Objective:To investigate the related factors of cognitive impairment in middle-aged and old-aged patients with type 2 diabetes mellitus(T2DM).Methods:A total of 970 patients with T2DM(585 middle-aged group and 385 old-aged group)were selected from residents of a large community in Beijing from September to December 2018.The Mini-Mental State Examination(MMSE)was used to assess the cognitive func-tion.Multivariate logistic regression was used to analyze the related factors.Results:The detection rates of cognitive impairment were 12.0％and 13.5％in middle-aged and old-aged patients with T2DM,respectively.Among mid-dle-aged patients with T2DM,work(OR=0.22,95％CI:0.03-0.77)and education at the junior college or un-dergraduate level and above(OR=0.18,95％CI:0.04-0.55)were protective factors for cognitive impair-ment.Myocardial infarction(OR=4.13,95％CI:1.26-13.63)was a risk factor for cognitive impairment.Among old-aged patients with T2DM,drinking tea 1-2 times a week(OR=0.11,95％CI:0.01-0.58)and education at the junior college or undergraduate level and above(OR=0.19,95％CI:0.05-0.54)were protective factors for cognitive impairment.Stroke(OR=3.64,95％CI:1.55-8.39)and good sleep self-assessment(OR=2.75,95％CI:1.13-7.35)were risk factors for cognitive impairment.Conclusion:Cognitive impairment in middle-aged pa-tients with T2DM is related to work,education level and myocardial infarction,and cognitive impairment in old-aged patients with T2DM is related to lifestyle,education level and stroke.

Objective:To investigate the related factors of cognitive impairment in middle-aged and old-aged patients with type 2 diabetes mellitus(T2DM).Methods:A total of 970 patients with T2DM(585 middle-aged group and 385 old-aged group)were selected from residents of a large community in Beijing from September to December 2018.The Mini-Mental State Examination(MMSE)was used to assess the cognitive func-tion.Multivariate logistic regression was used to analyze the related factors.Results:The detection rates of cognitive impairment were 12.0％and 13.5％in middle-aged and old-aged patients with T2DM,respectively.Among mid-dle-aged patients with T2DM,work(OR=0.22,95％CI:0.03-0.77)and education at the junior college or un-dergraduate level and above(OR=0.18,95％CI:0.04-0.55)were protective factors for cognitive impair-ment.Myocardial infarction(OR=4.13,95％CI:1.26-13.63)was a risk factor for cognitive impairment.Among old-aged patients with T2DM,drinking tea 1-2 times a week(OR=0.11,95％CI:0.01-0.58)and education at the junior college or undergraduate level and above(OR=0.19,95％CI:0.05-0.54)were protective factors for cognitive impairment.Stroke(OR=3.64,95％CI:1.55-8.39)and good sleep self-assessment(OR=2.75,95％CI:1.13-7.35)were risk factors for cognitive impairment.Conclusion:Cognitive impairment in middle-aged pa-tients with T2DM is related to work,education level and myocardial infarction,and cognitive impairment in old-aged patients with T2DM is related to lifestyle,education level and stroke.

Objective:To study the relationship between hemoglobin glycation index (HGI) and blood lipid indices such as low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and plasma atherogenic index (AIP).Methods:This cross-sectional study included 16 049 participants from the Beijing Apple Garden community between December 2011 and August 2012. The subjects were divided into three groups based on the HGI quartile: low ( n=5 388), medium ( n=5 249), and high ( n=5 412). The differences in blood lipid indicators between different HGI groups were compared and multivariate logistic regression model was established to analyze the association between HGI and dyslipidemia. And multivariate logistic regression model was established to analyze the relationship between HGI and blood lipid indicators in different glucose metabolism populations. Results:There were 16 049 participants in all (mean age: 56 years), including 10 452 women (65.1%). They were classified into normal glucose tolerance (9 093 cases), prediabetes (4 524 cases), and diabetes (2 432 cases) based on glucose tolerance status. In the general population, with the increase of HGI, LDL-C, non-HDL-C, and AIP gradually increased (all P values for trends were <0.05), and the proportion of abnormalities increased significantly ( χ2=101.40, 42.91, 39.80; all P<0.001). A multivariate logistic regression model was established, which suggested a significant correlation between HGI and LDL-C, non-HDL-C, and AIP (all P<0.05), after adjusting for factors such as age, sex, fasting blood glucose, hypertension, body mass index, smoking, and alcohol consumption. In the overall population, normal glucose tolerance group, and diabetes group, HGI had the highest correlation with non-HDL-C ( OR values of 1.325, 1.678, and 1.274, respectively); in the prediabetes group, HGI had a higher correlation with LDL-C ( OR value: 1.510); and in different glucose metabolism groups, AIP and HGI were both correlated ( OR: 1.208-1.250), but not superior to non-HDL-C and LDL-C. Conclusion:HGI was closely related to LDL-C, non HDL-C, and AIP in the entire population and people with different glucose metabolism, suggesting that HGI may be a predictor of atherosclerotic cardiovascular disease.

