Association Between Metabolic Syndrome and Mortality: Prospective Cohort Study.

BACKGROUND: Metabolic syndrome (MetS) is a common metabolic disorder that results from the increasing prevalence of obesity, which has been an increasing concern in recent years. Previous evidence indicated that MetS was associated with mortality; however, different definitions of MetS were used. In 2005, the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III updated the definition of MetS, which has since been widely adopted. Therefore, it is necessary to conduct a novel study among other populations and countries with a larger sample size using the updated definition of MetS and death code to examine the association of MetS with all-cause and cause-specific mortality. OBJECTIVE: We aimed to examine the associations of MetS with all-cause and cause-specific mortality. METHODS: A total of 36,414 adults were included in this study, using data from the National Health and Nutrition Examination Survey (NHANES) III (1988-1994) and the continuous NHANES (1999-2014) in the United States. Death outcomes were ascertained by linkage to National Death Index records through December 31, 2015. MetS was defined by the NCEP ATP III-2005 criterion. Complex survey design factors including sample weights, clustering, and stratification were considered for all analyses with instructions for using NHANES data. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs for mortality from all causes, heart disease, diabetes, and cancer. RESULTS: We observed 8494 deaths during the 16.71 years of follow-up. Compared with those without MetS, individuals with MetS were associated with a significantly elevated multiadjusted HR of 1.24 (95% CI 1.16-1.33), 1.44 (95% CI 1.25-1.66), and 5.15 (95% CI 3.15-8.43) for all cause, heart diseases, and diabetes mellitus, respectively, whereas no significant association was found for cancer mortality (HR 1.17, 95% CI 0.95-1.43). CONCLUSIONS: Our study provides additional evidence that MetS and its components are significantly associated with all-cause, heart disease, and diabetes mortality, but not with cancer mortality. Health care professionals should pay more attention to MetS and its individual component.

Association of polycyclic aromatic hydrocarbons with systemic inflammation and metabolic syndrome and its components.

OBJECTIVE: This study aimed to evaluate the relationship of polycyclic aromatic hydrocarbon (PAH) exposure with metabolic syndrome (MetS) and its components and to explore the potential mechanism. METHODS: Participants from the National Health and Nutrition Examination Survey (NHANES 2001-2016) were included. RESULTS: A total of 6532 adults and 1237 adolescents were included in the present analysis. For adults, the odds ratios (ORs) and 95% CIs for each one-unit increase in the log-transformed level of 1-hydroxynaphthalene (1-OHNa), 2-hydroxynaphthalene (2-OHNa), 3-hydroxyfluorene (3-OHFlu), 2-hydroxyfluorene (2-OHFlu), 1-hydroxyphenanthrene (1-OHPh), 1-hydroxypyrene (1-OHP), 2- and 3-hydroxyphenanthrene (2&3-OHPh), and total urinary PAH metabolites (∑OH-PAHs) with MetS were 1.11 (1.03-1.20), 1.18 (1.07-1.29), 1.10 (1.01-1.12), 1.18 (1.07-1.30), 1.17 (1.03-1.33), 1.09 (1.01-1.22), 1.24 (1.09-1.40), and 1.17 (1.06-1.29), respectively. They were 1.61 (1.21-2.14) for 2-OHNa, 1.27 (1.01-1.60) for 2-OHFlu, 1.53 (1.15-2.03) for 1-OHPh, and 1.61 (1.20-2.15) for ∑OH-PAHs among adolescents. C-reactive protein was not only positively associated with urinary PAH metabolites, but also positively related to MetS, and it mediated 10.23% to 20.21% for urinary PAH metabolites and MetS among adults. CONCLUSIONS: PAH exposure is associated with a higher prevalence of MetS or MetS components among adults and adolescents. Systemic inflammation partly mediated the association among adults.

Association of weight change across adulthood with hearing loss: A retrospective cohort study.

