Body composition and metabolic syndrome in patients with type 1 diabetes

BACKGROUND In recent years,the prevalence of obesity and metabolic syndrome in type 1 diabetes(T1DM)patients has gradually increased.Insulin resistance in T1DM deserves attention.It is necessary to clarify the relationship between body composition,metabolic syndrome and insulin resistance in T1DM to guide clinical treatment and intervention.AIM To assess body composition(BC)in T1DM patients and evaluate the relationship between BC,metabolic syndrome(MS),and insulin resistance in these indi-viduals.METHODS A total of 101 subjects with T1DM,aged 10 years or older,and with a disease duration of over 1 year were included.Bioelectrical impedance analysis using the Tsinghua-Tongfang BC Analyzer BCA-1B was employed to measure various BC parameters.Clinical and laboratory data were collected,and insulin resistance was calculated using the estimated glucose disposal rate(eGDR).RESULTS MS was diagnosed in 16/101 patients(15.84%),overweight in 16/101 patients(15.84%),obesity in 4/101(3.96%),hypertension in 34/101(33.66%%)and dyslip-idemia in 16/101 patients(15.84%).Visceral fat index(VFI)and trunk fat mass were significantly and negatively correlated with eGDR(both P<0.001).Female patients exhibited higher body fat percentage and visceral fat ratio compared to male patients.Binary logistic regression analysis revealed that significant factors for MS included eGDR[P=0.017,odds ratio(OR)=0.109],VFI(P=0.030,OR=3.529),and a family history of diabetes(P=0.004,OR=0.228).Significant factors for hypertension included eGDR(P<0.001,OR=0.488)and skeletal muscle mass(P=0.003,OR=1.111).Significant factors for dyslipidemia included trunk fat mass(P=0.033,OR=1.202)and eGDR(P=0.037,OR=0.708).CONCLUSION Visceral fat was found to be a superior predictor of MS compared to conventional measures such as body mass index and waist-to-hip ratio in Chinese individuals with T1DM.BC analysis,specifically identifying visceral fat(trunk fat),may play an important role in identifying the increased risk of MS in non-obese patients with T1DM.

Clinical significance of programmed death 1/programmed death ligand 1 pathway in gastric neuroendocrine carcinomas

BACKGROUND Recently, more and more studies have demonstrated the pivotal role of programmed death 1/programmed death ligand 1(PD-1/PD-L1) pathway in the immune evasion of tumors from the host immune system. However, the role of PD-1/PD-L1 pathway in gastric neuroendocrine carcinomas(G-NECs) remains unknown.AIM To investigate the expression of PD-1/PD-L1 and role of PD-1/PD-L1 pathway in G-NECs, which occur rarely but are highly malignant and clinically defiant.METHODS We investigated the expression of PD-L1 on tumor cells and PD-1^+, CD8^+, and FOXP3^+ T cell infiltration by immunohistochemistry in 43 resected G-NEC tissue specimens. The copy number alterations of PD-L1 were assessed by qRT-PCR.RESULTS Most of the G-NECs tumor cells exhibited a near-uniform expression pattern of PD-L1, while some showed a tumor-stromal interface enhanced pattern. Of the 43G-NECs, 21(48.8%) were classified as a high PD-L1 expression group, and the high expression of PD-L1 was associated with poor overall survival(OS). The high expression of PD-L1 was correlated with abundant PD-1^+ tumor infiltrating lymphocytes(TILs) instead of CD8^+ TILs and FOXP3^+ regulatory T cells(Tregs).Our analysis also suggested that the infiltration of CD8^+ TILs tended to be a favorable factor for OS, although the difference did not reach the statistical significance(P = 0.065). Meanwhile, PD-L1 was significantly overexpressed in cases with copy number gain as compared with those without.CONCLUSION Our data demonstrated for the first time that high expression of PD-L1 in GNECs is associated with a poor prognosis, while the high expression may be due to the copy number variation of PD-L1 gene or stimulation of TILs. These results provide a basis for the immunotherapy targeting PD-1/PD-L1 pathway in GNECs.

