Objective:To understand the impact of diet on glycemic control in community-managed patients with type 2 diabetes mellitus (T2DM) and provide evidence for implementing prevention strategies and measures for diabetes patients.Methods:Eight communities were randomly selected from Changshu and Wuhan in 2015, and T2DM patients managed in the community were selected to conduct questionnaire surveys, physical measurements, and blood glucose testing. Factor analysis was used to obtain dietary patterns. A binary logistic regression model was used to analyze the factors affecting glycemic control.Results:Finally, 1 818 T2DM patients were included, and the control rate of FPG was 57.59% (95% CI: 55.30%-59.86%), and the control rate of 2 h postprandial blood glucose (2 h PBG) was 24.90% (95% CI: 22.93%- 26.91%). Five dietary patterns were obtained by factor analysis: animal food pattern, fruit-aquatic products-potato patterns, vegetable-grain pattern, egg-milk-bean pattern, and oil-salt patterns. No-conditional multivariate logistic regression analysis showed that after adjusting for confounding factors, the reduced probability of FPG control was related to animal food pattern ( OR=0.71, 95% CI: 0.52-0.98) and fruit-aquatic products-potato patterns ( OR=0.71, 95% CI: 0.51-0.97). The decrease in the 2 h PBG control probability was related to fruit-aquatic products-potato patterns ( OR=0.60, 95% CI: 0.40-0.90). The increased probability of FPG and 2 h postprandial glucose control were both related to vegetable-grain pattern ( OR=1.41, 95% CI: 1.03-1.94; OR=1.68, 95% CI: 1.13-2.51) and egg-milk-bean pattern ( OR=1.75, 95% CI: 1.25-2.46; OR=1.56, 95% CI: 1.00-2.42). Compared with the Q4 group of egg-milk-bean pattern, the FPG control rate of the combination of "fruit-aquatic products-potato pattern ( Q4 group), vegetable-grain pattern ( Q2 group), egg-milk-bean pattern ( Q3 group)" was higher ( OR=6.79, 95% CI: 1.15-40.23, P=0.035). Compared with the Q4 group of vegetable-grain pattern, the combination of "fruit-aquatic products-potato pattern ( Q4 group), vegetable-grain pattern ( Q3 group), egg-milk-bean pattern ( Q2 group), oil-salt pattern ( Q2 group)" had higher control rate of 2 h PBG ( OR=12.78, 95% CI: 1.26-130.05, P=0.031). Conclusions:A proper combination of dietary patterns and dietary patterns are more conducive to the control of FPG and 2 h PBG in T2DM patients managed in the communities of Wuhan and Changshu. Patient nutrition education should be strengthened, and the food-matching ability of patients should be improved.

Objective:To investigate the relationship between histone deacetylase (HDAC) gene polymorphism and type 2 diabetes mellitus (T2DM) in Bai and Han populations in Dali of Yunnan province.Methods:A total of 148 patients with T2DM of Bai and Han nationalities who received treatment in Dali Bai Autonomous Prefecture People's Hospital from May 2019 to March 2021 were included in the T2DM group. An additional 100 healthy controls of Bai and Han nationalities who concurrently received physical examination in the same hospital from May 2019 to December 2020 were included in the normal control group. The susceptibility genes of T2DM were detected using the Taqman MGB probe method. The susceptibility gene loci were amplified using polymerase chain reaction. The whole sequence of susceptibility gene was sequenced.Results:There were no significant differences in the distribution frequencies of rs2530223 genotype, rs11741808 genotype, rs2547547 genotype, and rs1741981 genotype between Bai and Han populations (all P > 0.05). There was a significant difference in blood lipid level between four loci ( t = -1.06, -0.19, 0.39, -2.12, -2.04, 0.16, 1.47, < 0.01, -0.16, -3.17, -2.93, 0.69, -2.58, -2.33, all P < 0.05). There was a significant difference in homeostasis model assessment of insulin resistance between different states (all P < 0.05). The frequency distributions of each genotype and each allele did not differ significantly between healthy control people of Bai nationality and T2DM patients of Bai nationality and between healthy control people of Han nationality and T2DM patients of Han nationality (all P > 0.05). Logistic regression analysis showed that the polymorphism was not an independent risk factor for T2DM. Conclusion:The relationships between HDAC gene polymorphism and T2DM, obesity and dyslipidemia differ between Bai and Han populations.

