Objective To explore the relationship between neutrophil‐to‐lymphocyte ratio (NLR) and early‐stage diabetic nephropathy in patients with newly diagnosed type 2 diabetes(T2DM ). Methods A total of 160 patients with newly diagnosed T2DM were enrolled in this study and divided into two groups:early‐stage diabetic nephropathy (EDN ) group and non‐DN group (T2DM group). The clinical and biochemical data were collected. Results NLR ,neutrophia cell count ,2 hPG ,HbA1 c ,age were significantly higher in EDN group than in T2DM group[NLR (2.27 ± 0.92)vs(1.81 ± 0.56) ,neutrophia cellcount(4.35±1.47)vs(3.78±1.08)109/L,2hPG(21.98±4.30)vs(20.37±4.40)mmol/L,HbA1c (11.06±2.02)% vs (10.22 ± 1.89)% ,age(49.22 ± 12.71) vs (44.41 ± 10.81)years] (P< 0.05).Logistic regression analysis showed that NLR (OR= 6.529 ,95% CI:1.946 ~ 21.873 ,P= 0.002)and 2 hPG(OR = 1.213 ,95% CI:1.002 ~ 1.467 ,P= 0.047 ) were independent risk factors for EDN.Conclusion Increased NLR is significantly associated with EDN. High NLR level may be a reliable predictive marker for EDN.

24) among male adults increased by years:9.4% in 1989,28.6% in 2000,and 34.1% in 2004。In 1989 the prevalence of hypertension was only 7.8% in men and 4.8% in women,while it reached 26.5% and 20.1% respectively in 2004. Conclusion:In the period of dietary transition,people in Jiangsu experienced the inadequate intake of some nutrients and high intake of fat. Overweight,obesity and hypertension are prevalent as results of this transition,so implementation of nutrition intervention is needed.

Objective To screen for microRNA (miRNA) involved in fetal rat lung development.Methods Fetal lungs were collected at their 16 d,19 d and 21 d of gestational age,and were observed after HE staining.Differentially expressed miRNA (fold change＞ 1.0) were screened by miRCURYTM locked nucleic acids chip.Some differentially expressed miRNA were selected for further analysis to investigate their change trends in 16 d,19 d and 21 d of gestational age.Results (1) Under the observation after HE staining,in gestational age 16 d group,original bronchus was dendritic distributed,with thick interstitial,rare capillary and no alveolar structure existed; in gestational age 19 d group,primary alveolar was seen,interstitial became thinner,and more capillaries were found; in gestational age 21 d group,more alveolar septa were identified and pulmonary acinus cavity was extremely expanded.(2) Two hundred and two differentially expressed miRNA were found.Among them,many miRNA were firstly reported in rat fetal lung development,suchas miRNA-3560 (8.4211415,4.8889050),miRNA-126 * (7.5239524,1.5118160),miRNA-186* (0.980 325 0,0.688 447 5),miRNA-466c* (0.977 220 0,0.877 227 0),miRNA-195 (13.549 629 0,0.985 488 8),miRNA-34a (12.426 133 0,0.604 066 2) and miRNA-466b-1 *(0.993 153 1,1.732 802 3).(3)The expression of miRNA-466c * and miRNA 186 * decreased as the gestational age increased from 16 d to 21 d,while expression of miRNA-195,miRNA-3560,miRNA-466b-1 *,miRNA-126 * and miRNA-let-7b increased; miRNA-34a expression increased during 16 d to 19 d.miRNA 17-92 family expression decreased,while expression of most let-7 family members (except let-7i and let-7e) increased from 16 d to 21 d of gestational age.Conclusions These miRNA might play an important role in the physiological mechanisms of fetal lungs development.