Home-based nursing for improvement of quality of life and depression in patients with postpartum depression

BACKGROUND Postpartum depression is a common mental illness in puerpera,with an incidence of approximately 3.5%-33.0%abroad,and the incidence of postpartum depression in China is higher than the international level,reaching 10.0%-38.0%.Providing effective nursing care in clinical nursing activities is one of the key points of obstetrical care.However,little research has been designed to investigate the positive role of home-based nursing in the prevention of postpartum depression.AIM To study the effect of home-based nursing for postpartum depression patients on their quality of life and depression.METHODS The clinical data of 92 patients with postpartum depression treated at our hospital were retrospectively analyzed.The patients were grouped according to the nursing methods used;40 patients receiving basic nursing were included in a basic nursing group,and 52 receiving home-based nursing were included in a home-based nursing group.Depression and anxiety were evaluated and compared between the two groups.The estradiol(E2),serotonin(5-hydroxytryptamine,5-HT),and progesterone(PRGE)levels were measured.RESULTS The SAS and SDS scores of the home-based nursing group were significantly lower than those of the basic nursing group(P<0.05).The E2 and 5-HT levels of the home-based nursing group were significantly higher than those of the basic nursing group,but the PRGE level was significantly lower than that of the basic nursing group.The GQOLI-74 scores(material,social,somatic,and psychological)and nursing satisfaction were significantly higher in the home-based nursing group(P<0.05).CONCLUSION Postpartum depression through home-based nursing can effectively alleviate depression and improve the quality of life of patients,help modulate their serum E2,5-HT,and PRGE levels,and improve their satisfaction with nursing care.

Botany,Traditional Uses,and Pharmacology of Polygonati Rhizoma

Huang Jing (黄精 Polygonati Rhizoma, PR) was first documented as a herbal medicine in Ming Yi Bie Lu (《名医别录》 Miscellaneous Records of Famous Physicians) in China. However, there was no comprehensive review on the botany, traditional uses, and pharmacological effects of PR till now. In this study, the botany, traditional uses including Taoist medicine, and pharmacological effects of PR were reviewed and summarized to provide insights on drug development of PR. In Taoist medicine, PR maintains agerasia and helps prolong human life-span, and is used for fasting (Bigu). In the Zhong Guo Yao Dian (《中国药典》Chinese Pharmacopeia) version 2020, PR exerts replenishing qi and nourishing yin, invigorating the spleen, moistening the lung, and strengthening the kidney. Pharmacological studies show that PR has effects of anti-oxidation, anti-diabetes, anti-osteoporosis, anti-cancer, anti-hyperlipidemia, cardiomyocyte protection, immunomodulatory, and thus can be used for treatment of infertility, anti-microorganisms, and improving sleep and memory. In conclusion, PR may play a potential role for chronic disease management and health preservation and this very role deserves a more in-depth research.

Application of ozonated water for treatment of gastro-thoracic fistula after comprehensive esophageal squamous cell carcinoma therapy: A case report

BACKGROUND Gastro-thoracic fistula is a serious complication after radical surgery for esophageal cancer,and a conservative approach or endoscopic intervention is commonly applied to treat most cases.CASE SUMMARY Here we describe the case of a patient with a gastro-thoracic fistula which could not be closed during gastroscopy after receiving postoperative radiotherapy,together with severe multiple drug-resistant bacterial infection and chest wall fistula.The abscess was drained and local irrigation applied with ozonated water,together with oral ozonated water,which achieved a good effect and highlighted a new way to cure fistula in such patients.CONCLUSION Patients with gastro-thoracic fistula that cannot be closed and severe infection can be treated by drainage and flushing with ozonated water.

