目的横断面研究不同性别的糖尿病患者多种饮食模式对全因死亡的影响和差异。方法分析来自美国国家健康和营养检查调查(National Health and Nutrition Examination Survey,NHANES)数据库中20002名参与者(3737名糖尿病患者)。用COX比例...目的横断面研究不同性别的糖尿病患者多种饮食模式对全因死亡的影响和差异。方法分析来自美国国家健康和营养检查调查(National Health and Nutrition Examination Survey,NHANES)数据库中20002名参与者(3737名糖尿病患者)。用COX比例风险回归模型分析饮食质量评分与不同性别糖尿病患者全因死亡的关系。分层分析评估其他因素是否与饮食模式评分有相互作用。结果在74个月的中位随访期内,有512例死亡记录,男性311例,女性201例。饮食评分较高的糖尿病患者组对比较低组调整风险比如下:饮食炎症指数[男性:风险比(hazard ratio,HR)=1.22,P=0.084;女性HR=1.00,P=0.818];地中海饮食评分(男性:HR=0.99,P=0.873;女性HR=0.79,P=0.027);健康饮食指数-2020(男性HR=1.00,P=0.956;女性HR=0.83,P=0.046)。饮食评分对糖尿病患者死亡风险的影响是独立的,未发现饮食评分与其他变量存在内在的相互作用。结论糖尿病人群中,地中海饮食和健康饮食指数-2020与女性较低的死亡风险相关,而在男性未发现明显的关联。展开更多
Dear Editor,I mplantable collamer lens(ICL)surgery demonstrates longterm stability and favorable refractive outcome[1-2].An increasing number of individuals across all age groups opt for refraction removal through ICL...Dear Editor,I mplantable collamer lens(ICL)surgery demonstrates longterm stability and favorable refractive outcome[1-2].An increasing number of individuals across all age groups opt for refraction removal through ICL surgery.Currently,instances of ICL displacement resulting from trauma remain rare,and there are no documented cases of ICL damage due to blunt trauma.Postoperative ICL dislocations were found in 7 eyes(9775 total,equating to 0.072%of ICL implants),averaging 28.6mo(11-82mo)[3].展开更多
AIM:To observe the clinical efficacy of the combined use of small incision lenticule extraction(SMILE)-derived lenticule patches in corneal dermoid excision,with fixation of the lenticule patches assisted by fibrin gl...AIM:To observe the clinical efficacy of the combined use of small incision lenticule extraction(SMILE)-derived lenticule patches in corneal dermoid excision,with fixation of the lenticule patches assisted by fibrin glue.METHODS:Seventeen eyes of 17 patients with corneal dermoid were treated with dermoid removal combined with SMILE-derived lenticule transplantation.All lenticule patches were fixed by fibrin glue.Ocular changes were assessed using slit lamp microscopy and anterior-segmental optical coherence tomography.The best-corrected visual acuity(BCVA)and ocular dioptric variations were examined preoperatively and postoperatively.Intraocular pressure(IOP)was also monitored in all visited time.RESULTS:Totally,18 lenticule patches were used on 17 eyes of 17 cornea dermoid patients.The mean follow-up time was 11.47±5.28mo.All lenticule patches we resuccessfullyg lued,kept on its location and maintained transparent during the follow-up time,with a consecutive epithelial cover for 1wk.Nine of the patients could coordinate visual and optometry exam well.Their preoperative BCVA is 0.60±0.35 in decimal,significantly improved to 0.80±0.26 in decimal at 6mo postoperatively(Z=-2.392,P=0.017),but the changes of their corneal astigmatism diopters showed no significance,with 2.22±1.91 D preoperatively,and 2.28±1.31 D at 6mo postoperatively(Z=-0.135,P=0.893).Limbal pannus formation occurred in 4(23.52%)cases and decreased with the application of tacrolimus eyedrops.IOP increased in 2(11.76%)cases,but well decreased by timolol maleate eyedrops.All the adult patients or guardians of minor patients were satisfied with the cosmetic improvement.CONCLUSION:Dermoid excision combined with transplantation of SMILE-derived lenticule patches using fibrin glue is a safe and effective novel tectonic keratoplasty procedure for corneal dermoid.展开更多
