Screening for diabetes and its complications contributes to slowing the progression of diabetes mellitus. Based on the setting of grass-roots diabetes complication screening workstation with the concept of two stages of screening and three levels of prevention, we proposed a hospital-community-family integrated diabetes management strategy. This article discusses the background, organization structure, operation mechanism and implementation process of this strategy, aiming to provide reference for constructing a suitable and practical grass-roots diabetes management model.

A-kinase anchor protein 12 (AKAP12) is a scaffold protein that improves the specificity and efficiency of spatio-temporal signals by assembling intracellular signal proteins into specific complexes. In recent years, the role of AKAP12 in chronic liver diseases has attracted more and more attention. This article introduces the physiological functions of AKAP12 and reviews the role of AKAP12 in chronic liver diseases, in order to lay a foundation for the use of AKAP12 small molecule as a new therapeutic target for chronic liver diseases.

Liver fibrosis (LF) is a pathological process of hepatic stellate cell (HSC) activation and excessive deposition of extracellular matrix caused by chronic liver injury and inflammation. HSC activation is the core mechanism of LF, and inhibiting HSC activation is the key to promoting the reversal of LF. In recent years, rapid development has been achieved for the application of nanomedicine targeting HSC in the treatment of LF. This article mainly introduces nanomedicine, the mechanism of action of nanomedicine in the treatment of LF, and potential targets, and it is pointed out that nanomedicine may become a new method for the treatment of LF.

OBJECTIVES: The aims of this study were to update the latest data on the prevalence of hypertension (HTN) in the elderly Chinese population and to assess relationships between new anthropometric indices and HTN. METHODS: Data were obtained from the Basic Public Health Service (BPHS) survey for Jiangsu Province, China. A total of 944,760 people aged 65 years and older were included in this study. Blood pressure was measured by trained investigators. Body weight, body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), conicity index (COI), body roundness index (BRI), and a body shape index (ABSI) were included in the analysis as anthropometric indices. Logistic regression analysis and restricted cubic splines were used to evaluate the association of anthropometric indices with HTN. RESULTS: The prevalence of HTN among elderly residents of Jiangsu Province was 64.7% (95% confidence interval, 64.6 to 64.8). After adjusting for multiple covariates, all anthropometric indices except ABSI showed significant non-linear positive dose-response associations with HTN across sex (pnonlinear<0.001). Among participants with BMI <28 kg/m2, abnormal weight, WC, WtHR, BRI, COI, and ABSI were positively associated with HTN. CONCLUSIONS The prevalence of HTN in the elderly in Jiangsu Province is gradually increasing. It is necessary to consider the combination of ABSI and COI with BMI for screening elderly individuals for HTN in follow-up prospective studies.

Objective:To analyze the correlation between saliva glucose and blood glucose level by measuring the concentration of saliva with high-precision ion chromatograph, and further to provide the clinical data for saliva glucose as an auxiliary index of blood glucose monitoring.Methods:A total of 268 subjects with normal glucose metabolism (NGT) and diabetes mellitus (DM) were enrolled and fasting venous blood and saliva samples were collected at the same time. The levels of saliva glucose, blood glucose and glycosylated hemoglobin (HbA1c) were measured by ion chromatograph, automatic biochemical analyzer and glycosylated hemoglobin analyzer, respectively. Methods of Kruskal-Wallis H test was used for comparison between groups, and the Spearman correlation was used for correlation analysis. Results:The mean values of blood glucose, saliva glucose and HbA1c in the DM group are all higher than those in the NGT group, and the differences are all statistically significant ( P<0.05). Saliva glucose cut-off points are set at 10, 15, 20 and 25 mg/L, respectively. When the saliva glucose concentration is greater than or equal to the above cut-off points, the saliva glucose level are positively correlated with the blood glucose level ( r=0.321, 0.379, 0.509 and 0.428, respectively, P<0.05) . Conclusion:The level of saliva glucose in DM is significantly higher than that in NGT. When the concentration of saliva glucose is greater than 20 mg/ L, there is a significant positive correlation between saliva glucose and blood glucose, and the max correlation coefficient r is 0.509.

