OBJECTIVE: To investigate the association between long-term glycemic control and cerebral infarction risk in patients with diabetes through a large-scale cohort study. METHODS: This prospective, community-based cohort study included 12,054 patients with diabetes. From 2006 to 2012, 38,272 fasting blood glucose (FBG) measurements were obtained from these participants. FBG trajectory patterns were generated using latent mixture modelling. Cox proportional hazards models were applied to assess the subsequent risk of cerebral infarction associated with different FBG trajectory patterns. RESULTS: At baseline, the mean age of the participants was 55.2 years. Four distinct FBG trajectories were identified based on FBG concentrations and their changes over the 6-year follow-up period. After a median follow-up of 6.9 years, 786 cerebral infarction events were recorded. Different trajectory patterns were associated with significantly varied outcome risks (Log-Rank P < 0.001). Compared with the low-stability group, Hazard Ratio ( HR) adjusted for potential confounders were 1.37 for the moderate-increasing group, 1.23 for the elevated-decreasing group, and 2.08 for the elevated-stable group. CONCLUSION Sustained high FBG levels were found to play a critical role in the development of ischemic stroke among patients with diabetes. Controlling FBG levels may reduce the risk of cerebral infarction.
Humans ; Cerebral Infarction/blood* ; Middle Aged ; Male ; Female ; Blood Glucose/analysis* ; Fasting/blood* ; Aged ; Prospective Studies ; Risk Factors ; Diabetes Mellitus/blood* ; Adult ; Proportional Hazards Models

AIM To establish an HPLC method for the simultaneous content determination of 5-hydroxymethylfurfural,chlorogenic acid,caffeic acid,strychnine,paeoniflorin,ferulic acid,paeoniflorin Ⅰ,epimedium glycoside,psoralen,isopsoralen and glycyrrhetinic acid in Bunao Soft Capsules.METHODS The analysis was performed on a 35 ℃ thermostatic Waters Symmetry C18 column(250 mm×4.6 mm,5 μm),with the mobile phase comprising of acetonitrile-0.1％phosphoric acid flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelengths were set at 230,280 nm.RESULTS Eleven constituents showed good linear relationships within their own ranges(r＞0.999 0),whose average recoveries were 98.47％-103.30％with RSDs of 1.13％-2.80％.CONCLUSION This simple and reliable method can be used for the quality control of Bunao Soft Capsules.

As a member of the Citrus genus of the Rutaceae family, Citrus changshan-huyou(CSHY) is mainly produced in Quzhou city, Zhejiang province. Modern research shows that different medicinal parts of CSHY(immature fruit, mature fruit peel, flower buds, leaves, seeds, etc.) are abundant in flavonoids, terpenes, coumarins, phenolic acids, and volatile oils. Their pharmacological activities include respiratory system protection, liver protection, anti-inflammation, anti-hyperlipidemia, anti-hyperglycemia, and antioxidation. Based on the summarization of 374 chemical components in different medicinal parts of CSHY identified in the past 20 years, this study reviewed their pharmacological actions and mechanisms and further analyzed the current status of quality control of different medicinal parts of CSHY, aiming to provide reference for the resource development and exploitation and the quality control research of different medicinal parts of CSHY.
Citrus/chemistry* ; Drugs, Chinese Herbal/pharmacology* ; Humans ; Plants, Medicinal/chemistry* ; Quality Control ; Animals

