Impact of polluting fuels for cooking on diabetes mellitus and glucose metabolism in south urban China.

We hypothesized that exposure to polluting fuels for cooking was associated with abnormality of glucose metabolism and diabetes mellitus (DM) in south urban China. 3414 residents were surveyed in 14 urban areas of Guangdong Province in 2018. We recorded polluting fuels for cooking exposure, different DM status (DM, prediabetes), fasting blood glucose (FBG), oral glucose tolerance test (OGTT), glycated hemoglobin (HbA1c ), and other covariates by using a structured questionnaire. We conducted logistic regression model and multivariate linear regression model based on propensity-score method (inverse probability of weighting) to examine the effect of polluting fuels for cooking exposure on DM and glucose metabolism. Exposure to polluting fuels for cooking was associated with DM (odds ratio: 2.57, 95% confidence interval: 1.71 to 3.86) and prediabetes (odds ratio: 1.98, 95% confidence interval: 1.52 to 2.58) in both the adjusted and unadjusted models (all p < 0.05). Exposure to polluting fuels for cooking was significantly associated with an increase of FBG (ß: 0.30 mmol/L, 95% confidence interval: 0.22 to 0.38 mmol/L). Sensitivity analysis showed that the results were not substantially changed. There was an increased risk of DM, prediabetes and high levels of FBG, OGTT, and HbA1c among participants aged ≥ 40 years with exposure to polluting fuels for cooking. We demonstrated that exposure to polluting fuels for cooking was associated with higher levels of FBG, which contributed to the increased risk of DM and prediabetes in middle-aged elderly Chinese population living in urban areas.

[Risk factors for death due to fungal septicemia and prognostic analysis].

OBJECTIVE: To analyze the incidence, clinical features and the predisposing factors of fungal septicemia, and investigate the risk factors for death due to fungal septicemia and the prognosis of the patients. METHODS: We retrospectively analyzed the clinical data of 91 patients with fungal septicemia diagnosed in the last 17 years, including 60 patients with clinical cure or improvement, and 31 who die of the disease. Based on the results by univariate analysis, the data were analyzed using logistic multiple regression and Fisher's discriminant analysis. RESULTS: Fungal septicemia had many predisposing factors with high mortality rate. Univariate analysis revealed significant differences between the cured/improved cases and the fatal cases for 12 variables, including advanced age, complication by bacterial infection, septic shock, multiple organ dysfunction syndrome (MODS), ICU patients, cortical hormone therapy, surgery, chemotherapy, use of immunopotentiating agents, length of hospital stay before antifungal therapy, time of anti-fungus therapy and types of invasive procedures. Logistic multiple regression analysis showed that the types of invasive procedures, MODS, surgery and prolonged hospital stay before antifungal therapy were the independent risk factors for fungal septicemia-related death. Fisher's linear discriminant equation was established for predicting the prognosis of the disease. CONCLUSION: The types of invasive procedure, MODS, surgery and prolonged hospital stay before antifungal therapy are the independent risk factors for fungal septicemia-related death, and the patients' prognosis can be predicted using Fisher's linear discriminant equation.

[Pharmacokinetics of nalmefene after a single or multiple intravenous doses in Chinese healthy volunteers].

OBJECTIVE: To investigate the pharmacokinetics of nalmefene after intravenous administration at a single or multiple doses in Chinese healthy volunteers. METHODS: This open, randomized clinical trial involved 12 healthy volunteers, who received a single-dose (2 mg) nalmefene injection. Before and at different time points after the injection, blood sample were obtained from the subjects. After the single intravenous dose trial, 8 healthy volunteers received intravenous nalmefene at 2 mg once daily for 6 consecutive days, and the plasma drug concentrations were determined on the morning of days 4, 5 and 6 using liquid chromatography/tandem mass spectrometry and the pharmacokinetic parameters were calculated using PKS program. RESULTS: The main pharmacokinetic parameters of nalmefene (Cmax, Tmax, T1/2, AUC0-48, and AUC0-infinity) after the single intravenous dose were 7.34-/+1.56 microg/L, 0.08 h, 12.01-/+2.20 h, 30.29-/+9.84 microg.L(-1).h, and 32.23-/+9.94 microg.L(-1).h, respectively; the parameters after multiple doses were 8.04-/+1.09 microg/L, 0.08 h, 12.43-/+1.44 h, 33.64-/+9.15 microg.L(-1).h and 35.98-/+9.23 microg.L(-1).h, respectively. The steady-state pharmacokinetic parameters including the degree of fluctuation (DF), AUCss and Cav were 4.69-/+1.29, 19.64-/+6.20 microg.L(-1).h and 1.64-/+0.52 microg/L, respectively. CONCLUSION: Nalmefene showed similar pharmacokinetics in Chinese healthy volunteers with those in the foreign testees, and can be safely administered in healthy volunteers without producing unmanageable pain.

