Association of interaction between urinary glucose excretion and body mass index on serum uric acid in type 2 diabetes mellitus / 中华内分泌代谢杂志

Objective:To investigate the relationship between urinary glucose excretion, body mass index, and serum uric acid in type 2 diabetes mellitus, and to evaluate the association of interaction between uric glucose and body mass index on the risk of hyperuricemia.Methods:A total of 867 hospitalized patients with type 2 diabetes mellitus were included in this study. The height, weight, blood pressure and other general conditions were measured. 24-hour urine glucose quantification, glycolipid metabolism, and serum uric acid were collected. Multivariate linear regression analysis and multivariate logistic regression analysis were performed to determine the association of body mass index and urinary glucose with hyperuricemia.Results:After adjusting for age, sex, course of disease, blood pressure, HbA 1C, insulin, homeostasis model assessment for insulin resistance, fasting plasma glucose, 2 h postprandial blood glucose, total cholesterol, triglyceride, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, creatinine, and glomerular filtration rate, body mass index was positively associated with serum uric acid( β=4.281, 95% CI 2.645-5.917, P<0.001), and 24-hour urine glucose was negatively associated with serum uric acid( β=-0.435, 95% CI -0.708--0.162, P=0.002). Body mass index is an independent risk factor of hyperuricemia( P<0.01). There was a significant interaction between urine glucose and body mass index(interaction P<0.05). In the low urine glucose group, obese patients displayed odds ratio of 2.203 for hyperuricemia compared with non-obese patients, whereas the odds ratio was not significant in the high urine glucose group.The associations between body mass index and hyperuricemia were stronger in participants with low urine glucose than in those with high urine glucose. Conclusion:Urinary glucose excretion can weaken the positive correlation between body mass index and serum uric acid, suggesting that promoting urinary glucose excretion may be an effective strategy to control serum uric acid levels in type 2 diabetes mellitus, especially in obese patients.

Hemoglobin and all-cause mortality in China elderly population with varying degree of body mass index: Analysis of CLHLS data / 中华内分泌代谢杂志

To explore the association between hemoglobin and all-cause mortality in China elderly population varying level of body mass index. The data were from Chinese Longitudinal Healthy Longevity Survey 2008 to 2018. A total of 1 449 elderly participants were included with 247 lost to follow-up. According to the hemoglobin levels, the participants were divided into three groups: low hemoglobin group (male<120 g/L, female<110 g/L), normal hemoglobin group (120 g/L≤male<160 g/L, 110 g/L≤female<150 g/L), and high hemoglobin group (male≥160 g/L, female≥150 g/L). According to the BMI levels, the data was divided into three groups: overweight or obesity(BMI≥25 kg/m 2), normal weight(18.5 kg/m 2≤BMI<25 kg/m 2), and malnutrition (BMI<18.5 kg/m 2). Differences of association between hemoglobin and mortality were analyzed. In this dataset, the constituent ratio of anemia was 23.1%(334/1 449), and malnutrition was 26.6%(385/1 449). During the follow-up, a total of 778 participants died. Among whom, 233 cases(77.2%) were in the low hemoglobin group and 87 cases (55.4%) in the high hemoglobin group. In the BMI subgroup analysis, the people combined malnutrition and anemia had the highest cumulative mortality rate (79.1%), and the people with overweight and higher hemoglobin had a lower cumulative mortality rate (46.2%). In people with low BMI, increase in hemoglobin by one category reduced the risk of death by 0.572 (95% CI 0.446-0.734, P<0.001). In people with normal BMI, improvement in hemoglobin by one category reduced the risk of death by 0.717(95% CI 0.620-0.829, P<0.001). The reduction of hemoglobin levels increases the risk of all-cause mortality rate. And this correlation is particularly prominent in the population with low BMI.

Total ankle arthroscopy for osteogenic posterior ankle impingement syndrome complicated with flexor hallucis longus tenosynovitis / 中华创伤骨科杂志

Objective:To investigate the efficacy of total ankle arthroscopy for resection of the talus os trigonum and debridement of the synovium of flexor hallucis longus (FHL) in the treatment of osteogenic posterior ankle impingement syndrome (PAIS) complicated with flexor hallucis longus tenosynovitis (FHLT).Methods:The 14 patients with osteogenic PAIS and FHLT were retrospectively analyzed who had been treated at Department of Hand-Foot-Ankle Microsurgery, Xuzhou Central Hospital from July 2017 to July 2019. They were 8 men and 6 women, aged from 29 to 53 years (mean, 42.4 years). The talus os trigonum and the giant posterolateral process of the talus were resected under total ankle arthroscopy in the prone position of the posterior ankle while the FHL was released and cleared. The efficacy was evaluated by comparing the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Maryland functional score, and pain visual analog scale (VAS) between preoperation and one year postoperation.Results:All patients were followed up for 12 to 24 months (average, 15 months). For all patients, their plantar flexion and dorsal extension were improved significantly from preoperative 19.2°±4.0° and 14.2°±2.7° to postoperative 42.9°±2.7° and 24.5°±3.2°, their AOFAS score increased significantly from preoperative 42.1±4.2 to 91.6±2.7 at one year postoperation, their Maryland score increased significantly from preoperative 43.9±4.1 to 91.9±3.5 at one year postoperation, and their VAS score decreased significantly from preoperative 6 (6, 7) to 0 (0, 0) at one year postoperation (all P<0.05). Conclusion:In the treatment of osteogenic PAIS complicated with FHLT, total ankle arthroscopy for resection of the talus os trigonum and release of FHL can lead to fine efficacy and limited surgical invasion, resolving the FHL pathological inflammation and PAIS at the same time.