Background: Diabetes can complicate hypertension management by increasing the risk of cardiovascular disease (CVD) and all-cause mortality. Studies targeting diabetes detection in hypertensive individuals demonstrating an increased risk of diabetes are lacking.We aimed to assess the performance of hemoglobin A1c (HbA1c) and its cut-off point in detecting diabetes in the abovementioned population. Methods: Data from 4,096 community-dwellers with hypertension but without known diabetes were obtained from the Study on Evaluation of iNnovated Screening tools and determInation of optimal diagnostic cut-off points for type 2 diaBetes in Chinese muLti-Ethnic (SENSIBLE) study; these data were randomly split into exploration (70% of the sample) and internal validation (the remaining 30%) datasets. The optimal HbA1c cut-off point was derived from the exploration dataset and externally validated using another dataset from 2,431 hypertensive individuals. The oral glucose tolerance test was considered the goldstandard for confirming diabetes. Results: The areas under the ROC curves for HbA1c to detect diabetes were 0.842, 0.832, and 0.829 for the exploration, internal validation, and external validation datasets, respectively. An optimal HbA1c cut-off point of 5.8% (40 mmol/mol) yielded a sensitivity of 76.2% and a specificity of 74.5%. Individuals who were not diagnosed as having diabetes by HbA1c at 5.8% (40 mmol/mol) had a lower 10-year CVD risk score than those diagnosed as having diabetes (P = 0.01). HbA1c ≤ 5.1% (32 mmol/mol) and ≥ 6.4% (46 mmol/mol) could indicate the absence and presence of diabetes, respectively. Conclusions HbA1c could detect diabetes effectively in community-dwellers with hypertension.

Objective To investigate the value of next-generation sequencing (NGS) technique for genetic analysis of spontaneous abortion. Methods From January to June 2017, 154 patients who visited the First Affiliated Hospital of Zhengzhou University for spontaneous abortion were enrolled. All abortion tissue samples were analyzed by both NGS combined with short tandem repeat (STR) and single nucleotide polymorphism array (SNP-array). Results of the two methods were compared by Chi-square or Fisher's exact test. Results (1) Chromosomal abnormalities were detected in 109 of the 154 cases (70.7%), including 52 (47.7%) of numerical chromosomal abnormalities, 49 (45.0%) of structural chromosomal abnormalities, six (5.5%) of mosaicism, and two (1.8%) of uniparental disomy (UPD). In those 52 cases of numerical chromosome abnormalities, there were 45 of chromosome aneuploidy and seven of polyploidy. The top three numerical chromosomal abnormalities were 45,X (27.0%, 14/52), trisomy 22 (9.6%, 5/52) and trisomy 16 (7.7%, 4/52). Forty-nine structural abnormality cases carried 67 copy number variations (CNV), including 13 pathogenic CNV (pCNV, 19.4%), 24 variants of unknown clinical significance (35.8%) and 30 benign CNV (44.8%). In those 13 pCNVs, two were responsible for microdeletion and microduplication syndromes. (2) SNP-array was successful in 152 cases, but failed in two (1.3%) due to genomic DNA <200 ng. However, NGS technology was successful in all 154 cases and identified chromosomal abnormalities in the two cases that SNP-array had failed. No statistically significant difference was shown in the detection rate of chromosomal abnormalities between SNP-array and NGS technology [70.4% (107/152) vs 67.5% (104/154), χ2=0.293, P=0.588]. (3) No significant difference in the detection of chromosome aneuploidy (six cases in each group, 3.9% vs 3.9%) and mosaicism (45 cases in each group, 29.2% vs 29.6%) was found between NGS technology and SNP-array. Three cases of polyploidy (69, XXX) and two of UPD were identified by SNP-array, but not by NGS. When combined with STR, NGS was able to detect all three cases of polyploidy (69, XXX). (4) Forty-seven structural abnormality cases detected by SNP-array carried 53 CNVs, and 49 detected by NGS carried 67 CNVs. (5) NGS detected ten, three and one more CNVs than SNP-array did when the genome lengths were 100-<500, 500-<1 000 and ≥1 000 kb, respectively. Conclusions NGS can be used to detect chromosomal aneuploidy and mosaicism that can be identified by SNP-array with fewer limitations on total amount of genome. Moreover, CNVs that fail to be identified by SNP-array can also be detected by NGS. When combined with STR, NGS can effectively detect chromosomal polyploidy. Therefore, NGS could be a potential genetic analysis method for spontaneous abortion and of importance for genetic counseling.

