Homocysteine and serum uric acid levels in type 2 diabetic retinopathy and their predictive value for disease / 中华眼底病杂志

Objective:To observe the correlation between homocysteine (Hcy) and serum uric acid (SUA) and retinopathy in type 2 diabetes mellitus (T2DM), preliminary study on its predictive value.Methods:A retrospective study. From January 2020 to March 2021, a total of 324 T2DM patients hospitalized in Department of Endocrinology, Cangzhou Central Hospital of Hebei Province were included. Fasting blood glucose (FBG), glycated hemoglobin (HbA1C), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), serum creatinine (Scr), blood urea nitrogen (BUN), Hcy, SUA, peripheral blood endothelial progenitor cells (EPC), circulating endothelial cells (CEC) were counted and homeostasis model assessment for insulin resistance (HOMA-IR) was calculated. According to the absence or presence of diabetic retinopathy (DR), the patients were divided into non DR (NDR) group and DR group with 100 and 214 cases, respectively. Clinical data and laboratory biochemical indexes of the two groups were compared and observed. The logistic regression was used to analyze the independent risk factors for DR in T2DM patients. Smooth curve fitting was used to analyze the curve relationship between Hcy, SUA and DR, and ROC area (AUC) of Hcy, SUA; their combined prediction of DR in T2DM patients was calculated by receiver operating characteristic curve (ROC curve), and the predictive value of Hcy and SUA for DR in T2DM patients was evaluated.Results:Diabetic course ( t=5.380), systolic blood pressure ( t=2.935), hypertension ( χ2=10.248), diabetic nephropathy ( χ2=9.515), diabetic peripheral neuropathy ( χ2=24.501), FBG ( t=3.945), HbA1C ( t=3.336) and TG in DR Group ( t=2.898), LDL-C ( t=3.986), Scr ( t=2.139), SUA ( t=7.138), HOMA-IR ( t=3.237), BUN ( t=3.609), Hcy ( t=2.363) and CEC ( t=19.396) were significantly higher than those in NDR group. The difference was statistically significant ( P<0.05). EPC ( t=9.563) and CPC ( t=7.684) levels were significantly lower than those of NDR group, and the difference was statistically significant ( P<0.05). Logistic regression analysis showed that diabetes course, SBP, hypertension, FBG, HbA1C, LDL-C, SUA, Hcy, EPC, CPC and CEC were all independent risk factors for developing DR in T2DM patients ( P<0.05). The smooth curve fitting analysis showed that Hcy and SUA were positively correlated with the occurrence of DR. After adjusting for confounding factors, when Hcy≥15 μmol/L, the risk of DR Increased by 14% for every 1 μmol/L increase in Hcy [odds ratio ( OR)=0.92, 95% confidence interval ( CI) 0.88-0.98, P<0.05]. When Hcy <15 μmol/L, there was no significant difference ( OR=0.96, 95% CI 0.92-1.08, P>0.05). When SUA≥304 μmol/L, the risk of DR increased by 17%, every 20 μmol/L SUA increased ( OR=0.80, 95% CI 0.68-0.94, P<0.05). When SUA <304 μmol/L, the difference was not statistically significant ( OR=0.83, 95% CI 0.72-0.95, P>0.05). ROC curve analysis results showed that the AUC values of Hcy, SUA and Hcy combined with SUA in predicting the occurrence of DR in T2DM patients were 0.775 (95% CI 0.713-0.837, P<0.001), 0.757 (95% CI 0.680-0.834, P<0.001) and 0.827 (95% CI 0.786-0.868, P<0.001). Hcy combined with SUA showed better predictive efficiency. Conclusions:The abnormal increase of Hcy and SUA levels in T2DM patients are closely related to the occurrence of DR, they are independent risk factors for the occurrence of DR. Hcy combined with SUA has high predictive value for the occurrence of DR.

