The outbreak of the coronavirus disease 2019(COVID-19,previously named 2019-nCoV)has become a serious public health situation in China.1,2 As of February 18,2020,over 70000 patients were diagnosed with COVID-19,includ...The outbreak of the coronavirus disease 2019(COVID-19,previously named 2019-nCoV)has become a serious public health situation in China.1,2 As of February 18,2020,over 70000 patients were diagnosed with COVID-19,including thousands of healthcare providers.Chinese hospitals,especially those in Hubei Province,are facing increasing admission of infected patients,and the epidemics involve hospitals across all levels.展开更多
Background:Current practice uses the latest measure of glycated hemoglobin(HbAlc)to facilitate clinical decision-making.Studies have demonstrated that HbAlc variability links the risk of death and complications of dia...Background:Current practice uses the latest measure of glycated hemoglobin(HbAlc)to facilitate clinical decision-making.Studies have demonstrated that HbAlc variability links the risk of death and complications of diabetes.However,the role of HbAlc variability is unclear in clinical practice.This systematic review summarized the evidence of visit-to-visit HbAlc variability regarding different metrics in micro-and macro-vascular complications and death in people with type 2 diabetes.Methods:We searched PubMed,EMBASE(via OVID),and Cochrane Central Register(CENTRAL,via OVID)for studies investigating the association between HbAlc variability and adverse outcomes in patients with type 2 diabetes and performed random-effects meta-analysis stratified by HbAlc variability metrics in terms of standard deviation(SD),coefficient of variation(CV),and HbAlc variability score(HVS).Results:In people with type 2 diabetes,the highest quantile of all three HbAlc variability metrics(HbAlc-standard deviation[HbAlc-SD],HbAlc-coefficient of variance[HbAlc-CV],and HVS)is associated with increased risks of all-cause mortality,cardiovascular events,progression to chronic kidney disease,amputation,and peripheral neuropathy.For example,the hazard ratio of HbAlc-SD on all-cause mortality was 1.89 with 95%confidence interval(95%CI)1.46–2.45(HbAlc-CV 1.47,95%CI 1.26-1.72;HVS 1.67,95%CI 1.34–2.09).Conclusions:High HbAlc variability leads to micro-and macro-vascular complications of type 2 diabetes and related death.People with type 2 diabetes and high HbAlc variability need additional attention and care for the potential adverse outcomes.展开更多
In order to improve the life quality of diabetic patients,it is very important to develop rapid-acting insulin formulations that can mimic the physiological meal-time secretion profile of insulin in healthy people.Alt...In order to improve the life quality of diabetic patients,it is very important to develop rapid-acting insulin formulations that can mimic the physiological meal-time secretion profile of insulin in healthy people.Although several insulin analogues have been designed to provide postprandial glycemic control,still there are some serious disadvantages.A supramolecular strategy is presented here to inhibit insulin aggregation and improve its bioactivity by using Cp1-11 peptide.As a fragment of C-peptide in proinsulin,Cp1-11 peptide was found to influence insulin oligomerization by supramolecular interactions.This work demonstrates that the Cp1-11 peptide can interact with oligomeric insulin and facilitate its disaggregation into the physiologically active monomeric form.Computer simulation indicates that Cp1-11 can insert into the space between the C-terminal tail and the N-terminal helix of the B-chain of insulin,causing dissociation of the insulin dimer.The supramolecular assembly of Cp1-11 and insulin can improve the bioavailability and therapeutic effect of insulin on the control of in vivo blood glucose levels.These results suggest that Cp1-11 peptide can modulate the intermolecular interaction of aggregated insulin and prevent the transition from monomeric to multimeric states,and shows great potential for the development of an effective rapid-acting strategy to treat diabetes.展开更多
Dear Editor,Evidence-based medicine guides modern clinical practice.Quantitative evidence synthesis facilitates clinical decision-making after comprehensive interviews between clinicians and patients.Individualised co...Dear Editor,Evidence-based medicine guides modern clinical practice.Quantitative evidence synthesis facilitates clinical decision-making after comprehensive interviews between clinicians and patients.Individualised concern is always critical,not only for the diversity of patients’values and preferences,but also for questioning whether the treatment response of the individual is in line with the population.Precision medicine aims to choose the right treatment for each person.展开更多
China faces a substantial burdensome pandemic of obesity.Recent data from the Chinese Centre for Disease Control and Prevention suggested that over an estimated 8.1%of Chinese adults(85 million Chinese adults)had obes...China faces a substantial burdensome pandemic of obesity.Recent data from the Chinese Centre for Disease Control and Prevention suggested that over an estimated 8.1%of Chinese adults(85 million Chinese adults)had obesity in 2018,which was three times the level in 2004.[1]To understand the trends of overweight and obesity in China,we accessed the country/territory-level year-specific data of age-standardized summary exposure value(SEV,standing for the pooled proportion among the population),deaths,and disability-adjusted life of years(DALYs)for high body mass index(BMI,high BMI was defined as the BMI level higher than theoretical minimum risk exposure level[25 kg/m2])and its associated diseases for 204 countries/territories between 1990 and 2019 using data from the Global Burden of Disease Collaborative Network.[2]Previous literature described detailed methods for the data synthesis.[3,4]Using the country/territory-level data by year,we calculated the estimated annual percentage changes(EAPCs)with 95%uncertainty intervals(UI)to estimate the annual changing patterns of age-standardized SEV,death,and DALY rates among 204 countries/territories.To compare statistics from China and other regions,we calculated the corresponding estimates from regions including global,North Africa and Middle East,Sub-Saharan Africa,Western Pacific Region,European Union,Latin America and Caribbean,and South Asia.展开更多
文摘The outbreak of the coronavirus disease 2019(COVID-19,previously named 2019-nCoV)has become a serious public health situation in China.1,2 As of February 18,2020,over 70000 patients were diagnosed with COVID-19,including thousands of healthcare providers.Chinese hospitals,especially those in Hubei Province,are facing increasing admission of infected patients,and the epidemics involve hospitals across all levels.
