Inverted U-Shaped Associations between Glycemic Indices and Serum Uric Acid Levels in the General Chinese Population: Findings from the China Cardiometabolic Disease and Cancer Cohort (4C) Study

Objective The relationship between serum uric acid(SUA)levels and glycemic indices,including plasma glucose(FPG),2-hour postload glucose(2 h-PG),and glycated hemoglobin(HbA1 c),remains inconclusive.We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population.Methods The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study.A total of 105,922 community-dwelling adults aged≥40 years underwent the oral glucose tolerance test and uric acid assessment.The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models.Results A total of 30,941 men and 62,361 women were eligible for the current analysis.Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels,but with different inflection points in men and women.The thresholds for FPG,2 h-PG,and HbA1 c for men and women were 6.5/8.0 mmol/L,11.0/14.0 mmol/L,and 6.1/6.5,respectively(SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices).Conclusion An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes,while the inflection points were reached earlier in men than in women.     

A descriptive pharmacokinetic/pharmacodynamic analysis of continuous infusion ceftazidime-avibactam in a case series of critically ill renal patients treated for documented carbapenem-resistant Gram-negative bloodstream infections and/or ventilator-associated pneumonia

ObjectivesTo describe the pharmacokinetic/pharmacodynamic (PK/PD) behaviour of continuous infusion (CI) ceftazidime-avibactam and the microbiological outcome in a case series of critically ill renal patients treated for documented carbapenem-resistant Gram-negative (CR-GN) bloodstream infections (BSI) and/or ventilator-associated pneumonia (VAP).MethodsCritically ill patients with different degrees of renal function who were treated with CI ceftazidime-avibactam for documented CR-GN infections, and who underwent therapeutic drug monitoring from April 2021 to March 2022, were retrospectively assessed. Ceftazidime and avibactam concentrations were determined at steady-state, and the free fraction (fC_ss) was calculated. The joint PK/PD target of ceftazidime-avibactam was considered as optimal when both C_ss/MIC ratio for ceftazidime ≥4 (equivalent to 100%fT>_4xMIC) and C_ss/C_T ratio for avibactam >1 (equivalent to 100% fT>C_T of 4.0 mg/L) were simultaneously achieved (quasi-optimal if only one of the two was achieved, and suboptimal if neither of the two was achieved). The relationship between ceftazidime-avibactam PK/PD targets and microbiological outcome was assessed.ResultsTen patients with documented CR-GN infections (5 BSIs, 4 VAP, 1 BSI+VAP) were retrieved. The joint PK/PD targets of ceftazidime-avibactam were optimal and quasi-optimal in eight and two cases, respectively. Microbiological failure occurred in two patients (one with VAP, one with BSI+VAP), one of whom developed ceftazidime-avibactam resistance. Both underwent renal replacement therapy, and failed despite attaining optimal joint PK/PD target and receiving fosfomycin co-treatment.ConclusionCI administration may enable optimal joint PK/PD targets of ceftazidime-avibactam to be achieved in most critical renal patients with CR-GN infections, and may help to minimize the risk of microbiological failure.     

体位复位经皮椎体成形术治疗骨质疏松性椎体压缩骨折

目的探讨体位复位经皮椎体成形术(PVP)治疗骨质疏松性椎体压缩骨折的疗效。方法采用体位复位PVP治疗88例GenantⅠ、Ⅱ、Ⅲ型骨质疏松性椎体压缩骨折患者。分别记录GenantⅠ、Ⅱ、Ⅲ型骨折患者的手术前后伤椎前缘高度比、伤椎后凸角、疼痛VAS评分,比较术后骨水泥渗漏情况。结果患者均获得随访,时间3~12个月。GenantⅠ、Ⅱ、Ⅲ型骨折患者的伤椎前缘高度比、伤椎后凸角、VAS评分术后2 d均较术前显著改善,差异均有统计学意义(P<0.01)。术后患者均未发生脊髓神经损伤、肺栓塞及下肢静脉血栓形成等并发症。术后17例(19.3%)发生骨水泥渗漏,其中13例渗漏到椎体旁,4例渗漏到椎间盘,无椎管内渗漏发生,均未产生临床症状。骨水泥渗漏发生率GenantⅠ型较GenantⅡ、Ⅲ型低,差异有统计学意义(P<0.05)。结论体位复位PVP治疗骨质疏松性椎体压缩骨折能有效减轻患者疼痛,明显改善GenantⅡ、Ⅲ型椎体压缩骨折的伤椎前缘高度比及后凸角,但随着椎体压缩程度的增加,骨水泥渗漏风险增高。     

