与谁同坐:亭+——城市设计专业设计基础课的教学思考与实践

设计基础是城市设计专业的专业启蒙和导引课程,对于学生价值观的形成、方法论的建立具有重要的作用。面对“传统知识型”大学新生,如何建立适宜的教学方案,培养学生的研究意识和创新能力,是专业教学需要思考的关键问题。本文从设计的概念原点出发,围绕基础教育关于空间启蒙和表达基础训练的两个核心内容,构建“望、闻、问、切”四个维度的空间设计方法论,在此基础上以“在校园”为题,形成大学一年级的设计基础课程体系,并结合设计基础Ⅱ“与谁同坐:亭+”课题介绍教学方案制订和教学实践的过程。

Radar Quantitative Precipitation Estimation Based on the Gated Recurrent Unit Neural Network and Echo-Top Data

The Gated Recurrent Unit(GRU) neural network has great potential in estimating and predicting a variable. In addition to radar reflectivity(Z), radar echo-top height(ET) is also a good indicator of rainfall rate(R). In this study, we propose a new method, GRU_Z-ET, by introducing Z and ET as two independent variables into the GRU neural network to conduct the quantitative single-polarization radar precipitation estimation. The performance of GRU_Z-ET is compared with that of the other three methods in three heavy rainfall cases in China during 2018, namely, the traditional Z-R relationship(Z=300R1.4), the optimal Z-R relationship(Z=79R1.68) and the GRU neural network with only Z as the independent input variable(GRU_Z). The results indicate that the GRU_Z-ET performs the best, while the traditional Z-R relationship performs the worst. The performances of the rest two methods are similar.To further evaluate the performance of the GRU_Z-ET, 200 rainfall events with 21882 total samples during May–July of 2018 are used for statistical analysis. Results demonstrate that the spatial correlation coefficients, threat scores and probability of detection between the observed and estimated precipitation are the largest for the GRU_Z-ET and the smallest for the traditional Z-R relationship, and the root mean square error is just the opposite. In addition, these statistics of GRU_Z are similar to those of optimal Z-R relationship. Thus, it can be concluded that the performance of the GRU_ZET is the best in the four methods for the quantitative precipitation estimation.

Research on the Dynamic Response of Submerged Floating Tunnels to Wave Currents and Traffic Load

Submerged floating tunnel(SFTs)are typically subjected to complex external environmental and internal loads such as wave currents and traffic load.In this study,this problem is investigated through a finite element method able to account for fluid-structure interaction.The obtained results show that increasing the number of vehicles per unit length enhances the transverse vibrational displacements of the SFT cross sections.Under ultimate traffic load condition,one-way and two-way syntropic distributions can promote the dynamic responses of SFTs whereas two-way reverse distributions have the opposite effect.

表里山河 山西聚落——山西潇河国际会议会展中心及配套酒店设计策略浅析

大型会议会展建筑组团作为城市新区聚集空间的核心节点,其资源整合与社会影响力是毋庸置疑的,是实现在地文化展示与技术进步的重要时机。潇河国际会议会展中心组团以“表里山河”为主题,提取“巍巍太行,黄河汤汤,万壑千岩,山西聚落”等城市基因,从规划结构到建筑单体,充分展现雄浑的山西之美;同时,设计关注城市水绿网络、立体交通、功能集合、绿建技术等内容,重新建立起“城市、自然、建筑”的和谐内涵关系。

Activation of various brain areas during acupuncture at Taixi (KI 3) and Qiuxu (GB 40) acupoints

