Objective:To investigate blood glucose management in elderly diabetic patients and the factors that affected achieving high rates of achieving it.Methods:The quality of blood glucose control by elderly diabetic patients who visited five community health service centers in Beijing in June 2022 was surveyed retrospectively using a questionnaire.Participants were divided into the high-quality group and not high-quality groups by the criteria of glycosylated hemoglobin(HbA 1C)<7% without hypoglycemia and weight gain.Single factor analysis and multiple-stepwise Logistic regression analysis were used to identify the relative risk of factors affecting the achievement of good glucose management. Results:A total of 287 valid questionnaires were collected, including 80 cases(27.9%)in the high-quality group and 207 cases(72.1%)in the not high-quality group.There were significant differences in sex, course of disease, occurrence of hypoglycemia, number of chronic complications, medication, alcohol consumption, dietary changes, missed medication doses, prolonged outpatient visit intervals, and depressive mood between the two groups( P<0.05).Multivariate stepwise logistic regression analysis showed that insulin use, missed medication ≥ 1 time/week, and prolonged outpatient visit intervals were independent risk factors for good control( P<0.05). Conclusions:The percentage of elderly diabetes patients with good blood glucose control was low.Factors affecting the rate included insulin use, medication compliance, and prolonged outpatient visit intervals.

Objective:To investigate changes in the self-management ability of chronic diseases in elderly diabetic patients during the novel coronavirus pneumonia pandemic.Methods:A multi-stage cluster sampling method was used to retrospectively collect diabetes management information from elderly diabetic patients treated in five community health service centers in Beijing in June 2022, including 295 elderly diabetic patients, and changes in management of their self-care practices such as diet, exercise, medical treatment and medication, blood glucose monitoring, complication management, and psychological states before and after the outbreak(2019-2022)were analyzed.Results:In 295 elderly diabetic patients, increased glycated hemoglobin( P<0.05)and body mass index(BMI)( P<0.05)were observed during the pandemic.Among 115 patients with underlying diabetic complications, 75.7%(87)of patients had worsening symptoms of chronic complications of diabetes and a shortened weekly exercise time[124(60, 300)min vs.140(60, 300)min, Z=6.00, P<0.05].The number of weekly blood glucose tests was reduced(5.6±4.2 vs.5.8±4.3, t=3.17, P<0.05).The weekly time spent interacting with family members increased( P<0.05).There were no significant differences in body weight, sleep time, and number of times of forgetting to take medication per week before and after the outbreak( P>0.05).21.0% of patients had a decrease in the number of hospital visits, and 72.2% of patients experienced low mood and increased adverse psychological emotions during the pandemic. Conclusions:The pandemic has had a negative impact on the management of chronic diseases in elderly diabetic patients, mainly reflected in the reduction of exercise time and blood glucose monitoring.It also affected regular hospital visits of patients, resulting in negative psychological emotions, poor blood glucose control, increased BMI, and aggravated symptoms of chronic complications, compared with their pre-pandemic conditions.

The outbreak of COVID-19 as an acute communicable disease has also changed the epidemiological status of diabetes mellitus and other noncommunicable chronic diseases. During the COVID-19 epidemic period, it was observed that there were increased morbidity of diabetes, difficulties in blood sugar control and increased acute complications for diabetic patients. This may be attributed to lifestyle changes during the epidemics, such as the reduced exercise time and increased sedentary time, more snacks and sugary food intake, as well as anxiety and depression. However, it is not known the long-term impact of COVID-19 epidemic on the management of diabetic patients, so it is necessary to closely monitor the exposed diabetic patients in the future.

Diabetes mellitus is a chronic metabolic disease, in which the abnormality of glucose and lipid metabolism may cause multisystem damage. Sodium-glucose synergistic transporter 2 (SGLT2) inhibitors are a novel type of hypoglycemic drug that can lower blood sugar level by inhibiting the absorption of glucose through renal tubules. Studies have shown that SGLT2 inhibitors also have a lowering effect on blood pressure, but the mechanism is not fully elucidated. In this article the hypotensive effects of SGLT2 inhibitors and possible mechanisms are reviewed.

Physical fitness is the basic ability necessary to meet daily living activities,including walking, running, jumping, throwing, climbing, and so on. Adequate physical fitness is essential for the prevention and management of metabolic diseases. Impaired physical fitness is common in patients with diabetes mellitus and its chronic complications. This article reviews the impact of diabetes and its complications on physical fitness, current methods for assessment and management to provide a reference for comprehensive prevention and treatment of diabetic patients.

