Objective To evaluate the current state of glycemie control in Chinese patients with type 2 diabetes mellitus who have received oral antidiabetic agents in the out-patient clinic,and the efficacy and safety of optimized regiments of gliclazide modified-release tablets (Diamicron MR, SERVIER, Tianjin) in patients with failed glycemic control (HbA1c 6.5%). Methods The patients with type 2 diabetes were enrolled from 54 hospitals in more than 20 cities and received long-term (more than 3 months) oral antidiabetic agents. HbA1c was measured and the success rate of HbA1c reduction was evaluated. The patients who failed to achieve glycemic control (HbA1c 6. 5%) and received daily multiple-dosing insulin secretagogues were provided with the optimized treatment regimen, consisting of replacing daily multiple-dosing insulin secretagogues with single-dosing gliclazide sustained-release tablets. Clinical efficacy and safety were evaluated after three months treatment. Results The survey of glycemic control revealed that the mean HbA1c of 5 586 patients with diabetes mellitus was (7.97±2.89)% ,and the success rate (HbA1c≤6.5%) was 14. 1%. Further more, HbA1c decreased from (8.23±4.00)% before optimization to (6.86±2.24)% after optimization with the average decrement of 1.37% (P<0. 001) and the success rate was raised to 34. 1%. The gliclazide modified-release tablets were well tolerated by most patients, only 2.6% of whom were reported to experience unconfirmed hypoglycemia. Conclusion The success rate of glycemic control was low in Chinese out-patients with type 2 diabetes mellitus receiving oral antidiabetic agents in the clinic. The optimized regimen of gliclazide modified-release tablets taken once daily can down-regulate glycemic levels and increase the success rate of HbA1c reduction,and thus plays efficiently and safely a key role in the optimized management of type 2 diabetes mellitus.

Background Familial hyperaldosteronism type Ⅱ(FH-Ⅱ) is characterized by autosomal dominant inheritance and hyperaldosteronism.Linkage analysis demonstrated chromosome 7q22 most likely harbor the genetic defect.Objective To identify the disease locus in a Chinese pedigree with FH-Ⅱ using genetic linkage analysis.Methods Haplotypes of the FH-Ⅱ pedigree were analyzed using four microsatellite markers(D7S531,D7S2521,D7S511,D7S481) at 7p22 to determine the critical region,and multipoint logarithm of odds(LOD) scores were calculated to assess linkage with FH-Ⅱ.Results Several members(affected members) in the family had hypertension,hypokalemia,hyperaldosteronism,low renin activity.Hypertension and hypokalemia was improved by spironolactone test.Dexamethasone suppression test was performed but without clinical or hyperaldosteronism improvement in three affected members,confirmed FH-Ⅱ family pedigree.The same haplotypes D7S531(ac,n=24)-D7S2521(ac,n=11)-D7S511(ca,n=21)-D7S481(ac,n=16) were shared by all known affected members and one suspicious member,but also by one unaffected member of the family,making it unlikely that this region contains the causative gene mutation.In this FH-Ⅱ family,the LOD scores of the four markers were

Objective To explore the expression and significance of CD26/DPPⅣand galectin-3 in papillary thyroid carcinoma.Methods Expression of CD26/DPPⅣ or galectin-3 in 68 papillary thyroid carcinomas and 36 thyroid adenomas were determined with EnVision immunohistochemical technique respectively.Results CD26/DPPⅣ and galectin-3 were highly expressed in most of papillary carcinomas but absent or expressed in a low level in most of all thyroid adenomas.With CD26/DPPⅣ as marker to detect papillary carcinoma,the sensitivity,specificity,diagnostic accuracy were 86.8%,97.2% and 90.4%,and with galectin-3 the respective figures were 97.1%,91.7% and 95.2%.There was no statistic significance in intrathyroidal and extrathyroidal invasion,with or without lymph node metastasis,low and poor prognosis groups about positive expression of CD26/DPPⅣ or galectin-3 in papillary carcinomas.Conclusion Both CD26/DPPⅣ and galectin-3 are potential markers of papillary thyroid carcinoma.CD26/DPPⅣ or galectin-3 immunohistochemical staining can be used as a supplement technology for routine pathological diagnosis to differentiate thyroid papillary carcinomas from adenomas,but not accepted as the bio-markers for the invasion,metastasis and prognosis of papillary thyroid carcinomas.

