Objective To investigate severe complications of inferior vena cava filter (IVCF) applying for preventing pulmonary embo-lism after spinal cord injury. Methods From December 2014 to July 2015, 95 patients with acute spinal cord injury (SCI) in our hospital were retrospected. Results Deep venous thrombosis (DVT) appeared in 23 cases, in which 15 cases placed IVCF. All patients accepted anti-coagulant therapy, except 10 cases with contraindication. 3 cases had severe complication, in which 2 cases had comprehensive DVT distal to IVCF, with both lower limbs severe swelling, acute renal inadequacy and hypertension;1 case had continuous hyperpyrexia. Conclusion Although the IVCF placement was widely used in acute SCI for preventing pulmonary embolism in patients with DVT, however, the selec-tion of IVCF and complication prevention should be taken into account.

ed in vitro and in vivo,which was inhibited by aspirin treatment.

Female ; Humans ; Male ; Diabetes Mellitus, Type 2/genetics* ; Genetic Predisposition to Disease/genetics* ; Postmenopause ; Risk Factors ; Sex Hormone-Binding Globulin/genetics* ; Testosterone

Background::The serum vitamin D level varies widely by population, and studies have linked vitamin D levels with the risk of type 2 diabetes mellitus (T2DM). However, the relationship is inconsistent and the impact of vitamin D on T2DM among East Chinese adults is unclear. The study aimed to investigate the association between serum 25-hydroxyvitamin D (25[OH]D) levels and the risk of T2DM and evaluated whether the association is modified by genetic predisposition.Methods::In the Survey on Prevalence in East China for Metabolic Diseases and Risk Factors (SPECT-China) cohort, 1862 participants free of T2DM at baseline were included. A weighted genetic risk score was calculated with 28 variants associated with T2DM. Hierarchical logistic models were used to examine the association of serum 25(OH)D and genetic risk with T2DM.Results::After a 5-year follow-up, 132 cases of T2DM were documented. We observed no significant association between quartiles of serum 25(OH)D and T2DM risk after multivariable adjustment (χ 2 = 0.571, Pfor trend = 0.426). Compared to those in the lowest quartile of 25(OH)D, the odds ratios (ORs) (95% confidence interval [CI]) for participants with increased quartiles were 1.29 (0.74-2.25), 1.35 (0.77-2.36), and 1.27 (0.72-2.24), respectively. We observed a positive association of glycated hemoglobin (HbA1c) with 25(OH)D at baseline (β = 1.752, P = 0.001) and after follow-up (β = 1.385, P = 0.003), and a negative association of ln conversion homeostasis model assessment (HOMA)-β with 25(OH)D at baseline (β = -0.982, P = 0.021). There was no significant interaction between 25(OH)D and diabetes genetic predisposition on the risk of T2DM (χ 2 = 2.710, Pfor interaction = 0.100). The lowest OR (95% CI) of T2DM was among participants with low genetic risk and the highest quartile of 25(OH)D (0.17 [0.05–0.62]). Conclusion::Serum 25(OH)D may be irrelevant to the risk of incident T2DM among East Chinese adults regardless of genetic predisposition.

Background::Prenatal and postnatal factors may have joint effects on cardiovascular health, and we aimed to assess the joint association of birth weight and ideal cardiovascular health metrics (ICVHMs) prospectively in adulthood with incident cardiovascular disease (CVD).Methods::In the UK Biobank, 227,833 participants with data on ICVHM components and birth weight and without CVD at baseline were included. The ICVHMs included smoking, body mass index, physical activity, diet information, total cholesterol, blood pressure, and hemoglobin A1c. The Cox proportional hazards model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) in men and women.Results::Over a median follow-up period of 13.0 years (2,831,236 person-years), we documented 17,477 patients with incident CVD. Compared with participants with birth weights of 2.5-4.0 kg, the HRs (95% CIs) of CVD among those with low birth weights was 1.08 (1.00-1.16) in men and 1.23 (1.16-1.31) in women. The association between having a birth weight <2.5 kg and CVD risk in men was more prominent for those aged <50 years than for those of older age ( P for interaction = 0.026). Lower birth weight and non-ideal cardiovascular health metrics were jointly related to an increased risk of CVD. Participants with birth weights <2.5 kg and ICVHMs score 0-1 had the highest risk of incident CVD (HR [95% CI]: 3.93 [3.01-5.13] in men; 4.24 [3.33-5.40] in women). The joint effect (HR [95% CI]: 1.36 [1.17-1.58]) could be decomposed into 24.7% (95% CI: 15.0%-34.4%) for a lower birth weight, 64.7% (95% CI: 56.7%-72.6%) for a lower ICVHM score, and 10.6% (95% CI: 2.7%-18.6%) for their additive interaction in women. Conclusions::Birth weight and ICVHMs were jointly related to CVD risk. Attaining a normal birth weight and ideal ICVHMs may reduce the risk of CVD, and a simultaneous improvement of both prenatal and postnatal factors could further prevent additional cases in women.

