Importance of serum phosphate in elderly patients with diabetes mellitus

BACKGROUND Metabolic disturbances including changes in serum calcium,magnesium or phosphate(P) influence the prevalence of type 2 diabetes mellitus(DM).We assessed the importance of serum P in elderly patients with type 2 DM vs nondiabetes mellitus(non-DM) in relation to renal function.AIM To determine the association between serum P and serum glucose or insulin resistance in diabetic and non-diabetic patients.METHODS One hundred-ten subjects with a mean age of 69.02±14.3 years were enrolled.Twenty-nine of the participants had type 2 DM(26.4%).The incidence of hypertension,smoking and receiving vitamin D(vitD) derivates were recorded.The participants were classified by both estimated glomerular filtration rate(eGFR) and albuminuria categories according to the Kidney Disease Improving Global Outcomes 2012 criteria.RESULTS We divided the patients in two groups according to the P cut-off point related to DM value.A comparison between high and low P showed that body mass index30.2±6.3 vs 28.1±4.6(P=0.04),mean glucose 63.6 vs 50.2(P=0.03),uric acid 6.7±1.6 vs 6.09±1.7(P=0.05),mean intact-parathyroid hormone 68.06 vs 47.4(P=0.001),systolic blood pressure 147.4±16.7 vs 140..2±16.1(P=0.02),mean albuminuria 63.2 vs 50.6(P=0.04) and eGFR 45.6±22.1 vs 55.4±21.5(P=0.02)were significantly different.χ~2 tests showed a significant association between high P and DM,hypertension,receiving vitD,smoking and eGFR stage(χ~2=6.3,P=0.01,χ~2=3.9,P=0.03,χ~2=6.9,P=0.009,χ~2=7.04,P=0.01 and χ~2=7.36,P=0.04,respectively).The adjusted model showed that older age,female gender and increased body mass index were significant predictors of type 2 DM when entering the covariates.CONCLUSION High serum P contributes to vascular and metabolic disturbances in elderly patients with type 2 DM and renal impairment.     

血清SAA/CRP、CD64对儿童甲型流感早期诊断的临床价值分析

目的探讨血清淀粉酶A蛋白(SAA)与C-反应蛋白(CRP)比值SAA/CRP、中性粒细胞表面抗原CD64对儿童甲型流感早期诊断的临床价值。方法选择2017年8月~2019年2月来医院儿科就诊的125例流感症状患儿作为研究对象,根据患儿临床诊断结果将其分为甲型流感组31例、非甲型流感组94例;再选择同期在天津海河教育园区达文路卫生服务中心健康体检健康儿童30例作为对照组。患儿入组后立即留取鼻咽吸取液,采用RT-PCR鉴定流感病毒型别;采集末梢血进行7项呼吸道病毒联合检测及血清SAA、CRP以及外周血中性粒细胞表面抗原CD64表达水平。结果甲型流感组与非甲型流感组患儿血清SAA、SAA/CRP以及CD64指数显著高于对照组,甲型流感组血清SAA、SAA/CRP以及CD64指数显著高于非甲型流感组,差异均有统计学意义(P<0.05),3组儿童血清CRP水平比较差异无统计学意义(P>0.05)。运用ROC曲线分析在疑似甲型流感125例患儿中血清SAA、CRP、SAA/CRP以及CD64对甲型流感诊断价值,结果显示各指标诊断曲线下面积分别为0.908、0.641、0.994、0.957。结论甲型流感患儿血清SAA、SAA/CRP以及中性粒细胞表面受体CD64表达显著升高,在甲型流感患儿的早期临床诊断中具有较高的辅助价值。     

血清尿酸水平评估慢性阻塞性肺疾病急性加重者病情的临床价值

目的探讨血清尿酸水平评估慢性阻塞性肺疾病急性加重（AECOPD）者病情的临床价值。方法收集2014年4月至2015年4月在呼吸科住院治疗的111例经肺功能检测确诊的AECOPD患者的临床资料。以血清尿酸值416μg/L为临界点，分成血清尿酸＞416μg/L组，血清尿酸＜416μg/L组，进行临床资料分析。结果血清尿酸＞416μg/L组以男性为主，年龄更大，吸烟率更高，肺功能更差，D级患者构成比更多，在首次住院床日、1年内机械通气发生率、1年内病死率、1年内住院次数均显著高于血清尿酸＜416μg/L组（P＜0.05或0.01）。血清尿酸＞416μg/L组呼吸衰竭更严重，更多合并有冠心病、充血性心力衰竭、心律失常、糖尿病、恶性肿瘤、意外骨折和褥疮（P＜0.05或0.01）。结论测定AECOPD患者血清尿酸水平有助于对其病情及预后作出评估。     

