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AIM: Gitelman syndrome (GS) is a rare inherited salt-losing renal tubulopathy. Data on clinical features and the pregnancy outcome for female GS patients in a large cohort are lacking. The study was aimed to explore the phenotype and pregnant issue for female GS patients. METHODS: GS cases from the National Rare Diseases Registry System of China (NRSC) were collected, and detailed clinical, laboratory and genetic data were analysed. Articles on pregnancy in GS were also systemically reviewed. RESULTS: A total of 101 GS patients were included; among them, 42.6% were female and 79.2% showed hypomagnesaemia. A lower proportion of female patients presented before 18 years of age, with less frequently reported polyuria, higher serum potassium and less urine sodium and chloride excretions. There was no gender difference in the sodium-chloride cotransporter (NCC) dysfunction evaluated by hydrochlorothiazide test. Twelve of the 43 female GS patients delivered after disease symptom onset, and their pregnancies were generally uneventful. As a group, pregnant GS patients had lower potassium levels in the first-trimester (P = .002) requiring higher potassium supplementation. After delivery, serum potassium (P = .02) and magnesium (P = .03) increased significantly. Both caesarean section and vaginal delivery were safe. CONCLUSION: Female GS patients may have a less severe phenotype with generally favourable outcomes of pregnancy. Intensive monitoring and increased potassium supplementation are necessary during pregnancy, especially in the first-trimester.
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Parto Obstétrico , Síndrome de Gitelman , Potasio , Complicaciones del Embarazo , Miembro 3 de la Familia de Transportadores de Soluto 12/genética , Desequilibrio Hidroelectrolítico , Adulto , China/epidemiología , Cloruros/orina , Parto Obstétrico/métodos , Parto Obstétrico/estadística & datos numéricos , Femenino , Síndrome de Gitelman/epidemiología , Síndrome de Gitelman/genética , Síndrome de Gitelman/fisiopatología , Síndrome de Gitelman/terapia , Humanos , Recién Nacido , Magnesio/sangre , Masculino , Mutación , Poliuria/diagnóstico , Poliuria/etiología , Potasio/sangre , Potasio/uso terapéutico , Embarazo , Complicaciones del Embarazo/epidemiología , Complicaciones del Embarazo/etiología , Complicaciones del Embarazo/fisiopatología , Complicaciones del Embarazo/terapia , Resultado del Embarazo/epidemiología , Eliminación Renal/genética , Sodio/orina , Miembro 3 de la Familia de Transportadores de Soluto 12/metabolismo , Desequilibrio Hidroelectrolítico/sangre , Desequilibrio Hidroelectrolítico/etiología , Desequilibrio Hidroelectrolítico/terapia , Desequilibrio Hidroelectrolítico/orinaRESUMEN
Large-volume cubic high-pressure apparatus is commonly used to produce synthetic diamond. Due to the high pressure, high temperature and alternative stresses in practical production, cracks often occur in the carbide anvil, thereby resulting in significant economic losses or even casualties. Conventional methods are unsuitable for crack detection of the carbide anvil. This paper is concerned with acoustic emission-based crack detection of carbide anvils, regarded as a pattern recognition problem; this is achieved using a microphone, with methods including sound pulse detection, feature extraction, feature optimization and classifier design. Through analyzing the characteristics of background noise, the cracked sound pulses are separated accurately from the originally continuous signal. Subsequently, three different kinds of features including a zero-crossing rate, sound pressure levels, and linear prediction cepstrum coefficients are presented for characterizing the cracked sound pulses. The original high-dimensional features are adaptively optimized using principal component analysis. A hybrid framework of a support vector machine with k nearest neighbors is designed to recognize the cracked sound pulses. Finally, experiments are conducted in a practical diamond workshop to validate the feasibility and efficiency of the proposed method.
