1.The early diagnostic value of corneal laser confocal microscopy for small neuropathy in elderly patients with type 2 diabetes mellitus
Haiyan JIA ; Lifang LYU ; Yun ZHANG ; Fuping XIE ; Quanzhong LI
Chinese Journal of Geriatrics 2017;36(5):543-546
Objective To investigate the early diagnostic value of cornel confocal microscopy for the screening of small neuropathy in elderly patients with type 2 diabetic mellitus.Methods In the prospective study,96 elderly patients with diabetes as study group and 46 patients with non-diabetes as the control group were continuously collected from our hospital endocrinology and ophthalmology out patients during May 2014 to February 2016.The 96 cases of type 2 diabetes were subdivided into 47 patients with diabetic peripheral neuropathy (DPN)and 47 patients with nowdiabetic peripheral neuropathy(non DPN).Results The diabetes course was shorter in non-DPN group than in DPN group(P=0.000).The levels of glycosylated hemoglobin and urine albumin were lower in the nonDPN than in the DPN(P =0.072,0.007,respectively).The corneal nerve fiber density was lower in the DPN group than in NDPN group (P =0.000).Corneal nerve fiber density was higher in control group than in DPN and NDPN group.The differences in number of corneal nerve fibers showed no statistical significance between DPN and NDPN group (x2 =2.391,P =0.314).But the number of corneal nerve fibers was significant less in DPN and NDPN group than in control group(x2 =16.014,P =0.000).The negative correlation was found between the course of disease and corneal fibrous density by using single factor linear regression analysis.The number of corneal nerve fibers was lower in smoking group than in non-smoking group(P=0.003).The multiple linear regression analysis showed that duration of diabetes was a risk factor for diabetic neuropathy.Conclusions In some elderly diabetic patients with non-neuropathy,corneal nerve fiber density and number have been significantly decreased before nerve conductive velocity is reduced.Therefore,corneal confocal microscopy can be used to detect and diagnose small diabetic neuropathy in elderly patients with diabetes mellitus.
2.The efficacy and safety of injection-related risk management based on WeChat platform in type 2 diabetic patients with the first insulin self-injection
Lingyu ZHENG ; Chunxia XU ; Jiaqi YAO ; Jing ZHAN ; Jia LYU ; Yun RUAN ; Jing WANG ; Qingying TAN
Chinese Journal of General Practitioners 2021;20(3):339-343
Objective:To assess the implementation of injection-related risk management based on WeChat platform for type 2 diabetic patients with the insulin self-injection.Methods:A total of 124 diabetic patients, who would receive insulin therapy by self-injection at home after discharge from the PLA 903 hospital during April 2017 to July 2018, were divided into the control group( n=62)and the study group( n=62). All patients were given routine education on insulin injection during the hospitalization,while the study group( n=62)received additional video and text education based on WeChat platform after discharge. The skill of self-injection and the status of blood glucose control were evaluated in both groups 4 weeks and 8 weeks after discharge, respectively. Results:The insulin injection skill, including skin disinfection [36(58%) vs. 11(18%),χ 2=21.42, P<0.01], exhaust before injection [62(100%) vs. 51(82%),χ 2=12.07, P<0.01], stay 10s after injection [60 (97%) vs. 47(76%),χ 2=11.52, P<0.01], disposal of used needle[49(79%) vs. 18(29%),χ 2=31.20, P<0.01], rotation of injection site [48(77%) vs. 35(56%),χ 2=6.16, P=0.01], insulin storage [62(100%) vs. 57(92%),χ 2=5.21, P=0.02], and the ability of correctly dealing with hypoglycemia [52(84%) vs. 38(61%),χ 2=7.94, P=0.01] in the study group were significantly better than those in the control group after 4 weeks of injection-related risk management. The fasting plasma glucose [(6.41±0.76) vs.(7.19±0.81)mmol/L, t=5.61, P<0.01], glycosylated hemoglobin A1c [(6.71±0.64)% vs. (7.37±0.78)%, t=5.18, P<0.01], incidence of hypoglycemia [6(10%) vs. 15(24%),χ 2=4.64, P=0.03] in the study group were significantly lower than those in the control group after 12 weeks of the management. Conclusion:The risk management based on WeChat platform can improve insulin self-injection skill and the ability of dealing with hypoglycemia,also promote effective blood glucose control for diabetes patients.