OBJECTIVES: We aimed to investigate the relationship of weight change across adulthood with the risk of hearing loss. METHODS: The data from National Health and Nutrition Examination Surveys. Cox proportional hazards models were applied to explore the association between weight change and risk of hearing loss. Kaplan-Meier method was used to plot the survival curves associated with weight change patterns. RESULTS: Compared with participants who remained at normal weight, those with stable obese participants had increased risks of total hearing loss across adulthood, with hazard ratios of 1.24 (95% confidence intervals 1.11-1.38) from age 25 years to baseline, 1.09 (1.001-1.18) from 10 years before baseline to baseline, and 1.23 (1.10-1.37) from age 25 years to 10 years before baseline. Moving the obese to non-obese weight change pattern from middle to late adulthood was not significantly associated with an increased risk of total hearing loss (1.04, 0.91-1.19) and high-frequency hearing loss (1.02, 0.90-1.17), whereas changing from non-obese to obese body mass index over this period was associated with total hearing loss risk (1.20, 1.11-1.29), and speech- and high-frequency hearing loss (1.21, 1.07-1.36; 1.18, 1.09-1.28). Those moving from the non-obese to obese category between young and middle adulthood had a 16% (1.16, 1.02-1.33) higher risk of speech-frequency hearing loss. CONCLUSIONS: Stable obesity and weight gain across adulthood are both associated with increased risks of hearing loss. Our findings imply that maintaining normal weight across adulthood is of great importance for preventing hearing loss in later life.

Association between triglyceride-glucose index and carotid atherosclerosis detected by ultrasonography.

BACKGROUND: Several previous studies have indicated that the triglyceride-glucose index (TyG) index is associated with carotid atherosclerosis (CA); however, the evidence of the association is limited and inconsistent, which may result from small sample sizes or differences in study populations. Therefore, we examined the relation between the TyG index and CA in a large general population of Chinese middle-aged and elderly population. METHODS: A total of 59,123 middle-aged and elderly participants were enrolled. The TyG index was calculated as ln[fasting triglycerides (mg/dL)×fasting glucose (mg/dL)/2]. Logistic regression models were used to analyze the relationship between the TyG index as continuous variables and quartiles and CA. The relationships between the TyG index and CA according to sex, age groups, blood pressure groups and body mass index groups were also assessed. RESULTS: The multivariate logistic regression analysis showed that the TyG index was significantly associated with the prevalence of CA (OR: 1.48; 95% CI 1.39-1.56), carotid intima-media thickness (CMT) (1.55; 1.45-1.67), plaques (1.38; 1.30-1.47) and stenosis severity (> 50%) (1.33; 1.14-1.56). Compared with the quartile 1, quartile 4 was significantly associated with a higher prevalence of CA (1.59; 1.45-1.75), CMT (1.93; 1.82-2.18), plaques (1.36; 1.22-1.51) and stenosis severity (> 50%) (1.56; 1.20-2.04). Subgroup analyses showed significant associations between the continuous TyG index and the prevalence of CA, CMT, plaques and stenosis severity (> 50%) according to sex, with a higher prevalence of CA, CMT, and plaques among males, while a higher prevalence of stenosis severity in females (> 50%). For participants aged < 60 years old and with hypertension, the relationship between the TyG index and stenosis severity (> 50%) was not observed (1.47; 0.97-2.22 and 1.13; 0.91-1.41). For body mass index (BMI), the association was just observed among overweight participants (1.48; 1.17-1.86). In addition, similar results were also observed when the TyG index was used as a categorical variable. CONCLUSIONS: There is a positive association between the TyG index and CA. The association is higher in males and middle-aged individuals than those in females and elderly individuals. Besides, the relationship is stronger among individuals with normal blood pressure and underweight subjects.

Prevalence and associated factors of depression and anxiety symptoms among college students: a systematic review and meta-analysis.

