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Chen X, Wei MM, Zhang ZX, Liu G, Wang RS, You XY, Hu DS, Zhao Y. [Association of triglyceride glucose index and risk of incident hypertension: a prospective cohort study]. Zhonghua Xin Xue Guan Bing Za Zhi 2024; 52:413-419. [PMID: 38644257 DOI: 10.3760/cma.j.cn112148-20230911-00149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Objective: To explore the relationship between the triglyceride glucose (TyG) index and the risk of developing hypertension among rural Chinese adults. Methods: A prospective cohort study was conducted from 2007 to 2008, involving 20 194 adults selected through random cluster sampling from a rural community in Luoyang City, Henan Province. Follow-ups were carried out in 2013-2014 and 2018-2020. After excluding participants with hypertension at baseline, those with missing TyG index data, individuals who passed away during follow-up, and those with incomplete hypertension status at the second visit, 9 802 participants were included in the analysis. Baseline and follow-up assessments included questionnaire interviews, physical measurements (including blood pressure), and blood sample collection for fasting lipid and glucose levels. Participants were divided into four groups according to TyG index quartiles, and a modified Poisson regression model was utilized to assess the association between TyG index quartiles and hypertension risk. Results: The study cohort comprised 9 802 participants with a median age of 48 (39, 57) years, including 3 803 males (38.80%). Participants were distributed across TyG index quartiles as follows: TyG<8.2 group (2 224 individuals), TyG 8.2-8.5 group (2 653 individuals), TyG 8.6-8.9 (2 441 individuals), and TyG≥9.0 (2 484 individuals). Over a follow-up period of (11.1±1.3) years, 3 378 subjects developed hypertension, resulting in a cumulative incidence of 34.46% (3 378/9 802). The risk of hypertension increased with higher TyG index quartiles (Ptrend<0.05). Compared to the TyG<8.2, the TyG 8.2-8.5 (RR=1.11, 95%CI 1.01-1.22, P=0.023), TyG 8.6-8.9 (RR=1.16, 95%CI 1.06-1.27, P=0.023), and TyG≥9.0 (RR=1.20, 95%CI 1.10-1.31, P=0.023) exhibited increased hypertension risk after adjusting for age, gender, educational level, and other potential confounders. Subgroup analyses based on gender and age at baseline yielded results consistent with the main analysis. Conclusions: The TyG index is positively correlated with the risk of developing hypertension in the rural adult population.
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Affiliation(s)
- X Chen
- Henan Provincial Chest Hospital, Zhengzhou University, Zhengzhou 450000, China
| | - M M Wei
- Henan Provincial Chest Hospital, Zhengzhou University, Zhengzhou 450000, China
| | - Z X Zhang
- Henan Provincial Chest Hospital, Zhengzhou University, Zhengzhou 450000, China
| | - G Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - R S Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - X Y You
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - D S Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Y Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
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Ma PF, Li S, Wang GZ, Jing XS, Liu DY, Zheng H, Li CH, Wang YS, Wang YZ, Wu Y, Zhan PY, Duan WF, Liu QQ, Yang T, Liu ZM, Jing QY, Ding ZW, Cui GF, Liu ZQ, Xia GS, Wang GX, Wang PP, Gao L, Hu DS, Zhang JL, Cao YH, Liu CY, Li ZY, Zhang JC, Li CZ, Li Z, Zhao YZ. [Safety of double and a half layered esophagojejunal anastomosis in radical gastrectomy: A prospective, multi-center, single arm trial]. Zhonghua Wei Chang Wai Ke Za Zhi 2023; 26:977-985. [PMID: 37849269 DOI: 10.3760/cma.j.cn441530-20230301-00058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
Objective: To evaluate the safety of double and a half layered esophagojejunal anastomosis in radical gastrectomy. Methods: This prospective, multi-center, single-arm study was initiated by the Affiliated Cancer Hospital of Zhengzhou University in June 2021 (CRAFT Study, NCT05282563). Participating institutions included Nanyang Central Hospital, Zhumadian Central Hospital, Luoyang Central Hospital, First Affiliated Hospital of Henan Polytechnic University, First Affiliated Hospital of Henan University, Luohe Central Hospital, the People's Hospital of Hebi, First People's Hospital of Shangqiu, Anyang Tumor Hospital, First People's Hospital of Pingdingshan, and Zhengzhou Central Hospital Affiliated to Zhengzhou University. Inclusion criteria were as follows: (1) gastric adenocarcinoma confirmed by preoperative gastroscopy;(2) preoperative imaging assessment indicated that R0 resection was feasible; (3) preoperative assessment showed no contraindications to surgery;(4) esophagojejunostomy planned during the procedure; (5) patients volunteered to participate in this study and gave their written informed consent; (6) ECOG score 0-1; and (7) ASA score I-III. Exclusion criteria were as follows: (1) history of upper abdominal surgery (except laparoscopic cholecystectomy);(2) history of gastric surgery (except endoscopic submucosal dissection and endoscopic mucosal resection); (3) pregnancy or lactation;(4) emergency surgery for gastric cancer-related complications (perforation, hemorrhage, obstruction); (5) other malignant tumors within 5 years or coexisting malignant tumors;(6) arterial embolism within 6 months, such as angina pectoris, myocardial infarction, and cerebrovascular accident; and (7) comorbidities or mental health abnormalities that could affect patients' participation in the study. Patients were eliminated from the study if: (1) radical gastrectomy could not be completed; (2) end-to-side esophagojejunal anastomosis was not performed during the procedure; or (3) esophagojejunal anastomosis reinforcement was not possible. Double and a half layered esophagojejunal anastomosis was performed as follows: (1) Open surgery: the full thickness of the anastomosis is continuously sutured, followed by embedding the seromuscular layer with barbed or 3-0 absorbable sutures. The anastomosis is sutured with an average of six to eight stitches. (2) Laparoscopic surgery: the anastomosis is strengthened by counterclockwise full-layer sutures. Once the anastomosis has been sutured to the right posterior aspect of the anastomosis, the jejunum stump is pulled to the right and the anastomosis turned over to continue to complete reinforcement of the posterior wall. The suture interval is approximately 5 mm. After completing the full-thickness suture, the anastomosis is embedded in the seromuscular layer. Relevant data of patients who had undergone radical gastrectomy in the above 12 centers from June 2021 were collected and analyzed. The primary outcome was safety (e.g., postoperative complications, and treatment). Other studied variables included details of surgery (e.g., surgery time, intraoperative bleeding), postoperative recovery (postoperative time to passing flatus and oral intake, length of hospital stay), and follow-up conditions (quality of life as assessed by Visick scores). Result: [1] From June 2021 to September 2022,457 patients were enrolled, including 355 men and 102 women of median age 60.8±10.1 years and BMI 23.7±3.2 kg/m2. The tumors were located in the upper stomach in 294 patients, mid stomach in 139; and lower stomach in 24. The surgical