Objective:To investigate the effect of vitamin D supplementation on weight loss efficacy and insulin resistance (IR) in obese patients.Methods:It was a randomized controlled trial. A total of 190 obese patients with vitamin D deficiency were selected from the obesity clinic of Tianjin Union Medical Center from March to December in 2023. The patients were divided into control group (95 cases) and vitamin D group (95 cases) according to random number table. The control group was given energy-limited high-protein diet combined with moderate intensity exercise, and the vitamin D group was supplemented with vitamin D on the basis of the control group, 14 000 U/week for 24 weeks. A total of 25 dropped out of the study from the two groups for various reasons. Finally, 79 cases in the control group and 86 cases in the vitamin D group were included in the analysis. Independent sample t test and rank sum test were used to compare serum 25 hydroxyvitamin D [25 (OH) D] level, body weight, body mass index, fat mass, visceral fat area, fasting blood glucose, fasting insulin and glycated hemoglobin (HbA 1c) between the two groups at baseline and after intervention. Homeostasis model insulin resistance index (HOMA-IR) was used to evaluate the degree of insulin resistance (IR), and the effects of vitamin D supplementation on weight loss efficiency and IR in those patients were analyzed. Results:There was no significant differences in serum 25(OH)D level between the two groups before intervention ( P>0.05); the serum 25(OH)D level in the vitamin D group was significantly higher than that in the control group after intervention [(30.90±7.55) vs (16.00±4.34) μg/L] ( t=-15.35, P<0.001). The body weight, body mass index, fat mass, visceral fat area, fasting blood glucose, fasting insulin, HbA 1c, and HOMA-IR were all significantly lower after the intervention than those before the intervention in both groups [control group: (93.32±13.47) vs (98.95±14.31) kg, (33.74±5.09) vs (35.80±5.52) kg/m 2, (39.77±11.87) vs (44.12±12.79) kg, (183.76±40.95) vs (204.01±32.18) m 2, 5.00 (4.55, 5.67) vs 5.24 (4.68, 6.42) mmol/L, 16.78 (13.94, 24.30) vs 22.56 (15.95, 31.2) mU/L, 5.55%±0.53% vs 6.05%±0.99%, 4.11 (3.14, 5.57) vs 5.51 (3.61, 8.49); vitamin D group: (88.14±17.66) vs (104.43±22.02) kg, (31.02±5.10) vs (36.66±5.98) kg/m 2, (35.51±12.87) vs (46.67±13.33) kg, (166.50±49.50) vs (213.64±40.14) m 2, 4.70 (4.35, 5.07) vs 5.17 (4.77, 6.30) mmol/L, 13.18 (9.87, 18.84) vs 21.67 (15.78. 32.74) mU/L, 5.43%±0.48% vs 6.21%±1.22%, 2.88 (1.99, 4.21) vs 5.19 (3.82, 9.27)], and the body weight, body mass index, adiposity, visceral fat area, fasting blood glucose, fasting insulin, and HOMA-IR were all significantly lower in vitamin D group than those in the control group [(88.14±17.66) vs (93.32±13.47) kg, (31.02±5.10) vs (33.74±5.09) kg/m 2, (35.51±12.87) vs (39.77±11.87) kg, (166.50±49.50) vs (183.76±40.95) m 2, 4.70 (4.35, 5.07) vs 5.00 (4.55, 5.67) mmol/L, 13.18 (9.87, 18.84) vs 16.78 (13.94, 24.30) mU/L, and 2.88 (1.99, 4.21) vs 4.11 (3.14, 5.57), respectivley] (all P<0.05). The IR remission rate was significantly higher in the vitamin D group than that in the control group after the intervention (37.3% vs 15.3%) ( χ2=8.071, P=0.002). Conclusion:Supplementation of vitamin D on the basis of energy-limited high-protein diet combined with moderate intensity exercise can significantly improve the efficacy of weight loss and IR in obese patients with vitamin D deficiency.