BACKGROUND: To evaluate the global prevalence of depression and anxiety symptoms among college students and potential associated factors. METHODS: PubMed and Web of Science were searched from their inception to March 28, 2021. Random-effects models were used to calculate the pooled prevalence of depression and anxiety. Subgroup analyses were conducted to explore potential heterogeneity. Egger's and Begg's test were used to assess publication bias. RESULTS: A total of 64 studies with 100,187 individuals were included in the present meta-analysis. The pooled prevalence of depression and anxiety symptoms among college students was 33.6% (95% confidence interval [CI] 29.3%-37.8%) and 39.0% (95% CI, 34.6%-43.4%), respectively. The highest prevalence of depression symptoms was found in Africa region (40.1%, 95% CI 12.3-67.9%), lower middle-income countries (42.5%, 95% CI 28.6-56.3%), and medical college students (39.4%, 95% CI 29.3-49.6%). For the prevalence of anxiety symptoms, the highest was observed in North America (48.3%, 95% CI 37.4-59.2%), lower middle-income countries (54.2%, 95% CI 35.0-73.4%), medical college students (47.1%, 95% CI 35.1-59.1%) and identified by Beck Anxiety Inventory (BAI) (49.1%, 95% CI 31.0-43.0%). Besides, the prevalence of depression symptoms (35.9%, 95% CI 20.2-51.7%) and anxiety symptoms (40.7%, 95% CI 39.5-42.0%) was higher in studies conducted after the coronavirus disease 2019 (COVID-19) outbreak. CONCLUSIONS: Our study suggests that a lot of college students experience depression and anxiety symptoms and clarifies factors that are related to these mental disorders. Effective prevention and intervention strategies for mental disorders should be developed among college students.

Association of polycyclic aromatic hydrocarbons exposure, systemic inflammation with hearing loss among adults and adolescents.

The association between polycyclic aromatic hydrocarbons (PAHs) exposure and hearing loss is rarely assessed. We aimed to evaluate the relationship of polycyclic aromatic hydrocarbons (PAHs) exposure and hearing loss among US adults and adolescents, and to explore the mediating role of systemic inflammation in the associations. Participants from the National health and Nutrition Examination Surveys (NHANES, 2001-2016) were included. Multiple logistic regression models were used to explore the associations between PAH metabolites and hearing loss. A total of 4200 adults and 1337 adolescents were included in the present analysis. For adults, we found positive association between urinary PAH metabolites and hearing loss, including total, speech-frequency and high-frequency hearing loss. The odds ratios (ORs) and 95% confidence intervals (CIs) for each one-unit increase in the log-transformed level of 3-Hydroxyfluorene (3-OHFlu), 2-Hydroxyfluorene (2-OHFlu) and 2 & 3-Hydroxyphenanthrene (2&3-OHPh) with total hearing loss were 1.17 (1.04-1.31), 1.24 (1.07-1.43), and 1.18 (1.03-1.37), respectively. For adolescents, urinary PAH metabolites were positively associated with total and speech-frequency hearing loss, not with high-frequency. The ORs and 95% CIs for each one-unit increase in the log-transformed level of 3-OHFlu, 2-OHFlu and total urinary PAH metabolites with total hearing loss were 1.34 (1.06-1.68), 1.48 (1.13-1.93), and 1.33 (1.04-1.72), respectively. Each one-unit increase in the log-transformed level 2-OHFlu (ß = 0.112, 95%CI = 0.018-0.206) and 2&3-OHPh (ß = 0.145, 95%CI = 0.037-0.253) were positively associated with C-reactive protein (CRP) among adolescents, but not among adults. No mediating effect for CRP on the association of urinary PAH metabolites with hearing loss was found (all P > 0.05). 3-OHFlu and 2-OHFlu are associated with increased prevalence of hearing loss among adults and adolescents. Systemic inflammation does not mediate the associations. Further studies should be conducted to verify the results.

Associations of depression, sleep disorder with total and cause-specific mortality: A prospective cohort study.

