Vegetarians have a lower fasting insulin level and higher insulin sensitivity than matched omnivores: A cross-sectional study

Background and aims

Potential associations of vegetarian diet patterns with fasting insulin (FI) and insulin sensitivity remain unclear. We aimed to investigate whether vegetarian diets were associated with FI and insulin sensitivity in a cross-sectional study in Chinese vegetarians and matched omnivores and then to test whether it is independent of body mass index (BMI).

托特罗定治疗直肠癌术后排尿功能障碍患者的效果观察

目的 探讨托特罗定在直肠癌术后排尿功能障碍患者中的应用效果。方法 选择2016年2月～2019年6月期间于我院接受治疗的85例直肠癌术后排尿功能障碍患者,采用随机数字表法分为对照组(n=42)与观察组(n=43)。两组均连续治疗8周,观察两组治疗前后排尿功能障碍分级,并比较两组治疗前后尿动力学指标,同时记录两组治疗期间不良反应发生情况。结果 治疗8周后,两组入选者排尿功能障碍分级均低于治疗前,且与对照组相比,观察组更低,差异有统计学意义(P0.05);治疗8周后,两组入选者最大尿流率(Mean maximal flow rate,Qmax)、排尿量(Mean voided volume,Vcomp)、最大尿道压(Maximum urethral pressure,MUP)水平均高于治疗前,残余尿量(RVU)水平均低于治疗前,且与对照组相比,观察组Qmax、Vcomp、MUP水平更高,RVU水平更低,差异有统计学意义(P0.05);观察组不良反应发生率(9.30%)与对照组(0.00%)比较,差异无统计学意义(P0.05)。结论托特罗定治疗直肠癌术后排尿功能障碍患者效果显著,利于减轻患者排尿功能障碍,改善尿动力学指标及膀胱过度活动症状,且不良反应较少。     

Cabozantinib as a second-line treatment option in hepatocellular carcinoma

ABSTRACT

Introduction

Hepatocellular carcinoma (HCC) is one of the most frequent tumors affecting the gastrointestinal tract and a universal cause of morbidity and mortality. Cabozantinib is a strong multi-inhibitor of receptor tyrosine kinases approved for renal cell carcinoma that could be useful also for the treatment of HCC.     

血清胱抑素C和尿微量白蛋白联合检测在人类免疫缺陷病毒感染者肾功能损伤检测中的应用价值

目的评估血肌酐和尿常规的常规检测基础上联合血清胱抑素C和尿微量白蛋白检测在人类免疫缺陷病毒（HIV）感染者肾功能损伤检测中的应用价值。 方法以2019年2～5月于首都医科大学附属北京地坛医院感染一科住院的169例HIV感染者为研究对象，完善其尿常规、尿微量白蛋白、血肌酐、血清胱抑素C检测；分析尿蛋白及尿微量白蛋白的阳性检出率及其差异，血肌酐升高及血清胱抑素C升高的比例及其差异。计算应用替诺福韦酯（TDF）及合并丙型肝炎、高血压、糖尿病、肿瘤的肾功能损伤的相对危险度。 结果169例HIV感染者中尿常规示尿蛋白阳性者5例（3.0%），尿微量白蛋白升高者17例（10.1%），两者阳性检出率差异具有统计学意义（χ² = 5.9、P = 0.007）。血肌酐升高者10例（5.9%），血清胱抑素C升高者20例（11.8%），两者阳性检出率差异具有统计学意义（χ² = 3.0、P = 0.042）。在尿常规和血肌酐检测的基础上联合检测尿微量白蛋白和血清胱抑素C的总体阳性检出率为49例（30.0%）。CD4⁺ T淋巴细胞计数< 200个/μl与≥ 200个/μl组患者血清胱抑素C水平分别为0.94（0.83，1.05）mg/L、0.85（0.77，0.95）mg/L，差异具有统计学意义（Z =-3.02、P = 0.003）。应用TDF及合并丙型肝炎、高血压、糖尿病、肿瘤的肾功能损伤的相对危险度分别为1.1、1.5、1.9、2.2和1.4。 结论HIV感染者中，单纯以尿常规为依据评估有无蛋白尿，以血肌酐水平为依据评估肾小球滤过功能会低估肾功能损伤的患病率。在常规检测血肌酐和尿常规的基础上联合检测血清胱抑素C和尿微量白蛋白在提高HIV感染者肾功能损伤检出率方面具有重要的应用价值。低CD4⁺ T淋巴细胞计数、应用TDF及合并丙型肝炎、高血压、糖尿病、肿瘤均为肾功能损伤的危险因素。     

Comparison of screw fixation versus non-fixation in dorsal opening wedge medial cuneiform osteotomy of adult acquired flatfoot

BackgroundThe aim of this study was to compare the radiographic and functional results between fixation and non-fixation in the Cotton osteotomy for the treatment of adult acquired flatfoot.MethodsA retrospective, case-controlled study of consecutive stage IIB posterior tibial tendon dysfunction (PTTD) patients treated with the same bony reconstructive surgery including cotton osteotomy between 2013 and 2017. Meary’s angle, the medial arch sag angle (MASA), and medial cuneiform cobb angle (MCCA) were evaluated pre-operation, at first weight bearing after surgery, and 12 months post operation.ResultsForty feet were included in the study. The cotton osteotomy utilized screw fixation (n = 20) or non-fixation technique (n = 20). No significant differences between groups were found in pre-operative and follow-up radiographic parameters, union rate, and functional results.ConclusionThe non-fixation with press fit technique is a reliable procedure for Cotton osteotomy and as effective as screw fixation.Level of evidenceLevel III, case control study     

