The role of traditional Chinese medicine on fracture surgery, hospitalization, and total mortality risks in diabetic patients with osteoporosis.

BACKGROUND: Studies have confirmed that osteoporosis has been considered as one of the complications of diabetes, and the health hazards to patients are more obvious. This study is mainly based on the Taiwan National Health Insurance Database (TNHID). Through the analysis of TNHID, it is shown that the combined treatment of traditional Chinese medicine (TCM) medicine in patients of diabetes with osteoporosis (T2DOP) with lower related risks. METHODS: According to the study design, 3131 patients selected from TNHID who received TCM treatment were matched by 1-fold propensity score according to gender, age, and inclusion date as the control group. Cox proportional hazards analyzes were performed to compare fracture surgery, hospitalization, and all-cause mortality during a mean follow-up from 2000 to 2015. RESULTS: A total of 1055/1469/715 subjects (16.85%/23.46%/11.42%) had fracture surgery/inpatient/all-cause mortality of which 433/624/318 (13.83%/19.93%/10.16%) were in the TCM group) and 622/845/397 (19.87%/26.99%/12.68%) in the control group. Cox proportional hazards regression analysis showed that subjects in the TCM group had lower rates of fracture surgery, inpatient and all-cause mortality (adjusted HR = 0.467; 95% CI = 0.225-0.680, P<0.001; adjusted HR = 0.556; 95% CI = 0.330-0.751, P<0.001; adjusted HR = 0.704; 95% CI = 0.476-0.923, P = 0.012). Kaplan-Meier analysis showed that the cumulative risk of fracture surgery, inpatient and all-cause mortality was significantly different between the case and control groups (all log-rank p<0.001). CONCLUSION: This study provides longitudinal evidence through a cohort study of the value of integrated TCM for T2DOP. More research is needed to fully understand the clinical significance of these results.

Gender-specific impacts of thigh skinfold thickness and grip strength for predicting osteoporosis in type 2 diabetes.

BACKGROUND: Diabetes with co-existing bone fragility or osteoporosis is common in elderly patients, whereas is frequently underestimated. METHODS: We conducted dual-energy x-ray absorptiometry (DXA) with 7-site skinfold (SF) and dominant hand grip strength measurements among patients with type 2 diabetes (T2DM) to assess their gender-specific associations. A total of 103 patients with T2DM (60 females and 43 males), aged between 50 and 80 years (median 68.0 years) were enrolled and 45 non-DM females were also included to compare with T2DM females. RESULTS: Our results revealed osteoporosis was negatively correlated with grip strength in both genders, negatively correlated with lean mass solely in males and negatively correlated with fat mass (particular the gynoid fat mass and thigh SF thickness) in females. Via performing multivariable stepwise logistic regression, we identified grip strength in both genders and thigh SF thickness in females as predictors for osteoporosis. Receiver operating characteristic curve analysis further disclosed 20.5 mm female thigh skinfold thickness, 18.1 kg female grip strength and 29.0 kg male grip strength as reasonable cutoff levels for predicting osteoporosis in the Taiwanese patients with T2DM. CONCLUSIONS: Patients with T2DM presented gender-specific associations between osteoporosis, body composition and grip strength. Grip strength and thigh SF thickness might serve as predictors for detection of osteoporosis in patients with T2DM.

The efficacy and safety of combined GLP-1RA and basal insulin therapy among inadequately controlled T2D with premixed insulin therapy.

This study investigated the effect of a combination of glucagon-like peptide-1 receptor agonist (GLP-1 RA) and basal insulin (BI) in poorly controlled type 2 diabetes mellitus previously treated with premixed insulin. The possible therapeutic benefit of the subject is mainly hoped to provide a direction for optimizing treatment options to reduce the risk of hypoglycemia and weight gain. A single-arm, open-label study was conducted. The antidiabetic regimen was switched to GLP-1 RA plus BI to replace previous treatment with premixed insulin in type 2 diabetes mellitus subjects. After 3 months of treatment modification, GLP-1 RA plus BI was compared for superior outcomes by continuous glucose monitoring system. There were 34 subjects at the beginning, 4 withdrew due to gastrointestinal discomfort, and finally 30 subjects completed the trial, of which 43% were male; the average age was 58 ± 9 years old, and the average duration of diabetes was 12 ± 6 years, the baseline glycated hemoglobin level was 8.6 ± 0.9 %. The initial insulin dose of premixed insulin was 61 ± 18 units, and the final insulin dose of GLP-1 RA + BI was 32 ± 12 units (P < .001). Time out of range (from 59%-42%), time-in-range (from 39%-56%) as well as glucose variability index including standard deviation also improved, mean magnitude of glycemic excursions, mean daily difference and continuous population in continuous glucose monitoring system, continuous overall net glycemic action (CONGA). Also noted was a decrease in body weight (from 70.9 kg-68.6 kg) and body mass index (all P values < .05). It provided important information for physicians to decide to modify therapeutic strategy as individualized needs.

