BACKGROUND: Alpha-glucosidase inhibitors or dipeptidyl peptidase-4 inhibitors are both hypoglycemia agents that specifically impact on postprandial hyperglycemia. We compared the effects of acarbose and sitagliptin add on to metformin on time in range (TIR) and glycemic variability (GV) in Chinese patients with type 2 diabetes mellitus through continuous glucose monitoring (CGM). METHODS: This study was a randomized, open-label, active-con-trolled, parallel-group trial conducted at 15 centers in China from January 2020 to August 2022. We recruited patients with type 2 diabetes aged 18-65 years with body mass index (BMI) within 19-40 kg/m 2 and hemoglobin A1c (HbA1c) between 6.5% and 9.0%. Eligible patients were randomized to receive either metformin combined with acarbose 100 mg three times daily or metformin combined with sitagliptin 100 mg once daily for 28 days. After the first 14-day treatment period, patients wore CGM and entered another 14-day treatment period. The primary outcome was the level of TIR after treatment between groups. We also performed time series decomposition, dimensionality reduction, and clustering using the CGM data. RESULTS: A total of 701 participants received either acarbose or sitagliptin treatment in combination with metformin. There was no statistically significant difference in TIR between the two groups. Time below range (TBR) and coefficient of variation (CV) levels in acarbose users were significantly lower than those in sitagliptin users. Median (25th percentile, 75th percentile) of TBR below target level <3.9 mmol/L (TBR 3.9 ): Acarbose: 0.45% (0, 2.13%) vs . Sitagliptin: 0.78% (0, 3.12%), P = 0.042; Median (25th percentile, 75th percentile) of TBR below target level <3.0 mmol/L (TBR 3.0 ): Acarbose: 0 (0, 0.22%) vs . Sitagliptin: 0 (0, 0.63%), P = 0.033; CV: Acarbose: 22.44 ± 5.08% vs . Sitagliptin: 23.96 ± 5.19%, P <0.001. By using time series analysis and clustering, we distinguished three groups of patients with representative metabolism characteristics, especially in GV (group with small wave, moderate wave and big wave). No significant difference was found in the complexity of glucose time series index (CGI) between acarbose users and sitagliptin users. By using time series analysis and clustering, we distinguished three groups of patients with representative metabolism characteristics, especially in GV. CONCLUSIONS: Acarbose had slight advantages over sitagliptin in improving GV and reducing the risk of hypoglycemia. Time series analysis of CGM data may predict GV and the risk of hypoglycemia. TRIAL REGISTRATION Chinese Clinical Trial Registry: ChiCTR2000039424.
Humans ; Metformin/therapeutic use* ; Sitagliptin Phosphate/therapeutic use* ; Acarbose/therapeutic use* ; Diabetes Mellitus, Type 2/blood* ; Middle Aged ; Male ; Female ; Adult ; Blood Glucose/drug effects* ; Hypoglycemic Agents/therapeutic use* ; Aged ; Glycated Hemoglobin/metabolism* ; Adolescent ; Young Adult ; China ; East Asian People