Objective To investigate the effects of acyl-CoA synthetase 5 (ACS5) silencing by siRNA on expression and proliferation of colon carcinoma cell lines.Methods The expression of ACS5 in 30 case colon carcinoma and adjacent tissues were analyzed by immunohistochemical staining.The siRNA of ACS5 with Lipofectamine2000TM was transfected into colon carcinoma cell lines (HT-29 and SW480).The expression of ACS5 in colon carcinoma cell lines (HT-29 and SW480) was detected by real-time reverse transcription polymerase chain reaction.Proliferation of colon carcinoma cell lines was analyzed by 3-(4,5-dimenthylthiazol-2-yl)-5-(3-carboxymethoxy-phenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS).Results The expression of ACS5 in colon cancer was significantly higher than in adjacent tissues by immunohistochemical staining.The mRNA of ACS5 in siRNA-ACS5 group (0.18 ± 0.03) was significantly lower than in NC siRNA group (2.55 ± 0.31) and blank control group (2.48 ± 0.12) in HT-29 colon cancer lines,and the inhibition ratio was 92.96％ (F =146.9,P ＜0.01).The mRNA of ACS5 in siRNA-ACS5 group (0.14 ± 0.01) was significantly lower than in NC siRNA group (1.21 ± 0.05) and blank control group (1 ± 0.03) in SW480 colon cancer lines,and the inhibition ratio was 88.5％ (F =826.5.9,P ＜ 0.01).Proliferation of HT-29 and SW480 colon cancer line in siRNA-ACS5 group was slower on 72 h and 96 h than in NC siRNA group and blank control group (P ＜ 0.05).Conclusions Expression of ACS5 is elevated in colon cancer tissues.siRNA interference of colon cancer line downregulated ACS5 expression and inhibited the proliferation of the colon cancer cells.

ObjectiveTo investigate the risk factors for long-term complications after endoscopic sphincterotomy (EST) for benign biliary and pancreatic diseases. MethodsThe follow-up data of the patients who underwent EST in Department of Gastroenterology, The First Affiliated Hospital of Shenzhen University, from July 2008 to June 2013 were analyzed retrospectively, and the risk factors for long-term complications after EST were investigated. The chi-square test was applied for comparision of categorical data betwee groups. The Kaplan-Meier method was applied to analyze the cumulative incidence of complications, and the univariate and multivariate logistic regression analyses were applied to investigate the risk factors for long-term complications. ResultsThe patients were followed up for 4-57 months, and the mean follow-up time was 30.9±12.1 months. The cumulative incidence of long-term complications after EST was 9.9% (18/182), and these complications included recurrent common bile duct stones (n=9), recurrent cholangitis (n=6), acute cholecystitis (n=2), and biliary stricture (n=1). There were significant differences between the two groups in diameter of common biledute, pneumobilia, and juxtapapillary diverticulum(all P＜005). The multivariate logistic regression analysis showed that diameter of common bile duct ≥15 mm (OR=4.82, 95%CI: 1.08-21.55, P=0.040) and pneumobilia (OR=6.19, 95%CI: 1.23-31.23, P=0.027) were the risk factors for long-term complications after EST. ConclusionThe incidence of long-term complications after EST for benign biliary and pancreatic diseases is low, and diameter of common bile duct ≥15 mm and pneumobilia are the risk factors for long-term complications after EST.

Objective To explore the relationship between dyslipidemia and colorectal cancer.Methods The levels of total cholesterol(TC),triglyceride (TG),1ow density lipoprotein-cholesterol (LDL-C) and high density lipoprotein-cholesterol (HDL-C) of 182 patients with colorectal cancer and 86 controls were tested.The serum lipids levels between the colorectal cancer group and control group,colorectal cancer with different location,different gender were compared.Results The level of TC in the colorectal cancer group [(5.51 ± 0.76) mmol/L] was significantly higher than that of the control group [(4.84 ± 0 53) mmol/L] (t =2.41,P ＜ 0.05) ; The level of HDL-C in the colorectal cancer group[(0.85 ± 0.26) mmol/L] was significantly lower than that of the control group [(1.24 ± 0.27) mmol/L] (t =-3.56,P ＜ 0.05).There were no significant differences in the 1 evels of TG and LDL-C between the colorectal cancer group and control group(t＝0.89,1.45,all P ＞ 0.05).TC level in the male colorectal cancer group [(5.96 ± 0.87) mmol/L] was significantly higher than that of the female colorectal cancer group [(5.26 ± 0.74) mmol/L] (t =2.10,P ＜ 0.05).The level of TC in the distal colon and rectal cancer group was (6.07 ± 0.78) mmol/L,which was significantly higher than (5.14 ± 0.56)mmol/L of the proximal colon cancer group (t =3.24,P ＜ 0.05) ;The level of HDL-C in the distal colon and rectal cancer group was (0.75 ± 0.26) mmol/L,which was significantly lower than (1.07 ± 0.19) mmol/L of the proximal colon cancer group (t =-3.20,P ＜ 0.05).Conclusion TC was positively correlated with colorectal cancer,and HDL-C was negatively correlated with colorectal cancer.