Objective To analyze the incidence and risk factors of microalbuminuria in newly diagnosed and hospitalized type 2 diabetes mellitus patients,and to provide the theoretical basis for therapy of diabetes and diabetic chronic complications.Methods The blood glucose,lipid profile,24h-urinaryalbumin,fasting and postprandial serum insulin and peptid C were measured in 286 newly diagnosed and hospitalized type 2 diabetic patients from Mar.2006 to Sep.2009.Microalbuminuria was defined as the 24h-urinary albumin between 30 to 300 mg twice.Insulin resistance index (HOMA-IR) was recorded and all the patients received fundus examination by ophthalmologists after expansion of the pupil to ensure whether there was retinopathy or not.Results (1)The incidence rate of microalbuminuria in this study was 19.58％ (56/286).(2)Normal albuminuria group and MA group combined DR were 19.57％ (45/230) and 33.93 ％ ( 19/56 ) respectively,and the difference was statistically significant( x2 =5.349,P =0.021 ).Compared with control,the FPG,HbA1c and HOMA-IR were significantly higher in microalbuminuria group ( FPG:[ 11.08 ± 1.76 ] mmol/L vs [9.24 ±1.65]mmol/L,t =-6.148,P ＜0.001;HbA1c:[11.54 ± 1.59]％ vs [9.39 ± 1.64]％,t =-7.533,P ＜0.001 ;HOMA-IR:[3.73 ±0.42] vs [3.50 ±0.30],t =-3.774,P ＜0.001 ).(3) Pearson correlation analysis revealed microalbuminuria was positively correlated with FPG( r =0.460),HbA1 c ( r =0.499),HOMA-IR( r =0.308)and combined DR(r =0.405)(P ＜0.01).(4)Stepwise multiple regression analysis revealed that FPG (ββ =- 0.804,P ＜ 0.01 ),HbA1 c (β =- 0.455,P ＜ 0.01 ) and combined DR (β =1.527,P ＜ 0.05 ) were independently risk factors of microalbuminuria.Conclusion The development of microalbuminuria in newly diagnosed and hospitalized type 2 diabetic patients is associated with FPG,HbA1c and HOMA-IR,and will be easier to merge diabetic retinopathy.

Objective To discuss the application of the degree of portal systemic shunting in assessing the upper gastrointes-tinal bleeding in patients with hepatic schistosomiasis. Methods Thirty - three patients with upper gastrointestinal bleeding caused by hepatic schistosomiasis(a bleeding group)and 29 schistosomiasis cirrhosis patients without bleeding(a non-bleeding group)were enrolled as investigation subjects in Jinshan Hospital. The subjects were scanned by the 128 abdominal slice spiral CT. The portal systemic shunting vessels were reconstructed by using thin slab maximum intensity projection(TSMIP)and multi-planar reconstruction(MPR). The degrees of the shunting vessels of the subjects were evaluated and compared,and the relation-ship between upper gastrointestinal bleeding and the degree of the shunting was analyzed. Results In the bleeding group,the occurrence rates of the shunting vessels were found as follows:86.4% in left gastric varices,68.2% in short gastric varices, 50.0% in esophageal varices,50.0% in para-esophageal varices,37.9% in gastric varices,69.7% in gastric-renal varices, 51.5% in spleen-renal varices,25.8% in abdominal wall varices,15.2% in omentum varices,63.6% in para-splenic varices, 34.8% in umbilical varices,40.9% in retroperitoneal-paravertebral varices,and 36.4% in mesenteric varices. In the bleeding group,the occurrence rates and the degree of shunt were significantly higher than those in the non-bleeding group in esophageal varices,esophageal vein,left gastric vein and gastric varices(all P < 0.05). Conclusions CT portal vein reconstruction can accurately display the location,degree and walking of all kinds of shunting vessels. Esophageal varices,esophageal vein,left gastric vein and gastric varices can accurately predict the risk of upper gastrointestinal bleeding in patients with hepatic schisto-somiasis. The patents with higher degree of the shunting vessels have a higher risk of gastrointestinal bleeding.

