BMI is strongly associated with hypertension, and waist circumference is strongly associated with type 2 diabetes and dyslipidemia, in northern Chinese adults

Background

Obesity is closely associated with chronic diseases such as hypertension, type 2 diabetes mellitus (T2DM), and dyslipidemia. We analyzed the optimal obesity index cut-off values for metabolic syndrome (MetS), and identified the obesity index that is more closely associated with these chronic diseases, in a population of northern Chinese.

Methods

We surveyed 8940 adults (age, 20–74 years) living in northern China for chronic diseases. Receiver operating characteristics (ROC) analysis, relative risk, and multivariate regression were used to develop an appropriate index and optimal cut-off values for MetS and obesity-related chronic diseases.

Results

Waist circumference (WC) and body mass index (BMI) were good markers for MetS, WC was a good marker for T2DM and dyslipidemia, and BMI was a good marker for hypertension. The optimal BMI cut-off value of MetS was 24 kg/m², and the optimal WC cut-offs were 86 cm and 78 cm in men and women, respectively. Relative risk regression models showed that BMI was associated with hypertension, T2DM, and hypertriglyceridemia and a higher prevalence ratio (PR) for hypertension: 2.35 (95% CI, 2.18–2.50). WC was associated with T2DM, hypertension, and hypertriglyceridemia, with PRs of 2.05 (1.63–2.55) for T2DM and 2.47 (2.04–2.85) for hypertriglyceridemia. In multivariate regression models, the standardized regression coefficients (SRCs) of BMI were greater for SBP and DBP, and the SRC of WC was greater for fasting blood glucose, 2-hour postload blood glucose, triglyceride, and total cholesterol.

Conclusions

Our analysis of a population of northern Chinese indicates that the optimal cut-off values for MetS are WCs of 86 cm in men and 78 cm in women and a BMI of 24 kg/m² in both sexes. BMI was strongly associated with hypertension, while WC was strongly associated with T2DM and dyslipidemia.Key words: obesity, chronic disease, cut-off value     

经皮椎体后凸骨水泥成形联合^125I放射粒子植入治疗脊柱转移瘤

背景：针对肿瘤破坏导致的椎体骨折,进而引起的神经功能障碍,单纯的放疗作用微小。近年来125I放射粒子已广泛应用于多种原发或继发肿瘤并取得良好效果。经皮球囊扩张椎体后凸成形可效恢复椎体高度,重建脊柱稳定性,缓解疼痛症状。 目的：观察经皮球囊扩张椎体后凸成形骨水泥注入联合125I放射粒子治疗脊柱转移瘤的疗效及安全性。 方法：回顾性分析2011年3月至2012年7月经皮球囊扩张椎体后凸成形注入骨水泥联合125I放射粒子治疗的30例脊柱转移瘤患者,收集患者的症状、体征、影像学资料,治疗前均有顽固性背痛,CT提示有椎体骨质破坏。采用目测类比评分、WHO疼痛缓解标准、功能障碍指数来评估治疗后临床症状转归及神经功能恢复情况,测量病椎高度变化。随访时间为治疗后1 d、1个月及6个月。 结果与结论：30例患者治疗过程顺利,治疗后24 h疼痛缓解,无神经损伤及压迫症状。治疗后目测类比评分、疼痛缓解情况、功能障碍指数、椎体高度均较治疗前显著改善（P 〈 0.05）。治疗后随访1个月及6个月,目测类比评分、功能障碍指数、椎体高度变化与治疗后24 h差异无显著性意义（P 〉 0.05）。骨水泥向椎间隙、前纵韧带下渗漏各2例无临床症状。提示经皮球囊扩张椎体后凸成形骨水泥注入联合125I放射粒子治疗脊柱转移瘤,能迅速缓解肿瘤所致的疼痛,有效恢复病椎高度,并发症少,显著提高患者生活质量。     