OBJECTIVE: Evidence on the association of depression and sleep disorder with mortality is limited. We aimed to evaluate the relationship of depression and sleep disorder with mortality. METHODS: A total of 25,978 participants from the National health and Nutrition Examination Surveys (NHANES 2005∼2014) were included in the present study. Cox proportional hazards models were used to explore the associations of depression and sleep disorder with total and cause-specific mortality. RESULTS: A total of 1,864 deaths occurred among 25,978 participants during a median follow-up of 5.67 years, including 301 deaths from cardiovascular diseases (CVD) and 415 deaths from cancer. We observed significant positive relationship between depression and total and CVD mortality, the multiple adjusted hazard rations (HRs) and 95% confidence intervals (CIs) were 1.56 (1.31-1.85) and 2.11 (1.36-3.30), respectively. Sleep disorder was only significantly associated with total mortality, and the HR and 95% CI was 1.49 (1.28-1.72). Sleep disorder was associated with total mortality in male (HR=1.64, 95% CI 1.29-2.08), excessive sleep time increased the risk of total mortality in elders (1.31, 1.05-1.63). No joint effect of depression and sleep disorder on total mortality was observed. A dose-response relationship of depression score and sleep time with total mortality was observed. CONCLUSIONS: Depression and sleep disorder are associated with increased risks of total and specific-cause mortality, and differences in sex, age and BMI were observed. More studies should be conducted to examine these relationships and to explore mechanisms.

The Rates and the Determinants of Hypertension According to the 2017 Definition of Hypertension by ACC/AHA and 2014 Evidence-Based Guidelines Among Population Aged ≥40 Years Old.

Background: In November 2017, the American College of Cardiology/American Heart Association (ACC/AHA) updated their definition of hypertension from 140/90 mm Hg to 130/80 mm Hg. Objectives: We sought to assess the situation of hypertension and the impact of applying the new threshold to a geographically and ethnically diverse population. Methods: We analyzed selected data on 237,142 participants aged ≥40 who had blood pressure taken for the 2014 China National Stroke Screening and Prevention Project. Choropleth maps and logistic regression analyses were performed to estimate the prevalence, geographical distribution and risk factors of hypertension using both 2017 ACC/AHA guidelines and 2014 evidence-based guidelines. Results: The present cross-sectional study showed the age- and sex-standardized prevalence of hypertension was 37.08% and 58.52%, respectively, according to 2014 evidence-based guidelines and 2017 ACC/AHA guidelines. The distribution of hypertension and risk factors changed little between guidelines, with data showing a high prevalence of hypertension around Bohai Gulf and in south central coastal areas using either definition. The age- and sex-standardized prevalence of newly labeled as hypertensive was 21.44%. Interestingly, the high prevalence region of newly labeled as hypertensive was found in the north China. Conclusion: The prevalence of hypertension increased significantly on 2017 ACC/AHA guidelines compared to the prevalence when using 2014 evidence-based guidelines, with high prevalence areas of newly labeled as hypertensive now seen mainly in north China. There need to be correspondingly robust efforts to improve health education, health management, and behavioral and lifestyle interventions in the north.

Impaired olfactory neural circuit in patients with SLE at early stages.

OBJECTIVE: To investigate the changes of olfactory function and odor-induced brain activation in patients with systemic lupus erythematosus (SLE) at early stages compared with healthy controls. MATERIALS AND METHODS: Olfactory function and odor-induced brain activation in 12 SLE patients at early stages and 12 age, gender and education matched healthy controls were evaluated using olfactory behavior test and odor-induced task-functional magnetic resonance imaging (task-fMRI). RESULTS: No significant differences in olfactory behavior scores (including olfactory threshold, olfactory identification, and olfactory memory) were found in the patients with SLE at early stages compared with the healthy controls, while significantly decreased odor-induced activations in olfactory-related brain regions were observed in the patients. In the SLE group, the patients with better performance in the olfactory threshold test had significantly lower levels of anti-dsDNA antibody. CONCLUSION: The current study demonstrated that significant alterations in odor-induced brain activations occurred prior to measurable olfactory decline in SLE at early stages, which provided a new method for early diagnosis of olfactory dysfunction in SLE.

Poor vitamin D status and the risk of maternal depression: a dose-response meta-analysis of observational studies.

