Exploring hot topics and evolutionary paths in the Diagnosis-Related Groups (DRGs) field: a comparative study using LDA modeling.

BACKGROUND: This study reviews the research status of Diagnosis-related groups (DRGs) payment system in China and globally by analyzing topical issues in this field and exploring the evolutionary trends of DRGs in different developmental stages. METHODS: Abstracts of relevant literature in the field of DRGs were extracted from the China National Knowledge Infrastructure (CNKI) database and the Web of Science (WoS) core database and used as text data. A probabilistic distribution-based Latent Dirichlet Allocation (LDA) topic model was applied to mine the text topics. Topical issues were determined by topic intensity, and the cosine similarity of the topics in adjacent stages was calculated to analyze the topic evolution trend. RESULTS: A total of 6,758 English articles and 3,321 Chinese articles were included. Foreign research on DRGs focuses on grouping optimization, implementation effects, and influencing factors, whereas research topics in China focus on grouping and payment mechanism establishment, medical cost change evaluation, medical quality control, and performance management reform exploration. CONCLUSIONS: Currently, the field of DRGs in China is developing rapidly and attracting deepening research. However, the implementation depth of research in China remains insufficient compared with the in-depth research conducted abroad.

Association between risk of preterm birth and long-term and short-term exposure to ambient carbon monoxide during pregnancy in chongqing, China: a study from 2016-2020.

BACKGROUND: Preterm birth (PTB) is an important predictor of perinatal morbidity and mortality. Previous researches have reported a correlation between air pollution and an increased risk of preterm birth. However, the specific relationship between short-term and long-term exposure to carbon monoxide (CO) and preterm birth remains less explored. METHODS: A population-based study was conducted among 515,498 pregnant women in Chongqing, China, to assess short-term and long-term effects of CO on preterm and very preterm births. Generalized additive models (GAM) were applied to evaluate short-term effects, and exposure-response correlation curves were plotted after adjusting for confounding factors. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using COX proportional hazard models to estimate the long-term effect. RESULTS: The daily incidence of preterm and very preterm birth was 5.99% and 0.41%, respectively. A positive association between a 100 µg/m³ increase in CO and PTB was observed at lag 0-3 days and 12-21 days, with a maximum relative risk (RR) of 1.021(95%CI: 1.001-1.043). The exposure-response curves (lag 0 day) revealed a rapid increase in PTB due to CO. Regarding long-term exposure, positive associations were found between a 100 µg/m3 CO increase for each trimester(Model 2 for trimester 1: HR = 1.054, 95%CI: 1.048-1.060; Model 2 for trimester 2: HR = 1.066, 95%CI: 1.060-1.073; Model 2 for trimester 3: HR = 1.007, 95%CI: 1.001-1.013; Model 2 for entire pregnancy: HR = 1.080, 95%CI: 1.073-1.088) and higher HRs of very preterm birth. Multiplicative interactions between air pollution and CO on the risk of preterm and very preterm birth were detected (P- interaction<0.05). CONCLUSIONS: Our findings suggest that short-term exposure to low levels of CO may have protective effects against preterm birth, while long-term exposure to low concentrations of CO may reduce the risk of both preterm and very preterm birth. Moreover, our study indicated that very preterm birth is more susceptible to the influence of long-term exposure to CO during pregnancy, with acute CO exposure exhibiting a greater impact on preterm birth. It is imperative for pregnant women to minimize exposure to ambient air pollutants.

Affiliate stigma and caregiver burden in parents of children with epilepsy.

Objective: This study aimed to investigate the current status of affiliated stigma and caregiver burden among parents of children with epilepsy, analyze their correlation, and identify factors influencing affiliated stigma. Methods: A cross-sectional survey was conducted among 194 parents of children with epilepsy who met the inclusion and exclusion criteria in Shenzhen City, Guangdong Province, China. Data were collected through questionnaires, including a demographic information sheet, an affiliated stigma scale, and a caregiver burden scale. Results: The results revealed that parents of children with epilepsy experienced a moderate level of affiliated stigma, with an average score of 54.92 ± 10.44. Similarly, caregiver burden scores fell within the moderate range, with an average score of 44.14 ± 16.02. Factors influencing affiliated stigma scores included the frequency of epileptic seizures in children, the types of anti-epileptic medications taken by children, and the place of residence. The total caregiver burden score and scores in various dimensions (emotional, cognitive, and behavioral) of caregivers for epilepsy patients were positively correlated with the affiliated stigma score. Affiliated stigma was found to independently explain 21.3 % of the variation in caregiver burden. Conclusion: In the future, healthcare professionals should develop targeted interventions for children with epilepsy and their parents to reduce affiliated stigma, decrease caregiver burden, and enhance the caregiving capabilities of parents of children with epilepsy. These measures are essential to improve the overall well-being of both parents and children affected by epilepsy.