Humans ; Intra-Abdominal Fat/diagnostic imaging* ; Coronary Artery Disease ; Body Mass Index

Objective:To construct a new model for assessing insulin resistance(IR) in newly diagnosed type 2 diabetic patients by combining anthropometry parameters and biochemical parameters.Methods:A total of 677 newly diagnosed type 2 diabetic patients were included in this study. Clinical data, biochemical indicators, and body composition measurements were collected, and a predictive model was constructed using logistic regression analysis.Results:The IR prediction model was constructed based on five indicators: triglycerides(TG), fasting plasma glucose(FPG), visceral fat area(VFA), alanine aminotransferase(ALT), and uric acid(UA). The formula for the new predictive model was as follows: y=-17.765+ 1.389×ln VFA+ 1.045×ln UA+ 0.91×ln ALT+ 2.167×ln FPG+ 0.805×ln TG. The receiver operating characteristic curve(ROC) area under the curve(AUC) for the model was 0.82, with an optimal cutoff value of 1.67, sensitivity of 0.80, and specificity of 0.71. The AUC values for the triglyceride glucose(TyG) index, lipid accumulation product(LAP), and triglyceride/high-density lipoprotein cholesterol ratio(THR) were 0.75, 0.75, and 0.70, respectively. The corresponding sensitivities were 0.66, 0.84, and 0.71, and the specificities were 0.71, 0.59, and 0.60. The optimal cutoff values were 1.81, 30.31, and 1.14, respectively. Conclusion:The new model constructed using TG, FPG, VFA, ALT, and UA as indicators showed high predictive value and can serve as a new model for assessing IR in newly diagnosed type 2 diabetic patients.

Objective: To investigate the satisfaction and well-being of Chinese women with breast deficiency, and to analyze the relevant influencing factors. Methods: A cross-sectional study was conducted using a self-designed questionnaire to investigate the women with breast deficiency, visiting the Plastic Surgery Hospital of Chinese Academy of Medical Sciences from November 2013 to August 2018. The BREAST-Q BR (breast reconstruction) pre-operation and post-operation modules were used to assess the quality of life. Results: A total of 139 effective questionnaires were collected, including 83 patients before BR surgery and 56 post. There was no difference in quality of life in different ages, marital status, education levels, working status, and causes of breast deficiency. Mean scores of satisfaction with breasts, psychosocial well-being and sexual well-being of patients after breast reconstruction were significantly higher than those of patients without reconstruction (P=0.000), but there was no statistical difference in physical well-being-chest score. The physical well-being abdomen scores of patients with abdominal flap reconstruction was lower than that of the patients without reconstruction (P=0.007). With regard to analysis of specific items, compared with preoperative patients, patients with abdominal flap reconstruction reported lower scores in the items related to abdominal muscle weakness (P<0.05). Conclusions The breast deficiency resulting from Poland syndrome, breast cancer and other causes, can lead to a significant decrease in quality of life. Breast reconstruction can improve satisfaction with breast, psychosocial and sexual well-being in women with breast deficiency. The abdomen well-being of patients with abdominal flap reconstruction is decreased. Therefore, more attention should be paid to retain abdominal muscles to maintain abdominal shape and motor function during operation.

OBJECTIVE To assess the association of SLC12A3 and SCNN1B gene polymorphisms (rs11643718 and rs12447134) with essential hypertension among ethnic Koreans from Mudanjiang, China. METHODS For 204 patients with essential hypertension and 186 healthy controls, the genotypes of rs11643718 and rs12447134 loci were determined with an improved multiplex ligase detection reaction (iMLDR) method. RESULTS Allelic and genotypic frequencies of rs11643718 of SLC12A3 gene are associated with the onset of disease hypertension (P <0.05) as well as systolic blood pressure (P < 0.01, under a recessive model). No association was found between rs12447134 of SCNN1B gene with the onset of disease (P > 0.05) but diastolic blood pressure (P < 0.05, under a recessive model). CONCLUSION The polymorphisms of rs11643718 locus is associated with the susceptibility for essential hypertension among ethnic Koreans from Mudanjiang area and can be used as a predictor for the disease.