procedures comprised 48 proximal gastrectomies and 409 total gastrectomies. Neoadjuvant chemotherapy was administered to 85 patients. Other organs were resected in 85 patients. The maximum tumor diameter was 4.3±2.2 cm, number of excised lymph nodes 28.3±15.2, and number of positive lymph nodes five (range one to four. As to pathological stage,83 patients had Stage I disease, 128 Stage II, 237 Stage III, and nine Stage IV. [2] The studied surgery-related variables were as follows: The operation was successfully completed in all patients, 352 via a transabdominal approach, 25 via a transhiatus approach, and 80 via a transthoracoabdominal approach. The whole procedure was performed laparoscopically in 53 patients (11.6%), 189 (41.4%) underwent laparoscopic-assisted surgery, and 215 (47.0%) underwent open surgery. The median intraoperative blood loss was 200 (range, 10-1 350) mL, and the operating time 215.6±66.7 minutes. The anastomotic reinforcement time was 2 (7.3±3.9) minutes for laparoscopic-assisted surgery, 17.6±1.7 minutes for total laparoscopy, and 6.0±1.2 minutes for open surgery. [3] The studied postoperative variables were as follows: The median time to postoperative passage of flatus was 3.1±1.1 days and the postoperative gastrointestinal angiography time 6 (range, 4-13) days. The median time to postoperative oral intake was 7 (range, 2-14) days, and the postoperative hospitalization time 15.8±6.7 days. [4] The safety-related variables were as follows: In total, there were 184 (40.3%) postoperative complications. These comprised esophagojejunal anastomosis complications in 10 patients (2.2%), four (0.9%) being anastomotic leakage (including two cases of subclinical leakage and two of clinical leakage; all resolved with conservative treatment); and six patients (1.3%) with anastomotic stenosis (two who underwent endoscopic balloon dilation 21 and 46 days after surgery, the others improved after a change in diet). There was no anastomotic bleeding. Non-anastomotic complications occurred in 174 patients (38.1%). All patients attended for follow-up at least once, the median follow-up time being 10 (3-18) months. Visick grades were as follows: Class I, 89.1% (407/457); Class II, 7.9% (36/457); Class III, 2.6% (12/457); and Class IV 0.4% (2/457). Conclusion: Double and a half layered esophagojejunal anastomosis in radical gastrectomy is safe and feasible.
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Affiliation(s)
- P F Ma
- Department of General Surgery, Affiliated Tumor Hospital of Zhenzhou University(Henan Tumor Hospital), Zhengzhou 450003,China
| | - S Li
- Department of General Surgery, Affiliated Tumor Hospital of Zhenzhou University(Henan Tumor Hospital), Zhengzhou 450003,China
| | - G Z Wang
- Department of General Surgery, Nanyang Central Hospital, Nanyang 473000,China
| | - X S Jing
- Department of General Surgery, Nanyang Central Hospital, Nanyang 473000,China
| | - D Y Liu
- Department of General Surgery, Zhumadian Central Hospital,Zhumadian 463000, China
| | - H Zheng
- Department of General Surgery, Zhumadian Central Hospital,Zhumadian 463000, China
| | - C H Li
- Department of General Surgery, Luoyang Central Hospital,Luoyang 471000, China
| | - Y S Wang
- Department of General Surgery, Luoyang Central Hospital,Luoyang 471000, China
| | - Y Z Wang
- Department of General Surgery, The First Affiliated Hospital of Henan Polytechnic University,Jiaozuo 454000, China
| | - Y Wu
- Department of General Surgery, The First Affiliated Hospital of Henan Polytechnic University,Jiaozuo 454000, China
| | - P Y Zhan
- Department of General Surgery, The First Affiliated Hospital of Henan University,Kaifeng 475000, China
| | - W F Duan
- Department of General Surgery, The First Affiliated Hospital of Henan University,Kaifeng 475000, China
| | - Q Q Liu
- Department of General Surgery, Luohe Central Hospital,Luohe 462000, China
| | - T Yang
- Department of General Surgery, Luohe Central Hospital,Luohe 462000, China
| | - Z M Liu
- Department of General Surgery, The People's Hospital of Hebi,Hebi 458000 China
| | - Q Y Jing
- Department of General Surgery, The People's Hospital of Hebi,Hebi 458000 China
| | - Z W Ding
- Department of General Surgery, First People's Hospital of Shangqiu,Shangqiu 476000, China
| | - G F Cui
- Department of General Surgery, First People's Hospital of Shangqiu,Shangqiu 476000, China
| | - Z Q Liu
- Department of General Surgery, Anyang Tumor Hospital,Anyang 455000, China
| | - G S Xia
- Department of General Surgery, Anyang Tumor Hospital,Anyang 455000, China
| | - G X Wang
- Department of General Surgery, First People's Hospital of Pingdingshan, Pingdingshan 467000, China
| | - P P Wang
- Department of General Surgery, First People's Hospital of Pingdingshan, Pingdingshan 467000, China
| | - L Gao
- Department of Gastrointestinal Surgery, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou 450000, China
| | - D S Hu
- Department of Gastrointestinal Surgery, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou 450000, China
| | - J L Zhang
- Department of General Surgery, Affiliated Tumor Hospital of Zhenzhou University(Henan Tumor Hospital), Zhengzhou 450003,China
| | - Y H Cao
- Department of General Surgery, Affiliated Tumor Hospital of Zhenzhou University(Henan Tumor Hospital), Zhengzhou 450003,China
| | - C Y Liu
- Department of General Surgery, Affiliated Tumor Hospital of Zhenzhou University(Henan Tumor Hospital), Zhengzhou 450003,China
| | - Z Y Li
- Department of General Surgery, Affiliated Tumor Hospital of Zhenzhou University(Henan Tumor Hospital), Zhengzhou 450003,China
| | - J C Zhang
- Department of General Surgery, Affiliated Tumor Hospital of Zhenzhou University(Henan Tumor Hospital), Zhengzhou 450003,China
| | - C Z Li
- Department of General Surgery, Affiliated Tumor Hospital of Zhenzhou University(Henan Tumor Hospital), Zhengzhou 450003,China
| | - Z Li
- Department of General Surgery, Affiliated Tumor Hospital of Zhenzhou University(Henan Tumor Hospital), Zhengzhou 450003,China
| | - Y Z Zhao
- Department of General Surgery, Affiliated Tumor Hospital of Zhenzhou University(Henan Tumor Hospital), Zhengzhou 450003,China
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Yan TT, Xiao R, Wang Y, Lin GA, Zheng Y, Zhao H, Li WJ, Shang XZ, Meng JS, Hu DS, Li S, Wang C, Lin ZC, Chen HC, Zhao DY, Tang D. [A prospective study on application of human umbilical cord mesenchymal stem cells combined with autologous Meek microskin transplantation in patients with extensive burns]. Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi 2023; 39:114-121. [PMID: 36878520 DOI: 10.3760/cma.j.cn501225-20220728-00319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
