Objective:To investigate the association of serum cholinesterase(ChE) with insulin resistance(IR) in patients with type 2 diabetes mellitus(T2DM).Methods:General information and laboratory results of 376 hospitalized patients with type 2 diabetes were collected from the Endocrinology Department of Xuzhou Medical University Affiliated Hospital from June 2020 to November 2022. Based on quartile levels of serum cholinesterase(ChE), the patients were divided into four groups: Q1 group(≤7 912 IU/L), Q2 group(7 913-9 083 IU/L), Q3 group(9 084-10 304 IU/L), and Q4 group(≥10 305 IU/L). The Homeostasis model was used to evaluate insulin resistance(HOMA-IR) for each group, and the correlation between ChE and HOMA-IR was analyzed. Results:As ChE levels increased, HOMA-IR levels significantly increased( P<0.05). Spearman correlation analysis showed that ChE was positively correlated with body mass index, diastolic blood pressure, high-sensitivity C-reactive protein, HbA 1C, total cholesterol, triglycerides, low density lipoprotein-cholesterol(LDL-C), aspartate aminotransferase, alanine aminotransferase(ALT), glutamyl transpeptidase, prealbumin, albumin, uric acid, and HOMA-IR( P<0.05). ChE was negatively correlated with age, duration of diabetes, and blood urea nitrogen( P<0.05). Multivariat stepwise linear regression analysis showed that disease duration, body mass index, HbA 1C, ALT, and ChE were independent influencing factors of HOMA-IR( P<0.01). Logistic regression analysis showed that compared to the Q1 group, the risks of developing IR in the Q4, Q3, and Q2 groups were 3.969(1.791-8.797), 2.100(1.059-4.164), and 2.026(1.071-3.833), respectively. Conclusion:Serum ChE is closely associated with IR in patients with T2DM.

Objective To investigate the impact of various distribution of bone cement on the early clinical outcomes in osteoporotic vertebral compression fracture (OVCF) patients treated with percutaneous kyphoplasty (PKP).Methods A total of 312 patients (54 males and 258 females,mean age 69.37 years) who diagnosed as OVCF and received PKP treatment from January 2015 to July 2017 were enrolled in the present study.All subjects were divided into two groups according to different distribution of bone cement:the shaped "O" distribution (group O,113 cases),in which bone cement in the vertebral body presented whole crumb,no separation or loss of bone cement,and the shaped "H" distribution (group H,199 cases),in which bone cement in the vertebral body presented two briquettes,connected with or without a small amount of bone cement.Demographic data,surgical details,radiographic data,and clinical outcomes (at preoperatively,two-days and one-year follow-up) were compared between the two groups.Results There was no significant difference in bone mineral density (BMD),operation duration,blood loss,and occurrence of leakage of bone cement between two groups.In comparison with group O,group H was accompanied with higher volume of injected bone cement and higher proportion of bilateral approach (P＜0.05).Both groups achieved significant improvement of VAS scores after surgery,while the group H had a dramatical reduction of VAS scores at one-year follow-up compared with two-days follow-up (P＜0.05).In addition,group H had a better restoration of VAS scores at one-year follow-up than group O (P＜0.05),though no significant difference was observed at preoperative and two-days follow-up.Both groups achieved significant improvement of radiographic data after surgery (P＜0.05) with similar effects of correction.Conclusion Either shaped "H" or shaped"O" distribution of bone cement can obtain satisfied early clinical effects of PKP for the treatment of OVCF.Compared with shaped "O" distribution,shaped "H" distribution can achieve better pain relief at early follow-up.