Prevalence of comorbid chronic obstructive pulmonary disease and osteoporosis among residents aged 40 years and older in Zhangjiagang City / 预防医学

Objective @#To investigate the prevalence of comorbid chronic obstructive pulmonary disease (COPD) and osteoporosis (OP) and its influencing factors among residents aged 40 years and older in Zhangjiagang City, Jiangsu Province, so as to provide insights into prevention of comorbid COPD and OP. @*Methods@#Permanent residents aged 40 years and older were sampled using a multi-stage stratified cluster random sampling method in Zhangjiagang City in 2019, and their pulmonary functions and bone mineral density were measured. The prevalence of comorbid COPD with OP was estimated. The demographic features, smoking, diet, exercises and physical examinations were collected, and factors affecting the prevalence of comorbid COPD with OP were identified using a logistic regression model.@*Results@#Totally 3 140 subjects were enrolled, including 1 315 men (41.88%) and 1 825 women (58.12%), and a mean age of (62.89±9.13) years. A total of 137 subjects were detected with comorbid COPD and OP, with prevalence of 4.36%. The patients with COPD alone included 19 cases with mild, 133 cases with moderate, 87 cases with severe and 26 cases with very severe COPD, and the patients with comorbid COPD and OP included 10 cases with mild, 56 cases with moderate, 56 cases with severe and 15 cases with very severe COPD. The grade of pulmonary functions was higher in patients with comorbid COPD and OP than in patients with COPD alone (Z=-12.304, P<0.001). Multivariable logistic regression analysis identified ages of 65 years and older (OR=2.703, 95%CI: 1.862-3.923), women (OR=2.897, 95%CI: 1.915-4.384) and physical labor (OR=1.540, 95%CI: 1.083-2.189) as factors affecting the development of comorbid COPD and OP.@*Conclusion@#The prevalence of comorbid COPD and OP was 4.36% among residents at ages of 40 years and older in Zhangjiagang City, and moderate and severe degree was the predominant grade of pulmonary functions. The elderly, women and physical labors are at a high risk of developing comorbid COPD and OP.

Factors influencing peak bone mass gain / 医学前沿

Bone mass is a key determinant of osteoporosis and fragility fractures. Epidemiologic studies have shown that a 10% increase in peak bone mass (PBM) at the population level reduces the risk of fracture later in life by 50%. Low PBM is possibly due to the bone loss caused by various conditions or processes that occur during adolescence and young adulthood. Race, gender, and family history (genetics) are responsible for the majority of PBM, but other factors, such as physical activity, calcium and vitamin D intake, weight, smoking and alcohol consumption, socioeconomic status, age at menarche, and other secondary causes (diseases and medications), play important roles in PBM gain during childhood and adolescence. Hence, the optimization of lifestyle factors that affect PBM and bone strength is an important strategy to maximize PBM among adolescents and young people, and thus to reduce the low bone mass or osteoporosis risk in later life. This review aims to summarize the available evidence for the common but important factors that influence bone mass gain during growth and development and discuss the advances of developing high PBM.

Analysis of the cost structure of inpatients in a hospital in Tianjin based on DRGs / 中华医院管理杂志

Objective To analyze the impact of the comprehensive reform of public hospitals in Tianjin on the cost structure of inpatients at a tertiary general hospital.Methods Homepage data of the medical records from January 2015 to June 2018 were selected from a tertiary general hospital in Tianjin.The Beijing version of diagnosis related groupings(BJ-DRGs) was used to compare the expense structure of these inpatients before and after such a reform.Wilcoxon signed rank sum test,Z test and Pearson correlation analysis were performed for each index.Results Since the reform,the number of hospital discharges and that of DRGs had remained basically stable,while the case mixed index(CMI) weight increased slightly(from 1.0065 to 1.0386);the total hospitalization expenses,medical expenses,nursing expenses,management expenses and consumables expenses had increased.On the other hand,the expenses of medication and medical technology decreased,and the differences of these expenses were statistically significant (P ＜0.05).The time consumption index (0.87) and drug consumption index (0.80) were always lower than average,but the cost consumption index (1.38) remains above average with a slight rise.Conclusions The reform of public hospitals in Tianjin has encouraged such hospitals to improve their service procedures by adjusting such measures as pricing of medical services,and promoted their proactive management of hospitals.Hence the initial goal of "controlling costs,adjusting structure,and reducing costs" has been met.However,cost rise control still deserves major attention.

