A survey on self-management level and physical activity in patients with type 2 diabetes mellitus of Zang and Han nationalities in Tibetan of China / 中国基层医药

Objective:To investigate the level of self-management and daily physical activity in patients with type 2 diabetes mellitus (T2DM) of Zang and Han nationalities in Tibetan, China, and to compare the difference in daily management between T2DM patients of Zang and Han nationalities, to develop reasonable and effective chronic disease management strategies for long-term out-of-hospital management of T2DM patients of Zang nationalities.Methods:A total of 265 T2DM patients with glycosylated hemoglobin (HbA1c) ≥ 7% who were admitted to the Endocrinology Ward of the Hospital of Chengdu Office of People's Government of Tibet Autonomous Region from November 2020 to April 2021 and who were from different regions of Tibet were included in this study according to inclusion and exclusion criteria. The general data of all included patients were collected. Glucose and lipid metabolism-related indicators were determined. The Generalized Diabetes Self-Management Efficacy Scale and International Physical Activity Questionnaires (IPAQ) were used to evaluate patients' levels of self-management and daily physical activity.Results:The hemoglobin level in T2DM patients of Zang nationality was (154.09 ± 24.11) g/L, which was significantly higher than that in T2DM patients of Han nationality ( P < 0.05). The total cholesterol, fasting blood glucose, and low-density lipoprotein in T2DM patients of Zang nationality were (4.63 ± 1.41) mmol/L, (7.94 ± 2.19) mmol/L, and (2.75 ± 1.11) mmol/L, respectively, which significantly higher compared with T2DM patients of Han nationality (all P < 0.05). Compared with T2DM patients of Han nationality, T2DM patients of Zang nationality had lower self-management scores (81.40 ± 15.44) points, diet control scores (17.26 ± 4.97) points, physical exercise scores (11.67 ± 4.42) points, prevention and treatment of high and low blood sugar score (12.21 ± 5.72) points. The differences were statistically significant (all P < 0.05). Moderate-intensity physical activity was a significant difference between T2DM patients of Zang and Han nationalities ( P < 0.05). Conclusion:Compared with T2DM patients of Han nationality, T2DM patients of Zang nationality have lower overall self-management levels, including diet control, physical exercise, prevention and management of high and low blood glucose, and moderate-intensity physical activity. Targeted individualized education should be carried out according to the Tibetan cultural characteristics, to further develop an intervention method and an out-of-hospital management strategy for chronic disease, which are suitable for T2DM patients of Zang nationality.

Prevalence and risk factors of diabetic retinopathy in Tibet / 中国基层医药

Objective:To investigate the prevalence and risk factors of diabetic retinopathy (DR) in patients in Tibet.Methods:A total of 239 patients with DR who received treatment in Department of Endocrinology and Metabolism, Hospital of Chengdu Office of People's Government of Tibet Autonomous Region from December 2017 to December 2018 were included in this study. They were divided into Han nationality and Zang nationality groups according to ethnicity. The condition of DR was evaluated with nonmydriatic ocular fundus photography according to the staging criteria of the severity of retinopathy.Results:The prevalence of DR in Tibet was 18.0％. The prevalence of DR in Tibetan and Han patients with diabetes was 17.5% and 19.2%, respectively. There was no significant difference in the prevalence of DR between Tibetan and Han patients with diabetes ( χ2 = 0.10, P = 0.754). Logistic regression analysis revealed that the risk factors of developing DR in Tibet included diabetes duration ( OR = 1.14, 95% CI: 1.05-1.24, P < 0.05), insulin therapy ( OR = 2.74, 95% CI: 1.09-6.89, P < 0.05), fasting plasma glucose ( OR = 1.37, 95% CI: 1.07-1.75, P < 0.05) and hypertension ( OR = 1.98, 95% CI: 1.02-3.86, P < 0.05). Diabetes duration and fasting plasma glucose are independent risk factors of DR. However, although elevated glycated hemoglobin levels were high in Tibet, they could not be used to predict the risk for developing DR ( OR = 1.01, 95% CI: 0.82-1.25, P > 0.05). Conclusion:Hyperglycemia is an important risk factor of developing DR in Tibet. However, elevated glycated hemoglobin levels cannot be used to predict the risk of developing DR in Tibet. Findings from this study fill the gap in the research on DR prevalence and ethic difference of DR prevalence, providing scientific evidence for prevention and treatment of DR in high-altitude areas.

