Overweight, obesity and risk of all-cause and cardiovascular mortality in patients with type 2 diabetes mellitus: a dose-response meta-analysis of prospective cohort studies.

Overweight and obese individuals with type 2 diabetes are recommended to lose weight, but the associations between excess body weight and all-cause and cardiovascular mortality in patients with type 2 diabetes remain controversial. Therefore, we performed a dose-response meta-analysis to investigate this association. We searched PubMed and Embase through 19th October 2014 and examined the references of retrieved articles to identify relevant prospective cohort studies. A random-effect model was used to calculate the summary risk estimates. Nine studies including 13 cohorts with 161,984 participants were identified. The relative risks (RRs) of all-cause mortality in overweight and obese patients with type 2 diabetes were 0.81 (95% confidence interval (CI) 0.74-0.90) and 0.72 (95% CI 0.63-0.81) respectively, compared with the normal or non-overweight patients. Furthermore, a 5 kg/m(2) increase in body mass index was associated with a significantly reduced risk of all-cause mortality by 5% (RR 0.95, 95% CI 0.93-0.97). However, no significant association was found between obese and/or overweight and the risk of cardiovascular mortality in type 2 diabetic patients (RR 0.89; 95% CI 0.66-1.20 for overweight and RR 0.77; 95% CI 0.54-1.10 for obesity, respectively). The findings from the present meta-analysis indicate that excess body weight may be a protective factor for all-cause mortality among patients with type 2 diabetes.

Analysis of the inhibitory effect of a refined human resources salary system on job transfer and transfer tendency of nurses.

To evaluate the impact of a refined human resources salary system on job transfer and transfer tendency. From January 2019 to December 2019, a refined human resources salary system reform was implemented at the Tangshan Workers' Hospital in Hebei Province, and the job transfer and transfer tendency of clinical nurses was assessed using the nurse job transfer tendency scale before and 1 year after the intervention. A total of 640 nurses completed the intervention and evaluation. The results showed that the job transfer rate following the intervention reduced to 0.22%. The total score of clinical nurse job transfer tendency was (10.80 ±â€…3.23) before the intervention and (9.66 ±â€…3.58) after 1 year of intervention, which was substantially lower (P < .001). The satisfaction scores of nurses on performance-based salary increased significantly from (67.83 ±â€…18.54) before the intervention to (80.66 ±â€…15.87) after intervention, with varying degrees of increase observed in each dimension (P < .001). The refined human resources salary system effectively reduced job transfer and transfer tendency of clinical nurses in hospital nursing management, and can be widely promoted and applied.

[Clinical value of radial endorectal ultrasound in the assessment of preoperative staging of rectal carcinoma].

OBJECTIVE: To evaluate the clinical value of radial endorectal ultrasound (ERUS) in the assessment of preoperative staging of rectal carcinoma. METHODS: One hundred and ten patients with rectal cancer underwent preoperative endorectal ultrasound (ERUS) examination in our hospital from February 2010 to September 2011. ERUS was performed using a Hitachi 900, Hitachi HI Vision Preirus US scanner, with a 5 - 10 MHz rigid rotating radial transducer and a focal length of 2 - 5 cm. The size, shape, echo pattern, infiltration depth, degree of circumferential involvement, extra-rectal invasion of the lesions and lymph node involvement were observed. The results of ERUS staging were compared with histopathological findings of the surgical specimens. RESULTS: The accuracy of ERUS for T staging was 91.4%. The accuracy of ERUS in diagnosing stage T1, T2, T3, T4 cancers was 92.7%, 88.2%, 88.2% and 96.4%, respectively. The sensitivity of ERUS in diagnosing stage T1, T2, T3, T4 cancers was 92.3%, 72.7%, 85.4% and 71.4%, respectively. The specificity of ERUS in diagnosing stage T1, T2, T3, T4 cancer was 92.9%, 92.0%, 90.3% and 100.0%, respectively. Comparing the consistency of preoperative T-staging and postoperative pathological results, the Kappa value was 0.75, with a considerable consistency. The sensitivity, specificity, and accuracy of ERUS in the assessment of lymph node metastasis were 74.2%, 89.9% and 85.5%, respectively. Comparing the consistency of preoperative N-staging and postoperative pathological results, the Kappa value was 0.64, with a considerable consistency. CONCLUSIONS: ERUS is a practical and accurate tool in assessment of preoperative staging of rectal tumors in regard to tumor invasion depth (T) and regional lymph node status (N), with advantages of simple operation, less pain, and high accuracy.