Objective Resuscitation with whole blood is known to be better than that with saline in attaining the return of spontaneous circulation(ROSC)and improving the short-term survival rate for hemorrhage-induced traumatic ...Objective Resuscitation with whole blood is known to be better than that with saline in attaining the return of spontaneous circulation(ROSC)and improving the short-term survival rate for hemorrhage-induced traumatic cardiac arrest(HiTCA).However,the resuscitation with whole blood alone fails to address the pathophysiological abnormalities,including hyperglycemia,hyperkalemia and coagulopathy,after HiTCA.The present study aimed to determine whether the modified glucose-insulin-potassium(GIK)therapy can ameliorate the above-mentioned pathophysiological abnormalities,enhance the ROSC,improve the function of key organs,and reduce the mortality after HiTCA.Methods HiTCA was induced in rabbits(n=36)by controlled hemorrhage.Following arrest,the rabbits were randomly divided into three groups(n=12 each):group A(no resuscitation),group B(resuscitation with whole blood),and group C(resuscitation with whole blood plus GIK).The GIK therapy was administered based on the actual concentration of glucose and potassium.The ROSC rate and survival rate were obtained.Hemodynamical and biochemical changes were detected.Thromboelastography(TEG)was used to measure coagulation parameters,and enzyme-linked immunosorbent assay to detect parameters related to inflammation,coagulation and the function of brain.Results All animals in groups B and C attained ROSC.Two rabbits died 24–48 h after HiTCA in group B,while no rabbits died in group C.The GIK therapy significantly reduced the levels of blood glucose,potassium,and biological markers for inflammatory reaction,and improved the heart,kidney,liver and brain function in group C when compared to group B.Furthermore,the R values of TEG were significantly lower in group C than in group B,and the maximum amplitude of TEG was slightly lower in group B than in group C,with no significant difference found.Conclusion Resuscitation with whole blood and modified GIK therapy combined can ameliorate the pathophysiological disorders,including hyperglycemia,hyperkalemia and coagulopathy,and may improve the function of key organs after HiTCA.展开更多
文摘目的横断面研究不同性别的糖尿病患者多种饮食模式对全因死亡的影响和差异。方法分析来自美国国家健康和营养检查调查(National Health and Nutrition Examination Survey,NHANES)数据库中20002名参与者(3737名糖尿病患者)。用COX比例风险回归模型分析饮食质量评分与不同性别糖尿病患者全因死亡的关系。分层分析评估其他因素是否与饮食模式评分有相互作用。结果在74个月的中位随访期内,有512例死亡记录,男性311例,女性201例。饮食评分较高的糖尿病患者组对比较低组调整风险比如下:饮食炎症指数[男性:风险比(hazard ratio,HR)=1.22,P=0.084;女性HR=1.00,P=0.818];地中海饮食评分(男性:HR=0.99,P=0.873;女性HR=0.79,P=0.027);健康饮食指数-2020(男性HR=1.00,P=0.956;女性HR=0.83,P=0.046)。饮食评分对糖尿病患者死亡风险的影响是独立的,未发现饮食评分与其他变量存在内在的相互作用。结论糖尿病人群中,地中海饮食和健康饮食指数-2020与女性较低的死亡风险相关,而在男性未发现明显的关联。
基金Supported by the Guangdong Medical Research Foundation(No.B2023206).
文摘Dear Editor,I mplantable collamer lens(ICL)surgery demonstrates longterm stability and favorable refractive outcome[1-2].An increasing number of individuals across all age groups opt for refraction removal through ICL surgery.Currently,instances of ICL displacement resulting from trauma remain rare,and there are no documented cases of ICL damage due to blunt trauma.Postoperative ICL dislocations were found in 7 eyes(9775 total,equating to 0.072%of ICL implants),averaging 28.6mo(11-82mo)[3].