3.Research on the correlation between uric acid levels and thyroid nodules and gender differences
Yao LIU ; Ziwei LIN ; Chunjun SHENG ; Dajin ZOU ; Zhongwei LYU ; Huixiong XU ; Yikun ZHU ; Yun HUANG ; Ni ZHONG ; Zhao JIA ; Qing WEI ; Shen QU
Chinese Journal of Endocrinology and Metabolism 2017;33(5):377-381
Objective To explore the correlation between thyroid nodules and uric acid levels and to find their gender differences.Methods A total of 68 056 subjects in a regional medical physical examination center of Shanxi Province from January 2013 to June 2015 were enrolled in this study.All the participants′ general information and parameters were recorded.Thyroid nodules were detected by color Doppler ultrasonography.Results The total prevalence of thyroid nodule was 35.5%, 30.7% in males and 40.0% in females.The prevalence of single nodule was 50.1%, and multiple 49.9%.Compared with no nodule group, thyroid nodule group tended to be older, with higher BMI, and with a worse metabolic status(all P<0.01).The uric acid levels were lower[(352.37±78.14 vs 357.70±77.51) μmol/L, P<0.01] in thyroid nodule group in male and higher[(260.22±61.91 vs 253.91±59.18) μmol/L, P<0.01] in female.Conclusion Thyroid nodules may be associated with metabolism and inflammation.In males, hyperuricemia group had lower, while in females, hyperuricemia ones were with a higher prevalence of thyroid nodules.
4.Health self-assessment of the migrant workers received physical examination in Shanghai
Xiao-meng LOU ; Yun-jia LYU ; Jia-hua SHI
Shanghai Journal of Preventive Medicine 2021;33(8):732-738
Objective:To understand the health self-assessment and related influencing factors in the migrant workers who received of physical examination in Shanghai, so as to provide reference for formulating health service policies for migrant workers. Methods:Taking Shanghai "Intelligent Blue Collar" Health Science Popularization Service Station as the investigation site, 8,100 urban workers were surveyed by questionnaire. The questionnaire includes basic information, health self-assessment, basic medical insurance coverage and satisfaction, subjective well-being and so on. Results:There were significant differences between migrant workers and local workers in health self-assessment, two-week disease prevalence rate, and chronic disease prevalence rate(
6.Analysis of the incidence and epidemic trend of gallbladder cancer in China
Wencai LYU ; Yun ZOU ; Shuang WEN ; Li JIA ; Weili FU ; Xiaoping GENG
Chinese Journal of Digestive Surgery 2019;18(2):186-189
Many clinicians have the following 4 misconceptions about the incidence and epedemil trend of gallbladder cancer.(1) The incidence of gallbladder cancer and extrahepatic bile duct carcinoma is considered as the incidence of gallbladder cancer.(2) The gallbladder cancer is the common malignant tumor of the digestive system.(3) The gallbladder cancer is the most common malignant tumor of biliary tract system.(4) The incidence of gallbladder cancer is increasing year by year.Based on the latest annual report of the 2016 Chinese Cancer Registry Annual Report,published by the National Cancer Center (NCCR),combined with previous annual reports and the data of the incidence of gallbladder and extrahepatic bile duct cancer in the related articles,supplemented by clinical data,the author points out that the incidence of gallbladder cancer in China is about 1.00-1.30 per 100 000.It is pointed out that gallbladder cancer is not the most common cancer in the digestive and biliary systems.The incidence of gallbladder cancer has not been significantly increased in recent years,and its 5-year relative survival rate has been reduced by 0.9% since 2003.Although the incidence of gallbladder cancer is low,the malignant degree is high and the prognosis is poor.It highlights the lack of effective treatment for the disease,and further hints that we should strengthen the necessity of early diagnosis and treatment of gallbladder cancer.
7.Mortality and Morbidity of Extremely Low Birth Weight Infants in the Mainland of China: A Multi-center Study.
