Objective To observe the influence of triglyceride(TG),hemoglobin(HGB),total bilirubin(TBIL)and rheumatoid factor(RF)on the results of two kinds of D-dimer detection reagent assay.Methods Five samples were prepared into series with 2,4,6,8 and 10 mmol/L triglyceride by adding fat emulsion.Five samples were prepared into series with 1,2,3,4 and 5 g/L of hemolysis degree by adding hemoglobin solution.Five samples were prepared into series with 20,40,60,80 and 100μmol/L total bilirubin by adding bilirubin standard preparation.Ten samples were prepared into rheumatoid factor levels be-tween 0~150 IU/L by adding rheumatoid factor standard solution.Simultaneously with D-dimer detection reagent and D-di-mer HS detection reagent for testing,each sample was measured two times and the results averaged.Results When TG≤2 mmol/L,the D-dimer reagents without interference,and TG≥4 mmol/L,the D-dimer reagents due to “SD baseline data out of range”couldn’t be detected.TG≤10 mmol/L,for D-dimer HS reagents was without interference.When HGB≥1 g/L, the D-dimer reagents due to“SD baseline data out of range”couldn’t be detected.HGB≤4 g/L,for D-dimer HS reagents was without interference.When hemoglobin levels was equal to 5 g/L,the D-dimer HS reagents test results false increased about 30.4%.With total bilirubin concentration increases,D-dimer and D-dimer HS reagents test results were false increase, showed amplitude by a power law,and the two reagents increased consistency.Preparation a series of pooled plasma of rheu-matoid factor levels in 0~150 IU/L,D-dimer test results reagent falsely elevated levels of rheumatoid factor with a linear correlation (Y=59.31X+50.43,R2=0.998).When RF≤150 IU/L,the D-dimer HS reagents was without interference. Conclusion Triglyceride,hemoglobin,total bilirubin and rheumatoid factor may interfere D-dimer testing process,icterus and severe hemolysis will interfere D-dimer HS testing process.D-dimer HS reagents against interfere exceed D-dimer rea-gents.When D-dimer test results does not match with clinicians determine,the influence ofinterfering substances should be considered.

Objective To observe the all-cause and cardiocerebrovascular disease(CCVD)-related mortalities in the senile male population and the relationship of them with fasting plasma glucose (FPG) level.Methods A survey was performed among 1 572 male subjects aged 60-90.All the subjects were groups were calculated by Kaplan-Meier method and the log-rank test was used to compare the survival rates of the 4 groups.Logistic regression model was used to analyze the correlation factors of all-cause mortality and CCVD-related regression model analysis showed that age was related with the all-cause mortality.Among all these factors, age, body mass index, FPG and the history of CCVD had the relationships with the mortality of CCVD.Conclusion In the older male population, CCVD are considered as one of the main causes of death.With the increased levels of FPG, the all-cause mortality and CCVD mortality of senile male population are increased.

Objectives To investigate the relationship between albuminuria and all-cause mortality and cardiovascular mortality in middle-to-old-aged Chinese population. Methods A total of 2500 residents aged more than 40 years old were selected using random cluster sampling in Shougang community, Beijing, and 2315 of them took part in the survey finally. Morning urinary samples were collected. Urinary albumin and creatinine were measured. Albumin to creatinine ratio (ACR) was calculated and used as an index of albuminuria. The subjects were grouped according to ACR: normoalbuminuria (NO, ACR＜ 30 mg/g), microalbuminuria (MI, ACR 30-299 mg/g), and macroalbuminuria (MA, ACR ≥ 300 mg/g). Albuminuria (AL) group consisted of MI group and MA group. Cardiovascular risk factors were also investigated. Then all-cause mortality and cardiovascular mortality were collected after 4 years. The Cox model was used to analyze the relationship between albuminuria and all-cause mortality after adjusting for confounders. Results The prevalence of microalbuminuria and macroalbuminuria was 7.6% and 1.4% respectively. After 4 years follow-up,the cardiovascular mortality was 2.7/1000 person-years in NO group, 19.9/1000 person-years in MI group, and 11.5/1000 person-years in MA group and the all-cause mortality was 6.6/1000,25.9/1000 and 57.5/1000 person-years respectively. After adjusting for age, gender, smoking, body mass index, serum lipids, hypertension, diabetes mellitus, cardiovascular disease at baseline and serum creatinine, the hazard ratio (HR) of cardiovascular mortality in AL group was 5.26 [95% confidence intervals (CI) 2.26-12.24] compared with NO group; the HR of all-cause mortality was 3.34 (95% CI 1.82-6.15). Among patients without cardiovascular disease at baseline, the corresponding HRs were 6.92 (95%CI 1.80-26.58) and 2.85 (95%CI 1.22-6.65) respectively.Conclusion In the population studied, albuminuria is an independent risk factor for all-cause mortality and cardiovascular mortality.

