The relationship between diabetic retinopathy and diabetic nephropathy in type 2 diabetes.

Context: Diabetic retinopathy (DR) and diabetic nephropathy (DN), are major microvascular complications of diabetes. DR is an important predictor of DN, but the relationship between the severity of DR and the pathological severity of diabetic glomerulopathy remains unclear. Objective: To investigate the relationship between severity of diabetic retinopathy (DR) and histological changes and clinical indicators of diabetic nephropathy (DN) in patients with type 2 diabetes mellitus (T2DM). Methods: Patients with T2DM (n=272) who underwent a renal biopsy were eligible. Severity of DR was classified as non-diabetic retinopathy, non-proliferative retinopathy, and proliferative retinopathy (PDR). Relationship between DN and DR and the diagnostic efficacy of DR for DN were explored. Results: DN had a higher prevalence of DR (86.4%) and DR was more severe. The sensitivity and specificity of DR in DN were 86.4% and 78.8%, while PDR was 26.4% and 98.5%, respectively. In DN patients, the severity of glomerular lesions (p=0.001) and prevalence of KW nodules (p<0.001) significantly increased with increasing severity of DR. The presence of KW nodules, lower hemoglobin levels, and younger age were independent risk factors associated with more severe DR in patients with DN. Conclusion: DR was a good predictor of DN. In DN patients, the severity of DR was associated with glomerular injury, and presence of KW nodules, lower hemoglobin levels and younger age were independent risk factors associated with more severe DR. Trial registration: ClinicalTrails.gov, NCT03865914.

Robust reverse-electrowetting based energy harvesting on slippery surface.

Reversed-electrowetting based droplet electricity generator (REWOD-DEG) shows merits in high power densities, tunable output formats, and wide adaptability to diverse mechanical energies. However, the surface charge trapping and dielectric failure, which are also common challenges for electrowetting system, hinders the development of reliable REWOD-DEGs for long-term running. We innovatively introduce a slippery lubricant-infused porous surface (SLIPS) into REWOD-DEG. Benefits from the significant inhibitory effect for surface charge trapping and ambient contamination, self-healing characteristic given by SLIPS, and robust reversed-electrowetting based energy harvesting were achieved. The SLIPS enhanced REWOD-DEG experienced 100 days of intermittent energy harvesting without deterioration. In addition, the device shows robust performances when exposed to a variety of extreme working conditions, like low temperature, pH, humidity, fouling, and even scratching. This work may address the core application challenges of REWOD based devices, and inspire the development of other robust droplet-based electricity generators.

Evaluation of Renal Impairment in Patients with Diabetic Kidney Disease by Integrated Chinese and Western Medicine.

OBJECTIVE: To investigate the factors related to renal impairment in patients with diabetic kidney disease (DKD) from the perspective of integrated Chinese and Western medicine. METHODS: Totally 492 patients with DKD in 8 Chinese hospitals from October 2017 to July 2019 were included. According to Kidney Disease Improving Global Outcomes (KDIGO) staging guidelines, patients were divided into a chronic kidney disease (CKD) 1-3 group and a CKD 4-5 group. Clinical data were collected, and logistic regression was used to analyze the factors related to different CKD stages in DKD patients. RESULTS: Demographically, male was a factor related to increased CKD staging in patients with DKD (OR=3.100, P=0.002). In clinical characteristics, course of diabetes >60 months (OR=3.562, P=0.010), anemia (OR=4.176, P<0.001), hyperuricemia (OR=3.352, P<0.001), massive albuminuria (OR=4.058, P=0.002), atherosclerosis (OR=2.153, P=0.007) and blood deficiency syndrome (OR=1.945, P=0.020) were factors related to increased CKD staging in patients with DKD. CONCLUSIONS: Male, course of diabetes >60 months, anemia, hyperuricemia, massive proteinuria, atherosclerosis, and blood deficiency syndrome might indicate more severe degree of renal function damage in patients with DKD. (Registration No. NCT03865914).

Investigation into the effect of upstream obstacles and hazardous sources on dispersion in the urban environment with LES model.

The release of hazardous materials originated from industrial/natural accidents or intentional attacks within a compact urban environment can be disastrous. Once released, the hazardous pollutants will be dispersed through the atmosphere instantaneously and threaten human health. This study aims at evaluating the overall effect of upstream obstacles and hazardous sources on the downstream targets through parametric investigations. A complex building morphology composed of obstacle group, target group, one main street canyon and several subsidiary street canyons is proposed. The dimensional parameters along with the sources are set as variables. An orthogonal numerical test with Large Eddy Simulation (LES) model is carried out, indicating that the source conditions play a more important role than the obstacles dimension in pollutants accumulation around targets. The flow and dispersion structures are categorized into five patterns, which are strongly relevant to the dimension parameters. Due to the upstream perturbation, the sidewalls of targets are found to be contaminated more seriously than the obstacles, while both their windward and leeward walls have a lower concentration of pollutants.