Digestive system related symptoms in patients with Parkinson's disease and influencing factors / 中华神经科杂志

Objective To observe the digestive system related symptoms in patients with early-middle stage Parkinson's disease (PD) and healthy subjects,and investigate the incidence of the symptoms and the influencing factors.Methods One hundred and eight PD patients with early and middle stage (Hoehn-Yahr staging 1-3) were admitted to Xuzhou Central Hospital and followed up for a long time.A questionnaire,including seven items of digestive system related symptoms selected from the PD Non-Motor Symptom Scale and the Scale for Outcomes in PD for Autonomic Symptoms (taste abnormalities,swallowing disorders,salivation,easy or early satiety,constipation,loose stools,fecal incontinence),and additional five items of digestive system related symptoms (loss of appetite,dry mouth,oral pain,nausea,vomiting),totally 12 items,was used in a survey on PD patients.Seventy-six healthy subjects in the physical examination center of the hospital served as control group,and conducted the same questionnaire survey.Results There was no statistically significant difference in age,gender,height,weight,body mass index (BMI) between the PD and control groups.In 108 PD patients,dry mouth accounted for 64 cases (59.26％),constipation 53 cases (49.07％) and taste abnormalities 40 cases (37.04％),followed by loss of appetite 35 cases (32.41％) and early satiety 26 cases (24.07％),swallowing disorders 20 cases (18.52％),nausea 11 cases (10.19％),salivation 10 cases (9.26％),oral pain seven cases (6.48％),vomiting four cases (3.70％),loose stools one case (0.87％).In 76 controls,taste abnormalities accounted for 13 cases (17.11％),early satiety six cases (7.89％),loss of appetite six cases (7.89％),nausea five cases (6.58％),salivation three cases (3.95％),oral pain one case (1.32％),and the rest zero.The incidence of constipation (x2=52.390,P＜0.01),dry mouth (x2=69.050,P＜0.01),early satiety (x2=8.128,P=0.004),loss of appetite (x2=16.010,P＜0.01),taste abnormalities (x2=8.642,P=0.003) and swallowing disorders (x2=15.790,P＜0.01) showed statistically significant difference between the two groups.Analysis of the influencing factors showed that male had an effect on constipation (95％CI 1.371-7.495,OR=3.205),early satiety (95％CI 4.227-282.913,OR=34.582),taste abnormalities (95％CI 6.620-88.942,OR=24.260) and swallowing disorders (95％CI 2.784-88.475,OR=22.906),while other factors such as age,body mass index,disease duration and motor symptom types had no effect on the occurrence of digestive system related symptoms.Conclusions Digestive system related symptoms in patients with PD include dry mouth,constipation,taste abnormalities,loss of appetite,early satiety,and swallowing disorders,which may be their unique symptoms.Male is a risk factor for taste abnormalities,swallowing disorders,early satiety and constipation.

Study on correlation between serum γ-glutamyltransferase and hypertension / 重庆医学

Objective To investigate the correlation between serum γ-glutamyltransferase(γ-GGT) and hypertension onset.Methods A total of 1 487 subjects without hypertension undergoing physical examination in the hospital during 2016 were selected as the study subjects and equally divided into 2 groups according to γ-GGT level.The hypertension onset situation in 2011 was observed after 5-year follow up.The levels of serum γ-GGT,AST,triacylglycerol,total cholesterol,high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),fasting blood glucose and anthropometry indexes were measured in the study subjects.Results The 5-year follow up found that the incidence rate of hypertension in the high γ-GGT group was higher than that in the lowγ-GGT group,the difference was statistically significant(P＜0.05).After correcting various metabolic indexes of sex and base line,the γ-GGT change value had a correlation with the hypertension incidence rate[RR =1.012,95 ％ CI(1.004,1.019)],after correcting the 5-year change value of sex and various metabolic indexes,RR of γ-GGT change value causing hypertension onset =1.013,95％CI(1.005,1.020),the difference was statistically significant(P＜0.05).Conclusion γ-GGT is closely correlated with prehypertension.