A number of previous studies of acupuncture acupoint specificity have used sham acupoints, sham acupuncture or meridian acupoints at a great distance from each other as controls in functional MRI （fMRI） experiments. However, few studies have compared different meridian acupoints within the same segment, which are associated with similarly intense needle sensations. We performed fMRI on 12 healthy young volunteers and observed differences in brain activation elicited by acupuncture of the Taixi （KI 3） and Qiuxu （GB 40） acupoints. Acupuncture was applied at the Taixi and Qiuxu acupoints, using a multiple-block fMRI design with three blocks, involving three altemations of resting and task phases. After scanning, needle sensation was assessed. The behavioral results revealed that the subjective needle sensation was similar between the Taixiand Qiuxu acupoints. The fMRI results revealed that acupuncture at the right Taixi acupoint activated the right superior temporal gyrus （BA 22）, left middle frontal gyrus （BA 46） and inferior frontal gyrus （BA 45）, bilateral parietal lobe postcentral gyrus （BA 2）, right parietal lobe （BA 3）, and left parietal lobe （BA 40）. Acupuncture at the right Qiuxu acupoint activated the left superior temporal gyrus （BA 42）, right parietal lobe postcentral gyrus （BA 40, BA 43）, right inferior frontal gyrus （BA 47）, bilateral superior temporal gyrus （BA 22）, and right insula BA13. These results suggest that the right Taixiand Qiuxu acupoints activated different brain areas.

The impact of industrial distribution on the distribution of pollution:Evidence from China

This study aims to investigate the effect of industrial development strategies on the distribution of pollution in China.For this purpose,it uses the Theil index to measure the degree to which pollution was concentrated in particular areas of China from 2003 to 2015.Using chart analysis,it shows that industries became more widely spread out over time,and finds water-polluted cities but no air-polluted cities in areas of high industry concentration.Employing estimates from the Theil indices,I find that,while the within-region and between-region imbalances of industrial output were both reduced by the strategic plan,the speed of water pollution diversion does not align with the overall movement of industries,and there is not much between-region movement in wastewater pollution.The distribution of soot emissions is found to differ significantly from that of industrial output,with negligible initial levels and subsequent changes in the between-region concentration of soot emissions.Most of the initial concentration and changes in concentration are within region,suggesting that industrial development strategies have helped spread industries out more evenly.Meanwhile,the distribution of industries is found to have changed the distribution of water pollution,but it did not have any impact on the concentration of air pollution.

Non-alcoholic fatty liver degree and long-term risk of incident inflammatory bowel disease:A large-scale prospective cohort study

Background:Non-alcoholic fatty liver disease(NAFLD)and inflammatory bowel disease(IBD)have shown similar worsening epidemic patterns globally and shared various overlapping pathophysiological mechanisms.However,evidence on the relationship between NAFLD and IBD risk is lacking.We aimed to investigate the associations between long-term risk of incident IBD and NAFLD in a large prospective cohort.Methods:Participants from the United Kingdom Biobank cohort(https://biobank.ndph.ox.ac.uk/)who were free of IBD and alcoholic liver disease at baseline were enrolled.Baseline non-alcoholic fatty liver degree was measured by the well-established fatty liver index(FLI).The outcomes of interest included incident IBD,ulcerative colitis(UC),and Crohn’s disease(CD).Multivariable Cox proportional hazard regression was used to calculate hazard ratios(HRs)and 95%confidence intervals(CIs).Results:Among 418,721 participants(mean FLI:48.11±30.11),160,807(38.40%)participants were diagnosed as NAFLD at baseline.During a median of 12.4 years’follow-up,2346 incident IBD cases(1545 UC,653 CD,and 148 IBD-unclassified)were identified.Due to limited events,those IBD-unclassified were combined in UC or CD when examining the associated risk of UC or CD,separately.Compared with the lowest quartile of FLI,the highest quartile showed a separately 36.00%,25.00%,and 58.00%higher risk of incident IBD(HR_(Q4 vs.Q1)=1.36,95%CI:1.19-1.55,P_(trend)<0.001),UC(HR_(Q4 vs.Q1)=1.25,95%CI:1.07-1.46,P_(trend)=0.047),and CD(HR_(Q4 vs.Q1)=1.58,95%CI:1.26-1.97,P_(trend)<0.001)after multivariable adjustment.Compared with non-NAFLD,NAFLD participants had a significantly higher risk of incident IBD(HR=1.13,95%CI:1.04-1.24)and CD(HR=1.36,95%CI:1.17-1.58).Conclusions:Higher degree of non-alcoholic fatty liver is associated with increased risk of incident IBD.Interventions aimed at improving NAFLD may be a potential targeted strategy for the detection and treatment of IBD.