氯吡格雷治疗急性缺血性脑卒中的疗效及对血浆大内皮素1血清脂蛋白(a)的影响

目的探讨氯吡格雷治疗急性缺血性脑卒中的临床效果及对患者血浆大内皮素1、血清脂蛋白(a)的影响。方法将我院于2012-01—2014-03收治的诊断为急性缺血性脑卒中的患者134例,按照随机数字法将患者平均为观察组67例和对照组67例,入院后2组患者均给予常规治疗,观察组患者在此基础上给予氯吡格雷片治疗,观察2组患者治疗前后big ET-1、Lp(a)的水平变化以及治疗前与治疗后1、3、6个月时患者的神经功能缺损情况、日常生活能力以及脑血管血流速度。结果 2组患者经过治疗后NIHSS评分、ADL评分、血浆big ET-1、Lp(a)的水平均有显著降低,而VMCA显著升高,其中观察组治疗后3个月及6个月时的NIHSS评分、ADL评分及VMCA水平均有显著改善,同时显著优于对照组,而观察组经过治疗后血浆big ET-1、Lp(a)水平也显著低于对照组,差异均具有统计学意义(P0.05)。结论氯吡格雷治疗急性缺血性脑卒中临床效果显著,能够显著促进神经功能恢复,改善患者的血管内皮功能,提高生活质量,同时能够显著降低患者的血浆big ET-1、Lp(a)水平,可通过血浆big ET-1、Lp(a)水平对患者的预后预测提供依据。     

糖尿病行血清C肽与糖化血红蛋白联合检验的临床价值研究

〔摘 要〕 目的：探讨对糖尿病患者实施血清 C 肽、糖化血红蛋白联合检验的临床价值。方法：选取 2019 年 5 月至 2020 年 5 月阳春市人民医院收治的糖尿病患者 120 例作为观察组，另选取同期健康体检者 120 例作为对照组，所选研究对 象均通过 TOSOHHLC–723G8 型全自动糖化血红蛋白分析仪和西门子全自动化学发光分析仪 Siemens ADVIA Centaur XP 实 施糖化血红蛋白和血清 C 肽水平检验，比较两组的检验结果。结果：相较于对照组健康体检者，观察组患者的糖化血红蛋 白水平明显更高，血清 C 肽明显更低，组间比较，差异均具有统计学意义（P ＜ 0.05）。结论：联合检验血清 C 肽和糖化 血红蛋白水平能够为糖尿病的早期诊断提供参考。     

Evidence-based tailored nutrition educational intervention improves adherence to dietary guidelines,anthropometric measures and serum metabolic biomarkers in early-stage breast cancer patients: A prospective interventional study

PurposeThe impact of the adherence to dietary guidelines of early-stage breast cancer (EBC) patients on body composition changes during treatment is not entirely defined. This study aimed to evaluate the role of an evidence-based nutrition educational intervention, according to adherence to dietary guidelines, in EBC patients.MethodsThis prospective study included EBC patients, candidates for neoadjuvant/adjuvant therapy. Patients received an evidence-based tailored nutrition educational intervention. The adherence to dietary guidelines, anthropometric and dietary assessments, and blood glucose and lipid profile tests were evaluated at baseline and after a 12-months nutritional intervention.ResultsTwo hundred and forty-three patients were enrolled. At baseline, 38.3% and 23.9% of patients were overweight and obese, weight gain ≥5% (compared to 6-months before enrollment) and central obesity were observed in 47.3% and 52.7% of patients, respectively. Adherence to dietary guidelines was low (median Med-Diet score: 6 [IQR 4–8]). After the nutritional intervention (median follow-up: 22 months [range 12–45]), adherence to dietary guidelines significantly increased (median Med-Diet score: 12 [IQR 8–13]), p < 0.0001). High adherence to dietary guidelines (defines as Med-Diet score ≥10) significantly correlated with: 1) overall weight loss ≥5% (21.8% vs. 2.5%, p = 0.003); 2) median BMI drop (from 25.6 kg/m² to 24.4 kg/m², p = 0.003); 3) lower prevalence of central obesity (38.2% vs. 7.2%, p = 0.01); 4) improvement in blood glucose levels and lipid profile.ConclusionThis study suggests that an evidence-based tailored nutrition educational intervention during treatment for EBC significantly increases overall adherence to dietary guidelines, and it improves both anthropometric measures and serum metabolic biomarkers in patients with high adherence.     