Objective: To compare the scar condition after breast implantation with axillary, periareolar and inframammary fold (IMF) incisions. Methods: The consecutive patients who were diagnosed as breast hypoplasia and underwent breast implantation surgeries between May 2012 to December 2014 were included in the research. The scars were assessed at 1, 6 and 12 months after surgery with VSS and patient satisfaction scoring. The results were analyzed with Variance and Kruskal-Wallis test based on the data type. Results: The scars of 173 patients were assessed 3 times with the follow-up rate being 82.4%. The VSS scores of every incision declined with time, and the patient satisfaction scores increased gradually. At one month after surgery, the media VSS scores were 6 in axillary group and 4 in periareolar and IMF groups, the differences had statistical significance (P<0.05). The media scores of patients satisfaction were 8 in periareolar group and 7 in axillary and IMF groups. The scores of periareola group were higher than those of axillary with statistical significance(P<0.05). When 6 months after surgery, the media VSS scores were 4 in axillary group and 3 in periareolar and IMF groups. The scores of axillary group were higher than those of IMF with statistical significance(P<0.05). The media scores of patients satisfaction were 8 in 3 groups. When 12 months after surgery, the media VSS scores were 0.5 and 1 in periareolar group (left and right respectively), and 2 in axillary and IMF groups. The media scores of patients satisfaction were 9 in 3 groups. No differences were found in VSS and patients satisfaction scores among three kinds of incisions (P>0.05). Conclusions The scars of three incisions achieved similar cosmetic effects and patient satisfaction at long-time follow-up.

Objective To investigate the effect of trastuzumab for injection on apoptosis and the expression of related genes in locally advanced breast cancer and related indexes.Methods 166 patients with locally advanced breast cancer were selected and divided into two groups, 83 cases in the control group treated with neoadjuvant chemotherapy before operation, 83 cases in the experimental group received trastuzumab for injection on the basis of the control group, serum tumor marker levels, tumor cell apoptosis index and proliferation activity, Bcl-2, Bax gene expression levels, the clinical effect and incidence of adverse reactions were compared after the treatment.Results The effective rate in the control group(78.32%)was lower than the experimental group(90.36%), with significant difference (P<0.05).Compared with the control group, serum levels of CA153,CA125,CEA,TSGF were lower in the experimental group after chemotherapy, levels of apoptosis index(AI) in tumor tissue was higher, levels of S-phase fraction (SPF), proliferation index ( PI) were lower after treatment, Bcl-2 gene in tumor tissue expression level was lower, Bax gene expression level was higher after treatment, all with significant difference (P<0.05).There was no significant difference in the incidence of adverse reactions between two groups. Conclusion The trastuzumab for injection treatment can significantly improve the total remission rate of patients with locally advanced breast cancer , reduce the levels of serum tumor markers, can down-regulate the expression of apoptosis related gene Bcl-2, up-regulate the expression of Bax gene, promote the apoptosis of tumor cells.

Objective To investigate the relationship between subclinical hypothyroidism (SCH) and diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM).Methods A total of 792 patients of T2DM were enrolled in the study.There were 448 males and 344 females,with an average age of (54.13 ± 13.06)years.The average duration of diabetes was (8.03 4±6.70) years.The patients were grouped according to the degree of DR and thyroid function.Among them,483 patients (61.0％) were no DR,240 patients (30.3％) were mild DR,69 patients (8.7％) were severe DR.725 patients (91.5％) were normal thyroid function,67 patients (8.5％) were SCH.The prevalence of SCH among no DR group,mild DR group and severe DR group was compared.And the prevalence of DR between normal thyroid function group and SCH group was compared.Logistic regression analysis was used to estimate the association between SCH and DR.Results No significant differences among the three groups (no DR group,mild DR group,severe DR group) were found in the prevalence of SCH (x2=1.823,P=0.402).There were no significant differences in the incidences of DR between normal thyroid function group and SCH group (x2=1.618,P=0.239).Logistic regression analysis demonstrated that SCH was not significant associated with DR [mild DR:odds ratio (OR)=1.361,95％ confidence interval (CI)=0.773-2.399,P=0.286;severe DR:OR=1.326,95％CI=0.520-3.384,P=0.555;DR:OR=1.353,95％ CI=0.798-2.294,P=0.261).Conclusion SCH is not significant associated with DR in patients with T2DM.

