OBJECTIVE: To investigate the correlation of stress-inducible phosphoprotein 1 (STIP1) expression level with prognosis of different cancers and its potential role in immunotherapy. METHODS: TCGA, TARGET and GTEx databases were used for bioinformatic analysis of STIP1 expression level and its prognostic value in different cancers. We also detected STIP1 expression immunohistochemically in 10 pairs of colorectal cancer and adjacent tissues. We further analyzed the correlation of STIP1 expression level with tumor mutational burden, microsatellite instability, immune cell infiltration, immune regulators and outcomes of different cancers. STIP1- related proteins were identified using protein- protein interaction (PPI) network analysis, and functional enrichment analysis was performed to analyze the regulatory pathways involving STIP1. RESULTS: Bioinformatics analysis showed that STIP1 was highly expressed in most tumors compared with the normal tissues (P < 0.05), which was confirmed by immunohistochemistry of the 10 pairs of colorectal cancer tissues. STIP1 expression level was correlated with clinical stages of multiple cancers (P < 0.05), and in some cancer types, an upregulated STIP1 expression was correlated with a poor prognosis of the patients in terms of overall survival, disease-specific survival, disease-free survival and progression-free survival (P < 0.05). STIP1 expression was significantly correlated with tumor mutational burden, microsatellite instability, immune cell infiltration and immunomodulatory factors in most tumors (P < 0.05). PPI network analysis indicated that STIP1-related proteins included HSPA4, HSPA8, and HSP90AA1. KEGG enrichment analysis suggested that the high expression of STIP1 in liver cancer was related mainly with valerate metabolism, tryptophan metabolism, and butyrate metabolism pathways; HALLMARK enrichment analysis suggested high STIP1 expression in liver cancer was involved in bile acid and fatty acid metabolism. CONCLUSION STIP1 is up-regulated in multiple cancer types and its expression level is correlated with clinical tumor stage, tumor mutational burden, microsatellite instability, immune cell infiltration and immunomodulatory factors.
Humans ; Microsatellite Instability ; Liver Neoplasms ; Immunotherapy ; Prognosis ; Computational Biology ; Heat-Shock Proteins ; Colorectal Neoplasms

Objective To evaluate the effect of community management of diabetic patients with hypertension in Beijing Cuigezhuang community in last three years.Methods A community diabetic management program was started from 2007 in Beijing Cuigezhuang community.Three hundred and seventy six patients who participated in the program for more than 3 years were enrolled in the study, including 196 with type 2 diabetes mellitus (T2DM) only (DM group) and 180 with T2DM and hypertension (DMH). The control rate of blood glucose, blood pressure, lipids and the comprehensive control rate were compared between two groups after 3-year intervention.Results There were no significant differences in age, gender ratio, course of diabetes, education background, monthly income and the history of stoke between two groups;while prevalence of dyslipidemia in DMH group was significantly higher than that in DM group [41.7%(75/180) vs.24.5%(48 196),χ2 =11.938,P=0.001].Compared with the baseline data, the types of antidiabetic drugs used were not significantly changed in two groups after 3-year intervention ( DM group:1.32 ±0.81 vs.1.31 ±0.93, t=-0.155, P=0.877, DMH group:1.43 ±0.72 vs.1.48 ±0.82, t=0,831, P =0.407) .The types of antihypertensive drug in DMH group were significantly decrease. (1.12 ±0.77 vs.1.25 ±0.45, t=2.484, P=0.014), while the rate of statins usage in DM group was significantly increased [13.3%(26/196) vs.5.1%(10/196),χ2 =7.830, P=0.005].The hemoglobin A1c (HbA1c) levels in DM group was decreased [(7.4 ±1.5)% vs.(7.8 ±2.1)%, t=2.586, P=0.011].The systolic pressure [(129 ±12) mmHg (1 mmHg=0.133 kPa) vs.(133 ±16) mmHg, t=3.503, P=0.001] and the diastolic pressure [(80 ±8) mmHg ratio (82 ±10) mmHg, t=2.436, P=0.016] in DMH group were significantly declined. The average LDL-C level [ DM group: ( 3.0 ± 0.9) mmol/L vs.(3.2 ±1.0) mmol/L, t =2.165, P=0.032; DMH group (2.9 ±1.0) mmol/L vs. (3.2 ±1.1) mmol/L, t=3.210, P=0.002] were also significantly decrease.Compared with the baseline, the comprehensive control rates of blood glucose, blood pressure and lipid level were increased in both groups [DM group:9.7% (19/196) vs.6.1%(12/196),χ2 =1.716, P=0.190, DMH group 13.9%(25/180) vs.5.0%(9/180),χ2 =8.315, P =0.004] .Conclusions The community management program is effective for improvement of comprehensive control rates of blood glucose, blood pressure and blood lipids in diabetic patients with hypertension in Beijing Cuigezhuang community.