Background::Life’s Simple 7, the former construct of cardiovascular health (CVH) has been used to evaluate adverse non-communicable chronic diseases (NCDs). However, some flaws have been recognized in recent years and Life’s Essential 8 has been established. In this study, we aimed to analyze the association between CVH defined by Life’s Essential 8 and risk of 44 common NCDs and further estimate the population attributable fractions (PAFs) of low-moderate CVH scores in the 44 NCDs.Methods::In the UK Biobank, 170,726 participants free of 44 common NCDs at baseline were included. The Life’s Essential 8 composite measure consists of four health behaviours (diet, physical activity, nicotine exposure, and sleep) and four health factors (body mass index, non-high density lipoprotein cholesterol, blood glucose, and blood pressure), and the maximum CVH score was 100 points. CVH score was categorized into low, moderate, and high groups. Participants were followed up for 44 NCDs diagnosis across 10 human system disorders according to the International Classification of Diseases 10th edition (ICD-10) code using linkage to national health records until 2022. Cox proportional hazard models were used in this study. The hazard ratios (HRs) and PAFs of 44 NCDs associated with CVH score were examined.Results::During the median follow-up of 10.85 years, 58, 889 incident NCD cases were documented. Significant linear dose-response associations were found between higher CVH score and lower risk of 25 (56.8%) of 44 NCDs. Low-moderate CVH (<80 points) score accounted for the largest proportion of incident cases in diabetes (PAF: 80.3%), followed by gout (59.6%), sleep disorder (55.6%), chronic liver disease (45.9%), chronic kidney disease (40.9%), ischemic heart disease (40.8%), chronic obstructive pulmonary disease (40.0%), endometrium cancer (35.8%), lung cancer (34.0%), and heart failure (34.0%) as the top 10. Among the eight modifiable factors, overweight/obesity explained the largest number of cases of incident NCDs in endocrine, nutritional, and metabolic diseases (35.4%), digestive system disorders (21.4%), mental and behavioral disorders (12.6%), and cancer (10.3%); however, the PAF of ideal sleep duration ranked first in nervous system (27.5%) and neuropsychiatric disorders (9.9%).Conclusions::Improving CVH score based on Life’s Essential 8 may lower risk of 25 common NCDs. Among CVH metrics, avoiding overweight/obesity may be especially important to prevent new cases of metabolic diseases, NCDs in digestive system, mental and behavioral disorders, and cancer.

Objective To assess vitamin D levels in eastern China by a standard measurement. Methods The data were from a 2014 Survey on the Prevalence in East China for Metabolic Diseases and Risk Factors-China data base. There were 12662 subjects included in this cross-sectional study from February 2014 to June 2016. We assessed the vitamin D levels of natural population by a standard classification in which serum 25-hydroxy vitamin D (25-OHD)<50 nmol/ L was defined as vitamin D deficiency. Results The average serum 25-OHD level was (40. 5 ± 12. 5)nmol/ L, and there were 80. 3% subjects who would be classified as vitamin D deficiency; The average serum 25-OHD level of women was significantly lower than that of men (P< 0. 05); The serum 25-OHD concentrations of the <30, 30-39, 40-49, 50-59, 60-69, ≥70 age groups were 37. 81(31. 98-43. 52)nmol/ L, 39. 46(33. 87-45. 72) nmol/ L, 41. 17(34. 10-48. 65) nmol/ L, 40. 67(34. 20-49. 02) nmol/ L, 44. 00 (35. 67-53. 93) nmol/ L, 44. 14 (34. 61-55. 85)nmol/ L for males, and 36. 86 (30. 52-43. 75) nmol/ L, 37. 11 (31. 68-43. 23) nmol/ L, 36. 94 (30. 72-43. 71) nmol/ L, 38. 42(32. 08-46. 41) nmol/ L, 38. 58(31. 04-46. 21) nmol/ L, 37. 31(29. 34-47. 17) nmol/ L for females in corresponding subgroups. Conclusion The prevalence of vitamin D deficiency of natural population in eastern China was common, the levels of vitamin D in women were lower than those of men. However, the vitamin D levels were tended to be increasing with the advance of age.