Knowledge Development Trajectories of Crime Prevention Domain: An Academic Study Based on Citation and Main Path Analysis.

This study performed main path analysis to explore the academic field of crime prevention. Studies were collected from the Web of Science database, and main path analysis was used to analyze the studies and identify influential authors and journals on the basis of the g-index and h-index. Cluster analysis was then performed to group studies with related themes. Wordle was used to output keywords and word clouds for each cluster, both of which were used as reference to name each cluster. Five clusters were identified, namely crime displacement control, crime prevention through environmental design, developmental crime prevention, the effects of communalism on crime prevention, and the effect of childhood sexual abuse on crime. Each cluster was analyzed, and suggestions based on the results are provided. The main purpose of crime prevention is to advance our understanding of the psychological criminal mechanisms (i.e., personal, social and environmental impacts) associated with different criminal behaviors at the intersection of law by using main path analysis.

A New TDR-Based Sensing Cable for Improving Performance of Bridge Scour Monitoring.

The use of time domain reflectometry (TDR) for real-time monitoring of bridge scour process has gone through several stages of development. The recently-proposed concept of bundled TDR sensing cable, in which two sets of insulated steel strands are twisted around and connected to a central coaxial cable to form a compact sensing cable, is a major change that has several advantages including the bottom-up sensing mechanism. Nevertheless, there is big room for improving its measurement sensitivity and signal to noise ratio (SNR). Changes in waveguide configuration also need to be made to avoid the adverse effect of insulation abrasion observed in field implementation. This study evaluated three new conductor and insulator configurations for constructing the sensing waveguide, including a balanced two-conductor waveguide (Type I), an unbalanced three-conductor waveguide with insulation coating on the middle conductor (Type II) and an unbalanced three-conductor with insulation coating on the two outer conductors (Type III). In all cases, the spacing between the two sets of steel strands (i.e., the waveguide conductors) was especially enlarged by replacing some steel strands with non-conductor wires to increases measurement sensitivity and avoid shorted conditions due to insulation abrasion. Experimental results show that Type III has the best performance on all counts. A new improved TDR sensing cable was hence proposed based on Type III configuration. Its performance was further evaluated by a full-scale experiment to take into consideration the long range of measurement in most field conditions. Detailed discussions on improvements of measurement sensitivity and SNR, limitation of sensing range, and mitigating the adverse effect of insulation abrasion are presented.

Dielectric Spectroscopy Using Dual Reflection Analysis of TDR Signals.

Time-domain reflectometry (TDR) has been a powerful tool for measuring soil dielectric properties. Initiating from apparent dielectric constant ( K a ) measurement up until apparent and complex dielectric spectroscopies, the embedded information in the TDR signal can be extracted to inspire our understanding of the underlying dielectric behaviors. Multiple full waveform inversion techniques have been developed to extract complex dielectric permittivity (CDP) spectrum, but most of them involved prior knowledge of input function and tedious calibration. This rendered the field dielectric spectroscopy challenging and expensive to conduct. Dual reflection analysis (DRA) is proposed in this study to measure CDP spectrum from 10 MHz to 1 GHz. DRA is a simple, robust, model-free, and source-function free algorithm which requires minimal calibration effort. The theoretical framework of DRA is established and the necessary signal processing procedures are elaborated in this study. Eight materials with different dielectric characteristics are selected to evaluate DRA's performance, by using both simulated and experimental signals. DRA is capable of measuring non-dispersive materials very well, whereas dispersive materials require the assistance of a long-time-window (LTW) extraction method to further extend the effective bandwidth. The DRA approach is suitable for field applications that can only record a limited amount of data points and in-situ dielectric spectroscopy.

Static magnetic field attenuates mortality rate of mice by increasing the production of IL-1 receptor antagonist.