Objective: To investigate the effects of human umbilical cord mesenchymal stem cells (hUCMSCs) combined with autologous Meek microskin transplantation on patients with extensive burns. Methods: The prospective self-controlled study was conducted. From May 2019 to June 2022, 16 patients with extensive burns admitted to the 990th Hospital of PLA Joint Logistics Support Force met the inclusion criteria, while 3 patients were excluded according to the exclusion criteria, and 13 patients were finally selected, including 10 males and 3 females, aged 24-61 (42±13) years. A total of 20 trial areas (40 wounds, with area of 10 cm×10 cm in each wound) were selected. Two adjacent wounds in each trial area were divided into hUCMSC+gel group applied with hyaluronic acid gel containing hUCMSCs and gel only group applied with hyaluronic acid gel only according to the random number table, with 20 wounds in each group. Afterwards the wounds in two groups were transplanted with autologous Meek microskin grafts with an extension ratio of 1∶6. In 2, 3, and 4 weeks post operation, the wound healing was observed, the wound healing rate was calculated, and the wound healing time was recorded. The specimen of wound secretion was collected for microorganism culture if there was purulent secretion on the wound post operation. In 3, 6, and 12 months post operation, the scar hyperplasia in wound was assessed using the Vancouver scar scale (VSS). In 3 months post operation, the wound tissue was collected for hematoxylin-eosin (HE) staining to observe the morphological changes and for immunohistochemical staining to observe the positive expressions of Ki67 and vimentin and to count the number of positive cells. Data were statistically analyzed with paired samples t test and Bonferronni correction. Results: In 2, 3, and 4 weeks post operation, the wound healing rates in hUCMSC+gel group were (80±11)%, (84±12)%, and (92±9)%, respectively, which were significantly higher than (67±18)%, (74±21)%, and (84±16)% in gel only group (with t values of 4.01, 3.52, and 3.66, respectively, P<0.05). The wound healing time in hUCMSC+gel group was (31±11) d, which was significantly shorter than (36±13) d in gel only group (t=-3.68, P<0.05). The microbiological culture of the postoperative wound secretion specimens from the adjacent wounds in 2 groups was identical, with negative results in 4 trial areas and positive results in 16 trial areas. In 3, 6, and 12 months post operation, the VSS scores of wounds in gel only group were 7.8±1.9, 6.7±2.1, and 5.4±1.6, which were significantly higher than 6.8±1.8, 5.6±1.6, and 4.0±1.4 in hUCMSC+gel group, respectively (with t values of -4.79, -4.37, and -5.47, respectively, P<0.05). In 3 months post operation, HE staining showed an increase in epidermal layer thickness and epidermal crest in wound in hUCMSC+gel group compared with those in gel only group, and immunohistochemical staining showed a significant increase in the number of Ki67 positive cells in wound in hUCMSC+gel group compared with those in gel only group (t=4.39, P<0.05), with no statistically significant difference in the number of vimentin positive cells in wound between the 2 groups (P>0.05). Conclusions: The application of hyaluronic acid gel containing hUCMSCs to the wound is simple to perform and is therefore a preferable route. Topical application of hUCMSCs can promote healing of the autologous Meek microskin grafted area in patients with extensive burns, shorten wound healing time, and alleviate scar hyperplasia. The above effects may be related to the increased epidermal thickness and epidermal crest, and active cell proliferation.
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Affiliation(s)
- T T Yan
- Military Burn Center, the 990th Hospital of PLA Joint Logistics Support Force, Zhumadian 463002, China
| | - R Xiao
- Military Burn Center, the 990th Hospital of PLA Joint Logistics Support Force, Zhumadian 463002, China
| | - Y Wang
- Beijing Zhongjing Hi-Tech Biotechnology Co., Beijing 100089, China
| | - G A Lin
- Military Burn Center, the 990th Hospital of PLA Joint Logistics Support Force, Zhumadian 463002, China
| | - Y Zheng
- Military Burn Center, the 990th Hospital of PLA Joint Logistics Support Force, Zhumadian 463002, China
| | - H Zhao
- Henan Cellular Industry Technology Research Institute Co., Zhengzhou 450121, China
| | - W J Li
- Military Burn Center, the 990th Hospital of PLA Joint Logistics Support Force, Zhumadian 463002, China
| | - X Z Shang
- Military Burn Center, the 990th Hospital of PLA Joint Logistics Support Force, Zhumadian 463002, China
| | - J S Meng
- Military Burn Center, the 990th Hospital of PLA Joint Logistics Support Force, Zhumadian 463002, China
| | - D S Hu
- Military Burn Center, the 990th Hospital of PLA Joint Logistics Support Force, Zhumadian 463002, China
| | - S Li
- Military Burn Center, the 990th Hospital of PLA Joint Logistics Support Force, Zhumadian 463002, China
| | - C Wang
- Military Burn Center, the 990th Hospital of PLA Joint Logistics Support Force, Zhumadian 463002, China
| | - Z C Lin
- Military Burn Center, the 990th Hospital of PLA Joint Logistics Support Force, Zhumadian 463002, China
| | - H C Chen
- Military Burn Center, the 990th Hospital of PLA Joint Logistics Support Force, Zhumadian 463002, China
| | - D Y Zhao
- Military Burn Center, the 990th Hospital of PLA Joint Logistics Support Force, Zhumadian 463002, China
| | - D Tang
- Department of Burns & Plastic Surgery, PLA General Hospital of Central Theater Command, Wuhan 430012, China
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Lian HC, Xie XK, Zhou RX, Lin R, Shi SX, Fu XR, Hu DS, Zhao Y. [Association between metabolically healthy obesity and incident risk of stroke in adult aged over 40 from rural Henan province]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:295-301. [PMID: 35381650 DOI: 10.3760/cma.j.cn112150-20211206-01126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To investigate the association between metabolically healthy obesity and the incident risk of stroke in people aged ≥40 years from rural areas of Henan Province. Methods: During 2007 to 2008, 20 194 residents aged ≥18 years were selected for baseline examination by random cluster sampling and 17 265 participants were followed up during 2013 to 2014. According to the aim of current study, a total of 11 864 eligible subjects were included in this post-hoc analysis. Depending on body mass index and metabolic status, subjects were divided into four groups: metabolically healthy normal weight, metabolically healthy obesity, metabolically abnormal normal weight and metabolically abnormal obesity. Multivariate logistic regression model was used to analyze the relationship between metabolically healthy obesity and the risk of stroke. Results: The median (Q1, Q3) age of study participants was 54(46, 61) years, and 4 526 participants were men. During the mean follow-up of 6 years, the cumulative incidence of stroke was 7.16%. The incidence of stroke in metabolically healthy normal weight, metabolically healthy obesity, metabolically abnormal normal weight, and metabolically abnormal obesity were 3.73%, 4.61%, 8.99% and 9.38%, respectively (χ²=117.458, P<0.001). After adjusting possible confounding factors, compared with metabolically healthy normal weight, the risk of stroke was significantly increased in the metabolically healthy obesity group, metabolically abnormal normal weight group and metabolically abnormal obesity group with the odds ratio (OR) and 95% confidence interval (CI) of 1.52(1.10-2.12), 2.11(1.61-2.77) and 2.78(2.18-3.55), respectively. Stratified analysis showed that the risk of stroke was significantly higher in metabolically healthy obesity people aged 40-59 years compared with metabolically healthy normal weight group (OR=2.12, 95%CI: 1.36-3.30). Conclusion: Metabolically healthy obesity, metabolically abnormal normal weight and metabolically abnormal obesity are positively associated with the risk of stroke.