BACKGROUND: It is inaccurate to reflect the level of dust exposure through working years. Furthermore, identifying a predictive indicator for lung function decline is significant for coal miners. The study aimed to explored whether club cell secretory protein (CC16) levels can reflect early lung function changes. METHODS: The cumulative respiratory dust exposure (CDE) levels of 1,461 coal miners were retrospectively assessed by constructed a job-exposure matrix to replace working years. Important factors affecting lung function and CC16 were selected by establishing random forest models. Subsequently, the potential of CC16 to reflect lung injury was explored from multiple perspectives. First, restricted cubic spline (RCS) models were used to compare the trends of changes in lung function indicators and plasma CC16 levels after dust exposure. Then mediating analysis was performed to investigate the role of CC16 in the association between dust exposure and lung function decline. Finally, the association between baseline CC16 levels and follow-up lung function was explored. RESULTS: The median CDE were 35.13 mg/m³-years. RCS models revealed a rapid decline in forced vital capacity (FVC), forced expiratory volume in the first second (FEV₁), and their percentages of predicted values when CDE exceeded 25 mg/m³-years. The dust exposure level (<5 mg/m³-years) causing significant changes in CC16 was much lower than the level (25 mg/m³-years) that caused changes in lung function indicators. CC16 mediated 11.1% to 26.0% of dust-related lung function decline. Additionally, workers with low baseline CC16 levels experienced greater reductions in lung function in the future. CONCLUSIONS CC16 levels are more sensitive than lung indicators in reflecting early lung function injury and plays mediating role in lung function decline induced by dust exposure. Low baseline CC16 levels predict poor future lung function.
Uteroglobin/blood* ; Humans ; Dust/analysis* ; Occupational Exposure/analysis* ; Male ; Middle Aged ; Adult ; Retrospective Studies ; Lung Injury/chemically induced* ; Coal Mining ; Biomarkers/blood* ; China/epidemiology* ; Air Pollutants, Occupational ; Female

Purpose Based on liver lesions,to investigate the feasibility and influencing factors of virtual non-contrast(VNC)replacing true non-contrast(TNC)in tri-phase derived from Revolution CT.Materials and Methods A total of 62 patients who underwent TNC and tri-phase(arterial,venous,and delayed phases)spectral enhanced liver scans were retrospectively enrolled in Zhongda Hospital Affiliated to Southeast University from December 2021 to April 2022.Liver lesions with a diameter of≥5 mm were measured and categorized into Group 1(≤20 Hu)and Group 2(>20 Hu)according to the CT values of TNC,then were respectively further categorized into group a(≤20 Hu across all three phases of enhancement)and group b(>20 Hu in at least one phase of enhancement)based on the degree of enhancement.CT attenuation,maximum diameter and detection rates of lesions were compared between TNC and three-phase VNC groups.Multivariate regression analysis was used to investigate the influencing factors of the density difference between VNC and TNC.Results A statistically significant difference in the attenuation of lesions was observed among the each groups(χ2/F=14.712,18.603,7.334,all P<0.01).Except for VNCV and VNCD in Group-1a which had no significant difference with TNC(both P>0.05),the attenuation of other VNCs were lower than TNC in category-a and greater than TNC in category-b(all P<0.05).Maximal diameter presented strong correlation and no significant difference in VNCA and VNCV compared to TNC in each group(all P>0.05;all r>0.8 and P<0.001).A significant difference in the detection rate of the lesions was observed among the groups(χ2=47.660,P<0.001),VNCV images displayed the higher detection rate than VNCA and VNCD(all P<0.05).The density difference between VNC and TNC was positively correlated with CT values of the corresponding enhancement phase(r2adjusted=0.209,0.142,0.062,P<0.001).Conclusion Based on Revolution CT,VNCV is the optimal phase to replace TNC and can be mitigated by CT value of the lesions in venous-phase.

