?AIM: To study the changes of choroidal thickness and hemodynamic parameters in patients with diabetic retinopathy and their influencing factors.?METHODS: From January 2013 to January 2015, 100 patients (100 eyes) with type 2 diabetes were divided into 3 groups:34 patients without diabetic retinopathy ( NDR) , 36 patients with non proliferative diabetic retinopathy ( NPDR) group, and 30 patients with proliferative diabetic retinopathy (PDR). According to the results of OCT, the patients with diabetic retinopathy were divided into 2 groups: diabetic macular edema ( DME ) group ( 28 cases) , and 38 cases without diabetic macular edema. During the same period in our hospital 35 subjects for physical examination were selected as the control group. The hemodynamic parameters of the posterior ciliary artery in different groups of patients at different distance from the center of the macular were compared, analyzing influencing factors.?RESULTS:With the aggravation of diabetic retinopathy, the choroidal thickness in different distance from the center of the macular decreased. The choroidal thickness of NPDR and PDR group were thinner than that of the control group (P<0. 05). The choroidal thickness of NDR group was not different from the control group (P>0. 05). There was no significant difference in the choroidal thickness between the DME patients and non DME patients (P>0. 05). Pearson correlation analysis showed that there was no significant correlation between choroidal thickness of patients with diabetic retinopathy and diabetic duration, fasting blood glucose, HbA1c, eye axis length, systolic blood pressure and diastolic blood pressure (P>0. 05), but there was a correlation with BCVA (logMAR) (P<0. 01). EDV and PSV in NDR group and NPDR group were significantly lower than those in control group, RI was higher than that in control group. PSV and EDV in PDR group were significantly lower than those in other three groups, RI was higher than the other three groups, and the difference was statistically significant ( P<0. 05).?CONCLUSION:With the severity of retinopathy in type 2 diabetic patients, the choroidal thickness decreased, and the thickness of the choroid is beneficial in the comprehensive analysis of 2 diabetic retinopathy.

Objective:To explore the willingness to use mobile healthcare in patients with gout and explore its influencing factors, and provide theoretical guidance for optimizing the gout mobile healthcare platform and improving patients' willingness to use it.Methods:This study was a cross-sectional study. Totally 234 patients with gout who attended the outpatient service in Shandong Provincial Gout Clinic Medical Center from November 2019 to January 2020 were selected by convenient sampling, and investigated with a self-designed general information questionnaire and questionnaire of gout patients' willingness to use mobile healthcare and its influencing factors. Univariate analysis and multiple linear regression analysis were used to analyze the influencing factors of gout patients' willingness to use mobile healthcare.Results:A total of 53.85% (126/234) of patients with gout mainly used gout WeChat official account as a form of mobile healthcare, and the commonly used functions were diet guidance (64.96%, 152/234) , disease knowledge (60.26%, 141/234) , exercise guidance (54.27%, 127/234) ; 47.01% (110/234) of patients were not satisfied with mobile healthcare. The gout patients' willingness score to use mobile healthcare was (10.91±3.28) . Univariate analysis showed that there were statistically significant differences in the willingness scores of patients with different personal monthly income, education level, and whether have comorbid diseases ( F/t=12.511, 6.343, -2.229; P< 0.05) . Regression analysis showed that the influencing factors of gout patients' willingness to use mobile healthcare included perceived susceptibility, perceived severity, perceived benefits, perceived barriers, information quality and system quality (adjust R2=0.446, P<0.01) . Conclusions:The willingness of gout patients to use mobile healthcare services is at a moderately high level, and there are differences between different individuals. The willingness to use mobile healthcare is affected by patients' health beliefs and the quality of mobile healthcare information systems.

Objective:To explore the impact of pain, functional disability, self-efficacy and social support on health-related quality of life (HRQOL) in gout patients.Methods:From November 2019 to January 2020, a total of 218 patients with gout were investigated using the general information questionnaire, Visual Analogue Scale, Health Assessment Questionnaire Disability Index, General Self-Efficacy Scale, Perceived Social Support Scale, and Gout Impact Scale. The structural equation model was established by AMOS 24.0 for parth analysis, and the mechanism of pain dysfuction, self-efficacy and social support affecting the quality of life in gout patients was tested.Results:The total score of Gout Impact Scale, pain, functional disability, self-efficacy and social support respectively was 59.94±18.39, 6.00±2.76, 0.25 0, 0.88, 23.39±6.40 and 62.92±8.24. Pain directly influenced HRQOL ( β=-0.293, P<0.01), and indirectly influenced HRQOL ( β=-0.039, P<0.05). Functional disability directly influenced HRQOL ( β=-0.244, P<0.01). Self-efficacy directly influenced HRQOL ( β=0.182, P<0.01), and indirectly influenced HRQOL ( β=0.202, P<0.01) through pain and functional disability. Social support indirectly influenced HRQOL ( β=0.278, P<0.01) through pain, functional disability and self-efficacy. Conclusions:HRQOL of patients among gout is affected by several factors, mainly affected by pain, functional disability and self-efficacy; and there are interactions among them. Targeted interventions should be strengthened to relieve pain, prevent or slow down the progress of physical disability, enhance self-efficacy and social support to improve HRQOL.

