Effect of H2H management mode on blood sugar control and living ability in patients with schizophrenia and type 2 diabetes mellitus.

OBJECTIVE: To explore the effect of H2H management mode on blood sugar control and living ability in patients with schizophrenia and type 2 diabetes mellitus. METHODS: A retrospective analysis was conducted on 95 patients with schizophrenia and type 2 diabetes who were hospitalized in Wuhan Mental Health Center from July 2021 to February 2022. The subjects were grouped according to management mode: 50 cases in group A (H2H management mode) and 45 cases in group B (conventional mode). Psychiatric symptoms were assessed with the Positive and Negative Symptoms Scale (PANSS), and changes in living ability before and after the intervention were assessed by the activity of daily living scale (ADL). Fasting blood glucose (FPG), 2-h postprandial blood glucose (2hPG), and glycosylated hemoglobin (HbA1c) were detected by high-performance liquid chromatography on a blood glucose analyzer. Schizophrenia Quality of Life Scale (SQLS) was used to evaluate changes in life quality, and Pittsburgh Sleep Quality Index (PSQI) and the Simple Roy Coping Adaptation Scale (CAPS-15) were for the sleep quality and coping adaptability of the two groups before and after intervention, respectively. Self-perceived burden scale (SPBS) was used to evaluate the self-perceived burden of the two groups before and after intervention. RESULTS: After intervention, PANSS score of group A was observed markedly lower than that of group B, as well as its ADL score, SQLS score and the levels of 2hPG, FPG and HbA1c (all P < 0.05). Compared to group B, the patients in group A were also assessed with evidently lower SQLS score (P < 0.05) and lower scores of physical burden, emotional burden and economic burden after intervention (all P < 0.05). CONCLUSION: H2H management model can effectively improve the mental state, quality of life, sleep quality and coping adaptability of patients with schizophrenia complicated with type 2 diabetes, as well as reducing patients' blood sugar, which is worthy of clinical promotion.

Wunderlich syndrome secondary to severe acute pancreatitis.

A 35-year-old male was diagnosed with severe acute pancreatitis (SAP). CT showed inflammation changes of the pancreas and peripancreatic tissue, known as pseudocyst formation. The patient subsequently heard a clicking noise in his abdomen, followed by left low back pain and abdominal distension with palpitation and hemodynamic instability. Blood tests showed a high white blood cell count (38.2 x 109/L) and low hemoglobin level (55 g/L). CT revealed a massive subcapsular hematoma of the left kidney that filled the left abdominal cavity.

MiR-155-Mediated Deregulation of GPER1 Plays an Important Role in the Gender Differences Related to Inflammatory Bowel Disease.

AIM: The incidence and clinical manifestations of inflammatory bowel disease (IBD) are thought to have gender differences, which suggests that the estrogen signaling pathway and intestinal flora may play key roles in the pathogenesis of IBD. In IBD, microRNA-155 (miR-155) is upregulated and regulates G protein coupled estrogen receptor (GPER1), which affects the intestinal flora. The objective of this study was to investigate the role of the estrogen receptors and miR-155 in the pathogenesis of IBD. METHODS: From July 2018 to July 2019, in the Department of Gastroenterology at Daping Hospital, Army Military Medical University, a total of 50 patients with IBD were included in this study, and 24 healthy examinees were randomly selected as the control group. Colonoscopies were performed, and clinical characteristics and blood samples were collected from all of the subjects. The serum cytokine levels in the patients with IBD and the health donors were detected by ELISA, and the estrogen receptor level measurements for all of the participants were assessed by immunohistochemistry (IHC) and quantitative real-time PCR (qPCR). The miR-155 levels were detected by qPCR in all of the participants, and miR-155-/- mice were used to investigate the mechanism of miR-155 in the pathogenesis of IBD. RESULTS: The clinical characteristics and medications were different for the IBD patients when gender was considered. The male patients produced more proinflammatory cytokines, and while GPER1 expression was downregulated, miR-155 was upregulated in the patients with IBD. MiR-155 showed proinflammatory activity, while GPER1 showed an anti-inflammatory response during the pathogenesis of IBD. The miR-155-/- mice showed improvements in weight loss, survival, rectal bleeding, colon length, and histopathological changes compared with the wild-type mice. Furthermore, the male miR-155-/- mice showed increased inflammation compared to the female miR-155-/- mice in the above aspects. CONCLUSION: This study presents evidence indicating that miR-155 plays a key role in the pathogenesis of IBD for the different genders. MiR-155 was upregulated and showed proinflammatory activity, whereas GPER1 showed an anti-inflammatory response during the pathogenesis of IBD. The results demonstrated that more proinflammatory cytokines and reduced GPER1 levels were observed in the male IBD patients. Thus, miR-155 was involved in the regulation of GPER1 and induced gender differences in IBD patients. MiR-155 may be a potential marker for IBD-targeted therapy.