Vitamin D and neuropsychiatric disease in children / 国际儿科学杂志

Vitamin D refers to a group of biologically active lipid soluble steroid derivatives,which are not only related to calcium-phosphorus homeostasis,but also play an important role in maintaining the normal physiological function of the nervous system.A variety of neuropsychiatric disorders such as autism,attention deficit hyperactivity disorder,schizophrenia,Alzheimer's disease,Parkinson's disease,depression are suggested to be associated with vitamin D deficiency.This review summarizes the recent research progress of vitamin D po tential role in children neuropsychiatric disorders at home and abroad.

Effect of resveratrol on the proliferation of malignant melanoma cell lines in vitro / 中华皮肤科杂志

Objective To investigate the anticancer activities of resveratrol on malignant melanoma cells in vitro and involved mechanisms. Methods A375 human malignant melanoma cells and B16-F1mouse malignant melanoma cells were cultured and treated with various concentrations of resveratrol for different durations. The cell proliferation, apoptosis and cycle of both B16-F1 and A375 cells were detected with MTT assay, Annexin V-F1TC/propidium iodide (PI) double staining flow cytometry and propidium iodide flow cytometry, respectively. Western blot analysis was performed to measure the expression of Bcl-2 and Bax protein in both cells. Results Resveratroi inhibited the proliferation of A375 and B16-F1 cells in a time- and dose- dependent manner. The apoptosis rate of A375 cells was (16.7±2.1 )%, (17.2±1.7)% and (52.3±4.1 )% after treatment with resveratrol of 25 μmol/L for 24 hours, resveratrol of 100 μmol/L for 12 and 72 hours, respectively;, and resveratrol of 100 μmol/L induced the apoptosis of B16-F1 at a rate of ( 18.4±1.6)%, (39.6±3.3 )% and (56.7±4.5 )% at 12, 24 and 72 hours, respectively. Flow cytometry showed that A375 and B16-F1 cells treated with resveratrol were arrested in the G1 phase of cell cycle, and the blocking effect increased in a dose-dependent manner. The percentage of A375 and B16-F1 cells in G1 phase was (40.51±3.97 )% and (41.34±3.12 )%, respectively, after 24-hour treatment with resveratrol of 25 μmol/L,(55.64±4.95)% and (53.93±5.12)%, respectively with resveratrol of 100μmol/L for the same duration.The expression of Bcl-2 protein was decreased in malignant melanoma cells treated with resveratrol,while that of Bax protein increased. Conclusions Resveratrol can effectively inhibit the proliferation of malignant melanoma cells by regulating the cell cycle and inducing cell apoptosis, which seems to be associated with the regulation of Bcl-2 and Bax expressions.

Retroperitoneoscopic ureterolithotomy for upper ureteral calculi / 中国微创外科杂志

Objective To evaluate the clinical signifi ca nce of retroperitoneoscopic ureterolithotomy for upper ureteral calculi. Methods Retroperitoneoscopic ureterolithotomy was carried out in 22 p atients with upper ureteral calculi. The operation was performed in the retroper itoneal space. After the upper ureter and calculi were exposed, a scalpel was ut ilized to cut the ureter longitudinally for the removal of calculi. A double-J t ube was inserted into the ureter routinely and the ureterotomy closure was perfo rmed with sutures. Results A conversion to open surgery was needed in 1 patient because the calculi had moved into the kidney. One patient e xperienced urinary leakage at 500～800 ml/d postoperatively, and received an ope n surgery of double-J tube insertion 3 days later. Of the remaining 20 patients, the procedure was successfully accomplished, with the operation time of 50~240 min (mean, 110 min) and the blood loss of 30~100 ml (mean, 50 ml). The time to t he recovery of intestinal functions was 12~30 h (mean, 18 h).The postoperative h ospital stay was 5~8 days (mean, 6.8 days). Follow-up with B-ultrasonography and intravenous urethrography for 1~12 months in the 20 patients found no residual calculi or ureteral stricture. Hydronephrosis disappeared in 15 patients and mil d hydronephrosis was detected in the rest of 5 patients. Conclusions Retroperitoneoscopic ureterolithotomy is a safe and effective option for upper ureteral calculi. It may be considered as the first-line treatment for re latively large-sized upper ureteral calculi.