[Ultrasonic scores of conventional ultrasound and ultrasound elastography in the diagnosis of thyroid nodular lesions].

OBJECTIVE: To explore the values of total ultrasonic scores of conventional ultrasound and ultrasound elastography in the diagnosis of thyroid nodular lesions. METHODS: A total of 347 thyroid nodules proved by fine-needle aspiration cytology (FNAC) and surgery underwent preoperative conventional ultrasound and ultrasound elastography. The features on gray scale, color Doppler flow imaging (CDFI) and elastograms were documented and total ultrasonic scores recorded. RESULTS: Among 347 nodules, 184 nodules were benign and 163 malignant. Significant differences of total ultrasonic scores were found between thyroid carcinoma and benign nodular lesions including the parameters of nodular shape, edge, echoes, sound attenuation, psammous calcifications, internal blood flow and ultrasound elastography score. The higher the total ultrasonic scores, the more possibility of thyroid carcinoma was. By the analysis of receiver operating characteristic curve, the sensitivity, specificity and accuracy of distinguishing thyroid carcinoma from benign nodular lesions was 84.0%, 89.6% and 84.9% if the cut-off value of total ultrasonic scores was over 4. CONCLUSION: For the differential diagnosis of benign and malignant thyroid lesions, the total ultrasonic scores of conventional ultrasound and ultrasound elastography can offer greater values.

Aortic root dilatation is associated with carotid intima-media thickness but not with carotid plaque in hypertensive men.

BACKGROUND: The role of atherosclerosis-related processes in aortic root dilatation (ARD) has not been fully determined. The present study was to assess the relationship between carotid IMT, carotid plaque, and ARD. METHODS: Hypertensive men with ARD (n = 30) were compared with hypertensive men without ARD (n = 52) and normal control subjects (n = 29). Two-dimensional echocardiography was used to measure the aortic root at the aortic annulus, the sinus of Valsalva, the sinotubular junction and the proximal part of the ascending aorta. Carotid IMT and carotid plaque were also assessed by ultrasound. RESULTS: The measured mean carotid IMT was significantly increased in patients with ARD (1.37 +/- 0.80 mm) compared to the subjects without ARD (1.06 +/- 0.54 mm) and healthy control subjects (0.84 +/- 0.44 mm) (P < 0.05). However, no significant differences of the prevalence of carotid plaque were found in the three groups (P > 0.05). Aortic diameters at all levels except for the diameter of the supra-aortic ridge were significantly related to carotid IMT when the hypertensive population was considered (P < 0.05). No significant correlation was found between carotid plaque and aortic root dimension (P > 0.05). CONCLUSION: This study shows that carotid intima-media thickening, but not carotid atherosclerotic plaque, is positively associated with ARD. Further studies to explore the underlying mechanism are awaited.

[Diagnostic value of lesion-directed prostate biopsy under TRUS in early detection of prostate cancer].

OBJECTIVE: To evaluate lesion-directed biopsy in improving the detection rate of early prostate cancer (PCa) and in differentiating PCa from other prostate pathological changes. METHODS: We performed TRUS-guided prostate biopsy for 95 patients suspected of PCa, each subjected to extended random biopsy plus lesion-directed biopsy, and analyzed the sonographic characteristics and pathological findings. RESULTS: PCa was detected in 35 of the patients (36.8%), including 16 hypoechoic (45.7%), 4 hyperechoic (11.4%), 10 isoechoic (28.6%) and 5 mixed hetero-echoic lesions (14.3%). Of the 35 PCa cases, 17 (46.2%) were within T2b, 70.6% (12/17) of which were detected by lesion-directed biopsy and 29.4% (5/17) by sextant biopsy, the former obviously higher than the latter (P < 0.05). CONCLUSION: Lesion-directed prostate biopsy under TRUS can significantly improve the early diagnosis of prostate cancer, increase convenience and reduce patients' pain, but is not sufficient to replace traditional sextant biopsy.