{L-End}Objective To establish a method for the simultaneous determination of dimethyltin (DMT), trimethyltin (TMT), diethyltin (DET), and triethyltin (TET) in human whole blood using high performance liquid chromatography-inductively coupled plasma-mass spectrometry (ICP-MS). {L-End}Methods The 1.0 mL of blood was added with 4.0 mL 65% aqueous solution (containing 6% acetic acid), extracted and separated by C₄ column (150 mm×3 mm×3 μm) using a mobile phase of methanol and 4% acetic acid aqueous solution (containing 0.25 mmol/L tropolone) at a volume ratio of 35∶65, and detected by ICP-MS. {L-End}Results The linear range of DMT, TMT, DET, and TET was 30.60-550.80, 29.00-522.00, 46.10-829.80, and 34.05-612.90 μg/L, respectively. All correlation coefficients were 0.999. The detection limit of DMT, TMT, DET and TET was 21.40, 20.30, 32.27 and 23.80 μg/L, respectively. The recovery rate was 81.9%-104.9%. The within-run and between-run relative standard deviation was 1.6%-6.9% and 0.1%-10.0%, respectively. The samples can be stored at -20 ℃ and 4 ℃ for at least three days. {L-End}Conclusion This method can be used for trace analysis of DMT, TMT, DET, and TET in whole blood.

Objective: To investigate the specificity of endogenous metabolic profile in plasma of patients with occupational acute methyl acetate poisoning using non-targeted metabolomics. Methods: A total of six patients with occupational acute methyl acetate poisoning were selected as the poisoning group, while 10 healthy workers without occupational exposure history of chemical hazards in the same industry were selected as the control group using the judgment sampling method. Metabolites in patient plasma of the two groups were detected using ultra-high performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry, and non-targeted metabolomics analysis was performed. Principal component analysis and partial least squares discriminant analysis were used to identify differential metabolites and analyze their metabolic pathways. Results: There were significant differences in metabolite profiles in patient plasma between poisoning group and control group. A total of 195 differentially expressed metabolites were screened in plasma of patients in poisoning group, including 119 upregulated and 76 downregulated metabolites. Lipid substances (lipids and lipid-like molecules) accounted for the highest proportion (21.5%). The differential metabolites of poisoning group were related to folate biosynthesis, amino acid metabolism, pyrimidine metabolism, sphingolipid biosynthesis and other metabolic pathways in plasma compared with the control group (all P<0.05). Conclusion: Occupational acute methyl acetate poisoning affects metabolism of the body. The folic acid biosynthesis, amino acid and lipid metabolism and other pathways may be involved in the occurrence and development of poisoning.

Objective:To investigate the influence of hemoglobin glycation index (HGI) on the risk of incident chronic kidney disease (CDK) among nondiabetic patients.Methods:Prospective cohort study. At baseline, a total of 7 407 nondiabetic patients without a history of CKD from Pingguoyuan Community of the Shijingshan District in Beijing were included from December 2011 to August 2012, who were then divided into three groups according to the tertiles of their baseline HGI levels. The CKD incidence rate was compared among the different HGI groups at last follow-up. Cox multivariable regression was applied to evaluate whether HGI measures predicted CKD risk. Test for trend across tertiles were examined using ordinal values in separate models.Results:The mean age of the subjects was (56.4±7.5) years, and 4 933 (66.6%) were female. At mean follow-up of 3.23 years, 107 (1.4%) individuals developed CKD. The incidence of CKD was gradually increasing from the low to high HGI groups [1.1% (28/2 473) vs. 1.2% (31/2 564) vs. 2.0% (48/2 370), P=0.016]. In the multivariate Cox regression analysis, after adjustment for potential confounders, the high HGI group had a 68.5% increased risk of CKD compared with the low HGI group ( HR=1.685, 95% CI 1.023 to 2.774). CKD risk increased with increasing HGI tertiles ( P for trend=0.028). Conclusion:High HGI is associated with an increased risk for CKD in the nondiabetic population, indicating that HGI may help identify individuals at high risk for CKD.