Effects of long-term blood pressure variability on renal function in community population

High blood pressure is a significant contributor to premature mortality,resulting in nearly 10 million deaths and over 200 million disabilities worldwide.1 In recent years,hypertension treatment has shifted focus not only to average blood pressure but also to blood pressure variability(BPV),categorized into very short-term,short-term,and long-term BPV based on the time period of occurrence.2,3 Long-term BPV has emerged as clinically significant,with studies demonstrating its superiority in predicting long-term cardiovascular events,stroke,and mortality compared to short-term variability.Given its association with pre-renal function decline,reducing blood pressure fluctuations is imperative.

A non-viral gene therapy for melanoma by staphylococcal enterotoxin A

Staphylococcal enterotoxin A(SEA)derived from Staphylococcus aureus,as a superantigen,shows potential for cancer immunotherapy,but systemic immunotoxicity restricts its clinical application.Targeted delivery of SEA to tumor site provides a promising option for reducing the systemic toxicity.Here,we constructed an iRGD peptide(H-[Cys-Arg-Gly-Asp-Lys-Gly-Pro-Asp-Cys]-NH_(2))modified nanoparticle(iDPP)to deliver plasmids encoding SEA for melanoma treatment.The iDPP/SEA nanocomplexes efficiently mediated SEA expression in B16-F10 cells in vivo and in vitro and induced the activation of lymphocytes and maturation of murine bone marrow-derived dendritic cells(BMDCs)in vitro.In the subcutaneous B16-F10 melanoma model,the iDPP/SEA nanocomplexes could effectively enhance immune response and T lymphocytes infiltration in tumor site after intravenous administration,thereby considerably decreased melanoma growth.Meanwhile,no obvious adverse effect was observed after intravenous administration of the iDPP/SEA nanocomplexes in vivo.Our findings demonstrated that gene therapy of SEA is a potential candidate for melanoma treatment.

Identification of high oxygen-consuming substances in stormwater drainage systems illicitly connected with sewage system

The dissolved oxygen content in water is an important indicator for assessing the quality of the water environment,and maintaining a certain amount of dissolved oxygen is essential for the healthy development of the ecological environment.When a water body is anoxic,the activity of anaerobic microorganisms increases and organic matter is decomposed to produce a large number of blackening and odorizing substances,resulting in black and odorous water bodies,which is a very common and typical phenomenon in China.Presently,there is still a relatively universal occurrence of illicitly connected stormwater and sewage pipes in the urban drainage pipe network in China,which makes oxygen-consuming substances be directly discharged into rivers through stormwater pipes and consume the dissolved oxygen in the water bodies,resulting in an oxygen deficiency of the water.This induces seasonal or year-round black and stink phenomena in urban rivers.Hence,identifying high oxygen-consuming substances,which lays the foundation for the subsequent removal of oxygen-consuming substances,is essential.Through a series of comparisons of water quality indicators and analysis of organic characteristics,it was found that the oxygen consumption capacity of domestic sewage was higher than that of industrial wastewater in the selected area of this study,and the oxygen-consuming substances of domestic sewage were small molecular amino acids.By comparing 20 conventional free amino acids,it was found that seven of them consumed oxygen easily,and compared with chemical oxygen consumption,biological oxygen consumption was in a leading position.