Objective: To study the effect of high-dose methylprednisolone intravenous pulse therapy on immunoglobulins and CD series in patients with active moderate-to-severe Graves′ orbitopathy. Methods: Twenty-seven patients with active moderate-to-severe Graves′ orbitopathy were enrolled in this study. All the patients received iv methylprednisolone pulse therapy for 12 weeks according to the 2016 European Thyroid Association/European Group on Graves′Orbitopathy(EUGOGO) Guidelines. Serum thyroidal autoantibodies, such as thyroid-stimulating hormone receptor antibody (TRAb), anti-thyroperoxidase antibody (TPOAb), and serum immunoglobulins, such as IgG, IgE, IgA, IgM were evaluated at the baseline, at the end of 4th and 12th week. Percentages of CD3⁺ T cells, CD4⁺ T cells, CD8⁺ T cells and CD19⁺ B cells, CD16⁺ or CD56⁺ NK cells were also evaluated at each time point. Results: TRAb, TPOA and IgE, IgG, IgA were significantly decreased both after 4th week and after 12th week (all P<0.05). Percentages of CD3⁺ T cells, CD4⁺ T cells and CD4⁺ /CD8⁺ ratio were gradually decreased after treatment. However, change of CD8⁺ T cells was not significant (P>0.05). Conclusion High-dose methylprednisolone may exert an immunosuppressive effect not only by modifying humoral and cellular immune functions, but also by decreasing serum immunoglobulins.

Objective: To investigate the use of diabetes medications and their effects on the community diabetic patients in Shanghai, China, and provide the evidence for the use of antidiabetic drugs in diabetic patients in the region. Methods: The data were from a database of a 2018 Survey on Community Diabetes Mellitus in Shanghai, China. There were 4 612 subjects included in this cross-sectional study in 2018. According to the use of antidiabetic drugs, the population was divided into untreated group, single drug group, double drugs combination group and multi-drugs combination group, to compare the fasting blood glucose, glycosylated hemoglobin, BMI and prevalence of diabetic complications in different groups. Results: About 70.9% of the 4 612 patients used hypoglycemic agents, 34.8% used metformin, 35.1% used sulfonylureas, 22.9% used alpha glycosidase inhibitors, and 13.8% used insulin. The prevalence of diabetic nephropathy, retinopathy, neuropathy, stroke, and diabetic foot was higher in the combination than in the untreated and single-drug users (P<0.01). Only 41.3% subjects had HbA_1C<7%. The fasting blood glucose and HbA_1C values were lower in the untreated group than in other three medication groups, and the rate of the HbA_1C reaching target in the untreated group was higher than the other medication groups (P<0.01). As the types of drug increased, HbA_1C was less likely to reach the target (P<0.01). There were 42.2% of patients with BMI<24 kg/m², and there was no significant difference in the proportion of BMI reaching target among the four groups (P>0.05). Conclusion The most common used antidiabetic drugs in diabetic patients in Shanghai are metformin, sulfonylureas, α-glycosides inbibitor, and insulin. The blood glucose control in diabetic patients in Shanghai community is not good enough. Patients with a longer duration of diabetes, a lower rate of HbA_1C at goal, and a higher prevalence of diabetic complications may be more prone to use multiple hypoglycemic drugs.

The prevalence of metabolic diseases, such as type 2 diabetes mellitus and obesity, is increasing all over the world. Metabolic diseases have become a major public health problem in China, and primary prevention is particularly important and urgent. According to the theory of DOHaD (Developmental Origin of Health and Diseases), negative environmental factors in early life, such as malnutrition, may increase the risk of some non-communicable diseases, especially metabolic diseases in adulthood. Due to regional economic development disparities in China, life cycle nutrition imbalance (such as malnutrition in early life and overnutrition in adults) is still a common problem. Recently, many scholars have made comprehensive and in-depth studies on the relationship between malnutrition in early life and the development of metabolic diseases in adulthood. This paper summarizes the recent results in this field and puts forward a metabolic model of undernutrition in early life and overnutrition in adulthood (double burden theory). These studies will provide related evidence for the prevention of metabolic diseases in rapidly developing countries such as China and India.