Objective To investigate the multi factor for type 2 diabetes with hyperuricemia and metabolic syndrome for preven‐tion cardiovascular disease .Methods 672 cases diagnosed type 2 diabetes were selected in Beijing Anzhen and Cuigezhuang com‐munities to measure height ,weight ,neck circumference ,waist ,BMI ,blood pressure ,fasting plasma glucose ,HbA1c and lipid pro‐file .Results The prevalence of HUA in 672 cases is 8 .04% .It was significantly lower than coastal area population in Shandong Province .BMI ,neck circumference ,waist ,DBP ,FBG ,2 hPG ,HbA1c ,GLT ,BUN ,blood uric were significantly higher than NUA group .The prevalence of MS and fatty in HUA group is 75 .93% ,77 .78% .While in NUA group is 58 .9% ,56 .8% respectively P=0 .014 ,0 .003 .Logistic regression analysis showed that BMI ,HbA1c ,ALT ,BUN were associated with hyperuricemia in T2DM . Conclusion The prevalence of HUA in Beijing diabetic patients was lower than coastal area population ,but complicated MS and cardiovascular risk factor were high and seriously .

Objective To observe the effect of long-term intensive glucose control therapy on diabetic retinopathy in outpatients with type 2 diabetes mellitus.Methods Forty-nine patients with type 2 diabetes mellitus were randomly assigned to participate in the trial from 2002 to 2007,receiving either intensive (24 cases) or standard glucose control (25 cases).The patients were examined by the same ophthalmologists to identify any new diabetic retinopathy (DR).After 5 years of intensive glucose control,all of the patients were asked to attend our clinic every 6 months,but no attempts were made to maintain their previously assigned therapies.Hemoglobin A1c (HbA1 c) was measured regularly.In November of 2009,a retinal examination was carried out by the same ophthalmologist who worked in the trial.The visual acuity,lens,vitreous body and fundus were examined after pupil dilation to identify diabetic retinopathy (DR).Fundus fluorescein angiography and retinal laser photocoagulation were carried out when necessary.Results In the second year after enrollment in the trail,the median HbA1c level of the intensive-therapy group was significantly lower than that of the standard-therapy group [(6.3 ± 0.6) ％ vs.(7.2 ± 1.2) ％,t =2.09,P ＜ 0.05],and was maintained in a controlled level throughout the following 4 years.During the post-trial monitoring,no new case of of macula edema or diabetic associated blindness occurred in either intensive or standard-therapy group,the whole occurrence of micro-aneurysms,fundus hemorrhage,as well as those who needed retinal laser photocoagnlation and lowering in visual acuity in intensive-therapy group was lower than that in the standard-therapy group (3 vs.14,1 vs.7,2 vs.4,3 vs.11,respectively ;9 vs.36,totally,x2 =4.719,P ＜ 0.05).During the first post-trial monitoring,there was no difference in median HbAlc level between intensive-therapy group and standard-therapy group [(7.2 ± 1.1) ％ vs.(7.3 ± 1.3) ％,t =0.25,P =0.806],which was sustained in the following years.In the trail,no new case of fundus hemorrhage or diabetic associated blindness occurred in intensive-therapy group during the five-year period of therapy.Number of new episodes of micro-aneurysm,macula edema were less in intensive-therapy group than that in standard-therapy group,number of new episodes of lowering in visual acuity,and those who needed retinal laser photocoagnlation,were significantly less in intensive-therapy group than that in standardtherapy group(15 vs.25,4 vs.23,Z =-4.459,P ＜ 0.05) during five-year follow-up.Conclusions The benefit of reduced incidence of diabetic retinopathy in intensive glucose can be maintained because of the legacy effect.