Objective To summarize the condition of delayed elimination occurred on a patient with acute B lymphocytic leukemia after the forth time of high-dose methotrexate (MTX) chemotherapy and to analyze its reasons.Methods Reviewed the patient's relevant data during the four times of high-dose chemotherapy,including the therapeutic regimen,the results of therapeutic drug monitoring,and other relevant laboratory reports etc.What's more,consulted some related literature,further analyzed the reason of delayed elimination appeared on the patient after repeated chemotherapy of MTX in different views.Results The patient hadn't suffered the MTX relevant adverse reactions after the rescue drug therapy by calcium folinate etc.The blood concentration of MTX decreased to 0.10 μmol · L-1 after 216 hours of administration.It was suggested that the pH of the patient's urine was the possible reason influencing the elimination of MTX,but the foods,the cycles of chemotherapy and the disease stage also couldn't be excluded.Conclusion The blood drug concentration in the different cycles of MTX therapy for the patient were not same,and its specific mechanism needs an in-depth study.If the delayed elimination of MTX occurred,the rescue should be strengthened to ensure the safety and effectiveness of patients.

Objective In order to investigate etiology and molecular-epidemiological characteristics of enterovirus associated encephalitis (EAE) in Zhejiang,2008-2012.Method Cerebrospinal fluid and stool specimens were collected from suspected EAE patients,who were admitted to our hospitals.RD and Hep-2 cell lines were used to isolate enterovirus (EV).Serotypes of these EV isolates were identified through neutralization test by using serotype specific anti-sera.VP 1 genes of these isolates were sequenced,compared and used for the construction of phylogenetic tree.Results 127 (20.6％) human enterovirus (HEV) strains were isolated from 616 samples,which were collected from 610 patients.Serotypes of these EV isolates,including 60 coxsackievirus (CV),and 67 Echovirus (E) appeared to be CVA9,CVB1,CVB3-5,E3,E4,E6,E9,El4,E25 and E30,respectively.Predominant EV serotypes on EAE from 2008 to 2012 were seen as CVB3,CVB5,E6,E30 and E30,respectively.The full length of VP1 genes from different EV isolates was between 834 and 918 nucleotides.The VP1 gene similarities between these isolates and the reference strains were from 76.7％ to 85.0％ (nucleotides level) and 91.1％ to 97.9％ (amino acids level).The VP1 genes from E6 serotype isolates appeared most diverged,reaching 20.4％ (nucleotides level) attd 4.8％ (amino acids level).Based on the generated phylogenetic tree,all the EV isolates were fallen on the same branch of HEV-B,and the isolates in the same serotype formed one sub-branch,suggesting there existed geographical and temporal effects.E6 isolates diverged into two branchlets.Conclusion EVs from HEV-B were the etiologic agents for EAE in Zhejiang province from 2008 to 2012.All these EV isolates showed 12 serotypes,with predominant isolates varied every year.E30 was determined as the most dominant serotype while serotype E6 diverged into two sub-genetypes.

OBJECTIVETo investigate the association of urinary albumin excretion rate (UAER) and hyperuricemia with macrovascular atherosclerosis in type 2 diabetic patients.

METHODSNinety-seven type 2 diabetic patients were divided into two groups according to the UAER, namely group A with UAER between 20 and 200 microg/min (n=63) and group B with UAER > or = 200 microg/min (n=34); the patients were also classified into hyperuricemia group (group C, n=59) and normal blood uric acid (BUA) group (group D, n=38). The disease course, BUA, fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoproteins (HDL), UAER and arteria carotis intima-media thickness (IMT) were determined in these patients. The relationship of UAER and hyperuricemia with carotid arterial IMT was analyzed statistically.

RESULTSThe levels of TG, TC, LDL and HDL showed no significant differences between the 4 groups (P>0.05). The disease course, BUA, UAER, and FBG levels and IMT in groups A and C were significantly higher than those in groups C and D (P<0.05), but no such differences were found between groups A and C or between groups B and D (P>0.05). Arotid arterial IMT was independently correlated to the disease course, BUA and UAER (r=0.201, 0.1999, 0.211, respectively, P<0.05), and a significant positive correlation was noted between BUA and UAER (r=0.221, P<0.05).