Clinical Application of Confocal Laser Endomircoscopy Combined with Cryobiopsy in the Diagnosis of Interstitial Lung Disease.

INTRODUCTION: Confocal laser endomicroscopy (CLE) has the characteristics of high resolution, real-time imaging, and no radiation, which is helpful for the precise and effective implementation of transbronchial cryobiopsy (TBCB). The study aimed to compare the efficacy and safety of TBCB combined with CLE (CLE group) or fluoroscopy (fluoroscopy group) in the diagnosis of interstitial lung disease (ILD). METHODS: From a prospective randomized controlled trial, 80 patients with undiagnosed ILD or ILD requiring biopsy between January 2022 and November 2022 were randomly assigned to CLE group and fluoroscopy group. The rate to reach an etiological diagnosis of ILD, maximum cross-sectional area of specimens, operation time, and complications were compared between the two groups. RESULTS: The rate to reach an etiological diagnosis in the CLE group was significantly higher than that in the fluoroscopy group (95.0% vs. 80.0%, p < 0.05), but there was no difference in the maximum cross-sectional area of the specimens (42.1 ± 10.1 mm2 vs. 41.5 ± 10.3 mm2, p > 0.05). In terms of operation time, the CLE group was significantly shorter than the fluoroscopy group (37.6 ± 10.6 min vs. 54.8 ± 24.9 min, p < 0.05). The bleeding volume in the CLE group was significantly lower than that in the fluoroscopy group (4.9 ± 3.6 mL/case vs. 9.0 ± 9.2 mL/case, p < 0.05). Further analysis showed that the incidence of moderate bleeding was also lower in the CLE group (20.0% vs. 75.0%, p < 0.001). In addition, the incidence of pneumothorax in the CLE group was significantly lower than that in the fluoroscopy group (0 vs. 25.0%, p < 0.001). CONCLUSIONS: Compared with simple fluoroscopy, the combination of CLE significantly improves the rate of etiological diagnosis, shortens the operation time, and reduces complications such as bleeding and pneumothorax.

Straw mulch improves soil carbon and nitrogen cycle by mediating microbial community structure and function in the maize field.

This study was conducted to investigate the capability of the microbial community characteristics and soil variables to promote carbon and nitrogen cycles in maize fields under straw mulch. We covered the surface soil of the maize field with different amounts of wheat straw (0 kg/ha, 2,250 kg/ha, and 4,500 kg/ha) and used 16S rRNA and ITS sequencing, Biology ECO-plate, traditional enzymology, TOC analyzer, and HPLC to measure bacterial and fungal community composition and functions, characteristics of microbial carbon source metabolism, carbon and nitrogen fraction, enzyme activity, and organic acid content in the maize rhizosphere and non-rhizosphere. The results indicated that short-term straw mulch insignificantly affected the alpha diversity of bacterial and fungal communities whereas significantly influenced their beta diversity. The results of functional prediction revealed that straw mulch considerably boosted the relative abundances of bacteria belonging to chemoheterotrophy, aerobic chemoheterotrophy, ureolysis, and nitrogen fixation and inhibited fermentation and nitrate reduction in maize rhizosphere soil. These processes primarily drove the C and N cycles in soil. Straw mulch also improved fungal saprotrophs by raising the proportion of Chaetomiaceae and Chaetosphaeriaceae. The Biology ECO-plate results illustrated that straw mulch weakened the metabolism capacity of microbial labile carbon resources. As a result, the labile C and N fractions were raised under straw mulch. Our results also showed that straw mulch primarily regulated the microbial community structure in rhizosphere soil by significantly decreasing Firmicutes and Ascomycota relative abundance while increasing Basidiomycota. The fungal community structure is more than bacterial for affecting soil microbial biomass carbon, readily oxidizable organic carbon, dissolved organic carbon, available nitrogen, ammonium, and nitrate directly and indirectly through malic acid content and cellulase, protease, and amylase activity. Overall, our findings imply that straw mulch might influence the bacterial and fungal community structures, thereby boosting the production of labile C and N components and accelerating the C and N cycle in maize fields.