Objective The literature study the setup errors of head and neck, thoracic, abdominal and pelvic tumors by megavoltage fan-beam CT based image guidance in TOMO-HD to provide the margin enlarging from clinic target volume (CTV) to planning target volume (PTV) in treatment planning system of TOMO-HD. Methods 103 patients with head and neck (30 patients), thoracic (42 patients), abdominal and pelvic (31 patients) carcinoma were enrolled. Megavoltage fan-beam CT based image guidance in tomotherapy-HD was used to acquire CT scan before every treatment. The left-right (X), superior-inferior (Y), anterior-posterior (Z) and rotation (Fy) setup errors of patients can be obtained from the tomography image automatically restructured by the system. Calculating the systematic error and the random error in the three dimensions and check whether the setup data accord with the normal distribution or not, then acquire the data expand in the three directions. Results According to 2593 fan-beam CT scans, the shift errors (µ ± s) in X, Y, Z and Fy (rotation) of three study group were [(−0.31 ± 2.16) mm、(1.09 ± 3.56) mm、(2.36 ± 2.27) mm, (0.29 ± 0.96)°] (head and neck tumor), [(−0.98 ± 2.95) mm、(0.45 ± 6.86) mm、(3.79 ± 2.47) mm, (0.18 ± 0.60)°] (thoracic cancer) and [(−0.86 ± 2.85) mm、(−1.59 ± 6.91) mm、(5.77 ± 2.40) mm, (0.20 ± 0.68)°](abdominal and pelvic carcinoma). The systematic errors (∑) and random errors (σ) in X, Y, Z dimensions of patients with head and neck, thoracic, abdominal and pelvic tumors were (1.06 mm and 1.84 mm), (1.93 mm and 3.43 mm), (2.41 mm and 2.71 mm), (1.10 mm and 2.56 mm), (3.79 mm and 5.46 mm), (1.38 mm and 1.99 mm) and (1.39 mm and 0.87 mm), (4.98 mm and 5.69 mm), (1.19 mm and 2.05 mm), respectively. Conclusion It is recommended as a reference for image guidance in TOMO-HD according to the frequency distribution of setup errors, for patients with head and neck, chest and abdominal and pelvic tumors, the maximum range of motion in three dimensions are (5.00, 5.00, 5.00) mm, (6.63, 17.25, 16.00) mm and (6.49, 16.24, 13.60) mm.

Behcet′s disease is a chronic, multisystemic, inflammatory disease characterized by recurrent episodes of mucous membranes, eyes, musculoskeletal, blood vessels, central nervous system, and gastrointestinal tract.The treatment of Behcet′s disease varies according to the degree of organ involvement, gender and age of the patient, and there is no standard treatment. Behcet′s disease can be divided into vascular type, gastrointestinal type and neural type. Vascular type often leads to high mortality and disability rate.Glucocorticoids, azathioprine and cyclophosphamide are still recommended as first-line treatments for vascular Behcet′s disease.However, with the use of tumor necrosis factor inhibitors, they are an acceptable option for the treatment of refractory vascular Bezier′s disease.This article reviews the current treatment of vascular Behcet′s disease.

Objective:To explore the application of ArcCheck system in the validation of Helical and Direct tomotherapy plans for esophageal cancer and summarize relevant experience.Methods:The Helical and Direct tomotherapy verification plans were established for 32 patients with esophageal cancer at different positions according to the doctor′s instructions, which were verified by the ArcCHECK system to compare the passing rate of the results.The correlation between the volume of the target area and the passing rate of the planned verification was analyzed. The therapeutic verification plan with a small target volume was made. The target area was placed at the center of ArcCHECK phantom and the area of detectors to statistically compare the verification passing rates.Results:Helical plan showed a significantly higher passing rate than the Direct plan ( P<0.01). The correlation coefficients between the target volume and the passing rate of the Helical and Direct plans were -0.364 and -0.042, and the P values were 0.041 and 0.819, respectively. For the Helical plan, when the 3%/2mm criterion was adopted, there was significant difference between placing the high-dose area at the center of the phantom and the area of detectors ( P=0.005), and the passing rate of the latter was higher. There was no significant difference in the other cases (all P>0.05). Conclusions:The passing rate of the Helical plan is generally higher than that of the Direct plan, which may be related to the angular response of the ArcCHECK detector and the fact that more reference points are not included for calculation due to low-dose radiation. In addition, it may also be related to the higher requirements of Direct plan for tomotherapy dose control system. In the Helical verification plan, when the 3%/3mm criterion is adopted, the larger the target volume, the higher the possibility of lower passing rate, whereas the correlation coefficient between them is relatively low. The high-dose area can be verified by the plans at the center of the phantom or the detection point. With the comprehensive consideration, we suggest putting it at the center of the phantom.

Objective To investigate the effects of periostin (Postn) on oxidized low density lipoprotein (ox-LDL)-induced injury in human artery endothelial cells (HAECs) and its underlying mechanisms.Methods The HAECs were randomly divided into 4 groups:control group,ox-LDL group,Postn siRNA group and negative siRNA group.The mRNA and protein expression was analyzed by RT-qPCR and Westem blot respectively.Cell proliferation was tested by MTT.Cell apoptosis was determined by flow cytometry.NF-κB DNA binding ability was measured by EMSA.Results Compared with control group,the mRNA and protein levels of Postn were increased significantly (P＜0.05);the ability of cell proliferation was reduced (P＜0.05);the cell apoptosis rate was increased (P＜ 0.05);the protein expression levels of VCAM1,ICAM1,E-selectin,IL-1β,IL-6,TNF-α,p65 and p-IκB-α were significantly up-regulated (P＜0.05),and the NF-κB DNA binding ability was markedly increased (P＜ 0.05) in ox-LDL group,which were all reversed in Postn siRNA group.Conclusions Postn siRNA transfection may reduce ox-LDL-induced endothelial cell injury,which may be related with the inhibition of NF-κB signaling pathway.