Objective To evaluate the effects of known-to-have health management on diabetes patients.Methods A total of 585 diabetic patients from Desheng Community of Beijing received an intensive health management for 3 months,including diet intervention,physical exercises,medication,health education and individual health guidance.Body weight (BW),body mass index (BMI),waist circumference (WC),blood pressure (BP),fasting blood glucose (FBG),2-h postprandial blood glucose (PBG),glycated hemoglobin A1C (HbA1 c),total cholesterol (TC),triglycerides (TG),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),total physical exercises,effective physical exercises,effective physical exercise ratio to BW and dietary intake were compared before and after the intervention.Results Of 585 patients with type 2 diabetes mellitus,240 were male and 345 were female (average age (64.4 ± 9.1) years old).BW,BMI,WC,systolic blood pressure,diastolic blood pressure,FBG,2-h PBG,HbA1c,TC,TG,HDL-C,LDL-C,amount and time or frequency of effective physical exercises,effective physical exercise ratio to BW and total dietary intake were significantly improved after intensive health management (t values were 20.35,20.34,23.74,14.06,12.35,13.35,16.50,9.90,7.53,6.37,-3.74,4.91,-7.44,-7.91,-5.60,-8.41 and 5.21,respectively ; all P ＜ 0.05).More healthy eating habits were found in 321 subjects (54.8％).Those having normal FBG were increased from 54.2％ to 80.1％ following known-to-have health management,with 2-h PBG from 60.4％ to 87.8％ and HbA1c from 58.9％ to 77.9％ (x2 values were 88.21,109.31 and 39.97,respectively; all P ＜ 0.05).Conclusion Known-to-have management may provide an effective tool for community diabetics.

To investigate and step in the compliance of clinician hand hygiene, we used vari-ous management tools of the quality control circle (QCC), and then compared the change of the com-pliance before and after any operations. Firstly, we followed this 5 steps: selecting themes, drafting plans, grasping current situations, setting goals and analyzing objectives. Then, we formulated and im-plemented the interventions pertinently. All of the QCC members participated actively in the whole process. The compliance of clinician hand hygiene was improved from 41.11%to 57.59%. The realiza-tion rate was 115.97%, the progress rate was 40.99%, and the hand hygiene compliance of hand hy-giene in different time was significantly improved with the average value 1.25. Standardized result formed by quality control circle activity had a comprehensive promotion in the hospital and promoted the management of hospital infection and the development of hospital.

Objective:To explore the effect of family history of cancer on clinical features and prognostic factors in nasopharyngeal car-cinoma (NPC) patients. Methods:The clinical data of 89 NPC patients with a family history of cancer and 388 NPC patients without a family history of cancer were retrospectively reviewed. Univariate and multivariate survival analyses were performed to identify possi-ble prognostic factors. Results:The clinical characteristics of NPC patients with and without family history of cancer were compared. The gender, age, TNM stage, pathological type, and hemoglobin radiotherapy concentration before treatment did not significantly dif-fer between the two groups (P>0.05). NPC patients with a family history of cancer had better 3-year overall survival than those with-out family history of cancer (91.6%vs. 85.5%), but no statistically significant difference was observed (P=0.211). Both univariate and multivariate analyses showed that T, N, and TNM stages were the important prognosis factors affecting 3-year overall survival (OS), progression free survival (PFS), and distant metastasis-free survival (DMFS) of NPC (P<0.05). However, neither family history of cancer nor family history of NPC in 3-year OS, PFS, LRFS, and DMFS was significant in NPC patients (P>0.05). Conclusion:NPC patients with family history of cancer had better 3-year OS than those without family history of cancer, but no statistically significant observation was found. Large T stage or high lymph node stage contributed to poor survival of NPC. Family history of cancer had no significant in-fluence on the survival of NPC patients.

Objective To observe the changes of serum and fecal taurine-conjugated bile acid levels and its association with glucose metabolism during the spontaneous development of type 2 diabetes in OLETO rats.Methods Twenty male OLETF rats(4 weeks old)were included and 10 male LETO rats of the same age were used as the normal control group.OLETF rats were fed with high fat diet whereas LETO rats were fed with normal diet.Serum and fecal taurine-conjugated bile acid levels of OLETF rats were tested at different stage of diabetes including baseline, normal glucose tolerance, impaired glucose tolerance and diabetes periods, and the association of taurine-conjugated bile acid level with body weight, blood glucose, and glucose-regulating hormones were also investigated.Results Compared with LETO rats, the baseline serum levels of taurine-conjugated bile acid in OLETF rats did not change, but the levels of fecal taurine-conjugated bile acid including taurine-conjugated chenodeoxycholic acid(TCDCA), taurocholic acid(TCA)and taurine-conjugated deoxycholic acid(TDCA)were significantly decreased [(14.25±7.18 vs 0.90±0.31)mg/kg,(7.12±4.14 vs 1.30±0.35)mg/kg,(4.30±1.78 vs 1.02±0.14)mg/kg, all P<0.01].During the development of diabetes, the fecal levels of TCDCA, TCA and TDCA were still lower than those in the control rats.TDCA was negatively associated with the level of fasting blood glucose(r=-0.470, P=0.032),but positively associated with the serum level of glucagon-like peptide(GLP)-l(r=0.406, P=0.044).Conclusion The decrease of intestinal taurine-conjugated bile acid level is involved in the development of diabetes in OLETF rats.Intestinal TDCA may regulate the secretion of GLP-1 by paracrine pathway.

