The diabetes mellitus multimorbidity network in hospitalized patients over 50 years of age in China: data mining of medical records.

OBJECTIVE: Many diabetes mellitus (DM) patients suffer from multimorbidity. Understanding the DM multimorbidity network should be given priority. The purpose of this study is characterize the DM multimorbidity network in people over 50 years. METHODS: Data on 75 non-communicable diseases (NCDs) were extracted from electronic medical records of 309,843 hospitalized patients older than 50 years who had at least one NCD. The association rules analysis was used as a novel classification method and combined with the Chi-square tests to identify associations between NCDs and DM. RESULT: A total of 12 NCDs were closely related to DM, {cholelithiasis, DM} was an unexpected combination. {dyslipidemia, DM} and {gout, DM} had the largest lift in the male and female groups, respectively. The negative related group included 7 NCDs. There were 9 NCDs included in the strong association rules. Most combinations were different by age and sex. In males, the strongest rule was {peripheral vascular disease (PVD), dyslipidemia, DM}, while {hypertension, dyslipidemia, chronic liver disease (CLD), DM} was the strongest in females. In patients younger than 70 years, hypertension, CLD, and dyslipidemia were the most dominant NCDs in the DM multimorbidity network. In patients 70 years or older, chronic kidney disease (CKD), CVD, CHD, and heart disease (HD) frequently co-occurred with DM. CONCLUSION: Future primary healthcare policies for DM should be formulated based on age and sex. In patients younger than 70 years, more attention to hypertension, CLD, and dyslipidemia is required, while attention to CKD, CVD, CHD and HD is needed in patients older than 70 years.

The Impact of Perioperative Use of Nonbiologic Disease-Modifying Anti-rheumatic Drugs on Perioperative Blood Loss and Complications in Patients Who Have Rheumatoid Arthritis Undergoing Total Knee Arthroplasty.

BACKGROUND: The use of disease-modifying antirheumatic drugs (DMARDs) before total knee arthroplasty (TKA) was associated with increased risk of postoperative periprosthetic joint and wound infections as well as worse platelet function in patients who have knee rheumatoid arthritis (RA). This study investigated the effects of DMARDS on perioperative blood loss, complications, and blood transfusion in patients undergoing TKA for knee RA. METHODS: We retrospectively enrolled patients undergoing TKA for knee RA at our hospital between 2017 and 2021 who received DMARDs (n = 73) or not (n = 84). Every RA patient was matched with patients who had osteoarthritis (OA) in a ratio of 1:1 or 1:2. Primary outcomes were intraoperative and perioperative blood losses, while secondary outcomes were complications and allogeneic transfusions. RESULTS: The mean total (804 versus 728 mL (mL), P = .114), mean intraoperative (113 versus 101 mL, P = .488), or hidden blood losses (705 versus 640 mL, P = .340) did not differ statistically between RA patients who received DMARDs versus those who did not. RA patients who received DMARDs showed significantly greater mean total (804 versus 654 mL, P = .001), intraoperative (113 versus 75 mL, P = .002), and hidden blood losses (705 versus 560 mL, P = .016) than OA patients. No statistical differences were found in complications or allogeneic transfusions. CONCLUSION: Although RA patients experienced greater perioperative blood loss than OA patients, there was no statistical difference in perioperative blood loss, complications, or allogeneic transfusions between RA patients who received DMARDs and those who did not.

Synthesis of palladium-decorated defective tungsten oxide heterostructures with enhanced photothermal catalytic activity for hydrodeoxygenation of vanillin.

The selective hydrodeoxygenation (HDO) of sustainable lignocellulosic biomass plays a pivotal role in the conversion of biomass into high-value fuels and chemicals. Nevertheless, HDO for biomass upgrading always demands high temperatures and high hydrogen (H2) pressure. Photothermal catalysis has been recognized as an effective approach for boosting chemical reactions under mild conditions while maintaining superior selectivity. Herein, we report the design of palladium-decorated defective tungsten oxide (Pd/WO3-x) catalysts with enhanced photothermal catalytic performances for the efficient HDO of vanillin. Pd/WO3-x nanoflowers have been synthesized through a solvothermal/in-situ reduction two-step strategy, and they exhibit notable photoabsorption in a wide range (200-1100 nm), high photothermal conversion and efficient charge separation efficiency. Under simulated sunlight irradiation (0.3 W cm-2), Pd/WO3-x exhibits a maximum vanillin conversion up to 86.8 % with a 2-methoxy-4-methylphenol (MMP) selectivity of 100 %, which is obviously higher than that (vanillin conversion = 33.1 %, MMP selectivity = 100 %) in the oil bath at the same temperature. Such higher conversion efficiency and selectivity under sunlight should result from the synergistic integration of hot electrons and photothermal heating, both of which are derived from localized surface plasmon resonance (LSPR) in WO3-x. Importantly, Pd/WO3-x catalyst demonstrates good stability and high selectivity to MMP even after 5 cycles. This work may offer a novel viewpoint on the advancement of photothermal catalysts and the realization of photothermal catalytic biomass conversion under mild conditions.