Objective: The relationship between serum uric acid (SUA) levels and glycemic indices, including plasma glucose (FPG), 2-hour postload glucose (2h-PG), and glycated hemoglobin (HbA1c), remains inconclusive. We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population. Methods: The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study. A total of 105,922 community-dwelling adults aged ≥ 40 years underwent the oral glucose tolerance test and uric acid assessment. The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models. Results: A total of 30,941 men and 62,361 women were eligible for the current analysis. Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels, but with different inflection points in men and women. The thresholds for FPG, 2h-PG, and HbA1c for men and women were 6.5/8.0 mmol/L, 11.0/14.0 mmol/L, and 6.1/6.5, respectively (SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices). Conclusion An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes, while the inflection points were reached earlier in men than in women.
Aged ; Asian Continental Ancestry Group ; Blood Glucose/analysis* ; China/epidemiology* ; Cohort Studies ; Diabetes Mellitus/blood* ; Female ; Glucose Tolerance Test ; Glycated Hemoglobin A/analysis* ; Glycemic Index ; Humans ; Male ; Middle Aged ; Uric Acid/blood*

BACKGROUND: We examined changes in hepatitis B core-related antigen (HBcrAg) during the four sequential phases of chronic hepatitis B virus (HBV) infection: hepatitis B e antigen (HBeAg)-positive chronic infection (EPCI) and hepatitis (EPCH), followed by HBeAg-negative chronic infection (ENCI) and hepatitis (ENCH). We compared the performance of serum HBcrAg, hepatitis B surface antigen (HBsAg), and HBV DNA in predicting EPCH and ENCH. METHODS: We enrolled 492 consecutive patients: 49 with EPCI, 243 with EPCH, 101 with ENCI, and 99 with ENCH. HBcrAg was detected by chemiluminescent enzyme immunoassays. HBsAg and HBeAg were detected by chemiluminescent microparticle immunoassays. HBV DNA was detected by real-time PCR. Predictive performance of HBcrAg, HBsAg, and HBV DNA was evaluated using ROC curves. RESULTS: Areas under ROC curves (AUCs) of HBcrAg, HBsAg, and HBV DNA for predicting EPCH were 0.738, 0.812, and 0.717, respectively; optimal cutoffs were ≤1.43×105 kU/mL, ≤1.89×104 IU/mL, and ≤3.97×107 IU/mL, with sensitivities and specificities of 66.3% and 77.6%, 65.0% and 93.9%, and 60.5% and 79.6%, respectively. AUCs of HBcrAg, HBsAg, and HBV DNA for predicting ENCH were 0.887, 0.581, and 0.978, respectively; optimal cutoffs were >26.8 kU/mL, >2.29×102 IU/mL, and >8.75×103 IU/mL, with sensitivities and specificities of 72.7% and 95.1%, 86.9% and 39.6%, and 89.9% and 92.1%, respectively. CONCLUSIONS: HBsAg and HBV DNA were the best predictors of EPCH and ENCH, respectively. HBcrAg is an important surrogate marker for predicting EPCH and ENCH.
Area Under Curve ; Biomarkers ; DNA ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens* ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis B, Chronic ; Hepatitis* ; Hepatitis, Chronic* ; Humans ; Immunoassay ; Immunoenzyme Techniques ; Real-Time Polymerase Chain Reaction ; ROC Curve

BACKGROUND: The endoscopic transnasal approach has been proven to have advantages on the removal of the tumors in pterygopalatine fossa (PPF) and infratemporal fossa (ITF). Herein, this study aimed to describe a modified approach for resection of the tumors in these areas, both in cadaveric specimen and clinical patients. METHODS: The 20 adult cadaveric specimens and five patients with tumors in PPF and ITF were enrolled in this study. For the cadaveric specimens, ten were simulated anterior transmaxillary approach and ten were performed modified endoscopic transnasal transmaxillary approach. The exposure areas were compared between two groups and main anatomic structure were measured. Surgery was operated in the five patients with tumors of PPF and ITF to verify the experience from the anatomy. Perioperative management, intraoperative findings and postoperative complications were recorded and analyzed. RESULTS: The modified endoscopic transnasal transmaxillary approach provided as enough surgical exposure and high operability to the PPF and ITF as the anterior transmaxillary approach did. The diameter of maxillary artery in the PPF was 3.77 ± 0.78 mm (range: 2.06-4.82 mm), the diameter of middle meningeal artery in the ITF was 2.79 ± 0.61 mm (range: 1.54-3.78 mm). Four patients who suffered schwannoma got total removal and one of adenocystic carcinoma got subtotal removal. The main complications were facial numbness and pericoronitis of the wisdom tooth. No permanent complication was found. CONCLUSIONS With the widespread use of neuroendoscopy, the modified endoscopic transnasal transmaxillary approach is feasible and effective for the resection of tumors located in PPF and ITF, which has significant advantages on less trauma and complications to the patients.
Adult ; Female ; Humans ; Infratentorial Neoplasms ; pathology ; surgery ; Male ; Middle Aged ; Neuroendoscopy ; Perioperative Care ; Postoperative Complications ; Pterygopalatine Fossa ; pathology ; surgery

OBJECTIVETo study the effect of the DA-EPOCH chemotherapy combined with G-CSF and the CTX therapy with G-CSF on mobilizing and collecting the peripheral blood hematopoietic stem cells and the later hematopoietic recovery.