Objective To study the effects of community comprehensive intervention model on osteoporosis, in order to provides a reference for osteoporosis health education work. Methods A multistage stratified random cluster sampling was applied to conduct a survey in Jiangsu province, in accordance with the economic level and geographic location. Nanjing, Nantong and Xuzhou cities were sampled, three urban streets were sampled in every district , respectively. A total of 1 500 40-69 years old community residents were screened, 619 high-risk participants for osteoporosis were arranged into the intervention group, and a total of 590 residents from the same communities were chosen as control group, who were gender- and age-matched with the intervention group. The intervention group residents received health management and comprehensive intervention, after half a year, a self-designed questionnaire was used to investigate the effects. Results Compared with control group, after six months, knowledge of intervention group related to osteoporosis awareness was improved significantly, such as the most serious harm to human body for osteoporosis (χ2=24.27), characteristic of osteoporosis (χ2=11.05), basic supplements to improve bone health (χ2=60.65) , the recommended daily calcium intake to postmenopausal women and the elderly (χ2=26.80), the difference was statistically significant (P<0.05); daily behavior related to diet and exercise of intervention group has improved significantly, such as drinking milk or itsproducts less than 3 days a week (χ2=25.83), eating beans and products for less than 3 days a week (χ2=19.20), drinking coffee for more than three days a week (χ2=7.77), not often taking outdoor activities (χ2=18.55) ,(P<0.05);Diseases and symptoms related to osteoporosis in intervention group was significantly reduced (P<0.001). Conclusions The osteoporosis is one of the most important public health problem for Jiangsu province, the work for osteoporosis prevention and control should be emphasized in community.

Objective To explore the influencing factors of high risk osteoporosis (OP) population. Methods Using multi-stage cluster sampling method, 1 district was selected from each of the 6 cities randomly, then 3 communities were selected from each district randomly. Questionnaire investigation and physical examination were applied to community residents aged 40-69 years old. The questionnaire mainly included basic information, OP risk assessment (using the 1 minute test method developed by the International OP Foundation), health status and lifestyle information (recent 12 months). The relationship between high-risk groups and influencing factors was analyzed by unconditional logistic regression. Results Totally 6577 valid questionnaires were collected, 2069 were male (31.46％) and 4508 were female (68.54％). A total of 166 cases (2.52％) were found as self-reported OP patients at the age of 40-69, self-reported rate of male (1.55％) was lower than that of female (2.97％) (χ2=11.719, P<0.01), the rate was higher among people aged 60-69 years than people aged 40-49 (χ2=44.766, P<0.01);3400 cases (52.28％) were found as high-risk individuals,there were more male at higher risk than female (OR=1.845). Among different age groups, the 50-59 and 60-69 years age groups had more high risk people than that of 40-49 years group (with OR=2.171 and OR=2.854 respectively). Comparative analysis was also conducted for the following factors: degree of education [college or above (OR=0.517) compared with primary school or junior middle school], occupation [compared with civil servants, technical management personnel (OR=2.289), business services (OR=2.224), farming/forestry/fishing (OR=2.258) and production/transportation staff (OR=2.552)], self-reported history of chronic disease (OR=1.596), fracture (OR=4.061), body pain (OR=2.286) and foot cramps (OR=1.923), as well as calcium/vitamin D intake (OR=1.357), increased sunlight (OR=1.256), daily walking steps>5000 (OR=1.336) and BMI>24.00 (OR=1.322), they were all related to a increased proportion of high risk population. Conclusion The proportion of OP high-risk groups is higher among people aged 40-69. Gender, age, cultural level, occupation, bad health status and lifestyle changes are closely related to higher OP risk. Community residents OP screening should be continued to further study the risk factors of OP.

OBJECTIVETo investigate the status quo and influence factors of self monitoring of blood glucose (SMBG) and self-efficacy of diabetes patients' that participated in community diabetes self management group.

METHODSBeijing, Shanghai, Chongqing, Jiangsu, Guangdong, and Zhejiang were selected as the study sites considering patients management experiences they had. 1 401 adult diabetes patients were recruited from communities via health records system screening, telephone notification, poster advertisement, letters invitation ways. Face to face questionnaire survey was applied to obtain patients' general information, diabetes history, diabetes knowledge awareness, SMBG, and self-efficacy information. Multiple linear regression was used to analyze the relationship between factors and self efficacy.