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Due to the endurance of alternating high pressure and temperature, the carbide anvils of the high-press apparatus, which are widely used in the synthetic diamond industry, are prone to crack. In this paper, an acoustic method is used to monitor the crack events, and the intelligent monitoring network is proposed to classify the sound samples. The pulse sound signals produced by such cracking are first extracted based on a short-time energy threshold. Then, the signals are processed with the proposed intelligent monitoring network to identify the operation condition of the anvil of the high-pressure apparatus. The monitoring network is an improved convolutional neural network that solves the problems that may occur in practice. The length of pulse sound excited by the crack growth is variable, so a spatial pyramid pooling layer is adopted to solve the variable-length input problem. An adaptive weighted algorithm for loss function is proposed in this method to handle the class imbalance problem. The good performance regarding the accuracy and balance of the proposed intelligent monitoring network is validated through the experiments finally.
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To determine the annual incidence and clinically relevant risk factors for foot ulceration in a large cohort study of diabetic foot ulcer (DFU) patients and diabetes mellitus (DM) patients in China. To investigate a cohort of 1,333 patients comprising 452 DFU patients and 881 DM patients, who underwent foot screening, physical examination, and laboratory tests in eight hospitals. The patients were assessed at baseline in terms of their demographic information, medical and social history, peripheral neuropathy disease (PND) screening, periphery artery disease (PAD) screening, assessment of nutritional status, and diabetic control. One year later, the patients were followed up to determine the incidence of new foot ulcers, amputation, and mortality. By univariate analysis, statistically significant differences were found in age, location, gender, living alone (yes/no), occupation, smoking, hypertension, PND, PAD, nephropathy, retinopathy, cataracts, duration of diabetes, Glycosylated hemoglobin A (HbA1c), fasting plasma glucose level, postprandial blood glucose level, insulin level, blood urea nitrogen, creatinine, cholesterol, triglyeride, high density lipoprotein (HDL), serum albumin, white blood cell, and body mass index. A binary logistic regression model was used to examine which of these risk factors were independent risk factors for foot ulceration. A total of 687 (51.5%) of the 1,333 patients were followed up for an average of 12 months; there were 458 DM patients and 229 DFU patients. A total of 46 patients died during the follow-up period; 13 were DM patients, and 33 were DFU patients. Of the 641 patients, 445 (69.4%) patients were DM patients, and 196 (30.6%) were DFU patients. At follow-up, 36/445 DM patients (8.1%), and 62/196 DFU patients (31.6%), developed new ulcers; 10/196 DFU patients underwent an amputation. The annual incidence of ulceration for DM patients and amputation for DFU patients were 8.1 and 5.1%, respectively. The annual mortality of the DM patients and DMF patients were 2.8 and 14.4%, respectively. A binary logistic regression model was used to examine which risk factors were independent risk factors for foot ulceration during the follow-up period, and the final results showed that nephropathy (odds ratio 2.32), insulin level (odds ratio 3.136, 2.629), and decreased HDL (odds ratio 0.427) were associated with increased risks for foot ulceration. Complications of diabetes affecting the feet represent a serious problem in China. The incidence of foot ulcers and amputation are much higher than that of Western countries. More intensive surveillance and aggressive care following a diagnosis of DFU and earlier referral to specialty care might improve the patient outcome.