低维凝聚态物质的相变与结构调控

低维凝聚态物质已被广泛应用于纳米电子、传感器、离子电池、太阳能电池、能量收集/存储和微/纳米机电等领域,其微观结构与物理性能的关联是凝聚态物理学研究的核心内容.在低维尺度下,凝聚态物质的结构对应力、温度、电场等外界因素非常敏感.因此,我们可以在一个多参数空间对其结构及物性进行精细调控,进而实现一系列新奇量子物态.澄清外场作用下低维凝聚态物质结构相变的原子机制是实现上述目标的关键一环.本文简要介绍本课题组近年来针对低维物质结构稳定性研究的相关进展:(1)应力场作用下,CuO和ZnO纳米线的可逆结构相变机理;(2)高温条件下,低维W、Cu_(2)Se的结构相变机制;(3)电场作用下,钠离子迁移对框架结构钠钨青铜纳米材料结构稳定性的影响;(4)高能电子束辐照对钠钨青铜结构稳定性的影响.上述结果澄清了低维凝聚态物质在单一外场作用下的原子尺度相变过程,进一步探讨了基于外场作用下低维凝聚态物质的结构调控机理.

Association of blood pressure variability with target organ damage in older patients with essential hypertension

Background:Although multiple measures of blood pressure variability(BPV)have been proposed,whether they are better than mean blood pressure in predicting target organs is unclear.We aimed to determine the relationship between short term BPV and target organ injury.Methods:This study was a retrospective study,and 635 inpatients in the Department of Cardiology from 2015 to 2020 were selected.We divided participants into four groups on the basis of the quartiles of BPV.One-way analysis of variance was used to compare the differences between the groups,and linear regression was used to analyze the relationship between BPV and target organ damage.Results:The average age of 635 patients was 74.36±6.50 years old.Among them,354 of 627 patients had diminished renal function(56.5%),221of 604 patients had associated left ventricular hypertrophy(36.6%),and 227 of 231 patients had carotid plaque formation(98.3%).The baseline data indicated significant differences in fasting glucose,total cholesterol,low-density lipoprotein,creatinine,glomerular filtration rate,sex,calcium channel blocker use,and the rate of diminished renal function.Multiple linear regression analysis showed that BPV was negatively correlated with renal injury(creatinine:r=0.306,p<0.01;estimated glomerular filtration rate:r=0.058,p<0.01),and BPV is positively correlated with cardiac injury(r=0.083,p<0.01).Elevated BPV was not found to be associated with vascularinjury.Conclusion:Renal function decreases with increasing BPV and left ventricular mass increases with increasing BPV.

睡眠呼吸暂停综合征患者静脉血栓栓塞症发生率的Meta分析

目的:系统评价阻塞性睡眠呼吸暂停综合征(OSAS)患者静脉血栓栓塞征(VTE)的发生率。方法:检索中国知网、万方、维普、Pubmed、Embase、Cochrane Library数据库,检索各数据库建库至2023年3月24日收录的关于OSAS患者VTE发生率的研究。根据纳入与排除标准,由两名研究者进行文献筛选及评价。采用Stata 15.1进行Meta分析。结果:共纳入10篇文献,包括18345例研究对象。Meta分析结果显示,OSAS患者VTE发生率为2.4%[95%置信区间(1.3%,3.7%)]。进一步的亚组分析结果显示,国内外OSAS患者VTE发生率比较,差异有统计学意义(Z=6.912,P=0.021)。结论:不同种族OSAS患者VTE发生率有所差异,临床上应高度重视OSAS高危人群,及时进行识别、预防VTE,以降低院内OSAS患者出现致死性肺栓塞的风险。

The prognostic role of circulating tumor DNA across breast cancer molecular subtypes:A systematic review and meta-analysis