RESULTSThere were 519 male patients (37.0%) and 882 female patients (63.0%) with an average age of (64.9 ± 8.9) years old. Patients lived in city accounted for 48.0% (672/1 401) and rural patients accounted for 52.0% (729/1 401). Patients who conducted SMBG accounted for 79.9% (1 120/1 401) and 33.3% (446/1 401) patients conducted blood glucose monitoring 1-3 times per month. Rural patients, primary school educated, and new rural cooperative medical system (NCMS) covered patients had a higher proportion of never conducting SMBG which were 21.9% (160/729), 24.2% (160/662), and 26.3% (125/475) , respectively. Scores of self-efficacy was (69.24 ± 16.30) (hundred-mark system) with a relative lower score in monitoring of blood glucose (64.09 ± 20.08) and foot care (63.63 ± 21.40), as well as a highest score in taking medicine and insulin injections (76.10 ± 22.00). Multiple regression analysis on self-efficacy and its related factors show a negative correlation between patients' place of residence and self-efficacy (β' = -0.076) and a positive correlation between education and self-efficacy (β' = 0.114) as well as between diabetes knowledge awareness and self-efficacy (β' = 0.193)(t = -2.46, 3.71, 7.18, P < 0.05).

CONCLUSIONCommunity diabetes patients had a low self-efficacy and it was even lower among low economic and education degree patients. The worst parts were SMBG and foot care. Place of residence, education, and diabetes knowledge awareness are factors that influence patients' self efficacy.

Aged ; Aged, 80 and over ; Blood Glucose ; Blood Glucose Self-Monitoring ; statistics & numerical data ; China ; epidemiology ; Diabetes Mellitus ; therapy ; Female ; Foot ; Humans ; Insulin ; Male ; Medication Adherence ; statistics & numerical data ; Middle Aged ; Regression Analysis ; Self Efficacy ; Surveys and Questionnaires

Objective To investigate the correlation between the appendicular skeletal mass index(ASMI)and os-teoporosis(OP)in postmenopausal patients with type 2 diabetes(T2DM).Methods 164 hospitalized postmeno-pausal elderly T2DM patients were selected and their bone density(BMD)and appendicular skeletal mass were measured using dual energy X-ray absorption method(DXA).ASMI=appendicular skeletal mass/height2(kg/m2),and they were divided into OP group and non OP group based on T value.The general clinical data,blood biochemical indicators,and ASMI between the two groups were compared,and Logistic regression analysis,ROC curve were further used to analyze the correlation and diagnostic power.Results Compared with non OP group,OP group had a higher incidence of sarcopenia(SAC)(P＜0.05);the differences in age,ASMI,body mass index(BMI),and estradiol(E2)had significant differences between the two groups(P＜0.05);Logistic regression analysis showed that the reduction of ASMI[OR=0.133,95％CI(0.029-0.611)],BMI[OR=0.785,95％CI(0.625-0.985)],and E2[OR=0.967,95％CI(0.942-0.993)]were protective factors for OP;receiver operating curve(ROC)suggested that the AUC of ASMI for OP prediction was 0.752[95％CI(0.632-0.872),P＜0.001]with sensitivity 87.5％,specificity 47.8％,and the best diagnostic value was 5.52 kg/m2.Conclusion The reduction of ASMI,BMI,and E2 is positively correlated with the occurrence of osteoporosis.ASMI is an important protective factor for osteoporosis.Early OP screening and risk factor assessment should be conducted for elderly postmenopausal T2DM patients,and early intervention measures should be taken to reduce the risk of falls and fractures.