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Amputación Quirúrgica/estadística & datos numéricos , Pie Diabético/mortalidad , Hemoglobina Glucada/metabolismo , Examen Físico/métodos , Autocuidado/estadística & datos numéricos , Fumar/mortalidad , Cicatrización de Heridas , Pueblo Asiatico , China/epidemiología , Pie Diabético/fisiopatología , Pie Diabético/terapia , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Evaluación Nutricional , Vigilancia de la Población , Estudios Prospectivos , Factores de Riesgo , Fumar/fisiopatología , Encuestas y CuestionariosRESUMEN
BACKGROUND: The intricate relationship between type 2 diabetes mellitus (T2DM) and diabetic nephropathy (DN) presents a challenge in understanding the significance of various biomarkers in diagnosis. AIM: To elucidate the roles and diagnostic values of α2-macroglobulin (α2-MG), podocalyxin (PCX), α-L-fucosidase (AFU), retinol-binding protein-4 (RBP-4), and cystatin C (CysC) in DN. METHODS: From December 2018 to December 2020, 203 T2DM patients were enrolled in the study. Of these, 115 were diagnosed with DN (115 patients), while the remaining 88 patients were classified as non-DN. The urinary levels of α2-MG, PCX, and AFU and the serum concentrations RBP-4 and CysC were measured in conjunction with other relevant clinical indicators to evaluate their potential correlations and diagnostic utility. RESULTS: After adjustments for age and gender, significant positive correlations were observed between the biomarkers CysC, RBP-4, α2-MG/urinary creatinine (UCr), PCX/UCr, and AFU/UCr, and clinical indicators such as urinary albumin-to-creatinine ratio (UACR), serum creatinine, urea, 24-h total urine protein, and neutrophil-to-lymphocyte ratio (NLR). Conversely, these biomarkers exhibited negative correlations with the estimated glomerular filtration rate (P < 0.05). Receiver operating characteristic (ROC) curve analysis further demonstrated the diagnostic performance of these biomarkers, with UACR showcasing the highest area under the ROC curve (AUCROC) at 0.97. CONCLUSION: This study underscores the diagnostic significance of α2-MG, PCX, and AFU in the development of DN. The biomarkers RBP-4, CysC, PCX, AFU, and α2-MG provide promising diagnostic insights, while UACR is the most potent diagnostic biomarker in assessing DN.
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Parkinson's disease (PD) is a common neurodegenerative pathology whose major clinical symptoms are movement disorders. The main pathological characteristics of PD are the selective death of dopaminergic (DA) neurons in the pars compacta of the substantia nigra and the presence of Lewy bodies containing α-synuclein (α-Syn) within these neurons. PD is associated with numerous risk factors, including environmental factors, genetic mutations and aging. In many cases, the complex interplay of numerous risk factors leads to the onset of PD. The mutated α-Syn gene, which expresses pathologicalα-Syn protein, can cause PD. Another important feature of PD is neuroinflammation, which is conducive to neuronal death. α-Syn is able to interact with certain cell types in the brain, including through phagocytosis and degradation of α-Syn by glial cells, activation of inflammatory pathways by α-Syn in glial cells, transmission of α-Syn between glial cells and neurons, and interactions between peripheral immune cells and α-Syn. In addition to the aforementioned risk factors, PD may also be associated with aging, as the prevalence of PD increases with advancing age. The aging process impairs the cellular clearance mechanism, which leads to chronic inflammation and the accumulation of intracellular α-Syn, which results in DA neuronal death. In the present review, the age-associated α-Syn pathogenicity and the interactions between α-Syn and certain types of cells within the brain are discussed to facilitate understanding of the mechanisms of PD pathogenesis, which may potentially provide insight for the future clinical treatment of PD.
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Aging-related hypogonadism involves complex mechanisms in humans, predominantly relating to the decline of multiple hormones and senile gonads. Late-onset hypogonadism (LOH) and erectile dysfunction (ED) are the main manifestations in men, while premature ovarian insufficiency (POI) and menopause are the main forms in women. Anti-aging measures include lifestyle modification and resistance training, hormonal supplementation, stem cell therapy, metformin, and rapamycin. In this expert consensus, the mechanisms, efficacy, and side effects of stem cell therapy on aging gonadal function are reviewed. Furthermore, various methods of stem cell therapy, administered intravenously, intracavernously, and intra-ovarially, are exemplified in detail. More clinical trials on aging-related gonadal dysfunction are required to solidify the foundation of this topic.
