Ratoon rice,which refers to a second harvest of rice obtained from the regenerated tillers originating from the stubble of the first harvested crop,plays an important role in both food security and agroecology while r...Ratoon rice,which refers to a second harvest of rice obtained from the regenerated tillers originating from the stubble of the first harvested crop,plays an important role in both food security and agroecology while requiring minimal agricultural inputs.However,accurately identifying ratoon rice crops is challenging due to the similarity of its spectral features with other rice cropping systems(e.g.,double rice).Moreover,images with a high spatiotemporal resolution are essential since ratoon rice is generally cultivated in fragmented croplands within regions that frequently exhibit cloudy and rainy weather.In this study,taking Qichun County in Hubei Province,China as an example,we developed a new phenology-based ratoon rice vegetation index(PRVI)for the purpose of ratoon rice mapping at a 30 m spatial resolution using a robust time series generated from Harmonized Landsat and Sentinel-2(HLS)images.The PRVI that incorporated the red,near-infrared,and shortwave infrared 1 bands was developed based on the analysis of spectro-phenological separability and feature selection.Based on actual field samples,the performance of the PRVI for ratoon rice mapping was carefully evaluated by comparing it to several vegetation indices,including normalized difference vegetation index(NDVI),enhanced vegetation index(EVI)and land surface water index(LSWI).The results suggested that the PRVI could sufficiently capture the specific characteristics of ratoon rice,leading to a favorable separability between ratoon rice and other land cover types.Furthermore,the PRVI showed the best performance for identifying ratoon rice in the phenological phases characterized by grain filling and harvesting to tillering of the ratoon crop(GHS-TS2),indicating that only several images are required to obtain an accurate ratoon rice map.Finally,the PRVI performed better than NDVI,EVI,LSWI and their combination at the GHS-TS2 stages,with producer's accuracy and user's accuracy of 92.22 and 89.30%,respectively.These results demonstrate that the proposed PRVI based on HLS data can effectively identify ratoon rice in fragmented croplands at crucial phenological stages,which is promising for identifying the earliest timing of ratoon rice planting and can provide a fundamental dataset for crop management activities.展开更多
BACKGROUND Type 2 diabetes mellitus(T2DM),a fast-growing issue in public health,is one of the most common chronic metabolic disorders in older individuals.Osteoporosis and sarcopenia are highly prevalent in T2DM patie...BACKGROUND Type 2 diabetes mellitus(T2DM),a fast-growing issue in public health,is one of the most common chronic metabolic disorders in older individuals.Osteoporosis and sarcopenia are highly prevalent in T2DM patients and may result in fractures and disabilities.In people with T2DM,the association between nutrition,sarcopenia,and osteoporosis has rarely been explored.AIM To evaluate the connections among nutrition,bone mineral density(BMD)and body composition in patients with T2DM.METHODS We enrolled 689 patients with T2DM for this cross-sectional study.All patients underwent dual energy X-ray absorptiometry(DXA)examination and were categorized according to baseline Geriatric Nutritional Risk Index(GNRI)values calculated from serum albumin levels and body weight.The GNRI was used to evaluate nutritional status,and DXA was used to investigate BMD and body composition.Multivariate forward linear regression analysis was used to identify the factors associated with BMD and skeletal muscle mass index.RESULTS Of the total patients,394 were men and 295 were women.Compared with patients in tertile 1,those in tertile 3 who had a high GNRI tended to be younger and had lower HbA1c,higher BMD at all bone sites,and higher