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The latest epidemiological data suggests that the situation of adult diabetes in China is severe, and metabolic diseases have become significant chronic illnesses that have a serious impact on public health and social development. After more than six years of practice, the National Metabolic Management Center(MMC) has developed distinctive approaches to manage metabolic patients and has achieved a series of positive outcomes, continuously advancing the standardized diagnosis and treatment model. In order to further improve the efficiency, based on the first edition, the second edition guideline was composed by incorporating experience of the past six years in conjunction with the latest international and domestic guidelines.
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Objective:To develop a nomogram model for screening of type 2 diabetes mellitus in a community population.Methods:From October to December, 2020, 6 028 community residents who participated in the " national health physical examination" in Karamay community with complete physical examination data and met the inclusion and exclusion criteria were selected. The physical examination data included medical history, physical examination, laboratory, and ultrasound reports. Random segmentation sampling was used to divide the population into modeling and validation cohorts, and LASSO regression analysis was used to screen for independent factors associated with diabetes diagnosis. The independent influencing factors were furthor incorporated into the multi-factor logistic regression, and the RMS software package was used to construct the column chart. The area under receiver operating characteristic(ROC) curve was used to measure the differentiation of the model. The calibration curve can directly reflect the calibration degree of the model.Results:In the modeling group, multivariate logistic regression analysis showed that age, gender(female), history of hypertension, history of hyperlipidemia, HbA 1C, urinary microalbumin, homeostasis model assessment for insulin resistance, and triglycerides and glucose index were independently associated with diabetes. OR were 1.053(95% CI 1.038-1.069), 0.681(95% CI 0.512-0.906), 1.802(95% CI 1.227-2.626), 1.789(95% CI 1.303-2.448), 10.973(95% CI 8.318-14.745), 1.002(95% CI 1.001-1.004), 2.914(95% CI 2.248-3.799), and 2.673(95% CI 2.03-3.536), respectively. The areas under ROC curves of the training set and the validation set were 0.945 and 0.955, respectively. The optimal critical value in the ROC curve was 0.178(sensitivity 0.930, specificity 0.839) in the training set and 0.201(sensitivity 0.945, specificity 0.848) in the validation set. Conclusion:The screening model of type 2 diabetes developed in this study has good accuracy, which can be used as a screening tool for high-risk population of type 2 diabetes.
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Objective:To explore the correlation between sleep duration and incident diabetes among residents of different ages in Xinjiang region.Methods:A total of 9 541 residents, aged 40 and over in Karamay, Xinjiang were identified by a cluster sampling method. Physical examinations and biochemical test were performed, and the data on sleep duration and lifestyle were obtained using standardized questionnaires. The population was divided into three categories according to sleep duration: insufficient sleep(<6 h), ideal sleep(6-8 h), and long sleep duration(>8 h). They were further divided into 2 subgroups based on age at survey. Those who were younger than 60 years old were defined as the middle-aged group, and the rest as the elderly. Multivariate logistic regression analysis was used to explore the correlation between sleep duration and the risk of diabetes in different age groups.Results:There existed an approximate U-shaped relationship between total sleep duration and fasting blood glucose as well as HbA 1C. Fasting blood glucose and HbA 1C were relatively lower among those with ideal sleep duration. After multivariable adjustment, residents with insufficient sleep revealed a 35% increased risk of diabetes( OR=1.35, 95% CI 1.06-1.71) compared with those with ideal sleep duration. However, the risk of diabetes was not significantly increased in those with long sleep duration( OR=1.04, 95% CI 0.94-1.14). Furthermore, the additive risk of insufficient sleep was only significant in the middle-aged group( OR=1.37, 95% CI 1.02-1.84). Conclusions:Among residents of different ages in Xinjiang region, insufficient sleep is associated with an increased risk of diabetes, which is only significant in the middle-aged group.
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Objective:To investigate the effect of metformin on the microRNA (miRNA) expression and screen potential target with network pharmacology analysis in patients with type 2 diabetes.Methods:Fifteen patients with new diagnosed type 2 diabetes admitted to our hospital were selected, who received metformin during hospitalization and after discharge. The expression of serum matrix metalloproteinase (MMP)-9, transforming growth factor (TGF)-β1, and myocardial fibrosis related miRNAs were compared before and 6 month after metformin treatment. In addition, gene ontology (GO) and KEGG pathway enrichment analysis were applied to analyze differential expression miRNAs showing statistical significance. Meanwhile, the network figure was established to reflect the target gene messenger RNA (mRNA) corresponding to differentially expressed miRNA.Results:Compared with pre-medication, the serum level of MMP-9 was significantly decreased after treatment ( P<0.05). Besides, the expression of homo sapiens microRNA (hsa-miR)29a-3p, hsa-miR133a-5p, hsa-miR21-5p, hsa-miR30c-5p, and hsa-miR1-3p in patients with type 2 diabetes were dramatically down-regulated by metformin ( P<0.05 or P<0.01). Results of GO analysis and KEGG pathway enrichment analysis showed that differentially expressed miRNAs were mainly concentrated in endoplasmic reticulum lumen, synapse, basement membrane and other cell components. The molecular functions such as Rho GTPase binding and participation in extracellular matrix structural constituent were exerted through biological processes such as collagen catabolic process, regulation of short-term neuronal synaptic plasticity, and axon extension, which were mainly enriched in advanced glycation end products-receptor for advanced glycation end products (AGE-RAGE) signaling pathway in diabetic complications, tumor necrosis factor (TNF) signaling pathway, and Wnt signaling pathway, etc. The outcome of miRNA-mRNA network analysis demonstrated that there were 230 target genes mRNAs corresponding to differentially expressed miRNA. Conclusion:Metformin could play its role in the treatment of type 2 diabetes by down regulating the expression of miRNA, participating in the transduction of related cellular signaling pathways, regulating chromatin, nucleic acid binding, and enzyme activities.