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BACKGROUND: Only 50% of patients with type 2 diabetes mellitus (T2DM) can control their blood glucose levels. Dapagliflozin is a selective inhibitor of sodium-glucose co-transporter 2 (SGLT-2) that improves the insulin sensitivity of the liver and peripheral tissues. Many studies confirmed that SGLT2 inhibitors reduce blood glucose and have multiple beneficial effects such as weight loss, lipid regulation, and kidney protection. Nevertheless, the mechanisms of the renal and cardiovascular protective effects of dapagliflozin from the perspective of differentially expressed proteins in the serum of T2DM patients have not been intensively explored so far. AIM: To identify differentially expressed proteins associated with dapagliflozin treatment in patients with T2DM. METHODS: Twenty T2DM patients [hemoglobin A1c (HbA1c) 7.0%-10.0%] were enrolled at The Affiliated Hospital of Inner Mongolia Medical University between January 1, 2017 and December 1, 2018. They received dapagliflozin (10 mg/d) for 3 mo, and the HbA1c < 7.0% target was achieved. The changes in clinical indexes were compared before and after treatments. Label-free quantitative proteomics was used to identify differentially expressed proteins using the serum samples of five patients. The identified differentially expressed proteins were analyzed using various bioinformatics tools. RESULTS: Dapagliflozin significantly improved the clinical manifestation of the patients. There were 18 downregulated proteins and one upregulated protein in the serum samples of patients after dapagliflozin administration. Bioinformatics analyses, including subcellular localization, EuKaryotic Orthologous Groups, Gene Ontology, and Kyoto Encyclopedia of Genes and Genomes annotations, were used to profile the biological characteristics of the 19 differentially expressed proteins. Based on the literature and function enrichment analysis, two downregulated proteins, myeloperoxidase (MPO) and alpha II B integrin (ITGA2B), and one upregulated protein, podocalyxin (PCX), were selected for enzyme linked immunosorbent assay validation. These validated differentially expressed proteins had multiple correlations with clinical indexes, including HbAc1 and fasting C-peptide. CONCLUSION: Dapagliflozin has hypoglycemic effects and regulates the serum expressions of MPO, ITGA2B, and PCX, possibly contributing to the effects of dapagliflozin on oxidative stress, insulin resistance, and lipid metabolism.
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Single-phase α-cordierite glass-ceramics for a low-temperature co-fired ceramic (LTCC) substrate were fabricated from tuff as the main raw material, using the non-stoichiometric formula of α-cordierite with excess MgO without adding any sintering additives. The sintering/crystallization behavior and the various performances of dielectric properties, thermal expansion, and flexural strength of the glass-ceramics were detected. The results indicated that only single-phase α-cordierite crystal was precipitated from the basic glass sintered at the range 875-950 °C, and µ-cordierite crystal was not observed during the whole sintering-crystallization process. The properties of glass-ceramics were first improved and then deteriorated with the increase in tuff content and sintering temperature. Fortunately, the glass-ceramics sintered at 900 °C with 45 wt.% tuff content possessed excellent properties: high densify (2.62 gâcm-3), applicable flexural strength (136 MPa), low dielectric loss (0.010, at 10 MHz), low dielectric constant (5.12, at 10 MHz, close to α-cordierite), and suitable coefficients of thermal expansion (CTE, 3.89 × 10-6 K-1).