Objective To investigate the appropriate waist circumference (WC) cutoff points for central obesity in the middle-aged and elderly Beijing residents by the metabolic syndrome definition of the International Diabetes Federation (IDF). Methods A total of 2,344Beijing residents aged ≥40 years were investigated. They answered questionnaires, received physical examinations, and underwent plasma glucose and lipid profile measurement. Those non-diabetic subjects underwent a 75g oral glucose tolerance test. All data were analyzed to calculate the appropriate WC cutoff points for central obesity reaching the diagonsis of MS. Results 1) Both in males and females, the triglyceride (TG), systolic blood pressure, diastolic blood pressure and fasting plasma glucose (FPG) increased linearly with WC, and the high density lipoprotein cholesterol (HDL-C) decreased linearly with WC (P＜0.05). 2)The prevalence of elevated TG,reduced HDL-C, elevated blood pressure, elevated FBG, or ≥ 2 of these factors increased with WC (P＜0.05). 3) Based on the receiver operating characteristic (ROC) curve analysis and Youden index, the WC values for central obesity and for detecting BMI ≥ 25 kg/m2were about 90 cm for men and 80 cm for women. 4) The odds ratio for the presence of two or more metabolic risk factors increased abruptly in men with WC ≥ 90 cm and in women with WC ≥ 80 cm. Conclusions The appropriate WC cutoff point for central obesity was determined to be 90 cm for men and 80 cm for women in the middle-aged and elderly Beijing residents by the metabolic syndrome definition of IDF.

ObjectiveTo evaluate the safety and efficacy of 30 mg pioglitazone hydrochloride combined with sulphonyurea in the treatment of type 2 diabetic patients.MethodsA randomized, double blind, placebo-controlled, parallel group, multicenter study was performed.A total of 236 patients, who had fasting plasma glucose(FPG) 7.5-13.0 mmol/L and glycosylated hemoglobin A1c(HbA1 c) 7.0％ -12.0％,treated with stable dosage of a sulphonyurea for at least 30 days previously, were randomized to receive placebo or pioglitazone 30 mg once daily for 16 weeks.The sulphonyurea and dosage remained unchanged.ResultsThe patients who had been treated with pioglitazone 30 mg showed significant decrease than that in the placebo group on the average from baseline in FPG [(1.48 ±2.08) mmol/L vs (-0.17 ± 1.92)mmol/L, P＜0.05], and in HbAlc [(0.92 ±0.10)％ vs (0.28 ±0.11)％, P＜0.05].Since fasting plasma insulin (Flns) levels decreased (0.24 ±0.04) mU/L and (0.09 ±0.04) mU/L in the two groups.The homeostatic model assessment insulin resistant (HOMA-IR) decreased 1.42 ± 2.90 and 0.46 ± 3.53 in two groups.The triglyceride level was decreased 0.36 mmol/L and 0.14 mmol/L, and the HDL-C level increased 0.17 mmol/L and 0.05 mmol/L in two groups.There were significant differences in two groups (all P ＜ 0.05).ConclusionsThe 16-week clinical study demonstrated that pioglitazone hydrochloride with a dosage of 30mg daily, could significantly improve the blood glucose control and enhance the insulin sensitivity, lower triglyceride and raise HDL-C level as an additional therapy to a stable-dose sulphonyurea in Chinese type 2 diabetic patients previously poorly controlled by single sulphonyurea therapy, and furthermore had good safety and compliance.