Objective:To analyze the factors associated with prolonged hospital stay in patients with mycoplasma pneumoniae pneumonia (MPP) and construct an early identification model.Methods:A case-control study was conducted on 503 newly diagnosed pediatric patients with MPP who received treatment at Suzhou Municipal Hospital from April to December 2023. Clinical data were collected. Patients were divided into an observation group ( n = 240, hospital stay > 8 days) and a control group ( n = 263, hospital stay ≤ 8 days). Logistic regression analysis was used to identify the independent factors that affect hospital stay in the observation group. A Nomogram model was constructed. Results:The incidence of lobar pneumonia in the observation group was significantly higher than that in the control group [62.5% (150/240) vs. 22.4% (59/263), χ2 = 82.94, P < 0.001]. The mean age of the observation group was significantly higher than that in the control group [5.0 (3.0, 7.0) years vs. 4.0 (2.0, 6.0) years, Z = 2.40, P = 0.016]. The hypersensitive C-reactive protein level in the observation group was significantly higher than that in the control group [10.5 (4.8, 22.0) mg/L vs. 6.1 (1.8, 14.2) mg/L, Z = 5.16, P < 0.001]. The ferritin level in the observation group was significantly higher than that in the control group [225.3 (180.9, 271.3) μg/L vs. 177.7 (138.0, 222.0) μg/L, Z = 6.31, P < 0.001]. The albumin level in the observation group was significantly lower than that in the control group [43.7 (41.0, 46.2) g/L vs. 44.4 (42.3, 46.5) g/L, Z = 2.45, P = 0.014]. The total protein level in the observation group was significantly lower than that in the control group [70.0 (66.8, 73.0) g/L vs. 71.5 (67.8, 74.6) g/L, Z = 2.45, P = 0.014]. The lactate dehydrogenase level in the observation group was significantly higher than that in the control group [337.5 (301.5, 391.8) U/L vs. 291.0 (258.0, 332.3) U/L, Z = 3.28, P = 0.001]. The creatine kinase level in the observation group was significantly lower than that in the control group [77.5 (55.3, 115.8) U/L vs. 89.0 (65.0, 126.0) U/L, Z = 2.75, P = 0.006]. The fibrinogen level in the observation group was significantly higher than that in the control group [4.3 (3.4, 4.8) g/L vs. 3.8 (3.0, 4.6) g/L, Z = 4.17, P < 0.001]. After performing univariate binary logistic regression using the glm method to screen variables, multivariate binary logistic regression was conducted. The results showed that the presence of lobar pneumonia, higher levels of hypersensitive C-reactive protein, ferritin, and lactate dehydrogenase were independent risk factors for prolonged hospital stays in children with MPP [ OR (95% CI): 3.803 (2.029,7.129), 0.986 (0.974,0.998), 0.994 (0.990,0.998), 0.989 (0.985,0.993), P < 0.001, 0.027, 0.002, < 0.001]. Conclusions:Based on the fundamental clinical laboratory indicators, an early prediction model was constructed for predicting prolonged hospital stay in children with MPP. This model provides a scientific basis for the early assessment of MPP in children and is suitable for broader application.

Objective:To analyze the factors associated with prolonged hospital stay in patients with mycoplasma pneumoniae pneumonia (MPP) and construct an early identification model.Methods:A case-control study was conducted on 503 newly diagnosed pediatric patients with MPP who received treatment at Suzhou Municipal Hospital from April to December 2023. Clinical data were collected. Patients were divided into an observation group ( n = 240, hospital stay > 8 days) and a control group ( n = 263, hospital stay ≤ 8 days). Logistic regression analysis was used to identify the independent factors that affect hospital stay in the observation group. A Nomogram model was constructed. Results:The incidence of lobar pneumonia in the observation group was significantly higher than that in the control group [62.5% (150/240) vs. 22.4% (59/263), χ2 = 82.94, P < 0.001]. The mean age of the observation group was significantly higher than that in the control group [5.0 (3.0, 7.0) years vs. 4.0 (2.0, 6.0) years, Z = 2.40, P = 0.016]. The hypersensitive C-reactive protein level in the observation group was significantly higher than that in the control group [10.5 (4.8, 22.0) mg/L vs. 6.1 (1.8, 14.2) mg/L, Z = 5.16, P < 0.001]. The ferritin level in the observation group was significantly higher than that in the control group [225.3 (180.9, 271.3) μg/L vs. 177.7 (138.0, 222.0) μg/L, Z = 6.31, P < 0.001]. The albumin level in the observation group was significantly lower than that in the control group [43.7 (41.0, 46.2) g/L vs. 44.4 (42.3, 46.5) g/L, Z = 2.45, P = 0.014]. The total protein level in the observation group was significantly lower than that in the control group [70.0 (66.8, 73.0) g/L vs. 71.5 (67.8, 74.6) g/L, Z = 2.45, P = 0.014]. The lactate dehydrogenase level in the observation group was significantly higher than that in the control group [337.5 (301.5, 391.8) U/L vs. 291.0 (258.0, 332.3) U/L, Z = 3.28, P = 0.001]. The creatine kinase level in the observation group was significantly lower than that in the control group [77.5 (55.3, 115.8) U/L vs. 89.0 (65.0, 126.0) U/L, Z = 2.75, P = 0.006]. The fibrinogen level in the observation group was significantly higher than that in the control group [4.3 (3.4, 4.8) g/L vs. 3.8 (3.0, 4.6) g/L, Z = 4.17, P < 0.001]. After performing univariate binary logistic regression using the glm method to screen variables, multivariate binary logistic regression was conducted. The results showed that the presence of lobar pneumonia, higher levels of hypersensitive C-reactive protein, ferritin, and lactate dehydrogenase were independent risk factors for prolonged hospital stays in children with MPP [ OR (95% CI): 3.803 (2.029,7.129), 0.986 (0.974,0.998), 0.994 (0.990,0.998), 0.989 (0.985,0.993), P < 0.001, 0.027, 0.002, < 0.001]. Conclusions:Based on the fundamental clinical laboratory indicators, an early prediction model was constructed for predicting prolonged hospital stay in children with MPP. This model provides a scientific basis for the early assessment of MPP in children and is suitable for broader application.