Insights into the genetic determinants of osteoporosis and related traits from genome-wide studies / 中华内分泌代谢杂志

Osteoporosis, which is characterized by reduced bone mineral density (BMD) and an increased risk of fragility fractures, is the result of a complex interaction between environmental factors and genetic variants that confer susceptibility. Fracture and other complications caused by osteoporosis have serious impact on the life quality and life span of patients. Although previous linkage and candidate gene studies have provided few replicated loci for osteoporosis, genome-wide approaches and next generation sequencing have produced clear and reproducible findings. To date, 25 genome-wide studies for osteoporosis and related traits have been conducted, identifying 76 genes and loci. In this review, we will update the genetic study of osteoporosis and provide some perspective views.

The expression of cancer-related gene gankyrin in pancreatic cancer / 中华胰腺病杂志

Objective To investigate the clinical significance of tumor related gene gankyrin expression in pancreatic cancer.Methods The immunohistochemical staining was performed to study the gankyrin expression in 62 pairs of pancreatic cancer and matched non-tumor tissues.The correlations ofgankyrin expression with pathological parameters and the influences on the prognosis were analyzed.Results Ggankyrin positivity in pancreatic cancer and matched non tumor tissue was 2.5％ (45/62)and 19.4％ (12/62),respectively.The positivity of gankyrin was significantly higher in pancreatic cancer compared with matched non-tumor tissues,and the differences were statistical significant (P ＜ 0.01).Gankyrin expression in pancreatic cancer tissues were significantly correlated with TNM stage,differentiation and metastasis (P ＜ 0.05),but not with age,gender or tumor location (P ＞ 0.05).The 3-year survival rates of patients with positive and negative gankyrin expression were 17.8 ％ (8/45)and 41.2％ (7/17),respectively.Patients with positive gankyrin expression had a significantly shorter survival period compared with these with negative expression in pancreatic cancer tissues (P =0.034).Conclusions Gankyrin was overexpressed in pancreatic cancer,which was correlated with poor prognosis.

Pathologic diagnosis and differential diagnosis of bizarre parosteal osteochondromatous proliferation / 肿瘤研究与临床

Objective To study the clinicopathological features and differential diagnosis of bizarre parosteal osteochondromatous proliferation (BPOP). Methods The clinicopathological features of 3 patients with BPOP were analyzed , and related literature was reviewed. Results 3 patients included 2 males and 1 female with an average age 40 years old (24-53 years old). The lesions in three patients were located in the left side of the distal radius, the left side of the little finger inside and the right side of ulna coracoid, respectively. Histologically, characterized by unusual mineralized cartilaginous matrix (`blue bone'), the lesion was composed of a heterogeneous mixture of bone, cartilage and fibrous tissue. Conclusion BPOP is a rare benign surface osteocartilaginous lesion, and its diagnosis and differential diagnosis mainly depend on radiographic and histopathologic features.

Association between serum Fractalkine and obesity and type 2 diabetic mellitus / 中国糖尿病杂志

Objective To investigate the association between serum chemotactic factor fractalkine (FKN) level and obesity and type 2 diabetic mellitus (T2DM).Methods According to BMI,88 cases of healthy persons with normal glucose tolerance (NGT) were divided into normal weight group (A group,n =44,BMI＜ 24 kg/m2) and obesity group (B group,n =44,BMI≥ 24 kg/m2);88 cases of newly diagnosed T2DM patients (T2DM group) were divided into the normal weight group (C group,n=44,BMI＜24 kg/m2) and obesity group (D group,n=44,BMI≥24 kg/m2).FKN and TNF-α levels were measured by ELISA.Results Serum FKN in T2DM group (0.625± 0.090) ng/ml was higher than that in NGT group (0.395±0.110) ng/ml (P＜0.01).The levels of FKN in C group (0.55±0.08) ng/ml were higher than that of A group (0.34±0.14) ng/ml and B group (0.45±0.08) ng/ml P＜0.01).Serum FKN was positively correlated with and the levels of FPG,HbA1 c,WHR,BMI,C reactive protein (C-RP),HOMA-IR and TNF-α (r=0.578,0.592,0.616,0.596,0.909,0.872 and 0.827,P＜0.01) in T2DM group.FKN was negatively correlated with HDL-C (r =-0.216,P ＜ 0.05).Multivariate regression analysis showed that C-RP,BMI and TNF-α were independent factors related to FKN (β=0.441,0.158 and 0.221,P＜0.05).Conclusion Serum FKN is closely related to inflammation response in T2DM patients.FKN may play an important role in the pathogenesis and development of T2DM and obesity.

