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Neutrophil-to-lymphocyte ratio associated with renal function in type 2 diabetic patients

World Journal of Clinical Cases 2024年第14期12卷 2308-2315页

作者： Jin-Li Gao Jue Shen Li-Ping Yang Li Liu Kai Zhao Xiao-Rong Pan Lei Li Ji-Ji Xu Department of Prevention and Health Care Community Health Service Center of Miaohang TownShanghai 200443China Department of Prevention and Health Care Community Health Service Center of Songnan TownShanghai 200434China Department of General Practice Community Health Service Center of Songnan TownShanghai 200434China Department of Administrative Community Health Service Center of Songnan TownShanghai 200434China

BACKGROUND Type 2 diabetes mellitus(T2DM)is a leading risk factor for the development and progression of chronic kidney disease(CKD).However,an accurate and con-venient marker for early detection and appropriate management of CKD in in-dividuals with T2DM is limited.Recent studies have demonstrated a strong correlation between the neutrophil-to-lymphocyte ratio(NLR)and CKD.None-theless,the predictive value of NLR for renal damage in type 2 diabetic patients remains understudied.This study included 1040 adults aged 65 or older with T2DM from Shanghai's community Health service Center.The total number of neutrophils and lym-phocytes was detected,and NLR levels were calculated.CKD was defined as an estimated glomerular filtration rate≤60 mL/min/1.73 m².Participants were di-vided into four groups based on NLR levels.The clinical data and biochemical characteristics were compared among groups.A multivariate logistic regression model was used to analyze the association between NLR levels and CKD.RESULTS Significant differences were found in terms of sex,serum creatinine,blood urea nitrogen,total cholesterol,and low-density lipoprotein cholesterol among patients with T2DM in different NLR groups(P<0.0007).T2DM patients in the highest NLR quartile had a higher prevalence of CKD(P for trend=0.0011).Multivariate logistic regression analysis indicated that a high NLR was an independent risk factor for CKD in T2DM patients even after adjustment for important clinical and pathological parameters(P=0.0001,odds ratio=1.41,95%confidence intervals:1.18-1.68).CONCLUSION An elevated NLR in patients with T2DM is associated with higher prevalence of CKD,suggesting that it could be a marker for the detection and evaluation of diabetic kidney disease.

关键词： Type 2 diabetes mellitus Neutrophil-to-lymphocyte ratio Chronic kidney disease Logistic regression Diabetes mellitus

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Navigating the complex terrain of hepatitis B virus reactivation in the era of Bruton tyrosine kinase inhibitors

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World Journal of Gastroenterology 2024年第21期30卷 2748-2750页

作者： Wei-Nung Liu Ming-Shen Dai Felicia Lin Gen-Min Lin Department of medicine Tri-Service General HospitalTaipei 114Taiwan Division of Hematology/Oncology Department of Internal MedicineNational Defense Medical CenterTaipei 114Taiwan community Care Minnesota OncologyMinneapolisMN 55404United States Department of medicine Hualien Armed Forces General HospitalHualien City 970Taiwan

In this editorial,we offer a summary of the risk associated with hepatitis B reactivation(HBVr)in the setting of both solid and hematologic malignancies treated with Bruton tyrosine kinase(BTK)inhibitors,with insights derived from current studies.Furthermore,we emphasize the critical need for a framework regarding robust risk evaluation in patients undergoing such treatments.This framework is essential for identifying those at increased risk of HBVr,enabling healthcare providers to implement proactive measures to prevent reactivation and ensure the safe administration of BTK inhibitor therapy.

关键词： Hepatitis B virus reactivation Bruton tyrosine kinase inhibitors Hematologic malignancies Solid tumors Prophylaxis guidelines

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Prevalence and risk factors of diabetes mellitus among elderly patients in the Lugu community

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World Journal of Diabetes 2024年第4期15卷 638-644页

作者： Li-Zhen Zhao Wei-Min Li Ying Ma Lugu community Health service Center West Campus Beijing Chao-yang Hospital Affiliated to Capital Medical UniversityBeijing 100043China

