Helping smokers with diabetes quit: A scoping review of the interventions utilised,and the challenges and barriers to smoking cessation

Tobacco smoking is recognised as a priority in diabetes management, yet many individuals with diabetes continue to smoke beyond diagnosis. This paper identifies the most promising smoking cessation strategies by reviewing the literature reporting interventions carried out amongst this study population, and the challenges and barriers to smoking cessation. Stand-alone smoking cessation interventions which included pharmacotherapy were found to be more successful in achieving abstinence than interventions which included smoking cessation as part of a broader intervention for improving diabetes management. Misconceptions about smoking and diabetes management were frequently reported, undervaluing smoking cessation. This emphasizes further the need to inform smokers with diabetes about the link between tobacco use and diabetes complications.     

Endobutton 钢板重建 Lisfranc 韧带的早期疗效观察

目的总结跖跗关节损伤中采用 Endobutton 钢板重建 Lisfranc 韧带的早期临床疗效。方法2015 年 3 月—2018 年 7 月，采用 Endobutton 钢板重建 Lisfranc 韧带治疗 18 例跖跗关节损伤患者。男 12 例，女 6 例；年龄 16～55 岁，平均 32.5 岁。致伤原因：交通事故伤 8 例，高处坠落伤 3 例，压砸伤 4 例，扭伤 3 例。Myerson 分型：A 型 10 例，B1 型 4 例，B2 型 2 例，C1 型 1 例，C2 型 1 例。受伤至手术时间 3～9 d，平均 4.9 d。术后定期行 X 线片复查，测量第 1、2 跖骨关节间隙距离；采用疼痛视觉模拟评分（VAS）评价疼痛缓解情况。末次随访时，测量并比较健、患侧足弓高度以评估跖跗关节复位情况，根据美国矫形足踝协会（AOFAS）评分评价足部功能。结果患者均获随访，随访时间 10～28 个月，平均 15.8 个月。术后切口均Ⅰ期愈合。X 线片复查示无螺钉松动、钢板断裂等并发症发生。术后 3 个月、内固定物取出前及末次随访时，第 1、2 跖骨关节间隙距离以及 VAS 评分与术前比较，差异均有统计学意义（P<0.05）；术后各时间点间差异均无统计学意义（P>0.05）。末次随访时，患侧足弓高度为（5.3±0.2）mm，与健侧（5.4±0.3）mm 比较，差异无统计学意义（t=1.798，P=0.810）。根据 AOFAS 评分评价足部功能为（89.5±7.3）分；获优 12 例、良 4 例、可 2 例，优良率 88.9%。 结论采用 Endobutton 钢板重建 Lisfranc 韧带，能较好地稳定跖跗关节，获得满意的早期足部功能。     

Development and Validation of a Laboratory Risk Score (LabScore) to Predict Outcomes after Resection for Intrahepatic Cholangiocarcinoma

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三氧化二砷诱导HL-60细胞凋亡效应及抑制细胞ERK的活性

目的:初步探讨三氧化二砷(arsenic trioxide,As2O3)促进HL-60细胞凋亡及其可能机制.方法:不同浓度的As2O3(0、2.5、5、10 μmol/L)作用于HL-60细胞24h后,MTT法检测细胞增殖,流式细胞术检测细胞凋亡,Western blot检测Caspase-3活化、ERK活性和cyclinD1蛋白的表达,RT-PCR法检测cyclinD1 mRNA的表达.结果:As2O3可抑制HL-60细胞增殖,诱导HL-60细胞的凋亡,并呈浓度依赖性 (P<0.05);As2O3可使HL-60细胞Caspase-3激活,并抑制ERK活性,但不能下调cyclinD1的表达(P>0.05).结论:As2O3能抑制HL-60细胞增殖,并诱导其凋亡,其效应可能与As2O3抑制HL-60细胞ERK活性有关.     

经皮椎体后凸成形术治疗后壁破裂的骨质疏松性椎体骨折

目的探讨经皮椎体后凸成形术(PKP)治疗后壁破裂的骨质疏松性椎体骨折的临床疗效。方法本组31例均CT证实为后壁破裂的椎体骨折,接受PKP手术,损伤节段为T11~T4共31个椎体。结果本组获得随访12~26个月,平均17个月。31例均成功实施手术,6例出现骨水泥渗漏,无经后壁向椎管内渗漏病例,疼痛视觉评分(VAS)评分,Oswestry功能障碍评分(ODI),椎体前、中柱高度,Cobb角,伤椎楔形角,在术前与术后2 d、末次随访时比较,差异有统计学意义(P0.05)。结论对于后壁破裂的骨质疏松性椎体骨折,PKP是一种可以选择的治疗方式。     

Prospective validation of the Eastern Staging in predicting survival after surgical resection for patients with hepatocellular carcinoma: a multicenter study from China

BackgroundThe Eastern Staging System, which was specially developed for patients undergoing surgical resection for hepatocellular carcinoma (HCC), has been proposed for more than ten years. To prospectively validate the predictive accuracy of the Eastern staging on long-term survival after HCC resection.MethodsPatients who underwent hepatectomy for HCC from 2011 to 2020 at 10 Chinese hospitals were identified from a prospectively collected database. The survival predictive accuracy was evaluated and compared between the Eastern Staging with six other staging systems, including the JIS, BCLC, Okuda, CLIP, 8th AJCC TNM, and HKLC staging.ResultsAmong 2365 patients, the 1-, 3-, and 5-year overall survival rates were 84.2%, 64.5%, and 52.6%, respectively. Among these seven staging systems, the Eastern staging was associated with the best monotonicity of gradients (linear trend χ²: 408.5) and homogeneity (likelihood ratio χ²: 447.3), and the highest discriminatory ability (the areas under curves for 1-, 3-, and 5-year mortality: 0.776, 0.787, and 0.768, respectively). In addition, the Eastern staging was the most informative staging system in predicting survival (Akaike information criterion: 2982.33).ConclusionUsing a large multicenter prospectively collected database, the Eastern Staging was found to show the best predictive accuracy on long-term overall survival in patients with resectable HCC than the other 6 commonly-used staging systems.     

Adherence patterns to oral hypoglycemic agents among primary care patients with type 2 diabetes

AimsTo examine patterns of adherence to oral hypoglycemic agents among primary care patients with type 2 diabetes mellitus and to assess whether these patterns were associated with baseline intervention allocation, sociodemographic characteristics, and clinical indicators.MethodsAdherence patterns were examined by Medication Event Monitoring System (MEMS) caps at baseline and 12 weeks. Participants (n = 72) were randomly allocated to a Patient Prioritized Planning (PPP) intervention or a control group. The PPP intervention employed a card-sort task to identify health-related priorities that included social determinants of health to address medication nonadherence. Next, a problem-solving process was used to address unmet needs involving referral to resources. Multinomial logistic regression examined patterns of adherence in relation to baseline intervention allocation, sociodemographic characteristics, and clinical indicators.ResultsThree patterns of adherence were found: adherent, increasing adherence, and nonadherent. Participants assigned to the PPP intervention were significantly more likely to have a pattern of improving adherence (Adjusted Odds Ratio (AOR)= 11.28, 95% confidence interval (CI)= 1.78, 71.60) and adherence (AOR=4.68, 95% CI=1.15, 19.02) than participants assigned to the control group.ConclusionPrimary care PPP interventions incorporating social determinants may be effective in fostering and improving patient adherence.