Correlation analysis between FXR gene polymorphisms and susceptibility to T2DM / 医学研究生学报

Objective The pathogenesis of T2DM has not been elucidated.This study aimed to explore the association of FXR gene polymorphisms with the risk of T2DM in Eastern China population. Methods We collected 467 cases in the Health Examination Center of our hospital from January 2011 to December 2012.Ligase detection reaction was performed to test the genotypes in 240 T2DM patients and 227 controls.Unconditioned logistic regression analysis was used to explore the association of FXR gene polymorphisms with the risk of T2DM in different genetic models, after adjusting for age, sex, smoking and drinking status. Results Compared with AA genotype, GG significantly increased the risk of T2DM (P=0.017), while GA+GG approached marginal significance in association with T2DM (P=0.049) in rs1030454.For rs10860598, GA reduced the incidence of T2DM (P=0.025) compared with AA genotype, while GA+GG had marginal significance with T2DM (P=0.049).For rs11110411, CT or CT+CC could reduce the risk of T2DM compared with TT with P value of 0.016 and 0.024 respectively.Compared with AA, GA or GA+GG in rs17030270 was negative with the risk of T2DM with P value of 0.018 and 0.032 respectively. Conclusion FXR gene polymorphisms are associated with the risk of T2DM in northern Chinese Han population and the variation of FXR gene may play a role in the pathogenesis of T2DM.

132 cases of gerontol delirium:a clinical study / 医学研究生学报

Objective To investigate clinical features , outcomes and prognosis gerontol delirium . Methods Patients with gerontol delirium diagnosed between January 2011 and January 2013 were identified by a retrospective review of records in the Nanjing General Hospital of Nanjing Military Command .Totally 132 patients were included , 59 females and 73 males, with a median age of 71.4 years (range 65-97).The diagnostic criteria were based on the DSM-Ⅳ and Delirium Rating Scale.Dementia, depression, mental retardation and other cognitive dysfunction were excluded .General condition of patients , etiology , clinical features , treatment and prognosis were all performed using the SPSS 20.0 for windows.A P value of <0.05 was considered as significant . Results Disturbance of consciousness were observed in all 132 patients.Old age, coma and serious infection in the course , endotracheal intuba-tion and(or) tracheotomy, a variety of basic diseases all come up with poor prognosis . Conclusion Delirium progresses quickly. Etiological treatment can help to control the conditions of delirium .

Relationship between obesity and related indicators with insulin resistance among the residents over 50-year-old in Wuxi area / 中华内分泌代谢杂志

To analyze the relationship between obesity with related measurable indicators and insulin resistance among the residents over 50-year-old in Wuxi area.The questionnaire survey,physical examination,and relevant biochemical measurements as well as gender,age,height,body w eight,waist circumference,and hip circumference were obtained.The prevalence of obesity was 11.95％ of which 57.24％ were with central obesity,and the prevalence in male was higher than that in female(P＜0.05).With inereasing body mass index (BMI) and waist circumference(WC),the prevalence of insulin resistance increased gradually (P ＜ 0.05).Meanwhile,With the increasing HOMA-IR,the prevalence of obesity and central obesity also gradually increased (P＜0.05).BMI,WC,and waist-to-hip ratio can effectively predict insulin resistance.The cut-off point of waist circumference was 87.5 cm for male,and 84 cm for female.At the same level of body mass index,metabolic measurements in central obesity group were higher than those of non-central obesity group with the same body mass index,especially in normal weight group.The related metabolic measurements of metabolic obesity but normal weight group were mostly higher than metabolically healthy but obese group,and there were statistically significant differences in fasting blood glucose,fasting insulin,HOMA-IR and HOMA-β.Obesity,especially central obesity,is closely related to insulin resistance among residents over 50-year-old in Wuxi area.Meanwhile,waist circumference may effectively predict insulin resistance and may serve as a parameter in the occurrence of metabolic syndrome and cardiovascular diseases.