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Affiliation(s)
- H C Lian
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - X K Xie
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - R X Zhou
- Department of Information and Computing Science, School of Mathematics and Statistics, Zhengzhou University, Zhengzhou 450001, China
| | - R Lin
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - S X Shi
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - X R Fu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - D S Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Y Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
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Li JX, Li Y, Liu FC, Chen JC, Cao J, Chen SF, Hu DS, Shen C, Huang JF, Lu XF, Gu DF. [Cardiovascular disease risk in diabetes patients aged 40 years old and above in China]. Zhonghua Xin Xue Guan Bing Za Zhi 2020; 48:968-974. [PMID: 33210870 DOI: 10.3760/cma.j.cn112148-20191203-00733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Objective: To evaluate the incidence of cardiovascular disease (CVD), ischemic and hemorrhagic cardiovascular events among Chinese diabetic patients aged 40 years and above with different CVD risk levels. Methods: This study enrolled participants aged 40 years and above in 15 provinces from a prospective cohort study, the China-PAR project (Prediction for Atherosclerotic Cardiovascular Disease Risk in China). Participants were categorized into two groups according to the presence or absence of diabetes at baseline. Individuals were further classified into low (0-4.9%), moderate (5%-9.9%) and high risk groups (≥10%), based on predicted ten-year CVD risk using the China-PAR equations. Two followed-up surveys were conducted between 2007 and 2015 to identify CVD events, which were defined as nonfatal acute myocardial infarction, or death due to coronary heart disease, or stroke. Ischemic cardiovascular events included nonfatal acute myocardial infarction, or death due to coronary heart disease, or ischemic stroke. Hemorrhagic cardiovascular events included subarachnoid hemorrhage and intracerebral hemorrhage. The incidences of CVD, ischemic and hemorrhagic cardiovascular events were compared in diabetes and non-diabetes population with different CVD risk levels. Results: This study included 89 209 participants aged 40 years and above, the average follow-up period was 8.5 years. The age was (54.8±9.4) years, and 36 794 (41.2%) were men, and 5 730 (6.4%) were diabetic patients. In diabetes patients aged 40 years and above, 53.7% (3 075/5 730) were at high risk of CVD. Age-and sex-adjusted incidence of CVD, ischemic and hemorrhagic cardiovascular events (1 066.93/100 000 person-years, 824.23/100 000 person-years, and 211.56/100 000 person-years) were significantly lower in diabetes patients than those in non-diabetes population with high CVD risk (1 773.73/100 000 person-years, 1 228.18/100 000 person-years, and 446.49/100 000 person-years) (all P<0.001). Among high CVD risk populations, incidence of ischemic events was significantly higher in diabetic patients than in non-diabetes population (1 638.47/100 000 person-years vs. 1 228.18/100 000 person-years, P<0.001), but incidence of hemorrhagic events tended to be lower in diabetic patients than in non-diabetes population (415.70/100 000 person-years vs. 446.49/100 000 person-years, P=0.635). Incidence of ischemic and hemorrhagic events were similar between diabetes patients and non-diabetes population at low or moderate CVD risk groups (all P>0.05). Conclusions: More than half of diabetes patients aged 40 years and above in China have high CVD risk. The incidence of CVD, ischemic and hemorrhagic cardiovascular events are different in diabetic patients with different CVD risk levels.
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Affiliation(s)
- J X Li
- Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Y Li
- Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - F C Liu
- Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - J C Chen
- Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - J Cao
- Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - S F Chen
- Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - D S Hu
- School of Public Health, Shenzhen University, Shenzhen 518060, China
| | - C Shen
- School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - J F Huang
- Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - X F Lu
- Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - D F Gu
- Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
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Chen Q, Han MH, Huang SB, Wu XY, Hu FL, Zhang M, Hu DS. [Progress of research on the relations between bipolar disorder and type 2 diabetes mellitus]. Zhonghua Liu Xing Bing Xue Za Zhi 2020; 41:1741-1744. [PMID: 33297636 DOI: 10.3760/cma.j.cn112338-20191108-00795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Both risks of type 2 diabetes mellitus (T2DM) in patients with bipolar disorder (BD) and of BD in patients with T2DM are both significantly higher than the general population, indicating the two disorders may share the common pathogenesis. Patients with BD and co-morbid T2DM behave poorly on managing their own behavior on health, thus increased risks of outcomes on related complications, disability and mortality. The article reviewed the epidemiologic features, health hazards, relations and possible mechanisms between BD and T2DM. Strategies and measures on intervention of BD and T2DM were also involved in the text to improve the awareness and research ability of the researchers.