METHODSForty patients accepted mobilization and collection of peripheral blood stem cells(PBSC) after treated by CTX+G-CSF and DA-EPOCH+G-CSF therapy respectively, and were treated by auto-transfusion after BEAM pre-regimen. The mobilization efficacy, adverse effects and hematopoietic recovery after autologous transplantation were analyzed retrospectively.

RESULTSDuring the CTX+G-CSF mobilization, only one patient achieved the white blood cell(WBC) at 0.8×10/L, while the others were with the lowest WBC level above 2.0×10/L. The platelet counts were all normal with the exception of 3 cases at 80×10/L. The median percentage of CD34cells in one period of collection was 0.99(0.35-1.30)%. The median MNC was (3.80±2.05)×10. The cumulative total of mononuclear cell was (5.84±2.48)×10/kg, and the median CD34cell count was 3.84(3.91-6.5)×10/kg. During the DA-EPOCH+G-CSF mobilization, the peripheral WBC count of patients were decreased to the lowest level at (0.2-1.4)×10/L. The platelet counts were all above 40×10/L except for 1 case in which the platelet count was reduced to 8×10/L. The median percentage of CD34cells in one period of collection was 0.85(0.34-1.2)%. The median MNC was (3.68±1.56)×10. The cumulative total of mononuclear cells was (6.01±2.26)×10/kg, and the median CD34cell count was 4.44(2.7-7.10)×10/kg. There were no statistical differences between the 2 groups in the median percentage of CD34cells, the median MNC, the cumulative total of mononuclear cells and the median CD34cell counts (P>0.05). The average acquired time for granulocyte engraftment was 10.00(9.00-11.00) days, and for platelet engraftment was 12.50(11.00-17.25) days, with no statistical difference(P>0.05). No death occurred during the process of transplantation.

CONCLUSIONDA-EPOCH therapy combined with G-CSF can effectively mobilize the peripheral blood hematopoietic stem cells in NHL patients with higher safety and lower price, and proves to be worth recommending in clinical use.

Objective:To explore the effectiveness of an 8-week hope group counseling on the level of hope in offenders.Methods:The experiment used quasi-experiment design and 24 offenders whose scores of Adult Dispositional Hope Scale (ADHS) were one standard deviation lower than the overall average were assigned to the intervention group (n =12) and the control group (n =12).The subjects in the intervention group received group counseling for improving the level of hope (90 min per week for 8 times),and the control group kept normal.The ADHS (including agency thoughts and pathway thoughts),Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were used to evaluate the effectiveness before and after intervention.Besides,the study involved the follow-up test in the forth-week after the intervention.Differences within groups were compared by using t-test of paired samples.Differences between groups were compared by using analysis of covariance and JohnsonNeyman method.Result:The results of differences within groups showed that,in the follow-up test,the scores of ADHS,agency thought and pathway thought were higher than that of before the intervention,and the scores of SAS were lower than that of before the intervention(Ps ＜0.01).The results of differences between groups showed that,=in the follow-up test,the scores of ADHS,agency thought and pathway thought were higher in the intervention group than in the control group,and the scores of SAS were lower in the intervention group than in the control group [(48.0 ±5.7)vs.(39.2 ±5.6),(23.1 ±3.4)vs.(19.0 ±3.2),(24.9 ±3.0)vs.(20.2 ± 3.4),(36.4 ± 7.6)vs.(41.2 ±6.5);Ps ＜0.01].The results of Johnson-Neyman method showed that when the scores of ADHS in the intervention group were between 8 and 37 points on the pre-test,the scores of hope on the post-test were higher in the intervention group than in the control group[(48.8 ± 4.9) vs.(35.7 ± 4.9),P ＜ 0.05].Conclusion:These findings suggest that the group counseling could improve the level of hope in offenders.

Hepatitis B virus (HBV) infection has been one of the most important public health problems,however,no complete cure is currently available.Although interferon (IFN)-α has been clinically used as a drug for chronic hepatitis B therapy because of its advantages including a higher rate of HBsAg/HBeAg seroconversion and a lower rate of recurrence after cessation of treatment,only 20％ -40 ％ of patients respond well to IFN therapy,thus hampering its clinical application.In recent years,based on the in vitro HBV replication and infection cell models,animal models and patient cohort with hepatitis B and by using a variety of methods,studies have been made.On the one hand,to identify new mechanisms underlying the IFN-and IFN-induced genes-mediated anti-HBV activities and signaling transduction,on the other hand,to reveal the effect and mechanisms of HBV replication and viral proteins in regulating the innate immune signaling pathways and IFN induction and antiviral action,based on which new strategies and approaches for optimization of IFN-based therapy and for a HBV cure have been further explored.This review mainly introduces the research findings of author's group and the future development is prospected.