Objective To explore the association of smoking and smoking cessation with glycemic control in male patients with type 2 diabetes. Methods From December 2013 to January 2014, a total of 7763 male patients with type 2 diabetes, who received national basic public health service in Changshu county of Suzhou city, Huai'an and Qinghe districts of Huai'an city, Jiangsu province, were recruited by cluster sampling. Questionnaire survey and anthropometric measurements were conducted, and fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) levels were measured. Multiple linear regression model was used to evaluate the association of smoking and smoking cessation with glycemic control. Results The prevalence of current smoking was 45.5%in male patients with type 2 diabetes. The levels of FPG and HbA1c increased with number of cigarettes smoked per day compared with non-smokers (P<0.001). Among patients with drug treatment, the average increase of HbA1c level in current smokers with smoking duration ≥30 years and smoking index ≥40 pack-years were 0.27% (95%CI: 0.05%-0.49%) and 0.38% (95%CI: 0.23%-0.53%),respectively. FPG and HbA1c level decreased obviously with smoking cessation years among former smokers (P<0.05). Among the patients receiving no drug treatment, no dose-response relationships were observed between smoking duration, smoking cessation years and levels of FPG and HbA1c. Conclusion Cigarette smoking was negatively related with glycemic control in male type 2 diabetes patients, especially in patients with drug treatment. Smoking cessation may be beneficial for glycemic control. Smoking cessation should be encouraged for diabetes patients as early as possible.

Objective: To investigate the association between fresh fruit consumption and status of glycemic control, among patients with type 2 diabetes mellitus (T2DM). Methods: Using the stratified cluster sampling method, a cross-sectional study was conducted among 19 473 diabetic patients who were under the Disease Management Program related to the National Basic Public Health Service in Changshu county, Huai’an and Qinghe districts of Huai’an city from December 2013 to January 2014, under the combination of fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) methods, the glycemic control status in T2DM patients was assessed. Multiple logistic regression method was used to explore the relationship between fresh fruit consumption and status of glycemic control among T2DM patients. Results: 62.4% of the T2DM patients reported their amount of fruits intake in the past year. Both the levels of FPG and HbA1c decreased in T2DM patients, when the frequency and amount of fresh fruit consumption were increasing. Compared with patients who did not take fresh fruits, the risk of poor glycemic control in patients with fresh fruit consumption of 1-4 times/week and ≥5 times/week decreased 20% (OR=0.80, 95%CI: 0.73-0.87) and 30% (OR=0.70, 95%CI: 0.62-0.80), respectively. Patients with fruit consumption of 50-99 g/day and ≥100 g/day had lower risk of poor glycemic control, with ORs (95%CI) as 0.71 (95%CI: 0.62-0.83) and 0.68 (95%CI: 0.59-0.78), respectively. Conclusions The association of fresh fruit intake and glycemic control was statistically significant in patients with type 2 diabetes. With the increase of frequencies and amounts of fresh fruit consumption, the levels of FPG and HbA1c showed a decreasing trend. Our findings suggested that fresh fruit intake seemed helpful for glycemic control.

Vision formation is classically based on projections from retinal ganglion cells (RGC) to the lateral geniculate nucleus (LGN) and the primary visual cortex (V1). Neurons in the mouse V1 are tuned to light stimuli. Although the cellular information of the retina and the LGN has been widely studied, the transcriptome profiles of single light-stimulated neuron in V1 remain unknown. In our study, in vivo calcium imaging and whole-cell electrophysiological patch-clamp recording were utilized to identify 53 individual cells from layer 2/3 of V1 as light-sensitive (LS) or non-light-sensitive (NS) by single-cell light-evoked calcium evaluation and action potential spiking. The contents of each cell after functional tests were aspirated in vivo through a patch-clamp pipette for mRNA sequencing. Moreover, the three-dimensional (3-D) morphological characterizations of the neurons were reconstructed in a live mouse after the whole-cell recordings. Our sequencing results indicated that V1 neurons with a high expression of genes related to transmission regulation, such as Rtn4r and Rgs7, and genes involved in membrane transport, such as Na/K ATPase and NMDA-type glutamatergic receptors, preferentially responded to light stimulation. Furthermore, an antagonist that blocks Rtn4r signals could inactivate the neuronal responses to light stimulation in live mice. In conclusion, our findings of the vivo-seq analysis indicate the key role of the strength of synaptic transmission possesses neurons in V1 of light sensory.