Effect of saccharin,a non-nutritive sweeteners,on insulin and blood glucose levels in healthy young men: A crossover trial

Background and aimsArtificial sweeteners used instead of sugar were considered as the best alternatives that have no endocrine effects. However, it has recently been suggested that artificial sweeteners may cause impaired metabolic parameters. The hypothesis of the study was there is an association between acute saccharin consumption and both glycemia and insulin response in young healthy adult men.Methods9 healthy adult males were included in this study. This study randomly provided participants with preloads as (a)300 ml of water, or 300 ml of water sweetened with (b)75 g of sucrose, (c)240 mg of saccharine (adjusted to the sweetness of 75 g of sucrose) 1 h before a standard breakfast.ResultsCompared to mean blood glucose and serum insulin after test drinks consumption, there was only one difference between sucrose and saccharin trials in the 15th minute (117.0 ± 18.70, 95.4 ± 5.64 mg/dl respectively, p < 0.05). At the 60th minute, insulin secretion (0.80 ± 0.27 pg/dl) after the sucrose trial was found significantly higher than the saccharin trial (0.53 ± 0.09 pg/dl) and water (0.49 ± 0.06 pg/dl) (p < 0.05). Although at all intervals (except 90th minute), the mean insulin is higher after the saccharin trial compared to the water trial, these were non-statistically significant differences (p > 0.05).ConclusionsConsequently, it was determined that saccharin had no glycemic effect. However, for the effect on serum insulin to be clarified, the long-term effects should be investigated.     

The balance of serum IL-18/IL-37 levels is disrupted during the development of oral squamous cell carcinoma

Growing evidences have demonstrated a pivotal role of chronic inflammation in oral squamous cell carcinoma (OSCC) through the modulation of inflammatory cells and cytokine production. IL-37 is newly discovered anti-inflammatory member of IL-1 family and can bind to IL-18 receptor to inhibit IL-18 (pro-inflammatory member of IL-1 family) function. Investigation on the balance of IL-18/IL-37 would provide new insights into the function of IL-1 family in OSCC. Thus, serum IL-18 and IL-37 levels of OSCC patients (n = 108), leukoplakia patients (n = 40), and healthy donors (n = 36) were collected to analyze the balance of IL-18 and IL-37, and also determine their diagnostic value and prognostic significance in OSCC. The results showed that OSCC patients had high IL-18 and low IL-37 levels in serum and peripheral blood mononuclear cell (PBMC). The ratio of IL-18/IL-37 in serum efficiently distinguished non-cancer individuals from OSCC patients (cut off value: 2.15). Moreover, patients with high IL-18 and low IL-37 were susceptible to develop advanced tumor stage and lymph node metastasis (Odd ratios of IL-18/IL-37 is 4.903 and 12.613, respectively). Meanwhile, higher IL-18/IL-37 ratio could predict shorter overall survival and disease-free survival of OSCC patients, although it was not an independent prognostic factor. We further analyze the correlations of serum IL-18/IL-37 with immunocytes in peripheral blood and found that high IL-18 level was associated with more CD19⁺ B cells, while serum IL-37 seem to be associated with reduced percentage of CD3⁺CD8⁺ T cells, indicating its balance could change the adaptive immune response. Unexpectedly, we first revealed the different function of IL-18/IL-37 in serum and tumor tissues. High mRNA expression of IL-18 in tumor tissues correlated with low lymph node metastasis rate and low tumor stage, which was contradictory to the pro-tumor role of IL-18 in serum. In conclusion, enhanced ratio of IL-18/IL-37 level in serum could be an efficient biomarker for OSCC. Its balance might regulate CD19⁺ B cells and CD3⁺ CD8⁺ T cells for OSCC progression.