Value of needle confocal laser microendoscopy combined with endobronchial ultrasound bronchoscopy in the diagnosis of hilar and mediastinal lymph node lesions.

Endobronchial ultrasound bronchoscopy (EBUS) and needle confocal laser endomicroscopy (nCLE) are techniques for screening benign and malignant lesions of the hilar and mediastinal lymph node (HMLN). This study investigated the diagnostic potential of EBUS, nCLE, and combined EBUS and nCLE in HMLN lesions. We recruited 107 patients with HMLN lesions who were examined by EBUS and nCLE. A pathological examination was performed, and the diagnostic potential of EBUS, nCLE, and combined EBUS-nCLE approach was analyzed according to the results. Among the 107 cases of HMLN lesions, 43 cases were benign and 64 cases were malignant on pathological examination, 41 cases were benign and 66 cases were malignant on EBUS examination; 42 cases were benign and 65 cases were malignant on nCLE examination; 43 cases were benign and 64 cases were malignant on combined EBUS-nCLE examination. The combination approach had 93.8% sensitivity, 90.7% specificity, and 0.922 area under the curve, which was higher than those of EBUS (84.4%, 72.1%, and 0.782, respectively) and nCLE diagnosis (90.6%, 83.7%, and 0.872, respectively). The combination approach had a higher positive predictive value (0.908), negative predictive value (0.881), and positive likelihood ratio (10.09) than that of EBUS (0.813, 0.721, and 3.03, respectively) and nCLE (0.892, 0.857, and 5.56, respectively), whereas, the negative likelihood ratio was lower than that for EBUS (0.22) and nCLE (0.11). No serious complications occurred in patients with HMLN lesions. To summarize, the diagnostic efficacy of nCLE was better than EBUS. The EBUS-nCLE combination is a suitable approach for diagnosing HMLN lesions.

Role of tillage measures in mitigating waterlogging damage in rapeseed.

BACKGROUND: Tillage measures have been effectively adopted for mitigating waterlogging damage in field crops, yet little is known about the role of tillage measures in crop responses to waterlogging. A field experiment was performed to investigate the effect of conventional planting (CK), small ridge planting (SR), big ridge planting (BR) and film side planting (FS) on soil available nutrients and enzymatic activity, chlorophyll contents, leaf nutrients, soluble protein, soluble sugar, nitrate reductase, antioxidant enzyme activity, lipid peroxidation, agronomic traits and yield of rapeseed under waterlogging stress conditions. RESULTS: Tillage measures remarkably improved rapeseed growth and yield parameters under waterlogging stress conditions. Under waterlogging conditions, rapeseed yield was significantly increased by 33.09 and 22.70% in the SR and BR groups, respectively, compared with CK. Correlation analysis showed that NO3--N, NH4+-N, and urease in soils and malonaldehyde (MDA), superoxide dismutase (SOD), and nitrate reductase in roots were the key factors affecting rapeseed yield. The SR and BR groups had significantly increased NO3--N by 180.30 and 139.77%, NH4+-N by 115.78 and 66.59%, urease by 41.27 and 26.45%, SOD by 6.64 and 4.66%, nitrate reductase by 71.67 and 26.67%, and significantly decreased MDA content by 14.81 and 13.35% under waterlogging stress, respectively, compared with CK. In addition, chlorophyll and N content in leaves, soluble sugar and POD in roots, and most agronomic traits were also significantly enhanced in response to SR and BR under waterlogging conditions. CONCLUSION: Overall, SR and BR mitigated the waterlogging damage in rapeseed mainly by reducing the loss of soil available nitrogen, decreasing the MDA content in roots, and promoting urease in soils and SOD and nitrate reductase in roots. Finally, thorough assessment of rapeseed parameters indicated that SR treatment was most effective followed by BR treatment, to alleviate the adverse effects of waterlogging stress.