BACKGROUND Age is a significant risk factor of diabetes mellitus(DM).With the develop of population aging,the incidence of DM remains increasing.Understanding the epidemiology of DM among elderly individuals in a certain area contributes to the DM interventions for the local elderly individuals with high risk of DM.AIM To explore the prevalence of DM among elderly individuals in the Lugu community and analyze the related risk factors to provide a valid scientific basis for the health management of elderly individuals.METHODS A total of 4816 elderly people who came to the community for physical examination were retrospectively analyzed.The prevalence of DM among the elderly was calculated.The individuals were divided into a DM group and a non-DM group according to the diagnosis of DM to compare the differences in diastolic blood pressure(DBP)and systolic blood pressure(SBP),fasting blood glucose,body mass index(BMI),waist-to-hip ratio(WHR)and incidence of hypertension(HT),coronary heart disease(CHD),and chronic kidney disease(CKD).RESULTS DM was diagnosed in 32.70%of the 4816 elderly people.The BMI of the DM group(25.16±3.35)was greater than that of the non-DM group(24.61±3.78).The WHR was 0.90±0.04 in the non-DM group and 0.90±0.03 in the DM group,with no significant difference.The left SBP and SBP in the DM group were 137.9 mmHg±11.92 mmHg and 69.95 mmHg±7.75 mmHg,respectively,while they were 126.6 mmHg±12.44 mmHg and 71.15 mmHg±12.55 mmHg,respectively,in the non-DM group.These findings indicate higher SBP and lower DBP in DM patients than in those without DM.In the DM group,1274 patients were diagnosed with HT,accounting for 80.89%.Among the 3241 non-DM patients,1743(53.78%)were hypertensive and 1498(46.22%)were nonhypertensive.The DM group had more cases of HT than did the non-DM group.There were more patients with CHD or CKD in the DM group than in the non-DM group.There were more patients who drank alcohol more frequently(≥3 times)in the DM group than in the non-DM group.CONCLUSION Older adults in the Lugu c

关键词： Diabetes mellitus Type 2 diabetes mellitus Elderly Risk factors

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Biotin-modified Galactosylated Chitosan-gene Carrier in Hepatoma Cells Targeting Delivery

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Journal of Wuhan University of Technology(Materials Science) 2024年第2期39卷 522-531页

作者：程明荣张锋李清王华 Department of General Surgery Nanxiang Branch of Ruijin HospitalShanghai 201802China Minhang District Pujin community Health service Center Shanghai 201112China Hepatobiliary Surgery Center Tongji Hospital Affiliated to Tongji UniversityShanghai 200065China

Our previous studies have successfully grafted biotin and galactose onto chitosan(CS)and synthesized biotin modified galactosylated chitosan(Bio-GC).The optimum N/P ratio of Bio-GC and plasmid DNA was 3:1.At this N/P ratio,the transfection efficiency in the hepatoma cells was the highest with a slow release effect.Bio-GC nanomaterials exhibit the protective effect of preventing the gene from nuclease degradation,and can target the transfection into hepatoma cells by combination with galactose and biotin receptors.The transfection rate was inhibited by the competition of galactose and biotin.Bio-GC nanomaterials were imported into cells’cytoplasm by their receptors,followed by the imported exogenous gene transfected into the cells.Bio-GC nanomaterials can also cause inhibitory activity in the hepatoma cells in the model of orthotopic liver transplantation in mice,by carrying the gene through the blood to the hepatoma tissue.Taken together,bio-GC nanomaterials act as gene vectors with the activity of protecting the gene from DNase degradation,improving the rate of transfection in hepatoma cells,and transporting the gene into the cytoplasm in vitro and in vivo.Therefore,they are efficient hepatoma-targeting gene carriers.

关键词： gene vector hepatocellular carcinoma nanoparticles sustained release gene therapy

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Prevalence,Characteristics and Treatment of Knee Osteoarthritis in Urban Residents of Beijing,China:A community-Based Cross-Sectional Study

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Biomedical and Environmental Sciences 2024年第4期37卷 418-422页

作者： ZHOU Jun YAN Yan DONG Ya Wei LIU Xiao Yu WANG Ping LIN Jia Ming DONG Peng Xuan QUAN Rui WANG Rong Tian MI Bao Hong CHEN Wei Heng Beijing University of Chinese medicine Third Affiliated Hospital Beijing 100029China Engineering Research Center of Chinese Orthopaedics and Sports Rehabilitation Artificial Intelligent Ministry of EducationBeijing 100029China Beijing Hepingli community Health service Center Beijing 100013China Minimally Invasive Joint Surgery Beijing University of Chinese Medicine Third Affiliated HospitalBeijing 100029China

Knee osteoarthritis(KOA)is a common progressive joint disease with chronic pain and movement disorders as the main clinical features.It is a major public health problem worldwide and it imposes serious medical and economic burdens.KOA accounts for nearly four-fifths of the global Osteoarthritis burden and increases with rising obesity and age[1].There are many reasons for the change in disease prevalence and risk factors,such as urbanization,lifestyle changes,population aging,and sex imbalances.