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Affiliation(s)
- Q Chen
- Department of Mental Health, Bao'an Chronic Diseases Prevent and Cure Hospital, Shenzhen 518051, China
| | - M H Han
- Department of Mental Health, Bao'an Chronic Diseases Prevent and Cure Hospital, Shenzhen 518051, China; Department of Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen 518051, China
| | - S B Huang
- Department of Mental Health, Bao'an Chronic Diseases Prevent and Cure Hospital, Shenzhen 518051, China; Department of Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen 518051, China
| | - X Y Wu
- Department of Mental Health, Bao'an Chronic Diseases Prevent and Cure Hospital, Shenzhen 518051, China; Department of Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen 518051, China
| | - F L Hu
- Department of Mental Health, Bao'an Chronic Diseases Prevent and Cure Hospital, Shenzhen 518051, China; Department of Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen 518051, China
| | - M Zhang
- Department of Mental Health, Bao'an Chronic Diseases Prevent and Cure Hospital, Shenzhen 518051, China; Department of Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen 518051, China
| | - D S Hu
- Department of Mental Health, Bao'an Chronic Diseases Prevent and Cure Hospital, Shenzhen 518051, China; Department of Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen 518051, China
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Wu YY, Zhao Y, Wu XL, Chen XL, Wang TQ, Hu DS, Zhang M. [Calculation Method of Incubation Period of Infectious Diseases and Its Epidemiological Significance]. Zhonghua Yu Fang Yi Xue Za Zhi 2020; 54:1026-1030. [PMID: 32907296 DOI: 10.3760/cma.j.cn112150-20200629-00943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Based on the practical application, this paper introduced the basic calculation conditions, methods and epidemiological significance of incubation period. The real data were used for calculations of the incubation period by lognormal, gamma, Weibull and Erlang distribution methods. Both of the complete and incomplete observation data were demonstrated.
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Affiliation(s)
- Y Y Wu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen 518055, China
| | - Y Zhao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - X L Wu
- Infectious Disease Control and Prevention Institute of Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China
| | - X L Chen
- Shenzhen Key Epidemiology Discipline of Guangming District Center for Disease Control and Prevention, Shenzhen 518100, China
| | - T Q Wang
- Shenzhen Key Epidemiology Discipline of Guangming District Center for Disease Control and Prevention, Shenzhen 518100, China
| | - D S Hu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen 518055, China
| | - M Zhang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen 518055, China
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Liu XJ, Wang BY, Ren YC, Zhao Y, Liu DC, Zhang DD, Chen X, Liu LL, Cheng C, Liu FY, Zhou QG, Chen GZ, Hong SH, Liu D, Hu SQ, Zhang M, Hu DS. [A cohort study on body mass index and risk of all-cause mortality among hypertensive population]. Zhonghua Liu Xing Bing Xue Za Zhi 2018; 39:914-919. [PMID: 30060304 DOI: 10.3760/cma.j.issn.0254-6450.2018.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the relationship between body mass index (BMI) and all-cause mortality in hypertensive population. Methods: All participants were selected from a prospective cohort study based on a rural population from Henan province, China. Cox proportional hazards regression models were used to estimate the associations of different levels of BMI stratification with all-cause mortality. Restricted cubic spline models were used to detect the dose-response relation. Results: Among the 5 461 hypertensive patients, a total of 31 048.38 person-years follow-up was conducted. The median of follow-up time was 6 years, and 589 deaths occurred during the follow-up period. Compared to normal weight group (18.5 kg/m(2)<BMI<24.0 kg/m(2)) the multivariate-adjusted hazard ratios for all-cause mortality associated with BMI levels (<18.5 kg/m(2), 24-28 kg/m(2), and ≥28 kg/m(2)) were 0.83 (95%CI: 0.37-1.87), 0.81 (95%CI: 0.67-0.97), and 0.72 (95%CI: 0.56-0.91), respectively. The dose-response analysis showed a nonlinear, reverse "S" shaped relationship (non-linearity P<0.001). Conclusion: Overweight or obese might have a protective effect on all-cause mortality in hypertensive population, which supports the "obesity paradox" phenomenon.
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Affiliation(s)
- X J Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - B Y Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Y C Ren
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Y Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - D C Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - D D Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - X Chen
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - L L Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - C Cheng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - F Y Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen 518060, China
| | - Q G Zhou
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen 518060, China
| | - G Z Chen
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen 518060, China
| | - S H Hong
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen 518060, China
| | - D Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen 518060, China
| | - S Q Hu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen 518060, China
| | - M Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen 518060, China
| | - D S Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
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Xiao R, Huang YS, Lin GA, Yuan SA, Hu DS. [Effects of cardiac support on delayed resuscitation in extensively burned patients with shock]. Zhonghua Shao Shang Za Zhi 2018; 34:8-13. [PMID: 29374921 DOI: 10.3760/cma.j.issn.1009-2587.2018.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the effects of cardiac support on delayed resuscitation in extensively burned patients with shock. Methods: Clinical data of 62 extensively burned patients with shock on admission, admitted to the 159th Hospital of PLA (hereinafter referred to as our hospital) from January 2012 to January 2017, were retrospectively analyzed. They were divided into cardiac support group (n=35) and control group (n=27) according to the use of deslanoside and ulinastatin. All patients were treated with routine fluid resuscitation based on the formula of the Third Military Medical University till post injury hour (PIH) 48. Patients in cardiac support group were given slow intravenous injection of deslanoside which was added in 20 mL 100 g/L glucose injection with first dose of 0.4 to 0.6 mg, 0.2 to 0.4 mg per 6 to 8 h, no more than 1.6 mg daily, and slow intravenous injection of 1×10(5)U ulinastatin which was added in 100 mL 50 g/L glucose injection, once per 12 h. Other treatments of patients in the two groups followed the same conventional procedures of our hospital. The following data of the two groups of patients were collected. (1) The data of urine volume per hour within PIH 48, heart rate, mean arterial pressure (MAP), central venous pressure (CVP), blood lactic acid, base excess, hematocrit, and albumin at PIH 48 were recorded. (2) The input volumes of electrolyte, colloid within the first and second 24 hours post burn and the total fluid input volumes within PIH 48 were recorded. (3) The data of creatine kinase, creatine kinase isoenzyme-MB, lactate dehydrogenase, total bile acid, alanine aminotransferase, aspartate aminotransferase, β(2)-microglobulin, urea nitrogen, and creatinine at PIH 48 were recorded. (4) The complications including cardiac failure, pulmonary edema, pleural effusion, seroperitoneum, renal failure, sepsis, and death were also recorded. Data were processed with independent sample ttest, Fisher's exact test, Pearson chi-square test, or continuous correction chi-square test. Results: (1) There were no statistically significant differences in urine volume within PIH 48, heart rate, MAP, CVP, hematocrit, or albumin at PIH 48 between the patients of two groups (t=0.150, 0.488, 0.805, 0.562, 1.742, 0.696, P>0.05). While the levels of blood lactic acid and base excess were respectively (4.2±2.2) and (-4.3±2.0) mmol/L in patients of cardiac support group, which were significantly better than (5.9±1.7) and (-6.0±3.1) mmol/L in patients of control group (t=3.249, 2.480, P<0.05 or P<0.01). (2) There was no statistically significant difference in input volume of colloid within the first 24 hours post burn between the patients of two groups (t=0.642, P>0.05). The input volume of electrolyte within the first 24 hours post burn, the input volumes of electrolyte and colloid within the second 24 hours post burn, and the total fluid input volume within PIH 48 of patients in cardiac support group were significantly less than those in control group (t=2.703, 4.223, 3.437, 2.515, P<0.05 or P<0.01). (3) The levels of creatine kinase, creatine kinase isoenzyme-MB, lactate dehydrogenase, total bile acid, alanine aminotransferase, aspartate aminotransferase, β(2)-microglobulin, urea nitrogen, and creatinine of patients in cardiac support group at PIH 48 were significantly lower than those in control group (t=3.066, 3.963, 3.225, 2.943, 2.431, 3.084, 4.052, 2.915, 3.353, P<0.05 or P<0.01). (4) The occurrences of pleural effusion and seroperitoneum and mortality of patients in cardiac support group were significantly lower than those in control group (χ(2)=5.514, 6.984, 4.798, P<0.05 or P<0.01). There were no statistically significant differences in cardiac failure, pulmonary edema, renal failure, and sepsis between the patients of two groups [χ(2)=1.314 (sepsis), P>0.05]. Conclusions: The cardiotonic and cardiac protection treatments in delayed resuscitation of extensively burned patients with shock contribute to improving the cellular anonic metabolism, reducing the volume of fluid resuscitation, and mitigating the ischemic and hypoxic damage to organs, so as to lay foundation for decreasing further complication incidences and mortality.