Formulation Optimization of Nanostructured Lipid Carriers Loaded with Lornoxicam by Central Compos-ite Design-response Surface Method / 中国药房

OBJECTIVE:To optimize the formulation of nanostructured lipid carriers loaded with lornoxicam (LN-NLC). METHODS:Emulsification-solvent evaporation method was used to prepare the LN-NLC. Using drug-lipid ratio,dosage of soy lec-ithin,liquid-lipid ratio (proportion of liquid lipid to total lipid) and dosage of emulsifier as factors,the overall normalized value was calculated by particle size,Zeta potential and entrapment efficiency as indexes was used as comprehensive index. Central com-posite design-response surface method was used to optimize the formulation and investigate the appearance and stability of prepared LN-NLC. RESULTS:The optimal formulation were as follows as drug-lipid ratio of 1:50,dosage of soy lecithin of 162.5 mg,liq-uid-lipid ratio of 25% and emulsifier dosage of 958.2 mg. The particle size of prepared LN-NLC was(96.9±3.3)nm,Zeta poten-tial was(-16.1±0.3)mV,entrapment efficiency was(60.1±0.9)%(n=3),which showed relative error of 2.47%,-4.55%,-0.17%with predicted value,respectively. The prepared LN-NLC was spherical. It had no obvious changes in particle size and Ze-ta potential in sealed storage for 30 d in 4 ℃,and the entrapment efficiency only declined 1.2%. CONCLUSIONS:The LN-NLC formulation is successfully optimized,and the LN-NLC has good stability.

Chemical constituents from Vigna umbellate / 中成药

AIM To study the chemical constituents from Vigna umbellata Ohwi et Ohashi.METHODS The ethyl acetate fraction of 80％ ethanol extract from V.umbellata was isolated and purified by silica,Sephadex LH-20 and ODS column,then the structures of obtained compounds were identified by spectral data and physicochemical properties.RESULTS Twelve compounds were isolated and elucidated as (+) catechin (1),(-) epicatechin (2),3-furanmethanol-β-D-glucopyranoside (3),myricetin-3-O-β-D-glucopyranoside (4),quercetin7-O-β-D-glucopyranoside (5),(+) catechin-3-O-β-D-glucopyranoside (6),(+) catechin-5-O-β-D-glucopyranoside (7),quercetin-3 '-O-α-L-rhamnoside (8),(±) dihydroquercetin (9),quercetin (10),ethyl gallate (11),propanediol (12).CONCLUSION All the compounds are isolated from V.umbellata for the first time,and compounds 4,8,9,11,12 are first obtained from genus Vigna.

Association of plasma dys-acyl ghrelin with different stages of chronic kidney disease / 实用医学杂志

Objectives To assess the plasma levels of acyl ghrelin (AG) and dys-acyl ghrelin (DG) in chronic kidney disease (CKD) and hemodialysis (HD) patients and analyze their relationships with different stages of CKD and hemodialysis. Methods Forty-six CKD stage 1-5 patients and 15 hemodialysis patients were enrolled into the study. Body weight, height, hemoglobin, biochemical parameters, inflammatory parameters, preprandial, postprandial and 3 hours after hemodialysis plasma AG and DG levels were measured. Appetite and food intake were assessed. Body mass index (BMI), and estimated glomerular filtration rate (eGFR) were calculated. Results There were no significant differences in BMI, SGA, appetite, food intake and malnutrition among CKD patients of different stages. eGFR was declining with the progression of CKD stages and patients received a three-week hemodi-alysis. Compared with that in CKD stage 1-2 patients, the level of preprandial and postprandial DG was remarkably increased in stage 3-5 patients (P 0.05);levels of DG decreased slightly postprandially and were markedly decreased by hemodialysis (P<0.01), even lower than those seen postprandially in CKD stage 1-2;Both preprandial and postprandial DG were negatively correlated with serum albumin levels (r=-0.64, P < 0.05; r=-0.59, P < 0.05), while there was no correlation between AG and serum albumin levels. Conclusions There is a strong and independent correlation of DG with CKD stage. Postprandial suppression of ghrelin is impaired with reduced renal function. Hemodialysis removes DG but not AG.

Treatment experience of critical children with tracheobronchial foreign body / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the rescue and treatment of critical children with tracheobronchial foreign body. METHODS From June 2011 to June 2015,there were 2489 children with tracheobronchial foreign bodies treated in Children's Hospital of HeBei Province, among which 11critical children who were rescued as soon as they came to the hospital. The clinical data of the 11critical children were analyzed. RESULTS All the 11 critical cases endured dyspnea of third degree or more severe and presented severe hypoxia, in which 2 children had been performed tracheal intubation before they came to the hospital and 1 child even showed the symptom of respiratory and cardiac arrest. Among these critical cases, the foreign body was removed directly without anesthesia in 1 child. The other 2 children with severe pneumothorax, mediastinal emphysema and subcutaneous emphysema in neck and chest area were treated by excision and drainage of emphysema firstly, and then the foreign bodies were extracted through bronchoscope after general anesthesia. The another 8 children were performed operations of extraction of bronchial foreign body and then the foreign bodies were taken out. All the 11 critical children were rescued successfully and no death cases happened. CONCLUSION Rapid diagnosis and rapid removal of foreign bodies is the key to save the lives of critical children with tracheobronchial foreign bodies.