Hui-Jia LIN ; Li-Zhong DU ; Xiao-Lu MA ; Li-Ping SHI ; Jia-Hua PAN ; Xiao-Mei TONG ; Qiu-Ping LI ; Jian-Guo ZHOU ; Bing YI ; Ling LIU ; Yun-Bing CHEN ; Qiu-Fen WEI ; Hui-Qing WU ; Mei LI ; Cui-Qing LIU ; Xi-Rong GAO ; Shi-Wen XIA ; Wen-Bin LI ; Chao-Ying YAN ; Ling HE ; Kun LIANG ; Xiao-Yu ZHOU ; Shu-Ping HAN ; Qin LYU ; Yin-Ping QIU ; Wen LI ; Dong-Mei CHEN ; Hong-Ru LU ; Xiao-Hong LIU ; Hong LIU ; Zhen-Lang LIN ; Li LIU ; Jia-Jun ZHU ; Hong XIONG ; Shao-Jie YUE ; Si-Qi ZHUANG
Chinese Medical Journal 2015;128(20):2743-2750
BACKGROUNDWith the progress of perinatal medicine and neonatal technology, more and more extremely low birth weight (ELBW) survived all over the world. This study was designed to investigate the short-term outcomes of ELBW infants during their Neonatal Intensive Care Unit (NICU) stay in the mainland of China.
METHODSAll infants admitted to 26 NICUs with a birth weight (BW) < l000 g were included between January l, 2011 and December 31, 2011. All the data were collected retrospectively from clinical records by a prospectively designed questionnaire. The data collected from each NICU transmitted to the main institution where the results were aggregated and analyzed. Categorical variables were performed with Pearson Chi-square test. Binary Logistic regression analysis was used to detect risk factors.
RESULTSA total of 258 ELBW infants were admitted to 26 NICUs, of whom the mean gestational age (GA) was 28.1 ± 2.2 weeks, and the mean BW was 868 ± 97 g. The overall survival rate at discharge was 50.0%. Despite aggressive treatment 60 infants (23.3%) died and another 69 infants (26.7%) died after medical care withdrawal. Furthermore, the survival rate was significantly higher in coastal areas than inland areas (53.6% vs. 35.3%, P = 0.019). BW < 750 g and GA < 28 weeks were the largest risk factors, and being small for gestational age was a protective factor related to mortality. Respiratory distress syndrome was the most common complication. The incidence of patent ductus arteriosus, intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia, retinopathy of prematurity was 26.2%, 33.7%, 6.7%, 48.1%, and 41.4%, respectively. Ventilator associated pneumonia was the most common hospital acquired infection during hospitalization.
CONCLUSIONSOur study was the first survey that revealed the present status of ELBW infants in the mainland of China. The mortality and morbidity of ELBW infants remained high as compared to other developed countries.
China ; Female ; Humans ; Infant ; Infant Mortality ; Infant, Extremely Low Birth Weight ; Infant, Newborn ; Intensive Care Units, Neonatal ; statistics & numerical data ; Male ; Morbidity ; Respiratory Distress Syndrome, Newborn ; mortality ; Retrospective Studies ; Surveys and Questionnaires
8.Evaluation of the performance of systems for whole blood C-reactive protein detection: a multi-center study
Juan CHENG ; Huaiyuan LI ; Haipeng LIU ; Yuxin WANG ; Jin XU ; Shangyang SHE ; Wei QU ; Yidong WU ; Guixia LI ; Junmei YANG ; Liya MO ; Yun XIANG ; Jiangwei KE ; Liyue KUI ; Lei ZHENG ; Hongbing CHEN ; Zhili YANG ; Xin LYU ; Hong ZHANG ; Zhenhua TANG ; Lijuan MA ; Hongquan LUO ; Xiangyang LI ; Wenli ZHANG ; Hui JIA ; Huiming YE ; Lijun TIAN ; Qiuhui PAN
Chinese Journal of Laboratory Medicine 2021;44(7):633-643
Objective:To explore the performance of the commonly used whole blood C-reactive protein (CRP) detection systems and give related recommendation on the performance requirements of detection systems.Methods:A total of 7 540 venous blood samples from 26 maternal, child and children′s hospitals were collected to conduct this multi-center study on the analytical performance of 5 commonly used whole blood CRP detection systems from March to April in 2019. The blank check, carryover, repeatability, intermediate precision, linearity, sample stability, influence of hematocrit/triglyceride/bilirubin, comparison with SIEMENS specific protein analyzer and trueness were evaluated. The 5 systems included BC-5390CRP autohematology analyzer, AstepPLUS specific protein analyzer, Ottoman-1000 Automated Specific Protein POCT Workstation, i-CHROMA Immunofluorometer equipment Reader and Orion QuikRead go detecting instrument. The 5 systems were labeled as a, b, c, d and e randomly.Results:Within