Objective: To investigate the interaction of Ca²⁺ protein TRPC1 and STIM1 in extracellular Ca²⁺ -sensing receptor (CaR)-induced extracellular Ca²⁺ influx and the production of nitric oxide (NO). Methods: Human umbilical vein endothelial cells (HUVECs) were cultured and incubated with CaR agonist spermine (activating store-operates cation channels (SOC) and receptor-operated channels (ROC)), CaR negative allosteric modulator Calhex231 (blocking SOC, activating ROC) and ROC analogue TPA (activating ROC, blocking SOC), protein kinase C (PKC) inhibitor Ro31-8220, PKCs and PKCμ inhibitor Go6967(activate SOC, blocking ROC), respectively. The interaction of TRPC1 and STIM1 was determined using the immunofluorescence methods. The interaction between TRPC1 and STIM1 were examined by Co-immuno precipitation. The HUVECs were divided into: TRPC1 and STIM1 short hairpin RNA group (shTRPC1+ shSTIM1 group), vehicle-TRPC1+ vehicle-STIM1 group and control group. The cells were incubated with four different treatments under the action of above mentioned interventions, intracellular Ca²⁺ concentration ([Ca²⁺ ]_i) was detected using the fluorescence Ca²⁺ indicator Fura-2/AM, the production of NO was determined by DAF-FM. Results: (1) The expression of TRPC1 and STIM1 proteins levels in HUVECs: Under the confocal microscope, TRPC1 and STIM1 protein expression showed masculine gender, both located in cytoplasm in the normal control group. Post incubation with Calhex231+ TPA, Ro31-8220 and Go6967, TRPC1 and STIM1 positioned in cytoplasm was significantly reduced, and the combined TRPC1 and STIM1 was also significantly reduced. (2) The interaction of TRPC1 and STIM1 in HUVECs: The relative ratios of Calhex231+ TPA+ Spermine+ Ca²⁺ group, Ro31-8220+ Spermine+ Ca²⁺ group and Go6976+ Spermine+ Ca²⁺ group STIM1/TRPC1 and TRPC1/STIM1 were as follows: (25.98±2.17)% and (44.10±4.01)%, (20.85±1.01)% and (46.31±3.47)%, (23.88±2.05)% and (39.65±2.91)%, which were significantly lower than those in the control group (100.00±4.66)% and (100.00±6.40)% and in the Spermine+ Ca²⁺ group (106.04±2.45)% and (107.78±2.66)% (all P<0.05). (3) The influence of joint TRPC1 and STIM1 transfection to four different drugs treated HUVECs on [Ca²⁺ ]_i and NO generation: The changes of two excitation fluorescence intensity ratio and NO net fluorescence intensity values were consistent, [Ca²⁺ ]_i and NO net fluorescence intensity values were significantly lower in the experimental group than the control group and the vehicle group (all P<0.05), while which were similar between the vehicle group and control group (all P>0.05). Conclusions Our results indicate that TRPC1 and STIM1 jointly regulate CaR-mediated Ca²⁺ influx and nitric oxide generation in HUVECs in the form of binary complex.

Objective To system review the effectiveness of rehabilitation exercise for preventing intensive care unit patients acquired weakness(ICU-AW).Methods A computerized database search was performed through the Cochrane Library,PubMed,EMBASE,Web of Science,CNKI,CBM,Wanfang and VIP database to find relevant studies. Two researchers independently selected the studies,evaluated the quality of the articles and extracted data according to the rigorous criterion,then we performed the Meta-analysis with the software RevMan5.3.Results Nine RCTs were included in this study. Comparing to routine care,Meta-analysis showed that rehabilitation exercise improved peripheral muscle strength in ICU-AW patients[MD=5.77,95%CI (2.36,9.18),P=0.0009],respiratory muscle strength[MD=20.38,95%CI(0.79,39.96),P=0.04],and quality of life[MD=27.96,95%CI(13.28,42.63),P=0.0002],shortened the duration of mechanical ventilation[MD=-2.73, 95%CI(-4.98,-0.48),P=0.02] and length of stay in hospital[MD=-1.99,95%CI(-3.28,-0.71),P=0.002], while it had no positive effect on mortality[OR=0.91,95%CI(0.51,1.62),P=0.74].Conclusions Rehabilitation exercise improves physical function of patients with ICU-AW,and reduces the bad clinically relevant indicators, and it doesn't influence the mortality,so it is worth being popularized.