Influence of nitrogen forms, pH, and water levels on cadmium speciation and characteristics of cadmium uptake by rapeseed.

Rapeseed (Brassica napus L.) is an ideal crop for remediation in cadmium (Cd)-contaminated soil in farmland. The main objective of this study was focused on the combined effects of four nitrogen forms (urea, ammonium nitrogen, nitrate nitrogen, ammonium nitrate fertilizer), four pH levels (5, 6, 7, 8), and three water levels (low water, middle water, high water) on Cd speciation and characteristics of Cd uptake by rapeseed. A pot experiment was conducted at the Xindu Experimental Park in Sichuan Province, China. Experimental results indicated that the interaction effects of pH and nitrogen forms, three factors on Cd speciation (except organic-bound Cd and exchangeable Cd), were significant and the interaction effects of pH and nitrogen forms on Cd uptake by rapeseed also was significant only under the condition of planting rapeseed. The higher the water level was or the lower the pH value was, the better the repair effect rapeseed to Cd was. High water significantly increased the stem Cd content by 11.89% and 29.55% through significantly increasing the content of exchangeable Cd by 23.40% and 52.63%, respectively, compared with middle water and low water as planting rapeseed, and pH 5 significantly increased the stem Cd content, total Cd enrichment coefficients, bio-availability coefficient, and Cd removal rate by 24.45~40.33%, 49.45~76.62%, 60.00~166.67%, and 16.67~26.00%, respectively, through significantly increasing the content of exchangeable Cd by 37.78~113.79%, compared with pH 7 and pH 8 as the significant decreasing of carbonate-bound Cd, bound to Fe-Mn oxide, and content of organic-bound Cd and residual Cd. Ammonium nitrate also significantly increased total Cd enrichment coefficients, bio-availability coefficient, and Cd removal rate by 45.63~138.10%, 21.05~109.09%, and 40.00~77.50%, respectively, compared with other three nitrogen forms as good growth and Cd resistance of rapeseed. Path analysis structural equation modeling revealed that content of exchangeable Cd and residual Cd had significant and direct path coefficients with variances in stem Cd content of rapeseed. Combined with the safety of edible oil, the best management practices for optimal remediation efficiency of rapeseed to Cd-contaminated soil were ammonium nitrate fertilizer, pH = 5, and high water.

Improved HbA1c and reduced glycaemic variability after 1-year intermittent use of flash glucose monitoring.

Flash glucose monitoring (FGM) was introduced in China in 2016, and it might improve HbA1c measurements and reduce glycaemic variability during T1DM therapy. A total of 146 patients were recruited from October 2018 to September 2019 in Liaocheng. The patients were randomly divided into the FGM group or self-monitoring blood glucose (SMBG) group. Both groups wore the FGM device for multiple 2-week periods, beginning with the 1st, 24th, and 48th weeks for gathering data, while blood samples were also collected for HbA1c measurement. Dietary guidance and insulin dose adjustments were provided to the FGM group patients according to their Ambulatory Glucose Profile (AGP) and to the SMBG group patients according to their SMBG measurements taken 3-4 times daily. All of the participants underwent SMBG measurements on the days when not wearing the FGM device. At the final visit, HbA1c, time in range (TIR), duration of hypoglycaemia and the number of diabetic ketoacidosis (DKA) events were taken as the main endpoints. There were no significant difference in the baseline characteristics of the two groups. At 24 weeks, the HbA1c level of the FGM group was 8.16 ± 1.03%, which was much lower than that of the SMBG group (8.68 ± 1.01%) (p = 0.003). The interquartile range (IQR), mean blood glucose (MBG), and the duration of hypoglycaemia in the FGM group also showed significant declines, compared with the SMBG group (p < 0.05), while the TIR increased in the FGM group [(49.39 ± 17.54)% vs (42.44 ± 15.49)%] (p = 0.012). At 48 weeks, the differences were more pronounced (p < 0.01). There were no observed changes in the number of episodes of DKA by the end of the study [(0.25 ± 0.50) vs (0.28 ± 0.51), p = 0.75]. Intermittent use of FGM by T1DM patients can improve their HbA1c and glycaemic control without increasing the hypoglycaemic exposure in insulin-treated individuals with type 1 diabetes in an developing country.