血塞通软胶囊联合比索洛尔治疗2型糖尿病合并左室舒张功能减退临床观察

目的探讨血塞通软胶囊联合比索洛尔治疗2型糖尿病合并左室舒张功能减退的临床效果。方法选择2017年8月-2018年8月治疗的2型糖尿病合并左室舒张功能减退的患者120例,依据随机数字的方法分为对照组(60例)和观察组(60例),患者入院后均常规治疗,对照组在常规治疗基础上给予比索洛尔,观察组在对照组治疗方法基础上给予血塞通软胶囊。对两组治疗前后的空腹血糖(FPG),餐后2 h血糖(2hPG),糖化血红蛋白(HbA1c),E波峰值流速/A波峰值流速(E/A),E峰减速时间(EDT),左心室容舒张时间(IVRT),血清B型尿钠肽(BNP)浓度进行比较。对两组的治疗效果进行比较。对治疗过程中的不良反应进行对比。结果经过治疗后,对照组的FPG从(7.85±0.67)mmol/L降低到(6.45±0.48)mmol/L,2 hPG从(12.21±1.23)mmol/L降低到(9.35±1.45)mmol/L,HbA1c从(9.31±0.95)%降低到(8.22±0.68)%,观察组的FPG从(7.89±0.71)mmol/L降低到(5.88±0.23)mmol/L,2hPG从(12.37±1.35)mmol/L降低到(8.27±1.34)mmol/L,HbA1c从(9.38±0.88)%降低到(7.14±0.71)%,观察组的变化幅度大于对照组,数据差异均具有统计学意义(t=8.295,4.237,8.509,P<0.05),经过治疗后,对照组的E/A从(0.83±0.13)升高到(0.98±0.17),EDT从(80.51±5.47)ms升高到(92.81±6.23)ms,IVRT从(121.48±7.79)ms升高到(131.51±7.66)ms,观察组的E/A从(0.84±0.12)升高到(1.18±0.21),EDT从(81.65±5.67)ms升高到(98.57±6.72)ms,IVRT从(120.98±7.81)ms升高到(139.25±6.81)ms,观察组的变化幅度大于对照组,数据差异均具有统计学意义(t=-5.734,-4.869,-5.849,P<0.05),经过治疗后,对照组的血清BNP浓度从(222.56±43.25)ng/L降低到(167.11±27.61)ng/L,观察组的血清BNP浓度从(228.92±44.91)ng/L降低到(131.25±25.07)ng/L,观察组的变化幅度大于对照组,数据差异均具有统计学意义(t=7.448,P<0.05),观察组治疗效果优于对照组,数据差异具有统计学意义(z=-2.184,P<0.05),两组的头晕[8.33%(5/60)vs.5.00%(3/60)],水肿[3.33%(2/60)vs.6.67%(4/60)],面部潮红[11.67%(7/60)vs.8.33%(5/60)],头痛[5.00%(3/60)vs.1.67%(1/60)],发生率数据差异均不具有统计学意义(χ^2=0.134,0.175,0.370,0.259,P>0.05)。结论利用血塞通软胶囊联合比索洛尔治疗2型糖尿病合并左室舒张功能减退的患者,可以改善血糖指标和心室功能指标,提升治疗效果,安全性良好。     

Redox state of adipose tissue for patients with gastric cancer and its connection with the body mass index and distance from the tumor

Excess body weight has been causally linked to an increased risk of different cancer types, including gastric cancer but the mechanisms underlying this relationship are not well understood. Superoxide generation rate, activity of complex I in electron transport chain of mitochondria, activity of matrix metalloproteinase (MMP-2 and 9) of adipose tissues (AT) of patients with gastric cancer in AT located adjacent to tumor (ATAT) and at a distance of 3 cm (ATD) are measured to follow the connection of the redox state with some of the microenvironment indicators (HIF-1α, CD68, Plin5), body mass index (BMI) and cancer metastasis.Superoxide generation rate in ATAT positively correlates with BMI (r = 0.59, p < 0.05) being 4 times higher than in control (p < 0.05). MMP-2, 9 activities in ATAT positively correlate with BMI (r = 0.67, p < 0.05) being 3.3-4.0 higher than in control (p < 0.05). In ATD a statistically significant increase of MMP-2 activity is found. In ATAT for the group of patients with distant metastasis (M1) the superoxide generation rate, MMP-2, 9 activities are about 2 times higher (p < 0.05) than in the subgroup without distant metastases (M0). M1 is also characterized by the increased values of HIF-1α+ (factor 1.25), CD68+ (factor 1.4) and Plin5+ (factor 2.1) compared to M0 category in tumor tissues (p < 0.05). The results can be used for better understanding the mechanism(s) of symbiosis of tumor and adipose tissues as well as serve as a basis for new therapeutic approaches.