Objective To investigate the outcome and related risk factors of integrated intensive intervention in participants with impaired glucose regulation (IGR) after two years by the criteria of American Diabetes Association 2003. Methods The subjects who remained to be IGR at the end of first year following 75 g oral glucose tolerance test were randomly assigned to either a routine care control group or to an intensive integrated intervention group. The control group received general dietary and exercise advice at baseline and was followed up. In addition to dietary control and exercise advice, mefformin or acarbose were administrated in the intervention group. The latter group was also advised to take antihypertensive agents, lipid-regulating agents if necessary, as well as aspirin. Results The proportion of patients who fulfilled the assigned goals of blood glucose, blood pressure, body mass index or triglycerides was significantly higher in the intensive group than those in the control group. None in the intensive group developed overt diabetes mellitus, while 8 (9.3%) in the control group did. The proportion of patients who reverted to normal glucose tolerance (NGT) was slightly higher in the intensive group than in the control group (29.5% vs 22.1%, P>0.05). Logistic analysis showed that increase of waist circumference and systolic blood pressure was positively while the improvement of islet β-cell function was negatively correlated with the development of diabetes mellitus. Conclusions The intensive integrated intervention could significantly decrease the conversion rate of IGR to diabetes mellitus, and increase the chance of reversion to NGT. The increase of waist circumference or systolic blood pressure, the deterioration of islet β-ccll function were the influencing factors of the conversion of IGR to diabetes mellitus.

Objective To analyze the effect of diabetes mellitus (DM) on the prognosis of patients with unresectable hepatocellular carcinoma (HCC) after receiving transcatheter arterial chemoembolization (TACE).Methods A total of 858 HCC patients,who were admitted to the Affiliated Xinhua Hospital,School of Medicine,Shanghai Jiaotong University,China,during the period from January 2010 to June 2015 to receive TACE,were selected.Among the 858 HCC patients,175 patients suffered from coexisting DM (DM group) and 683 patients had no DM (non-DM group).The differences in general clinical data and overall survival between the two groups were analyzed.Kaplan-Meier method was used to calculate the survival rate,the difference between the two groups was evaluated by log-rank method,and Cox proportional hazards regression was adopted to analyze the prognostic factors of HCC patients after receiving TACE.Results There were no statistically significant differences in sex,age,serum albumin,total bilirubin,prothrombin time,alpha fetoprotein (AFP),Child-Pugh grade,tumor size and number,cirrhosis,number of TACE treatment times and BCLC staging between the two groups (P＞0.05);the fasting blood glucose (FPG)level in DM group was higher than that in non-DM group (P＜0.05).The 1-,3-and5-year survival rates of the DM group were 60.9％,27.5％ and 10.7％ respectively,which were 70.9％,36.0％ and 17.6％ respectively in the non-DM group;the Log-rank test showed that the difference between the two groups was statistically significant (P=0.008).Multivariate Cox proportional hazard regression analysis revealed that the largest tumor diameter ＞5 cm,multiple tumor lesions,AFP＞20 ng/ml,BCLC stage and coexisting DM were independent risk factors that affected the prognosis of HCC patients after receiving TACE.Conclusion The coexisting DM is an independent risk factor that may affect the prognosis of patients with inoperable HCC after receiving TACE.