AIM To establish an HPLC method for the simultaneous content determination of 5-hydroxymethylfurfural,chlorogenic acid,caffeic acid,strychnine,paeoniflorin,ferulic acid,paeoniflorin Ⅰ,epimedium glycoside,psoralen,isopsoralen and glycyrrhetinic acid in Bunao Soft Capsules.METHODS The analysis was performed on a 35 ℃ thermostatic Waters Symmetry C18 column(250 mm×4.6 mm,5 μm),with the mobile phase comprising of acetonitrile-0.1％phosphoric acid flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelengths were set at 230,280 nm.RESULTS Eleven constituents showed good linear relationships within their own ranges(r＞0.999 0),whose average recoveries were 98.47％-103.30％with RSDs of 1.13％-2.80％.CONCLUSION This simple and reliable method can be used for the quality control of Bunao Soft Capsules.

Objective To investigate the clinical effect of modified suspension reduction method combined with percuta-neous vertebroplasty in the treatment of osteoporotic thoracolumbar compression fractures.Methods From February 2020 to October 2021,92 patients with thoracolumbar osteoporotic compression fracture were treated by percutaneous vertebroplasty.According to different treatment methods,they were divided into the observation group and the control group.The observation group was treated with modified suspension reduction and then percutaneous vertebroplasty,while the control group was treated with percutaneous vertebroplasty alone.The observation group(47 cases),including 20 males and 27 females,the age ranged from 59 to 76 years old with an average of(69.74±4.50)years old,fractured vertebral bodies:T10(2 cases),T11(7 cases),T12(19 cases),L1(14 cases),L2(5 cases);the control group(45 cases),including 21 males and 24 females,the age ranged from 61 to 78 years old with an average of(71.02±3.58)years old,fractured vertebral bodies:T10(3 cases),T11(8 cases),T12(17 cas-es),L1(12 cases),L2(5 cases);The leakage of bone cement were observed,the visual analogue scale(VAS),Oswestry lumbar dysfunction index(ODI),anterior vertebrae height(AVH),Cobb angle of kyphosis and the amount of bone cement injected before and after operation were recorded and compared between the two groups.Results All patients were followed up,ranged from 6 to1O with an average of(8.45±1.73)months.Two patients ocurred bone cement leakage in observation group and 3 pa-tients in control group.AVH of observation group increased(P＜0.05)and Cobb angle of injured vertebrae decreased(P＜0.05).Cobb angle of injured vertebrae and AVH of the control group were not significantly changed(P＞0.05).Cobb angle of injured vertebrae of the observation group was lower than that of control group(P＜0.05)and AVH was higher than that of the control group(P＜0.05).In the observation group,VAS before operation and 1 week,3 and 6 months after operation respective-ly were(7.32±1.05)scores,(3.56±1.18)scores,(1.83±0.67)scores,(1.27±0.34)scores,and ODI were(40.12±14.69)scores,(23.76±10.19)scores,(20.15±6.39)scores,(13.45±3.46)scores.In the control group,VAS before operation and 1 week,3 and 6 months after operation respectively were(7.11±5.26)scores,(3.82±0.68)scores,(1.94±0.88)scores,(1.36± 0.52)scores,and ODI were(41.38±10.23)scores,(25.13±14.22)scores,(20.61±5.82)scores,(14.55±5.27)scores.The scores of VAS and ODI after operation were lower than those before operation(P＜0.05),but there was no significant difference between the two groups(P＜0.05).Conclusion Modified suspension reduction method combined with PVP surgery for osteo-porotic thoracolumbar compression fractures has achieved good clinical results,which can effectively relieve lumbar back pain,restore vertebral height,correct kyphosis,improve lumbar function and patients'quality of life.