Evaluation on soil fertility quality under biochar combined with nitrogen reduction.

A two-year consecutive field experiment was conducted in purple soil in southwest China, to clarify the effects of biochar (0, 10, 20 and 40 t ha-1, namely, B0, B10, B20 and B40) combined with nitrogen reduction (100%, 80% and 60% of conventional nitrogen application rate, namely, N100, N80 and N60) on soil fertility. The performance of thirty-four indices related to soil chemical, physical and biological properties was evaluated by gray correlation analysis, principal component analysis and cluster analysis to determine the most appropriate mode for soil fertilization, and to identify the main soil environmental factors affecting rapeseed yield under the biochar combined with nitrogen reduction. The results indicated that available phosphorus, geometric mean diameter of water stability, fungi number, and the utilization of sugars, amino acids, polymers and carboxylic acids by microorganisms could be used as the main soil factors affecting rapeseed yield. The highest score of soil quality was observed in N100B10 treatment, followed by N80B10 and N100B20 treatments, which were almost in line with the results of rapeseed yields. Cluster analysis classified 12 treatments into 5 main groups on the basis of the measured parameters, which was mostly consistent with the result of soil quality scores. Considering both economic and environmental benefits, 10 t ha-1 biochar combined with 144 kg ha-1 nitrogen was the best combination to restore crop productivity and soil quality, and to achieve nitrogen decreasing and benefit increasing. This study provided scientific basis for the rational fertilization and scientific management of biochar combined with nitrogen fertilizer in purple soil area of southwest China.

Genome-Wide Identification and Expression Analysis of the ß-Amylase Gene Family in Chenopodium quinoa.

ß-Amylase (BAM) is an important starch hydrolase, playing a role in a variety of plant growth and development processes. In this study, 22 BAM gene family members (GFMs) were identified in quinoa (Chenopodium quinoa), an ancient crop gaining modern consumer acceptance because of its nutritional qualities. The genetic structure, phylogenetic and evolutionary relationships, and expression patterns of CqBAM GFMs in different tissues, were analyzed. Phylogenetic analyses assigned the CqBAMs, AtBAMs, and OsBAMs into four clades. The CqBAM gene family had expanded due to segmental duplication. RNA-seq analysis revealed expression of the duplicated pairs to be similar, with the expression of CqBAM GFM pairs showing a degree of tissue specificity that was confirmed by reverse transcription quantitative PCR (RT-qPCR). Several CqBAM GFMs were also responsive to abiotic stresses in shoots and/or roots. In conclusion, the BAM gene family in quinoa was identified and systematically analyzed using bioinformatics and experimental methods. These results will help to elucidate the evolutionary relationship and biological functions of the BAM gene family in quinoa.

Effects of Biochar Combined with Nitrogen Fertilizer Reduction on Rapeseed Yield and Soil Aggregate Stability in Upland of Purple Soils.