基金National Key R&D Program of China(No.2018YFC2SSlSSX)the 1.3.5 Project for Disciplines of Excellence,West China Hospital,Sichuan University(Nos.ZYGD18022 and 20HXFH011)。
文摘Background:Current practice uses the latest measure of glycated hemoglobin(HbAlc)to facilitate clinical decision-making.Studies have demonstrated that HbAlc variability links the risk of death and complications of diabetes.However,the role of HbAlc variability is unclear in clinical practice.This systematic review summarized the evidence of visit-to-visit HbAlc variability regarding different metrics in micro-and macro-vascular complications and death in people with type 2 diabetes.Methods:We searched PubMed,EMBASE(via OVID),and Cochrane Central Register(CENTRAL,via OVID)for studies investigating the association between HbAlc variability and adverse outcomes in patients with type 2 diabetes and performed random-effects meta-analysis stratified by HbAlc variability metrics in terms of standard deviation(SD),coefficient of variation(CV),and HbAlc variability score(HVS).Results:In people with type 2 diabetes,the highest quantile of all three HbAlc variability metrics(HbAlc-standard deviation[HbAlc-SD],HbAlc-coefficient of variance[HbAlc-CV],and HVS)is associated with increased risks of all-cause mortality,cardiovascular events,progression to chronic kidney disease,amputation,and peripheral neuropathy.For example,the hazard ratio of HbAlc-SD on all-cause mortality was 1.89 with 95%confidence interval(95%CI)1.46–2.45(HbAlc-CV 1.47,95%CI 1.26-1.72;HVS 1.67,95%CI 1.34–2.09).Conclusions:High HbAlc variability leads to micro-and macro-vascular complications of type 2 diabetes and related death.People with type 2 diabetes and high HbAlc variability need additional attention and care for the potential adverse outcomes.
基金supported by National Natural Science Foundation of China (21534008,51322303 and 21174088)Program for Changjiang Scholars and Innovative Research Team in University (IRT_15R48)State Key Laboratory of Polymer Materials Engineering (Grant No.sklpme2017-2-02).
文摘In order to improve the life quality of diabetic patients,it is very important to develop rapid-acting insulin formulations that can mimic the physiological meal-time secretion profile of insulin in healthy people.Although several insulin analogues have been designed to provide postprandial glycemic control,still there are some serious disadvantages.A supramolecular strategy is presented here to inhibit insulin aggregation and improve its bioactivity by using Cp1-11 peptide.As a fragment of C-peptide in proinsulin,Cp1-11 peptide was found to influence insulin oligomerization by supramolecular interactions.This work demonstrates that the Cp1-11 peptide can interact with oligomeric insulin and facilitate its disaggregation into the physiologically active monomeric form.Computer simulation indicates that Cp1-11 can insert into the space between the C-terminal tail and the N-terminal helix of the B-chain of insulin,causing dissociation of the insulin dimer.The supramolecular assembly of Cp1-11 and insulin can improve the bioavailability and therapeutic effect of insulin on the control of in vivo blood glucose levels.These results suggest that Cp1-11 peptide can modulate the intermolecular interaction of aggregated insulin and prevent the transition from monomeric to multimeric states,and shows great potential for the development of an effective rapid-acting strategy to treat diabetes.
文摘Dear Editor,Evidence-based medicine guides modern clinical practice.Quantitative evidence synthesis facilitates clinical decision-making after comprehensive interviews between clinicians and patients.Individualised concern is always critical,not only for the diversity of patients’values and preferences,but also for questioning whether the treatment response of the individual is in line with the population.Precision medicine aims to choose the right treatment for each person.
基金West China Hospital of Sichuan University(1.3.5 Project for Disciplines of Excellence,Nos.ZYGD18022 and 2020HXF011).
文摘China faces a substantial burdensome pandemic of obesity.Recent data from the Chinese Centre for Disease Control and Prevention suggested that over an estimated 8.1%of Chinese adults(85 million Chinese adults)had obesity in 2018,which was three times the level in 2004.[1]To understand the trends of overweight and obesity in China,we accessed the country/territory-level year-specific data of age-standardized summary exposure value(SEV,standing for the pooled proportion among the population),deaths,and disability-adjusted life of years(DALYs)for high body mass index(BMI,high BMI was defined as the BMI level higher than theoretical minimum risk exposure level[25 kg/m2])and its associated diseases for 204 countries/territories between 1990 and 2019 using data from the Global Burden of Disease Collaborative Network.[2]Previous literature described detailed methods for the data synthesis.[3,4]Using the country/territory-level data by year,we calculated the estimated annual percentage changes(EAPCs)with 95%uncertainty intervals(UI)to estimate the annual changing patterns of age-standardized SEV,death,and DALY rates among 204 countries/territories.To compare statistics from China and other regions,we calculated the corresponding estimates from regions including global,North Africa and Middle East,Sub-Saharan Africa,Western Pacific Region,European Union,Latin America and Caribbean,and South Asia.