Objective:To investigate the safety and curative effect of transumbilical single-incision laparoscopy with fascial platform for ovarian cystectomy.Methods:The clinical data of 105 patients underwent laparoscopy ovarian cystectomy in Fujian Maternity and Child Health Hospital from June 2018 to December 2021 were retrospectively analyzed. Among them, 45 patients underwent transumbilical single-incision laparoscopy with fascial platform for ovarian cystectomy (observation group), and 60 patients underwent multi-port laparoscopy for ovarian cystectomy (control group). The operative time, intraoperative bleeding, conversion to open surgery, cyst rupture, surgical collateral injury, postoperative exhaust time, postoperative hospital stays, hospitalization cost and postoperative infection, etc were recorded. The face rating scale (FRS) was used to evaluate the pain at 6 and 24 h after operation; the incision satisfaction was evaluated by the Kiyak satisfaction scale at 2 months after operation.Results:The operation was carried out successfully in both groups without surgical collateral injury or conversion to open surgery. There were no significant differences in operative time, intraoperative bleeding, postoperative hospital stays, hospitalization cost, cyst rupture rate and postoperative infection rate between 2 groups ( P>0.05); the postoperative exhaust time and FRS 6 and 24 h after operation in observation group were significantly less than those in control group: (22.1 ± 3.5) h vs. (23.9 ± 3.8) h, 1 (0, 2) scores vs. 2 (1, 4) scores and 1 (0, 1) scores vs. 1 (0, 2) scores, the incision satisfaction score was significantly higher than that in control group: 5 (4, 5) scores vs. 4 (3, 4) scores, and there were statistical differences ( P<0.05 or <0.01). Conclusions:Transumbilical single-incision laparoscopy with fascial platform for ovarian cystectomy is safe and feasible, with concealed incision and high patient satisfaction, and has good clinical application value.

Objective:To explore the influence of storage and delivery conditions of the peripheral blood samples from patients with chronic myeloid leukemia (CML) on the real-time quantitative PCR (RQ-PCR) detection of the BCR-ABL (P210) transcript levels.Methods:The peripheral blood samples of 84 CML patients were collected. The same sample was divided into different groups according to storage time (0, 6, 12, 24, 48, and 72 h) , temperature (room temperature, 18-24 ℃; low temperature, 2-8 ℃) , and vibration conditions (3, 6, and 12 h) . RQ-PCR was used to detect BCR-ABL (P210) transcript levels of the different groups. This study logarithmically transformed (log 10N) the original data [BCR-ABL copy number, ABL copy number, and BCR-ABL (P210) transcript levels]. Results:①Agarose gel electrophoresis showed significant RNA degradation of samples after storage for 48 and 72 h at room temperature. ②Among the overall samples, the BCR-ABL copy number of the samples stored at room temperature for 48 and 72 h was significantly lower than that of the samples stored at low temperature ( P<0.05) . However, the BCR-ABL (P210) transcript levels had no significant difference between samples stored at low temperature and room temperature. ③No significant changes were noted in the BCR-ABL (P210) transcript levels at different storage times (6, 12, 24, 48, and 72 h) regardless of storage temperature ( P>0.05) compared with that at baseline (0 h, -0.56±1.51) . ④ The BCR-ABL copy number of the overall sample only decreased significantly ( P<0.05) at 48 h (2.93±1.59) and 72 h (2.79±1.42) compared with that at baseline (0 h, 3.35±1.60) when stored at room temperature. The ABL copy number in the overall sample decreased significantly at 48 and 72 h (whether low and room temperature; P<0.05) . However, no significant changes were noted in the BCR-ABL (P210) transcript levels after vibration for 3 h (-1.29±1.81) , 6 h (-1.24±1.72) , and 12 h (-1.18±1.68; P>0.05) compared with that at baseline (0 h, -0.60±1.37) . Conclusion:Sample storage time, storage temperature, and vibration can interfere with the results of BCR-ABL and ABL copy number but have no significant effect on the quantitative determination of BCR-ABL (P210) transcript levels. This study provides strong support for the feasibility of transregional transportation of peripheral blood samples from patients with CML.