Objective:Circulating tumor DNA(ctDNA)is increasingly being used as a potential prognostic biomarker in cancer patients.We aimed to assess the prognostic value of ctDNA in different subtypes of breast cancer patients throughout the whole treatment cycle.Materials and methods:PubMed,Web of Science,Embase,Cochrane Library,Scopus,and clinical trials.gov databases were searched from January 2016 to May 2022.The following search terms were used:ctDNA OR circulating tumor DNA AND breast cancer OR breast carcinoma.Only studies written in English were included.The following pre-specified criteria should be met for inclusion:(i)original articles,conference abstracts,etc.;(ii)patients with breast cancer;(iii)ctDNA measurement;and(iv)clinical outcome data such as recurrence-free survival(RFS)and overall survival(OS).The random-effects model was preferred considering the potential het-erogeneity across studies.The main outcomes are ctDNA detection rate and postoperative long-term outcomes(RFS and OS).Results:A total of 24 studies were screened.At every measurement time,the ctDNA detection rate of the HR+subgroup was similar to that of the HR-subgroup(P=0.075;P=0.458;P=0.744;and P=0.578),and the ctDNA detection rate of the HER2+subgroup was similar to that of the HER2-subgroup(P=0.805;P=0.271;P=0.807;and P=0.703).In the HR+subgroup,RFS and OS of ctDNA positive patients were similar to those of ctDNA negative patients(P=0.589 and P=0.110),while RFS and OS of the ctDNA positive group was significantly shorter than those of the ctDNA negative patients in the HR-subgroup(HR=4.03,P<0.001;HR=3.21,P<0.001).According to HER grouping,the results were the same as above.In the triple negative breast cancer(TNBC)subgroup,the RFS and OS of ctDNA-positive patients was significantly shorter than of the ctDNA negative patients before and after surgery.Conclusions:ctDNA was more predictive of recurrence-free survival and overall survival in the HR-subgroup than in the HR+subgroup,and the same result was showed in the HER2-subgroup vs.HER2+subgroup.The prognosis of the TNBC subtype is closely related to ctDNA before and after surgery.

Circulating tumor DNA as prognostic markers of relapsed breast cancer:a systematic review and meta-analysis

Objective: Circulating tumor DNA (ctDNA) is increasingly being used as a potential prognosis biomarker in patients of breast cancer. This review aims to assess the clinical value of ctDNA in outcome prediction in breast cancer patients throughout the whole treatment cycle. Methods: PubMed, Web of Science, Embase, Cochrane Library, Scopus, and clinical trials.gov were searched from January 2016 to May 2022. Conference abstracts published in last three years were also included. The following search terms were used: ctDNA OR circulating tumor DNA AND breast cancer OR breast carcinoma. Only studies written in English languages were included. The following pre-specified criteria should be met for inclusion: (1) observational studies (prospective or retrospective), randomized control trials, case-control studies and case series studies;(2) patients with breast cancer;(3) ctDNA measurement;(4) clinical outcome data such as objective response rate (ORR), pathological complete response (pCR), relapse-free survival (RFS), overall survival (OS), and so on. The random-effect model was preferred considering the potential heterogeneity across studies. The primary outcomes included postoperative short-term outcomes (ORR and pCR) and postoperative long-term outcomes (RFS, OS, and relapse). Secondary outcomes focused on ctDNA detection rate. Results: A total of 30 studies, comprising of 19 cohort studies, 2 case-control studies and 9 case series studies were included. The baseline ctDNA was significantly negatively associated with ORR outcome (Relative Risk [RR] = 0.65, 95% confidence interval [CI]: 0.50–0.83), with lower ORR in the ctDNA-positive group than ctDNAnegative group. ctDNA during neoadjuvant therapy (NAT) treatment was significantly associated with pCR outcomes (Odds Ratio [OR] = 0.15, 95% CI: 0.04–0.54). The strong association between ctDNA and RFS or relapse outcome was significant across the whole treatment period, especially after the surgery (RFS: Hazard Ratio [HR] = 6.74, 95% CI: 3.73–12.17;relapse outcome: RR = 7.11, 95% CI: 3.05–16.53), although there was heterogeneity in these results. Pre-operative and post-operative ctDNA measurements were significantly associated with OS outcomes (pre-operative: HR = 2.03, 95% CI: 1.12–3.70;post-operative: HR = 6.03, 95% CI: 1.31–27.78). Conclusions: In this review, ctDNA measurements at different timepoints are correlated with evaluation indexes at different periods after treatment. The ctDNA can be used as an early potential postoperative prognosis biomarker in breast cancer, and also as a reference index to evaluate the therapeutic effect at different stages.