ObjectiveTo investigate the value of CD26/DPPⅣ or galectin-3 immunohistochemical staining and their combination in the diagnosis of thyroid carcinoma. MethodsEnVision immunohistochemical technique was applied to detect the expressions of CD26/DPPⅣ and galectin-3 in thyroid tissue of 114 cases with benign or malignant thyroid tumors. ResultsCD26/DPPⅣ and galectin-3 were expressed in most of papillary carcinomas but absent in normal thyroid tissues, most of follicular carcinomas and thyroid adenomas. With CD26/DPPⅣ as means to detect papillary carcinoma, the sensitivity, specificity, diagnostic accuracy, positive predictive value, negative predictive value and Kappa index were 86.8%, 97.2%, 90.4%, 98.3%, 79.5% and 0.80 respectively,andwithgalectin-3therespective figures were 97.1%, 91.7%, 95.2%, 95.7% , 94.3% and 0.89. With CD26/DPPⅣ and gelectin-3 combined, the sensitivity, specificity, Kappa index and others in papillary carcinoma were the same as those of galectin-3 in parallel test, and the same as those of CD26/DPPⅣ in serial test. ConclusionBoth CD26/DPPⅣ and galectin-3 are reliable markers of papillary carcinoma, CD26/DPPⅣ or galectin-3 immunohistochemical staining can be used as a supplement for conventional pathological diagnostic approach to differentiate thyroid papillary carcinomas from adenomas, while the application in the diagnosis of follicular thyroid carcinoma remains to be further investigated.