CONCLUSIONMacrovascular atherosclerosis in type 2 diabetic patients is significantly correlated to the disease course, BUA and UAER levels, which can be used to evaluate and predict macrovascular atherosclerosis in type 2 diabetic patients.

Adult ; Aged ; Albuminuria ; complications ; Atherosclerosis ; complications ; pathology ; Carotid Arteries ; pathology ; Diabetes Mellitus, Type 2 ; complications ; pathology ; Female ; Humans ; Hyperuricemia ; complications ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo explore the intervention effect of the auricular stimulator in the cavum concha for diabetes.

METHODSForty-five cases were treated with auricular simulator in the cavum concha for 30 min, once daily for consecutive 3 months. The changes of the fasting plasma glucose (FBG), blood glucose load after 2-hour 75 g oral glucose tolerance test (P2 BG)and glycosylated hemoglobin (HbA1c) were compared before and after treatment.

RESULTSThe level of the HbA1c was obviously decreased (P < 0.05, P < 0.01), and there were also statistically significant differences in FBG and P2 BG after the treatment (P < 0.05, P < 0.01).

CONCLUSIONWith the auricular stimulator, the stimulation in the cavum concha is benefit for the improvement of HbA1c of the diabetes.

Acupuncture, Ear ; Adult ; Aged ; Diabetes Mellitus ; metabolism ; therapy ; Female ; Glucose ; metabolism ; Glycated Hemoglobin A ; metabolism ; Humans ; Male ; Middle Aged

The work was aimed to investigate the differential expressions of lipid metabolism related genes in the early stage of atherosclerosis in the young apolipoprotein E deficient (apoE(-/-)) mice at different ages with normal chow diet. The genotypes of mice were identified by using multiplex polymerase chain reaction (multi-PCR) analysis. The semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) and real-time quantitative RT-PCR were used to analyze the expressions of lipid metabolism related genes in the liver of apoE(-/-) and age-matched wild type (WT) mice of 14-day old, 1-month old, 2-month old, 3-month old. The serum total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) contents were assayed using COD-PAP and GPO-PAP methods. The serum apolipoprotein B100 (apoB100) content was quantitated by immune turbidimetry. The hearts were perfusion-fixed in 4% formaldehyde, infiltrated with 30% gum sucrose for 24 h at 4 °C, and embedded in OCT compound. The aortic sinus tissues were serially sectioned at -15 °C, stained with Sudan IV, and counterstained with light green. The results were shown as follows. Compared with that in WT mice, the mRNA levels of apoA I and apoA IV in apoE(-/-) mice aged from 14-day old to 3-month old changed prominently (P<0.05), with apoA I up-regulated and apoA IV down-regulated. At the age of 1 month, the expression of apoB100 in apoE(-/-) mice was higher than that in WT mice (P<0.05). The expression of apoA V was up-regulated (P<0.05) and there was obvious lipid deposition in the aortic intima in apoE(-/-) mice at the age of 2 months. The expressions of fatty acid translocase (Fat/CD36) and angiopoietin-like protein 3 (Angptl 3) in apoE(-/-) mice were higher than those in WT mice at the age of 3 months (P<0.05), while the expressions of peroxisome proliferator-activated receptor α (PPARα), liver X receptor α (LXRα), carnitine palmitoyl transferase I (CPT I) and acyl coenzyme A oxidase 1 (ACOX1) showed no significant changes. The serum TC, TG, LDL-C and HDL-C contents in apoE(-/-) mice aged from 14-day old to 3-month old were higher than those in age-matched WT mice. apoE(-/-) mice showed a marked increase in serum apoB100 content, consistent with the trend of serum LDL-C content and apoB100 mRNA content in the liver. The results suggest that the mRNA expressions of apoA I, apoA IV, apoA V, apoB100 and Angptl 3 in apoE(-/-) mice change significantly compared with those in WT mice, and these genes might be relevant to the complicated lipid metabolism network, and involved in the early stage of atherogenesis.
Animals ; Apolipoprotein A-I ; metabolism ; Apolipoprotein B-100 ; blood ; Apolipoproteins A ; metabolism ; Apolipoproteins E ; genetics ; Atherosclerosis ; genetics ; Gene Expression ; Lipid Metabolism ; genetics ; Lipoproteins, HDL ; blood ; Lipoproteins, LDL ; blood ; Liver ; metabolism ; Mice ; Mice, Knockout ; Triglycerides ; blood

OBJECTIVETo clarify the differential expression of the genes related to the lipid metabolism in the early stage of atherosclerosis in the young LDLR-/- mice of different ages.

METHODSA RT-PCR assay was used to analyse the gene expression patterns in the livers of LDLR-/- mice and wild type (WT) mice from 14 to 90 days. The characteristics of early lipid deposition in intima were evaluated using biochemical and pathological techniques.

