Objective To explore the risk factors for lower extremity amputation in patients with diabetic foot.Methods The clinical data of 1 771 patients with diabetic foot at the Air Force General Hospital of PLA from November 2001 to April 2015 were retrospectively analyzed.The patients were divided into the non-amputation and amputation groups.Within the amputation group , subjects were further divided into the minor and major amputation subgroups.Binary logistic regression analyses were used to assess the association between risk factors and lower extremity amputation.Results Among 1 771 patients with diabetic foot , 323 of them ( 18.24%) were in the amputation group ( major amputation: 41; minor amputation:282 ) and 1 448 ( 81.76%) in the non-amputation group.Compared with non-amputation patients, those in the amputation group had a longer hospital stay and higher estimated glomerular filtration rate(eGFR)levels.Fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), C-reaction protein (CRP), ESR, ferritin, fibrinogen and WBC levels of the amputation group were higher , while hemoglobin albumin, transferrin, TC, TG, HDL-C and LDL-C were lower than those of the non-amputation group (all P<0.05 ).The proportion of hypertension ( 52.48% vs 59.98%) , peripheral vascular disease ( PAD ) (68.11% vs 25.04%), and coronary heart disease (21.33% vs 28.71%) were different between the amputation and non-amputation groups (all P<0.05).Multivariable logistic regression analyses showed that Wagner′s grade , PAD and CRP were the independent risk factors associated with lower extremity amputation in hospitalized patients with diabetic foot.Conclusion Wagner′s grade, ischemia of lower limbs and infection are closely associated with amputation of diabetic foot patients.

Objective To investigate the metabolic characteristics,body composition and dietary intake in elderly sarcopenia patients with type 2 diabetes(T2DM).Methods A total of 652 T2DM patients(327 males and 325 females)aged over 60 years were selected from endocrinology department of nine different hospitals in Beijing.Body composition was measured by bioimpedance analysis,and the appendicular skeletal mass index(ASMI)was calculated.Sarcopenia was defined as body height-adjusted skeletal muscle mass (ASMI)below the lower quintile of the young reference group.The diagnostic cutoff points for sarcopenia were 7.18 kg/m2 for men and 5.73 kg/m2 for women.All patients were divided into the sarcopenia group versus the control group(below vs.not below 7.18 kg/m2 for men and 5.73 kg/m2 for women).The anthropometric parameters,body composition,biochemical laboratory results and dietary intake were compared between the two groups.The blood glucose target levels were less than 7 mmol/L of fasting plasma glucose(FPG)or less than 7％ of haemoglobin A1c(HbA1c).The obesity ratio was calculated according to body fat percentage more than 25％ in men and more than 30％ in women as obesity.Results There were 116 (17.8％)patients in the sarcopenia group (men/women,82/34),and 536 (82.2 ％) patients in the control group (men/women,245/291).Age was higher in the sarcopenia group than in the control group(t =4.385,P =0.000),and body mass index and waist hip ratio(WHR)were lower in the sarcopenia group than in the control group(t =11.724 and 4.173,P=0.000 and 0.000).FPG[(7.5±2.4) mmol/L vs.(8.5±2.5)mmol/L,t =-3.450,P=0.001]and HbA1c[(7.0±1.6) ％ vs.(8.2± 1.7) ％,t =-5.745,P =0.000] were higher in male sarcopenia group than in male control group.The control rate of FPG (127.0％ or 51.8％ vs.27.0％ or 32.9％,x2=8.817,P=0.003)and HbA1c(131.0％ or 53.5％ vs.23.0％ or 28.0％,x2 =15.934,P=0.000)were lower in the sarcopenia group than in the control group.The red blood cell counts,hemoglobin and serum albumin levels,estimated glomerular filtr ationrate(eGFR)were lower in male sarcopenia group than in the male control group(P＜0.05).eGFR was lower in female sarcopenia group than in female control group(t =4.090,P =0.000).Both in men and women,ASMI,grip power,fatless circumference on upper arm,bone mineral content and basal metabolic rate were lower in the sarcopenia group than in the control group(P＜0.05).The total daily intake of energy,carbohydrate,protein and fat were lower in male sarcopenia group than in male control group(P＜ 0.05).Conclusions Compared with the control group,sarcopenia patients are older with worse glycemic control and lower levels of BMI,WHR,renal function,muscle mass and muscle strength.Sarcopenia patients are more prone to osteoporosis.Furthermore,they have poorer nutritional status with an imbalance of dietary intake.Appropriate increase of protein especially high quality protein intake should be recommended to sarcopenia patients with T2DM.

A whole-cell catalyst using Escherichia coli BL21(DE3) as a host, expressing L- threonine dehydratase from Escherichia coli, and co-expressing leucine dehydrogenase from Bacillus cereus and glucose dehydrogenase from Bacillus subtilis for cofactor regeneration, was constructed and used for one-pot production of L-2-aminobutyric acid (L-ABA) and D- gluconic acid from L-threonine and D-glucose. We used shake-flask culture to study the whole-cell catalytic condition including temperature, pH, proper permeabilization of cells and optimal wet cells amount. Moreover, the whole-cell catalyst was cultured in 5-L fermentor by fed-batch fermentation, and 164 g/L L-threonine and 248 g/L D-glucose were converted to 141.6 g/L L-ABA and 269.4 g/L D-gluconic acid. The whole-cell catalyst is promising to fulfill industrial requirements for L-ABA and D-gluconic acid.