Objective: To investigate the effect of recombinant human keratinocyte growth factor 2 (rhKGF-2) on lung tissue of rabbits with severe smoke inhalation injury. Methods: A total of 120 New Zealand rabbits were divided into 5 groups by random number table after being inflicted with severe smoke inhalation injury, with 24 rats in each group. Rabbits in the simple injury group inhaled air, while rabbits in the injury+phosphate buffer solution (PBS) group inhaled 5 mL PBS once daily for 7 d. Rabbits in injury+1 mg/kg rhKGF-2 group, injury+2 mg/kg rhKGF-2 group, and injury+5 mg/kg rhKGF-2 group received aerosol inhalation of 1 mg/kg, 2 mg/kg, and 5 mg/kg rhKGF-2 (all dissolved in 5 mL PBS) once daily for 7 d, respectively. On treatment day 1, 3, 5, and 7, blood samples were taken from the ear central artery of 6 rabbits in each group. After the blood was taken, the rabbits were sacrificed, and the tracheal carina tissue and lung were collected. Blood pH value, arterial oxygen partial pressure (PaO₂), arterial blood carbon dioxide pressure (PaCO₂), and bicarbonate ion were detected by handheld blood analyzer. The expressions of pulmonary surfactant-associated protein A (SP-A) and vascular endothelial growth factor (VEGF) in lung tissue were detected by Western blotting. Pathomorphology of lung tissue and trachea was observed by hematoxylin-eosin staining. Data were processed with analysis of variance of two-way factorial design and Tukey test. Results: (1) Compared with those in simple injury group, the blood pH values of rabbits in the latter groups on treatment day 1-7 had no obvious change (P>0.05). The PaO₂ of rabbits in injury+2 mg/kg rhKGF-2 group on treatment day 5 and 7 were (75.0±2.4) and (71.0±4.5) mmHg (1 mmHg=0.133 kPa), respectively, which were significantly higher than (62.0±6.8) and (63.0±3.0) mmHg in simple injury group (q=4.265, 8.202, P<0.05 or P<0.01). The PaO₂ of rabbits in injury+5 mg/kg rhKGF-2 group on treatment day 7 was (82.0±4.9) mmHg, which was significantly higher than that in simple injury group (q=6.234, P<0.01). Compared with that in simple injury group, the PaCO₂ of rabbits in injury+2 mg/kg rhKGF-2 group on treatment day 3 was significantly decreased (q=4.876, P<0.01) and significantly increased on treatment day 5 (q=5.562, P<0.01); the PaCO₂ of rabbits in injury+5 mg/kg rhKGF-2 group was significantly increased on treatment day 5 and 7 (q=5.013, 4.601, P<0.05 or P<0.01). Compared with that in simple injury group, the serum bicarbonate ion of rabbits in injury+1 mg/kg rhKGF-2 group on treatment day 7 was significantly increased (q=5.142, P<0.01); the serum bicarbonate ion of rabbits in injury+2 mg/kg rhKGF-2 group on treatment day 5 and 7 were significantly increased (q=4.830, 6.934, P<0.01); the serum bicarbonate ion of rabbits in injury+5 mg/kg rhKGF-2 group on treatment day 5 were significantly increased (q=3.973, P<0.05). (2) The expressions of SP-A in lung tissue of rabbits in simple injury group and injury+PBS group in each treatment time point were close (P>0.05). The expressions of SP-A in lung tissue of rabbits in injury+2 mg/kg rhKGF-2 group and injury+5 mg/kg rhKGF-2 group on treatment day 3 were 0.091±0.007 and 0.101±0.009, respectively, significantly higher than 0.069±0.009 in simple injury group (q=10.800, 13.580, P<0.01). The expressions of SP-A in lung tissue of rabbits in injury+1 mg/kg rhKGF-2 group, injury+2 mg/kg rhKGF-2 group, and injury+5 mg/kg rhKGF-2 group on treatment day 5 and 7 were 0.127±0.008, 0.132±0.006, 0.194±0.006, 0.152±0.017, 0.166±0.004, 0.240±0.008, significantly higher than 0.092±0.003 and 0.108±0.005 in simple injury group (q=6.789, 12.340, 17.900, 9.875, 31.480, 40.740, P<0.01). (3) On treatment day 1 and 5, there was no significant difference in the expression of VEGF in lung tissue of rabbits among the 5 groups (P>0.05). Compared with those in simple injury group, the expressions of VEGF in lung tissue of rabbits in injury+2 mg/kg rhKGF-2 group on treatment day 3 and 7 were significantly increased (q=4.243, 8.000, P<0.05 or P<0.01), and the expression of VEGF in lung tissue of rabbits in injury+5 mg/kg rhKGF-2 group on treatment day 7 was significantly increased (q=20.720, P<0.01). (4) On treatment day 1, the injury of rabbits in each group was similar, with a large number of neutrophils infiltrated and abscess formed in the alveolar and interstitial tissue, thickened alveolar septum, some collapsed alveolar and atelectasis; large area of tracheal mucosa was degenerated and necrotic, with a large amount of inflammatory exudates blocking in the cavity. On treatment day 3, the inflammation of lung tissue and trachea in each group were improved, but the inflammation in simple injury group and injury+PBS group was also serious. On treatment day 5, the inflammation in lung tissue and trachea of rabbits in injury+2 mg/kg rhKGF-2 group and injury+5 mg/kg rhKGF-2 group were improved much obviously than those in the other groups. On treatment day 7, the inflammation in lung tissue of rabbits in injury+5 mg/kg rhKGF-2 group alleviated obviously than those in the other groups, most alveoli had no obvious exudative fluid, the alveolar cavity was intact and clear, the local alveolar dilated like a cyst, and the alveolar septum thinning; the improvement of inflammation of trachea was more obvious than the other groups, the tracheal mucosa tended to be more complete, and few neutrophils were infiltrated in the endotracheal cavity. Conclusions Atomization inhalation of rhKGF-2 can improve the PaO₂ level of rabbits with severe smoke inhalation injury, reduce airway inflammation, increase the expression of SP-A and VEGF in lung tissue, thus promoting the repair of lung tissue.