Objective:To explore the related factors affecting the extravasation of CT enhanced high-pressure injection, and propose protective countermeasures for early warning intervention.Methods:From April to October 2019, 31 595 patients undergoing CT enhanced examination in the First Affiliated Hospital of Zhengzhou University were selected as the research subject. Patients were divided into extravasation group ( n=21) and no extravasation group ( n=31 574) according to whether they had extravasation of high-pressure injection. We collected clinical data and analyzed the related factors of extravasation of CT-enhanced high-pressure injection. Results:Among 31 595 patients undergoing CT enhanced examination, there were 21 cases with high-pressure injection extravasation, accounting for 0.07%. Univariate analysis showed that there was a statistical difference in the age, injection rate, contrast agent concentration, osmotic pressure, history of chemotherapy and working years of injection nurses between extravasation group and no extravasation group ( P<0.05) . Multivariate Logistic regression analysis showed that patient age, injection rate, contrast agent concentration, osmotic pressure, history of chemotherapy, and working years of injection nurses were related factors that affected the extravasation of CT enhanced high-pressure injection with a statistical difference ( P<0.05) . Conclusions:Related factors that affect CT enhanced high-pressure injection extravasation include patient age, disease type, injection rate, contrast agent concentration, osmotic pressure, working years of injection nurses, and history of chemotherapy.Taking active protective measures is of great significance to reduce the extravasation of contrast agent and the suffering of patients.

Objective To explore the problems of health poverty faced by a special group of people with disabilities and the difficulties in the practice of health poverty alleviation, so as to provide a scientific basis for the health poverty alleviation of the disabled. Methods A self-made questionnaire was used for one-to-one survey, and a database was established by Excel. SPSS was used for descriptive analysis and horizontal comparison. Results The participation rate of basic medical insurance for the disabled was relatively high (93.40%), and the medical insurance payment was mainly paid by individuals (70.13%). The satisfaction of medical insurance was low (43.12%), and 84.64% of the disabled thought that their medical expenses were high. 45.22% of the families of disabled patients met the universal standard of catastrophic health expenditure. Compared with Shandong Province, the basic medical insurance coverage rate of the disabled in Hubei Province was slightly lower, the satisfaction rate of medical insurance was higher, and the proportion of catastrophic health expenditure of families was larger. The analysis of the results showed that the disabled people with a lower disability level, children and middle-aged with disabilities, the disabled people with less or more family members, and the disabled people without the minimum living subsistence allowances were not satisfied with the medical insurance. Conclusion The basic medical insurance in the two places has alleviated the difficulty of medical treatment for the disabled to a certain extent, but the family burden of diseases of the disabled was still heavy. The level of medical security for people with disabilities should be improved, and their economic burden of disease should be reduced, so as to improve the satisfaction of medical insurance.

