Prevalence of hypertension among type 2 diabetes mellitus patients in China: a systematic review and meta-analysis.

This study aimed to estimate the prevalence of hypertension in Chinese patients with type 2 diabetes mellitus (T2DM) using the results of a regional study. The studies were reviewed using PubMed, EMBASE, Web of Science, the Cochrane Library, China National Knowledge Infrastructure, China Biology Medicine, Wan Fang Data and Chinese Science Citation Database. After screening articles and data extraction, Stata V.16 was used for statistical analysis. This study was registered in the Prospective Register Systematic Reviews (CRD42020170649). A total of 2126 articles were identified, and nine papers were finally included. Random-effects modelling showed that the pooled prevalence of hypertension among Chinese patients with T2DM was 54% (95% CI 47 to 61%). Subgroup analysis showed that the prevalence in men (59.8%; 95% CI 49.0 to 70.7%) was higher than that in women (40.2%; 95% CI 29.3 to 59.2%). The prevalence in North China was higher than that in East China. The prevalence in institution-based settings (56%; 95% CI 48 to 64%) was higher than that in community-based settings (51%; 95% CI 34 to 69%). Appropriate preventive measures should be undertaken, such as health education, to control and reduce the risk of hypertension in diabetic patients and reduce the burden of cardiovascular disease.

Association of educational attainment with hypertension and type-2 diabetes: A Mendelian randomization study.

BACKGROUNDDue to the long time interval between exposure and outcome, it is difficult to infer the causal relationship between educational attainment (EA) and common chronic diseases. Therefore, we utilized Mendelian randomization (MR) to predict the causal relationships of EA with hypertension and type-2 diabetes (T2DM). METHODSA two-sample MR analysis was conducted using genome-wide association studies (GWASs) combined with inferential measurements. A GWAS meta-analysis including 1,131,881 European individuals was used to identify instruments for EA. Hypertension and T2DM data were obtained from a Finnish database. MR analyses were performed using inverse-variance weighted meta-analysis (IVW), weighted median regression, MR‒Egger regression, simple mode regression, weighted mode regression and the MR-Pleiotropy RESidual Sum and Outlier test. Sensitivity analyses were further performed using the leave-one-out method to test the robustness of our findings. RESULTSUsing the MR approach, our results showed that EA was significantly associated with a reduced risk of hypertension (OR = 0.63; P = 2.94 × 10-47; [95% CI: 0.59, 0.67]) and type-2 diabetes (OR = 0.59; P = 1.25 × 10-16; [95% CI: 0.52, 0.67]). CONCLUSIONSThis study showed that EA is causally linked to the risk of chronic diseases, including high blood pressure and T2DM.

[Effects of moxibustion at Yongquan (KI 1) on cognition function and lower limb motor function in patients with post-stroke cognitive impairment of kidney essence deficiency].

OBJECTIVE: To observe the effects of moxibustion at Yongquan（KI 1） on the cognitive function and lower limb motor function in patients with post-stroke cognitive impairment of kidney essence deficiency. METHODS: Eighty-four patients with post-stroke cognitive impairment of kidney essence deficiency were randomly divided into an observation group（42 cases，1 case dropped off）and a control group（42 cases，1 case dropped off）.The control group was treated with medication，electroacupuncture，rehabilitation training and repetitive transcranial magnetic stimulation（rTMS）；on the basis of the treatment as the control group，moxibustion at bilateral Yongquan（KI 1）was adopted in the observation group.Both groups were treated once a day，5 days a week with 2-day interval，4 weeks were required. The Montreal cognitive assessment (MoCA) score, mini-mental state examination (MMSE) score, Fugl-Meyer assessment-lower extremity (FMA-LE) score, Berg balance scale (BBS) score, functional independence measure (FIM) score, modified fall efficacy scale (MFES) score and scale for the differentiation of syndromes of vascular dementia (SDSVD) score before and after treatment were observed in the two groups. RESULTS: After treatment，the MoCA, MMSE, FMA-LE, BBS, FIM and MFES scores were higher than those before treatment in both groups (P<0.05), and the scores in the observation group were higher than those in the control group (P<0.05). After treatment，the SDSVD scores were lower than those before treatment in both groups (P< 0.05), and the SDSVD score in the observation group was lower than that in the control group (P< 0.05). CONCLUSION: Moxibustion at Yongquan（KI 1） can improve the cognitive function and motor and balance function of lower limbs in patients with post-stroke cognitive impairment of kidney essence deficiency，reduce the risk of fall and improve the quality of life.

[Modified laparoscopic transabdominal preperitoneal repair of groin hernias].

OBJECTIVE: To assess the clinical value of modified transabdominal preperitoneal (TAPP) repair of groin hernias in adult patients. METHOD: From May 2006 to April 2008, modified TAPP repair for hernia was performed in 403 adult patients with groin hernia and 22 with femoral hernia. Indirect hernia sac was treated by high ligation of the hernia sac in similar fashion with the management in children, while direct or femoral hernia was treated by dissecting the hernia sac. An incision was made on the lateral umbilical ligament, and the mesh was stapled and covered completely by the peritoneum of the lateral umbilical ligament, followed by fixation of the mesh with stapling and absorbable sutures. RESULTS: All the operations were accomplished successfully with the operating time from 20 to 30 min for unilateral hemioplasty and the blood loss volume was 4-5 ml. Two patients developed scrotal edema and three showed scrotal seroma. No hernia recurrence was found in follow-up for 2-22 months. The patients complained of no intestinal obstruction symptoms including traction pain, abdominal pain, or nausea or urinary bladder stimulation symptoms. CONCLUSIONS: Modified TAPP repair of groin hernias requires simple operation and produces reliable effect, and is therefore of clinical values for wide application.

[Microlaparoscopic treatment of adhesive intestinal obstruction in children].

OBJECTIVE: To evaluate the clinical significance of microlaparoscopic treatment for adhesive intestinal obstruction in children. METHODS: Adhesion -lysis operation was performed in 18 patients with adhesive intestinal obstruct ion by microlaparoscope from March 2001 to January 2004. The clinical data were analyzed retrospectively. RESULTS: Microlaparoscope assisted accretion-lysis operation was successfully performed in all patients. The operative time ranged from 15 min to 45 min (averaged 30 min), the aerofluxus time ranged from 12 hours to 28 hours (averaged 22 hours) after operation. All patients can take general activity at the first day and take in food at the second day after operation respectively. The hospital stay ranged from 3 to 5 days (averaged 4 days) without complications. All patients were followed-up from 3 months to 18 months (average d 6 months). All patients recovered well without occurrence of adhesive intestinal obstruction. CONCLUSIONS: Micro-laparoscope assisted adhesion-lysis operation is a simple,safe,and feasible approach for adhesive intestinal obstruction in children.