Objective To study the inter-rater reliability of Wisconsin Gait Scale (WGS) and Gait Abnormality Rating Scale (GARS) in patients with stroke. Methods 20 hemiplegic patients were required to walk on their comfortable speed and videotaped from frontal, backward and lateral. The video recordings were scored with WGS and GARS by 2 experienced physical therapists. Intraclass correlation coefficient (ICC) was calculated for the scores in each category and the total score. Results ICC for the WGS were 0.372~1, and were 0~0.875 for the GARS. Conclusion WGS is more appropriater to assess the gait of hemiplegic stroke patients than GARS.

Objective To find the plantar pressure readings which best indicate foot inversion during the stance phase of walking among hemiplegic stroke survivors.Methods Twenty-two hemiplegic stroke survivors who were able to walk without extra aid were recruited as the experimental group, while 17 healthy elderly men of similar age and body weight were selected as the control group.Those in both groups were asked to walk at their preferred speed over a Footscan device which measured medio-lateral pressure ratios, maximum plantar pressures and the contact areas of both feet.The Clinical Spasticity Index (CSI) was used to evaluate the affected feet.Results The average medial forefoot pressure of the affected side in the experimental group was significantly lower than that of the control group, but their average mesopodium and heel pressure was significantly higher.The average pressure applied by the great toe on the uninjured side in the experimental group was significantly smaller than that of the control group, but the average mesopodium and heel pressure of both feet among the hemiplegics were significantly higher than those of the control group.Among the experimental group, the average medial forefoot pressure of the affected foot was significantly greater than that of the healthy foot.The average contact area of the great toe on the affected side was significantly bigger than was observed in the control group.That of the medial forefoot was, however, significantly smaller than in the control group.There was no significant difference in the contact area between the healthy and affected feet in the experimental group, though the maxmium medio-lateral pressure ratios of their full feet and forefeet on the affected side were significantly lower than those in the healthy group.No significant differences in the maxmium medio-lateral pressure ratios of the heel were observed between the two groups, nor of the full feet, forefeet and heels of the affected and unaffected sides in the experimental group.The patients demonstrated consistently reduced joint mobility on both sides during the stance phase, coinciding with increased inversion.A significant negative correlation was found between the maxmium medio-lateral pressure ratios of the full foot and the maximum pressure of the lateral part of forefoot in the experimental group, but there was no significant correlation with contact area or CSI.Conclusions Plantar pressure data can be used to describe the amount of foot inversion in the stance phase of walking with hemiplegic patients after stroke.The maxmium medio-lateral pressure ratios can effectively reflect their foot inversion.

This paper discussed the reform of teaching of medical rehabilitation as an elective course for postgraduates majored in non rehabilitation. As a clinical second-rate discipline, rehabilitation medicine covered extensive contents, but the class time is few. This paper discussed how to teach more practical, helpful clinical content in limited time.

BACKGROUNDData on the epidemiology of hypertension in Chinese non-dialysis chronic kidney disease (CKD) patients are limited. The aim of the present study was to investigate the prevalence, awareness, treatment, and control of hypertension in the non-dialysis CKD patients through a nationwide, multicenter study in China.

METHODSThe survey was performed in 61 tertiary hospitals in 31 provinces, municipalities, and autonomous regions in China (except Hong Kong, Macao, and Taiwan). Trained physicians collected demographic and clinical data and measured blood pressure (BP) using a standardized protocol. Hypertension was defined as systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg, and/or use of antihypertensive medications. BP < 140/90 mmHg and < 130/80 mmHg were used as the 2 thresholds of hypertension control. In multivariate logistic regression with adjustment for sex and age, we analyzed the association between CKD stages and uncontrolled hypertension in non-dialysis CKD patients.

RESULTSThe analysis included 8927 non-dialysis CKD patients. The prevalence, awareness, and treatment of hypertension in non-dialysis CKD patients were 67.3%, 85.8%, and 81.0%, respectively. Of hypertensive CKD patients, 33.1% and 14.1% had controlled BP to < 140/90 mmHg and < 130/80 mmHg, respectively. With successive CKD stages, the prevalence of hypertension in non-dialysis CKD patients increased, but the control of hypertension decreased (P < 0.001). When the threshold of BP < 130/80 mmHg was considered, the risk of uncontrolled hypertension in CKD 2, 3a, 3b, 4, and 5 stages increased 1.3, 1.4, 1.4, 2.5, and 4.0 times compared with CKD 1 stage, respectively (P < 0.05). Using the threshold of < 140/90 mmHg, the risk of uncontrolled hypertension increased in advanced stages (P < 0.05).

CONCLUSIONSThe prevalence of hypertension Chinese non-dialysis CKD patients was high, and the hypertension control was suboptimal. With successive CKD stages, the risk of uncontrolled hypertension increased.

Adult ; Aged ; Awareness ; Female ; Humans ; Hypertension ; complications ; epidemiology ; therapy ; Male ; Middle Aged ; Prevalence ; Renal Insufficiency, Chronic ; complications