appendicular skeletal muscle index(ASMI).These important trends persisted even when the patients were divided into younger and older subgroups.The GNRI was positively related to ASMI(men:r=0.644,P<0.001;women:r=0.649,P<0.001),total body fat(men:r=0.453,P<0.001;women:r=0.557,P<0.001),BMD at all bone sites,lumbar spine(L1-L4)BMD(men:r=0.110,P=0.029;women:r=0.256,P<0.001),FN-BMD(men:r=0.293,P<0.001;women:r=0.273,P<0.001),and hip BMD(men:r=0.358,P<0.001;women:r=0.377,P<0.001).After adjustment for other clinical parameters,the GNRI was still significantly associated with BMD at the lumbar spine and femoral neck.Additionally,a low lean mass index and higherβ-collagen special sequence were associated with low BMD at all bone sites.Age was negatively correlated with ASMI,whereas weight was positively correlated with ASMI.CONCLUSION Poor nutrition,as indicated by a low GNRI,was associated with low levels of ASMI and BMD at all bone sites in T2DM patients.Using the GNRI to evaluate nutritional status and using DXA to investigate body composition in patients with T2DM is of value in assessing bone health and physical performance.展开更多
BACKGROUND In patients with type 2 diabetes mellitus(T2DM),the risk of hypoglycemia also occurs in at a time-in-range(TIR)of>70%.The hemoglobin glycation index(HGI)is considered the best single factor for predictin...BACKGROUND In patients with type 2 diabetes mellitus(T2DM),the risk of hypoglycemia also occurs in at a time-in-range(TIR)of>70%.The hemoglobin glycation index(HGI)is considered the best single factor for predicting hypoglycemia,and offers new perspectives for the individualized treatment of patients with well-controlled blood glucose levels that are easily ignored in clinical settings.All participants underwent a 7-days continuous glucose monitoring(CGM)using a retrospective CGM system.We obtained glycemic variability indices using the CGM system.We defined HGI as laboratory hemoglobin A1c minus the glucose management indicator.Patients were categorized into low HGI(HGI<0.5)and high HGI groups(HGI≥0.5)according to HGI median(0.5).Logistic regression and receiver operating characteristic curve analyses were used to determine the risk factors for hypoglycemia.RESULTS We included 129 subjects with T2DM(54.84±12.56 years,46%male)in the study.Median TIR score was 90%.The high HGI group exhibited lower TIR and greater time below range with higher hemoglobin A1c than the low HGI group;this suggests more glycemic excursions and an increased incidence of hypoglycemia in the high HGI group.Multivariate analyses revealed that mean blood glucose,standard deviation of blood glucose and HGI were independent risk factors for hypoglycemia.Receiver operating characteristic curve analysis indicated that the HGI was the best predictor of hypoglycemia.In addition,the optimal cut-off points for HGI,mean blood glucose,and standard deviation of blood glucose in predicting hypoglycemia were 0.5%,7.2 mmol/L and 1.4 mmol/L respectively.CONCLUSION High HGI was significantly associated with greater glycemic excursions and increased hypoglycemia in patients with TIR>70%.Our findings indicate that HGI is a reliable predictor of hypoglycemia in this population.展开更多
目的综合分析对2型糖尿病患者实施达格列净联合胰岛素强化治疗对生化指标的影响。方法选取2022年7月至2023年7月中国人民解放军联勤保障部队第910医院就诊的90例2型糖尿病患者,以随机数表形式分成观察组(45例)及对照组(45例),对照组行...目的综合分析对2型糖尿病患者实施达格列净联合胰岛素强化治疗对生化指标的影响。方法选取2022年7月至2023年7月中国人民解放军联勤保障部队第910医院就诊的90例2型糖尿病患者,以随机数表形式分成观察组(45例)及对照组(45例),对照组行胰岛素强化,观察组行胰岛素强化+达格列净。对比两组治疗后的血糖水平[空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)]、血糖波动指标(平均血糖水平、血糖标准差)、血脂指标[总胆固醇(TC)、甘油三酯(TG)]及不良反应。结果治疗后的血糖中,观察组的FPG、2 h PG、HbA1c、平均血糖水平、血糖标准差水平、TC、TG水平均比对照组更低(均P<0.05),观察组的脂联素指标为(6.78±1.12)μg/ml,较对照组的(4.36±0.97)μg/ml高(P<0.05);观察组总不良反应发生率为6.67%,较对照组的22.22%更低(P<0.05)。结论对2型糖尿病患者实施达格列净联合胰岛素强化治疗的效果可观,有利于稳定或降低患者的血糖、血脂,预防或降低不良反应。展开更多