Objective To investigate the prevalence of dyslipidemia in subjects with type 2 diabetes mellitus in Beijing urban communities.Methods Total 3316 subjects with type 2 diabetes (age 20-80 years) were recruited from 15 urban community health centers in Beijing using a multi-stage random sampling approach.Dyslipidemia was diagnosed according to Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults:2007 version.Results Among 3316 diabetic subjects (1329 malesand 1987 females),75.6％ (2506/3316) had dyslipidemia,the prevalence was 72.5％ (964/1329)in men and 77.6％ (1542/1987) in women.The prevalence of hypertriglyceridemia and hypercholesterolemia was 41.9％ (1388/3316) and 48.1％ (1595/3316),respectively.31.5％ (1043/3316) subjects had high levels of low-density lipoprotein cholesterol (LDL-C) and 21.2％ (703/3316) had low high-density lipoprotein cholesterol (HDL-C).Among all subjects with dyslipidemia only 22.9％ (575/2506) took hypolipid agents.The overall blood lipid control rates of triglyceride (TG),total cholesterol (TC),LDL-C and HDL-C in 1393 subjects with dyslipidemia history were 48.0％ (669/1393),17.4％ (242/1393),30.9％ (430/1393) and 75.8％ (1056/1393),respectively.Diabetics with dyslipidemia had higher body mass index,waist circumference,blood pressure,plasma glucose and hemoglobin A1c.The prevalence of dyslipidemia in the overweight and uncontrolled-glucose group were 79.0％ (1678/2125),78.9％ (1756/2227),respectively.Logistic regression analysis showed that gender,age,body mass index and hemoglobin A1c were associated with dyslipidemia.Conclusions The prevalence of dyslipidemia in diabetic subjects in Beijing urban communities is high and less than one quarter patients take hypolipid agents.Age,body mass index and hemoglobin A1c are the risk factors of dyslipidemia in type 2 diabetic patients.

Objective To investigate current status of use of oral hypoglycemic drugs and insulin among adult patients with type 2 diabetes mellitus (T2DM) in urban community of Beijing.Methods In total,3297 T2DM patients aged more than 20 years from 15 urban communities of Beijing were studied.Their body weight,height,fasting plasma glucose level and glycosylated hemoglobin Alc (HbAlc) were measured.A door-to-door questionnaire survey on use of oral hypoglycemic drugs and insulin was conducted for them.All the T2DM patients surveyed were divided into four groups based on their received intervention.Results ①Of 3279 T2DM patients,454 (13.8％) received lifestyle intervention,971 (29.5％) used only one oral hypoglycemic drug,1179 (35.7％) with combined oral hypoglycemic drugs,and 693(21.0％) with insulin.②There was significant difference in average HbAlc among the four groups of T2DM patients with lifestyle intervention,only one oral hypoglycemic drug,combined oral hypoglycemic drugs,and insulin,with HbAI c of (7.0 ± 1.9) ％,(7.1 ± 1.5) ％,(7.4 ± 1.5 ) ％,and (7.5 ± 1.5 ) ％for them,respectively ( F =15.1,P ＜ 0.01 ).Proportions of the T2DM patients with HbAlc equal to or higher than 7.0％ were 32.2％,39.4％,52.1％ and 59.5％ for the four groups,respectively ( x2 =117.7,P ＜ 0.01 ).③In the T2DM patients with lifestyle intervention,32.2％ (146/454) of them with HbA1 c equal to or higher than 7.0％ were untreated with any oral hypoglycemic drug.In those with only one oral hypoglycemic drug,39.4％ (383/971) of them with HbAlc equal to or higher than 7.0％ were not treated with combined oral hypoglycemic drugs and/or insulin.In those with combined oral hypoglycemic drugs,52.1％ (614/1079) of them with HbAlc equal to or higher than 7.0％ were not received combined insulin treatment.④ Fasting plasma glucose level,treatment strategies,postprandial 2-h blood glucose level and length of the illness were independent risk factors for HbAlc level equal to or higher than 7.0％,with odds ratio (OR) of 1.757,1.256,1.175 and 1.031,respectively.⑤ In 2843 T2DM patients with oral hypoglycemie drugs and/or insulin treatment,1494 (52.6％ ) received biguanides and 693 received (24.4％ )insulin,respectively.Conclusions More than half of adult patients with T2DM do not meet the target of glycemic control of HbAlc less than 7.0％ in urban communities of Beijing,due to not active use of oral hypoglycemic drugs,and not timely adoption of combined use of oral hypoglycemic drugs and insulin therapy.

Objective To study clinical characteristics of type 2 diabetic(T2D)patients with metabolic syndrome(MS)and its components in Beijing urban communities.Methods Totally,3295 T2D patients involved in a combined prospective diabetic management study from 15 urban communities in Beijing were classified as four groups, according to 2004 Chinese Diabetes Society's definition of MS, i. e, isolated T2D, T2D with one component of MS, T2D with two components of MS and T2D with three components of MS. Their clinical characteristics were analyzed. Results ( 1 ) Among 3295 T2D patients, 155 (4. 7% )were isolated T2D, 107 (32.6%) T2D with one component of MS, 1386 (42.1%) T2D with two components of MS and 679 (20.6%) T2D with three components of MS, with an overall 62.7% (2065/3295) of T2D patients complicated with MS. (2) In these T2D patients, the more components of MS they had, the higher body mass index (BMI), waist circumference, waist to hip circumference ratio (WHR),systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting serum levels of insulin and triglyceride (TG) and the lower level of high-density lipoprotein-cholesterol (HDL) were presented (P <0. 01 ). (3) Percentage of isolated T2D in women increased from 49. 0% (76/155) to 61.9% (420/679)of those with three components of MS ( P < 0 01 ), with increasing of components of MS. (4) Multiple logistic regression analysis showed that BMI, history of hypertension, decreased HDL, increased TG,increased blood pressure, all were risk factors for T2D patients complicated with MS. Conclusions Among T2D patients in urban communities of Beijing, 95.3% (3140/3295) of them complicated with one or more components of MS, and 61.9% (420/679) of them complicated with MS. So, community diabetic management must be implemented in an all-round way, including control of blood pressure, blood lipids,body weight and so on, in addition to control of blood sugar.

