Objective:To study the risk factors for diabetic retinopathy(DR)in patients with coronary artery disease(CAD).Methods:353 patients with diabetes mellitus hospitalized at Beijing Anzhen Hospital between 2013 and 2015 were enrolled, including 96 patients with coronary artery disease(27%)and 156 patients with DR(44%).Medical history and examination/laboratory results of all patients were collected for analysis.Coronary artery disease was diagnosed according to coronary angiography.DR was diagnosed via ophthalmological examinations.The clinical characteristics of patients with and without DR were compared and contrasted between the groups.Results:Compared with patients without DR, patients with DR had a longer duration of diabetes, [15 years(10, 20) vs.8 years(4, 13), P<0.001]and a higher urine albumin/creatine ratio(UACR)[12.1 mg/g(3.2, 71.9) vs.4.8 mg/g(2.2, 3.5), P<0.001].Logistic regression analysis suggested that duration of diabetes( OR=1.107, 95% CI: 1.063~1.153, P<0.001)and UACR( OR=0.003, 95% CI: 1.001~1.006, P=0.008)were independent risk factors for DR.ROC curves revealed that a duration of diabetes >9.5 years or UACR>7.1 mg/g was significantly associated with DR.Also, of all patients with CAD, those with DR had a longer duration of diabetes[15 years(10, 20) vs.10 years(6, 15), P=0.002]and a higher percentage with hypertension(88.1% vs.67.6%, P=0.014).Hypertension history( OR=4.049, 95% CI: 1.099~14.925, P=0.036)and duration of diabetes( OR=1.159, 95% CI: 1.044~1.287, P=0.005)were independent risk factors for DR in patients with CAD.History of hypertension or a duration of diabetes>11.5 years was significantly associated with DR. Conclusions:In patients with coronary heart disease, hypertension history or a long duration of diabetes is significantly associated with an increased risk of DR.

Objective:To investigate the effects of fasting blood glucose levels on the quality of myocardial metabolism imaging via positron emission tomography/X-ray computed tomography(PET/CT)in patients with coronary heart disease.Methods:A total of 78 patients with coronary heart disease from 2019 to 2020 undergone 18-fluorine deoxyglucose( 18F-FDG)PET/CT myocardial imaging in Beijing Anzhen Hospital were retrospectively analyzed, with 64 patients meeting the inclusion criteria eventually enrolled in this study.All patients fasted over 8 hours and were injected with insulin and 18F-FDG following an oral glucose load.Then myocardial imaging evaluations were performed.Depending on whether the myocardial image quality(IQ)offered a match with clinical diagnosis, a score between 0-2 from the semiquantitative scoring system was defined as good IQ, while a score between 3-4 defined as poor IQ.Differences in sex, age, rate of diabetes, body mass index, fasting blood glucose(FBG), glycosylated hemoglobin, glycosylated serum albumin, triglycerides and free fatty acids, lipid-regulating drugs, and oral antidiabetic medications were analyzed between the good( n=55)and poor( n=19)image groups, and risk factors were examined. Results:The diabetes mellitus rate was higher in the poor group than in the good group(63.2% vs.33.3%, χ2=4.872, P=0.027). FBG, glycosylated hemoglobin and glycosylated serum albumin levels in the poor group were increased compared with the good group[7.67(6.02, 11.64)mmol/L vs.5.52(4.97, 6.37)mmol/L, 7.30(6.43, 8.70)% vs.6.20(5.60, 6.87)%, 19.8(15.1, 24.1)% vs.14.8(13.9, 16.8)%, U=-3.909, -2.419 and -3.042, P<0.001, P=0.016 and 0.002, respectively]. Multivariate Logistic regression analysis showed that FBG was an independent risk factor for poor imaging( OR=1.62, 95% CI: 1.19-2.20, P=0.002). The area under the receiver operator characteristic(ROC)curve for FBG was 0.811(95% CI: 0.69-0.93, P<0.001), and the cut-off value for FBG was 6.66 mmol/L. Conclusions:FBG is an independent risk factor for myocardial image quality.Patients with diabetes mellitus should rigorously control their blood glucose levels.

