The urinary noradrenaline (NA) and adrenaline (A) were determined by means of fluorometric assay with double wavelength technique in 12 volunteers who were asked to run over a distance of 800 m with moderate speed. The ereatinine concentration in urine was also monitored and taken to estimate the excreting function of kidney during exercise. The heart rate (HR) and blood pressure(BP) were simultaneously measured. During the period of running 1) The ratio of urinary NA to creatinine and that of A to creatinine (NA or A ng/creatinine mg) increased significantly by 215% and 97%, respectively. The HR and BP elevated by 92% and 20%, respectively. The urinary NA was still markedly high in the recovery period. 2) While the urinary level of A had come back to normal range. The change in HR was directly related to the urinary NA but not to A level. The excreting function of kidney was markedly reduced by exercise. 3) The data of urinary NA and A expressed as the ratio (NA or A ng/creatinine rag) were recommended. The estimation of urinary NA is the most sensitive approach to measure the extent of regulatory mechanism in the response to physical training.

Huaihua medical College has inquired into the questionnaire from more 500 students who are clinical doctors and graduate nurses and 50 teachs who are clinical teaching hospitals,finding that the results have indicated the significance,the necessity and the actual problems of clinical technical ability practice teaching,when they are in school by their firsthand experience,which are very helpful to shortening scheduled time to practice,improving clinical basic skills,adjusting to medical environment as soon as possible,to ensure practice teaching quality and also have notable effects on continuing reinforcing building the clinical technical ability training centre and improving the quality of clinical technical teaching ability at the same time.

OBJECTIVED: To explore the prevalence and risk factors of type 2 diabetes mellitus (T2DM) and impaired glucose regulation (IGR) in Zhangzi Island of Dalian, additionally to provide a better understanding of further intervention. METHODS: A cross-sectional study was performed in 907 residents aged over 18 years from Zhangzi Island of Dalian. The questionnaire, physical measurement, food intake frequency and previously dietary investigation were used in the analysis. Simultaneously, a series of biochemistrical and immune index was measured, including blood uric acid, blood sugar, total cholesterol, triacylglycerol, as well as serum insulin.RESULTS: The recovery rate of questionnaire was 95.9%, which demonstrated that the prevalence rates of T2DM and IGR in Zhangzi Island were 11.36% and 37.38%, there was no significant differences between males and females (P > 0.05). Only 29.13% of the people with T2DM were aware of the condition. The prevalence of DM and IGR were increased significantly with age (P < 0.01). The results of the logistic regression showed that age, education, alcohol drinking and hypercholesteremia were the risk factors of IGR. In addition, age, education, hypercholesteremia, hypertriglyceridemia, body mass index and hypertension were the important risk factors for the development of DM. CONCLUSION: The prevalence rates of T2DM and IGR in Zhangzi Island of Dalian are high with a low awareness. Health promotion on lifestyle changes may help to increase the public awareness and reduce the prevalence.

Objective To study the effects of berberine (BBR) on the gene mRNA expression of fat-specific protein 27 (FSP27) and PR domain containing 16 (PRDM16) signal pathway in visceral white adipose tissues (VWAT) from type 2 dia? betic (T2DM) Chinese hamsters, and explore the related mechanisms. Methods The obese insulin-resistant (OIR) hamster model was induced by high-fat diet, and T2DM hamster model was created by OIR hamster model injected with low-dose streptozotocin. The control group was fed with standard laboratory chow. After the induction, the hamsters were randomly di?vided into control, OIR, obese T2DM and BBR-treated T2DM groups. After nine-week BBR treatment, real-time quantita?tive PCR was used to measure the gene mRNA expression changes of VWAT FSP27 and PRDM16 signal pathway and their target genes from different groups. Results Compared with control group, the gene mRNA expressions of PRDM16, CtBP-1, CtBP-2, C/EBPβ, PPARγ, PGC1α, PGC-1β and brown adipose tissue-specific genes such as UCP-1, Cidea, Elovl3, PPARα, and Acox, Cpt1 and Acadm were decreased and that of FSP27 and white adipose tissue-specific genes including Resistin, MEST and Serpina3k were increased in VWAT in OIR and obese T2DM groups. BBR treatment down-regulated FSP27 expression, enhanced PRDM16 signal pathway, and induced the gene mRNA expression of brown adipose tissue-spe?cific genes in VWAT of obese T2DM group to develop browning gene phenotype of VWAT, and then improved fat-induced insulin resistance. Conclusion The decreased FSP27 expression and increased PRDM16 expression are involved in the molecular mechanisms of browning of visceral white adipose tissues induced by BBR, and which contributes to improve ab?normal lipids metabolism and fat-induced insulin resistance in VWAT by enhancing consumption of energy as heat to re?store VWAT function.