the 5 systems, all values of blank check were less than 1.00 mg/L, the carryovers were lower than 1.00%. The repeatability of different ranges of CRP concentrations including 3.00-10.00, 10.00-30.00 and>30.00 mg/L were less than 10.00%, 6.00% and 5.00%, respectively, and the intermediate precision was less than 10.00%. The linearity correlation coefficients of the 5 systems were all above 0.975, while the slope was within 0.950-1.050. Whole blood samples were stable within 72 hours both at room temperature (18-25 ℃) and refrigerated temperature (2-8 ℃). The CRP results were rarely influenced by high triglyceride or bilirubin, except for the immmunoturbidimetric test based on microparticles coated with anti-human CRP F(ab) 2 fragments. When triglyceride was less than 15.46 mmol/L, the deviation of CRP was less than 10.00%. When bilirubin was less than 345.47 μmol/L, the deviation of CRP was less than 10.00%. CRP was more susceptible to Hct on the systems without Hct correction. The deviation of CRP between different Hct dilution concentration and 40% dilution concentration can reach as high as 67.48%. The correlation coefficients ( r) of 5 systems were all more than 0.975 in the range of 0-300.00 mg/L compared with Siemens specific protein analyzer. All systems passed the trueness verification using the samples with specified values of 12.89 and 30.60 mg/L. Conclusion:The performance of 5 systems can basically meet the clinical needs, but it is suggested that the whole blood CRP detection system without automatic Hct correction should be modified manually.
9.Feasibility of radiofrequency ablation for cancer patients with atrial fibrillation.
Yun Song WANG ; Dao Bo LI ; Cheng CHEN ; Yu Shan WEI ; Hai Chen LYU ; Jia Yu HAN ; Ying Xue DONG ; Xiao Meng YIN ; Lian Jun GAO ; Yun Long XIA
Chinese Journal of Cardiology 2021;49(8):790-795
Objective: To analyze the impact of cancer on the recurrence rate of atrial fibrillation (AF) after AF radiofrequency ablation and further evaluate the feasibility of radiofrequency ablation therapy in cancer patients with AF. Methods: This study was a single-center, retrospective study. Cancer patients with AF undergoing radiofrequency ablation for the first time in the First Affiliated Hospital of Dalian Medical University from May 30, 2008 to September 30, 2018 were included (cancer group). AF patients without cancer undergoing radiofrequency ablation for the first time during the same period served as non-cancer group. Clinical data including age, gender, past history, cancer and AF-related parameters, etc. were analyzed. Patients were followed up after radiofrequency ablation. The primary endpoints were AF recurrence or all-cause death. Kaplan-Meier survival analysis was used to analyze the effect of cancers on the recurrence after AF ablation. The multivariate cox regression analysis was further applied to correct for other confounding factors to analyze whether the impact of cancers on the recurrence of atrial fibrillation was statistically significant. Results: A total of 90 patients were enrolled, there were 30 patients in the cancer group (mean age (64.8±6.6) years, 16 (53.3%) males) and 60 patients in the non-cancer group (mean age (63.6±6.2) years, 32 (53.3%) males). Clinical data, such as age, gender, and cancer treatment, were similar between the two groups. During an average follow-up period of (328.7±110.2) days, there were 6 AF recurrences (recurrence rate 20.0%) in the cancer group, and 17 AF recurrences (recurrence rate 28.3%) in the control group. AF recurrence rate was similar between the two groups (P>0.05). During the follow-up period, there was no all-cause death in the two groups. Kaplan-Meier survival analysis showed that cancer was not related to AF recurrence after radiofrequency ablation (P = 0.383). After adjusting for other confounding factors, the multivariate Cox regression analysis showed that cancer was not an independent predictor of AF recurrence after radiofrequency ablation (HR=0.508, 95%CI: 0.192-1.342, P = 0.172). Conclusions: The combination of cancer has no impact on the recurrence of AF after radiofrequency ablation. For cancer patients with AF, radiofrequency ablation therapy can be considered as a feasible heart rhythm control treatment strategy.