鼠伤寒沙门氏菌Ⅵ型分泌系统相关基因敲除及其功能特性

Ⅵ型分泌系统(T6SS)是大多数革兰氏阴性细菌中都存在的一种重要的分泌系统,能介导细菌与细菌之间以及细菌和宿主细胞之间的相互作用,溶血素共调节蛋白(Hcp)和缬氨酸甘氨酸重复蛋白G(VgrG)是组成T6SS穿刺装置的重要组分。但鼠伤寒沙门氏菌Ⅵ型分泌系统的Hcp与VgrG在该菌入侵宿主细胞及抗吞噬过程中发挥的作用尚不十分清楚。【目的】本研究旨在利用基因敲除技术构建的鼠伤寒沙门氏菌hcp及vgrg基因缺失株体外接种真核上皮细胞和巨噬细胞,并以其亲本株作为对照,以研究Hcp及VgrG在该菌粘附、侵入上皮细胞及抗吞噬过程中所发挥的作用。【方法】通过优化Red同源重组系统操作过程中各个条件,建立一套快速敲除鼠伤寒沙门氏菌Ⅵ型分泌系统相关基因的操作系统,成功构建鼠伤寒沙门氏菌CVCC541的hcp及vgrg单基因缺失株、双基因缺失株及三基因缺失株,并用Hela细胞接种试验和菌落计数试验,评估不同菌株的粘附和侵袭能力;用小鼠巨噬细胞RAW 264.7接种试验,评估不同菌株的抗吞噬能力。【结果】与亲本株CVCC541粘附侵袭Hela细胞相比,基因缺失株CVCC541Δvgrg、CVCC541Δhcp2Δvgrg和CVCC541Δhcp1Δhcp2Δhcp3的粘附率分别为17.17%±2.1%、14.73%±2.5%和82%±3.7%;CVCC541Δvgrg、CVCC541Δhcp2Δvgrg和CVCC541Δhcp1Δhcp2Δhcp3的侵袭率分别为7.05%±1.05%、6.21%±1.35%和87%±3.25%;与亲本株CVCC541在小鼠巨噬细胞RAW 264.7中的存活相比,基因缺失株CVCC541Δvgrg、CVCC541Δhcp2Δvgrg和CVCC541Δhcp1Δhcp2Δhcp3的存活率分别为15.67%±2.9%、14.47%±1.87%和56.12%±3.48%。【结论】鼠伤寒沙门氏菌Ⅵ型分泌系统VgrG和Hcp对该菌入侵细胞和抗吞噬方面具有重要作用,该研究为鼠伤寒沙门氏菌通过六型分泌系统与宿主细胞相互作用的机制研究奠定了基础。

非瓣膜病房颤患者口服新型抗凝药依从性的调查

目的调查非瓣膜病房颤患者服用新型口服抗凝药的依从性及其影响因素,并分析停药原因。方法采用便利抽样法,对2016年3月—2018年3月某三级甲等医院服用新型口服抗凝药的133例非瓣膜病房颤患者进行调查,统计患者持续服药时间、停药原因和不良事件发生率。采用Kaplan-Meier法和Cox回归分析患者服用新型口服抗凝药的依从性及影响因素。结果服用达比加群酯和利伐沙班的患者分别为101例(75.9%)和32例(24.1%)。患者持续服药中位时间为182 d,达比加群酯和利伐沙班的持续服药中位时间分别为182 d和305 d。生存分析显示,患者在3个月、6个月和1年时仍坚持服药的累积比例分别为72.5%,50.6%和32.3%。阵发性房颤、无心力衰竭和无脑卒中史是服药依从性差的主要因素,患者自行停药是抗凝终止的首要原因。结论非瓣膜病房颤患者服用新型口服抗凝药的依从性差,服药3~6个月时需加强关注,提示应进行多学科合作,对阵发性房颤、无心力衰竭和无脑卒中史的患者加强抗凝管理,改善抗凝质量。