Objective To examine children and adolescents physical activity level and its influencing factors based on the theory of planned behavior (TPB).Methods A total of 353 students aged 8-15 were chosen as samples.Accelerometers were used to measure the moderate-to-vigorous physical activity (MVPA) time and a TPB scale was used to measure the TPB constructs.Results ①Research results showed that only 5.3％ of the participating children and adolescents reached the recommended 60 miu MVPA each day.②There were significant gender differences in the attitude (t=1.360,P＜0.0 l),MVPA intention(t=2.076,P＜0.01) and MVPA time (t=2.076,P＜0.05) of children and adolescents.However,there was no significant differences in their subjective norms and perceived behavioral control (P＞ 0.05).Significant grade differences were also observed for attitude (F (5.352) =2.627,P＜ 0.05),MVPA intention (F(5.352)=2.890,P＜0.05) and MVPA time (F(5.352) =6.156,P＜0.01).③The regression results showed that MVPA intention (β=0.130,P＜0.01) was significantly related to MVPA time and it explained 0.4％ variance.Perceived behavioral control(β=0.496,P＜0.01) and attitude(β=0.155,P＜0.01) were significantly associated with MVPA intention and explained 1.8％ variance.Conclusion The average MVPA time of children and adolescents in this study do not achieve the international recommendation level and the behavioral intention determines their MVPA time.

Objective The prevalence of obesity is constantly increasing. Multiple metabolic complications are related to obesity, including type 2 diabetes mellitus and non-alcholic fatty liver disease(NAFLD). Our study aimed to investigate the prevalence of obesity comorbidities and its association with BMI. Methods 765 individuals who visited the multidisciplinary clinic for obesity in Peking University First Hospital from 2015, Jun. to 2018, Sept. were enrolled in this study. The height, body weight, waist circumference, hip circumference were measured during the first visit. Body adipose percentage and basal metabolic rate were recorded. Questionnaires for daily food intake, comorbidity, and lifestyle were recorded. Fasting insulin, C peptide, glucose, HbA1C , uric acid, liver enzymes and lipid profile were measured. Statistical analysis was performed using SPSS 16. 0, and P<0. 05 was considered as statistical significant. Results Daily energy intake was higher in obesity group [ obese vs non-obese, (2136.6±739.4vs1905.7±468.4)kcal/d,P=0.046].Hypertension,NAFLDandgoutriskincreasedsignificantly in obesity group (obese vs non-obese, 36.0％vs 24.5％, P=0.02;76.5％ vs 60.6％, P<0.01;6.9％ vs 1.8％, P=0.04, respectively) . Family history of obesity and diabetes increased in obesity group ( obese vs non-obese, 64.5％vs 53.6％, P=0.03;47.4％vs 37.3％, P=0.048). Fasting insulin and C-peptide levels were higher in obesity group [obese vs non-obese, (24.8 ± 15.3 vs 13.6 ± 9.5)μIU/ml, P<0.01;(3.72 ± 1.40 vs 2.70 ± 1.16)μIU/ml, P<0.01). Liver enzymes increased significantly in obesity group [obese vs non-obese, (47.2±45.4 vs 23.3±21.4)U/L, P<0.01; ( 30. 4 ± 24. 0 vs 19. 9 ± 8. 5 ) U/L, P=0. 001 ] . Conclusions Obesity population had higher risk of hypertension, NAFLD and gout. Fasting insulin, C-peptide, liver enzymes, and UA also increased significantly in these patients. It is critically important to those obese individuals for regular screening of NAFLD and diabetes mellitus.