Objective:To explore effects of impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM) on the 5-year prognosis after percutaneous coronary intervention (PCI) for coronary heart disease.Methods:A total of 165 patients receiving PCI from December 2011 to September 2013 were selected by the convenient sampling method. According to the results of oral glucose tolerance test, they were divided into T2DM group (54 cases) , IGT group (52 cases) , and non-diabetes mellitus (NDM) group (59 cases) . The patients were followed up in the outpatient clinic after discharge and recorded the occurrence of major adverse cardiovascular events (MACE) of patients within 5 years after PCI, including cardiogenic death, non-fatal reinfarction, non-fatal stroke and re-hospitalization for heart failure.Results:The 5-year follow-up results showed that 72 patients had MACE, of which 15 died of cardiogenic death, 11 were admitted to the hospital due to heart failure, 5 had non-fatal stroke and 41 had non-fatal reinfarction. Among the 72 patients with MACE, there were 17 cases in the NDM group, 30 cases in the IGT group and 25 cases in the T2DM group. The IGT group was higher than the NDM group, and the difference was statistically significant ( P<0.05) , but there was no statistically significant difference between the IGT group and the T2DM group ( P>0.05) . Among the 41 non-fatal reinfarction patients, there were 10 cases in the NDM group, 19 cases in the IGT group and 12 cases in the T2DM group. The IGT group was higher than the NDM group and the T2DM group, and the differences were statistically significant ( P<0.05) . Conclusions:IGT increases the risk of myocardial infarction in patients after PCI, which is a risk factor for MACE events.

Dissolving pulp consists of high purity cellulose and is widely used to as raw materials for the production of regenerated cellulose fiber, cellulose ester and cellulose ether. The characteristic of dissolving pulp affects greatly the production and processing performance of subsequent products. The α-cellulose content, hemicellulose content, pulp viscosity, ash, transition metal ion content, fiber morphology, molecular weight distribution of cellulose and the reactivity are the important properties. Because of its green, mild and high efficiency, the application of enzymes in improving the properties of dissolving pulp has a promising application prospect and has been researched significantly. In this review, the main properties of dissolving pulp are presented first, followed by a recommendation of the enzymes to improve these properties. The application and current research of cellulase and xylanase in improving the properties of dissolving pulp are emphasized. The main problems and the future research areas in improving the properties of dissolving pulp by enzymes are revealed. Finally, the technology prospects in this field are proposed.
Cellulase ; Molecular Weight ; Viscosity ; Wood

Objective:To evaluate the image quality (IQ) of 18F-fluorodeoxyglucose (FDG) PET/CT imaging and identify its influenfial factors in diabetes mellitus (DM) and non-DM patients with coronary artery disease (CAD). Methods:A total of 196 consecutive CAD patients (174 males, 22 females, 68 DM; age: (57±10) years) in Beijing Anzhen Hospital between June 2016 and February 2018 were retrospectively analyzed. All patients underwent 18F-FDG myocardial PET/CT imaging. The standardized fasting+ oral glucose loading (OGL) and intravenously injection of insulin protocol was performed. According to the FDG uptake by myocardium, background activity in blood and other visceral organ nearby the heart, the IQ was visually evaluated and scored by 0-4. Zero-two was considered as good IQ, 3-4 was regarded as poor IQ. Patients were divided into three groups: group 1 (non-DM+ good IQ), group 2 (DM+ good IQ), group 3 (DM+ poor IQ). Factors which may affect IQ were analyzed, which including OGL, the injection dose of insulin, fasting blood glucose (FBG), peak blood glucose (PBG), blood glucose (BG) level at 18F-FDG injection (BG injnection), BG increasing rate ((PBG-FBG)/FBG, %), and BG decreasing rate ((PBG-BG injection)/PBG, %). One-way analysis of variance, Spearman correlation analysis and logistic regression analysis were used for data analysis. Results:There were significant differences ( F values: 13.074-38.371, all P<0.05) of FBG, PBG, OGL, BG decreasing rate and the injection dose of insulin among group 1 ( n=132, 67.3%), group 2 ( n=53, 27.1%), group 3 ( n=11, 5.6%). All those parameters, except for OGL, were positively correlated with FDG PET/CT IQ ( r s values: 0.142-0.262, all P<0.05). OGL was negatively correlated with IQ ( r s=-0.324, P<0.05). Logistic regression analysis showed that FBG (odds ratio ( OR)=0.687, 95% CI: 0.633-0.746), PBG( OR=0.786, 95% CI: 0.746~0.829), BG injection( OR=0.631, 95% CI: 0.595-0.716), OGL( OR=0.897, 95% CI: 0.873-0.922), the injection dose of insulin( OR=0.680, 95% CI: 0.618-0.748) were predictive factors (all P<0.01) for good IQ in all patients. For DM patients, OGL was the only predictive factor for good IQ( OR =0.940, 95% CI: 0.904-0.960; P<0.01). Conclusions:FBG, PBG, BG injection, OGL, the injection dose of insulin can predict IQ for all patients with CAD. For DM patients with CAD, OGL is the only predictive factor for good IQ. A good IQ of 18F-FDG PET/CT could be obtained in majority of CAD patients, with the standardized fasting + OGL and intravenously injection of insulin protocol and adjust according to the personal status, and prevent the hypoglycemia from happening.