A retrospective study of patients with systemic lupus erythematosus combined with Pneumocystis jiroveci pneumonia treated with caspofungin and trimethoprim/sulfamethoxazole.

Systemic lupus erythematosus (SLE) complicated with Pneumocystis jiroveci pneumonia (PCP) is a clinical complex with unsatisfying treatment efficacy and poor prognosis which is difficult to be diagnosed at early stage. The present study aimed to investigate the clinical features of SLE with PCP, recognize the early onset indicating factors, and evaluate the treatment efficacy of combined caspofungin and trimethoprim/sulfamethoxazole (coSMZ).We reviewed data of 9 patients admitted with SLE-PCP and treated with caspofungin combined with coSMZ at Tangshan Gongren Hospital from January 2013 to December 2017. Patients' clinical manifestation and laboratory data [leucocyte, lymphocyte, cluster of differentiation 4 (CD4)T cell, lactate dehydrogenase (LDH), blood gas, etc] were compared before and after treatments. And the early onset factors of SLE-PCP, treatment efficacy of combined caspofungin and CoSMZ were analyzed.Among these 9 patients, 8 patients suffered renal impairment, and all of them had been taking prednisone in the past 3 months at an average dose of 29.4 ±â€Š13.6 mg/day. In addition, they had taken at least one kind of immunosuppressants. Laboratory data (leucocyte, lymphocyte, CD4T cell, PaO2, LDH) were remarkably abnormal at hospital admission, but they were improved significantly after 2 weeks of treatment, which is also statistically significant (P < .05), except that leukocyte had no significance change to the value at admission (P = .973). In addition, none of the studied patients died.The results of the study indicated that long-term use of glucocorticoids and immunosuppressants, low CD4T cell count, and renal impairment are the early-onset factors for SLE-PCP, caspofungin, when combined with CoSMZ, it could be a promising and effective strategy to treat SLE with PCP.

[Enhancement pattern of peripheral lung carcinoma:comparison between contrast-enhanced ultrasonography and contrast-enhanced computed tomography].

OBJECTIVE: To compare the enhancement pattern of low mechanical index contrast-enhanced ultrasonography (CEUS) in peripheral lung carcinoma with contrast-enhanced helical CT (CECT). METHODS: Thirty-five patients with peripheral lung carcinoma underwent CEUS performed with the contrast agent SonoVue at a low mechanical index contrast specific mode and CECT performed with the contrast agent Ultravist at a standard biphasic helical CT scanning protocol. The enhancement pattern related to tumor vascularity was analyzed. RESULTS: By using contrast-enhanced sonography, hyper-enhancement patterns were manifested in 57.1% (20/35) of the lesions and hypo-enhancement in 40% (14/35); both not significantly different from those manifested by using CECT [42.9% (15/35) and 54.3% (19/35) of the lesions respectively, both P > 0.05]. By using CEUS, inhomogeneous enhancement pattern rate in the lesions was 68.6% (24/35) and the homogeneous enhancement rate was 28.6%(10/35), both not significantly different from those of the CECT group [74.3% (26/35) and 22.9% (8/35) respectively, both P > 0.05]. The non-enhancement rates of CEUS and CECT group were both 2.9% (1/35). The enhancement intensity dB value of the CEUS group was positively correlated with the CT value of the CECT tumors (r = 0.836, P < 0.001). CONCLUSION: The diagnostic value of contrast-enhanced sonography is similar to that of enhancement CT in detecting peripheral lung carcinoma's vascularity.

[Qualitative evaluation of thyroid nodules with gray-scale contrast-enhanced ultrasound].