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Affiliation(s)
- R Xiao
- Burn Center, the 159th Hospital of PLA, Zhumadian 463008, China
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Wang CY, Hu DS, Wen J, Lu W, Li J. [Upper gastrointestinal bleeding caused by exfoliative esophagitis in one patient with hepatitis B cirrhosis]. Zhonghua Gan Zang Bing Za Zhi 2017; 25:868-869. [PMID: 29325283 DOI: 10.3760/cma.j.issn.1007-3418.2017.11.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- C Y Wang
- Tianjin Second People's Hospital, Tianjin Hepatopathy Research Institute, Tianjin 300192, China
| | - D S Hu
- Tianjin Second People's Hospital, Tianjin Hepatopathy Research Institute, Tianjin 300192, China
| | - J Wen
- Tianjin Second People's Hospital, Tianjin Hepatopathy Research Institute, Tianjin 300192, China
| | - W Lu
- Tianjin First Central Hospital, Tianjin Hepatopathy Research Institute, Tianjin 300192, China
| | - J Li
- Tianjin Second People's Hospital, Tianjin Hepatopathy Research Institute, Tianjin 300192, China
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Wang CY, Jiang B, Li J, Li S, Hu DS, Wei J, Guo XL, Lu W. [Value of endoscopic ultrasound in early diagnosis of gastroesophageal varices in patients with liver cirrhosis]. Zhonghua Gan Zang Bing Za Zhi 2017; 24:671-675. [PMID: 27788723 DOI: 10.3760/cma.j.issn.1007-3418.2016.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the value of endoscopic ultrasound in the early diagnosis of gastroesophageal varices in patients with liver cirrhosis. Methods: A total of 74 patients with liver cirrhosis who were not found to have esophageal or gastric varices by conventional endoscopic examination were enrolled. Endoscopic ultrasound was performed to evaluate its value in the early diagnosis of gastroesophageal varices in patients with liver cirrhosis. The Mann-Whitney U test was used for comparison of non-parametric data between groups, and a one-way analysis of variance was used for comparison between multiple groups; the Pearson simple correlation coefficient was used for correlation analysis. Results: Among the 74 patients with liver cirrhosis, 3(4.1%)were not found to have esophageal and gastric submucosal varices, peripheral varices, or perforating branches by endoscopic ultrasound. Among the 71 patients with liver cirrhosis who underwent endoscopic ultrasound, 16(22.5%)had esophageal submucosal varices, and 22(31.0%)had gastric submucosal varices; 58 patients(81.7%)were found to have at least one type of esophageal peripheral varices. The numbers of patients detected to have paraesophageal varices, periesophageal varices, paragastric varices, and perigastric varices were 29(40.8%), 24(33.8%), 28(39.4%), and 22(31.0%), respectively, which were significantly different from the number in patients with chronic liver diseases(P < 0.05). Among the 71 patients with liver cirrhosis who underwent endoscopic ultrasound, 20(28.2%)were found to have perforating branches with esophageal and gastric submucosal varices or peripheral varices, which showed a significant difference from the number in patients with chronic liver diseases(P < 0.05). In patients with liver cirrhosis, esophageal and gastric peripheral varices were associated with esophageal and gastric submucosal varices(P < 0.05). Conclusion: Endoscopic ultrasound has a certain value in the early diagnosis of esophageal and gastric varices in patients with liver cirrhosis.