Atractylodes macrocephala, a plant of the Asteraceae family, as a commonly used traditional Chinses medicine in clinic, has the efficacy of invigorating spleen and supplementing qi, eliminating dampness and inducing diuresis, and expelling wind and dispersing cold. Moreover, it was proved that it has many pharmacological effects such as anti-inflammation, anti-tumor, and improving immunical ability based on the scientific researches. Atractyloside is one of its active ingredients and characteristic ingredients. In this paper, using the search terms of Baizhu lactone, sesquiterpene lactone, quality evaluation, quality control, and chemical composition, the CNKI, Weipu and PubMed literature database were searched. And relevant literature results were compared and summarized. The catagories, structural formula of atractyloside and their transformation mechanism were summarized. It was found that the content of lactone components could be affected by different processing methods, different producing locations, different harvesting season, and different growth years. It was found that for the quality evaluation of Atractylodes macrocephala, the multivariate statistical analysis combined with content determination or fingerprint establishment could be more accurate, reliable and comprehensive, among which the supervised PLS-DA with OPLS-DA analysis was better than the unsupervised PCA analysis. This literature summary could provide a beneficial reference for the quality evaluation and utilization of Atractylodes macrocephala.

Objective To observe the efficacy and safety of Morinda officinalis oligosaccharides in the continuation treatment of mild and moderate depression.Methods An open,single-arm,multi-center design was adopted in our study.Adult patients with mild and moderate depression who had received acute treatment of Morinda officinalis oligosaccharides were enrolled and continue to receive Morinda officinalis oligosaccharides capsules for 24 weeks,the dose remained unchanged during continuation treatment.The remission rate,recurrence rate,recurrence time,and the change from baseline to endpoint of Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),Clinical Global Impression-Severity(CGI-S)and Arizona Sexual Experience Scale(ASEX)were evaluated.The incidence of treatment-related adverse events was reported.Results The scores of HAMD-17 at baseline and after treatment were 6.60±1.87 and 5.85±4.18,scores of HAMA were 6.36±3.02 and 4.93±3.09,scores of CGI-S were 1.49±0.56 and 1.29±0.81,scores of ASEX were 15.92±4.72 and 15.57±5.26,with significant difference(P＜0.05).After continuation treatment,the remission rate was 54.59％(202 cases/370 cases),and the recurrence rate was 6.49％(24 cases/370 cases),the recurrence time was(64.67±42.47)days.The incidence of treatment-related adverse events was 15.35％(64 cases/417 cases).Conclusion Morinda officinalis oligosaccharides capsules can be effectively used for the continuation treatment of mild and moderate depression,and are well tolerated and safe.

Objective The leptin receptor,encoded by the LEPR gene,is involved in tumorigenesis.A potential functional variant of LEPR,rs1137101(Gln223Arg),has been extensively investigated for its contribution to the risk of digestive system(DS)cancers,but results remain conflicting rather than conclusive.Here,we performed a case-control study and subsequent meta-analysis to examine the association between rs1137101 and DS cancer risk. Methods A total of 1,727 patients with cancer(gastric/liver/colorectal:460/480/787)and 800 healthy controls were recruited.Genotyping of rs1137101 was conducted using a polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)assay and confirmed using Sanger sequencing.Twenty-four eligible studies were included in the meta-analysis. Results After Bonferroni correction,the case-control study revealed that rs1137101 was significantly associated with the risk of liver cancer in the Hubei Chinese population.The meta-analysis suggested that rs1137101 is significantly associated with the risk of overall DS,gastric,and liver cancer in the Chinese population. Conclusion The LEPR rs1137101 variant may be a genetic biomarker for susceptibility to DS cancers(especially liver and gastric cancer)in the Chinese population.