Objective:To investigate the causes of secondary glaucoma after vitrectomy for familial vitreous amyloidosis associated with transthyretin (TTR) gene Gly83Arg mutation.Methods:A retrospective case study. From January 2008 to January 2020, 13 cases (23 eyes) with hereditary vitreous amyloidosis and treated by vitrectomy in the Affiliated Hospital of Zunyi Medical University were collected. Among them, there were 7 males with 12 eyes and 6 females with 11 eyes. The average age was 43.0±4.8 years. All the affected eyes underwent standard three-channel vitrectomy through the flat part of the ciliary body. According to whether complete vitreous detachment (PVD) was formed during the operation, it was divided into complete PVD group and incomplete PVD group; according to the occurrence time of secondary glaucoma and vitreous amyloidosis after surgery, it was divided into 1-12 months group and 13-36 months group, >37 months group. The average follow-up time after surgery was 36.7±6.0 months. The incidence of secondary glaucoma and the recurrence rate of vitreous amyloidosis between groups were compared by χ2 test; the correlation between recurrence of vitreous amyloidosis and secondary glaucoma after surgery was analyzed by Spearman rank correlation analysis. Results:Among the 23 eyes, there were 8 eyes in the complete PVD group and 15 eyes in the incomplete PVD group, respectively. Vitreous amyloidosis recurred in 15 eyes (65.22%, 15/23) after surgery. There were 14 (93.30%, 14/15) and 1 (6.70%, 1/15) eyes in the incomplete PVD group and the complete PVD group, respectively; the comparison of the recurrence rate of vitreous amyloidosis between the two groups was statistically significant ( χ2=11.676, P<0.01). 1-12 months group, 13-36 months group, >37 months group included 1 (4.35%, 1/23), 12 (52.17%, 12/23), 2 (8.70%, 2/23) Only eye. The recurrence rate in the 13-36 months group was significantly higher than that in the 1-12 months group and >37 month group. Secondary glaucoma occurred in 11 eyes (47.80%, 11/23) after surgery. 1-12 months group, 13-36 months group, above 37 months group were 1 (4.35%, 1/23), 8 (34.78%, 8/23), 2 (8.70%, 2/23) eyes. The incidence of secondary glaucoma in the 13-36 months group was higher than that in the 1-12 months group and >37 months group. Among 11 eyes with secondary glaucoma, 10 eyes had recurrence of vitreous amyloidosis after surgery, and 1 eye had no recurrence. The results of Spearman rank correlation analysis showed that there was a positive correlation between the recurrence of vitreous amyloidosis and the occurrence of secondary glaucoma ( rs=0.516, P=0.012). Conclusion:The incidence of secondary glaucoma after vitrectomy in a family with vitreous amyloidosis caused by the Gly83Arg mutation of TTR gene is higher, and its occurrence is significantly positively correlated with the recurrence of vitreous amyloidosis.

Objective To evaluate the curative effects of modified minimally invasive double eyelid operation and traditional embedding double eyelid operation.Methods Chinese and English databases including Wanfang Science and Technology Periodical Full-text Database,VIP Chinese Science and Technology Periodical Full-text Database (VIP) and CNKI,PubMed,Web of Science,Science Drirect Online and Cochrane Library were searched by computer.Some randomized controlled clinical trials that compared the effects of modified mini-eyelid operation and traditional embedding double eyelid operation were collected for this Meta analysis.Results The postoperative satisfaction of modified minimally invasive double eyelid surgery was higher than that of the traditional embedding double eyelid surgery (Z =6.16,P＜0.00001).The success rate of modified minimally invasive blepharoplasty surgery was higher than that of the traditional embedding double eyelid surgery (Z =4.84,P＜0.00001).Conclusions The clinical effect of modified minimally invasive double eyelid surgery is better than that of the traditional embedding double eyelid surgery.

PurposeTo investigate the multi-slice spiral CT features of lung primary invasive mucinous adenocarcinoma, a rare malignancy with few relevant literature. Materials and Methods Forty-one patients with pathology proven primary invasive mucinous adenocarcinoma of the lungs underwent MSCT examination, of which 27 patients received intravenous contrast. Imaging features were analyzed, and the patients were divided into groups according to morphology, density and enhancement.Results For 41 patients, 40 cases had one lesion, and one case had more than one lesion; the lesions were in the right upper lobe in 5 cases, right middle lobe in one case, right lower lobe in 17 cases, left upper lobe in 5 cases, and left lower lobe in 12 cases. There was solitary lesion in 40 cases. The other patient had multiple lesions. 29 cases showed nodules/masses, while non-mass lesions in 12 cases. Ground glass opacity was seen in 4 cases, single consolidation in 11 cases, and mixed consolidation in 26 cases. There was significant contrast enhancement in nodules/masses compared to non-mass lesions (t=5.00, 6.51 and 14.06,P<0.05).Conclusion MSCT shows a diversity of imaging features of primary invasive mucinous adenocarcinom, including single round lesion, lower lobe in both side; the density is lower than muscle on CT scan, and presents mild to moderate enhancement on enhancement scan round lesions has high density and enhancement range than irregular-shaped lesions.