卵巢良性囊肿剥除不同术式效果比较及阴式途径的特点分析

目的：比较采用阴式途径、腹腔镜以及腹式不同术式行卵巢囊肿剥除术治疗卵巢良性囊肿的临床效果,总结阴式途径术式的特点。方法2006年1月至2012年12月来我院治疗的卵巢良性囊肿患者226例,其中75例行经阴道手术（阴式组）,77例行腹腔镜下手术（腹腔镜组）,74例行开腹手术（腹式组）。观察比较3组的手术时间、术中出血量、术后镇痛病例、术后排气时间和住院天数,以及术后病率。随访时间为术后1、3个月,进行临床疗效评定。结果术中手术时间和出血量阴式组[（41.71±16.92）min、（33.11±20.19）ml]与腹腔镜组[（50.73±18.71）min、（38.21±18.73）ml]和腹式组[（61.81±19.75）min、（107.29±41.27）ml]相比最少;术后排气时间（12.19±4.17）h 较腹腔镜组（15.43±4.31）h、腹式组（30.00±6.21）h 短;住院时间阴式组[（4.38±1.30）d 较腹腔镜组（5.60±0.50）d、腹式组（8.50±2.00）d]短,差异有统计学意义（P ＜0.05或 P ＜0.01）;术后病率阴式组1.33％、腹腔镜组1.30％较腹式组（4.05％）低,差异有统计学意义（P =0.036）。随访到3个月,3组有效率[阴式组94.7％（71/75）、腹腔镜组94.8％（73/77）、腹式组94.6％（70/74）]比较差异无统计学意义（P ＞0.05）。结论经阴道手术和腹腔镜手术治疗卵巢良性囊肿各有利弊,临床应用要准确掌握手术指征,以最小的创伤达到最佳治疗效果。     

Comparison of Three Dimeric 18F-AlF-NOTA-RGD Tracers

Purpose

RGD peptide-based radiotracers are well established as integrin α_vβ₃ imaging probes to evaluate tumor angiogenesis or tissue remodeling after ischemia or infarction. In order to optimize the labeling process and pharmacokinetics of the imaging probes, we synthesized three dimeric RGD peptides with or without PEGylation and performed in vivo screening.

Procedures

Radiolabeling was achieved through the reaction of F-18 aluminum–fluoride complex with the cyclic chelator, 1,4,7-triazacyclononane-1,4,7-triacetic acid (NOTA). Three imaging probes were synthesized as ¹⁸F-AlF-NOTA-E[c(RGDfK)]₂, ¹⁸F-AlF-NOTA-PEG₄-E[c(RGDfK)]₂, and ¹⁸F-AlF-NOTA-E[PEG₄-c(RGDfk)]₂. The receptor binding affinity was determined by competitive cell binding assay, and the stability was evaluated by mouse serum incubation. Tumor uptake and whole body distribution of the three tracers were compared through direct tissue sampling and PET quantification of U87MG tumor-bearing mice.

Results

All three compounds remained intact after 120 min incubation with mouse serum. They all had a rapid and relatively high tracer uptake in U87MG tumors with good target-to-background ratios. Compared with the other two tracers, ¹⁸F-AlF-NOTA-E[PEG₄-c(RGDfk)]₂ had the highest tumor uptake and the lowest accumulation in the liver. The integrin receptor specificity was confirmed by co-injection of unlabeled dimeric RGD peptide.

Conclusion

The rapid one-step radiolabeling strategy by the complexation of ¹⁸F-aluminum fluoride with NOTA-peptide conjugates was successfully applied to synthesize three dimeric RGD peptides. Among the three probes developed, ¹⁸F-AlF-NOTA-E[PEG₄-c(RGDfk)]₂ with relatively low liver uptake and high tumor accumulation appears to be a promising candidate for further translational research.     

肿瘤坏死因子α与性激素结合球蛋白在孕早期糖尿病中的表达及其临床意义

目的探讨妊娠期糖尿病(GDM)患者孕早期肿瘤坏死因子α(TNF-α)、性激素结合球蛋白(SHBG)与胰岛素抵抗的关系及对妊娠结局进行研究。方法选择395例孕15周前妇女留取空腹静脉血和血浆,随访至24²8周进行75 g口服葡萄糖耐量试验。测定孕妇孕早期TNF-α、SHBG及HOMA-IR水平。结果 (1)395例孕妇中有65例(16.5%)诊断为GDM。(2)孕早期,GDM孕妇的TNF-α、HOMA-IR均显著高于正常孕妇(P<0.01);而GDM孕妇的SHBG显著低于正常孕妇(P<0.01)。Pearson分析显示,GDM组TNF-α、SHBG均与HOMA-IR呈正相关;正常孕妇的TNF-α、SHBG均与HOMA-IR不相关。(3)GDM妊娠的不良妊娠结局显著高于正常妊娠。(4)单项检测TNF-α的灵敏度为69.2%,特异度为75.5%;单项检测SHBG的灵敏度为70.8%,特异度为40.3%。TNF-α与SHBG联合检测,灵敏度和特异度分别为92.3%、93.0%。结论 TNF-α、SHBG对于早期预测GDM有非常重要的作用。联合TNF-α和SHBG检测可提高诊断GDM的灵敏度和特异度。     