This letter discusses the recent study by Mukherjee et al,which identifies a significant prevalence of metabolic dysfunction-associated steatotic liver disease(MASLD)among newly diagnosed type 2 diabetes mellitus(T2DM...This letter discusses the recent study by Mukherjee et al,which identifies a significant prevalence of metabolic dysfunction-associated steatotic liver disease(MASLD)among newly diagnosed type 2 diabetes mellitus(T2DM)patients in Bihar,India,and underscores the pressing need for integrated MASLD mana-gement within T2DM care.With 72.3%of the study cohort affected by MASLD,implementing routine liver function tests and ultrasound screenings is recom-mended as a standard practice in diabetes care,especially in regions with high prevalence rates.The study also advocates for dietary and lifestyle modifications,particularly the reduction of saturated fats,to slow MASLD progression.Patient education on monitoring body mass index and waist circumference,coupled with the integration of these metrics into digital health records,could enhance patient involvement and support proactive health management.Moreover,the letter emphasizes the advantages of developing a region-specific MASLD risk model that incorporates local dietary patterns and socioeconomic factors.Continued research into genetic and environmental determinants of MASLD remains es-sential for advancing our understanding of its etiology and informing targeted public health strategies.展开更多
目的分析脾瘅方加减联合二甲双胍治疗肥胖型2型糖尿病(Diabetes mellitus type 2,T2DM)患者的临床疗效及对其血脂、胰岛素抵抗指数(Homeostatic Model Assessment of Insulin Resistance,HOMA-IR)的影响。方法选取2022年1月—2023年2月...目的分析脾瘅方加减联合二甲双胍治疗肥胖型2型糖尿病(Diabetes mellitus type 2,T2DM)患者的临床疗效及对其血脂、胰岛素抵抗指数(Homeostatic Model Assessment of Insulin Resistance,HOMA-IR)的影响。方法选取2022年1月—2023年2月期间就诊于济宁市中医院的肥胖型T2DM患者100例作为研究对象,按随机数表法分为对照组和观察组,每组各50例。对照组常规服用二甲双胍0.5 g/次,3次/d;观察组在对照组基础上加用脾瘅方对症加减治疗。治疗12周后观察比较两组患者临床疗效,治疗前后血糖指标[血糖(Fasting blood glucose,FBG)、餐后2 h血糖(2-hour postprandial blood glucose,2 h PBG)、糖化血红蛋(Glycosylated hemoglobinA1c,HbA1c)]、中医证候积分、血脂指标[总胆固醇(Total cholesterol,TC)、甘油三酯(Triglycerides,TG)、低密度脂蛋白(Low density lipoprotein,LDL-C)]、胰岛素指标[空腹胰岛素(Fasting insulin,FINS)、胰岛素抵抗指数(Homeostasis Model Assessment-Insulin Resistance,HOMA-IR)、胰岛β细胞功能指数(Homeostatic model assessment ofβ-cell function,HOMA-β)]及炎症因子[白介素-6(Interleukin-6,IL-6)、超敏C反应蛋白(Highsensitivity C-reactive protein,hs-CRP)]水平。结果治疗后观察组临床总有效率94.00%(47/50)明显高于对照组78.00%(39/50),差异有统计学意义(P<0.05)。治疗后两组患者血糖FBG、2 h PBG、HbAlc指标及中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组血糖FBG、2 h PBG、HbAlc指标及中医证候积分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血脂指标TG、TC、LDL-C均较治疗前降低,差异有统计学意义(P<0.05);且观察组血脂指标TG、TC、LDL-C均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者胰岛素FINS、HOMA-IR指标均较治疗前降低,HOMA-β指标均较治疗前升高,差异有统计学意义(P<0.05);且观察组胰岛素FINS、HOMA-IR指标明显低于对照组,HOMA-β指标明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者炎症因子IL-6、hs-CRP水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组炎症因子IL-6、hs-CRP水平均明显低于对照组,差异有统计学意义(P<0.05)。结论脾瘅方加减联合二甲双胍治疗肥胖型T2DM患者能有效调节血糖、血脂水平,改善胰岛素抵抗,减轻炎症反应,临床疗效显著。展开更多
基金supported by the National Natural Science Foundation of China(42271360 and 42271399)the Young Elite Scientists Sponsorship Program by China Association for Science and Technology(CAST)(2020QNRC001)the Fundamental Research Funds for the Central Universities,China(2662021JC013,CCNU22QN018)。
文摘Ratoon rice,which refers to a second harvest of rice obtained from the regenerated tillers originating from the stubble of the first harvested crop,plays an important role in both food security and agroecology while requiring minimal agricultural inputs.However,accurately identifying ratoon rice crops is challenging due to the similarity of its spectral features with other rice cropping systems(e.g.,double rice).Moreover,images with a high spatiotemporal resolution are essential since ratoon rice is generally cultivated in fragmented croplands within regions that frequently exhibit cloudy and rainy weather.In this study,taking Qichun County in Hubei Province,China as an example,we developed a new phenology-based ratoon rice vegetation index(PRVI)for the purpose of