RESULTSIn LDLR-/- mice, when compared to WT mice, the mRNA level of the apolipoprotein A IV (apoA IV), fatty acid translocase (Fat/CD36) and carnitine palmitoyl transferase I (CPT I) changed prominently at the age of 14-days (P < 0.05). At 30 days, the mRNA level of apolipoprotein A I (apoA I) was up regulated, but apolipoprotein F (apoF), CD36 and CPT I were down regulated (P < 0.05). At 60 days, the mRNA levels of apoA I, CPT I and liver X receptor alpha (LXRalpha) were up regulated, but apoA IV was down regulated (P < 0.05). At 90 days, the level of the apoA I was higher, but the expression of the apoA IV, apoF and acyl-coenzymeA oxidase 1 (ACOX1) were down regulated (P < 0.05), whereas the expression of apolipoprotein A V (apoA V), apolipoprotein E (apoE), peroxidase proliferator-activated receptor alpha (PPARalpha) and angiopoietin-like protein 3 (angptl 3) had no significant changes (P > 0.05). The serum levels of TC (P < 0.05), TG (P < 0.05) and LDLC (P < 0.05) in LDLR-/- mice were significantly higher than those in wild type mice with the same age.

CONCLUSIONSThe mRNA levels of the apoA I, apoA IV, apoF, FAT/CD36, CPT I, ACOX1 and LXRalpha of the LDLR-/- mice were significantly changed compared to the WT mice. The genes may be of some relevance to the complicated lipid metabolism network, and have effect in the early stage of atherogenesis.

Animals ; Apolipoprotein A-I ; genetics ; metabolism ; Apolipoproteins A ; genetics ; metabolism ; Apolipoproteins E ; genetics ; metabolism ; Gene Expression ; Lipid Metabolism ; Liver ; metabolism ; Liver X Receptors ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Knockout ; Orphan Nuclear Receptors ; genetics ; metabolism ; RNA, Messenger ; metabolism ; Receptors, LDL ; deficiency

OBJECTIVETo explore the relationship between the expression characteristics of lipid metabolism-related genes in the liver and early atherosclerotic lesions in apolipoprotein E and low density lipoprotein receptor gene double knockout (apoE(-/-)/LDLR(-/-)) mice.

METHODSRT-PCR was used to detect the differential expression of lipid metabolism-related genes in the liver of apoE(-/-)/LDLR(-/-) and wild type (WT) mice. Serum total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) level as well as aortic morphology were also analyzed.

RESULTSAmong the 11 lipid metabolism-related genes, apolipoprotein B100 (apoB100) mRNA levels were significantly higher in apoE(-/-)/LDLR(-/-)mice compared with WT mice. At 14 days, 1, 2 and 3 months of age, the level of mRNA expression were 1.55, 1.47, 1.50 and 2.42 folds of those of the age matched WT mice respectively. The fatty acid transporter (FAT/CD36) mRNA expression levels were higher in 14-day and 3-month old mice at 1.30 and 1.35 folds of those of the age matched WT mice, respectively. Apolipoprotein A IV (apoA IV) and Apolipoprotein AV (apoAV) mRNA levels were significantly down-regulated (0.89 fold decrease in 14-day, and 0.90 folds decrease in 3-month, respectively). The mRNA expression levels of apolipoprotein AI (apo AI), apolipoprotein F (apo F), peroxidase proliferator-activated receptor alpha (PPAR-alpha), liver X receptor alpha (LXRalpha), angiopoietin-like protein 3 (ANGPTL3), acyl-coenzymeA oxidase 1 (ACOX1) and carnitine palmitoyl transferase 1 (CPT1) had no significant changes. Serum TC, TG and LDL-C were higher than those of age matched WT mice at 7, 2 and 30 folds, respectively. Furthermore, apoE(-/-)/LDLR(-/-) mice demonstrated typical early atherosclerotic lesions at sinus and root regions of aorta in an age dependent manner.

CONCLUSIONAlterations of the expression of lipid metabolism-related genes in liver play important roles in the development of AS in the apoE(-/-)/LDLR(-/-) mice at early ages.

Animals ; Aorta ; pathology ; Apolipoprotein A-V ; Apolipoprotein B-100 ; biosynthesis ; genetics ; Apolipoproteins ; biosynthesis ; genetics ; Apolipoproteins A ; biosynthesis ; genetics ; Apolipoproteins E ; deficiency ; Atherosclerosis ; etiology ; metabolism ; pathology ; CD36 Antigens ; biosynthesis ; genetics ; Gene Expression ; Lipid Metabolism ; Liver ; metabolism ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Knockout ; RNA, Messenger ; metabolism ; Receptors, LDL ; deficiency