Formulation Optimization of Nanostructured Lipid Carriers Loaded with Lornoxicam by Central Compos-ite Design-response Surface Method / 中国药房

OBJECTIVE:To optimize the formulation of nanostructured lipid carriers loaded with lornoxicam (LN-NLC). METHODS:Emulsification-solvent evaporation method was used to prepare the LN-NLC. Using drug-lipid ratio,dosage of soy lec-ithin,liquid-lipid ratio (proportion of liquid lipid to total lipid) and dosage of emulsifier as factors,the overall normalized value was calculated by particle size,Zeta potential and entrapment efficiency as indexes was used as comprehensive index. Central com-posite design-response surface method was used to optimize the formulation and investigate the appearance and stability of prepared LN-NLC. RESULTS:The optimal formulation were as follows as drug-lipid ratio of 1:50,dosage of soy lecithin of 162.5 mg,liq-uid-lipid ratio of 25% and emulsifier dosage of 958.2 mg. The particle size of prepared LN-NLC was(96.9±3.3)nm,Zeta poten-tial was(-16.1±0.3)mV,entrapment efficiency was(60.1±0.9)%(n=3),which showed relative error of 2.47%,-4.55%,-0.17%with predicted value,respectively. The prepared LN-NLC was spherical. It had no obvious changes in particle size and Ze-ta potential in sealed storage for 30 d in 4 ℃,and the entrapment efficiency only declined 1.2%. CONCLUSIONS:The LN-NLC formulation is successfully optimized,and the LN-NLC has good stability.

Value of BOLD-fMRI in the protection of visual function during postoperative intensity-modulated radiotherapy for cerebral gliomas / 中华放射肿瘤学杂志

Objective To investigate the clinical value of blood oxygenation level-dependent functional magnetic resonance imaging(BOLD-fMRI)in the protection of visual function during postoperative radiotherapy for occipital lobe gliomas. Methods Twenty-eight patients with occipital lobe gliomas receiving postoperative radiotherapy from 2014 to 2016 were enrolled as subjects. All patients underwent computed tomography(CT) simulation,conventional MRI,and BOLD-fMRI before radiotherapy. The location and scope of the visual cortex on 3DT1anatomical images were used to guide the labeling of the visual cortex on simulated CT images. A visual cortex protective radiotherapy plan and a conventional radiotherapy plan were made by intensity-modulated radiotherapy. The feasibility of the visual cortex protective radiotherapy plan was evaluated using conformity index(CI),homogeneity index(HI),Dmax,and Dmeanfor planning target volume(PTV)and Dmaxand Dmean to the visual cortex. Results For the two plans, if the effective dose to target volume was guaranteed and the doses to conventional organs at risk were acceptable, there were no significant differences in CI or HI for PTV between them(P=0.874,P=0.602).Compared with the conventional radiotherapy plan,the Dmaxand Dmeanto the ipsilateral visual cortex were reduced by 8.40% and 9.25%, respectively, while the Dmaxand Dmeanto the contralateral visual cortex were reduced by 13.26% and 14.77%, respectively, in the protective radiotherapy plan. Conclusions With a guaranteed prescribed dose to target volume and BOLD-fMRI used as a guide, the visual cortex protective radiotherapy, compared with the conventional plan, can reduce the dose to the visual cortex and protect the corresponding functional areas.

Evaluation of a portable sleep device in patients with obstructive sleep apnea hypopnea syndrome / 中国耳鼻咽喉头颈外科

[ABSTRACT]OBJECTIVETo evaluate the accuracy of the watch peripheral arterial tone (Watch-PAT) in the diagnosis of obstructive sleep apnea hypopnea syndrome (OSAHS).METHODSA total of 51 outpatients who had chief complaint of sleep snoring were carried out Watch-PAT test and polysomnography (PSG) simultaneously, and the results were statistically compared.RESULTSFifty one patients, consisted of 44 males and 7 females, had the mean age of (45.7±12.0) years (±s) and the mean body mass index of (28.8±3.6) kg/m2.The mean PSG apnea hypopnea index (AHI) was (45.69±12.02) events per hour, and mean Watch-PAT AHI was (35.49±24.49) events per hour. Significant correlation has been detected between Watch-PAT AHI and PSG AHI (r=0.878,P<0.001). The sensitivity and specificity of Watch-PAT were 97.73% and 85.71%, when PSG-AHI≥5/h events per hour was setting as the threshold value to diagnose OSAHS. The diagnostic efficiency of Watch-PAT has been tested by ROC curve, and the area under the curve approached to 0.997.CONCLUSIONThe Watch-PAT was proved as a portable and reliable device of screening patients who were suspected OSAHS.

