AIM: To quantify early changes of macular capillary parameters in type 2 diabetic patients using optical coherence tomography angiography(OCTA).METHODS: Retrospective case study. A total of 49 healthy subjects, 52 diabetic patients without retinopathy(noDR)patients, and 43 mild nonproliferative diabetic retinopathy(mNPDR)patients were recruited. Capillary perfusion density, vessel length density(VLD), and average vessel diameter(AVD)were calculated from macular OCTA images(3 mm×3 mm)of the superficial capillary plexus after segmenting large vessels and the deep capillary plexus. Parameters were compared among control subjects, noDR, and mNPDR patients. The area under the receiver operating characteristic curve estimated the abilities of these parameters to detect early changes of retinal microvascular networks.RESULTS: Significant differences were found in the VLD and AVD among the three groups(P<0.001). Compared with the control group, the noDR group had significantly higher AVD(P<0.05). VLD of both layers in patients of mNPDR group was significant decreased compared with that of noDR group(all P<0.01). Deep AVD had a higher area under the curve(AUC)of 0.796 than other parameters to discriminate the noDR group from the healthy group. Deep AVD had the highest AUC of 0.920, followed by that of the deep VLD(AUC=0.899)to discriminate the mNPDR group from the healthy group.CONCLUSIONS: NoDR patients had wider AVD than healthy individuals and longer VLD than mNPDR patients in both layers. When compared with healthy individuals, deep AVD had a stronger ability than other parameters to detect early retinal capillary impairments in noDR patients.

Objective:To analyze changes in nutritional status and immune function of elderly men receiving regular physical examinations, and to investigate the effects of aging on the nutritional status and immune function among elderly men.Methods:A total of 209 elderly men aged 60-101(72.9±11.5)years and receiving regular physical check-ups were enrolled.All research subjects were subjected to nutritional risk screening(NRS2002)and monitoring of nutrition and immune-related indicators, including routine blood work, blood biochemistry, immunoglobulin and T lymphocyte subsets.Results:Body weight, body mass index, hemoglobin, total protein, albumin and serum iron of elderly men decreased with age( F=21.754, 6.257, 47.528, 12.285, 18.397, 18.667, all P<0.001), with those aged 80 and above showing more significant decline and a greater proportion with malnutrition( χ2=77.134, P<0.001). The B lymphocyte counts of elderly men aged 80 and above were significantly lower( P<0.05)while serum IgA and IgG levels were significantly higher( F=3.110, 3.866, P=0.047, 0.022)than those of the 70-79 year old group.In addition, the B lymphocyte count and B lymphocyte ratio in malnourished elderly men were significantly lower( t=2.512, 2.874, P=0.013, 0.005), and IgA was significantly increased( t=2.513, P=0.017), compared with those with normal nutrition. Conclusions:The risk of malnutrition and reduced immune function among elderly men aged 80 years and above is significantly increased, and assessment and screening of the risk of malnutrition in the elderly should be stressed.

Objective:The aim of the present study was to observe the effects of liralutide on body composition and muscle function in adult obese patients with type 2 diabetes.Method:A total of 63 adult obese type 2 diabetic patients who were (52.6±9.7) years of age and with body mass index (BMI) of ≥28 kg/m 2 were enrolled. The patients were randomly assigned into two groups. On the basis of maintaining the original hypoglycemic regimen, patients in the control group ( n=24) were given dietary guidance only, and those in the treatment group ( n=39) were injected with liraglutide. All patients were followed up for a period of 12 weeks. Blood glucose, glycosylated hemoglobin(HbA1c) and insulin levels, liver and kidney function, body composition assessed with electrical impedance methods, and grip strength measured by a grip meter for muscle function were detected at the baseline and the end of the study. Results:Compared with those in the control group, the reductions in HbA1c [(-1.54±2.10) % vs.(-0.53±0.84) %], body weight [(-3.46±4.2) kg vs.(-0.34±3.66) kg], body fat mass [(-1.97±2.98) kg vs.(-0.01±2.16) kg] and visceral fat area [(-0.01±2.16) cm 2 vs.(0.34±6.39) cm 2] were more pronouced in liraglutide treated group (all P<0.05). However, no changes could be observed in muscle mass and grip strength after liraglutide treatment. Conclusions:In addition to reducing blood glucose, body weight and fat mass, treatment with lilaluptide had no impact on muscle mass and muscle function. Therefore, liralutide is suitable for obese patients with type 2 diabetes, especially for weight management patients who are at risk of muscle loss.