基金Supported by Science and Technology Planning Project of Guangxi Zhuang Autonomous Region (No.AB18221038)Guangxi Medical&Health Appropriate Technology Development and Promoted Application Project (No.S2021092)。
文摘AIM:To observe the clinical efficacy of the combined use of small incision lenticule extraction(SMILE)-derived lenticule patches in corneal dermoid excision,with fixation of the lenticule patches assisted by fibrin glue.METHODS:Seventeen eyes of 17 patients with corneal dermoid were treated with dermoid removal combined with SMILE-derived lenticule transplantation.All lenticule patches were fixed by fibrin glue.Ocular changes were assessed using slit lamp microscopy and anterior-segmental optical coherence tomography.The best-corrected visual acuity(BCVA)and ocular dioptric variations were examined preoperatively and postoperatively.Intraocular pressure(IOP)was also monitored in all visited time.RESULTS:Totally,18 lenticule patches were used on 17 eyes of 17 cornea dermoid patients.The mean follow-up time was 11.47±5.28mo.All lenticule patches we resuccessfullyg lued,kept on its location and maintained transparent during the follow-up time,with a consecutive epithelial cover for 1wk.Nine of the patients could coordinate visual and optometry exam well.Their preoperative BCVA is 0.60±0.35 in decimal,significantly improved to 0.80±0.26 in decimal at 6mo postoperatively(Z=-2.392,P=0.017),but the changes of their corneal astigmatism diopters showed no significance,with 2.22±1.91 D preoperatively,and 2.28±1.31 D at 6mo postoperatively(Z=-0.135,P=0.893).Limbal pannus formation occurred in 4(23.52%)cases and decreased with the application of tacrolimus eyedrops.IOP increased in 2(11.76%)cases,but well decreased by timolol maleate eyedrops.All the adult patients or guardians of minor patients were satisfied with the cosmetic improvement.CONCLUSION:Dermoid excision combined with transplantation of SMILE-derived lenticule patches using fibrin glue is a safe and effective novel tectonic keratoplasty procedure for corneal dermoid.
基金the Key Clinical Innovation Project of Army Medical University and Xinqiao Hospital(CX2019JS107/2018JSLC0023).
文摘Objective Resuscitation with whole blood is known to be better than that with saline in attaining the return of spontaneous circulation(ROSC)and improving the short-term survival rate for hemorrhage-induced traumatic cardiac arrest(HiTCA).However,the resuscitation with whole blood alone fails to address the pathophysiological abnormalities,including hyperglycemia,hyperkalemia and coagulopathy,after HiTCA.The present study aimed to determine whether the modified glucose-insulin-potassium(GIK)therapy can ameliorate the above-mentioned pathophysiological abnormalities,enhance the ROSC,improve the function of key organs,and reduce the mortality after HiTCA.Methods HiTCA was induced in rabbits(n=36)by controlled hemorrhage.Following arrest,the rabbits were randomly divided into three groups(n=12 each):group A(no resuscitation),group B(resuscitation with whole blood),and group C(resuscitation with whole blood plus GIK).The GIK therapy was administered based on the actual concentration of glucose and potassium.The ROSC rate and survival rate were obtained.Hemodynamical and biochemical changes were detected.Thromboelastography(TEG)was used to measure coagulation parameters,and enzyme-linked immunosorbent assay to detect parameters related to inflammation,coagulation and the function of brain.Results All animals in groups B and C attained ROSC.Two rabbits died 24–48 h after HiTCA in group B,while no rabbits died in group C.The GIK therapy significantly reduced the levels of blood glucose,potassium,and biological markers for inflammatory reaction,and improved the heart,kidney,liver and brain function in group C when compared to group B.Furthermore,the R values of TEG were significantly lower in group C than in group B,and the maximum amplitude of TEG was slightly lower in group B than in group C,with no significant difference found.Conclusion Resuscitation with whole blood and modified GIK therapy combined can ameliorate the pathophysiological disorders,including hyperglycemia,hyperkalemia and coagulopathy,and may improve the function of key organs after HiTCA.