[Correlation of type 2 diabetes and impaired glucose regulation with chronic kidney disease in middle-aged and elderly individuals].

OBJECTIVE: To explore the correlation of different glucose metabolism statues with chronic kidney disease (CKD) in middle-aged and elderly individuals in Lanzhou. METHODS: Based on the baseline data of REACTION Study in Lanzhou area, we randomly sampled 10 038 residents aged 40-75 years in 3 communities in Lanzhou, who were classified into normal glucose tolerance (NGT), impaired glucose regulation (IGR) and diabetes groups. The estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (ACR) were used to assess the renal function and albuminuria, respectively. Binary logistic regression was performed to analyze the contribution of the risk factors to CKD. Polynominal regression was used to determine the trends of eGFR with the increment of ACR. RESULTS: Among all the participants, the prevalences of albuminuria, CKD and renal insufficiency (RI) were 26.2%, 27.4% and 2.5%, respectively. The prevalence of albuminuria, CKD and RI were significantly higher in the diabetes group than in IGR and NGT groups (P < 0.05). In IGR group, age, hypertension, and hypertriglyceridemia were positively correlated with the risk of RI (OR: 1.113, 1.904, and 2.608, respectively; P < 0.05). In diabetes group, age, coronary heart disease, obesity, hypertriglyceridemia, and elevated LDL-C level were positively correlated with the risk of RI (OR: 1.069, 2.535, 3.359, 1.827, and 2.690, respectively; P < 0.05). Logistic regression analysis showed that diabetes mellitus significantly increased the risk of albuminuria (OR: 1.543, P=0.000) and RI (OR: 1.446, P=0.005). Logistic regression analysis and multivariate regression analysis showed that although the deterioration trends of eGFR were similar in diabetes group and IGR group, IGR was not a significant risk factor for albuminuria or RI (OR:1.057, P=0.355; OR: 0.918, P=0.614). CONCLUSIONS: Diabetes mellitus is a significant risk factor for albuminuria and RI, while IGR is not. Screening for albuminuria and eGFR is highly recommended for individuals with diabetes, hypertension, and obesity, especially in women and the elderly population.

Efficacy of neoadjuvant chemotherapy plus radical surgery in patients with bulky stage II cervical squamous cell carcinoma: A retrospective cohort study.

OBJECTIVE: In order to evaluate the usefulness of neoadjuvant chemotherapy (NAC) with cisplatin and taxol (PT) follow radical surgery for stage II cervical squamous cell carcinoma with a bulky mass. MATERIALS AND METHODS: We retrospectively compared patients receiving NAC with PT followed by radical hysterectomy and pelvic lymph node dissection (RS) (NAC group) with patients only underwent RS without NAC (ORS group). Enrolled 35 patients with FIGO stage II markedly bulky in the NAC group and 30 such patients in the ORS group from January 2011 to December 2013. All patients histopathology were squamous cell carcinoma (SCC). The surgical profiles and complications, disease-free survival (DFS) and overall survival (OS) were compared between the groups. RESULTS: There were no statistically significant differences between the two groups in age, BMI, tumor size, and FIGO stage. The response rate of NAC with PT was 82.8%. The two groups also had similar in operative time, blood transfusion. However, the estimated blood loss in ORS group was significantly higher compared to that in NAC group (P = 0.04). hospital stay of NAC group was shorter compared to ORS group (P = 0.03). The 3-year DFS rates were 84.9% and 65.6%, respectively, in the NAC and ORS groups. NAC significantly prolonged DFS (log-rank test, P = 0.03). Moreover, the OS tended to be longer in the NAC group, though the difference did not reach statistical significance (log-rank test, P = 0.287). CONCLUSIONS: NAC with PT follow radical surgery was confirmed to prolong disease-free survival, as compared with radical hysterectomy alone. The results of this study suggest that NAC with PT might be a useful adjunct to surgery in the treatment of stage II SCC presenting as a bulky mass.

Does pelvic floor muscle training augment the effect of surgery in women with pelvic organ prolapse? A systematic review of randomized controlled trials.

BACKGROUND: Pelvic floor muscle training (PFMT) is often used as a treatment for pelvic organ prolapse (POP) and can improve function. However, the effectiveness of this modality as an adjunct to prolapse surgery for women with POP is unknown. AIMS: To evaluate whether the use of pelvic floor muscle training as an adjunct to prolapse surgery is superior to surgery alone for women with pelvic organ prolapse. METHODS: We searched PubMed, Embase, the Cochrane Library, and the Web of Science from their inception dates to June 30, 2014 for data describing randomized controlled trials (RCTs) that compare the efficacy of PFMT with or without lifestyle modification plus surgery versus surgery alone for women with POP. Additional relevant studies were identified by searching the references of retrieved articles and using Google Scholar. Two investigators independently reviewed and selected relevant studies that met the pre-specified inclusion criteria, extracted the data, and assessed the risk of bias in the included studies according to the Cochrane Handbook, version 5.1.0. Due to great heterogeneity in the choice and reporting of outcome measures and the different durations of follow-up among the studies, this analysis is confined to a qualitative systematic review. RESULTS: Five RCTs involving 591 women were reviewed (treatment group [TG], 292 cases; control group [CG], 299 cases). Generally, the five RCTs exhibited low risk of bias. This study indicated no significant improvement in prolapse symptoms, in quality of life, or in the degree of prolapse for women with POP in the TG compared to those in the CG. CONCLUSIONS: Insufficient evidence was found to support adding perioperative PFMT to surgery over the use of surgery alone in women undergoing surgery for POP. Adequately, powered RCTs with longer follow-up periods are required to evaluate the long-term effect of perioperative PFMT. Neurourol. Urodynam. 35:666-674, 2016. © 2015 Wiley Periodicals, Inc.