10. Effect of Xiangsha Liu Junzitang on dyHDL in Hyperlipidemia Rats with Spleen Deficiency
Si CHEN ; Lian-qun JIA ; Nan SONG ; Jian WANG ; Ning CHEN ; Yuan CAO ; Yun-fei GAO ; Xiao-ming LYU
Chinese Journal of Experimental Traditional Medical Formulae 2019;25(7):22-28
Objective: To observe the changes of dysfunctional high density lipoprotein cholesterol (dyHDL) and the intervention effect of Xiangsha Liu Junzitang in rats with spleen deficiency and hyperlipidemia, and reveal the effect and mechanism of Xiangsha Liu Junzitang on dyHDL in rats with spleen-deficiency hyperlipidemia. Method: Seventy-five SPF SD rats were randomly divided into normal group, high fat group, spleen deficiency and high fat group, Xiangsha Liu Junzitang low and high dose groups (5.67, 11.34 g·kg-1). In the spleen deficiency and high fat group, as well as Xiangsha Liu Junzitang low and high dose groups, composite method of improper diet and exhaustive swimming was used for 15 days for modeling. After modeling for 15 days, normal group was fed with basic diet, while the high-fat group, spleen-deficiency and high-fat group, the Xiangsha Liu Junzitang low and high dose groups were fed with high-fat diet. After 12 weeks, the Xiangsha Liu Junzitang low dose and high dose groups received corresponding dosage of drugs, while normal group, high fat group and spleen deficiency high fat group received corresponding volume of normal saline. After 4 weeks, the contents of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol cholesterol (LDL-C), and high density lipoprotein cholesterol(HDL-C)were detected by automatic biochemistry analyzer, while D-xylose excretion rate was measured by phloroglucinol method. The morphological changes of liver cells were observed by hematoxylin eosin (HE) staining. The level of PON1, apoA1 and SAA in plasma were detected by enzyme-linked immunosorbent assay (ELISA). Paraoxonase 1(PON1), apolipoprotein A1 (apoA1) and serum amyloid protein A (SAA) gene expression in rats liver were detected by Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR). Result: As compared with normal group, the serum TC, TG, and LDL-C levels were significantly increased in the high-fat group and spleen-deficiency high-fat group (P<0.05), and HDL-C levels were significantly lower (P<0.05); the levels of PON1 and apoA1 in plasma were decreased (P<0.05), while the content of SAA was increased (P<0.05); the expression of SAA gene in liver tissues was increased (P<0.01), and the expression levels of PON1 and apoA1 genes in liver tissues were significantly decreased (P<0.01). In high-fat group and the spleen-deficiency and high-fat group, the hepatocytes were rounded and scattered, and scattered fat vacuoles were observed. In addition, the urinary D-xylose excretion rate was significantly decreased in the spleen-deficiency and high-fat group (P<0.05). After the intervention with Xiangsha Liu Junzitang, the serum TC, LDL-C levels were significantly decreased (P<0.05); HDL-C levels were significantly increased (P<0.05); plasma PON1, apoA1 levels were increased (P<0.05); the content of SAA was decreased (P<0.05); the expression of SAA gene in liver tissues was decreased (P<0.05); the expression of apoA1 gene was increased significantly (P<0.05). Liver cells swelling was significantly alleviated and fat foaming was reduced. As compared with high-fat group, the plasma PON1 and SAA levels in the spleen-deficiency high-fat group were significantly lower (P<0.05); hepatocyte swelling was obvious and foaming was aggravated. Conclusion: The lipid disorder in hyperlipidemia rats was aggravated by the spleen deficiency, but was corrected after intervention with Xiangsha Liu Junzitang. and its mechanism may be related to the regulation of the expression of dyHDL-related genes and protein.