Effects of lifestyle interventions on rural patients with type 2 diabetes mellitus

BACKGROUND The prevalence of type 2 diabetes mellitus(T2DM)is rising rapidly in rural areas,and lifestyle interventions can effectively reduce the blood glucose levels of patients with T2DM.However,current dietary and exercise guidelines are still at experimental stages and are difficult for subjects to understand and implement.The Human Metabolism Analyzer provides real life interventions for the prevention and treatment of T2DM,and our pilot research has demonstrated its effectiveness and good compliance.AIM To investigate the effect of and compliance with lifestyle interventions in rural patients with T2DM.METHODS A total of ten rural villages were randomly selected in Chaoshui Township,Penglai City,Shandong Province,China,to conduct health screening among residents aged 50 years or older.Each rural village represented a group,and 12 patients with T2DM were randomly selected from each group(total:120)to participate in this study and receive real life lifestyle interventions and medication guidance.Lifestyle interventions included changing the meal order(A),postprandial activities(B),resistance exercise(C),and reverse abdominal breathing(D).Diabetes education was conducted at least once a month with a weekly phone follow-up to monitor exercise and diet.Waist circumference,blood pressure,body mass index(BMI),motor function,body composition,fasting blood glucose,and glycated hemoglobin(HbA1c)were analyzed before and 3 mo after the intervention.Moreover,patient compliance and adjustments of hypoglycemic drugs were evaluated.RESULTS A total of 109 subjects completed the study.The compliance rates for lifestyle interventions A,B,C,and D were 57.79%,60.55%,64.22%,and 75.23%,respectively.Among the subjects who received hypoglycemic drugs,the dose was reduced 2 to 3 times based on blood glucose in 54(67.50%)subjects and was tapered and discontinued in 5(6.25%)subjects within 3 mo,with no significant fluctuations in blood glucose after dose reduction and withdrawal.After lifestyle interventions,waist circumference,BMI,fasting blood glucose,and HbA1c significantly decreased(P<0.001);motor function and body composition also significantly improved(P<0.001).CONCLUSION For patients with T2DM,compliance to real-life lifestyle interventions is good,and the interventions significantly improve metabolic indicators such as waist circumference,BMI,blood pressure,HbA1c,body composition,and motor function.Some patients are able to taper or discontinue hypoglycemic drugs.

Efficacy and safety of early oral feeding in postoperative patients with upper gastrointestinal tumor:A systematic review and metaanalysis

BACKGROUND Early oral feeding(EOF)is an important measure for early recovery of patients with gastrointestinal tumors after surgery,which has emerged as a safe and effective postoperative strategy for improving clinical outcomes.AIM To determine the safety and efficacy of early oral feeding in postoperative patients with upper gastrointestinal tumor.METHODS This meta-analysis was analyzed using Review Manager version 5.3 and Stata version 14.All clinical studies that analyzed efficacy and safety of EOF for postoperative patients with upper gastrointestinal tumor were included.RESULTS Fifteen studies comprising 2100 adult patients met all the inclusion criteria.A significantly lower risk of pneumonia was presented in the EOF compared with TOF group[relative risk(RR)=0.63,95%confidence interval(CI):0.44-0.89,P=0.01].Length of hospital stay was significantly shorter in the EOF group than in the TOF group[weighted mean difference(WMD)=-1.91,95%CI:-2.42 to-1.40;P<0.01].Cost of hospitalization was significantly lower(WMD=-4.16,95%CI:-5.72 to-2.61;P<0.01),and CD4 cell count and CD4/CD8 cell ratio on postoperative day 7 were significantly higher in the EOF group than in the TOF group:CD4 count(WMD=7.17,95%CI:6.48-7.85;P<0.01),CD4/CD8 ratio(WMD=0.29,95%CI:0.23-0.35;P<0.01).There was no significant difference in risk of anastomotic leak and total postoperative complications.CONCLUSION EOF as compared with TOF was associated with lower risk of pneumonia,shorter hospital length of stay,lower cost of hospitalization,and significantly improved postoperative immune function of patients.

Differential protein expression during colonic adaptation in ultra-short bowel rats