ratoon rice mapping at a 30 m spatial resolution using a robust time series generated from Harmonized Landsat and Sentinel-2(HLS)images.The PRVI that incorporated the red,near-infrared,and shortwave infrared 1 bands was developed based on the analysis of spectro-phenological separability and feature selection.Based on actual field samples,the performance of the PRVI for ratoon rice mapping was carefully evaluated by comparing it to several vegetation indices,including normalized difference vegetation index(NDVI),enhanced vegetation index(EVI)and land surface water index(LSWI).The results suggested that the PRVI could sufficiently capture the specific characteristics of ratoon rice,leading to a favorable separability between ratoon rice and other land cover types.Furthermore,the PRVI showed the best performance for identifying ratoon rice in the phenological phases characterized by grain filling and harvesting to tillering of the ratoon crop(GHS-TS2),indicating that only several images are required to obtain an accurate ratoon rice map.Finally,the PRVI performed better than NDVI,EVI,LSWI and their combination at the GHS-TS2 stages,with producer's accuracy and user's accuracy of 92.22 and 89.30%,respectively.These results demonstrate that the proposed PRVI based on HLS data can effectively identify ratoon rice in fragmented croplands at crucial phenological stages,which is promising for identifying the earliest timing of ratoon rice planting and can provide a fundamental dataset for crop management activities.
基金Supported by Social Development Projects of Nantong,No.MS22021008 and No.QNZ2022005.
文摘BACKGROUND Type 2 diabetes mellitus(T2DM),a fast-growing issue in public health,is one of the most common chronic metabolic disorders in older individuals.Osteoporosis and sarcopenia are highly prevalent in T2DM patients and may result in fractures and disabilities.In people with T2DM,the association between nutrition,sarcopenia,and osteoporosis has rarely been explored.AIM To evaluate the connections among nutrition,bone mineral density(BMD)and body composition in patients with T2DM.METHODS We enrolled 689 patients with T2DM for this cross-sectional study.All patients underwent dual energy X-ray absorptiometry(DXA)examination and were categorized according to baseline Geriatric Nutritional Risk Index(GNRI)values calculated from serum albumin levels and body weight.The GNRI was used to evaluate nutritional status,and DXA was used to investigate BMD and body composition.Multivariate forward linear regression analysis was used to identify the factors associated with BMD and skeletal muscle mass index.RESULTS Of the total patients,394 were men and 295 were women.Compared with patients in tertile 1,those in tertile 3 who had a high GNRI tended to be younger and had lower HbA1c,higher BMD at all bone sites,and higher appendicular skeletal muscle index(ASMI).These important trends persisted even when the patients were divided into younger and older subgroups.The GNRI was positively related to ASMI(men:r=0.644,P<0.001;women:r=0.649,P<0.001),total body fat(men:r=0.453,P<0.001;women:r=0.557,P<0.001),BMD at all bone sites,lumbar spine(L1-L4)BMD(men:r=0.110,P=0.029;women:r=0.256,P<0.001),FN-BMD(men:r=0.293,P<0.001;women:r=0.273,P<0.001),and hip BMD(men:r=0.358,P<0.001;women:r=0.377,P<0.001).After adjustment for other clinical parameters,the GNRI was still significantly associated with BMD at the lumbar spine and femoral neck.Additionally,a low lean mass index and higherβ-collagen special sequence were associated with low BMD at all bone sites.Age was negatively correlated with ASMI,whereas weight was positively correlated with ASMI.CONCLUSION Poor nutrition,as indicated by a low GNRI,was associated with low levels of ASMI and BMD at all bone sites in T2DM patients.Using the GNRI to evaluate nutritional status and using DXA to investigate body composition in patients with T2DM is of value in assessing bone health and physical performance.