Objective To evaluate the clinical efficacy and safety of insulin enteric-coated soft capsules in patients with type 2 diabetes mellitus. Methods Totally 260 patients were enrolled in this multi-center,randomized, open, parallel-controlled clinical trial. Patients were orally administered with the capsule (capsule group, n = 135) or subcutaneously injected with insulin (control group, n = 125)one hour before the breakfast and supper time for 12 weeks. Results In the capsule group, the glyeosylated hemoglobin A1 c (HbA1 c)and fasting/postprandial blood glucoses were significantly decreased. In terms of the proportions of subjects achieving HbA1c goals using American Diabetes Association standard (HbA1c ≤7.0%)and International Diabetes Federation standard (HbA1c≤6.5%), they were 38.9% and 21.4% in capsule group and were 45.1% and 30. 2% in control group (P = 0. 323; P = 0. 109). The incidences of adverse reactions were not significantly different between these two groups (P = 0. 618). The satisfaction score was significantly higher in capsule group than in control group (P = 0. 000). Conclusion The insulin enteric-coated soft capsule has similar effectiveness and safety with insulin injections, and meanwhile is more popular among subjects.

OBJECTIVETo assess the prevalence of colorectal cancer (CRC) in Beijing and the reliability of the sequential fecal occult blood test (SFOBT) for CRC screening.

METHODSOf the natural population (48 100 persons) in several Beijing communities, we screened 26 827 persons with age over 30 using the SFOBT screening program, Guaiacum Fecal Occult Blood Test (GFOBT), Immuno Fecal Occult Blood Test (IFOBT), and colonoscopies.

RESULTSThe screening rate of the population was 74%. The positive rate of SFOBT was 5.6%. The prevalence of CRC in the entire population of Beijing was therefore calculated to be 36.57/10(5). Of 12 CRC detected patients, 4 cases were in stage Dukes A (33.33%), 7 cases in stage Dukes B (58.33%), only 1 case (8.34%) in stage Dukes C.

CONCLUSIONSThe prevalence of CRC in Beijing is one of the highest in China. Individuals at high risk for CRC or those over 50 years of age should be considered as primary candidates for screening. SFOBT screening is a cost-effective and reliable method for early detection of CRC.

Adult ; Aged ; Aged, 80 and over ; China ; Colorectal Neoplasms ; diagnosis ; Female ; Humans ; Male ; Middle Aged ; Occult Blood

OBJECTIVEWe designed a multi-center, double-blind, randomized, parallel, with metformin controlled clinical trial to evaluate the efficacy and safety of low dose rosiglitazone combined with sulphonylurea therapy in type 2 diabetic patients who were inadequately controlled with sulphonylurea alone.

METHODSPatients were treated with 4 mg rosiglitazone once daily plus sulphonylurea (test group) or 0.5 g metformin twice daily plus sulphonylurea (control group) for 12 weeks. The mean levels of HbA(1c), fasting and postprandial plasma glucose were recorded and compared between the two groups.

RESULTSThe mean levels of HbA(1c) decreased by 1.09% and 0.95% in the test group (n = 102) and control group (n = 96) respectively. Fasting and postprandial plasma glucose levels in the test group decreased by 25.0% and 35.6%, and in the control group, decreased by 17.7% and 23.8% as compared with the baseline (both P < 0.01). No liver damage was found.

CONCLUSIONCombination treatment of rosiglitazone and sulphonylurea can effectively improve glycemic control in type 2 diabetic patients inadequately controlled with sulphonylurea alone.

Adult ; Aged ; Blood Glucose ; analysis ; Diabetes Mellitus, Type 2 ; drug therapy ; Double-Blind Method ; Drug Therapy, Combination ; Humans ; Hypoglycemic Agents ; administration & dosage ; Metformin ; administration & dosage ; Middle Aged ; Sulfonylurea Compounds ; administration & dosage ; Thiazoles ; administration & dosage ; Thiazolidinediones