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Objective:To assess the goal fulfillment in terms of blood glucose, blood pressure, blood lipid, and the composite indicator of these three in patients with diabetes who received intensified treatment at Peking Union Medical College Hospital and regular follow-up for 12 months, analyze the influencing factors, and explore the comprehensive management model for intensive diabetes treatment outpatient services.Methods:This study was a prospective, observational cohort study. The diabetes patients who received long-term regular follow-up at the intensive diabetes treatment outpatient clinic of Peking Union Medical College Hospital from 2012 to 2023 were selected as the research subjects. They were followed up and clinical data were collected at the 1st, 3rd, 6th, 9th, and 12th months of follow-up. The study assessed the goal fulfillment rates in terms of blood glucose, blood pressure, blood lipid, and the composite indicator of these three, with the goals of glycated hemoglobin (HbA1c)<7%, blood pressure<130/80 mmHg, and low-density lipoprotein cholesterol (LDL-C)<2.6 mmol/L. The study also analyzed the impact of factors, including gender, age, type of diabetes, duration of diabetes, body mass index, comorbidities, complications, and treatment regimens, on the outcomes of comprehensive diabetes management.Results:A total of 232 patients were included in the study, of whom 210 were with type 2 diabetes (90.5%), 13 with type 1 diabetes (5.6%), 5 with latent autoimmune diabetes of the adult (2.2%), 3 with diabetes after total pancreatectomy (1.3%), and 1 with mitochondrial diabetes (0.4%). After 3 months of intensified management, the goal fulfillment rates of blood glucose (67.7% vs. 34.1%, Kappa=0.336, P<0.001), blood pressure (53.4% vs. 37.5%, Kappa=0.159, P=0.001), blood lipid (59.1% vs. 39.2%, Kappa=0.198, P<0.001), and the composite indicator (20.7% vs. 3.0%, Kappa=0.177, P<0.001) were significantly increased. Continued treatment at 6, 9, and 12 months showed stable and sustained increases in the goal fulfillment rates of blood glucose, blood pressure, blood lipid, and the composite indicator. Logistic regression analysis showed that baseline hyperglycemia ( P=0.002), disease duration ≥5 years ( P<0.001), smoking ( P=0.009), alcohol consumption ( P=0.038), presence of diabetic complications ( P=0.001), combination therapy with oral antidiabetic drugs and insulin ( P<0.001), and use of antiplatelet drugs ( P=0.037) were risk factors for uncontrolled HbA1c. Baseline hypertension ( P<0.001), alcohol consumption ( P=0.030), and comorbid dyslipidemia ( P=0.028) were risk factors for uncontrolled blood pressure. Baseline uncontrolled LDL-C ( P=0.020) and non-use of statins ( P<0.001) were risk factors for uncontrolled blood lipid. Conclusions:Among patients with the long-term follow-up at our intensive diabetes treatment clinic, the goal fulfillment rates of blood glucose, blood lipid, blood pressure, and the composite indicator of these three are relatively higher. However, it is still necessary to improve patient compliance as much as possible, emphasize weight management, and persist on the comprehensive diabetes treatment.
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Myeloid sarcoma (MS) is a tumor mass formed by the proliferation of one or more myeloid primitive cells outside the marrow, which is mostly related to acute myeloid leukemia (AML). It is reported that 2.5% to 9.1% of AML patients have MS, and AML with spinal canal MS is very rare. Spinal canal MS often has an acute onset and is difficult to diagnose. It is easy to cause missed diagnosis and misdiagnosis, which will lead to a delay in accurate diagnosis seriously affecting the treatment and quality of life among these patients. The clinical data, diagnosis and treatment process of a case of MS with multiple space occupying lesions in the spinal canal diagnosed and treated by the Department of Hematology of Peking Union Medical College Hospital are reported, in order to provide reference for clinical workers.
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Obstructive sleep apnea （OSA） is a sleep disorder with a slow course and is often accompanied by multiple serious complications， having highly consistent pathogenic characteristics with the latent pathogen. By exploreing its pathogenesis and treatment based on the latent pathogen theory in traditional Chinese medicine， it is believed that congenital healthy qi deficiency is the root， while internal latent phlegm and stasis is the branch， and external pathogenic seven emotions are causing factors. In terms of treatment， it is necessary to target at root deficiency and use nourishing medicinals according to depletion degree of lungs， spleen， and kidneys. When protecting the healthy qi， it is important to prevent the generation and inducing of latent pathogen. Simultaneously， it is also critical to put focus on phlegm stasis by clearing existing latent pathogens with medicinals having the function of dissolving phlegm and dispelling stasis， as well as regulating liver and lung qi. All these are expected to provide new ideas and methods for the treatment of OSA patients in clinical practice.
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Although the issue of hyperuricemia (HUA) and gout in adults has attracted much attention in recent years, our understanding of HUA and gout in children and adolescents is still very limited. HUA is an important metabolic disease in children and adolescents, who are more likely to develop complications such as renal dysfunction than adult patients. Positive family history, growth history and obesity are risk factors for HUA in children and adolescents. The etiology of HUA in children and adolescents is different from that in adults, including secondary factors, genetic diseases and other diseases complicated with hyperuricemia and gout. Similar to the treatment strategies in adults, it is very important to control body weight and reduce the intake of high purine and high fructose diet on the premise of ensuring normal growth and development. If necessary, uric-acid-lowering drugs with favorable safely profiles in children and adolescents should be used with monitoring of renal uric acid excretion.
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Objective To investigate G. Pentaphyllums influence on the activity of glutathione peroxidase (GSH-PX) and catalase (CAT) in the skin of hireless photoaging mice, as well as the content of hydroxyproline (HYP). At the same time, G. Pentaphyllum's effect on the hireless photoaging mice was studied. Methods Healthy KM hireless mice were randomly divided into five groups. A skin photoaging model was established by G. Pentaphyllum administration. The changes of the activity of GSH-PX, CAT and the contents of dermal hydroxyproline in the skin were then measured by biochemical methods in each group of the experiment. Results In the model group, the activity of GSHPX, CAT and the content of HYP of skin were all decreased significantly (P＜0. 05). And there were different degrees of improvements in those of the herb given groups. Conclusion G. Pentaphyllumhas the protective effect on the skin of the photoageing in the hairless mice. The mechanism may be that G. Pentaphyllum could inhibit the oxidative damages of ultraviolet and skin photoaging by increasing the synthesis of collagen in skin.
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With the wide application of percutaneous coronary intervention (PCI) in patients with coronary heart disease (CHD), it is a popularly concerned problem within clinical doctors to promote the patients' early recovery and improve their health related quality of life (HR-QoL).
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Objective To discuss the correlation between hs-CRP and patterns of metabolic syndrome in TCM.Method One hundred patients with metabolic syndrome were classified according to patterns of TCM.The correlation between hs-CRP and patterns of metabolic syndrome in TCM was observed.Result hs-CRP of patients group was superior to that of control group (P