OBJECTIVE: To assess the feasibility of gray-scale contrast-enhanced ultrasound for characterizing thyroid nodules. METHODS: Forty thyroid nodules from 35 patients were studied both by conventional techniques and gray-scale contrast-enhanced ultrasound. Of the nodules examined, 15 were benign and 25 malignant. The enhancement of echogenicity was evaluated. The diagnosis was confirmed by surgical biopsy and histopathological examination. RESULTS: The study using gray-scale contrast-enhanced ultrasound showed absent contrast-enhancement in 9 of 25 malignant nodules and 1 of 11 benign solitary nodules; intense enhancement in 6 of 25 malignant nodules, with perfusion defect in the center; diffuse faint enhancement in 10 of 25 malignant nodules and 10 of 11 benign solitary nodules. Benign cystic nodules all showed absent enhancement in the cystic components and 2 of 4 intense enhancement in the solitary components. CONCLUSIONS: Gray-scale contrast-enhanced ultrasonography imaging may be a useful tool for evaluating the perfusion of thyroid nodules. Solitary nodules showing absent enhancement or intense enhancement with absent enhancement in the nodular center may suggest malignant.

Protective effects of Momordica grosvenori extract against lipid and protein oxidation-induced damage in dried minced pork slices.

The experiment was conducted to assess the protective effects of Momordica grosvenori extract (MGE) against lipid and protein oxidation-induced damage in vacuum-packed dried minced pork slices stored at room temperature for 21days. Antioxidant activity of MGE was evaluated by measuring its radical scavenging activities and reducing power with progressive concentrations from 40 to 200g/L. MGE was added to the dried minced pork slices at 7, 10 or 15g/100g. Results showed that inclusion of MGE in dried minced pork slice significantly delayed the formation of hexanal, thiobarbituric acid-reactive substances and carbonyls and reduced the sulfhydryl loss in a dose-dependent manner (P<0.05), indicating that MGE exerted a protective effect against lipids and protein oxidation. Concomitantly, an intense increase of redness and loss of lightness and yellowness was found to take place (P<0.05), though it exhibited little negative effects on the sensory properties of slices. Mogrosides, the main bioactive components in M. grosvenori, decreased primarily during processing while they were relatively stable during storage under vacuum condition, room temperature. All these results demonstrated MGE had great potential as a natural antioxidant used in meat products.

Dietary total flavonoids intake and risk of mortality from all causes and cardiovascular disease in the general population: A systematic review and meta-analysis of cohort studies.

SCOPE: Epidemiologic studies assessing the association between dietary total flavonoids intake and the risk of mortality from cardiovascular disease (CVD) and all causes have yielded inconsistent results. Therefore, we conducted a dose-response meta-analysis to investigate this association. METHOD AND RESULTS: We searched PubMed and Embase databases from January 1966 through May 2016 and examined the references of retrieved articles to identify relevant prospective cohort studies. The random-effect model was used to calculate the summary risk estimates and dose-response analysis was performed. Ten studies were included in the present meta-analysis. The relative risk (RR) of all-cause mortality for the highest versus lowest category of total flavonoids intake was 0.82 (95% confidence interval (CI): 0.72-0.92). Dose-response analysis showed that those consuming 200 mg/day of total flavonoids had the lowest risk of all-cause mortality. Furthermore, a marginally significant association was found between dietary total flavonoids consumption and risk of death from CVD (summary RR: 0.85; 95% CI: 0.70-1.03; P = 0.099) and coronary heart diseases (summary RR: 0.74; 95% CI: 0.54-1.02; P = 0.069), respectively. CONCLUSION: The meta-analysis provides strong evidence for the recommendation of consuming flavonoids-rich food to reduce risks of mortality from all causes as part of a healthy diet among general adults.

Characteristics of fecal microbial communities in patients with non-anastomotic biliary strictures after liver transplantation.