Abstract: Objective　To understand the pollution characteristics and sources of PM2.5 in the atmosphere during heating and non-heating periods in Urumqi City in 2021, and provide scientific basis for pollution control during different periods. Method A total of 188 air samples were collected from area A and area B of Urumqi City, and 12 metal elements and 5 water-soluble ions were quantitatively analyzed, and the pollution sources were analyzed by enrichment factor method and principal component analysis method. Results In 2021, the mass concentrations of PM2.5 in areas A and B of Urumqi were 45.0 (20.0, 158) µg/m3 and 28.0 (17.5, 66.0) µg/m3, respectively, with statistically significant difference (Z=-2.870, P<0.05). During the heating period, the concentrations were 110 (68.0, 250) µg/m3 and 61.0 (31.0, 88.0) µg/m3, respectively, with no statistically significant difference (Z=-3.822, P<0.01). During the non-heating period, the concentrations were 18.0 (13.0, 22.3) µg/m3 and 18.0 (12.8, 22.0) µg/m3, respectively, with no statistically significant difference (Z=-0.596, P>0.05). The SNA (the sum of SO42-, NO3-and NH4+) accounted for 71.7% and 23.4% of PM2.5 in A area during heating and non-heating periods, respectively, with statistically significant difference (Z=-8.057, P<0.01); the corresponding proportions in B area were 60.7% and 24.9%, with statistically significant difference (Z=-6.672, P<0.01). During the heating and non-heating periods, the ratios of NO3-/SO42-are 0.63 and 0.54 in A area were 0.63 and 0.54, respectively, with statistically significant difference (Z=-2.382, P<0.05); and the corresponding ratios in B area were 0.72 and 0.53, respectively, with statistically significant difference (Z=-3.182, P<0.05). The ratio of NO3- to SO42- was less than 1 in both heating and non-heating periods in the two areas. and the correlation between five water-soluble ions was significant (P<0.05). The correlation coefficient between NH4+ and SO42-, NO3-and Cl- in A and B areas during heating periods were all >0.9, indicating that NH4+and SO42-, NO3- and Cl- bind in (NH4)2SO4, NH4HSO4, NH4NO3, and NH4Cl. During non-heating periods, the correlation between NH4+ and each ion was slightly lower. During heating periods in area A, Sb, As, Cd, Pb, and Tl were severely enriched (EF>100). During non-heating periods in the same area, As, Cd, Pb, Tl, and Hg were severely enriched (EF>100). During heating periods in area B, Sb, As, Cd, Pb, and Hg were severely enriched (EF>100), and during non-heating periods in the same area, Sb, Cd, and Hg were severely enriched (EF>100). Coal emission, photochemical secondary pollution, motor vehicle exhaust, dust and industrial pollution were the main sources of PM2.5 pollution in the two areas, and the contribution rate of fixed sources was higher than that of mobile sources. Conclusion In 2021, the mass concentration of PM2.5, water-soluble ions and metal elements in Urumqi City were higher in area A than area B, the heating period was higher than the non-heating period, the excess rate of area A was higher than that in area B, and the contribution rate of fixed air pollution was greater than that of mobile sources.

Objective:To evaluate the diagnosis significance of breast mammography assisted by hook-wire localization biopsy for BI-RADSⅣand above negative or non-palpable breast lesions. Methods:A total of 48 cases of mammary molybdenum target with BI-RADSⅣlevel and above but with clinical-touched negative or non-palpable breast lesions (including 4 bilateral lesions and 44 uni-lateral lesions;total of 52 lesions) were used in the mammography aided by hook-wire localization biopsy. Results:Among the 52 le-sions, 13 cases were malignant lesions (single), 6 cases were at Stage 0 (accounted for 46.15%), 5 cases were in Stage I (38.46%), and 2 cases were in StageⅡ(15.39%). The remaining 39 cases were benign lesions. Results showed that the detection rate for breast cancer was 25.0%. A total of 39 cases of benign lesions and 10 cases of malignant lesions were found among mammography BI-RADSⅣpa-tients. Zero cases of benign lesions and 3 cases of malignant change were found among BI-RADS Ⅴ patients. The positive rates of breast cancer among BI-RADSⅣandⅤpatients were 25.64%and 100%, respectively. Conclusion:Breast mammography assisted by hook-wire localization biopsy could precisely excise both BI-RADSⅣandⅤnegative/non-palpable breast lesions. This technique can also improve the quality of life and prognosis of patients. It is a safe, accurate, and low-cost diagnostic method. Thus, breast mammogra-phy assisted by hook-wire localization biopsy must be widely used in clinical applications in China.