OBJECTIVE: The association between 25-hydroxyvitamin D (25(OH)D) and maternal depression (MD) is deemed to be inconclusive. The current analysis aimed to quantify the relationship between 25(OH)D serum concentrations, the main indicator of vitamin D nutritional status, and MD. DESIGN: Dose-response meta-analysis. SETTING: A systematic search in PubMed, Embase and Web of Science from inception to June 2019. PARTICIPANTS: Relevant observational studies reporting risk estimates and 95 % CI of random effects for 25(OH)D concentration on MD were identified. RESULTS: Twelve observational studies with thirteen independent reports involving 10 317 pregnant women were included. Compared with the lowest category of 25(OH)D, the pooled OR for the highest category of MD was 0·49 (95 % CI 0·35, 0·63); a high heterogeneity was observed (P = 0·001, I2 = 82·1 %). A non-linear association between 25(OH)D and MD was found (P for non-linearity = 0·001); the dose-response analysis indicated that the lowest pooled OR was at blood 25(OH)D concentrations of 90-110 nmol/l. Subgroup analyses suggested a stronger association between 25(OH)D and MD in summer time (OR 0·25, 95 % CI 0·08, 0·43) than in other seasons (OR 0·68, 95 % CI 0·52, 0·83) (P for interaction = 0·008). A visual inspection of funnel plot and Begg's and Egger's tests did not indicate any evidence of publication bias. CONCLUSIONS: Low circulating 25(OH)D is associated with MD, and our analysis suggests that they influence each other. Further randomised controlled trials would be needed to determine the direction of causation.

Optimal Gestational Weight Gain for Tibetans Based on Prepregnancy Body Mass Index.

We aimed to estimate the optimal gestational weight gain (GWG) in Tibetan women and to evaluate the appropriateness of the Institute of Medicine (IOM) GWG recommendations for Tibetan women. We analyzed data from 1474 Tibetan women from a cross-sectional study conducted in 2019. According to the three different body mass index (BMI) classification criteria (WHO BMI categories, WHO Asian BMI categories, Chinese BMI categories), we estimated the association of GWG with pregnancy outcomes (neonate birthweight and mode of delivery) using a polynomial regression model, and the optimal GWG in each BMI group was calculated. The risk of adverse outcomes showed a U-shaped curve with increasing GWG. The optimal GWG of Tibetan women based on the WHO BMI categories was 17.2 kg (range, 13.3 to 20.9 kg) for underweight, 9.3 kg (5.8 to 12.9 kg) for normal weight, and 5.2 kg (1.3 to 9.1 kg) for overweight. Underweight Tibetan mothers may gain more gestational weight than recommend by the IOM guidelines. However, normal weight Tibetan mothers are likely to benefit from gaining less weight than that recommended by the IOM. The GWG recommendations based on the IOM guidelines might not be appropriate for Tibetan women, and ethnicity-specific recommendations for GWG should be properly addressed.

Prevalence and risk factors for dyslipidemia among adults in rural and urban China: findings from the China National Stroke Screening and prevention project (CNSSPP).