Objective:To evaluate the characteristics of adult abdominal fat distribution and analyze its influencing factors by energy spectrum CT scan.Methods:The body height, weight, waist circumference, and hip circumference of 105 adults were measured, and the characteristics of abdominal fat distribution were evaluated by energy spectrum CT scan.Results:Compared with non-obese individuals, the contents of abdominal subcutaneous fat, abdominal cavity and liver ectopic fat were higher in obese patients ( P<0.05), and the intramuscular fat (IMAT) content did not increase with the increase of BMI. In middle-aged group, the waist circumference, waist-to-hip ratio (WHR) abdominal cavity area and IMAT content were higher than those in the youth group, and the muscle content of the middle-aged group was lower than that of the youth group, the difference between the two groups was significant ( P<0.05); the male group had higher abdominal cavity area and muscle content than the female group, while the female group had higher the subcutaneous fat area, abdominal subcutaneous fat thickness and erector spinae fat content than the male group, the differences were significant ( P<0.05). Conclusions:The characteristics of abdominal fat distribution of subjects with different BMI, age and gender were different. Therefore, we should pay attention to the individual assessment of ectopic fat distribution in obese patients. Energy spectrum CT can be used as an important approach for the assessment of ectopic fat to provide evidence for developing individualized weight loss programs.

To compare with the effects of the GM-CSF and IL-2 used as adjuvants in the baculovirus vaccine, we used genetic engineering to construct the recombinant baculovirus rBV-LMI-F and with GM-CSF and IL-2 to immunized chickens. Then, we compared the concentration of the neutralizing antibody and cytokines to determine the immunostimulatory effects of GM-CSF and IL-2. GM-CSF induced higher levels of antibodies and cytokines in chickens at 28 d and 42 d post-vaccination. In conclusion, GM-CSF could elicit higher serum antibody and cytokines responses and improved the effects of Baculovirus vaccine.

Objective To develop a nomogram for the use of predicting renal outcomes of Chinese lupus nephritis (LN) patients.Methods From January 1,2005 to October 1,2015,513 patients with biopsy-proven LN in the First Affiliated Hospital of Sun Yat-Sen University were enrolled into this study.Renal outcomes were defined as end-stage renal disease or doubling of serum creatinine.Demographic characteristics,laboratory data,and pathologic data were recorded and included for analysis.Nomograms were designed using multivariate Cox proportional hazards regression to predict the non-outcome renal survival in 5 and 8 year according to the Akaike information criterion (AIC) and continuous reclassification net improvement (cNRI).Predictive accuracy and discriminative ability of the models were determined by concordance index (C-index) and calibration curve.Results During a median follow up of 48 (24,71) months,44 patients (8.58％) reached the endpoint.1-year,5-year and 8-year non-outcome renal survival were 97.57％,92.89％,79.89％ respectively.According to multivariate Cox regression,four nomograms including index for baseline renal function,pathologic severity,and response to treatment were designed.The best model,within which included eGFR was lower than 30 ml · min-1 · (1.73 m2)-1(HR=4.44,95％ CI 2.16-9.13,P ＜ 0.01),percentage of global glomerulosclerosis was higher (HR=12.28,95％CI 3.58-42.13,P ＜ 0.01) and partial remission occurred after 6-month induction treatment (HR=9.16,95％ CI 4.71-17.82,P ＜ 0.01) demonstrated good discrimination to predict 5-year and 8-year non-outcome renal survival [C-index,0.80(95％CI 0.81-0.91),0.76(95％CI 0.68-0.85),respectively].The nomogram based on above model also performed good calibration.Conclusion The nomogram based on patients' baseline eGFR,percentage of global glomerulosclerosis,and treatment reaction after 6-month induction therapy can accurately predict 5-year and 8-year non-outcome renal survival in Chinese lupus nephritis patients.

