[Association between family history of diabetes and incident diabetes of adults: a prospective study].

Objective: To evaluate the association betweew family history of diabetes and incident diabetes of adults. Methods: A total of 49 266 participants in the China Kadoorie Biobank (CKB) study from Wuzhong district of Suzhou city were included in the analysis, after the exclusion of those with heart disease, stroke, cancer and diabetes at baseline survey. The person-year of follow-up was calculated from the date on completion of baseline survey to the date on any firstly-occurred event, i.e., diabetes incidence, death, loss of follow-up, or December 31, 2013. Cox regression model was used to estimate the hazards ratios of the association between family history of diabetes and incident diabetes. Results: During 348 677 person-years of the follow-up (median 7.08 years), a total of 423 men and 791 women were diagnosed as having diabetes. Compared to those without diabetic family history, participants with family history of diabetes showed a higher risk of diabetes, with a HR (95%CI) of 1.90 (1.57-2.29), and the risk increased with the number of relatives suffering from diabetes (Pfor trend<0.05). The family history of maternal type, sibling type, and sibling and parental type had a statistically significant association with the risk of diabetes. The adjusted HR (95%CI) was 2.03 (1.45-2.77), 2.07 (1.56-2.68) and 2.39 (1.14-4.34), respectively. Modification effects of tobacco smoking, alcohol drinking, body mass index and physical activity on the association between diabetic family history and risk of diabetes were not observed in the study (Pfor interaction >0.05). Conclusions: Diabetic family history is associated with the increased incident diabetes, and the risk increased with the number of relatives suffering from diabetes.

Clinical and laboratory profiles of 136 systemic sclerosis patients with and without echocardiographically detected pulmonary hypertension.

AIM: This study aims to review the clinical and laboratory profiles of systemic sclerosis (SSc) patients with and without echocardiographically detected pulmonary hypertension (PH) in China. PATIENTS AND METHODS: The study included 136 consecutive patients treated from 1992 to 2012. Diagnosis of SSc was made according to the 1980 revision of the American College of Rheumatology SSc criteria. PH was defined as systolic pulmonary artery pressure ≥ 40 mmHg detected by Doppler echocardiography. The clinical and laboratory parameters of SSc patients with pulmonary hypertension (SSc-PH) were compared to those of SSc patients without pulmonary hypertension (SSc-no PH). RESULTS: Of the 136 SSc patients, 28 (20.6 %) were diagnosed as having PH by echocardiography. Upon comparison with the SSc-no PH patients, SSc-PH patients were observed to have a significantly higher frequency of subjective dyspnea (P = 0.010) and a higher rate of anti-nuclear RNP (anti-nRNP) antibody positivity (P = 0.028). We also observed that the percentage of SSc-PH patients with increased urea nitrogen is significantly higher than that of SSc-no PH patients after correction for multiple testing (P = 0.006, compared to patients with normal values). CONCLUSION: This study demonstrates that SSc patients with PH detected by echocardiography had characteristic clinical and laboratory features. More specific treatment addressing these aspects should be offered to improve the curative effect of therapy in SSc-PH patients.

[Application of diffusion weighted imaging in accurate diagnosis of middle ear cholesteatoma].

Objective: To evaluate the accuracy of diffusion weighted magnetic resonance imaging (DWI-MRI) combined with high resolution temporal bone CT (HRCT) in the location diagnosis of middle ear cholesteatoma and its value in the postoperative follow-up. Methods: 134 patients with inital cholesteatoma and 22 patients with suspected recurrent cholesteatoma were selected for HRCT, conventional MRI and DWI examination. Based on the intraoperative and pathological diagnosis, DWI and HRCT images were combined to evaluate the consistency between the lesion location and invasion area of the initial cholesteatoma and intraoperative lesions. The results of HRCT and DWI in the diagnosis of recurrent middle ear cholesteatoma were statistically analyzed to evaluate their diagnostic efficacy. Results: The accuracy rate of DWI combined with HRCT was 90.3%.The sensitivity, specificity, positive predictive value and negative predictive value of HRCT and DWI in the diagnosis of recurrent middle ear cholesteatoma were 27.8%, 75.0%, 83.3%, 18.8% and 100%, 75.0%, 94.7% and 100%, respectively, and the Kappa values consistent with the pathological results were 0.024 and 0.843, respectively. Chi-square test confirmed that there were differences in the diagnosis between groups (P<0.001). Conclusions: Combined with the high sensitivity of DWI and the high resolution of HRCT, the accuracy of preoperative positioning of the newly diagnosed cholesteatoma can be improved and surgery strategy can be guided. DWI is also of high diagnostic value for recurrent cholesteatoma in the middle ear.