Objective:To investigate the effects of different frequency sling exercise therapy (SET) on the balance of trunk control and walking ability in stroke patients.Methods:A total of 90 patients with stroke who were admitted to the Department of Rehabilitation Medicine, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, from January 2018 to December 2018, received sling exercise therapy on a routine basis and were divided into 1 time/Day low frequency group, 2 time/Day medium frequency group, 3 time/Day high frequency group, 20 min/time, for a total of 3 months.After 1, 2 and 3 months, trunk control test (TCT), Berg balance scale(BBS), functional ambulation classification (FAC) and modified Barthel Index (MBI) were used to evaluate the three groups of patients.Results:There were significant differences in TCT, BBS, FAC and MBI between the low, middle and high frequency groups (all P < 0.05). The scores of TCT in the low, middle and high frequency groups were (36.21±6.31), (42.51±4.33), (49.52±4.90) and (41.23±6.31), (50.32±8.32), (58.12±7.23) respectively, and the scores of BBS were (15.11±4.31), (19.69±5.86), (24.56±8.74) and (21.43±5.37), (27.61 ± 7.50), (33.81±6.99) respectively, compared with those before treatment )The scores of (24.69±9.33), (22.84 ± 10.11) and (9.32 ± 3.11), (9.504.10), (9.47 ± 3.73) were significantly improved, and the differences between the high frequency group and the low frequency group and the medium frequency group were statistically significant (all P< 0.05), but there was no statistically significant difference between the three groups after three months of training ( P> 0.05). There was no significant difference between fAC and MBI in the low, medium and high frequency group, but there was no significant difference between the two groups after training for 2 and 3 months There were significant differences between fAC ((1.84±0.41), (2.39±0.44), (3.29 ± 0.33) and MBI ((27.32 ± 9.33), (34.45 ± 9.21), (44.77 ± 10.27) and (41.33±11.21), (52.73±12.31), (75.94±13.22)). There was significant difference between the high frequency group and the low frequency group ( P< 0.05). Conclusion:Multiple sling exercise therapy in one day can further improve the balance of trunk control and walking ability of stroke patients, and shorten the course of disease.

OBJECTIVE: To determine whether non-linear blending technique for arterial-phase dual-energy abdominal CT angiography (CTA) could improve image quality compared to the linear blending technique and conventional 120 kVp imaging. MATERIALS AND METHODS: This study included 118 patients who had accepted dual-energy abdominal CTA in the arterial phase. They were assigned to Sn140/80 kVp protocol (protocol A, n = 40) if body mass index (BMI) < 25 or Sn140/100 kVp protocol (protocol B, n = 41) if BMI > or = 25. Non-linear blending images and linear blending images with a weighting factor of 0.5 in each protocol were generated and compared with the conventional 120 kVp images (protocol C, n = 37). The abdominal vascular enhancements, image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and radiation dose were assessed. Statistical analysis was performed using one-way analysis of variance test, independent t test, Mann-Whitney U test, and Kruskal-Wallis test. RESULTS: Mean vascular attenuation, CNR, SNR and subjective image quality score for the non-linear blending images in each protocol were all higher compared to the corresponding linear blending images and 120 kVp images (p values ranging from < 0.001 to 0.007) except for when compared to non-linear blending images for protocol B and 120 kVp images in CNR and SNR. No significant differences were found in image noise among the three kinds of images and the same kind of images in different protocols, but the lowest radiation dose was shown in protocol A. CONCLUSION: Non-linear blending technique of dual-energy CT can improve the image quality of arterial-phase abdominal CTA, especially with the Sn140/80 kVp scanning.
Adult ; Aged ; Angiography/*methods ; Body Mass Index ; Female ; Humans ; Male ; Middle Aged ; Observer Variation ; Radiation Dosage ; Radiographic Image Enhancement/methods ; Radiographic Image Interpretation, Computer-Assisted/*methods ; Radiography, Abdominal/*methods ; Signal-To-Noise Ratio ; Statistics, Nonparametric ; Tomography, X-Ray Computed/*methods

OBJECTIVETo determine the plasma protein binding rates of brucine and strychnine in total alkaloids from the seed of Strychnou nux-vomica, and make comparison with the single components at the same concentration.

METHODUltrafiltration was employed to determine the rat the plasma protein binding rate of the alkaloids from the seed of S. nux-vomica. The plasma concentrations were measured by RP-HPLC.