PURPOSES: Disseminated intravascular coagulation (DIC) is a complex systemic thrombohemorrhagic disorder involving intravascular coagulation and hemorrhage. The aim of this study is to test whether static magnetic field (SMF) is effective in attenuating lipopolysaccharide (LPS)-induced DIC. MATERIALS AND METHODS: In vivo experiments were performed in this study using male BALB/cByJ mice. An intraperitoneal injection of 50 mg/kg LPS was shown to lead to approximately 50% mortality and this dose was used in subsequent experiments. To test the effects of SMF on the survival rate of LPS-induced animals, the mice were exposed to 0.25-T SMF for 2 h before LPS injection. In addition, the effect of a 2-h SMF treatment on the production of anti-inflammatory cytokines was evaluated. RESULTS: In the first set of experiments, we found that the survival rate was higher in the SMF-exposed group than in the sham-exposed group. The circulating platelet (PLT) counts in the SMF-exposed mice were significantly higher than in the unexposed animals. However, no significant changes in inflammatory cytokine, including tumour necrosis factor-alpha (TNF-alpha), interleukin-1alpha (IL-1alpha), interleukin-6 (IL-6) and monocyte chemotactic protein 1 (MCP-1), in plasma were found after SMF treatment. The results from the second experiment showed that the plasma levels of interleukin-1 receptor antagonist (IL-1ra) were higher in the SMF-exposed group than in the sham group. CONCLUSIONS: Exposure to an SMF increases the plasma levels of IL-1ra. This effect may inhibit the reduction in PLT in plasma, resulting in prevention in LPS induced DIC.

Long-term continuous exposure to static magnetic field reduces popolysaccharide-induced cytotoxicity of fibroblasts.

PURPOSES: Lipopolysaccharide (LPS) is one of the major substances initiating the immune host response in microbial infections that results in cytotoxicity. In terms of treatment of the immune response, research has been conducted on physical environments that can reduce LPS-induced damage. In this experiment, a long-term continuous static magnetic field (SMF) was used as a physical resource to reduce LPS-induced immune host response. MATERIALS AND METHODS: Cultured fibroblasts were challenged with LPS to initiate an inflammatory reaction. Cell viability and various proinflammatory cytokine levels were detected and compared between SMF and sham-exposed groups. RESULTS: Our in vitro study revealed that, with LPS challenge, fibroblasts continuously exposed to a 0.4-T SMF for 12 h demonstrated higher cell viability compared to unexposed analogs. From cytokine test, the levels of LPS-induced interleukin-1beta (IL-1beta) in the SMF-exposed groups were significantly lower relative to their unexposed counterparts (p < 0.05). By contrast, SMF exposure tended to increase the level of LPS-induced IL-1 receptor antagonist (IL-1Ra) and IL-6. CONCLUSIONS: Our results suggest that SMF stimulation inhibits LPS-induced cytotoxicity through reduction of proinflammatory cytokines and increase in anti-inflammatory cytokines of NIH-3T3 cells.

Aloe-emodin-induced apoptosis in human gastric carcinoma cells.

The purpose of this study was to investigate the anticancer effect of aloe-emodin, an anthraquinone compound present in the leaves of Aloe vera, on two distinct human gastric carcinoma cell lines, AGS and NCI-N87. We demonstrate that aloe-emodin induced cell death in a dose- and time-dependent manner. Noteworthy is that the AGS cells were generally more sensitive than the NCI-N87 cells. Aloe-emodin caused the release of apoptosis-inducing factor and cytochrome c from mitochondria, followed by the activation of caspase-3, leading to nuclear shrinkage and apoptosis. In addition, exposure to aloe-emodin suppressed the casein kinase II activity in a time-dependent manner and was accompanied by a reduced phosphorylation of Bid, a downstream substrate of casein kinase II and a pro-apoptotic molecule. These preclinical studies suggest that aloe-emodin represents a suitable and novel chemotherapeutic drug candidate for the treatment of human gastric carcinoma.

Premedication with pronase or N-acetylcysteine improves visibility during gastroendoscopy: an endoscopist-blinded, prospective, randomized study.

AIM: To assess the efficacy of premedicaton with pronase or N-acetylcysteine (NAC) at 20 min before upper gastrointestinal (UGI) endoscopy and to determine whether pronase or NAC pretreatment influences the reliability of the rapid urease test. METHODS: A total of 146 patients were prospectively and randomly assigned into the study groups according to different premedications before endoscopy. One endoscopist assessed mucosal visibility (MV) with scores ranged from 1 to 4 at four sites in the stomach. The sum of the MV scores from these four locations was defined as the total mucosal visibility (TMV) score. Identification of H pylori was performed using CLO test, histology, and serology. RESULTS: The Group with pronase premedication had a significantly lower TMV score than did the groups with gascon and gascon water (P < 0.001 and P < 0.01, respectively). The group with NAC had a significantly lower TMV score than the group with gascon (P < 0.01) and a trend of a lower MV score than the group with gascon water (P = 0.06). The TMV score did not significantly differ between the group with pronase and the group with NAC (P = 0.39 and P = 0.14, respectively). The sensitivity and specificity of the CLO test were 92.5% and 93.9%, respectively, in groups premedicated with pronase and NAC together. CONCLUSION: Premedication with pronase or NAC at 20 min before UGI endoscopy improves the mucosal visibility of the stomach. Neither pronase nor NAC produces any obvious interference with the CLO test for the identification of H pylori infection.