Non-linear relationship between the body roundness index and metabolic syndrome: data from National Health and Nutrition Examination Survey (NHANES) 1999-2018.

Obesity is an important characteristic manifestation of metabolic syndrome (MetS), and body roundness index (BRI) is one of the anthropometric indicators associated with obesity. However, studies on the relationship between BRI and MetS risk are limited. We aimed to explore the relationship between baseline BRI and MetS in the USA population. Our study used data from the National Health and Nutrition Examination Survey from 1999 to 2018, ultimately enrolling and analysing 47 303 participants. Data-driven tertiles were used to categorise BRI levels, and multivariate logistic regression models were fitted to investigate the association of BRI with MetS in adults. In addition, receiver operating characteristic curve analysis was used to assess the ability of BRI to predict MetS. The distribution of BRI was different across ethnic groups with a gradual decrease in the proportion of non-Hispanic Whites and other races. In addition, BRI was significantly associated with traditional cardiovascular risk factors. Univariate regression analysis indicated BRI to be a moderate risk factor for MetS, and multivariate logistic regression analysis found that BRI remained an independent risk factor for MetS. After adjusting for confounding variables, a non-linear relationship was found between BRI levels and the prevalence of MetS. More importantly, BRI predicted MetS with the largest AUC among anthropometric measures. In summary, elevated baseline BRI levels are independently associated with the development of MetS, and baseline BRI may assist in identifying patients at risk for MetS, leading to early and optimal treatment to improve their outcomes.

Distribution of lipid levels and prevalence of hyperlipidemia: data from the NHANES 2007-2018.

BACKGROUND: Lipid-lowering therapy is important, and the distribution of lipid levels and the incidence of hyperlipidemia may vary in different subgroups of the population. We aimed to explore the distribution of lipid levels and the prevalence of hyperlipidemia in subpopulations with subgroup factors, including age, sex, race, and smoking status. METHODS: Our study used data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018, ultimately enrolling and analyzing 15,499 participants. A cross-sectional analysis was performed to assess the distribution of lipids and prevalence of hyperlipidemia in subpopulations, and multifactorial logistic regression analyses were performed for the prevalence of hyperlipidemia, adjusted for age, sex, race and smoking status. RESULTS: Blacks had significantly lower mean serum total cholesterol and triglycerides and higher serum high-density lipoprotein cholesterol (HDL-C) than whites (P < 0.001). In contrast, Mexican Americans had markedly higher mean serum triglycerides and lower serum HDL-C than whites (P < 0.001). Furthermore, the prevalence of hypercholesterolemia and hypertriglyceridemia was lower in blacks than in whites (P = 0.003 and P < 0.001, respectively), while the prevalence of hypertriglyceridemia was significantly higher in Mexican Americans than in whites (P = 0.002). In addition, total cholesterol and triglyceride levels were significantly higher in women aged 65 years or older and markedly higher than in men in the same age group (P < 0.001). In addition, overall mean total cholesterol, triglyceride, and low-density lipoprotein cholesterol (LDL-C) levels were higher in smokers than in nonsmokers (P = 0.01, P < 0.001, and P = 0.005, respectively). CONCLUSION: Based on NHANES data, the mean lipid levels and prevalence of hyperlipidemia differed by sex, age, race, and smoking status.

[Impact of the Timing of Traditional Chinese Medicine Therapy on the Therapeutic Effect and Prognosis of Severe Coronavirus Disease 2019].

Objective To explore the optimal therapy time for the treatment of severe coronavirus disease 2019(COVID-19)by traditional Chinese medicine(TCM)and its influence on the therapeutic effect and prognosis. Methods The clinical data,laboratory findings,and outcomes of 64 patients with severe COVID-19 treated with TCM and western medicine in Chongqing from January 20,2020, to March 11,2020 were retrospectively analyzed.Patients were divided into early intervention group[TCM was initiated within 3 days (including day 3) after the first diagnosis of severe type/critical type COVID-19]and late intervention group[TCM was initiated after 7 days (including day 7) after the first diagnosis of severe type /critical type COVID-19].The changes in clinical parameters during the course of disease were compared between the two groups. Results On day 14,the oxygenation index was 292.5(252.0,351.0)mmHg in the early intervention group,which was significantly higher than that in the late intervention group [246.0(170.0,292.5)mmHg](P=0.005).The length of hospital stay [(18.56±1.11)d vs.(24.87±1.64)d,P=0.001],duration of ICU stay [(14.12±0.91)d vs.(20.00±1.53)d,P=0.000] and time to negativity [(16.77±1.04)d vs.(22.48±1.66)d,P=0.001] in the early intervention group were significantly shorter than those in the late intervention group.The intubation rate(7.3%)in the early intervention group was significantly lower than that in the late intervention group(30.4%)(P=0.028). Conclusion Early TCM therapy within three days after a diagnosis of severe COVID-19 can shorten the length of hospital stay,duration of ICU stay,and time to negativity and decrease intubation rate.

Mixed glandular neuroendocrine carcinoma of the endometrium with hypercalcemic crisis.

