老年2型糖尿病患者衰弱现状及影响因素分析

目的了解老年2型糖尿病患者的衰弱现状,并探讨老年2型糖尿病患者发生衰弱的影响因素。方法对成都中医药大学附属医院内分泌科住院治疗的306例老年2型糖尿病患者进行横断面调查,采用一般资料调查表、临床资料调查表分别收集患者的社会人口学资料、生活方式及疾病相关资料,采用Fried衰弱量表评估患者衰弱状况,采用营养状况调查表、Charlson合并症指数(CCI)分别评估患者营养状况、多病共存的情况。结果老年2型糖尿病患者衰弱发生率为54.58%(167/306),衰弱前期为21.24%(65/306),非衰弱24.18%(74/306)。其中握力低、躯体活动量低、步行速度慢是发生最多的3个衰弱指标。单因素分析结果显示:不同2型老年糖尿病患者的衰弱状况在年龄、糖尿病并发症数量、口服双胍类降糖药患者的比例、糖化血红蛋白水平、C反应蛋白水平、营养评分(微型营养评估简表)、BMI、血红蛋白水平、清蛋白水平、CCI评分方面差异有统计学意义(P <0.05)。多分类有序Logistic回归结果显示:年龄、营养状况、糖化血糖水平、CCI评分为老年2型糖尿病患者衰弱的影响因素。结论老年2型糖尿病患者的衰弱发生率高,衰弱的发生受多种因素影响,提示临床医护人员应密切关注老年2型糖尿病患者衰弱问题,针对性的采取干预措施,以减少衰弱发生。

Measurements of the parapapillary atrophy area and other fundus morphological features in high myopia with or without posterior staphyloma and myopic traction maculopathy

AIM:To investigate the affecting factors of parapapillary gamma and delta zones and other fundus morphological features in high myopia.METHODS:Seventy high myopia patients were included in this retrospective observational study and 47 patients were female.Patients were divided into three groups:no posterior staphyloma(no PS),PS with myopic traction maculopathy(PS with MTM),and PS without MTM using 3-dimensional magnetic resonance imaging and optical coherence tomography.MTM patients were fur ther classified into three types[epiretinal membrane,macular hole,and macular retinoschisis(MRS)].Diameters of the gamma and delta zones were measured among other morphometric variables using fundus photographs.RESULTS:Of the 70 individuals(127 eyes),the mean age was 57.46±13.56y.In univariate analysis,morphological features changed most dramatically in PS with MTM patients,who had the largest gamma zone diameters,the largest disk-fovea distance(DFD)and disk-fovea angle,and the smallest angle kappa and vertical distance of temporal arterial arcade.However,their horizontal delta zone diameter was smaller than in the patients with PS yet without MTM.In multivariate analysis,with axial length(AL)and age adjusted,the horizontal diameter in the delta zone of the PS without MTM group was still significantly larger than in the PS with MTM group(P=0.024).Comparing the three subtypes of MTM patients,the diameters of the gamma zone and DFD in MRS group were the largest.CONCLUSION:The characteristics of the gamma and delta zones change inconsistently in different stages of high myopia.These changes may be associated with anatomical changes caused by local traction.Factors such as PS,AL and age play an important role.These findings may provide a hint about the pathogenesis of traction in high myopia.

Comparison of ocular parameters of two biometric measurement devices in highly myopic eyes

AIM: To compare the differences and agreement of ocular biometric parameters in highly myopic eyes obtained by optical biometric measurement instruments, the OA-2000 and IOLMaster 500. METHODS: Totally, 90 patients(90 eyes) were included. They were divided into high myopia group and control group. Ocular parameters, including axial length(AL), mean keratometry(Km), anterior chamber depth(ACD), and white to white(WTW), were obtained from the OA-2000 and IOLMaster 500. RESULTS: For the control group, we applied BlandAltman graphs to assess the 95% limits of agreement(LoA) for most parameters including AL, ACD, Km, and WTW(-0.24 to 0.29 mm,-0.22 to 0.45 mm,-0.39 to 0.31 D, and-0.90 to 0.86 mm, respectively). In high myopia patients, AL, ACD, Km values had wider 95% LoA(-0.34 to 0.32 mm,-0.36 to 0.34 mm,-0.57 to 0.47 D, respectively), except WTW(-0.80 to 0.68 mm). Differences were not statistically significant between these two instruments(P>0.05). CONCLUSION: Most parameters obtained by the OA-2000 and IOLMaster 500 are comparable, including the AL, ACD, and K values. Among them, the agreement of the high myopia patients is poor compared to the patients without high myopia.