Correlation between income and non-alcoholic fatty liver disease in a Chinese population.

OBJECTIVE: The aim of the study was to analyze the correlation between income and non-alcoholic fatty liver disease (NAFLD) in a Chinese population. METHOD: subjects were divided into three groups according to liver fat content (LFC). (1) normal: LFC < 9.15%, 197 cases; (2) low LFC: LFC 9.15-20%, 532 cases; and (3) high LFC: LFC > 20%, 201 cases. Participants' clinical and social background were collected, including a routine fasting test to assess the relevant indices. Intergroup differences were compared on 1-way ANOVA, to analyze the relation between income and each index on Pearson correlation, and independent factors for LFC were identified on binary logistic regression. RESULTS: (1) In retired persons, prevalence of NAFLD was greater in females (81.2%) than males (75%), but fell with age: the highest prevalence was between 40 and 49 years of age (87.5%), and the lowest above 70 years (68%). (2) Income correlated positively with triglyceride and serum uric acid levels and LFC (P < 0.05) and negatively with alanine aminotransferase (P = 0.01). (3) As income increased from level I to V, prevalence of NAFLD increased progressively (P < 0.05). In the study, LFC was taken as the dependent variable, and the traditional NAFLD risk factors and income level (I-V) were taken as independent variables. Income emerged as an independent risk factor for NAFLD. Risk in group V was 1.964-fold higher than in group I. CONCLUSION: Prevalence of NAFLD was closely related to socio-economic level. Demographic risk factors include female gender, age 40-49 years, and monthly income > 5,000 RMB. Thus, if income is increased without improving educational level and health awareness, NAFLD prevalence will rise.

Epidemiological characteristics and risk factors of T2DM in Chinese premenopausal and postmenopausal women.

OBJECTIVE: This study was to analyse the prevalence of type 2 diabetes mellitus (T2DM) in premenopausal and postmenopausal women. METHODS: A total of 3227 women met the requirements from June to December in 2014, including 207 cases of premenopausal women and 3020 cases of postmenopausal women. The prevalence of T2DM and the associated risk factors in the two groups were analysed. RESULTS: The prevalence of premenopausal women with T2DM was 12.1%, while the prevalence in postmenopausal women was 19.4% (P < 0.05). Total serum protein (TP) (OR = 1.164 95% CI = 1.023-1.324) (P = 0.021) is a major risk factor for premenopausal women with T2DM. The prevalence of T2DM increased with the increase in TP. In postmenopausal groups, the prevalence of T2DM was associated with age (OR = 1.037 95% CI = 1.024-1.051) (P < 0.001), BMI (OR = 1.076 95% CI = 1.044-1.109) (P < 0.001), blood pressure (OR = 1.521 95% CI = 1.234-1.875) (P < 0.001), triglycerides (TG) (OR = 1.106 95% CI = 1.027-1.190) (P = 0.008), blood urea nitrogen (BUN) (OR = 1.065 95% CI = 1.004-1.129) (P = 0.036), alanine aminotransferase (ALT) (OR = 1.009 95% CI = 1.003-1.016) (P = 0.004) and TP (OR = 1.031 95% CI = 1.005-1.057) (P = 0.018). CONCLUSIONS: Postmenopausal women have a higher rate of type 2 diabetes than premenopausal women. TP is a major risk factor for premenopausal women with T2DM. TP, ALT, and BUN are postmenopausal risk factors in addition to traditional risk factors such as obesity, lipidaemia and blood pressure. We should monitor risk factors and take early prevention and intervention measures to reduce the prevalence of diabetes and improve the quality of life of postmenopausal women. TRIAL REGISTRATION: ChiCTR, ChiCTR-TRC-14005029. Registered 29 July 2014, http://www.chictr.org.cn/showproj.aspx?proj=4545.