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Objective According to analyse SCI papers published by hospital faculties during the period of 2010-2015,this paper discussed influential factors and strategies for paper publishing from the perspective of hospital scientific research management,proposed suggestions to administrative department and leaderships for decision making.Methods Taking SCI database developed by Institute for Scientific Information (ISI) as data resource.Literature analysis method was used to analyze the SCI papers during 2010 2015 in terms of publishing amount,subject development,periodical distribution,foundation support,citation analysis,etc.Results The amount of the SCI papers increased sharply each year with a wide spread of extensive subjects which reveals the development of the medical research.However,the average Impact Factor of the paper is still struggling behind that of the top medical institutes.Most papers published in the hospital is supported by National Science Foundation of China (NSFC).Conclusions This paper proposed that the hospital needs to establish a series of policies to strengthen the project management and talent training in the long run,encourage publishing high quality papers to promote the development of disciplines,increasing the investment for constructing research platforms and also making good use of administration for better research.
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Objective To evaluate the safety and feasibility of simple ligation and resection of the tumor involved inferior vena cava (IVC) without reconstruction during the resection of huge intraabdominal tumors.Methods From 2008 to 2011,4 cases of giant tumor encroaching on inferior vena cava underwent resection without IVC reconstruction.After resection,renal vein was not obstructed in patient 1 and 2.Tumor invaded the third patient's retrohepatic inferior vena cava,anastomosis was performed between the left hepatic vein and the opening of atrium dextrum with artificial vascular graft.The forth patient had right trisegmentectomy of the liver with retrohepatic inferior vena cava resection,anastomosis was performed between the left hepatic vein and the remaining inferior vena cava.Results All 4 patients had a successful operation without intraoperative massive bleeding and death.The postoperative complications included edema in one patient whose collateral circulation was damaged and bile leak in one.Ewin sarcoma patient died of tumor recurrence after a year,but there was no sign of poor renal function and other complications.Ligament fibroma patient had lower limb edema for a long time after the surgery,and tumor relapse for the fourth time in two years following resection.Conclusions When a giant tumor involving and invading IVC,undergoing resection,under the condition that the collateral circulations around IVC established completely,resection and ligation of the inferior vena cava along with huge tumor without IVC reconstruction is safe.This method saves operation time,increases the safety of surgery.
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Objective To investigate the status of diabetes and its risk factors in Karamay.Methods A sampling survey was carried out in Baijiantan district of Karamay from March,2003 to Dec.,2003,all subjects aged 20 to 75 and lived 5 years and above were selected with stratified sampling method according to the age structure of the inhabitants in Karamay.Results Diabetes prevalence was positively correlated with age(OR=1.047),male(OR=1.922),obesity(OR=1.641),hypertension(OR=1.624) and hyperlipidemia(OR=2.131)(P
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Objectives To study the clinical effects and therapeutic mechanisms of the application of Chinese traditional medicine,the Decoction of Jie Du Hua Yu Tang,in the treatment of psoriasis.Meth-ods The clinical effects were observed in50patients with psoriasis vulgaris,to whom the Decoction of Jie Du Hua Yu Tang was given.The mice were used as experimental models whose tail scale epidermis was nat-urally lacking granular layer,similar to psoriatic epidermis.The mice were fed with Jie Du Hua Yu Tang and the effects on the formation of granular layer in their tail scale epidermis were noticed.Results The clinical cure rate was42%and the total response rate was90%with the Jie Du Hua Yu Tang.There was a signifi-cantly strong promoting effect on the formation of granular layer in mouse tail scale epidermis with the use of Jie Du Hua Yu Tang,in comparison with the control group.Conclusions The Decoction of Jie Du Hua Yu Tang is effective for the treatment of psoriasis vulgaris.The decoction could promote the formation of granu-lar layer in mouse tail scale epidermis.The therapeutic mechanism of the decoction may be related to the inhibition of proliferation of epidermal cells.
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Micro-and ultrastructure of the photoreceptors and first visual ganglion in the different regions of the compound eye of the wild male and female housefly, and the projections of the photoreceptor cells within the subsequent visual centers have been studied. The morphology of the retina and lamina ganglia in the front dorsal and the equatorial regions of the male compound eye and the front ventral region of the female one, and the projections of the retina within the lamina show the sexspecific characteristics underlying the function of chasing behavior in the housefly.
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1. The central retinular cells R_7 in the compound eye of male housefly can be divided into two types which are called here R_(7a) and R_(7b) respectively. R_(7a) approximate many features of R_(1-6) cells, which have a larger, cell body, rhabdomere and axon, terminate in the first optic neuropil (lamina). R_(7b) approximate many features of R_8 cell and project directly to the second optic neuropil (medulla). 2. The central retinular cell R_(7a) in the compound eye of male housefly distribute mainly the dorsal region of the eye, there are a few of R_(7a) in the ventral region of the eye, which only distribute in the first and second row ommatidia under equatorial line, but not found in the compound eye of female housefly.
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The changes of the ultrastructure of the photoreceptors in the compound eye of horsefly (Tabanus mandarinus) were observed electromicroscopically at both the mid-day and mid-night. We found that there were various structural changes in cones, pigment cells, retinula cells, rhabdomeres at the two different times.The functional significance of the day and night changes of the photoreceptors and their relations to natural light illumination were discussed.