Objective To investigate the application of using urine ACR at different time points instead of 24-hour urinary albumin (24 h UA) for screening of early renal injury in patients with type 2 diabetes. Methods The 24-h urine samples at different time pointsfrom 89 hospitalized patients were collected. The correlations of the ACR of urine samples at different time points were compared with the 24-h UA. When the 24-h UA was taken as the standard,the receiver operating characteristic (ROC) curves of urine ACR at different time points were established and analized. Results No significant differences in urine ACR between the morning urine group [ACR 9.02 (5.69~ 11.64)mg/mmol] and the random urine group [ACR 8.65 (5.80 ~ 11.83) mg/mmol] (P > 0.05). A positive correlation was observed between the morning urine ACR and the random urine ACR (r = 0.951,P < 0.01), however, the ACR of the morning and the random urine group were all positively correlated with the 24-h UA (r=0.886, 0.859, P<0.01). There were no significant differences in the sensitivities and the specificities between the morning and the random urine specimens in screening for albuminuria (92.6%vs 90.1%, and 87.5%vs 87.5%, respectively). When the 24-h UA was taken as the standard,the area under the ROC curves of the ACR in the random urine specimens and the morning urine specimens were 0.954 ± 0.022 and 0.960 ± 0.021 , respectively. There were no statistical differences between these two groups. Conclusions The morning urine and the random urine ACR , instead of the 24-h UA , could be used for both the early screening and monitoring of the renal injury , and the random urine ACR detection is simple ,convenient and accurate for patients.

Objective To explore the interaction between polymorphisms of rs17222919 which located in the 5-1ipoxygenase-activating protein(ALOX5AP) gene promoter and environmental risk factors in ischemic stroke(IS).Methods We conducted a case-control study involving a total of 622 cases and 631 unrelated healthy controls which were selected from Henan Han populations,and the environment risk factors were recorded.Genotyping aimed at detecting both genetic and environmental factors in relation to IS was performed by TaqMan-polymerase chain reaction technology while interaction indexes (Υ) were calculated to determine interactions and their role models.Results The rs17222919 TG (189/622,30.4％),GG (18/622,2.9％)genotype frequencies and G (225/1244,18.1％)allele frequencies in IS subjects were significantly lower than those in controls (221/631,35.0％ ; 31/631,4.9％ ; 283/1262,22.4％ ; x2 =4.117,P =0.042 ; x2 =4.457,P =0.035 ; x2 =7.294,P =0.007).Negative interactions between TG + GG genotype and hypertension,diabetes or cigarette smoking in the occurrence of IS (Υ =0.943,0.922,0.830) were observed,whose role models were all super-multiplicative models.Conclusions According to our study,ischemic stroke is the result of the interaction of genetic and environmental factors and G allele of rs17222919 may have weakened the role of environmental factors for hypertension,diabetes and cigarette smoking in IS incidence.

Objective To analyze the efficacy,late complications and prognostic factors of post-op-erative radiotherapy for cervical cancer. Methods From Nov. 1999 to Feb. 2005,114 patients with cervi-cal cancer received adjuvant pelvic radiotherapy after radical hysterectomy and pelvic lymphadenectomy. The median age was 42.5 (24 to 72) years old. According to the FIGO staging system,6,51,18,26 and 13 pa-tients had stage ⅠA, Ⅰb1, Ⅰb2, ⅡA and ⅡBdisease. The pathological type was squamous cell carcinoma,ade-nocarcinoma, squamous-adenocarcinoma and undifferentiated carcinoma in 92,19,2 and 1 patients, respec-tively. The whole-pelvic external beam irradiation of 50 Gy (40 to 60 Gy) was given with 6 MV or 15 MV X-ray beams using four-field box technique. Eighty-one patients received intravaginal brachytherapy of 16 Gy (4 -30 Gy in 1 -6 fractions) 4 weeks after the beginning of radiotherapy, with the referrence point being at 0.5 cm under the vaginal mucosa. Eighty-seven patients received preoperative and/or concurrent chemother-apy. The survival and independent prognostic factors were analyzed by Log-rank method and Cox model. Results The median follow-up time was 26.0 (5 - 75) months. The overall survival rate, disease-free sur-rival rate and local control rate were 93.1%, 88.1% and 94.6% at 2-year, and 75.7%, 62.3% and 85.6% at 5-year,respectively. The independent prognostic factors were lymph node metastasis and positive surgical margin for overall survival, positive surgical margin for local control, and stage, uterine body invasion and positive surgical margin for disease-free survival. Sixteen patients ( 14% ) had distant metastasis, and the most common sites were the lung,inguinal region,bone,liver and brain. According to RTOG grading sys-tem, the incidence of late gastrointestinal side effects of grade 1,2 and 3 was 11.4%, 11.4% and 3.5%. The corresponding genitourinary side effects were 14.0% ,6.1% and 0.9%, respectively. The incidence of leg lymphedema was 7 % . Conclusions Post - operative radiotherapy can achieve good local control in cervical cancer with acceptable late side effects. Distant metastasis is the main cause of death.