Tear film functions of diabetes mellitus with pterygium / 中国医师进修杂志

ObjectiveTo study tear film functions of diabetes mellitus with pterygium before and after surgery.MethodsNinety patients with single side pterygium were divided into 3 groups with 30 cases each:simple pterygium (treatment group A ),pterygium combination with type 1 diabetes mellitus (treatment group B) and pterygium combination with type 2 diabetes mellitus(treatment group C).Ninety patients without pterygium were divided into 3 groups with 30 cases each:normal (control group A),type 1 diabetes mellitus (control group B) and type 2 diabetes mellitus (control group C ).Tear film functions were compared in each group before surgery,while tear film functions in treatment group B and C were compared between before and after surgery.ResultsBefore surgery,there was no significant difference among each group in lacrimal secretion test.Every group's tear film break-up time(BUT) was abnormal except control group A.Cornea fluorescein staining (CFS) score in treatment group B compared with control group B,and treatment group C compared with control group C were significant differences [ (9.08 ± 0.48 ) scores vs.(3.43 ± 0.51 )scores and (10.31 ±0.94) scores vs. (7.91 ±0.51 ) scores,P＜0.05].There was significant difference in mucus fern test(MFT) between treatment group B and control group B (P＜0.05).Tear clearance rate (TCR) were all abnormal except control group A.Before surgery compared with after surgery between treatment group B and treatment group C,there was no significant difference in lacrimal secretion test (P＞0.05 ),but there were significant differences in BUT,CFS score and MFT,the TCR were normal.Conclusion Diabetes mellitus with pterygium will aggravate damage in tear film functions,and these damaged functions could be recovered through pterygium surgery with conjunctival limbal autograft.

Clinical features of bacterial liver abscess in diabetic patients / 中华内分泌代谢杂志

This retrospective analysis showed that the most frequent pathogen causing bacterial liver abscess was Klebsiella pneumoniae in 138 patients.Compared with the patients without diabetes mellitus,it was found that:( 1 ) the percentage of diabetic patients having typical abdominal pain was lower ( P ＜ 0.05 ) ; ( 2 ) neutrophilic granulocytosis was more marked,but albumin and hemoglobin levels were lower in diabetic patients( P＜0.05 ) ; ( 3 )more diabetic patients were complicated with urinary tract infection and suffered from septicemia( P＜0.05 ) ; (4) the clinical course of treatment in diabetic patients was much more prolonged( P＜0.05 ).

Determination of 22 Kinds of Free Amino Acid in Urine of Hypertensive Patient by Pre-column Derivatization HPLC with Fluorescence Detection / 中国药房

0.990 0) with an average recovery ranged from 86.1% to 109.0%.The injection RSD were within 0.84%～3.1%(n=6).CONCLUSIONS:The method is successfully applied for simultaneous determination of 22 kinds of free amino acids.

Diagnosis of nutcracker syndrome with color Doppler flow imaging / 医学研究生学报

Objective: To investigate the diagnose nutcracker syndrome with color Doppler flow imaging.Methods:Doppler sonographic findings in 47 children with orthostatic proteinuria or idiopathic hematuria and in 23 healthy control subjects were compared.The peak velocity,anteroposterior diameter and anteroposterior diameter ratio(hilar segment/aortomesenteric segment) were measured in the left renal vein.Results: The anteroposterior diameter ratio of the 2 segments were 4.13?2.34 in the patient group and 2.16?0.56 in the control.The anteroposterior diameter and the peak velocity in the aortomesenteric segment were(0.16?0.07)cm/s and(83.3?37.2)cm/s in the patient group and(0.24?0.09)cm/s and(43.1?10.8)cm/s in the control,with significant difference in between(P

Hypertension management in acute ischaemic stroke / 医学研究生学报

The blood pressure changes is very common in patients with acute ischaemic stroke.However,the optimal management of the blood pressure in acute ischaemic stroke remains unclear.There is a very important clinical significance on how to manage hypertension in acute ischaemic stroke.The review summarizes recent guidelines on blood pressure management after acute ischaemic stroke.The aim of the review is to expound the treated principle of hypertension in acute ischaemic stroke.