[Summary] A total of 128 individuals with type 2 diabetes underwent continuous glucose monitoring for 3 consecutive days.The dawn phenomenon was defined by three different parameters according to the previous research:(1)the absolute increase of glucose level from nocturnal nadir to prebreakfast value(?G) above 20 mg/dl;(2)?G above 10 mg/dl;( 3 ) insulin requirement increased at least 20%.The participants were secondarily separated by presence/absence of a dawn phenomenon based on the definitions above.The impact on blood glucose fluctuation of different groups was assessed according to the standard deviation of blood glucose( SDBG) , the area under curve above 10 mmol/L ( AUC ) , and the mean amplitude of glycemic excursions ( MAGE ) , etc.The frequencies of dawn phenomenon were 64.8%(?G≥20mg/dl), 85.2%(?G≥10 mg/dl), and 59.4%(rise in insulin requirement≥20%)respectively.The impacts on SDBG, AUC, MAGE, and MODD were without statistical difference(P>0.05) between the presence and absence of the dawn phenomenon patients when?G≥10 mg/dl.However, the differences reached statistical significance(P<0.05) when ?G≥20 mg/dl and the increase in insulin requirement≥20%. Besides, the incidence of dawn phenomenon was positively correlated with HOMA-IR, HbA1C , and free C-peptide.Dawn phenomenon is a very frequent event in type 2 diabetes and not only impacts the overall glycemic control but also exaggerates glucose fluctuation.To be clinically relevant, ?G≥20mg/dl should be taken as the quantitative criterion of the dawn phenomenon.

Purpose: Following the withdrawal of propacetamol in Europe owing to safety issues, the regulatory authority of South Korea requested a post-marketing surveillance study to investigate its safety profile. Materials and Methods: We conducted nested case-control and case-time-control (CTC) analyses of cases and controls identified for outcomes of interest, including anaphylaxis, thrombosis, and Stevens–Johnson syndrome (SJS), using the claims database of South Korea, 2010–2019. Risk-set sampling was used to match each case with up to 10 controls for age, sex, cohort entry date, and follow-up duration. Exposure to anaphylaxis, thrombosis, and SJS was assessed within 7, 90, and 30 days of the index date, respectively. We calculated odds ratios (OR) with 95% confidence intervals (CIs) using conditional logistic regression to assess the risk of outcomes associated with propacetamol. Results: We identified cases of anaphylaxis (n=61), thrombosis (n=95), and SJS (n=1) and matched them to controls (173, 268, and 4, respectively). In the nested case-control analysis, the ORs for anaphylaxis and SJS were inestimable given the small number of propacetamol users during the risk period; meanwhile, the OR for thrombosis was 1.60 (95% CI 0.71–3.62). In the CTC design, the effect estimate was only estimated for thrombosis (OR 0.56, 95% CI 0.09–3.47). Conclusion In both nested case-control and CTC analyses, propacetamol was not associated with an increased risk of anaphylaxis, thrombosis, or SJS. The findings from this study, which used routinely collected clinical data, provide reassuring real-world evidence regarding the safety of propacetamol in a nationwide population to support regulatory decision-making.

Objective: To investigate the characteristics and prognostic value of peripheral blood T lymphocyte subsets in patients with severe influenza. Methods: This was a single-center cross-sectional study in influenza patients admitted to Peking Union Medical College Hospital from August 2017 to April 2018. Peripheral blood lymphocyte subsets were detected by flow cytometry in both patients and 108 healthy controls. Influenza patients were divided into mild group and severe group. Severe patients were further classified into alive and fatal subgroups. Results: A total of 42 influenza patients were recruited in this study, including 24 severe cases (6 deaths). The remaining 18 cases were mild. The peripheral blood lymphocyte counts and lymphocyte subset counts (B, NK, CD4⁺T, CD8⁺T) in either mild patients[795 (571,1 007), 43 (23,144), 70 (47,135), 330 (256,457), 226 (148,366) cells/μl respectively] or severe patients[661 (474,1 151),92 (52,139), 54 (34,134), 373 (235,555), 180 (105,310) cells/μl respectively] were both significantly lower than those of healthy controls [1 963 (1 603,2 394),179 (119,239), 356 (231,496), 663 (531,824), 481 (341,693) cells/μl respectively]. Meanwhile, the T cells and CD8⁺T counts in fatal patients [370 (260,537) cells/μl and 87 (74,105) cells/μl] were significantly lower than those in severe and alive patients [722 (390,990) cells/μl and 222 (154,404) cells/μl]. CD8⁺HLA-DR/CD8⁺and CD8⁺CD38⁺/CD8⁺T cell activating subgroups in mild cases[(53.7±19.2)% and 74.8% (64.1%,83.7%) respectively] were significantly higher than those in severe cases[(38.5±21.7)% and 53.3% (45.3%,67.2%) respectively].Moreover,CD8⁺HLA-DR/CD8⁺count in severe and alive group was higher than that in fatal group [(46.1±19.1)% vs. (18.2±14.6)%, P<0.01]. Logistic regression analysis showed that CD8⁺T cell count (OR=0.952, 95%CI 0.910-0.997, P=0.035) and CD8⁺HLA-DR/CD8⁺T (OR=0.916, 95%CI 0.850-0.987, P=0.022) were both negatively correlated with mortality.Peripheral blood lymphocyte counts in mild cases rapidly decreased within 1 day after diagnosis, and returned to the basic level one week later. Conclusions All peripheral blood lymphocyte subsets (T,B,NK) in patients with influenza are significantly reduced. These findings are consistent with the immunological characteristics of respiratory viral infections, in which peripheral lymphocytes (especially T cells) migrate to respiratory tract in the early stage and circulate to the peripheral blood after recovery. The activated CD8⁺T cell counts in peripheral blood are negatively correlated with the severity of disease, which could be considered as a prognostic indicator of severe influenza.

Animals ; SARS-CoV-2 ; Antibodies, Neutralizing ; Macaca mulatta ; COVID-19/prevention & control* ; Antibodies, Viral ; Vaccines