Objective:To analyze the characteristics of cardio-metabolic risk factors coronary artery disease(CAD)patients with in-stent restenosis(ISR)after percutaneous coronary intervention(PCI).Methods:A total of 169 patients undergone primary(T1)PCI and followed up and rechecked by coronary angiography(T2)in our hospital from 2010 to 2017 were enrolled.According to the results of coronary angiography during follow-up, patients were divided into the ISR group(n=66)and the control group(non-ISR or NISR, n=103). Patients were sub-grouped into the elderly ISR group(the E-ISR group, n=17), the elderly non-ISR group(the E-NISR group, n=19), the young ISR group(the Y-ISR group, n=49)and the young non-ISR group(the Y-NISR group, n=84). Clinical data including medical history, laboratory results, and coronary angiography records during the two hospital stays were collected.Cardio-metabolic risk factors and clinical features of coronary artery disease were analyzed for the groups.Results:The levels of systolic blood pressure, glycated hemoglobin A1c(HbA1c), fasting blood glucose(FBG), the percentage of patients with diabetes or myocardial infarction(MI)history, the coronary Gensini score and the percentage of patients with triple vessel disease were higher in the ISR group than in the NISR group(128.6±16.4) mmHg vs.(123.4±10.7) mmHg, P=0.023; (7.0±1.6)% vs.(6.2±0.9)%, P<0.001; 6.6 mmol/L vs.5.7 mmol/L, P<0.001; 53.0% vs.31.1%, P=0.004; 36.4% vs.20.4%, P=0.022; 40 vs.29, P=0.01; 57.6% vs.40.8%, P=0.033). The E-ISR group had higher systolic blood pressure and a lower glomerular filtration rate than the E-NISR group(135.9±27.2) mmHg vs.(124.1±10.8) mmHg, P=0.013; 77.5±14.4 ml·min -1·1.73 m -2vs.(84.8±9.4) ml·min -1·1.73 m -2, P=0.033), but the Y-ISR group had longer hypertension history, higher levels of low-density lipoprotein and HbA1c, and higher Gensini scores than the Y-NISR group[129.7 months vs.83.1 months, P=0.008; (2.78±1.08) mmol/L vs.(2.31±0.65) mmol/L, P=0.002; (7.2±1.7)% vs.(6.1±0.9)%, P<0.001; 41 vs.29, P=0.009]. Conclusions:Clinical features are different between elderly CAD patients and young and middle-aged CAD patients with ISR after PCI, and metabolic risk factors such as blood pressure, blood lipid and blood glucose levels should be proactively controlled