AIM: To investigate the proteins involved in colonic adaptation and molecular mechanisms of colonic adaptation in rats with ultra-short bowel syndrome (USBS). METHODS: Sprague Dawley rats were randomly assigned to three groups: USBS group (10 rats) undergoing an approximately 90%-95% small bowel resection; sham-operation group (10 rats) undergoing small bowel transaction and anastomosis; and control group (ten normal rats). Colon morphology and differential protein expression was analyzed after rats were given postsurgical enteral nutrition for 21 d. Protein expression in the colonic mucosa was analyzed by two-dimensional electrophoresis (2-DE) in all groups. Differential protein spots were detected by ImageMaster 2D Platinum soft-ware and were further analyzed with matrix-assisted laser desorption/ionization-time-of-flight/time-of-flightmass spectrometric (MALDI-TOF/TOF-MS) analysis. RESULTS: The colonic mucosal thickness significantly increased in the USBS group compared with the control group (302.1 ± 16.9 μm vs 273.7 ± 16.0 μm, P < 0.05). There was no statistically significant difference between the sham-operation group and control group (P > 0.05). The height of colon plica markedly improved in USBS group compared with the control group (998.4 ± 81.2 μm vs 883.4 ± 39.0 μm, P < 0.05). There was no statistically significant difference between the shamoperation and control groups (P > 0.05). A total of 141 differential protein spots were found in the USBS group. Forty-nine of these spots were down-regulated while 92 protein spots were up-regulated by over 2-folds. There were 133 differential protein spots in USBS group. Thirty of these spots were down-regulated and 103 were upregulated. There were 47 common differential protein spots among the three groups, including 17 downregulated protein spots and 30 up-regulated spots. Among 47 differential spots, eight up-regulated proteins were identified by MALDITOF/TOF-MS. These proteins were previously reported to be involved in sugar and fat metabolism, protein synthesis and oxidation reduction, which are associated with colonic adaption. CONCLUSION: Eight proteins found in this study play important roles in colonic compensation and are associated with sugar and fat metabolism, protein synthesis, and molecular

主要胃的图章戒指房间癌作为心脏的 tamponade 介绍

Primary gastric signet ring cell carcinoma presenting as cardiac tamponade is difficult to diagnosis early.Patients are generally asymptomatic until the disease is advanced.General practitioners usually focus on the initial symptoms related to pericarditis and pericardial effusion.We report a case of signet-ring cell carcinoma of the stomach presenting as cardiac tamponade with pericarditis and pericardial effusion but without any gastrointestinal symptoms.A 49-year old woman was admitted because of progressive dyspnea and cough.Chest X-ray revealed an increased cardiothoracic ratio and a small amount of bilateral pleural effusion.Two dimensional ultrasonographic echocardiography pericardial effusions with atrial and right ventricular early diastolic collapse were found,establishing the diagnosis of cardiac tamponade.Pericardiocentesis was performed and 420 mL of bloody fluid was taken.The patient died of respiratory failure and cardiac arrest on October 28,2009.Post-mortem examination revealed diffuse gastric mucosa erosion and edema with stomach mucosa incrassation in the greater curvature.The primary lesion was histopathologically diagnosed as signet-ring cell carcinoma of the stomach.

Molecular biomarkers of colorectal cancer:prognostic and predictive tools for clinical practice

Colorectal cancer remains one of the most common types of cancer and leading causes of cancer death worldwide.Although we have made steady progress in chemotherapy and targeted therapy,evidence suggests that the majority of patients undergoing drug therapy experience severe,debilitating,and even lethal adverse drug events which considerably outweigh the benefits.The identification of suitable biomarkers will allow clinicians to deliver the most appropriate drugs to specific patients and spare them ineffective and expensive treatments.Prognostic and predictive biomarkers have been the subjects of many published papers,but few have been widely incorporated into clinical practice.Here,we want to review recent biomarker data related to colorectal cancer,which may have been ready for clinical use.

高水溶性、抗氧化活性和口服吸收率的橙皮素纳米制剂的制备（英文）

目的:橙皮素拥有抗氧化、抗炎和降脂等多种生理活性,但由于其水溶性差、代谢快,导致其口服生物利用度很低。因此,本研究制备了橙皮素-维生素E聚乙二醇琥珀酸酯(TPGS)胶束和橙皮素-磷脂酰胆碱(PC)复合物,来提高橙皮素的水溶性、抗氧化活性和口服吸收率。创新点:本研究使用美国食品药品监督管理局(US FDA)批准的辅料制备了两种纳米制剂:橙皮素-TPGS胶束和橙皮素-PC复合物。不仅制备方法简单,而且能显著提高橙皮素的水溶性、抗氧化活性和口服吸收率。方法:本研究使用溶剂分散法制备纳米制剂。将橙皮素与分散剂溶于有机溶剂中,在40°C下搅拌30 min,然后旋转蒸发除去溶剂,用水复溶即得橙皮素-TPGS胶束和橙皮素-PC复合物。本研究使用差示扫描量热法表征纳米制剂的热效应;用动态光散射法测定纳米制剂的粒径;用噻唑蓝(MTT)法检测纳米制剂的细胞毒性;用细胞抗氧化活性测定法对比纳米制剂与橙皮素本身的抗氧化活性;使用灌胃法评估纳米制剂的口服吸收效果。结论:研究结果发现:以质量比1:12制备的橙皮素-TPGS胶束和橙皮素-PC复合物,其粒径分别为26.19和219.15 nm,没有明显的细胞毒性,同时能够将橙皮素的水溶性分别提高到21.5和20.7倍,抗氧化活性分别提高到4.2和3.9倍,口服生物利用分别提高到16.2和18.0倍。因此,这两种纳米制剂在药剂和保健品制造方面具有重要的应用价值。