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To construct a highly active g-C3N4 (CN)/silica hybrid nanosystem, the supramolecular precursor strategy of introducing melamine-cyanuric acid (MCA) by synergistically using micromolecular melamine (m) and urea (u) for CN nanostructure construction on the silica nanosheets (SiNSs) surface was researched. The results showed that the introduction of MCA supramolecular aggregates promoted the generation of ordered CN nanostructures attached to SiNSs, and the morphology of the CN nanostructure could be regulated through the m/u mass ratio. When the ratio is equal to 1/30, a typical g-C3N4/silica hybrid nanosheet (mu-CN/SiNSs-3) was successfully prepared, which showed the ultra-high photocatalytic activity for Rhodamine B dye degradation within 25 min with an apparent rate constant of 0.186 min-1, owing to the large surface area of highly dispersed and ordered CN nanosheets, a strong interaction between CN and SiNSs, high photogenerated carriers separation efficiency, and the more negative conduction band potential offering more active species of 1O2 and â¢O2-. Unexpectedly, the mu-CN/SiNSs-2 composite (m/u = 1/10) exhibited the highest activity for tetracycline antibiotic degradation, mainly due to the morphological advantage of a certain number of nanotubes generated on the CN/SiNSs hybrid nanosheets. It indicates that the supramolecular precursor strategy by synergistically using melamine and urea is highly efficient for the nanostructure construction of the CN/SiNSs hybrid system, enabling an appropriate nanostructure for the photodegradation of various pollutants.
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Objective: This study aimed to analyze the clinical characteristics and gene mutations of two families with maturity-onset diabetes of the young 3 (MODY 3) in Inner Mongolia. Methods: Fifty-three patients in Inner Mongolia suspected of having MODY 3 were enrolled in this study according to clinical manifestations. Blood samples were collected, and all exons of the HNF1α gene were analyzed; the second-generation DNA of the splicing regions of the gene was determined by direct sequencing. Results: In Family 1, the proband, mother, and uncle all carried the missense heterozygous mutation on exon 2 of the HNF1α gene (c.512G>A, p.Arg171Gln), and both the proband and uncle had MODY 3. In Family 2, the proband, grandfather, father, uncle I, and uncle II all carried a missense mutation on exon 2 (c.391C>t, p.Arg131Trp), and all had MODY 3. The blood glucose control in these patients was stable while they were being treated with oral sulfonylurea hypoglycemic drugs alone or with insulin. Uncle II had serious macrovascular and microvascular complications. Conclusion: Maturity-onset diabetes of the young 3 gene mutations (c.512G>A, p.Arg171Gln) and (c.391C>T, p.Arg131Trp) may be the main pathogenic genes of the two families with MODY 3. The two gene mutations found in this study have not been reported previously in China.
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Background: Lipoprotein (a) [Lp (a)] has been well recognized as a risk factor of cardiovascular disease. However, the association between serum Lp (a) and diabetic nephropathy in patients with type 2 diabetes mellitus (T2DM) remains unknown. We performed a meta-analysis to comprehensively evaluate the above association. Methods: Observational studies aiming to evaluate the independent association between serum Lp (a) and diabetic nephropathy in T2DM patients were identified by systematic search of PubMed and Embase databases. A random-effect model which incorporated the potential intra-study heterogeneity was used for the meta-analysis. Results: Eleven observational studies with 9304 T2DM patients were included. Results showed that compared to those with the lowest Lp (a), patients with the highest Lp (a) level had higher odds of diabetic nephropathy (adjusted odds ratio [OR]: 1.63, 95% confidence interval [CI]: 1.25-2.14, I2 = 54%, P < 0.001). Meta-analysis of studies in which Lp (a) was presented as continuous variables showed consistent result (adjusted OR: 1.13 for 1 mg/dl increment of Lp (a), 95% CI: 1.03-1.24, I2 = 36%, P = 0.008). Subgroup analyses showed that study characteristics such as definitions of diabetic nephropathy and study design did not significantly affect the association (P for subgroup difference all > 0.05). Conclusions: Higher serum Lp (a) in patients with T2DM is independently associated with higher odds of diabetic nephropathy. Large scale prospective cohort studies are needed to validate this finding. Moreover, the potential influence of Lp (a) lowering on renal function in T2DM patients may be further investigated.