RESULTThe protein binding rates of brucine were (65.60 3.01)%, (68.20 +/- 7.80)%, (59.58 +/- 3.78)% when the plasma concentrations was 0.520, 1.300, 2.600 mg x L(-1), respectively. The protein binding rates of strychnine was (66.17 +/- 6.36)%, (67.10 +/- 2.52)%, (57.21 +/- 0.79)% when the plasma concentrations were 0.936, 2.340, 4.680 mg x L(-1) respectively. As to the total alkaloids from the seed of S. nux-vomica, The protein binding rate of brucine was (62.19 +/- 2.45)%, (69.55 +/- 5.84)%, (61.76 +/- 3.68)% when the plasma concentrations were 0.519, 1.288, 2.607 mg x L(-1), respectively. And the protein binding rates of strychnine were (54.79 +/- 3.55)%, (57.13 +/- 4.49)%, (59.31 +/- 3.65)% when the plasma concentrations were 0.940, 2.338, 4.674 mg x L(-1), respectively.

CONCLUSIONBrucine and strychnine have medium capacity in binding to plasma protein. In comparison with the single component of the same concentration, the protein binding rate of brucine in total alkaloids shows little difference, while there seems to be an obvious decrease for strychnine.

Alkaloids ; analysis ; pharmacokinetics ; Animals ; Blood Proteins ; chemistry ; metabolism ; Drugs, Chinese Herbal ; analysis ; pharmacokinetics ; Protein Binding ; Rats ; Rats, Sprague-Dawley ; Seeds ; chemistry ; Strychnos ; chemistry

ObjectiveTo study the feasibility of abdominal aortic CT angiography with low dose contrast medium.MethodsThe patients who took the examinations were divided into three groups.In 34 patients of group A,the injection flow rate was 4 ml/s,and the contrast medium volume was 90 ml and 20 ml of saline was applied.The contrast medium dose and injection flow rate of the other 64 patients were determined according to the formula,injection tlow rate = patients' body mass × ratio of contrast medium dose to the body mass / (5 + exposure time).In B and C group with 32 cases each,the ratio of contrast medium dose to body mass were 0.8 to 0.9 and 0.6 to 0.7 ml/kg.The depiction and the measured intraarterial concentration of contrast medium of the abdominal aorta and the renal arteries as well as their branches were compared and evaluated on the source images and MIP images generated among three groups respectively.CT values of the abdominal aorta and its branches in each group were analyzed using singlefactor analysis of variance,while renal artery and its branches were analyzed using x2 test score.Results The abdominal aorta,the celiac trunk,the splenic artery,the superior mesenteric artery,the renal arteries and their branches were all well shown in three groups.The CT value within the abdominal aorta were (363 ±28),(362 ±28) and (334 ± 14) HU for the three groups respectively,the CT values within the celiac were (368 ±28),(367 ±28) and (338 ± 15)HU,the CT value within the renal artery were (365 ±27),(364 ± 29) and (336 ± 15) HU respectively,the CT value within the splenic artery were (373 ±28),(372 ± 28) and (343 ± 15) HU respectively,and the CT value within the superior mesenteric artery were ( 374 ± 28 ),( 372 ± 28 ) and ( 344 ± 16 ) HU respectively.There were significant differences among the three groups ( P = 0.000).There were significant differences between A group and C group,B group and C group ( P ＜ 0.01 ),while no significant difference existed between A group and B group( P ＞0.05 ).The amount of contrast agent for each patient in group A was 90 ml,while the amount of contrast agent in group B and C was (51 ± 9) and (40 ± 9) ml respectively.There were significant differences of the contrast medium volume among the three groups ( F = 537.091,P = 0.000).Results of pairwise comparisons were statistically significant(P =0.000).Image quality of renal artery in group A was rated as excellent,good,and generally for 26,7 and 1 cases,24,7 and 1 for group B,and 22,8 and 2 for group C.There were no significant differences in image quality of the renal arteries among the three groups ( x2 = 0.561,P = 0.755 ).ConclusionThe individualization of injection method in abdominal aortic CT angiography can minimize the amount of contrast agent but to meet the clinical requirements.