The application of free anterolateral thigh flap with a reporter skin paddle in the reconstruction of circumferential hypopharyngeal defects / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the short-term results and technological improvement of free anterolateral thigh (ALT) flaps in the reconstruction of circumferential hypopharyngeal defects.</p><p><b>METHODS</b>The free ALT flap with a reporter skin paddle was used in 22 cases with circumferential hypopharyngeal defects. The short-term results of reconstructive surgeries and key points, advantages and complications of this technique were summarized.</p><p><b>RESULTS</b>The length of circumferential hypopharyngeal defects ranged from 7 to 9 cm. ALT flap with an area of (8-9) cm × (11-18) cm was harvested. A reporter skin island with the skin area of (2.0-3.0) cm × (2.5-4.0) cm was designed. 91% (20/22) of ALT flaps survived. Two cases with flap necrosis underwent second reconstruction with a pedicled pectoralis major flap. All the patients had patent anastomotic lumen. Good postoperative subjective swallowing evaluation was obtained in 59% (13/22) of patients; 41% (9/22) of patients had acceptable swallowing results. Three patients (14%) presented with postoperative pharyngocutaneous fistula. One case recovered spontaneously in short-term and other two cases received the second reconstructive surgery.</p><p><b>CONCLUSIONS</b>The application of free ALT flap with a reporter skin paddle in the reconstruction of circumferential hypopharyngeal defect is technologically easy and reliable, with satisfying swallowing function and limited trauma.</p>

Analysis on the relationship between serum alanine aminotransferase and impaired fasting glucose / 中华内分泌代谢杂志

[Summary] To investigate the correlation of serum alanine aminotransferase (ALT) level with impaired fasting glucose (IFG) and evaluate the modification effects of body mass index in Chinese adults.The study samples were from a community-based health examination survey in Xuzhou,Jiangsu province of China.A total of 32 433 subjects with biomarkers available were included in the present study.Serum ALT,triglyceride,total cholesterol,high density lipoprotein-cholesterol,low density lipoprotein-cholesterol,and glucose levels were measured.IFG was defined as from 6.1 mmol/L to 7.0 mmol/L.Results are expressed as x±s.The correlation between serum ALT and impaired fasting glucose was assessed using logistic correlation.The correlation of serum ALT and IFG in the group of fasting blood glucose was segnificantly (r=0.07,P＜0.01),while the correlation with the normal blood glucose group fasting blood glucose is weak (r=0.001,P＞0.05).After adjusted for age,sex,and body mass index,there was a strong correlation between the fasting blood glucose (r =0.04,P＜0.01) in ALT and IFG group.After further adjustment for serum lipids,blood pressure,this correlation still exists (r =0.03,P＜0.01).Body mass index influences correlation of ALT and IFG.The present data indicate that the serum ALT is related to the risk of IFG in Chinese adults,and body mass index level may affect the relationship.

Relationship between hematocrit and the risk of nonalcoholic fatty liver disease: A follow-up observation for five years / 中华内分泌代谢杂志

Objective To investigate the relationship between hematocrit(HCT) and the risk of nonalcoholic fatty liver disease.Methods A community-based health examination survey in individuals who were randomly selected from residents living in the urban area of Xuzhou was carried out in 2006.2 798 subjects without nonalcoholic fatty liver disease were included in the present study.Subjects were divided into two groups according to HCT level,group A (HCT ≤ 0.49 L/L) and group B (HCT ＞ 0.49 L/L).Serum alanine aminotransferase,aspartate aminotransferase,triglycerides,total cholesterol,high density lipoprotein-cholesterol,low density lipoproteincholesterol,fasting plasma glucose,and imaging examinations were determined.Results The prevalence of nonalcoholic fatty liver disease was higher in group B than that in group A (26.5％ vs 15.9％,P＜0.01),and the difference was statistically significant.Logistic regression showed that the incidence of nonalcoholic fatty liver disease was increased along with elevated levels of HCT.Conclusions HCT is found to be correlated with the prevalence of nonalcoholic fatty liver disease.

Long-term Effect of Submandibular Salivary Gland Transfer on Radiation-Induced Xerostomia in Patients with Nasopharyngeal Carcinoma / 中国肿瘤临床

Objective: To investigate the long-term effect of submandibular salivary gland transfer on xerostomia induced by radiation in patients with nasopharyngeal carcinoma (NPC). Methods: A total of 70 eligible patients with NPC were divided into the test group (36 cases) and the control group (34 cases). In the test group, the submandibular salivary glands were transferred to the submental space before conventional radiotherapy (XRT) and shielded during XRT. Submandibular gland function and salivary fluid before and after radiotherapy, questionnaire of xerostomia at 60 months after XRT, and 5-year survival rate were compared between the two groups. Results: At 5 years after XRT, the trapping and excretion function of submandibular glands were significantly better in the test group (P=0.000 and P=0.000, respectively). The mean weight of saliva after XRT was greater in the test group than in the control group (1.65gvs.0.73g, P=0.000). Incidence of moderate to severe degree of xerostomia was significantly lower in the test group than in the control group (12.9%vs.78.6%, P=0.000). No significant difference was found in 5 year survival rate between the two groups (86.1%vs.82.4%, P＞0.05). Conclusion: Submandibular gland transfer procedure is safe for NPC patients. It can prevent XRT induced xerostomia and improve the quality of life of NPC patients.