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Diabetes Mellitus Tipo 2/sangre , Nefropatías Diabéticas/sangre , Lipoproteína(a)/sangre , Humanos , Factores de RiesgoRESUMEN
As an emerging nano-silica material, two-dimensional (2D) silica nanosheets (SiNSs) have been derived from natural layered kaolinite and applied as a substrate for the highly efficient and dispersed assembly of functional materials, such as noble metal nanoparticles (NPs). In this work, the nature of SiNSs and its particular role in the assembly of ultra-small AgNPs via the reduction-growth method using a Sn(ii) reductant were further researched. By adjusting the Sn(ii) content x (1.2-6.0 wt%), it was found that the surface areas of the Sn(ii)-activated SiNSs (xSn-SiNSs) had almost no change, and their reducibility did not fully increase with the increased x values, due to the saturated adsorption of the Sn(ii) reductant by the surface hydroxyls of the SiNSs, which subsequently caused the decrease of the adsorbed Ag(i) precursor by the hydroxyls on the xSn-SiNSs (x≥ 4.8 wt%). Accordingly, the sizes and loading amounts of the resultant AgNPs mainly showed a similar trend of increase before decrease. Furthermore, the regulated AgNPs with diverse mean sizes ranging from 1.71 to 2.16 nm were all ultra-small (more than half were nanoclusters < 2 nm) and highly dispersed, owing to the high electrostatic attraction of the negatively charged hydroxyls and the anchoring effect of the micropores on the hydroxylated surface of the Janus SiNSs. Therefore, the Ag/xSn-SiNSs nanocomposites displayed better catalytic properties for 4-nitrophenol reduction than most Ag-based supported catalysts, and the optimal Ag/2.4Sn-SiNSs catalyst exhibited quick reaction within 80 s and turnover frequency (TOF) of 3.34 min-1. It reveals the key role of negatively charged surface hydroxyls and micropores of Janus SiNSs in the highly efficient and dispersed assembly of functional materials.
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High blood glucose level (hyperglycemia) is a leading indicator of diabetes mellitus (DM). Erythrocytes are the most abundant cells in the circulation and the first to perceive changes in plasma composition. Long-lasting hyperglycemia affects the structure and function of erythrocytes. The detection of erythrocyte-related indicators can provide a valuable reference for the prevention, diagnosis, and treatment of DM and its complications. This paper reviews the normal structure and function of erythrocytes, the changes in erythrocytes in patients with diabetes, and the role of erythrocytes in the development of diabetic complications to provide more indicators for the early prevention of DM complications and to monitor the therapeutic effect of DM.
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Glucemia/metabolismo , Diabetes Mellitus/sangre , Eritrocitos/metabolismo , Animales , Biomarcadores/sangre , Diabetes Mellitus/diagnóstico , Índices de Eritrocitos , Eritrocitos/patología , Hemoglobina Glucada/metabolismo , Humanos , Valor Predictivo de las PruebasRESUMEN
Chiglitazar (Carfloglitazar) is a novel peroxisome proliferator-activated receptor (PPAR) pan-agonist that has shown promising effects on glycemic control and lipid regulation in patients with type 2 diabetes. In this randomized phase 3 trial, we compared the efficacy and safety of chiglitazar with sitagliptin in patients with type 2 diabetes who had insufficient glycemic control despite a strict diet and exercise regimen. Eligible patients were randomized (1:1:1) to receive chiglitazar 32 mg (n = 245), chiglitazar 48 mg (n = 246), or sitagliptin 100 mg (n = 248) once daily for 24 weeks. The primary endpoint was the change in glycosylated hemoglobin A1C (HbA1c) from baseline at week 24 with the non-inferiority of chiglitazar over sitagliptin. Both chiglitazar and sitagliptin significantly reduced HbA1c at week 24 with values of -1.40%, -1.47%, and -1.39% for chiglitazar 32 mg, chiglitazar 48 mg, and sitagliptin 100 mg, respectively. Chiglitazar 32 and 48 mg were both non-inferior to sitagliptin 100 mg, with mean differences of -0.04% (95% confidential interval (CI) -0.22 to 0.15) and -0.08% (95% CI -0.27 to 0.10), respectively. Compared with sitagliptin, greater reduction in fasting and 2-h postprandial plasma glucose and fasting insulin was observed with chiglitazar. Overall adverse event rates were similar between the groups. A small increase in mild edema in the chiglitazar 48 mg group and slight weight gain in both chiglitazar groups were reported. The overall results demonstrated that chiglitazar possesses good efficacy and safety profile in patients with type 2 diabetes inadequately controlled with lifestyle interventions, thereby providing adequate supporting evidence for using this PPAR pan-agonist as a treatment option for type 2 diabetes.