BACKGROUND: Dyslipidemia is a modifiable risk factor for cardiovascular disease (CVD). We investigated the prevalence and associated risk factors of dyslipidemia- raised total cholesterol (TC), raised triglycerides (TG), raised low-density lipoprotein (LDL-C), low high-density lipoprotein (HDL-C), and raised non-high-density lipoprotein (non-HDL-C) in rural and urban China. METHODS: We analyzed data from 136,945 participants aged 40-100 years of the CNSSPP project for 2014. Dyslipidemia was defined by the NCEP-ATP III and the 2016 Chinese guidelines for the management of dyslipidemia in adults. Complete data on demographic, metabolic and lifestyle characteristics were used. Chi-square tests and multivariable logistic regression were used to obtain age- and sex-adjusted prevalence and risk factors for dyslipidemia among participants. RESULTS: A total of 53.1% participants lived in rural areas. The prevalence of dyslipidemia was similar among rural and urban participants (43.2% vs. 43.3%). Regarding the components of dyslipidemia: urban compared with rural participants had a higher prevalence of low HDL-C (20.8% vs. 19.2%), whereas the prevalence of raised LDL-C (7.8% vs. 8.3%), raised TC (10.9% vs.11.8%) and raised non-HDL-C (10.0% vs. 10.9%) were lower in urban residents, (all p < 0.001). Women were more likely to have raised TC than men (adjusted OR [AOR] =1.83, 95% confidence interval [CI]:1.75-1.91), raised LDL-C (AOR = 1.55, 95% CI: 1.47-1.63) and high non-HDL-C (AOR = 1.52 95% CI: 1.45-1.59) (all p < 0.001). Compared with rural, urban participants had higher odds of dyslipidemia: low HDL-C (AOR = 1.04, 95% CI: 1.01-1.07), and raised TG (AOR = 1.06, 95% CI: 1.04-1.09). Hypertension and current drinker were less likely to get low HDL-C with AOR 0.93 (95% CI: 0.90-0.96) and AOR 0.73 (95% CI: 0.70-75), respectively. Overweight, obesity, central obesity and diabetes had higher odds of all dyslipidemias (p < 0.001). CONCLUSIONS: Low HDL-C was higher in urban areas, whereas the remaining dyslipidemia types were more common in rural areas. Dyslipidemia was more common in women in both areas of residence. Overweight, obesity, central obesity and diabetes were associated with dyslipidemias. The need to intensify intervention programs to manage dyslipidemia and risk factors should be prioritized.

Relationship between metabolic syndrome and its components and cardiovascular disease in middle-aged and elderly Chinese population: a national cross-sectional survey.

OBJECTIVES: To assess the relationship between metabolic syndrome (MetS) and its components and cardiovascular disease (CVD) according to different criteria of MetS, as well as whether the estimated association between MetS and CVD was affected by different definitions of MetS among the Chinese population. DESIGN: Population-based, cross-sectional study. SETTING: Data were from a large-scale national stroke screening survey, China National Stroke Screening and Prevention Project. PARTICIPANTS: A nationally representative sample of 109 551 Chinese adults aged ≥40 years in 2014-2015 were included. PRIMARY OUTCOME MEASURES: CVD conditions (stroke, coronary heart disease (CHD) and atrial fibrillation (AF)) diagnosed by clinicians were self-reported. RESULTS: ORs after adjusting for CHD, stroke, AF and CVD in those with MetS using the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criterion were 1.56 (95% CI 1.48 to 1.63), 1.23 (95% CI 1.17 to 1.30), 1.14 (95% CI 1.08 to 1.21) and 1.40 (95% CI 1.35 to 1.45); 1.51 (95% CI 1.44 to 1.58), 1.20 (95% CI 1.14 to 1.26), 1.09 (95% CI 1.04 to 1.15) and 1.34 (95% CI 1.29 to 1.38) with the American Heart Association/National Heart, Lung, and Blood Institute criterion; and 1.41 (95% CI 1.35 to 1.48), 1.24 (95% CI 1.19 to 1.30), 1.12 (95% CI 1.06 to 1.18) and 1.31 (95% CI 1.27 to 1.35) with the International Diabetes Federation criterion, respectively. Elevated blood pressures were all highly related to the prevalence of stroke and AF, and reduced high-density lipoprotein-cholesterol was associated with a higher OR for CHD than other individual components of MetS. CONCLUSIONS: MetS is significantly associated with CVD, and the prevalence of CVD was more evident when MetS was defined according to the NCEP ATP III criterion. Developing effective public health strategies for the prevention, detection and treatment of MetS should be an urgent priority to reduce the burden of CVD in China.

Assessment of hospital length of stay and direct costs of type 2 diabetes in Hubei Province, China.

