OBJECTIVETo investigate the therapeutic effect of prostaglandin E1 (PGEl) on diabetic nephropathy (DN) after a one-year treatment.

METHODSAccording to Mogensen DN diagnostic criteria, the patients were divided into DN stages III, IV and V groups. Patients in stage IV nephropathy were subdivided into three groups according to the proteinuria, namely early stage IV (protienuria less than 1.5 g/day), mid-stage IV (protienuria between 1.5 and 2.5 g/day) and late stage IV (protienuria above 2.5 g/day). The patients were randomly given PGEl, PGEl plus angiotensin-converting enzyme inhibitor (ACEI), ACEI mono-therapy or basal treatment (control group). Proteinuria and albuminuria were measured before and at 15 days and 1 year of the treatment.

RESULTSIn the patients in DN stages III and early stage IV, proteinuria and albuminuria decreased significantly after 15 days and 1 year of treatment with PGEl+ACEI and PGEl (P<0.01), and the decrements were greater than that in patients receiving ACEI only (P<0.01 or P<0.05). In the patients in mid- and late stage IV nephropathy, proteinuria and albuminuria decreased significantly in PGEl+ACEI group after 15 days and 1 year of treatment (P<0.01), showing greater decrement than in ACEI group (P<0.01 ). Proteinuria and albuminuria decreased significantly in PGEl group after 15 days of treatment (P<0.01), but remained higher than that in ACEI group at one year (P<0.05). In the patients with stage V nephropathy, significant proteinuria and albuminuria reduction occurred in PGEl+ACEI and PGEl groups at 15 days (P<0.01) with a greater decrement than that in ACEI group (P<0.01 or P<0.05). In PGEl+ACEI group, proteinuria and albuminuria showed no significant changes at one year but were lower than those in ACEI group (P<0.05). Proteinuria and albuminuria increased significantly in ACEI and PGEl group after the treatment but were comparable between the two groups (P<0.05).

CONCLUSIONSThe therapeutic effects are much better in patients with stage III nephropathy than in those in stage V. The combination of PGEl and ACEI produces stronger therapeutic effects than PGE1 or ACEI alone even at the one-year follow up.

Adult ; Aged ; Albuminuria ; urine ; Alprostadil ; therapeutic use ; Angiotensin-Converting Enzyme Inhibitors ; therapeutic use ; Diabetic Nephropathies ; drug therapy ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged

AIM:To explore the influence factors of the treatment zone diameter(TZD)and its correlation with axial length growth(ALG)after Paragon CRT orthokeratology.METHODS: Retrospective clinical study. The data of 226 myopic patients(226 eyes)wearing Paragon CRT orthokeratology from April 2020 to September 2022 were collect. The correlated factors of TZD after wearing lens for 1mo, and the relationship between the overlapping treatment zone/ pupil area ratio and the ALG after wearing lens for 1a were analyzed.RESULTS: After wearing lens for 1mo, the TZD was negatively correlated with central corneal thickness(CCT)and positively correlated with the flat corneal eccentricity. After wearing lens for 1a, the ALG of the small TZD group(0.25±0.18mm)was significantly smaller than that of the large TZD group(0.34±0.24mm, P=0.002), and the ALG of the small area ratio group(0.24±0.19mm)was significantly smaller than that of the large area ratio group(0.35±0.23mm,P<0.001). Age and overlapping treatment zone area/pupil area ratio were significantly associated with the ALG in multivariate linear regression(all P<0.05).CONCLUSION: The wearers with thicker CCT and smaller flat corneal eccentricity usually had smaller TZD, and both the TZD and the overlapping treatment zone area/pupil area ratio were correlated with the ALG.

Objective: The relationship between serum uric acid (SUA) levels and glycemic indices, including plasma glucose (FPG), 2-hour postload glucose (2h-PG), and glycated hemoglobin (HbA1c), remains inconclusive. We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population. Methods: The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study. A total of 105,922 community-dwelling adults aged ≥ 40 years underwent the oral glucose tolerance test and uric acid assessment. The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models. Results: A total of 30,941 men and 62,361 women were eligible for the current analysis. Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels, but with different inflection points in men and women. The thresholds for FPG, 2h-PG, and HbA1c for men and women were 6.5/8.0 mmol/L, 11.0/14.0 mmol/L, and 6.1/6.5, respectively (SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices). Conclusion An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes, while the inflection points were reached earlier in men than in women.
Aged ; Asian Continental Ancestry Group ; Blood Glucose/analysis* ; China/epidemiology* ; Cohort Studies ; Diabetes Mellitus/blood* ; Female ; Glucose Tolerance Test ; Glycated Hemoglobin A/analysis* ; Glycemic Index ; Humans ; Male ; Middle Aged ; Uric Acid/blood*