Background/Aims: Risk of venous thrombosis is increased in patients with inflammatory bowel disease (IBD); data on Asian IBD patients is limited and status quo of thrombosis screening and prophylaxis are unknown. Therefore, we aimed to investigate the incidence, screening, prophylaxis, and risk factors for venous thrombosis among Asian IBD patients. Methods: Medical files of patients with Crohn’s disease (CD) and ulcerative colitis (UC) from 17 hospitals across China between 2011 and 2016 were reviewed for venous thrombosis, use of screening and prophylaxis. A case-control study was performed among hospitalized patients with venous thrombosis and their age-, sex-matched IBD controls hospitalized around the same period; disease characteristics and known provoking factors of venous thrombosis were recorded. Risk factors were analyzed in both univariate and logistic regression analyses. Results: A total of 8,459 IBD patients were followed for 12,373 person-year. Forty-six patients (0.54%) had venous thrombosis, yielding an incidence of 37.18 per 10,000 person-year. Incidence increased with age, especially among CD. Less than 20% of patients received screening tests and 35 patients (0.41%) received prophylaxis. Severe disease flare was an independent risk factor for venous thrombosis (odds ratio [95% confidence interval]: CD, 9.342 [1.813– 48.137]; UC, 5.198 [1.268–21.305]); past use of steroids and extensive involvement were 2 additional risk factors in CD and UC, respectively. Conclusions Incidence of venous thrombosis in China was 37.18 per 10,000 person-year (0.54%). Use of screening and prophylaxis were rare. Severe disease flare was an independent risk factor for thrombosis among hospitalized patients.

Background/Aims: Risk of venous thrombosis is increased in patients with inflammatory bowel disease (IBD); data on Asian IBD patients is limited and status quo of thrombosis screening and prophylaxis are unknown. Therefore, we aimed to investigate the incidence, screening, prophylaxis, and risk factors for venous thrombosis among Asian IBD patients. Methods: Medical files of patients with Crohn’s disease (CD) and ulcerative colitis (UC) from 17 hospitals across China between 2011 and 2016 were reviewed for venous thrombosis, use of screening and prophylaxis. A case-control study was performed among hospitalized patients with venous thrombosis and their age-, sex-matched IBD controls hospitalized around the same period; disease characteristics and known provoking factors of venous thrombosis were recorded. Risk factors were analyzed in both univariate and logistic regression analyses. Results: A total of 8,459 IBD patients were followed for 12,373 person-year. Forty-six patients (0.54%) had venous thrombosis, yielding an incidence of 37.18 per 10,000 person-year. Incidence increased with age, especially among CD. Less than 20% of patients received screening tests and 35 patients (0.41%) received prophylaxis. Severe disease flare was an independent risk factor for venous thrombosis (odds ratio [95% confidence interval]: CD, 9.342 [1.813– 48.137]; UC, 5.198 [1.268–21.305]); past use of steroids and extensive involvement were 2 additional risk factors in CD and UC, respectively. Conclusions Incidence of venous thrombosis in China was 37.18 per 10,000 person-year (0.54%). Use of screening and prophylaxis were rare. Severe disease flare was an independent risk factor for thrombosis among hospitalized patients.

Adenocarcinoma of esophagogastric junction (AEG) has attracted more attention in recent years. Surgical method of Siewert type Ⅱ AEG is especially controversial, mainly focusing on the scope of lymph node dissection, safety of surgical margin, and digestive tract reconstruction. The abdominal transhiatal approach and right thoracoabdominal Ivor-Lewis approach are the main surgical approaches of totally laparoscopic or thoracoscopic surgery for Siewert type Ⅱ AEG, which not only need close teamwork, but also require rich experience in laparoscopic surgery. The authors has started to choose these two totally minimally invasive surgical approaches, the feasibility and safety of which are proved. The key surgical details are presented in this article for reference.

Colorectal cancer (CRC) is the second most common cause of cancer-related death worldwide, and its high rates of relapse and metastasis are associated with a poor prognosis. Despite extensive research, the underlying regulatory mechanisms of CRC remain unclear. Long noncoding RNAs (lncRNAs) are a major type of noncoding RNAs that have received increasing attention in the past few years, and studies have shown that they play a role in many biological processes in CRC. Here, we summarize recent studies on lncRNAs associated with CRC and the signaling pathways and mechanisms underlying this association. We show that dysregulated lncRNAs may be new prognostic and diagnostic biomarkers or therapeutic targets for clinical application. This review contributes not only to our understanding of CRC, but also suggests novel signaling pathways associated with lncRNAs that can be targeted to block or eradicate CRC.
Biological Processes ; Biomarkers ; Colon ; Colonic Neoplasms ; Colorectal Neoplasms ; Neoplasm Metastasis ; Prognosis ; Recurrence ; RNA, Long Noncoding ; RNA, Untranslated

Intraoperative hemorrhage is the most common complication of laparoscopic radical gastrectomy,which is also the main cause of conversion to open surgery.With the popularization of laparoscopic surgery technology worldwide,how to complete high-quality surgery and effectively avoid intraoperative or postoperative complications is the goal pursued by all surgeons.Intraoperative hemorrhage in the laparoscopic radical gastrectomy is mainly divided into parenchymal hemorrhage,perigastric vascular injury-induced hemorrhage,lymph node hemorrhage and anastomotic bleeding.Compression,electrocoagulation,vascular clipping and vascular suture repair are the most common treatments for intraoperative hemorrhage.It is necessary to use above methods in clinical work.Proficiency in laparoscopic operation skills,familiarity with perigastric vascular anatomy and variation,and improved teamwork to reduce complications are the key to laparoscopic surgery for gastric cancer.Combined with literature reports,the authors summarize experience in laparoscopic surgery for gastric cancer,discuss the prevention and treatment of hemorrhagic complications during laparoscopic radical gastrectomy.