Application of allostatic load in evaluating the effect of management for patients with type 2 diabetes mellitus / 中华健康管理学杂志

Objective:To explore the application of Allostatic Load (AL) in evaluation the effect of management for patients with type 2 diabetes.Methods:According to the control objectives of each indicator in the Guidelines for the Prevention and Treatment of Type 2 Diabetes in China, the P75 and P80 of the subjects before intervention, AL was calculated, which were AL1-1, AL1-2 and AL1-3 respectively. On the basis of the above three indicators, the number of complications was taken as the numerical sum to obtain AL2-1, AL2-2 and AL2-3. Study participants were from a one-year randomized controlled intervention trial in patients with type 2 diabetes. Patients in the control group were treated with the integrated diabetes management mode used bg the tier-three medical institutions, while the intervention group added the intervention based on " Your Doctor" App on the basis of the above strategy. The changes of 6 types of AL and HbA 1C in the two groups before and after intervention were compared. Two groups of patients were treated with propensity score matching method to ensure the balanced distribution of covariates between groups. Multiple regression analysis was used to explore the factors influencing the effect of AL intervention. Two independent samples t-test, paired t-test and chi-square test were used to analyze the efficacy of the intervention. Results:After propensity score matching, the control group and the intervention group each included 483 patients. Among the six types of AL, the score of AL2-1 was the highest, while the score of AL1-3 was the lowest. Compared with baseline, all other indicators in the two groups decreased after intervention except ALL-3 in control group ( P<0.05).Patients who were residing in rural areas, having less co-habitants and more diabetic complications, and lower annual household income, shown higher AL ( P<0.05). The number of complications and the situation of urban or rural areas were the factors influencing the effect of AL intervention. Conclusions:More research is needed on AL as an early evaluation index of the effect of comprehensive management of diabetes.

Progress on salt reduction and prevention of chronic non-communicable disease / 中华预防医学杂志

Salt reduction is one of the effective strategy for chronic non-communicable disease control and prevention recommended by World Health Organization. Research evidences on salt reduction emerge recently and some issues remain controversial. With the aim of providing reference for the future salt reduction action, this article reviewed the current evidence and strategies on the source of salt intake, the relationship between salt and health, the cost-effectiveness of salt reduction, as well as the targets and strategies of salt reduction. It also elaborated the main controversial issues in salt reduction, including salt reduction in population, evaluation method of salt intake, substitute salt, iodine intake, and the effectiveness of salt reduction strategy. The international and internal salt reduction activities were introduced as well.

Relationship Between Acute Cerebral Infarction and Serum Inflammatory Cytokines / 沈阳医学院学报

Objective:To investigate the changes of serum inflammatory cytokines in patients with acute cerebral infarction (ACI) and its clinical significance by detecting the serum levels of homocysteine (Hcy),cystatin C (Cys C),high-sensitivity C-reactive protein (hs-CRP) . Methods:A total of 82 ACI patients (ACI group) and 50 healthy persons (control group) were selected,the serum Hcy,Cys C,hs-CRP levels of all subjects were determined,the relationship between inflammatory cytokines and USA National Institutes of Health Stroke Scale (NIHSS) was analyzed. Finally,the roles of inflammatory cytokines in diagnosis of ACI were evaluated. Results:The levels of Hcy,Cys-C and hs-CRP in ACI group were significantly higher than those in control group (P<0.01) . The serum levels of these factors had significant difference among different neurological deficiency groups (P<0.05), and had a positive correlation with NIHSS score (r=0.396, 0.445, 0.391, P<0.01), hs-CRP had the highest sensitivity (72.0%) and specificity (82.0%) for diagnosis of ACI. Conclusions:The hs-CRP, Hcy and Cys C play important roles in the onset and development of ACI and can reflect the severity of ACI. Among them,Hcy is the important dangerous factor of ACI,the level of Cys C reflectes the degree of the vascular inflammatory injury,and hs-CRP can be used as an index to diagnose and evaluate the severity of ACI.

Evaluation measurement of urinary albumin in population survey / 中华检验医学杂志

Objective To evaluate the spot urine sample collection method and value of urinary albumin measurement in population survey. Methods Six hundred and fifty-nine Beijing residents were requested to collect 24 h urine for detection of UAER, as well as random spot urine samples and morning urine samples in the next day. Rapid semi-quantitative urinary albumin-specific dipstick and ACR were measured in each spot urine specimen. The 24 h UAER was measured as golden standard to generate ROC curves and evaluate the sensitivity, specificity and AUC of each method. Results The value of ACR in the morning spot urine samples and random spot urine samples were 9. 36(5. 12-33.29) mg/g and 11.29(6. 34-41.29) mg/g respectively and there was no significant difference between these two groups (t = - 1. 382,P＞0.05). The correlation was significant in the two groups (r = 0.932, P ＜ 0.01). The correlation coefficient between ACR in the morning spot urine samples and UAER was 0. 853 (P ＜ 0. 01). The correlation coefficient between ACR in the random spot urine samples and UAER was 0. 874 (P ＜0. 01).The sensitivity and specificity of ACR for diagnosis of albuminuria in the random urine samples were 77. 9% and 91.0%. The sensitivity and specificity of ACR for diagnosis of albuminuria in the morning urine samples were 78. 4% and 95.7%. Concerning the semi-quantitative urinary albumin-specific dipstick, sensitivity and specificity were 90. 3% and 41.1% , respectively. The specificity was much lower than that of ACR. The area under the ROC curves of ACR in the random urine specimens and the morning urine specimens was 0. 918 ±0. 012, 0. 929 ± 0. 015, respectively. There was no statistical difference between these two groups (χ2 =2. 13, P＞0. 05). The area under the ROC curves of semi-quantitative urinary albumin-specific dipstick in the random urine specimens was 0.661 ±0.021, lower than that of ACR (χ2 = 248.41, P＜0.01).Conclusion Measurement of ACR in random urine samples is a reasonable method with simplicity and accuracy for the detection of albuminuria in general population screening program.

Detection of Anti-Spirometra erinaceieuropaei Antibody Using ELISA / 中国寄生虫学与寄生虫病杂志

Objective To study specific diagnosis of Spirometra erinaceieuropaei . Methods An enzyme linked immunosorbent assay (ELISA) was studied using highly pure gene engineering antigen expressed by the recombination of the cloned cysteine proteinase gene of Spirametra erinaceieuropaei with expression vector pMAL TM c2. Six sera from patient infected with Spirometra erinaceieuropaei were detected using this method. Results and Conclusion The results showed that the gene engineering antigen reacted strongly with the sera from Spirometra erinaceieuropaei infected patients, but did not with the sera from Cysticercus cellulosae infected patients.