Objective To study the application values of ThinPrep cytologic test (TCT) and colposcope pathological biopsy in screening of cervical cancer and premalignant lesion.Methods Two hundred and forty-two female patients with TCT results abnormal were selected as the research object,and they were examined in colposcope pathological biopsy.The diagnostic accordance between TCT and colposcope pathological biopsy was analyzed,and the result of colposcope pathological biopsy in cervical different parts was compared.Results In TCT,the ratio of cervical intra-epithelial neoplasia (CIN) in atypical squamous cell of undetermined significance was 56.52％ (52/92),that in low-grade squamous intraepithelial lesion was 88.16％(67/76) and in high-grade squamous intraepithelial lesion was 100.00％(67/67),the test results of two methods had consistency by the Pearson rank correlation test (Pearson contingency coefficient =0.7588,x2 =328.37,P ＜ 0.05).In colposcope pathological biopsy,the positive rate of lesions center was 90.22％ (83/92),that of lesions edge was 73.17％ (60/82) and that of 3,6,9,12 point was 71.74％ (66/92),there were significant differences among the positive rate of the three parts by the unidirectional ordered categorical data rank and inspection (Kruskal-Wallis method)(P ＜ 0.05),the positive rate of lesions center was higher than that of lesions edge and 3,6,9,12 point (P＜ 0.05),there was no significant difference in positive rate between lesions edge and with 3,6,9,12 point (P ＞0.05).Condusion The result of TCT and colposcope pathological biopsy is consistent,and the positive rate of lesions center of colposcope pathological biopsy is higher,which is higher than that of lesions edge and 3,6,9,12 point.

OBJECTIVETo prepare silymarin nanosuspension and lyophilized power for enhancing the dissilution of poorly soluble drugs.

METHODThe precipitation technique was adapted to produce the silymarin nanosuspensions respectivly applying Tween 80, SDS and Poloxamer188 as stabilizers. The lyophilized formula contained 5% mannitol as cryoprotectant. Particle size, Polydispersity index and Zeta potential were detected by Mastersizer nano ZS (Malvern England). Morphological character was observed with Transmission Electron Microscopy. The product's structure was performed with X-ray diffractometer.

RESULTThe silymarin nanosuspension was successfully prepared, in which the drug particle size was about 100-300 nm,and the particles had ball-like shape and good dispersive properties.

CONCLUSIONThis study provided potential for the neotype dosage form development of the Chinese Traditional Medicine.

Chemistry, Pharmaceutical ; methods ; Freeze Drying ; Nanoparticles ; chemistry ; Particle Size ; Silymarin ; chemistry ; Solubility ; Suspensions ; chemistry

Chronic microinflammatory state is common in the patients undergoing maintenance hemodialysis (MHD), which seriously affects the long-term survival rate of MHD patients. It is important to improve the microinflammatory state in MHD patients.

Objective To explore the mechanism underlying the superiority of the biphasic waveform to monophasic waveform in defibrillation.Method The Luo-Rudy model was adjusted so that it could be used to study defibrillation.Based on the adjusted model the effects of different defibrillation waveforms on cell action potential duration(APD) were studied.Result Biphasic electrical field pulse extended the APD longer than that with monophasic one.Moreover,biphasic waveforms with different strengths could prolong the APD almost equally,while monophasic pulses with different strengths showed different ability to prolong the APD and the spatial distribution of the APD became dispersed.It was also found that the strength of electrical fields pulse contributed much to the change of APD while the duration showed little effect.Conclusion The clinical superiority of biphasic pulses to monophasic pulses in defibrillation is resulted from its ability to prolong the time course of the APD and more importantly,it causes even spatial distribution of the APD.