基金Supported by Investigator-initiated Trial Research Funds from Eli Lilly and Co.and Amylin Pharmaceuticals,Inc.,No.A1570Natural Science Foundation of Guangdong Province,No.2018A030313915。
文摘BACKGROUND In patients with type 2 diabetes mellitus(T2DM),the risk of hypoglycemia also occurs in at a time-in-range(TIR)of>70%.The hemoglobin glycation index(HGI)is considered the best single factor for predicting hypoglycemia,and offers new perspectives for the individualized treatment of patients with well-controlled blood glucose levels that are easily ignored in clinical settings.All participants underwent a 7-days continuous glucose monitoring(CGM)using a retrospective CGM system.We obtained glycemic variability indices using the CGM system.We defined HGI as laboratory hemoglobin A1c minus the glucose management indicator.Patients were categorized into low HGI(HGI<0.5)and high HGI groups(HGI≥0.5)according to HGI median(0.5).Logistic regression and receiver operating characteristic curve analyses were used to determine the risk factors for hypoglycemia.RESULTS We included 129 subjects with T2DM(54.84±12.56 years,46%male)in the study.Median TIR score was 90%.The high HGI group exhibited lower TIR and greater time below range with higher hemoglobin A1c than the low HGI group;this suggests more glycemic excursions and an increased incidence of hypoglycemia in the high HGI group.Multivariate analyses revealed that mean blood glucose,standard deviation of blood glucose and HGI were independent risk factors for hypoglycemia.Receiver operating characteristic curve analysis indicated that the HGI was the best predictor of hypoglycemia.In addition,the optimal cut-off points for HGI,mean blood glucose,and standard deviation of blood glucose in predicting hypoglycemia were 0.5%,7.2 mmol/L and 1.4 mmol/L respectively.CONCLUSION High HGI was significantly associated with greater glycemic excursions and increased hypoglycemia in patients with TIR>70%.Our findings indicate that HGI is a reliable predictor of hypoglycemia in this population.