个体化护理对肾结石经皮肾镜超声碎石术后肾造瘘管的影响

目的探讨个体化护理对肾结石经皮肾镜超声碎石术（PNUL）后患者肾造瘘管的影响。方法选择2010年3月—2013年3月收治的肾结石患者184例,按照随机数字表法分为研究组与对照组,每组各92例。两组患者均采取PNUL治疗,对照组患者术后采取常规护理,研究组患者在此基础上采取个体化护理干预,比较两组患者住院时间、拔出造瘘管时间及术后并发症发生情况。结果研究组患者住院时间、拔出造瘘管时间分别为（7．98±1．68）,（5．12±1．66）d,均少于对照组的（10．23±2．54）,（7．54±1．12）d,差异有统计学意义（t值分别为2．824,2．537;P〈0．05）。研究组无瘘管堵塞和感染患者;瘘管脱落发生率研究组为1．09％,对照组为11．96％,两组比较差异有统计学意义（x2=8．915,P〈0．01）;研究组护理的总满意度为98．91％,对照组为78．26％,两组比较差异有统计学意义（x2=114．649,P〈0．01）。结论针对肾结石PNUL术后患者。肾造瘘管采取个体化护理,能够有效降低术后并发症,保障治疗效果及手术的成功率。     

临床护士积极心理品质与专业自我概念的相关性研究

目的：了解临床护士积极心理品质与专业自我概念状况及两者相关性,为护理管理提供依据。方法采用自制一般情况调查表、积极心理品质量表和护理专业自我概念量表（ PSCNI ）对1139名临床护士进行问卷调查。结果临床护士积极心理品质量表总分为（174．95±16．68）分,节制维度条目平均得分最高,为（3．76±0．59）分,超越维度平均得分最低,为（2．13±0．41）分;护理专业自我概念量表总分为（91．32±12．76）分,技能维度条目平均得分最高,为（3．65±0．28）分,满意度条目平均得分最低,为（2．46±0．36）分。专业自我概念得分值与积极心理品质得分值呈正相关（ r值分别为0．218～0．526,P＜0．05）;多元回归分析显示,认知维度、情感维度、人际维度、公正维度及超越维度是专业自我概念的主要影响因素。结论临床护士专业自我概念状况不佳,提高护士积极心理品质,有助于增强专业自我概念水平。     

养血清脑颗粒对偏头痛病人头痛发作的影响研究

目的 :观察养血清脑颗粒对偏头痛病人的治疗效果。方法 :将 70例确诊为偏头痛的病人随机分为养血清脑颗粒组(治疗组 ) 3 5例和对照组 3 5例 ,治疗组服用养血清脑颗粒 ,对照组给予西比灵胶囊治疗 ,连续观察 3 0d。结果 :两组均可减少偏头痛发作持续时间和发作次数 ,但养血清脑颗粒组优于西比灵组 (P <0 .0 5 ) ;两组总有效率比较无统计学意义 ,但在缓解率上 ,治疗组优于对照组 (P <0 .0 1) ,在伴随症状的改善上 ,治疗组亦优于对照组。结论 :养血清脑颗粒对偏头痛病人头痛发作有良好的治疗作用。     

E-cadherin gene C-160A promoter polymorphism and risk of non-cardia gastric cancer in a Chinese population

AIM: To test the hypothesis that E-cadherin gene (CDH1) C-160A promoter variant genotype is associated with an increased risk for developing gastric cancer. METHODS: In this population-based case-control study of gastric cancer in Jiangsu Province, China, we performed polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) to genotype the C-160A polymorphism of CDH1 promoter in 206 non-cardia gastric cancer patients and 261 age- and sex-matched but unrelated cancer-free controls. RESULTS: The frequencies of genotypes CC, CA and AA were 57.8%, 36.4% and 5.8% in gasfric cancer cases, respectively, and 58.2%, 34.9% and 6.9% in controls respectively. The distributions of CDH1 genotypes were not significantly different between gastric cancer cases and controls (P=0.87 for genotype frequency and P=0.92 for allele frequency). Compared with the CC genotype, the CA and AA genotypes were not associated with an increased risk for non-cardia gastric cancer (adjusted odds ratios (OR)=1.15, and 95% confidence interval (95% CI)=0.78-1.72 for CA genotype, and OR = 0.90 and 95% CI = 0.42-2.01 for AA genotype). CONCLUSION: E-cadherin gene C-160A promoter polymorphism may not play a major role in the etiology of non-cardia gastric cancer in Chinese population.