Internal limiting membrane peeling with different dyes in the surgery of idiopathic macular hole: a systematic review of literature and network Meta-analysis

AIM: To evaluate the effect of internal limiting membrane(ILM) peeling with indocyanine green(ICG), brilliant blue G(BBG), triamcinolone acetonide(TA), trypan blue(TB), or without dye for the treatment of idiopathic macular hole(IMH). METHODS: A search was conducted using Pub Med, EMBASE, and CENTRAL(Cochrane Central Register of Controlled Trials) for related studies published before October 2018. RESULTS: A total of 29 studies and 2514 eyes were included in this network Meta-analysis. For IMH closure, the rank from the best to the worse treatment was: BBG, TB, TA, ICG, and no dye. There was a significant difference in postoperative IMH closure rate between BBG and no dye. The rank of the best to the worse treatment to improve visual acuity was: BBG, TB, no dye, TA, and ICG. The improvement rate of visual acuity after using BBG was significantly higher than ICG. The improvement rate of visual acuity was more favorable with TB than ICG, TA, and no dye. CONCLUSION: BBG can contribute to better anatomical and functional outcomes compared to other dyes for ILM peeling in patients with IMH. The results show that the best treatment of ILM peeling with dyes is BBG.

Bioinspired design of integral molded Janus silk fibroin-MXene evaporator for efficient solar vapor generation

Solar vapor generation is a promising sustainable technology that uses solar distillation to produce fresh water from seawater and wastewater,helping relieve global water resource shortage.Here,inspired by naturally grown integrally molded mulberry leaves with a Janus hydrophilic and hydrophobic structure,a novel,simple,and efficient integrated molding method is proposed to break through the limitations of the traditional split manufacturing strategy and realizes the integrated formation of Janus evaporator.Based on the spontaneous sedimentation characteristics of MXene in silk fibroin solution and its regulation of mesoscopic structure and hydrophilicity of silk fibroin,layered structures with different compositions and hydrophilicities were obtained in one step.Meanwhile,ethanol and glutaraldehyde were added to construct a physical crystallization-chemical crosslinking dual stabilization structure in silk fibroin.Our evaporator has the evaporation rate of 3.07 kg·m^(-2)·h^(-1) and the efficiency of 86.8%under 1 sun and maintains high evaporation performance under various extreme test conditions including vigorous washing,repeated compression,and high-intensity ultraviolet(UV)irradiation.Additionally,the evaporator performs well in practical application scenarios,its evaporation rate in the simulated Dead Sea seawater exceeds 2.13 kg·m^(-2)·h^(-1),and more than 99.9%of the salt,heavy metal ions,oil pollution,and dyes are purified.

CBLN2 rs2217560 was Associated with Pulmonary Arteria Hypertension in Systemic Lupus Erythematosus

To the Editor:Pulmonary arterial hypertension (PAH)is a hemodynamic disorder with elevated pressure of pulmonary circulation.Genetic studies in familial PAH (fPAH)and idiopathic PAH (iPAH)have discovered that transforming growth factor-β (TGF-β) superfamily plays an important role,and the identified mutations occur in bone morphogenetic protein type 2 receptor (BMPR2), activin receptor-like kinase type 1 (ALK1),Endoglin,and SMAD9. A genome-wide association study (GWAS)in patients without BMPR2 mutations discovered that one single-nucleotide polymorphism (SNP)rs2217560 had a significant association with i/fPAH,which located 52-kb downstream of the CBLN2 gene.

Transpiration-prompted Photocatalytic Degradation of Dye Pollutant with AuNPs/PANI Based Cryogels

Incautious discharge of organic dyes such as methyl orange(MO)has produced serious pollution to the environment,calling for the efficient techniques to remove them with retaining the green world.The photo-catalytic degradation of organic dyes is promising among the developed techniques.Thus,a strategy based on transpiration-prompted photocatalytic degradation of dye pollutant under sunlight is put forward.Aniline(ANI)is graft-polymerized onto poly(acrylamide-co-N-4-aminophenylacrylamide)(PAAm)cryogel embedded with gold nanoparticles(AuNPs,diameter:4-10 nm).The obtained cryogels integrated with AuNPs and PANI inside PAAm matrix(AuNP@PAAm-g-PANI)have been structurally explored based on the chemical composition and the phase/porous morphology.SEM and TEM observation shows that PANI and AuNPs are uniformly distributed in PAAm matrix.Since the macro-porosity of cryogel,hydrophilicity of PAAm and photo-thermal activity of PANI,PAAm-g-PANI cryogels without AuNPs can have a photo-thermal evaporation rate of water at 1.63 kg·m^(-2)·h^(-1).As a comparison,Au NP@PAAm-g-PANI cryogels with AuNPs exhibit higher one at 2.20 kg·m^(-2)·h^(-1),suggesting the promotion of AuNPs to photo-thermal evaporation.Meanwhile,PANI appreciatively assists AuNPs to display higher catalytic ability for the oxidative degradation of MO.Therefore,the removal of MO from water is obviously prompted by the water transpiration under sunlight with AuNP@PAAm-g-PANI cryogels,whose rate constant can reach to 0.320 h^(-1),being three folds of that for the sole absorption of MO.This transpiration-prompted photocatalytic degradation provides a fascinating route to eliminate organic pollutants and obtain pure water from wastewater simultaneously with sustainable sunlight energy.