[A case-control study of the risk factors for fungal rhinosinusitis].

OBJECTIVE: To investigate the risk factors of fungal rhinosinusitis. METHODS: The preoperative clinical data of 57 patients with a diagnosis of fungal rhinosinusitis confirmed pathologically using Gomori methenamine silver staining were analyzed statistically against the data of 57 age- and gender-matched control patients with chronic rhinosinusitis. RESULTS: Compared with chronic rhinosinusitis, fungal rhinosinusitis was characterized by a significantly shorter mean disease course (37.31 months vs 130.84 months, t = 5.59, P = 0.000). The factors related to fungal rhinosinusitis included nasal mucus, purulent nasal discharge, unilateral/bilateral sinus lesion and calcified plaque in CT scan , with odds ratios of 0.17 (0.04-0.62), 0.35 (0.15-0.80), 41 (12.50-100.00) and 91 (24.01-344.95), respectively. Conditional logistic regression identified calcified plaque in CT scan as the high-risk factor of fungal rhinosinusitis. CONCLUSION: The presence of calcified plaque in CT scan indicates high risk of fungal rhinosinusitis and may serve as an important evidence for diagnosis of this disease.

Clinical prognostic factors of chronic rhinosinusitis after endoscopic sinus surgery.

OBJECTIVE: We aimed to determine the clinical prognostic factors of chronic rhinosinusitis after endoscopic sinus surgery (ESS) in order to better guide the management of patients. METHODS: A total of 254 patients with chronic rhinosinusitis after ESS with a follow-up of 24 months were evaluated retrospectively. Clinical grouping, hyperplasia of the ethmoid bone, anatomic variations, allergy, polyps, previous sinonasal surgery and recurrent polyps were analyzed. RESULTS: The success rates were 64.4 and 91.9% with and without hyperplasia of the ethmoid bone, 87.6 and 86.4% with and without anatomic variations, 67.9 and 92.0% with and without allergy, 81.0 and 94.0% with and without polyps, 72.8 and 93.6% with and without history of surgery and 52.3 and 94.3% with and without recurrent polyps. In logistic multiple regression analysis, allergy (p = 0.0002; estimate, -4.2094), nasal polyps (p = 0.0007; estimate, -3.6393) and history of surgery (p < 0.0001; estimate, -5.0938) were found to reach a statistically significant level. CONCLUSIONS: We propose that allergy, polyps and history of surgery might be significant indicators of poor prognosis after ESS.

[Study on correlated factors and clinical features of fungal rhinosinusitis].

OBJECTIVE: To investigate the correlated factors and clinical features of fungal rhinosinusitis. METHODS: The clinical data of 110 patients with fungal rhinosinusitis treated by surgery and another group of 110 patients with chronic rhinosinusitis who were sampled randomly between January 1999 and June 2004 in our hospital were retrospectively compared. The correlated factors and the clinical features of fungal rhinosinusitis were investigated by using the multiple factor Logistic regression analysis and chi-square test. The pathological types of 110 fungal rhinosinusitis were classified by using Gomori methenamine silver staining which was special for fungi. RESULTS: The logistic regression predictive equation for fungal rhinosinusitis was : y = -8.713 + 0.496x1 + 4.575x2 + 1. 190x3 + 4.119x4 + 1.199x5 + 2. 698x6, P = exp (y)/[1 + exp(y)], in which the concomitant variables were course of the disease (x1), haem-nasal discharge (x2), headache (x3), calcified plaque in CT scan (x4), age (x5) and unilateral/bilateral sinus lesion (x6), respectively. The P value meant the probability of suffering fungal rhinosinusitis. Compared with chronic rhinosinusitis, the clinical features of fungal rhinosinusitis were female, over 40-year-old, course of disease < 3 years, headache, haem-nasal discharge, unilateral sinus lesion and calcified plaque in CT scan. Among the 110 patients with fungal rhinosinusitis, 34 cases were chronic invasive and 76 were non-invasive. CONCLUSIONS: The clinical features of fungal rhinosinusitis are significant for the diagnosis, and it can be predicted by using the suitable logistic predictable equation.