Sixty-two patients with type 2 diabetes were treated with acarbose combined intensive insulin therapy( combined intensive group)or intensive insulin therapy alone (simple intensive group).As the blood glucose control reached the target,the mean amplitude of glycaemic excursion (MAGE),the absolute difference between the mean of daily differences ( MODD ),and standard deviation of blood glucose (SDBG) in combined intensive group were lower than those in simple intensive group [ ( 3.76 ± 1.47 vs 6.52 ± 1.57 ) mmol/L,( 0.57 ±0.49 vs 1.10 ±0.69 )mmol/L,( 1.44±0.60 vs 2.42±0.92 ) mmol/L,all P＜0.01 ].Daily mean blood glucose (MBG) of the former group was better than that of the latter group [ (7.08±0.69 vs 8.27 ± 1.31 ) mmol/L,P＜0.01 ].By the end of treatment,HbA1c [ 6.77％ ± 0.57％ vs 7.21％ ±0.83％,P＜0.05 ],incidence of hypoglycemia( 29％ vs 48％,P＜0.01 ),and body mass index[ (24.14±2.7 vs 27.63±3.41 ) kg/m2,P＜0.01 ] in combined intensive group were statistically improved more than those in the simple intensive group.

BACKGROUND: Diabetes mellitus is a chronic metabolic disease caused by various factors,such as environmental factor,inherited factor,etc.,and its cause isn't very clear now. This study aims to investigate the risk factors mentioned above in the onset of diabetes mellitus, and is of significance in the first and second grade of prevention of diabetes mellitus.OBJECTIVE: To investigate the risk factors of type 2 diabetes mellitus to provide evidence for the proper intervention of it.DESIGN: Cross-sectional study based on diagnosis.SETTING: Department of epidemiology in a university and department of endocrinology in a university hospital.PARTICIPANTS: The subjects were residents who have resided in town and country of Dalian for more than 5 years and were elder than 40 years old. The method of stratified cluster random sampling was carried out among natural persons who were divided into two groups according to city and country. Totally 2 500 persons were taken in total and 1 250 persons were from each group. The subjects who had been diagnosed as diabetes mellitus were included.METHODS: Questionnaire survey was employed for all the subjects, including physical examinations such as height,weight,waist girth,hip girth,blood pressure,blood glucose,etc. Patients of type 2 diabetes mellitus were taken as the case group and the normal was as the control group. The unconditional univariate and multivariate logistic regression were used.MAIN OUTCOME MEASURES: Unconditional logistic regression analysis of risk factors of type 2 diabetes mellitus with single factor analysis and multivariate analysis.RESULTS: Family history of diabetes mellitus(OR = 2.339),obesity[body mass index(BMI),OR = 1.462],systolic pressure(OR = 1.016),hyperlipidemia(OR = 1.615), age(OR = 1.043) were the major risk factors for type 2 diabetes mellitus.CONCLUSION: Family history of diabetes mellitus, increase of systolic pressure,obesity,high blood lipid and age are the risk factor for type 2 diabetes mellitus. For all communities,control of body mass and high blood pressure is an important way to prevent type 2 diabetes mellitus.

To investigate the effect of lipid accumulation index on islet βcell function in middle-aged and elderly people.A total of 10 109 subjects were enrolled in the community residents of Dalian City,aged≥40 years, from July to December 2011, according to enrollment and exclusion criteria.The relationship between lipid accumulation index(LAP)and homeostasis model assessment for βcell function(HOMA-β)was described by curve fitting model, and the effect of LAP on HOMA-βwas proved by correlation and linear regression analysis.The relationship between LAP and HOMA-βshowed an inverted U trend.With the increase of LAP,HOMA-βincreased gradually, following then entered the plateau, and then decreased slowly.According to the LAP quartile classification,each category was analyzed separately as a separate data.Spearman correlation results showed that HOMA-βwas positively correlated with LAP in Q1 group, not in Q2 and Q3 group, while in Q4 group, it was negatively correlated.Multivariate linear regression analysis showed that LAP could enter the equation in group Q1 and group Q4 after adjustment of age, sex, systolic blood pressure, diastolic blood pressure, low density lipoprotein-cholesterol,and high density lipoprotein-cholesterol(all P<0.05).With the increase of LAP,pancreatic β-cell secretion activity increases compensatorily,then decreases to decompensation and finally to the process of weakening secretion.