Objective:To compare the efficacy and safety of Changsulin ? with Lantus ? in treating patients with type 2 diabetes mellitus (T2DM). Methods:This was a phase Ⅲ, multicenter, randomized, open-label, parallel-group, active-controlled clinical trial. A total of 578 participants with T2DM inadequately controlled on oral hypoglycemic agents were randomized 3∶1 to Changsulin ? or Lantus ? treatment for 24 weeks. The efficacy measures included changes in glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), 2h postprandial plasma glucose (2hPG), 8-point self-monitoring of blood glucose (SMBG) profiles from baseline, and proportions of subjects achieving targets of HbA1c and FPG. The safety outcomes included rates of hypoglycemia, adverse events (AEs) and anti-insulin glargine antibody. Results:After 24 weeks of treatment, mean HbAlc decreased 1.16% and 1.25%, FPG decreased 3.05 mmol/L and 2.90 mmol/L, 2hPG decreased 2.49 mmol/L and 2.38 mmol/L in Changsulin ? and in Lantus ?, respectively. No significant differences could be viewed in above parameters between the two groups (all P>0.05). There were also no significant differences between Changsulin ? and Lantus ? in 8-point SMBG profiles from baseline and proportions of subjects achieving the targets of HbA1c and FPG (all P>0.05). The rates of total hypoglycemia (38.00% and 39.01% for Changsulin ? and Lantus ?, respectively) and nocturnal hypoglycemia (17.25% and 16.31% for Changsulin ? and Lantus ?, respectively) were similar between the two groups (all P>0.05). Most of the hypoglycemia events were asymptomatic, and no severe hypoglycemia were found in both groups. No differences were observed in rates of AEs (61.77% vs.52.48%) and anti-insulin glargine antibody (after 24 weeks of treatment, 6.91% vs.3.65%) between the two groups (all P>0.05). Conclusions:Changsulin ? shows similar efficacy and safety profiles compared with Lantus ? and Changsulin ? treatment was well tolerated in patients with T2DM.

Objective To characterize the baseline status of Chinese diabetic patients based on data derived from Chinese cohort from SOLVETM study.Methods Patients with type 2 diabetes initiating basal insulin detemir at the decision of the physician were eligible for the study.Data on demographics,medical history,glycemic profile and treatment regimen at baseline were collected by physicians.Results A total of 3272 patients [female 42％,male 58％,mean age (56.2 ± 10.8) years] were included in the study.Their BMI was (25.3 ± 3.3) kg/m2.The duration of diabetes was 4.0 (0.1-27.0) years,and the duration of treatment with oral antidiabetic drugs (OADs) was 3.0(0.0-20.2) years.The proportions of subjects with diabetic macro-and micro-vascular complications were 15.8％ (515 cases) and 27.1％ (866 cases),respectively.The hemoglobin Al c (HbAl c) at baseline was (8.33 ± 1.70) ％,and the fasting blood glucose (FPG) was (9.5 ± 2.6) mmol/L.Conclusions A large proportion of patients with type 2 diabetes remain in poor glycemic control,and the prevalence of diabetic complications is high,which requires optimal therapeutic strategy for the patients with suboptimal glycemic control.

Objective: To investigate the relevant prognostic factors of liposarcoma (LPS). Methods: The data of 78 patients with LPS treated in our hospital from July 2009 to March 2017 were reviewed. The 78 patients included 41 males and 37 females, and the average age was (60.5 ±13.4) years (ranged from 18 to 85 years). Among the 78 LPS patients, 27 were well-differentiated LPS, 13 were myxoid LPS, 35 were dedifferentiated LPS and 3 were pleomorphic LPS.The distribution of lesion location included 40 cases of extremities and 38 cases of retroperitoneal. 21 cases were treated with radical excision, 57 cases were treated with marginal resection. 7 patients were treated with postoperative radiotherapy and 9 patients with postoperative chemotherapy. Progression free survival (PFS) and overall survival (OS) of LPS patients were analyzed as clinical outcomes. Prognostic factors were analyzed by univariate and multivariate analyses. Results: 43 patients had local recurrence (9 of extremities/ 34 of retroperitoneal), 18 patients with metastasis (4 of extremities/ 14 of retroperitoneal). The 5-year PFS rate was 31.4% and 5-year OS rate was 44.3%. Univariate analysis showed that the histological subtype and the tumor location were related with PFS (P<0.05), while the histological subtype, the tumor location, the tumor size, the recurrence and metastasis were related with OS (P<0.05). Multivariate cox regression analysis showed that the tumor location was the independent prognostic factor of PFS (P<0.05), while the histological subtype and metastasis were the independent prognostic factors of OS (P<0.05). The median PFS of patients with myxoid LPS treated with radiotherapy was 34.6 months, which was significantly longer than 28.3 months of myxoid LPS patients without radiotherapy (P<0.05). Conclusions The tumor location is an independent prognostic factor of PFS in LPS patients.Retroperitoneal LPS is more prone to relapse and metastasize. OS is affected by pathological subtype and metastasis. Radiotherapy can improve the PFS of patients with myxoid LPS.