OBJECTIVE: To explore the ideas and research progress in diagnosing and treating hypercalcemic crisis in patients with cancer. METHODS: We reviewed the clinical data, diagnosis and treatment of hypercalcemic crisis in a patient with mixed glandular neuroendocrine carcinoma of the endometrium. RESULTS: The patient had gastrointestinal symptoms and acute renal impairment as the main manifestations, and the blood biochemical indexes suggested a hypercalcemic crisis with elevated parathyroid hormone (PTH). No lesions were seen in the parathyroid glands on imaging and nuclide imaging, but an abnormal pelvic mass was seen in the pelvis and the biopsy of the uterine cervix tissue suggested that it was an adenocarcinoma. Surgery was performed to remove the mass, and postoperative findings suggested endometrial large-cell neuroendocrine carcinoma with endometrioid adenocarcinoma. The calcium and PTH decreased to normal after surgery and chemotherapy. CONCLUSIONS: The condition of the hypercalcemia crisis is dangerous, so it is necessary to think from different aspects of the clinical diagnosis and treatment.

Plasma Alarin Level and Its Influencing Factors in Obese Newly Diagnosed Type 2 Diabetes Patients.

OBJECTIVE: To investigate the plasma alarin level in newly diagnosed obese type 2 diabetes mellitus (T2DM) and its correlation with glucose and lipid metabolism and insulin resistance. METHODS: From October 2018 to June 2020, 239 newly diagnosed T2DM patients were collected. According to obesity, patients were divided into T2DM obese group (n=135) and T2DM non-obese group (n =104). Gender, age, body mass index (BMI), blood lipids, blood glucose, glycosylated hemoglobin A1c (HbA1c), fasting insulin (FINS), plasma alarin concentration, homeostasis model assessment for insulin resistance (HOMA-IR), homeostasis model assessment for ß-cell function (HOMA-ß) and other clinical data were collected and analyzed. RESULTS: BMI, triacylglycerol (TG), total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), fasting blood glucose (FPG), HbA1c, FINS, plasma alarin levels and HOMA-IR in the control group, T2DM non-obese group and T2DM obese group increased sequentially, and high-density lipoprotein-cholesterol (HDL-L) and HOMA-ß decreased sequentially (P<0.05). Correlation analysis results showed that plasma alarin levels in T2DM patients were positively correlated with waistline, BMI, TC, LDL-C, FPG, HbA1c, FINS and HOMA-IR (P<0.05), and negatively correlated with HDL-C and HOMA-ß (P <0.05), and the correlation coefficient of T2DM obese group was significantly higher than that of T2DM non-obese group (P<0.05). Multiple linear stepwise regression analysis showed that BMI, FPG, HbA1c, HOMA-ß, and HOMA-IR were independent factors related to plasma alarin levels in T2DM non-obese and T2DM obese patients, and the correlation coefficient of the T2DM obese group was significantly higher than that of the T2DM non-obese group (P <0.05). CONCLUSION: Plasma alarin levels increase in newly diagnosed T2DM and obese T2DM patients, which are affected by TC, BMI, FPG, HbA1c, HOMA-ß and HOMA-IR, and may be involved in development of T2DM.

A transendocardial delivery and intracardiac ultrasound irradiation treatment catheter.

OBJECTIVES: This study introduces the structural design, working principles, performance testing and treatment effects of a newly developed ultrasonic irradiation delivery and treatment catheter system that integrates interventional catheterization technology. BACKGROUND: Systemic administration method needs a high dose of gene and induces side effect of non-target organ delivery. Direct intramyocardial injection of a low-dose angiogenic gene followed by insonation treatment can enhance gene expression. So, a novel transendocardial gene delivery and intracardiac ultrasound irradiation strategy was tested. METHODS: The medical interventional ultrasonic therapeutic apparatus is comprised of an ultrasonic irradiation catheter and a host. The ultrasonic irradiation catheter, which is equipped with an advance-and-retreat convenient miniature syringe needle and a miniature piezoelectric transducer on the tip, was used. Twelve dogs were divided into three groups: (1) EGFP and US (EGFP + US), (2) EGFP alone and (3) control group. In the EGFP + US group, EGFP plasmid DNA (500 µg) was injected and followed by intracardiac insonation. In the EGFP alone group, EGFP plasmid DNA (500 µg) was injected without insonation. In the control group, saline was injected. RESULTS: The catheter can enter the heart through percutaneous intervention to realize intramyocardial injection, directly irradiate cardiac muscular tissues at close range and correctly control the ultrasonic irradiation energy delivered to cardiac muscular tissues. Compared with the EGFP gene group, an average sixfold enhancement in gene expression was achieved in the EGFP EGFP + US group (p < 0.05). CONCLUSIONS: The experimental results confirmed that the treatment catheter was safe and reliable, which can realize transendocardial intramyocardial gene injection in the left ventricular chamber, and the ultrasonic parameter can increase gene expression after intracardiac ultrasonic irradiation. The intracardiac ultrasound irradiation treatment catheter may be a useful delivery and therapy tool in the future.