Objective To explore the predictive value of obesity-related index for metabolic syndrome(MS)among Tianjin adults. Methods A total of 522 adults who participated in a physical examination were included in this cross-sectional study. Participants 'gender and age were record-ed,height,weight,waist circumference(WC)and hip circumference were measured,and TC,TG,HDL-C and FPG were tested. The receiver op-erating characteristic(ROC)curves were generated to identify the optimal measurement of obesity for the prediction of metabolic risk in this popu-lation. Results The area under the ROC curve(AUC)value for waist-to-height ratio(WHtR)predicted the maximum value of MS,followed by WC and BMI,and WHR was the lowest. The optimal cut off value of WHtR was 0.509. There was significant difference in the ability of BMI be-tween different age groups and WC to predict MS. In the groups of<40 years old and≥60 years old,BMI had higher predictive value for MS than WC. Conclusion WHtR has the best predictive value for evaluating the MS risk compared to BMI ,WC or WHR alone among Tianjin adults. The predictive value of BMI and WC for evaluating the MS risk can be improved by the method of age stratification.

Objective To investigate the effect of Berberine on insulin resistance and its mechanism in Otsuka Long-Evans Tokushima Fatty(OLETF) rats with metabolic syndrome(MS).Methods LETO(Long-evans Tokushima Otsuka)rats(the control group receiving standard normal diet,n=10)and diabetic OLETF rats(the MS group receiving high-fat diet for 24 weeks,n=30).Rats in the MS group were randomly divided into 3 subgroups(n=10,each subgroup).Each subgroup was gavaged with normal saline,high-dose Berberine(100 mg · kg-1 · d-1)and low-dose Berberine (50 mg · kg-1 · d-1) respectively,and the high-fat diet remained unchanged.After 6 weeks of berberine treatment,body weight,blood glucose and lipid metabolism parameters were determined.The oral glucose tolerance test(OGTT) and insulin tolerance test(ITT) were used to detect insulin resistance.Expression levels of the protein and mRNA of 78 kDa glucose-regulated protein (GRP7 8),Caspase-12 and CCAAT/enhancer-binding protein(C/EBP) homologous protein(CHOP) in skeletal muscles were detected by Western blot and RT-PCR.Results After Berberine treatment,the body weight,fasting plasma glucose,fasting insulin[(28.9 ± 2.0) mU/L,(31.5± 2.4) mU/L vs.(36.9 ± 4.7) mU/L],total cholesterol,triglycerides,and low-density lipoprotein cholesterol were decreased,while the high-density lipoprotein cholesterol(HDL-C) levels were increased in MS rats with high-dose berberine and low-dose berberine as compared with the control group (P ＜ 0.05) respectively.Berberine treatment could reduce the protein and mRNA expression levels of GRP78,Capase-12 and CHOP in the skeletal muscle of MS rats(P＜0.05).Conclusions Berberine may alleviate insulin resistance in rats with metabolic syndrome by reducing endoplasmic reticulum stress in skeletal muscle.

Objective:To evaluate the safety and efficacy of 3D printing-assisted pre-fenestration and branch stent endovascular repair (F/b EVAR) in the treatment of thoracoabdominal aortic aneurysms.Methods:The clinical data of 26 patients treated with 3D printing-assisted F/b EVAR for complicated thoracic and abdominal aortic diseases at the Department of Vascular Surgery, the Ninth People's Hospital,Shanghai Jiaotong University School of Medicine from May 2019 to Sep 2022 were retrospectively analyzed.Results:The success rate in these 26 cases of TAAA with 3D printing combined with F/b EVAR was 97.89%, and the mean follow-up time was (8.03±4.15) months. Four cases had Ⅲc internal leakage and disappeared during the follow-up. One case of type Ⅲ leakage were narrowed during follow-up. Ic type internal leakage occurred in 1 patient and disappeared after the addition of a stent at the distal end. During the follow-up period, aortic CTA indicated that 1 patient had renal artery stent occlusion and smooth blood in other visceral branches. No complications such as organ ischemia, lower limb ischemia and all-cause death occurred during follow-up.Conclusion:3D printing-assisted F/b EVAR minimally invasive repair of TAAA is a feasible, effective and safe technique, with high success rate and low complication rate of visceral branch artery reconstruction.

BACKGROUND: There is still uncertainty regarding whether diabetes mellitus (DM) can adversely affect patients undergoing carotid endarterectomy (CEA) for carotid stenosis. The aim of the study was to assess the adverse impact of DM on patients with carotid stenosis treated by CEA. METHODS: Eligible studies published between 1 January 2000 and 30 March 2023 were selected from the PubMed, EMBASE, Web of Science, CENTRAL, and ClinicalTrials databases. The short-term and long-term outcomes of major adverse events (MAEs), death, stroke, the composite outcomes of death/stroke, and myocardial infarction (MI) were collected to calculate the pooled effect sizes (ESs), 95% confidence intervals (CIs), and prevalence of adverse outcomes. Subgroup analysis by asymptomatic/symptomatic carotid stenosis and insulin/noninsulin-dependent DM was performed. RESULTS: A total of 19 studies (n = 122,003) were included. Regarding the short-term outcomes, DM was associated with increased risks of MAEs (ES = 1.52, 95% CI: [1.15-2.01], prevalence = 5.1%), death/stroke (ES = 1.61, 95% CI: [1.13-2.28], prevalence = 2.3%), stroke (ES = 1.55, 95% CI: [1.16-1.55], prevalence = 3.5%), death (ES = 1.70, 95% CI: [1.25-2.31], prevalence =1.2%), and MI (ES = 1.52, 95% CI: [1.15-2.01], prevalence = 1.4%). DM was associated with increased risks of long-term MAEs (ES = 1.24, 95% CI: [1.04-1.49], prevalence = 12.2%). In the subgroup analysis, DM was associated with an increased risk of short-term MAEs, death/stroke, stroke, and MI in asymptomatic patients undergoing CEA and with only short-term MAEs in the symptomatic patients. Both insulin- and noninsulin-dependent DM patients had an increased risk of short-term and long-term MAEs, and insulin-dependent DM was also associated with the short-term risk of death/stroke, death, and MI. CONCLUSIONS In patients with carotid stenosis treated by CEA, DM is associated with short-term and long-term MAEs. DM may have a greater impact on adverse outcomes in asymptomatic patients after CEA. Insulin-dependent DM may have a more significant impact on post-CEA adverse outcomes than noninsulin-dependent DM. Whether DM management could reduce the risk of adverse outcomes after CEA requires further investigation.
Humans ; Endarterectomy, Carotid/adverse effects* ; Carotid Stenosis/surgery* ; Risk Factors ; Treatment Outcome ; Time Factors ; Stents/adverse effects* ; Diabetes Mellitus, Type 2/complications* ; Diabetes Mellitus, Type 1 ; Stroke/complications* ; Insulin/therapeutic use* ; Myocardial Infarction/complications* ; Risk Assessment