Objective To explore the utility of different body composition for the prediction of myocardial ischemia in exercise in type 2 diabetes mellitus (T2DM) patients. Methods T2DM outpatients were selected from Jul. 2013 to Nov. 2014 (male 83, female 57) to measure body composition and clinical biochemical parameters, and divided them into two groups according to treadmill exercise testing results. Group A cases were positive (27 patients) and Group B cases were negative (113 patients). SPSS19.0 was used to make statistical analysis. Results (1) The age, gender, diabetes mellitus (DM) duration, medical history of hypertension and dyslipidemia, body mass index (BMI), waist circumference, the waist-hip fat ratio of the two groups had no significant difference (P>0.05). (2) The fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C) between the two groups had no significant difference. Compared with group B, the low density lipoprotein cholesterol (LDL-C) of group A [(2.48 ± 0.75) mmol/L vs. (2.81 ± 0.77) mmol/L, t=2.009, P<0.05] decreased significantly. (3) Overall body fat percentage, skeletal muscle weight of the two groups had no significant difference. Compared with group B, the waist-hip fat ratio (0.93±0.06 vs. 0.88±0.08, t=-2.790, P<0.01) andvisceral fat area [(99.47 ± 32.84) cm2 vs. (81.10 ± 25.47) cm2, t=-2.822, P<0.01] of group A increased significantly, while this difference mainly existed in male patients visceral fat area [(100.99±39.33) cm2 vs. (79.91 ± 27.09) cm2, t=-2.231, P<0.05], and waist-hip fat ratio was different in female patients of the two groups (0.91±0.06 vs. 0.85±0.09, t=-2.043, P<0.05) . Conclusion Abdominal obesity, especially visceral fat accumulation had close correlation with myocardial ischemia in exercise in T2DM patients. Waist-hip fat ratio and visceral fat area may be more effective indicators of myocardial ischemia in exercise in T 2DM patients than BMI.