Reduction of soil fertility and production efficiency resulting from excessive application of chemical fertilizers is universal in rapeseed-growing fields. The main objective of our study was to assess the effects of biochar combined with nitrogen fertilizer reduction on soil aggregate stability and rapeseed yield and to identify the relationship between yield and soil aggregate stability. A two-factor field experiment (2017-2019) was conducted with biochar (0 (C0), 10 (C10), 20 (C20) and 40 t·ha-1 (C40)) and nitrogen fertilizer (180 (N100), 144 (N80) and 108 kg N·ha-1 (N60)). Experimental results indicated that under N100 and N80 treatments, C10 significantly increased the macro-aggregates (R0.25), mean weight diameter (MWD) and geometric mean diameter (GMD) of soil water stable aggregate by 14.28%-15.85%, 14.88%-17.08% and 36.26%-42.22%, respectively, compared with C0. Besides, the overall difference of the soil water-stable aggregate content in 2-5 mm size range among nitrogen treatments was significant under the application of C10, which increased by 17.04%-33.04% compared with C0. Total organic carbon (TOC) in R0.25 of soil mechanical-stable aggregates was basically all increased after biochar application, especially in 0.25-1 mm and 1-2 mm aggregates, and had an increasing trend with biochar increase. C10 significantly increased rapeseed yield by 22.08%-45.65% in 2019, compared with C0. However, the reduction of nitrogen fertilizer reduced the two-year average rapeseed yield, which decreased by 11.67%-31.67% compared with N100. The highest yield of rapeseed was obtained by N100C10 in two consecutive years, which had no statistical difference with N80C10. However, the two-year yields of N80C10 were all higher than those of N100C0 with increase rate of 16.11%, and which would reduce 35.43% nitrogen fertilizer in the case of small yield difference, compared with the highest yield (2.67 t·ha-1) calculated by multi-dimensional nonlinear regression models. The regression analysis indicated R0.25, MWD and GMD had the strong positive associations with rapeseed yield, whereas percentage of aggregate destruction (PAD0.25) had a significant negative correlation with rapeseed yield. This study suggests that the application of biochar into upland purple soil could improve soil structure, increase the content of TOC in macro-aggregates under nitrogen fertilizer reduction as well as replace part of nitrogen fertilizer to achieve relatively high rapeseed yield.

Overexpression of DgWRKY4 Enhances Salt Tolerance in Chrysanthemum Seedlings.

High salinity seriously affects the production of chrysanthemum, so improving the salt tolerance of chrysanthemum becomes the focus and purpose of our research. The WRKY transcription factor (TF) family is highly associated with a number of processes of abiotic stress responses. We isolated DgWRKY4 from Dendranthema grandiflorum, and a protein encoded by this new gene contains two highly conserved WRKY domains and two C2H2 zinc-finger motifs. Then, we functionally characterized that DgWRKY4 was induced by salt, and DgWRKY4 overexpression in chrysanthemum resulted in increased tolerance to high salt stress compared to wild-type (WT). Under salt stress, the transgenic chrysanthemum accumulated less malondialdehyde, hydrogen peroxide (H2O2), and superoxide anion ([Formula: see text]) than WT, accompanied by more proline, soluble sugar, and activities of antioxidant enzymes than WT; in addition, a stronger photosynthetic capacity and a series of up-regulated stress-related genes were also found in transgenic chrysanthemum. All results demonstrated that DgWRKY4 is a positive regulatory gene responding to salt stress, via advancing photosynthetic capacity, promoting the operation of reactive oxygen species-scavenging system, maintaining membrane stability, enhancing the osmotic adjustment, and up-regulating transcript levels of stress-related genes. So, DgWRKY4 can serve as a new candidate gene for salt-tolerant plant breeding.

Association of body mass index with bladder cancer risk: a dose-response meta-analysis of prospective cohort studies.

Prospective epidemiologic studies on the association between body mass index (BMI) and bladder cancer yielded inconsistent findings. This study sought to quantitatively summarize the evidence by performing a dose-response meta-analysis on prospective cohort studies. Eligible studies were retrieved via PubMed and Embase databases, and by manual review of the references. Linear and nonlinear trend analyses were conducted to explore the relationships between BMI and bladder cancer risk. Meta-analyses on the categories of overweight and obesity were also conducted. The summary relative risk (SRR) was estimated. Heterogeneity across the studies was explored through subgroup analyses based on gender, age, year of publication, sample size, assessment of BMI, geographic location, physical activity and family history of cancer. A total of 14 prospective cohort studies involving 12,642 cases were included. Result of the dose-response analysis showed a nonlinear positive relationship between BMI and bladder cancer (SRR = 1.03, 95% CI: 1.01-1.06, P-nonlinearity =0.031), suggesting that per 5 kg/m2 increment on BMI corresponded to a 3.1 % increase of bladder cancer risk, especially BMI exceed 30kg/m2.Furthermore, significant positive association was also observed between obesity category and bladder cancer risk (SRR: 1.10, 95%CI: 1.03-1.17). In summary, this dose-response meta-analysis suggests a nonlinear positive association between BMI and bladder cancer risk. Further studies are required to confirm these findings and elucidate the pathogenic mechanisms.