Successful revascularization of noninfarct related artery with chronic total occlusion among acute myocardial infarction patients: A systematic review and meta-analysis.

BACKGROUND: Randomized trials and meta-analyses demonstrated that chronic total occlusion (CTO) in noninfarct related artery (n-IRA) was associated with increased all-cause mortality. Recently, several observational studies suggested that the successful revascularization of n-IRA with CTO decreased all-cause mortality. METHODS: A systematic search was performed in Cochrane Controlled Trials Registry, PubMed, MEDLINE, and EMBASE databases for relevant studies. Article assessing the prognostic role of revascularization of n-IRA with CTO was enrolled in this meta-analysis. Data and characteristics of each study were extracted. A meta-analysis was performed to generate pooled odds ratio (OR) and 95% confidence intervals (95% CIs) for outcomes. The primary outcome was major adverse cardiac events (MACE). Beg funnel plot was used to evaluate publication bias. RESULTS: Four observational studies and one randomized controlled trial involving 1083 patients were enrolled for analysis. Compared with nonreperfusion, the successful percutaneous coronary intervention (PCI) of n-IRA with CTO was related to decreased all-cause mortality (OR was 0.34, and 95% CI was 0.2-0.59; P = .0001). CONCLUSIONS: Successful PCI of n-IRA with CTO could significantly decrease all-cause mortality, cardiac mortality, MACE, and stroke in acute myocardial infarction patients. In addition, it was not associated with the increased risk of repeat revascularization and myocardial infarction.

Relationship of Serum Betatrophin with Nonalcoholic Fatty Liver in a Chinese Population.

OBJECTIVE: This study aimed to investigate the association of serum betatrophin with the status and progression of nonalcoholic fatty liver disease (NAFLD). METHODS: A total of 249 subjects who received ultrasonic examination of liver fat content (LFC) were recruited. Anthropometric and biochemical examinations were performed. Serum betatrophin was measured by ELISA. RESULTS: Compared with control group, serum betatrophin significantly increased in NAFLD group (P < 0.05). There was significant difference in serum betatrophin among control, low liver fat content (LLFC), and high liver fat content (HLFC) groups (P < 0.01). After adjustment for gender, age, BMI, FPG and HbA1c, the betatrophin positively correlated with LFC (r = 0.185, P < 0.01) and TG (r = 0.195, P < 0.01). Stepwise multiple regression analysis indicated serum betatrophin was independently related to LFC (P < 0.05). Multivariate logistic regression analysis revealed subjects in the highest tertile of serum betatrophin had higher odds of having NAFLD after adjustment for traditional NAFLD risk factors (OR = 2.88, 95%CI: 1.15-7.19) (P<0.05). CONCLUSION: Serum betatrophin is an independent risk factor for NAFLD and potential non-invasive marker for its progression. Serum betatrophin may be helpful for the early diagnosis of NAFLD and improvement of its prognosis.

Compound heterozygous mutations (p.T561M and c.2422delT) in the TPO gene associated with congenital hypothyroidism.

BACKGROUND: The objective of the study was to determine the genetic basis of goitrous congenital hypothyroidism (GCH) in Chinese siblings. METHODS: The proband and her younger brother with GCH were enrolled for molecular analysis of the dual oxidase 2 (DUOX2), dual oxidase maturation factor 2 (DUOXA2), and thyroid peroxidase (TPO) genes. Mutation screening was performed by Sanger sequencing the fragments amplified from genomic DNA. The detected mutations were verified among the close relatives of the patients and 105 controls. All participants underwent clinical examination and laboratory tests. RESULTS: Analysis of the TPO gene revealed two heterozygous mutations, the frameshift mutation c.2422delT in the exon14 of the TPO gene, that has been reported previously, and a novel missense mutation c.1682C>T (p.T561M) in the exon10 of the TPO gene. Nine family members of the patients were enrolled for mutation screening. The patients' parents and grandfathers harbored a single heterozygous mutation. The germline mutations from this family were consistent with an autosomal recessive inheritance pattern. No mutations in the DUOXA2 and DUOX2 genes were observed. CONCLUSIONS: The inactivating mutations (c.2422delT and p.T561M) in the TPO gene were identified in the Chinese siblings with GCH. The compound heterozygous mutations can cause GCH.