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@#Objective To investigate the perioperative efficacy and safety of all-port robotic lobectomy versus thoracoscopic lobectomy in stageⅠA non-small cell lung cancer. Methods The clinical data of patients with stageⅠA non-small cell lung cancer who underwent lobectomy with lymph node dissection performed by the same operator in our center from June 2019 to June 2022 were retrospectively analyzed. The patients were divided into a robotic group and a thoracoscopic group according to different procedures. We compared the relevant indexes such as operation time, intraoperative bleeding, number of lymph node dissection stations, number of lymph node dissection, postoperative tube time, postoperative hospitalization time, closed chest drainage volume, postoperative pain, postoperative complications and hospitalization cost between the two groups. Results There were 83 patients in the robotic group, including 34 males and 49 females with a median age of 60.0 (53.0, 67.0) years, and 94 patients in the thoracoscopic group, including 36 males and 58 females with a median age of 60.5 (54.0, 65.3) years. There was no conversion to thoractomy or death in postoperative 90 days in both groups. No statistical difference was seen in the operation time, total postoperative drainage volume and postoperative complication rates between the two groups (P>0.05). Patients in the robotic group had less intraoperative bleeding (P<0.001), more lymph node dissection stations (P=0.002) and numbers (P=0.005), less postoperative pain (P=0.002), and shorter postoperative time with tubes (P=0.031) and hospital stay (P<0.001). However, the surgery was more expensive in the robotic group (P<0.001). Conclusion All-port robotic surgery is safe and effective for patients with early-stage non-small cell lung cancer with less intraoperative bleeding, more lymph node dissection, less postoperative pain, and shorter hospital stay compared with the thoracoscopic surgery.
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ObjectiveTo determine the risk factors associated with hypoglycemia in community patients with type 2 diabetes mellitus（T2DM）. MethodsA case-control study was performed among 914 patients with T2DM and no medical history of hypoglycemia were selected in the Diabetes Unit of Tongji University School of Medicine Affiliated Anting Community Health Center in 2018. A total of 196 patients with T2DM who had ≥1 hypoglycemia event in the past 12 months were presented as the case group， and 718 patients who did not have any hypoglycemia event during the same period were included as the control group. Medical history， medication， life style， and related factors were collected. Multivariate logistic regression analysis was used to determine the risk factors associated with hypoglycemia. ResultsHistory of coronary heart disease ［adjusted odds ratio（aOR）=2.077， 95% CI： 1.293-3.337］， renal disease （aOR=4.775， 95% CI： 1.537-14.830）， and previous insulin use （aOR =1.765， 95%CI： 1.147-2.716） significantly increased the risk of hypoglycemia， while angiotensin converting enzyme inhibitors（ACEI）（aOR =0.127， 95%CI： 0.044-0.366） and β-receptor blockers （aOR =0.271， 95%CI： 0.119-0.616） decreased the risk of hypoglycemia among diabetic patients. ConclusionIncidence of hypoglycemia in community patients with diabetes is high. History of coronary heart disease and kidney disease， and previous insulin use may increase the risk of hypoglycemia， which warrants further attention by community general practitioners.
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Dietary fiber contents in 34 common foods perchased in Beijing markets have been determined with detergent method, including neutral detergent fiber, acid detergent fiber, cellulose, hemicellulose and lignin. On dry basis, the dietary fiber contents of vegetables varied with kinds of food: the dietary fiber contents were higher in tender stems, leaves, stalks and flowers; lower in starchy tubers and roots; medium in non-starchy tubers and roots. The propotions of dietary fiber components were different in various categories of foods. Cellulose was the major component in vegetables and legumes, but in most cereals, hemicellulose content was higher than cellulose. All foods had the lowest lignin content with the exception of garlic bolt.
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Foods derived from plants are thought to be devoid of vitamin B12. We have found that some fermented foods contained microbiologically active vitamin B12 components.In order to ascertain the amount of physiological active vitamin B12, we have established a bioautographic area quantitative method of determination of vitamin B12. The procedure is described briefly as follows:The extract of fermented soybean food sample is spotted on a filter paper strip. The Paper is developed with a mixture of secbutanol-water-ammonia water- 5 % potassium cyanide (100: 50: 1: 0.5) using descending technique. After developing for 24-72 hours, the strip is taken out and dried in air. It is then put on the surface of nutrient agar containing E. coli 44110 and 2,3,5,-triphenyl tetrazolium chloride. After incubation, the area of spot of growth is measured and the amount of vitamin B12 in the sample is calculated.Two types of fermented soybean food samples were assayed by the above procedure, mean values of vitamin B12 content are: fermented soybean curd with strong smell contains 0.97 ?g/100g sample, fermented soybean curd contains 0.41 ?g/100g sample. Compared with animal foods, both types of fermented soybean foods may be considered as good source of vitamin B12.
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The result of a nutritional survey on potassium intakes of population and serum potassium contents of healthy adults in Shanghai (high occurrence of hypokalemia), Sichun (moderate occurrence of hypokalemia) and Shandong (null occurrence of hypokalemia) revealed that the average daily potassium intakes for the three areas were 60.1?16.6, 54.6? 13.4 and 58.7? 11.1 mmol per capita per day respectively; The serum potassium contents of the three areas were 4.2?0.3,4.0 ?0.3 and 4.2?0.4 mmol/L respectively. These results indicated that the daily potassium intakes and serum potassium contents between Shanghai and Shandong were not significantly different and might suggest that the occurrence of gossypol related hypokalemia in Shanghai and Sichun could not be attributed to the low potassium intakes and low serum potassium contents of the population.