Objective:To investigate the effect of intensive blood glucose monitoring and nursing program on blood glucose variability of patients transferred to general wards after coronary artery bypass grafting (CABG) .Methods:A convenient sampling method was used to select 106 patients with coronary heart disease and hyperglycemia who were transferred from the ICU within 72 hours after CABG from Beijing Anzhen Hospital from June to December 2018. They were divided into control group (54 cases) and research group (52 cases) according to the random number table method. The control group was given routine nursing care, and the research group adopted a comprehensive nursing strategy including intensive blood glucose monitoring based on the control group. The average daily blood glucose level (MGL) , standard blood glucose standard deviation ( SD) , daily average blood glucose fluctuation range (MAGE) , and blood glucose variation coefficient ( CV) of the two groups were compared within 3 days after CABG patients were transferred to the general ward. Results:After the patients were transferred from the ICU to the general ward, there were time effects, inter-group effects, and time-group interaction effects in SD; inter-group effects in SD; time- and inter-group effects in MAGE; and inter-group effects and time and group in CV interaction effect. Conclusions:Within 1 to 3 days after the patient is transferred from the ICU to the general ward, compared with the conventional nursing group, continued intensive blood glucose monitoring and nursing can reduce the degree of blood glucose variation.

Objective: To establish the in vitro porcine gastric model of submucosal eminence lesion and to evaluate its application to endoscopic submucosal dissection(ESD). Methods: Silicone rubber impression materials and steel balls with diameters of 1 cm, 2 cm, and 3 cm were used to make three pairs of spherical cavities. And then raw ground beef was put into spherical cavities and boiled for 20 minutes to make spherical mass models. Six isolated porcine stomach with esophagus and duodenum were selected. The mass models with diameters of 1 cm, 2 cm and 3 cm were imbedded respectively into the submucosa of fundus, body, and antrum of porcine stomach through the incision on serosal layer. The submucosal masses were observed by endoscopy and endoscopic ultrasonography and ESD was performed. Results: A total of 18 mass models were constructed in 6 porcine stomachs, of which 17 models were successfully established and 1 failed. Typical endoscopic characteristics of gastric submucosal eminence lesions were found in 17 models. Endoscopic ultrasonography showed that these models originated from submucosal layer and demonstrated mixed echo. There were no significant differences between mucosa of lesions and that of surrounding areas. ESD was successfully performed in the porcine gastric models of submucosal eminence lesions, and all models were not broken or detached. Conclusion The in vitro porcine gastric model of submucosal eminence lesions can well replicate disease status and provide a suitable model for study on endoscopic therapy of submucosal eminence lesion and training of endoscopists.

Objective To study the mechanical properties and degradation behavior of biodegradable silicon-covered magnesium alloy stent in vitro,to investigate the technical feasibility of its implantation into rabbit esophagus and to observe the tissue reaction in vivo.Methods The mechanical compression recovery properties and the degradation behavior of biodegradable silicon-covered magnesium alloy stent were tested in vitro.A total of 30 healthy Holland rabbits were randomly divided into silicon-covered magnesium alloy stent group (n=15) and control group (n=15).For rabbits in the silicon-covered magnesium alloy stent group fluoroscopy-guided insertion of the stent into the lower third segment of esophagus was conducted,while for rabbits in the control group no intervention was adopted.One,2 and 4 weeks after the implantation of the stent,esophagography was performed for all rabbits of both groups,and each time every 5 rabbits from both groups were sacrificed,the specimens were collected and sent for histological examinations.Results In vitro test indicated that biodegradable silicon-covered magnesium alloy stent had good flexibility and elasticity,and in phosphate-buffered saline with pH 4.0 or pH 7.4 it degraded more slowly than bare magnesium alloy stent.In vivo test showed that the stent implantation could be well tolerated by all experimental rabbits.Before stent insertion the esophageal diameter was(9.2±0.8) mm,and at one,2 and 4 weeks after stent insertion the esophageal diameters were (9.7±0.7) mm,(9.6±0.8) mm and (9.6±0.5) mm respectively (P＞0.05).In the silicon-covered magnesium alloy stent group,stent displacement occurred in 6 rabbits in one week (n=l),2weeks (n=1) and 4 weeks (n=4).After stent implantation,the tissue reactions such as esophageal wall injury,collagen deposition,etc.were not obviously different from those in the control group (P＞0.05).Conclusion It is technically feasible to insert silicon-covered magnesium alloy stent into the rabbit's esophagus,the stent can provide sufficient support for at least 2 weeks,the stent displacement rate is low and acceptable,and no severe esophageal wall injury and collagen deposition are observed.