文摘目的综合分析对2型糖尿病患者实施达格列净联合胰岛素强化治疗对生化指标的影响。方法选取2022年7月至2023年7月中国人民解放军联勤保障部队第910医院就诊的90例2型糖尿病患者,以随机数表形式分成观察组(45例)及对照组(45例),对照组行胰岛素强化,观察组行胰岛素强化+达格列净。对比两组治疗后的血糖水平[空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)]、血糖波动指标(平均血糖水平、血糖标准差)、血脂指标[总胆固醇(TC)、甘油三酯(TG)]及不良反应。结果治疗后的血糖中,观察组的FPG、2 h PG、HbA1c、平均血糖水平、血糖标准差水平、TC、TG水平均比对照组更低(均P<0.05),观察组的脂联素指标为(6.78±1.12)μg/ml,较对照组的(4.36±0.97)μg/ml高(P<0.05);观察组总不良反应发生率为6.67%,较对照组的22.22%更低(P<0.05)。结论对2型糖尿病患者实施达格列净联合胰岛素强化治疗的效果可观,有利于稳定或降低患者的血糖、血脂,预防或降低不良反应。
文摘This letter discusses the recent study by Mukherjee et al,which identifies a significant prevalence of metabolic dysfunction-associated steatotic liver disease(MASLD)among newly diagnosed type 2 diabetes mellitus(T2DM)patients in Bihar,India,and underscores the pressing need for integrated MASLD mana-gement within T2DM care.With 72.3%of the study cohort affected by MASLD,implementing routine liver function tests and ultrasound screenings is recom-mended as a standard practice in diabetes care,especially in regions with high prevalence rates.The study also advocates for dietary and lifestyle modifications,particularly the reduction of saturated fats,to slow MASLD progression.Patient education on monitoring body mass index and waist circumference,coupled with the integration of these metrics into digital health records,could enhance patient involvement and support proactive health management.Moreover,the letter emphasizes the advantages of developing a region-specific MASLD risk model that incorporates local dietary patterns and socioeconomic factors.Continued research into genetic and environmental determinants of MASLD remains es-sential for advancing our understanding of its etiology and informing targeted public health strategies.
文摘目的分析脾瘅方加减联合二甲双胍治疗肥胖型2型糖尿病(Diabetes mellitus type 2,T2DM)患者的临床疗效及对其血脂、胰岛素抵抗指数(Homeostatic Model Assessment of Insulin Resistance,HOMA-IR)的影响。方法选取2022年1月—2023年2月期间就诊于济宁市中医院的肥胖型T2DM患者100例作为研究对象,按随机数表法分为对照组和观察组,每组各50例。对照组常规服用二甲双胍0.5 g/次,3次/d;观察组在对照组基础上加用脾瘅方对症加减治疗。治疗12周后观察比较两组患者临床疗效,治疗前后血糖指标[血糖(Fasting blood glucose,FBG)、餐后2 h血糖(2-hour postprandial blood glucose,2 h PBG)、糖化血红蛋(Glycosylated hemoglobinA1c,HbA1c)]、中医证候积分、血脂指标[总胆固醇(Total cholesterol,TC)、甘油三酯(Triglycerides,TG)、低密度脂蛋白(Low density lipoprotein,LDL-C)]、胰岛素指标[空腹胰岛素(Fasting insulin,FINS)、胰岛素抵抗指数(Homeostasis Model Assessment-Insulin Resistance,HOMA-IR)、胰岛β细胞功能指数(Homeostatic model assessment ofβ-cell function,HOMA-β)]及炎症因子[白介素-6(Interleukin-6,IL-6)、超敏C反应蛋白(Highsensitivity C-reactive protein,hs-CRP)]水平。结果治疗后观察组临床总有效率94.00%(47/50)明显高于对照组78.00%(39/50),差异有统计学意义(P<0.05)。治疗后两组患者血糖FBG、2 h PBG、HbAlc指标及中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组血糖FBG、2 h PBG、HbAlc指标及中医证候积分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血脂指标TG、TC、LDL-C均较治疗前降低,差异有统计学意义(P<0.05);且观察组血脂指标TG、TC、LDL-C均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者胰岛素FINS、HOMA-IR指标均较治疗前降低,HOMA-β指标均较治疗前升高,差异有统计学意义(P<0.05);且观察组胰岛素FINS、HOMA-IR指标明显低于对照组,HOMA-β指标明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者炎症因子IL-6、hs-CRP水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组炎症因子IL-6、hs-CRP水平均明显低于对照组,差异有统计学意义(P<0.05)。结论脾瘅方加减联合二甲双胍治疗肥胖型T2DM患者能有效调节血糖、血脂水平,改善胰岛素抵抗,减轻炎症反应,临床疗效显著。