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Diabetes Mellitus Tipo 2 , Fosfato de Sitagliptina , Humanos , Fosfato de Sitagliptina/efectos adversos , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Receptores Activados del Proliferador del Peroxisoma , Hipoglucemiantes/efectos adversosRESUMEN
BACKGROUND: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. METHODS: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. RESULTS: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. CONCLUSION: The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.
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Hipertensión , Hipotiroidismo , Adolescente , Adulto , Anciano , Presión Sanguínea , Femenino , Humanos , Hipertensión/epidemiología , Hipotiroidismo/diagnóstico , Hipotiroidismo/epidemiología , Masculino , Valores de Referencia , Tirotropina , Estados UnidosRESUMEN
Primary aldosteronism (PA) is a category of secondary hypertension induced by inhibition of the renin-angiotensin system due to increased aldosterone secretion. Aldosterone-producing adenoma (APA) is the most common hypotype of PA. Primary hyperparathyroidism (PHPT) refers to the symptoms of increased bone resorption and increased calcium reabsorption of kidney tubules caused by parathyroid secretion and excessive synthesis of parathyroid hormone. APA, complicated with PHPT has been extremely rare in clinical practice. In this study, the diagnosis and treatment of one case of APA complicated by PHPT was reported. Relevant literature review was performed.
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Accumulating evidence suggests that smoking is associated with diabetic foot amputation. However, the currently available results are inconsistent and controversial. Therefore, the present study performed a meta-analysis to systematically review the association between smoking and diabetic foot amputation and to investigate the risk factors of diabetic foot amputation. Public databases, including PubMed and Embase, were searched prior to 29th February 2016. The heterogeneity was assessed using the Cochran's Q statistic and the I2 statistic, and odds ratio (OR) and 95% confidence interval (CI) were calculated and pooled appropriately. Sensitivity analysis was performed to evaluate the stability of the results. In addition, Egger's test was applied to assess any potential publication bias. Based on the research, a total of eight studies, including five cohort studies and three case control studies were included. The data indicated that smoking significantly increased the risk of diabetic foot amputation (OR=1.65; 95% CI, 1.09-2.50; P<0.0001) compared with non-smoking. Sensitivity analysis demonstrated that the pooled analysis did not vary substantially following the exclusion of any one study. Additionally, there was no evidence of publication bias (Egger's test, t=0.1378; P=0.8958). Furthermore, no significant difference was observed between the minor and major amputation groups in patients who smoked (OR=0.79; 95% CI, 0.24-2.58). The results of the present meta-analysis suggested that smoking is a notable risk factor for diabetic foot amputation. Smoking cessation appears to reduce the risk of diabetic foot amputation.
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Hierarchical porous SiO2-AlOOH composite nanosheets (HPSA) with a three-dimensional (3D) structure were prepared from two-dimensional (2D) layered mineral kaolinite (A12Si2O5(OH)4) via a template-free structural reorganization method. The obtained material was subjected to homogeneous and effective amino-functionalization by grafting it with (3-aminopropyl) triethoxysilane. Owing to the enhanced 3D hierarchical meso-macroporous structure containing highly dispersed protonated amino groups (NH3+), the as-prepared amino-functionalized HPSA (NH2-HPSA) showed unique adsorption performance towards the congo red anionic dye. It provides feasibilities to fabricate other functional hierarchical porous materials from clay minerals, which can offer potential applications in adsorption, separation, catalysis and other environmental remediation fields.