Retroperitoneal laparoscopic simple nephrectomy: Reports of 6 cases / 中国微创外科杂志

Objective To discuss the clinical value of retroperitoneal laparoscopic simple nephrectomy. Methods Retroperitoneal laparoscopic simple nephrectomy was performed in 6 patients, including 5 cases of severe hydronephrosis with non-functioning kidney resulted from ureteral calculi and 1 case of renal tuberculosis. The operation was conducted via retroperitoneal approach. After the upper ureter and the renal pedicle were exposed, the renal artery and vein were clipped and severed. The renal pedicle was occluded only with titanium clips before the removal of the kidney. Results All the operations were performed successfully without complications. The operation time was 130~220 min (mean, 150 min) and the intraoperative blood loss, 80~150 ml (mean, 120 ml). The postoperative hospital stay ranged 5~7 days. Follow-ups for 3 months in the 5 patients with ureterolithiasis revealed normal renal functions. The patient with renal tuberculosis was given anti-tuberculosis therapy and followed for 6 months. No recurrence was seen and the patient’s serum creatinine level was 120 ?mol/L, which was slightly higher than the normal. Conclusions Retroperitoneal laparoscopic simple nephrectomy has advantages of minimal invasion, short hospital stay and rapid recovery. The procedure should be regarded as the “golden standard” for simple nephrectomy.

Comparison of enhanced thin CT sections with pathologic findings in pulmonary carcinoma, inflammatory, pseudo-tumor and pulmonary tuberculoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To compare quantitatively the enhanced thin CT section with pathologic findings in pulmonary carcinoma, pulmonary inflammatory pseudotumor (IPT) and pulmonary tuberculoma so as to demonstrate the relation of degree of enhancement and the vascular structure within the lesion with special emphasis on pulmonary carcinoma.</p><p><b>METHODS</b>Enhanced thin CT sections were obtained in 35 cases with nodular or patchy lesions in the peripheral lung field which are difficult to differentiate clinically. There were pulmonary carcinoma 21, inflammatory pseudotumor 7 and tuberculoma 7. The number of small vessels (inner diameter 0.02 approximately 0.1 mm), relatively large vessels (inner diameter > 0.1 mm) and their vascular bed areas were analyzed by computed image analyzing system. The relation between CT average attenuation and the number of vessels or the vascular bed areas were statistically evaluated.</p><p><b>RESULTS</b>1. The differences of average attenuation in carcinoma, inflammatory pseudotumor and tuberculoma were statistically significant (P < 0.05). 2. The differences in number of small vessels, relatively large vessels and vascular bed areas among these three types of lesion were also significant (P < 0.05). 3. A positive correlation was found in the average CT affenuation of lung carcinoma and its number of small vessels and relatively large vessels and 4. A positive correlation was found between the average CT attenuation in these three lesions and the relatively large vessels, total vascular amount and vascular bed areas.</p><p><b>CONCLUSIONS</b>1. The average degree of attenuation, being divided into four degrees, is of practical value in the differentiation of lung carcinoma, inflammatory pseudotumor and tuberculoma. 2. The average CT attenuation of lung carcinoma, inflammatory pseudotumor and tuberculoma is in direct proportion to the number of vessels and vessel bed areas and 3. The characteristic CT enhancement in lung carcinoma reflexes the condition of vessels and blood supply within the tumor.</p>

The Clinical and Radiological Diagnosis of the Straight Back Syndrome / 实用放射学杂志

Objective To improve diagnosis of straight back syndrome.Methods 21 patients with straight back syndrome include 12 male and 9 female,and aged 15～36 years old(mean 21 years old).The standard P-A and left lateral chest film were taken and the A-P diameter and transverse diameter of the chest were measured,and the ratio between the both was calculated.Results The A-P diameter of the chest were 5.3 cm～8.5 cm(mean 6.6 cm)in male and 4.2 cm～8.1 cm(mean 6.2 cm)in female.the ratio between the A-P diameter and transverse diameter of the chest were 0.22～0.37(mean 0.34)in male,and 0.19～0.366(mean 0.31)in female.Conclusion The ratio between the A-P diameter and transverse diameter of the chest ≤0.37 is the diagnostic basis of the straight back syndrome.