Objective:To investigate the influence of Covid-19 epidemic on the number of acute ischemic stroke patients with intravenous thrombolytic therapy in Dalian in 2020, the way to hospital, onset to door time (ODT), door to needle time(DNT), onset to needle time(ONT), and the National Institute of Health Stroke Scale (NIHSS) before and after intravenous thrombolytic therapy.Methods:This was a retrospective descriptive study on 13 map-participating hospitals in Dalian from August 2020 to December 2020. The number of acute ischemic stroke patients with intravenous thrombolytic therapy, ODT, DNT, ONT, modes of transport to hospital, the NIHSS score before and after intravenous thrombolytic therapy, etc were analyzed. Data were collected from August 1, 2020 to December 31, 2020, and compared with the baseline data from the same period in 2019.Results:SPSS 22.0 statistical software and Data Analysis ToolPak were used for statistical analysis of the obtained data, and T tests statistic was used for data analysis. In 2020,the number of acute ischemic stroke patients with intravenous thrombolytic therapy increased (681 cases vs 416 cases), and DNT increased [50 minutes vs 45 minutes P = 0.01]. In 2020, 83.55% of patients indicated self-visit as their main mode of transport to the hospital. In 2020, among the self-visit patients with NIHSS score<15 scores,the number of the patients with the NHISS score unchanged or decreased after intravenous thrombolytic therapy was more (562 scores vs. 535 scores, P<0.001), and the patients with NIHSS score ≥15 scores were more willing to call ambulances to hospital. Conclusions:During the Covid-19 epidemic period of 2020, the number of acute ischemic stroke patients receiving intravenous thrombolytic therapy increased, DNT increase; the patients withNIHSS score<15 scores are more willing to choose to visit the hospital using their own transportation and benefit from intravenous thrombolytic therapy. The patients with NIHSS ≥15 scores prefer to call ambulances to hospital.

Objective To determine the impact of uric acid changes on kidney function in middle-aged and elderly women with normal renal function.Methods Serum uric acid and estimated glomerular filtration rate(eGFR) were studied by prospective cohort analysis in 1152 middle-aged and elderly Dalian women with serum uric acid<7 mg/dl, estimated glomerular filtration rate(eGFR)≥90 ml·min-1·(1.73 m2)-1, and age>45 years old.Results The analysis of variance (ANOVA) of clinical indices between baseline and follow-up data showed that an eGFR was decreased after three years in both middle-aged and elderly women even with normal serum uric acid.Compared with those in the lowest guartile subgroup, a significant drop of eGFR to less than 90 ml·min-1·(1.73 m2)-1 was seen in those with the highest guartile of baseline serum uric acid group (OR=1.707, 95%CI 1.192-2.443, P=0.003).Furthermore, there were positive correlations between changes in the levels of serum uric acid and eGFR, and linear regression analysis showed that, as the change level of serum uric acid increased, the change level of eGFR declined(β=1.562, 95%CI 1.050-2.075, P<0.01], and the changing degree of uric acid increase is independent risk factors refor eGFR reductions.Conclusion Reduction in eGFR level is inversely related to serum uric acid in perimenopausal and postmenopausal women.However, our study showed that, women with serum uric acid level ranging from normal, slight increase, and relatively high levels, the increasing degrees of uric acid are independent risk factors responsible for the changing degree of eGFR reduction.

Objective To explore the influence of family history of diabetes and central obesity on prediabetes(Pre-DM)and their interaction.Methods Based on the REACTION studyduring August December 2011 in Dalian,2587 individuals aged≥40 with normal blood glucose(BG)were divided into newly diagnosed Pre-DM(n=522)and BG normal group(NC,n=2065)during follow-up.The influence of family history of DM and central obesity on prediabetes and their interaction were analyzed.Results The age,SBP,DBP,BMI,WC,HDL-C,LDL-C,TG,ALT,GGT,FPG,2 hPG,HbA1c,FIns,HOMA-IR,SUA and the incidence of hypertension,fatty liver disease,dyslipidemia,overweight/obesity and central obesity in Pre-DM group were all higher than those in NC group(P＜0.05).Multivariate logistic regression analysis showed that family history of diabetes and central obesity were risk factors for Pre-DM.After adjustment,no significant multiplicative interaction was shown between diabetes family history and central obesity on the risk of Pre-DM(P=0.764).Quantitative analysis of interaction showed that RERI=0.110,S=1.112 and AP=0.053,suggesting that DM family history and central obesity have no significant additive interaction on the risk of Pre-DM.Conclusion The family history of DM and central obesity are both associated with the occurrence of Pre-DM,but there is no significant interaction.