Objective:To investigate the correlation between collateral circulation and infarct pattern and outcome in acute ischemic stroke patients with anterior circulation intracranial atherosclerosis.Methods:Acute ischemic stroke patients with anterior circulation intracranial atherosclerotic severe stenosis or occlusion admitted to the Department of Neurology, the First Affiliated Hospital of Xinxiang Medical College from September 2018 to March 2020 were included prospectively. According to diffusion-weighted imaging, the infarct patterns were divided into perforator pattern, territorial pattern, watershed pattern, and mixed pattern. At 90 d after onset, the modified Rankin Scale was used to evaluate the outcome. 0-2 was defined as good outcome, and >2 was defined as poor outcome. Multivariate logistic regression analysis was used to determine the independent influencing factors of clinical outcome. Results:A total of 89 patients were enrolled, 50 (56.2%) had good collateral circulation and 39 (43.8%) had poor collateral circulation. The distribution patterns of infarct: 22 patients (24.7%) were perforator pattern, 26 (29.2%) were territorial pattern, 17 (19.1%) were watershed pattern, and 24 (30.0%) were mixed pattern. The proportion of patients with good collateral circulation was 81.8%, 65.4%, 29.4% and 41.7%, respectively in the perforator pattern group, territorial pattern group, watershed pattern group, and mixed pattern group. Good collateral circulation was more common in the perforator pattern group, and poor collateral circulation was more common in the watershed pattern group. At 90 d after onset, 53 patients (59.6%) had a good outcome and 36 (40.4%) had a poor outcome. The baseline homocysteine level in the good outcome group was significantly lower than that in the poor outcome group (17.91±4.62 μmol/L vs. 20.35±4.67 μmol/L; t=2.436, P=0.017), and the proportion of patients with good collateral circulation was significantly higher than that of patients with poor outcome (73.6% vs. 30.6%; χ2=16.124, P<0.001). Multivariate logistic regression analysis showed that higher homocysteine level was an independent risk factor for poor outcome (odds ratio 1.174, 95% confidence interval 1.061-1.298; P=0.002) and good collateral circulation was an independent protective factor for good outcome (odds ratio 0.095, 95% confidence interval 0.038-0.239; P<0.001). Conclusions:Good collateral circulation was more common in patients with perforator pattern, and poor collateral circulation was more common in patients with watershed pattern. Good collateral circulation was independently associated with the good clinical outcome in acute ischemic stroke patients with anterior circulation intracranial atherosclerosis.

A bicyclic depsipeptide, chromopeptide A (1), was isolated from a deep-sea-derived bacterium Chromobacterium sp. HS-13-94. Its structure was determined by extensive spectroscopic analysis and by comparison with a related known compound. The absolute configuration of chromopeptide A was established by X-ray diffraction analysis employing graphite monochromated Mo K α radiation (λ=0.71073 Å) with small Flack parameter 0.03. Chromopeptide A suppressed the proliferation of HL-60, K-562, and Ramos cells with average IC50 values of 7.7, 7.0, and 16.5 nmol/L, respectively.

Objective:To retrospectively analyze the treatment status of tyrosine kinase inhibitors (TKI) in newly diagnosed patients with chronic myeloid leukemia (CML) in China.Methods:Data of chronic phase (CP) and accelerated phase (AP) CML patients diagnosed from January 2006 to December 2022 from 77 centers, ≥18 years old, and receiving initial imatinib, nilotinib, dasatinib or flumatinib-therapy within 6 months after diagnosis in China with complete data were retrospectively interrogated. The choice of initial TKI, current TKI medications, treatment switch and reasons, treatment responses and outcomes as well as the variables associated with them were analyzed.Results:6 893 patients in CP ( n=6 453, 93.6%) or AP ( n=440, 6.4%) receiving initial imatinib ( n=4 906, 71.2%), nilotinib ( n=1 157, 16.8%), dasatinib ( n=298, 4.3%) or flumatinib ( n=532, 7.2%) -therapy. With the median follow-up of 43 ( IQR 22-75) months, 1 581 (22.9%) patients switched TKI due to resistance ( n=1 055, 15.3%), intolerance ( n=248, 3.6%), pursuit of better efficacy ( n=168, 2.4%), economic or other reasons ( n=110, 1.6%). The frequency of switching TKI in AP patients was significantly-higher than that in CP patients (44.1% vs 21.5%, P<0.001), and more AP patients switched TKI due to resistance than CP patients (75.3% vs 66.1%, P=0.011). Multi-variable analyses showed that male, lower HGB concentration and ELTS intermediate/high-risk cohort were associated with lower cytogenetic and molecular responses rate and poor outcomes in CP patients; higher WBC count and initial the second-generation TKI treatment, the higher response rates; Ph + ACA at diagnosis, poor PFS. However, Sokal intermediate/high-risk cohort was only significantly-associated with lower CCyR and MMR rates and the poor PFS. Lower HGB concentration and larger spleen size were significantly-associated with the lower cytogenetic and molecular response rates in AP patients; initial the second-generation TKI treatment, the higher treatment response rates; lower PLT count, higher blasts and Ph + ACA, poorer TFS; Ph + ACA, poorer OS. Conclusion:At present, the vast majority of newly-diagnosed CML-CP or AP patients could benefit from TKI treatment in the long term with the good treatment responses and survival outcomes.