Effect of male HBV infection on the outcomes of IVF/ICSI cycles:a retrospective cohort study based on propensity score matching

This study aimed to investigate the effects of male hepatitis B virus(HBV)infection on male fertility,embryonic development,and in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)outcomes.We performed a retrospective cohort study that included 3965 infertile couples who received fresh embryo transfer cycles for the first time at the Fujian Maternity and Child Health Hospital(Fuzhou,China)from January 2018 to January 2021.Infertile couples were categorized based on their HBV infection status into the HBV group(HBV-positive men and HBV-negative women)and the control group(HBV-negative couples).A 1:1 propensity score matching was performed with relatively balanced covariates.Baseline characteristics,semen parameters,laboratory outcomes,clinical outcomes,and obstetric and neonatal outcomes were compared between groups.After propensity score matching,821 couples were included in each group.Both groups had similar semen parameters and obstetric and neonatal outcomes.The HBV group showed a significantly lower live birth rate than the control group(P<0.05).The HBV group had a significantly higher abortion rate than the control group(P<0.05).The rates of high-quality embryos and blastocyst formation were significantly lower in the HBV group than those in the control group(both P<0.05).In conclusion,in couples who undergo IVF/ICSI,male HBV infection reduces the live birth rate and increases the risk of miscarriage.However,the incidence of low birth weight in women with IVF/ICSI does not increase with male HBV infection.

Refractory hypotension under neuraxial anesthesia for cesarean delivery

Aortocaval compression syndrome is also known as a supine hypotensive syndrome, it is very common in late pregnancy especially in supine positioning under neuraxial anesthesia. It is occurred when the inferior vena cava and the aorta were compressed by the uterus, and often manifested as hypotension, tachycardia, nausea, dizziness, and syncope. Besides, reducing of uteroplacental perfusion may result in morbidity or even mortality to the fetus. It is critical to recognize the cause of hypotension in the pregnant patient, and it is necessary to alleviate the compressing pressure of uterus on the inferior vena cava immediately if suspected of aortocaval compression. We report a pregnant woman with rheumatoid arthritis (RA) who experienced refractory hypotension resistant to large doses of vasopressor therapy when undergoing cesarean delivery with combined spinal-epidural anesthesia.

Tetracycline removal by a magnetic heterojunction Cu_(2)O/CoFe_(2)O_(4) activating peroxymonosulfate

The electron transfer mechanism in the process of peroxymonosulfate(PMS)activation using heterojunction catalyst was controversial.In this work,magnetic heterojunction Cu_(2)O/CoFe_(2)O_(4)(CC)was first synthesized to activate PMS.An innovative reaction mechanism based on built-in electric field-driven electron migration from Cu2O to CoFe2O4 and effective magnetic moment of CC for enhancing PMS activation was proposed.Meanwhile,the CC/PMS system was used for efficient removal of antibiotic tetracycline(TC).Under optimal conditions,98.0%TC could be removed using CC/PMS catalytic system after only 30 min.The catalytic activity was higher than that of Cu_(2)O/PMS and CoFe_(2)O_(4)/PMS.Meanwhile,the impact of solution pH on TC removal was insignificant,suggesting the pH-insensitive PMS activation ability of CC.Besides,the coexisting inorganic ions in the environment,such as HCO_(3)-,H_(2)PO4-,NO_(3)-,Cl-and humic acid(HA)as representative of natural organic matter,did not inhibit TC removal in CC/PMS system.Furthermore,CC/PMS system exhibited excellent reusability with more than94.0%TC removal after the 5th reuse.Electron paramagnetic resonance(EPR)tests and quenching experiments showed that O_(2)·-and 1O_(2) played vital roles in TC removal.The intermediate products and corresponding toxicity assessment revealed that this catalytic system could reduce TC toxicity.This work provided new insights into the PMS activation mechanism using heterogeneous magnetic catalysts,including transition metal oxide.

Case of multiple verruca plantaris

A female student,23 years old,suffering from multiple warts scattered on the right sole for 2 years and pain on the bottom of the first metatarsal bone when walking for 1 month.The case was diagnosed as kujinjian(枯筋箭)in traditional Chinese medicine and verruca plantaris in western medicine.At the beginning of treatment,fire needling therapy was applied to local lesions,once every two days.Afterwards,moxibustion with moxa cone was used at the local lesions,once a day,three cones on each lesion till warts were dropped.Simultaneously,in combination,mild moxibustion was given at bilateral Zusanli(足三里ST36)for 15 min,once a day.After three times of moxibustion therapy,a part of warts were crusted and 3 weeks later,all the warts were dropped.No recurrence was found in the follow-up visit.The therapeutic methods of this case are simple in manipulation and satisfactory in therapeutic effect.