The expressions of Galectin-3 andβ-catenin and their correlation studies in endometriosis / 天津医药

Objective To investigate the expressions and mutual relationship of Galectin-3 andβ-catenin in endome?triosis (EM). Methods Immunohistochemistry was used to detect expression levels of Galectin-3 andβ-catenin and their mutual relationship in expression was also examined. Samples were collected from ectopic endometrium of patients with en?dometriosis (ectopic endometrium group, n=34), eutopic endometrium of patients with endometriosis (eutopic endometrium group, n=34) and normal endometrium from people without endometriosis (control group, n=30). Results The expressions of Galectin-3 were seen in 88.2%, 85.3%, 50.0%of cases in ectopic endometrium group, eutopic endometrium group and control group respectively. On the other hand, the expression ofβ-catenin were seen in 55.9%, 52.9%, 26.7%of cases in ecto?pic endometrium group, eutopic endometrium group and control group respectively. In EMs patients, the expression of Galec?tin-3 andβ-catenin were significantly higher in ectopic endometrium and eutopic endometrium than those in normal endome?trium group(P<0.05). Expression of Galectin-3 was positive correlated with expression ofβ-catenin(rs=0.512, 0.428, P<0.01). Conclusion Galectin-3 andβ-catenin may play important roles synergistically in the pathogenesis of endometriosis.

Iodine deficiency up-regulates monocarboxylate transporter 8 expression of mouse thyroid gland / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Iodine deficiency is a major factor affecting thyroid auto-regulation, the quantity of iodine may greatly influence the synthesis of thyroid hormones (THs). It has long been believed that TH enters the cell through passive diffusion. Recent studies have suggested that several transporters could facilitate transportation of TH. The monocarboxylate transporter 8 (MCT8) was identified as a very active and specific TH transporter. The purpose of this study was to investigate whether iodine insufficient affected the expression of MCT8 in the thyroid gland.</p><p><b>METHODS</b>Sixty BALB/c mice were randomly divided into two groups: control group was fed with standard feed (iodine concentration of 300 µg/kg); while low-iodine (LI) group received iodine-insufficient feed (iodine concentration of 20-40 µg/kg). After 3 months, 10 mice of each group were sacrificed. The remaining 20 mice of each group were kept till 6 months. From the LI group, we randomly selected 15 mice and injected triiodothyronine (T3, 100 µg/kg body weight per day) intraperitoneally for 24, 48 or 72 hours (5 mice for each time-point). Then, all the mice were sacrificed. Mouse serum thyroxine (T4), T3, and thyroid-stimulating hormone (TSH) levels were determined by chemiluminescence immunoassay (CIA). The protein content or messenger RNA (mRNA) level of thyroid MCT8 was measured by Western blotting analysis or real time RT-PCR respectively. MCT8 subcellular location in thyroid tissues was probed with immunohistochemistry (IHC) assay.</p><p><b>RESULTS</b>We found that mouse serum T3 and T4 levels decreased and TSH level increased by the end of the third month. Consistent with these findings, there was significant goiter and hypothyroidism in the LI group. Meanwhile, the MCT8 mRNA increased to 1.36-fold of the level in the control group at the 3(rd) month. At 6(th) month, the serum T4 level in LI mice remained at a lower level, and MCT8 mRNA expression continued rising to nearly 1.60-fold compared with the control group. The protein content was also about 3 times higher than that in the control group. IHC results also revealed MCT8 was of higher expression and localized in the cytoplasm of thyroid follicular cells. After providing exogenous T3 to iodine deficient mice, the serum T3 and T4 gradually increased, whereas MCT8 mRNA and protein both started to decrease and returned to the same level as the control group.</p><p><b>CONCLUSION</b>There is a compensatory increase in thyroid MCT8 expression to enhance its capability to transport TH from thyroid to the blood circulation in iodine deficient mice.</p>

Moxifloxacin-based triple therapy for helicobacter pylori eradication in type 2 diabetic patients / 中华全科医师杂志

Alc in trial group were significant better than those in control group ( P < 0. 05 ). The results indicate that type 2 diabetic patients with Hp infection should receive moxifloxacin-based triple therapy as first-line treatment.