Objective To investigate the relationship and mechanism of the serum vitamin D levels with insulin sensitivity and adipokines APN,RBP4,visfatin and TNF-α in patients with gestational diabetes mellitus(GDM). Methods A total of 101 patients with gestational diabetes( GDM group) and 50 pregnant women with normal blood sugar( control group) were recruited to detect the serum levels of correlative biochemical indexes,APN,RBP4,visfatin,TNF-α and 25OHD3 using an HPLC method. Twenty-four patients in the GDM group diagnosed with vitamin D deficiency(<25 nmol·L-1 ) were randomized to receive either 1,25(OH) 2D3(0. 25 μg·d-1) orally or no treatment. Serum levels of correlative biochemical indexes were detected after 1 month. Results GDM patients had 25OHD3 levels significantly lower than the control group(P<0. 05),APN levels lower than the control group,and RBP4,visfatin,TNF-α levels significantly higher than the control group(all P<0. 05). After 1 month of 1,25(OH) 2D3 treatment,HOMA-IR increased,while HOMA-β decreased. APN levels was positively correlated(r= 0. 526) with 25OHD3;RBP4,visfatin,TNF-α decreased and were negatively correlated with 25OHD3( r values were -0. 272,-0. 153,-0. 072). Conclusion Vitamin D can reduce the adipokines RBP4,visfatin,TNF-α,increase APN,and thus play a protective role for gestational diabetes.

Objective:To analyze the prevalence of epilepsy and its clinical features in patients with Alzheimer's disease(AD).Methods:Clinical data of patients with AD from a separate database of Tianjin Huanhu Hospital for dementia and degenerative diseases from January 2010 to January 2019 were retrospectively examined.The prevalence of AD combined with epilepsy was analyzed.The characteristics from neuropsychological assessment, clinical manifestations of epileptic attacks, electroencephalogic patterns and other features were analyzed and compared with those of AD patients without epilepsy.Results:Of 376 AD patients, 11.4% had epilepsy, with 4.0% showing non-induced seizures before AD diagnosis and 7.5% after AD diagnosis.The average age of AD patients at first onset of epilepsy was 59.8±19.9 years, and the average age of patients at initial diagnosis with AD was 62.8±6.6 years.The most common type was focal seizures(65.1%), and EEG showed mostly focal slow waves(69.8%)and focal epileptiform discharges(23.3%). The AD diagnosis for patients with epilepsy was 8 years earlier than those without epilepsy.Conclusions:Epilepsy has a high prevalence in AD patients, and seizures may be a risk factor for progression from cognitive impairment to AD.Early identification of seizures and cognitive impairment may have a positive effect on delaying the progression of dementia.

Platinum-based anticancer drugs have been becoming one of the most effective drugs for clinical treatment of malignant tumors for its unique mechanism of action and broad range of anticancer spectrum. But, there are still several problems such as side effects, drug resistance/cross resistance and no-specific targeting, becoming obstacles to restrict its expanding of clinical application. In recent years, supramolecular chemistry drug delivery systems have been gradually concerned for their favorable safety and low toxicity. Supramolecular macrocycles-platinum complexes increased the water solubility, stability and safety of traditional platinum drugs, and have become hot focus of developing novel platinum-based anticancer drugs because of its potential targeting of tumor tissues/organs. This article concentrates in the research progress of the new drug delivery system between platinum-based anticancer drugs with three generations of macrocycles: crown ether, cyclodextrin, cucurbituril and calixarene.
Antineoplastic Agents ; pharmacology ; Calixarenes ; Crown Compounds ; Cyclodextrins ; Drug Delivery Systems ; Humans ; Macrocyclic Compounds ; pharmacology ; Neoplasms ; drug therapy ; Platinum Compounds ; pharmacology