AIM: To explore the possible relationship between fecal microbial communities and non-anastomotic stricture (NAS) after liver transplantation (LT). METHODS: A total of 30 subjects including 10 patients with NAS, 10 patients with no complications after LT, and 10 non-LT healthy individuals were enrolled. Fecal microbial communities were assessed by the 16S rRNA gene sequencing technology. RESULTS: Different from the uncomplicated and healthy groups, unbalanced fecal bacterium ratio existed in patients with NAS after LT. The results showed that NAS patients were associated with a decrease of Firmicutes and Bacteroidetes and an increase of Proteobacteria at the phylum level, with the proportion-ratio imbalance between potential pathogenic families including Enterococcaceae, Streptococcaceae, Enterobacteriaceae, Pseudomonadaceae and dominant families including Bacteroidaceae. CONCLUSION: The compositional shifts of the increase of potential pathogenic bacteria as well as the decrease of dominant bacteria might contribute to the incidence of NAS.

An automatic step adjustment method for average power analysis technique used in fiber amplifiers.

An automatic step adjustment (ASA) method for average power analysis (APA) technique used in fiber amplifiers is proposed in this paper for the first time. In comparison with the traditional APA technique, the proposed method has suggested two unique merits such as a higher order accuracy and an ASA mechanism, so that it can significantly shorten the computing time and improve the solution accuracy. A test example demonstrates that, by comparing to the APA technique, the proposed method increases the computing speed by more than a hundredfold under the same errors. By computing the model equations of erbium-doped fiber amplifiers, the numerical results show that our method can improve the solution accuracy by over two orders of magnitude at the same amplifying section number. The proposed method has the capacity to rapidly and effectively compute the model equations of fiber Raman amplifiers and semiconductor lasers.

Optical properties of electrospun nanofibers of conducting polymer-based blends.

Conducting polymers were electrospun into fibers with other spinnable polymers. The optical properties of the electrospun fibers were characterized in comparison with spin-cast thin films. The electrospun conducting polymer-based fibers with different fiber diameters of 100 nm and 1 microm were prepared. Aligned nanofibers were prepared using a rotating disc collector in order to induce molecular orientation in the electrospun fibers. The effect of electrospinning processes on the optical properties was discussed in terms of fiber diameter and molecular orientation.

Ultrasonographic findings at the resected area after hepatectomy.

BACKGROUND: Since hepatectomy has been widely performed, different operative manner, operating areas, and material in the residual cavity may be found ultrasonographically near the resected area after the operation. In this study, we investigated the changes of focal ultrasonography at the resected area post hepatectomy and recognized the characteristic ultrasonographic images. METHODS: 176 patients whose ultrasonographic findings were studied in the residual area during the early and later periods after hepatectomy were retrospectively analyzed in terms of operative manner, operative area, and material in the residual cavity. RESULTS: There were absence of partial hepatic lobe or hepatic segment, focal anechoic area with thin wall or mixed mass at the resected area, and conformation of irregular high-echoic conglomeration at the resected area, cystic non-anechoic area, and mixed mass with irregularly thickened wall at the resected area, inconsistent internal echoes, and color Doppler twinking artifacts around the material and the residual cavity after curettage and aspiration. CONCLUSIONS: Focal ultrasonographic findings at the resected area after hepatectomy vary with different operative procedures, operative area, resection size, absence or existence of material, and kinds of material in the residual cavity.

[Application of real-time tissue elastography in diagnosis of breast cancer].

OBJECTIVE: To investigate the clinical value of real-time tissue elastography (RTE) in the diagnosis of breast cancer. METHODS: One hundred and twenty patients with breast lumps (135 lesions) were examined with B-mode imaging, color Doppler flowing imaging (CDFI) and RTE. The elastogram was graded using 5-score evaluating method. The postoperative pathological diagnosis was used as gold standard, and the sensitivity, specificity and accuracy of RTE and two-dimensional ultrasonography combined with RTE in diagnosis of breast cancer were calculated. RESULT: When the score >4 was set for cut-off criteria of malignancy, the sensitivity, specificity and accuracy of RTE was 85.45%, 83.75% and 84.4%, respectively. While two-dimensional ultrasonography combined with RTE was used, the sensitivity, specificity and accuracy increased up to 100%, 95% and 97%, respectively. CONCLUSION: RTE combined with two-dimensional ultrasonography can improve the validity in the diagnosis of malignant breast lesions.