BACKGROUND: The incidence of type 2 diabetes is increasing, creating a huge burden for China's social healthcare system. This study aimed to evaluate hospital length of stay (LOS) based on admission characteristics and direct costs correlated with various types of complications for type 2 diabetic inpatients in Hubei Province, China. METHODS: A total of 1528 inpatients diagnosed with type 2 diabetes discharged between April 1, 2013, and March 31, 2014, were included in this study. Information regarding patients' admission and hospitalization were obtained from the hospital information system. The relationship between admission characteristics and LOS, distribution of total costs, and types of complications were described and analysed. RESULTS: (1) The mean LOS was 11.65 days (median: 10 days). Multiple linear regression analysis demonstrated that inpatients with New Cooperative Medical Scheme (NCMS), aged 80 and above, had longer LOS than the reference group, and inpatients with chronic or acute + chronic complications had shorter LOS than those without. (2) Mean total costs per patient were US$159.72 ± 130.83 (median: US$135.33), US$240.60 ± 166.58 (median: US$192.09), and US$247.98 ± 166.22 (median: US$200.99) for inpatients with no complications, chronic complications, and acute + chronic complications, respectively. Total and individual costs were significantly less for patients without complications than for those with the two types of complications (p < 0.001). (3) Mean total costs per patient were US$225.40 ± 115.32 (median: US$200.34), US$221.25 ± 177.64 (median: US$170.05), and US$275.18 ± 193.14 (median: US$217.91) for inpatients with microvascular complications, macrovascular complications, and microvascular + macrovascular complications, respectively. Total costs were significantly higher for patients with microvascular + macrovascular complications than for those with other types of chronic complications (p < 0.001). (4) Drugs were the greatest expense for patients, and the least expensive treatment was nursing care. CONCLUSIONS: Medical insurance status, age, and type of complication may help to predict LOS for patients with type 2 diabetes in Hubei Province, China. The total and individual costs for patients with complications were higher than for those without, and hospitalization expenses posed a heavy burden. Efforts should be made to reduce the financial impact on patients by integrating the medical insurance system of urban and rural areas, and by reducing the risk of complications, especially microvascular complications.

Lycium barbarum polysaccharides ameliorates renal injury and inflammatory reaction in alloxan-induced diabetic nephropathy rabbits.

AIMS: This study was aimed to investigate the effect of Lycium barbarum polysaccharides (LBP) on renal function and inflammatory reaction in rabbits with diabetic nephropathy. MAIN METHODS: Diabetes was induced by injecting alloxan (ALX). Japanese male white rabbits were randomly assigned into 5 groups: normal control group, diabetic nephropathy (DN) model group, LBP prevention group, positive control group and LBP treatment group. LBP (10mg/kg) was given to the LBP prevention group after diabetes mellitus (DM) model succeeded for 12weeks and to the LBP treatment group after DN model succeeded for 4weeks. Telmisartan (3.7mg/kg) was given to the positive group after DN model succeeded for 4weeks, and the same volume of balanced saline was given to the normal group and DN group for 12weeks. Urea nitrogen (BUN), creatinine (SCr), and C-reaction protein (CRP) in serum were detected at the end of the 12th week. The expression of MCP-1 mRNA and ICAM-1 mRNA extracted from cortex were detected by RT-PCR. Western blot analysis was carried out to examine NF-κB p65 protein expression. KEY FINDINGS: LBP improves the renal function and alleviates the inflammatory reaction in the kidneys of diabetic rabbits. In addition, the prevention effect of LBP is better than the treatment effect of LBP. SIGNIFICANCE: LBP has obvious protective effect on the diabetic nephropathy rabbits' renal function and postpones the appearance and development of DN. The mechanisms may be related to the reduction the expression of MCP-1mRNA and ICAM-1mRNA by restraining the expression of NF-κB and AngII.

[Determination of ten pesticides of pyrazoles and pyrroles in tea by accelerated solvent extraction coupled with gas chromatography-tandem mass spectrometry].