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Affiliation(s)
- C Y Wang
- Tianjin Second People's Hospital, Tianjin Hepatopathy Research Institute, Tianjin 300192, China
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12
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Yang XY, Zhang M, Luo XP, Wang JJ, Yin L, Pang C, Wang GA, Shen YX, Wu DT, Zhang L, Ren YC, Wang BY, Zhang HY, Zhou JM, Han CY, Zhao Y, Feng TP, Hu DS, Zhao JZ. [Body mass index, waist circumference and waist-to-height ratio associated with the incidence of type 2 diabetes mellitus: a cohort study]. Zhonghua Yu Fang Yi Xue Za Zhi 2017; 50:328-33. [PMID: 27029364 DOI: 10.3760/cma.j.issn.0253-9624.2016.04.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To investigate the association between body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), and the incidence risk of type 2 diabetes mellitus (T2DM). METHODS In total, 20 194 participants ≥18 years old were selected randomly by cluster sampling from two township (town) of the county in Henan province from July to August of 2007 and July to August of 2008 and the investigation included questionnaires, anthropometric measurements, fasting plasma glucose, and lipid profile examination were performed at baseline; 17 236 participants were enrolled in this cohort study. 14 720 (85.4%) were followed up from July to August 2013 and July to October 2014. Finally, 11 643 participants (4 301 males and 7 342 females) were included in this study. Incidence density and Cox proportional hazards regression models were used to evaluate the risk of T2DM associated with baseline BMI, WC, WHtR, and their dynamic changes. RESULTS After average of 6.01 years following up for 11 643 participants, 613 developed T2DM and the incidence density was 0.89 per 100 person-years. After adjusted for baseline sex, age, smoking, drinking, family history of diabetes, as well as the difference of fasting plasma-glucose (FPG), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP) between baseline and follow-up, Cox Proportional-Hazards regression analysis indicated that T2DM risk of baseline BMI overweight group, BMI obesity group, abnormal WC group and abnormal WHtR group were significantly higher than that of the corresponding baseline normal groups , and the incidence risk of T2DM reached the highest for those whose baseline BMI, WC and WHtR were all abnormal, the corresponding HR (95%CI) were 2.05 (1.62-2.59), 3.01 (2.33-3.90), 2.34 (1.89-2.90), 2.88 (2.21-3.74), 3.32 (2.50-4.40), respectively. Whether baseline BMI/WC was normal or not, T2DM risk increased if baseline WHtR was abnormal, and the HR (95%CI) of baseline normal BMI/abnormal WHtR group, baseline abnormal BMI/abnormal WHtR group, baseline normal WC/abnormal WHtR group, baseline abnormal WC/abnormal WHtR group were 1.88 (1.29-2.74), 3.08 (2.34-4.05), 2.15(1.53-3.00), 3.22 (2.45-4.23), respectively. The analysis for dynamic changes of BMI, WC, and WHtR indicated that in baseline normal WC or WHtR group, T2DM risk increased when baseline normal WC or WHtR developed abnormal at follow-up, and the corresponding HR (95%CI) were 1.79 (1.26-2.55), 2.12(1.32-3.39), respectively. In baseline abnormal WC or WHtR group, T2DM risk decresed when baseline abnormal WC or WHtR reversed to normal at follow-up, and the corresponding HR (95%CI) were 2.16 (1.42-3.29), 2.62 (1.63-4.20), respectively. CONCLUSION BMI, WC, and WHtR were associated with increased T2DM risk. The more abnormal aggregation of BMI, WC, and WHtR presents, the higher T2DM risk was. T2DM risk could be decreased when abnormal WC or WHtR reversed to normal.
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Affiliation(s)
- X Y Yang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
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Zhang HY, Zhang M, Shi WH, Hu DS. [Research progress of risk assessment model of type 2 diabetes mellitus]. Zhonghua Yu Fang Yi Xue Za Zhi 2016; 50:836-840. [PMID: 27655609 DOI: 10.3760/cma.j.issn.0253-9624.2016.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Established models of type 2 diabetes mellitus(T2DM)are used to determine predictors with the aim of disease prevention. Established models are used to determine predictors, then assign risk scores or calculate the probability of T2DM development within a certain timeframe. A number of countries and regions have established T2DM risk assessment models, which can be divided into non-invasive and invasive tools, depending on whether they use routinely collected information or laboratory markers. Here, we review the latest progress of two assessment models at the national and international levels, and explore and summarize their applications. The noninvasive Finnish Diabetes Risk Score and the invasive Framingham model are widely used internationally. However, invasive models were more widely applied, as studies on T2DM risk assessment models started relatively late in China.
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Affiliation(s)
- H Y Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
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Zhang HY, Shi WH, Zhang M, Yin L, Pang C, Feng TP, Zhang L, Ren YC, Wang BY, Yang XY, Zhou JM, Han CY, Zhao Y, Zhao JZ, Hu DS. [Establishing a noninvasive prediction model for type 2 diabetes mellitus based on a rural Chinese population]. Zhonghua Yu Fang Yi Xue Za Zhi 2016; 50:397-403. [PMID: 27141894 DOI: 10.3760/cma.j.issn.0253-9624.2016.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To provide a noninvasive type 2 diabetes mellitus (T2DM) prediction model for a rural Chinese population. METHODS From July to August, 2007 and July to August, 2008, a total of 20 194 participants aged ≥18 years were selected by cluster sampling technique from a rural population in two townships of Henan province, China. Data were collected by questionnaire interview, anthropometric measurement, and fasting plasma glucose and lipid profile examination. A total 17 265 participants were followed up from July to August, 2013 and July to October, 2014. Finally, 12 285 participants were selected for analysis. Data for these participants were randomly divided into a derivation group (derivation dataset, n= 6 143) and validation group (validation dataset, n=6 142) by 1∶1, respectively. Randomization was carried out by the use of computer-generated random numbers. A Cox regression model was used to analyze risk factors of T2DM in the derivation dataset. A T2DM prediction model was established by multiplying β by 10 for each significant variable. After the total score was calculated by the model, analysis of the receiver operating characteristic (ROC) curve was performed. The area under the ROC curve (AUC) was used for evaluating model predictability. Furthermore, the model's predictability was validated in the validation dataset and compared with the Finnish Diabetes Risk Score (FINDRISC) model. RESULTS A total 779 of 12 285 participants developed T2DM during the 6-year study period. The incidence rate was 6.12% in the derivation dataset (n=376) and 6.56% in the validation dataset (n=403). The difference was not statistically significant (χ(2)=1.00, P=0.316). A total of four noninvasive T2DM prediction models were established using the Cox regression model. The ROCs of the risk score calculated by the prediction models indicated that the AUCs of these models were similar (0.67-0.70). The AUC and Youden index of model 4 was the highest. The optimal cut-off value, sensitivity, specificity, and Youden index were scores of 25, 65.96%, 66.47%, and 0.32, respectively. Age, sleep time, BMI, waist circumference, and hypertension were selected as predictive variables. Using age<30 years as reference, β values were 1.07, 1.58, and 1.67 and assigned scores were 11, 16, and 17 for age groups 30-44, 45-59, and ≥60 years, respectively. Using sleep time<8.0 h/d as reference, the β value and assigned score were 0.27 and 3, respectively, for sleep time ≥10.0 h/d. Using BMI 18.5-23.9 kg/m(2) as reference, β values were 0.53 and 1.00 and assigned scores 5 and 10, respectively, for BMI 24.0-27.9 kg/m(2), and ≥28.0 kg/m(2). Using waist circumference <85 cm for males/< 80 cm for females as reference, β values were 0.44 and 0.65 and assigned scores 4 and 7, respectively, for 85 cm ≤ waist circumference <90 cm for males/80 cm≤ waist circumference <85 cm for females, and waist circumference ≥90 cm for males/≥85 cm for females. Using nonhypertension as reference, the respective β value and assigned score were 0.34 and 3 for hypertension. The AUC performance of this model and the FINDRISC model was 0.66 and 0.64 (P=0.135), respectively, in the validation dataset. CONCLUSION Based on this cohort study, a noninvasive prediction model that included age, sleep time, BMI, waist circumference, and hypertension was established, which is equivalent to the FINDRISC model and applicable to a rural Chinese population.