Human organoids in basic research and clinical applications

Organoids are three-dimensional(3D)miniature structures cultured in vitro produced from either human pluripotent stem cells(hPSCs)or adult stem cells(AdSCs)derived from healthy individuals or patients that recapitulate the cellular heterogeneity,structure,and functions of human organs.The advent of human 3D organoid systems is now possible to allow remarkably detailed observation of stem cell morphogens,maintenance and differentiation resemble primary tissues,enhancing the potential to study both human physiology and developmental stage.As they are similar to their original organs and carry human genetic information,organoids derived from patient hold great promise for biomedical research and preclinical drug testing and is currently used for personalized,regenerative medicine,gene repair and transplantation therapy.In recent decades,researchers have succeeded in generating various types of organoids mimicking in vivo organs.Herein,we provide an update on current in vitro differentiation technologies of brain,retinal,kidney,liver,lung,gastrointestinal,cardiac,vascularized and multi-lineage organoids,discuss the differences between PSC-and AdSC-derived organoids,summarize the potential applications of stem cell-derived organoids systems in the laboratory and clinic,and outline the current challenges for the application of organoids,which would deepen the understanding of mechanisms of human development and enhance further utility of organoids in basic research and clinical studies.

一种基于荧光qPCR检测新型冠状病毒核酸的优化反应体系的建立及相关测试

为实时并快速地检出SARS-CoV-2冠状病毒RNA,对基于荧光定量聚合酶链式反应(Polymerasechain reaction,PCR)的反应体系进行了优化。结果表明,按照本实验提供的方法操作后,检测SARS-CoV-2冠状病毒所用的RNA样本的最小浓度稀释度可调至1/10000(初始值设为10ng/μL)。且用于检测COVID-19临床阳性样本所测得循环值(Cycle threshold,Ct)均低于35或40。其灵敏性测试结果也表明该方法的敏感性较好。同时在同等条件下,与目前市场上的COVID-19试剂盒的检测结果基本一致,并且检测循环数缩短2个单位。因此,本实验所建立的体系适用于前期临床诊断的筛查工作,为在医学上实现快速诊断提供了工具。

Negative association of time in range and urinary albumin excretion rate in patients with type 2 diabetes mellitus:a retrospective study of inpatients

Background:Time in range(TIR)refers to the time an individual spends within their target glucose range,which now has been popularized as an important metric to classify glycemic management and also recognized as an important outcome of current diabetes therapies.This study aimed to investigate the association between TIR and the severity of the urinary albumin excretion rate(UAER)in patients with type 2 diabetes mellitus(T2DM).Methods:We retrospectively analyzed the data of 1014 inpatients with T2DM at the Department of Endocrinology and Metabolism of Peking University International Hospital,China.TIR was defined as the percentage of blood glucose within the target range of 3.90-10.00 mmol/L.Urine samples for assessment of UAER were collected for 3 consecutive days from the start of hospitalization.Results:The TIR values for patients with normal urine levels of albumin,microalbuminuria,and macroalbuminuria were 70%±20%,50%±20%,and 30%±20%,respectively(allP<0.001).The patients were stratified according to quartiles of TIR as follows:quartile(Q)1,<55%;Q2,55%-72%;Q3,73%-83%;and Q4,>83%.The incidences of microalbuminuria in Q1,Q2,Q3,and Q4 were 41.1%,21.6%,7.1%,and 5.5%(allP<0.001),respectively.The respective incidences of macroalbuminuria were 24.2%,1.1%,1.4%,and 0%(allP<0.001).In multinomial logistic regression analyses,TIR was significantly correlated with microalbuminuria(odds ratio[OR]0.58,95%confidence interval[CI]:0.52-0.65,P<0.001)and macroalbuminuria(OR 0.26,95%CI:0.18-0.38,P<0.001)after adjusting for age,sex,body mass index,diabetes duration,systolic blood pressure,and levels of triglycerides,glycosylated hemoglobin A1c,and creatinine.Conclusion:The proportion of blood glucose in TIR is closely related to the severity of UAER in patients with T2DM.