An effective method was developed and applied to determine the residues of ten pesticides of pyrazoles and pyrroles in tea by accelerated solvent extraction coupled with gas chromatography-tandem mass spectrometry (ASE-GC-MS/MS). The samples were extracted with ethyl acetate-hexane (1:1, v/v) for 5 min at 1.03 x 10(7) Pa and 100 degree C for one cycle. Then, they were purified by Envi-Carb/PSA column, and eluted by ethyl acetate-hexane (1:1, v/v). The analytes were determined by GC-MS/MS and quantified by external standard method. The limits of quantification were 0.003 mg/kg for fenpyroximate, 0.001 mg/kg for fipronil-sulfide, 0.002 mg/kg for fipronil, 0.005 mg/kg for fipronil-sulfone, 0.002 mg/kg for chlorfenapyr, 0.006 mg/kg for flusilazole, 0.001 mg/kg for difenzoquat, 0.001 mg/kg for pyraflufen-ethyl, 0.000 3 mg/kg for tebufenpyrad and 0.005 mg/kg for tolfenpyrad. The results show that the proposed method is sensitive and accurate for the determination of the ten pesticide residues.

[Determination of fungicide anilinopyrimidine residues in food by series solid phase extraction-high performance liquid chromatography-tandem mass spectrometry].

A high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/ MS) method was established for the determination of fungicide anilinopyrimidine residues including pyrimethanil, mepanipyrim, and cyprodinil in foodstuffs with series solid phase extraction (SPE). The food sample was first extracted with ethyl acetate, and then purified by an ENVI-Carb cartridge and a Florisil SPE cartridge. The analytes were determined by HPLC-MS/MS and quantified by external standard method. The mass spectrometric detection was operated with electrospray in positive ionization mode and the fungicide anilinopyrimidines were identified in multiple reaction monitoring (MRM) mode. The linear range of the method was 1 - 20 microg/L, with the correlation coefficient (r2) over 0. 999 0. The transitions of the precursor ions to two selected product ions were involved, in which one group for quantification were m/z 200. 1/107. 1 for pyrimethanil, m/z 224. 0/106. 0 for mepanipyrim and m/z 226. 0/108. 1 for cyprodinil, and the other group for identification were m/z 200. 1/183. 1 for pyrimethanil, m/z 224. 0/131. 1 for mepanipyrim and m/z 226. 0/133. 1 for cyprodinil, respectively. No significant matrix effect was found for spiked samples after the purification. The recoveries of the fungicide anilinopyrimidines spiked in food samples were 73.2% -98.7% at the spiked levels of 0. 1, 0.5, 1.0 microg/kg. The relative standard deviations (RSDs) were less than 10%. The limits of detection (LODs) and limits of quantification (LOQs) were 0. 03 microg/kg and 0.1 microg/kg for the three fungicides, respectively. The results showed that the proposed method is sensitive and accurate for the determination of fungicide anilinopyrimidines in foodstuffs. The method should be applicable for routine analysis of pyrimethanil, mepanipyrim, cyprodinil residues in foodstuffs.

[Determination of fipronil and its metabolites in tea by solid-phase microextraction coupled with gas chromatography and gas chromatography-mass spectrometry].

An effective multi-residue method for the trace analysis of fipronil and four metabolites (fipronil-desulfinyl, fipronil-sulfide, fipronil-sulfone and fipronil-carboxamide) in tea was developed based on solid-phase microextraction coupled with gas chromatography (SPME-GC). The targets were extracted with a fused-silica fiber coated with 85 microm polyacrylate (PA). The extraction was performed in a pH 9 buffer (containing 0.1 mol/L boracic acid, 0.1 mol/L KCI and 0.1 mol/L NaOH) at 60 degrees C and under 2500 r/min for 30 min. With the concentration range of 2-10 microg/kg, the recoveries ranged from 71.2% to 109.3% and the relative standard deviations (RSDs) were lower than 10% (n = 6). The limits of detection (LODs) and limits of quantitation (LOQs) of the studied compounds ranged from 0.3 microg/kg to 1.2 microg/kg and 1.0 microg/kg to 4.0 microg/kg, respectively, with the values well below the residue limits set by Japan, European Union and China. By the proposed method, 1 positive samples of 30 tea samples were found with fipronil and fipronil-sulfone. The identification of the method was done by gas chromatography-mass spectrometry (GC-MS). The method can be applied as a monitoring tool for tea, in the investigation of food to fipronil and its metabolites.