Elevated urinary level of vitamin D-binding protein as a novel biomarker for diabetic nephropathy.

Improving the early prediction and detection of diabetic nephropathy (DN) remains a great challenge in disease management. The aim of this study was to evaluate the early detection power of urinary vitamin D-binding protein (VDBP) for the diagnosis of DN. Urine samples were obtained from 45 healthy volunteers and 105 diabetic patients with normoalbuminuria (DM group), microalbuminuria (DN1 group) and macroalbuminuria (DN2 group) (n=35 per group). The VDBP expression patterns in urine from patients and controls were quantified by western blot analysis. The excretion levels of urinary VDBP were quantified with enzyme-linked immunosorbent assay. The quantification results were obtained by correcting for creatinine expression and showed that urinary VDBP levels were significantly elevated in the patients of the DN1 and DN2 groups compared with those of the DM group and normal controls (1,011.33±325.30 and 1,406.34±239.66 compared with 466.54±213.63 and 125.48±98.27 ng/mg, respectively) (P<0.001). Receiver operating characteristic analysis of urinary VDBP levels for the diagnosis of DN rendered an optimum cut-off value of 552.243 ng/mg corresponding to 92.86% sensitivity and 85.00% specificity, which also showed an area under the ROC curve of 0.966. In conclusion, the findings of the present study suggest that urinary VDBP may be a potential biomarker for the early detection and prevention of DN. Further studies are required to examine the pathogenic mechanisms of elevated VDBP levels and their role in the diagnosis of DN.

Vitamin D intake and type 2 diabetes risk: a meta-analysis of prospective cohort studies.

BACKGROUND: The findings form studies on the relationship between vitamin D and type 2 diabetes were inconsistent. OBJECTIVES: To elucidate the association between vitamin D consumption and type 2 diabetes risk by conducting a meta-analysis. METHODS: We conducted a systematic literature search to identify prospective cohort studies of vitamin D intake and type 2 diabetes risk prior to November 2012. Eligible studies were retrieved via both computer searches and manual review of references. The summary risk estimates were calculated based on the highest versus the lowest categories. RESULTS: Meta-analysis of 4 prospective cohort studies involving 187, 592 participants and 9, 456 incident cases showed an absence of significant association between total vitamin D intake and type 2 diabetes risk. The combined RR was 0.93 (95% CI: 0.85-1.01). The associations were similar for subgroup analyses, a combined RR respectively was 0.94 (95% CI: 0.77-1.08), 0.91 (95% CI: 0.77-1.08), 0.93 (95% CI: 0.84-1.02), and 0.92 (95% CI: 0.84-1.01) for the intake of dietary vitamin D, supplemental vitamin D, total vitamin D in USA and total vitamin D for women only. CONCLUSIONS: Our results support that there was no association between vitamin D intake and type 2 diabetes.

Development and validation of a liquid chromatography-tandem mass spectrometry method for the determination of xanthinol in human plasma and its application in a bioequivalence study of xanthinol nicotinate tablets.

A sensitive, rapid liquid chromatographic-electrospray ionization mass spectrometric method for the determination of xanthinol in human plasma was developed and validated. Xanthinol nicotinate in plasma (0.5 mL) was pretreated with 20% trichloroacetic acid for protein precipitation. The samples were separated using a Lichrospher silica (5 microm, 250 mm x 4.6 mm i.d.). A mobile phase of methanol-water containing 0.1% formic acid (50: 50, v/v) was used isocratically eluting at a flow rate of 1 mL/min. Xanthinol and its internal standard (IS), acyclovir, were measured by electrospray ion source in positive selected reaction monitoring mode. The method demonstrated that good linearity ranged from 10.27 to 1642.8 ng/mL with r=0.9956. The limit of quantification for xanthinol in plasma was 10.27 ng/mL with good accuracy and precision. The mean plasma extraction recovery of xanthinol was in the range of 90.9-100.2%. The intra- and inter-batch variability values were less than 4.8% and 7.9% (relative standard deviation, R.S.D.), respectively. The established method has been successfully applied to a bioequivalence study of two xanthinol nicotinate tablets for 20 healthy volunteers.