Prognostic Value of Elevated Plasma Galectin-3 for Renal Adverse Events in Dialysis Patients: A Systematic Review and Meta-Analysis.

Context: In prognostic research, Galectin-3 (Gal-3) has gained recognition in renal fibrosis and nephrosis for its characteristics of promoting inflammation and fibrosis. High levels of Gal-3 may function as a predictor of adverse outcomes for patients with end-stage renal disease (ESRD). Objective: The review intended to systematically examine the significance of Gal-3 in the forecast of adverse outcomes for dialysis patients, using a method of evidence-based medicine. Design: The research team performed a systematic narrative review and meta-analysis by searching the Excerpta Medica Database (EMBASE) and the PubMed, Cochrane, and Web of Science databases for pertinent studies published before June 1, 2022. The search contained both meshes and free terms, such as Galectin 3, Gal-3, renal dialysis, hemodialysis, peritoneal dialysis, HD, and PD. Setting: The review took place at First People's Hospital of Linping District in Hangzhou, China. Outcome Measures: The research team used the Newcastle-Ottawa Scale (NOS) for assessment of the quality of the included research. The team created two reports to assess the value of Gal-3 in prediction of risk: (1) one for studies using continuous variables and (2) one for studies using categorical variables, dividing patients into high- and low-level Gal-3 groups with a cut-off value of Gal-3, being Gal-3 < 10.5 ng/mL for the lower tertile, and Gal-3 ≥ 13.4 ng/mL for the higher tertile. The team performed the meta-analysis using Stata 15.0, analyzed publication bias using Egger's test and directly showed it in a funnel plot. Results: The search found 1061 publications, with eight studies with 5194 participants being included in the current review. For the continuous variables, Gal-3 was associated with all-cause risk of death-Hazard ratio (HR) 1.06, 95%CI 1.01-1.12, and P = .024-and cardiovascular (CV) events-HR 1.13, 95%CI 1.07-1.203, and P = .000, but no significant correlation existed between Gal-3 and risk of CV mortality-HR 1.07, 95%CI 0.99-1.16, and P = .091. For the categorical variables, a high level of Gal-3 was correlated with a high risk of dying, from all causes-HR 2.05, 95%CI 1.50-2.80, and P = .000. Conclusions: Clinicians can use Gal-3 as a standalone forecaster of all-cause mortality and CV events for hemodialysis patients because correlates with these outcomes. Further research is necessary to determine its predictive value for CV mortality. Investigators need to perform further research with a large sample size on the predictive value of Gal-3 for dialysis patients, particularly PD patients, from a variety of ethnic backgrounds to improve the precise treatment for high-risk patients.

Association between tea consumption and glucose metabolism and insulin secretion in the Shanghai High-risk Diabetic Screen (SHiDS) study.

INTRODUCTION: The relationship between tea consumption and glucose metabolism remains controversial. This study investigated the associations of tea consumption with impaired glucose regulation, insulin secretion and sensitivity in Shanghai High-risk Diabetic Screen project. RESEARCH DESIGN AND METHODS: A total of 2337 Chinese subjects were enrolled in the study from 2014 to 2019. Each participant conducted a 75 g oral glucose tolerance test (OGTT) with five-point glucose and insulin level examined. They also completed a nurse-administered standard questionnaire including tea, coffee, and alcohol consumption, smoking habit, physical activity, education, sleep quality, etc. RESULTS: The result showed that tea consumption was positively associated with plasma glucose levels during OGTT after adjusting for confounder (Ps <0.05) and was associated with worsening glucose tolerance (OR 1.21, 95% CI 1.01-1.44; p=0.034). Strong tea consumption or long-term tea intake (>10 years) had an increased risk of glucose intolerance (all p<0.05). These associations did not vary in participants drinking green tea. In addition, insulin secretion indexes were decreased 7.0%-13.0% in tea consumption group. Logistic regression analysis showed that tea consumption was independently associated with lower insulin secretion (homeostasis model assessment of ß-cell function (HOMA-ß) (OR 0.81, 95% CI 0.68-0.97; p=0.021); Stumvoll first-phase index (OR 0.81, 95% CI 0.68-0.97; p=0.020)) in a fully adjusted model. Green tea consumption showed a negative association with insulin secretion (HOMA-ß (OR 0.77, 95% CI 0.62-0.96; p=0.019)). CONCLUSIONS: Tea intake is associated with an increased risk of glucose intolerance in a large high-risk diabetic Chinese population. Habitual tea consumption subjects might have lower pancreatic ß-cell function.

The efficacy and safety of cold atmospheric plasma as a novel therapy for diabetic wound in vitro and in vivo.