Apigenin attenuates oxidative stress and neuronal apoptosis in early brain injury following subarachnoid hemorrhage

Apigenin (API) is a naturally occurring plant flavone that exhibits powerful antioxidant and antiapoptosis. Oxidative stress plays an important role in the pathogenesis of early brain injury (EBI) following subarachnoid hemorrhage (SAH). The potential anti-oxidative and anti-apoptosis effects of API on EBI following SAH, however, have not been elucidated. The aim of this study was to assess whether API alleviates EBI after SAH via its anti-oxidative and anti-apoptotic effects. The endovascular puncture model was used to induce SAH and all the rats were subsequently sacrificed at 24 h after SAH. Our data demonstrated that administration of API could significantly alleviate EBI (including neurological deficiency, brain edema, blood–brain barrier permeability, and cortical cell apoptosis) after SAH in rats. Meanwhile, API treatment reduced the reactive oxygen species (ROS) level and the concentration of malondialdehyde (MDA) and myeloperoxidase (MPO), elevated the ratio of glutathione (GSH) and oxidized glutathione (GSSG), and increased the amount of super-oxide dismutase (SOD) and hydrogen peroxide in brain cortex at 24 h following SAH. Moreover, API treatment inhibited SAH-induced the expression of Bax and caspase-3, significantly reduced neuronal apoptosis. Collectively, API exerts its neuroprotective effect likely through the dual activities of anti-oxidation and anti-apoptosis, at least partly. These data provide a basic platform to consider API may be safely used as a potential drug for treatment of SAH.     

Association of ischemic and hemorrhagic strokes hospital admission with extreme temperature in Nanchang,China—A case-crossover study

Despite consistent evidence of a higher short-term risk of stroke mortality associated with ambient temperature, there are no findings on the association between extreme temperature and stroke. A total of 16,264 stroke hospital admissions were observed in three hospitals of Nanchang between 2008 and 2015. The case-crossover design was utilized for our study. Conditional logistic regression models were used to calculate the odds ratios. Extreme high temperature exposure during the 3 days before the stroke was associated with both ischemic (OR = 1.18; 95% CI: 1.07–1.36) and hemorrhagic stroke admissions (OR = 1.34; 95% CI: 1.26–1.42) as compared to 3-day control periods (1–3 days last week before the onset of stroke). Extreme low temperature was associated with hemorrhagic stroke admission (OR = 1.42; 95% CI: 1.28–1.58) but not ischemic stroke (OR = 1.06; 95% CI: 0.93–1.13). This study suggests that extreme high temperature might be a risk factor for both hemorrhagic and ischemic strokes, and that extreme low temperature might be a risk factor of hemorrhagic stroke. Further studies are necessary in order to clarify this relationship and provide evidence for stroke prevention.     

不同波形电针治疗单纯性肥胖病的临床对比观察

目的观察连续波、疏密波电针对单纯性肥胖病肥胖指标及临床疗效的影响。方法将68例患者随机分为连续波组33例和疏密波组35例,两组患者均选取中脘、天枢、气海、足三里,三阴交、曲池,并分别在中脘、气海、双侧天枢穴上加用10Hz连续波和2Hz、10Hz、100Hz循环疏密波。30次为1个疗程,治疗2个疗程后评价临床疗效。治疗过程中对体重、体脂含量的变化进行动态监测,并于治疗前后分别测定两组患者的临床症状积分及各项肥胖指标。结果连续波组显效率21.21%,总有效率87.88%;疏密波组显效率45.71%,总有效率94.29%,两组显效率比较差异有统计学意义(P<0.05),总有效率比较差异无统计学意义(P>0.05)。除腰臀比外,两组患者其他肥胖指标及临床症状总积分治疗后均较治疗前明显下降(P<0.01);其中两组治疗后临床症状总积分比较,两组治疗前后体重、体重指数、腰围差值比较差异亦有统计学意义(P<0.05或P<0.01)。两组体重、体脂含量的动态变化情况基本一致,体重基本呈现"下降明显-近似平台-缓慢下降"的趋势;而体脂含量治疗初期变化缓慢,之后下降幅度日渐增大,且持续稳步下降,未见明显的平台期。结论连续波、疏密波电针均可改善单纯性肥胖病症状及肥胖指标,但总体疗效疏密波优于连续波。