degree, anxiety, and depression mood were investigated.@*RESULTS@#All the indexes, such as total scale of life quality, appetite, spirit, sleep, family comprehension and coordination, recognition of cancer, attitude to therapy, and facial expression of the mortal inpatients after the interference, were raised and higher than those of the controls (P<0.05 or P<0.01). Life satisfaction index and the total scale of social support and subjective support, utilization ratio of support were raised and higher than those of the controls (P<0.05 or P<0.01). The level of anxiety and depression was decreased and lower than the control (P<0.05 or P<0.01).@*CONCLUSION@#Hospice care can raise the life quality, subjective support, utilization ratio of support and life satisfaction of aged mortal inpatients. It could decrease the negative mood, such as anxiety and depression and improve the psychological state.

Variability of human cytomegalovirus UL144 gene in low-passage clinical isolates analyzed by HMA-SSCP / 中华实验和临床病毒学杂志

<p><b>BACKGROUND</b>Human cytomegalovirus (HCMV) infection is an important infectious agent that results in neonatal disease and congenital deformity. HCMV infection may affect in many organs. The different symptoms and tissue tropism of HCMV infection perhaps resulted from the genetic polymorphism of HCMV. HCMV UL144 open reading frames encode a homologue of the tumor necrosis factor receptor. It seems important to study the strain-specific variability of UL144 sequence in low-passage clinical isolates and to discuss if the variability related to the clinical HCMV infection.</p><p><b>METHODS</b>HCMV-UL144 gene was amplified by PCR assay in 65 low-passage clinical isolates and urine from 7 healthy children who were HCMV-DNA positive by quantitative PCR. All the positive PCR products were analyzed by Heteroduplex mobility assay and single-stranded conformation polymorphism (HMA-SSCP) and 32 of them were sequenced.</p><p><b>RESULTS</b>Fifty-five isolates and 5 urine specimens were HCMV-UL144 positive by PCR. Sequencing and HMA-SSCP analysis showed that significant strain-specific variability was present in the UL144 ORFs. Comparing UL144 sequences and the corresponding symptoms showed that genotype 2 did not exist in megacolon isolates. And genotype 1 and 3 were the major types among microcephaly and jaundice isolates respectively.</p><p><b>CONCLUSION</b>HCMV-UL144 existed in almost all the low passage isolates. HMA-SSCP assay is an easy and effective method to detect the genetype of HCMV-UL144 sequence. The characteristic of sequences in different isolates showed that UL144 gene may play an important role in HCMV infection.</p>