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Affiliation(s)
- H Y Zhang
- College of Public Health, Zhengzhou University, Zhengzhou 450001, China
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Zheng ZH, Zhang LJ, Liu WX, Lei YS, Xing GL, Zhang JJ, Quan SX, Liu D, Hu DS, Li LL, Liu ZS. Predictors of survival in Chinese patients with lupus nephritis. Lupus 2012; 21:1049-56. [PMID: 22513365 DOI: 10.1177/0961203312445230] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The current study was to determine the predictors of survival in 491 Chinese patients with lupus nephritis (LN). All patients were evaluated and consecutively followed up from 2003 to 2010. The female: male ratio was 9.5:1, with a median age of 31.1 ± 12 years. Forty-nine (10.0%) patients were lost to follow-up and 47 (10.3%) patients died. The overall cumulative probability of survival at 5, 10, 15 and 20 years by Kaplan-Meier analysis was 88%, 77%, 53% and 45%, respectively. The log-rank test showed that the probability of survival was significantly decreased in the late-onset patients (≥50 years) ( P = 0.036), patients with hypoproteinaemia (≤35 g/l) ( P = 0.014), patients with increased creatinine (≥1.5 mg/dl) ( P = 0.002) and patients with massive proteinuria (≥3.5 g/24 h) ( P = 0.009). However, the probability of survival was significantly higher in patients treated with hydroxychloroquine (HCQ) ( P = 0.003) than those not treated with it. Based on a multivariate model, increased creatinine (hazard ratio (HR) = 2.041; P = 0.017) and proteinuria ≥3.5 g/24hours (HR=1.716; P = 0.016) were independent risk factors. Glucocorticoid (HR = 0.457; P = 0.01) and HCQ (HR=0.197; P = 0.026) were independent protective factors. Our findings suggest that renal dysfunction and massive proteinuria are independent risk factors for mortality. HCQ could improve the survival of patients with LN.
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Affiliation(s)
- ZH Zheng
- Department of Nephrology and Rheumatology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - LJ Zhang
- Department of Nephrology and Rheumatology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - WX Liu
- Department of Nephrology and Rheumatology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - YS Lei
- Department of Nephrology and Rheumatology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - GL Xing
- Department of Nephrology and Rheumatology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - JJ Zhang
- Department of Nephrology and Rheumatology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - SX Quan
- Department of Nephrology and Rheumatology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - D Liu
- Department of Nephrology and Rheumatology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - DS Hu
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, China
- Shenzhen University School of Medicine, Shenzhen, China
| | - LL Li
- Department of Biostatistics, School of Public Health, Zhengzhou University, China
| | - ZS Liu
- Department of Nephrology and Rheumatology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Wu XL, Qiu T, Hu DS, Huang GS, Yuan RK, Siu GG, Chu PK. Resonant electron transfer and luminescent enhancement in a toluene suspension of Si nanocrystals. J Chem Phys 2006; 125:054713. [PMID: 16942247 DOI: 10.1063/1.2227384] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Efficient resonant electron transfer from the surface bonding structure to the conduction band of quantum confined Si nanocrystals is observed by Si nanocrystals in a toluene suspension. Based on the electron transfer mechanism, the enhancement of photoluminescence originates from the band-to-band recombination in the p-type Si nanocrystals suspended in a toluene solution. The energy levels of the electrons in the Si nanocrystals chemisorbed with toluene molecules are calculated using the method of linear combination of atomic orbitals, and the characteristics of the obtained density of states is in good agreement with the observed photoluminescence properties.
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Affiliation(s)
- X L Wu
- National Laboratory of Solid State Microstructures and Department of Physics, Nanjing University, Nanjing 210093, People's Republic of China.
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Hu DS, Hood DW, Heidstra R, Hodgson DA. The expression of the trpD, trpC and trpBA genes of Streptomyces coelicolor A3(2) is regulated by growth rate and growth phase but not by feedback repression. Mol Microbiol 1999; 32:869-80. [PMID: 10361288 DOI: 10.1046/j.1365-2958.1999.01407.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Transformation of tryptophan auxotrophs of Streptomyces coelicolor A3(2) and subsequent analysis have allowed the identification of four tryptophan biosynthetic genes. Subcloning, complementation of trp strains, nucleotide sequencing of 5.1 kb and 1.95 kb of DNA and subsequent homology comparisons identified the trpC, trpB and trpA genes and trpD gene respectively. The arrangement of genes in the trpCBA cluster is unusual in that trpC is separated by a small open reading frame, trpX, from the potentially translationally coupled trpB and trpA genes. Sequence analysis of the trpD gene revealed the presence of a large mRNA loop structure directly upstream of the trpD-coding region. S1 nuclease mapping studies of trpCXBA have revealed two major potential transcription start points, one just upstream of the trpC gene and the other located upstream of the trpX gene. S1 nuclease mapping of the trpD region revealed four fragment end-points. Quantitative S1 nuclease protection assays and a promoterless catechol dioxygenase reporter gene have revealed that the expression of all these genes is growth phase dependent and growth rate dependent, expression being maximal during early exponential phase and dropping off sharply in late exponential phase. This growth phase-dependent and growth rate-dependent regulation is the first reported in streptomycete primary metabolism.
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Affiliation(s)
- D S Hu
- Department of Biological Sciences, University of Warwick, Coventry CV4 7AL, UK
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18
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Hu DS, Silberfarb PM. Management of sleep problems in cancer patients. Oncology (Williston Park) 1991; 5:23-7; discussion 28. [PMID: 1835874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Sleep disturbances are common in cancer patients, but there are few specific data on their prevalence. Among other things, sleep problems may be a symptom of the cancer itself, part of a stress reaction to having cancer, a sequela to some other cancer symptom such as pain, or a side effect of cancer treatment. Insomnia is the more common sleep problem, although hypersomnia also occurs. Most insomnias are related either to pain or to psychophysiologic factors. Treatment should start with identification of a specific cause of sleeplessness; after that, behavioral interventions, medication, or psychotherapy may be helpful. When using medications, keep in mind possible complications, such as daytime sedation, tolerance, and rebound insomnia.
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Liu QY, Zhu CG, Deng DZ, Lu JH, Zhu JX, Chen TX, Wu ZJ, Hu DS. Synaptic connections in the spinal ganglia of the rat. Acta Acad Med Wuhan 1985; 5:1-4. [PMID: 4000585 DOI: 10.1007/bf02856901] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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