Methane Production from Rice Straw Hydrolysate Treated with Dilute Acid by Anaerobic Granular Sludge.

The traditional anaerobic digestion process of straw to biogas faces bottlenecks of long anaerobic digestion time, low digestion rate, less gas production, etc., while straw hydrolysate has the potential to overcome these drawbacks. In this study, the dilute sulphuric acid-treated hydrolysate of rice straw (DSARSH) containing high sulfate was firstly proved to be a feasible substrate for methane production under mesophilic digestion by granular sludge within a short digestion time. Batch anaerobic digestion process was operated under different initial chemical oxygen demand (COD) values at temperature of 37 °C with the pH of 8.5. Among the initial COD values ranging from 3000 to 11,000 mg/L, 5000 mg/L was proved to be the most appropriate considering high COD removal efficiency (94.17 ± 1.67 %), CH4 content (65.52 ± 3.12 %), and CH4 yield (0.346 ± 0.008 LCH4/g COD removed) within 120 h. Furthermore, when the studied system operated at the initial COD of 5000 mg/L, the sulfate removal ratio could reach 56.28 %.

A Novel Mesophilic Anaerobic Digestion System for Biogas Production and In Situ Methane Enrichment from Coconut Shell Pyroligneous.

A novel mesophilic anaerobic digestion process with detoxification-treated coconut shell pyroligneous was established, exhibiting an effective advantage in biogas production. The pyroligneous collected contained 166.2 g l(-1) acetic acid, indicating great potential for biogas production. Detoxification was an effective way of simultaneously enriching biodegradable ingredients and removing inhibitors (mainly as phenols and organic acids) for digestion process. The digestion process lasted 96 h and fermentation characteristics (chemical oxygen demand (COD) removal ratio, volatile fatty acid (VFA) consumptions, pH, total gas, methane yield, and phenol removal efficiency) were measured. The experiments successfully explored the optimum detoxification parameters, oxidized with 10 % H2O2 followed by overliming, and demonstrated 89.3 % COD removal, 91.4 % methane content, 0.305 LCH4/g COD removed CH4 yield, and 88.81 % phenol removal ratio. This study provided clues to overcome the negative effects of inhibitors in pyroligneous on biogas production. The findings could contribute to significant process in detoxified pretreatment of pyroligneous and develop an economically feasible technology for treating pyroligneous after producing charcoal.

Mulberry anthocyanin biotransformation by intestinal probiotics.

This study was designed to evaluate mulberry anthocyanins bioconversion traits for intestinal probiotics. Five intestinal beneficial bacteria were incubated with mulberry anthocyanins under anaerobic conditions at 37°C, and bacterial ß-glucosidase activity and anthocyanin level were determined. Results demonstrated that all strains could convert mulberry anthocyanins to some extent. With high ß-glucosidase production capacity, Streptococcus thermophiles GIM 1.321 and Lactobacillus plantarum GIM 1.35 degraded mulberry anthocyanins by 46.17% and 43.62%, respectively. Mulberry anthocyanins were mainly biotransformed to chlorogenic acid, crypto-chlorogenic acid, caffeic acid, and ferulic acid during the anaerobic process. Non-enzymatic deglycosylation of anthocyanins also occurred and approximately 19.42% of the anthocyanins were degraded within 48h by this method.

Novel glassy tetra(N-alkyl-3-bromocarbazole-6-yl)silanes as building blocks for efficient and nonaggregating blue-light-emitting tetrahedral Materials.

[structure: see text] Tetrahedral precursors of tetra(N-alkyl-3-bromocarbazole-6-yl)silanes (1-3), which were amorphous with T(g) being adjustable by changing the chain length of the N-substitutent, were developed. Fluorene-conjugated glassy compound 4 and hyperbranched polymer 5 were synthesized from the precursors via Suzuki coupling reaction. 4 and 5 emitted blue light efficiently in the condensed state with high quantum efficiencies of 80 (4) and 59% (5) and small fwhm (full width at half-maximum) of 48 (4) and 55 nm (5), indicating that they did not pack into detrimental aggregates in the solid state.