Cold atmospheric plasma (CAP) is a group of various chemical active species, such as ozone and nitric oxide, generated by working gas. CAP was demonstrated to have an effect on tissue regeneration and wound healing. We conducted this study to evaluate the efficacy and safety of CAP as a novel therapy for diabetic wounds in vitro and in vivo. The plasma consists of ionised helium gas that is produced by a high-voltage and high-frequency power supply. Eight-week-old male db/db mice and C57BL mice were treated with helium gas (control group), 90s' CAP (low-dose group), and 180s' CAP (high-dose group). Mice were treated and observed for 2 weeks. Skin samples from around the wound and blood samples were collected. Our in vitro analysis included scratch wound-healing assays by using human HaCaT immortalised human epidermal cells. After 14 days of treatment, CAP could obviously promote diabetic wound healing. Wound closure rates were significantly higher in the low-dose group and high-dose groups compared with the control group. Meanwhile, compared with the control group, the protein expression of IL-6, tumour necrosis factor-α, inducible nitric oxide synthase, and superoxide dismutase in two CAP groups significantly decreased, while the protein expression of vascular endothelial growth factor and transforming growth factor-ß in two CAP groups significantly increased (all P < .05); these data show good agreement with the change in mRNA level (all P < .05). In vitro, scratch wound-healing assays showed that plasma treatment could effectively ensure healing within 3 minutes of exposure (all P < .05). In addition, no difference was found in histological observations of normal skin and the level of serum alanine transaminase, aspartate aminotransferase, blood urea nitrogen, creatinine, and white blood cells among the CAP groups and control group. CAP treatment for 3 minutes every day improves wound healing in diabetic mice by suppressing inflammation, reducing oxidative stress, and enhancing angiogenesis, involving several proteins signalling, and it is safe for the liver and kidney.

Auricular point acupressure to manage chronic low back pain in older adults: a randomized controlled pilot study.

This prospective, randomized clinical trial (RCT) pilot study was designed to (1) assess the feasibility and tolerability of an easily administered, auricular point acupressure (APA) intervention and (2) provide an initial assessment of effect size as compared to a sham treatment. Thirty-seven subjects were randomized to receive either the real or sham APA treatment. All participants were treated once a week for 4 weeks. Self-report measures were obtained at baseline, weekly during treatment, at end-of-intervention (EOI), and at a 1-month follow-up. A dropout rate of 26% in the real APA group and 50% in the sham group was observed. The reduction in worst pain from baseline to EOI was 41% for the real and 5% for the sham group with a Cohen's effect size of 1.22 (P < 0.00). Disability scores on the Roland Morris Disability Questionnaire (RMDQ) decreased in the real group by 29% and were unchanged in the sham group (+3%) (P < 0.00). Given the high dropout rate, results must be interpreted with caution; nevertheless, our results suggest that APA may provide an inexpensive and effective complementary approach for the management of back pain in older adults, and further study is warranted.

Glipizide controlled-release tablets, with or without acarbose, improve glycaemic variability in newly diagnosed Type 2 diabetes.

1. The aim of the present study was to compare the effects of glipizide controlled-release (CR) tablets monotherapy with that of glipizide CR tablets plus acarbose on glycaemic variability in newly diagnosed Type 2 diabetes (T2DM) patients using a continuous glucose-monitoring system (CGMS). 2. Forty newly diagnosed T2DM patients whose glycated haemoglobin A1c (HbA1c) levels ranged from 7.0% to 9.8% were randomized to either monotherapy or combination therapy. Overall glycaemic control and blood glucose variability were evaluated by CGMS parameters. 3. After 8 weeks treatment, fasting and postprandial blood glucose, HbA1c, glycated albumin (GA), mean blood glucose (MBG), mean amplitude of glycaemic excursions (MAGE), postprandial incremental area under the curve (AUC(pp)) and homeostasis model assessment of insulin resistance decreased significantly in both groups (P < 0.01). There was also a significant decrease in the mean of daily differences (MODD) in the combination therapy group. Mean changes in MBG, MAGE, MODD and AUC(pp) were significantly greater in the combination therapy group than in the monotherapy group (all P < 0.01), whereas no significant differences were found in the mean changes of HbA1c and GA. Multivariate regression analysis showed that the decrement in AUC(pp) was significantly associated with decreases in MAGE. 4. In conclusion, glipizide CR tablets alone or in combination with acarbose can improve overall blood glucose levels and glycaemic variability. Combination therapy using glipizide CR tablets and acarbose was more effective in reducing intraday and day-to-day glycaemic variability than glipizide CR tablet monotherapy.