Objective To analyze the dietary habits, energy intake and expenditure, anthropometrics, and body composition of the outpatients visiting the weight loss clinic of Beijing Hospital.Methods We pro-spectively enrolled 89 consecutive patients with body mass index ( BMI) ≥24 kg/m2 from November 2014 to August 2015 in the weight loss clinic of Beijing Hospital.There were 35 male and 54 female, with the mean age of (45.8 ±16.4) years.We divided them into two groups:the diabetes group (n=35) and the non-diabetes group (n=54), and compared the dietary habits, energy intake and expenditure, anthropometrics and body composition between the two groups.Results Regardless of diabetes, the overweight and obese patients all ate fast, mostly finishing a meal in about 10 minutes.They preferred Chinese food and meat, and disliked hot food.The frequency of dinning out in the non-diabetes group (3-5 times per week) was higher than that in the diabetes group (1-2 times per week) .Compared with the diabetes group, the non-diabetes group had higher fat-to-energy ratio [(34.9 ±7.6)%vs.(30.8 ±5.9)%], but lower carbohydrate intake [(232.2 ±59.7) g vs.(283.6 ±89.5) g], carbohydrate-to-energy ratio [ (47.9 ±8.3)%vs.(53.4 ±7.1)%], and the ratio of resting metabolic rate to body weight [ (66.9 ±9.6) kJ/(d? kg) vs.(71.1 ±7.9) kJ/(d? kg)] (all P<0.05).There were no statistically significant differences between the two groups in total energy intake, pro-tein intake, high quality protein intake, fat intake, protein-to-energy ratio, and resting metabolic rate (all P>0.05).Anthropometrics showed that the mean BMI of the patients was (32.8 ±4.4) kg/m2, with the maxi-mum being 53.5 kg/m2.The hip circumference [ (117.15 ±9.9) cm vs.(111.1 ±8.2) cm], upper arm circumference [ (36.4 ±3.8) cm vs.(34.0 ±3.3) cm], and triceps skinfold thickness [ (36.1 ±8.9) mm vs.(31.6 ±8.8) mm] were larger in the non-diabetes group than in the diabetes group (all P<0.05), but the mean age was lower in the non-diabetes group [ (41.7 ±16.9) years vs.(52.9 ±13.1) years) (P=0.01).There were no statistically significant differences between the two groups in body weight, BMI, waist circumference, neck circumference, and bilateral hand grip strength (all P>0.05).According to body compo-sition analysis, the body weight [ (94.8 ±18.3) kg vs.(86.9 ±17.2) kg], body fat mass [ (39.7 ± 11.3) kg vs.(33.5 ±8.9) kg], body fat percentage [ (41.7 ±6.5)%vs.(38.5 ±6.7)%], and visceral fat area [ (145.3 ±24.8) cm2 vs.(130.7 ±27.5) cm2 ] were larger in the non-diabetes group than in the di-abetes group ( all P<0.05) .There were no statistically significant differences between the two groups in BMI and skeletal muscle mass (both P>0.05).Conclusion Compared with diabetes patients, overweight and obese non-diabetes patients may be younger, having worse dietary habits, and having larger body fat mass, body fat percentage, and visceral fat area.

OBJECTIVETo analyze the impact of atorvastatin on blood lipids and arterial media thickness (IMT) in new-onset type 2 diabetes patients.

METHODS333 patients, 30-70 years old and diagnosed within one year as type 2 diabetes, were selected from the Chinese Diabetes Complication Prevention Study (CDCPS) to take part in this study. Changes of blood lipids and IMT of carotid, femoral and iliac artery pre and post the administration of atorvastatin were tested and followed for 24 months.

RESULTSTotal cholesterol, triglycerides and low-density lipoprotein decreased significantly (P = 0.000) and maintained at a low level. The carotid artery IMT decreased significantly (P = 0.022) at the end of this study, but the femoral and iliac artery IMT did not show any obvious change. There were no serious adverse events noticed, during the study period.

CONCLUSIONLong-term use of atorvastatin seemed to be safe and effective in reducing blood lipids in patients with type 2 diabetes thus could delay the development of atherosclerosis.

Adult ; Aged ; Atorvastatin Calcium ; Diabetes Mellitus, Type 2 ; drug therapy ; Female ; Follow-Up Studies ; Heptanoic Acids ; therapeutic use ; Humans ; Lipids ; blood ; Male ; Middle Aged ; Pyrroles ; therapeutic use ; Tunica Media ; pathology

Objective To analyze the impact of atorvastatin on blood lipids and arterial media thickness(IMT)in new-onset type 2 diabetes patients. Methods 333 patients,30-70 years old and diagnosed within one year as type 2 diabetes,were selected from the Chinese Diabetes Complication Prevention Study(CDCPS)to take part in this study. Changes of blood lipids and IMT of carotid, femoral and iliac artery pre and post the administration of atorvastatin were tested and followed for 24 months. Results Total cholesterol,triglycerides and low-density lipoprotein decreased significantly (P=0.000)and maintained at a low level. The carotid artery IMT decreased significantly(P=0.022) at the end of this study,but the femoral and iliac artery IMT did not show any obvious change. There were no serious adverse events noticed,during the study period. Conclusion Long-term use of atorvastatin seemed to be safe and effective in reducing blood lipids in patients with type 2 diabetes thus could delay the development of atherosclerosis.