关键词： Osteoarthritis clinical obesity

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Analysis of the Effect of Outpatient Nursing Intervention on Hypoglycemic Treatment Effect and Psychological Emotions of Diabetic Patients

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Journal of Clinical and Nursing Research 2024年第2期8卷 249-254页

作者： Xiu’e Zhang Nancaiyuan community Health service Center Yanqing DistrictBeijing 102100China

Objective:To explore the effect of outpatient nursing interventions on the hypoglycemic treatment and psychological emotions of diabetic patients.Methods:148 patients who came to our hospital for outpatient treatment from February 2022 to October 2023 were selected and divided into a control group and an observation group,with 74 cases per group,according to the random number table method.The control group received routine nursing intervention,and the observation group received outpatient nursing intervention based on the control group.The two groups were observed for their effects of hypoglycemic treatment and psychological and emotional improvement before and after outpatient nursing intervention.Results:The health behavior scores of the control group were lower than that of the observation group;the post-intervention fasting blood glucose,2h postprandial blood glucose,anxiety self-rating scale(SAS),and the depression self-rating scale(SDS)of the control group were significantly higher than that of the observation group,and the difference was statistically significant(P<0.01).Conclusion:Outpatient nursing intervention encouraged patients to comply with healthy behaviors and helped control blood sugar levels.Patients’anxiety,depression,and other adverse psychological states were also improved hence the outpatient nursing intervention is worthy of further promotion.

关键词： Outpatient nursing intervention Diabetes Hypoglycemic effect Psychological emotion

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针灸对子宫内膜异位症大鼠异位内膜组织UHRF1和DNMT1的影响

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Journal of Acupuncture and Tuina Science 2024年第3期22卷 204-213页

作者：李铭旸王延文邵燕婷孙祎纯胡佳玮高源李语然吴楚婷张春雁 Yueyang Hospital of Integrated Traditional Chinese and Western medicine Shanghai University of Traditional Chinese MedicineShanghai 200437China Shanghai Minhang District Meilong community Health service Center Shanghai 201108China Longhua Hospital Shanghai University of Traditional Chinese MedicineShanghai 200032China

目的:观察针灸对子宫内膜异位症(EMS)泛素样PHD和含环指结构域蛋白1(UHRF1)和DNA甲基转移酶1(DNMT1)的影响。方法:将40只Sprague-Dawley大鼠按体质量随机分为假手术组10只和造模组30只。造模组大鼠复制EMS模型后随机分为模型组、针灸组... 详细信息

目的:观察针灸对子宫内膜异位症(EMS)泛素样PHD和含环指结构域蛋白1(UHRF1)和DNA甲基转移酶1(DNMT1)的影响。方法:将40只Sprague-Dawley大鼠按体质量随机分为假手术组10只和造模组30只。造模组大鼠复制EMS模型后随机分为模型组、针灸组和孕酮组,每组10只。固定器固定各组大鼠。假手术组和模型组予以生理盐水灌胃;针灸组予以针刺血海和三阴交,艾灸关元和生理盐水灌胃;孕酮组给予地屈孕酮生理盐水混悬液灌胃。治疗28 d后,测量大鼠异位囊肿三径(长、宽及厚度)并计算体积,减掉干预前异位囊肿体积,取差值评估异位囊肿生长情况;实时荧光定量聚合酶链反应和免疫组织化学法检测正常子宫内膜、在位及异位内膜组织UHRF1、DNMT1 mRNA和蛋白水平。结果:针灸组和孕酮组异位囊肿体积差值无统计学差异(P>0.05),但均小于模型组异位囊肿体积差值(P0.05)。结论:针灸可能通过上调异位内膜组织中UHRF1 mRNA和UHRF1、DNMT1蛋白水平,使其趋于正常子宫内膜水平,从而达到缩小异位囊肿体积,治疗大鼠子宫内膜异位症的效应。

关键词：针刺疗法灸法针灸疗法子宫内膜异位症泛素样PHD和含环指结构域蛋白1 DNA甲基转移酶1 大鼠

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Update in lean metabolic dysfunction-associated steatotic liver disease

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World Journal of Hepatology 2024年第3期16卷 452-464页

作者： Karina Sato-Espinoza Perapa Chotiprasidhi Mariella R Huaman Javier Díaz-Ferrer Division of Gastroenterology and Hepatology Department of MedicineMayo ClinicRochesterMN 55902United States Obesity and Metabolic Center for Obesity and Metabolic HealthLima 02002LimaPeru Hepatology service Department of Digestive DiseasesHospital Nacional Edgardo Rebagliati MartinsLima 02002LimaPeru medicine Faculty Universidad San Martin de PorresLima 02002LimaPeru Gastroenterology service Clinica InternacionalLima 02002LimaPeru

BACKGROUND A new nomenclature consensus has emerged for liver diseases that were previously known as non-alcoholic fatty liver disease(NAFLD)and metabolic dysfunction-associated fatty liver disease(MAFLD).They are now defined as metabolic dysfunction-associated steatotic liver disease(MASLD),which includes cardiometabolic criteria in adults.This condition,extensively studied in obese or overweight patients,constitutes around 30%of the population,with a steady increase worldwide.Lean patients account for approximately 10%-15%of the MASLD population.However,the pathogenesis is complex and is not well understood.AIM To systematically review the literature on the diagnosis,pathogenesis,characteristics,and prognosis in lean MASLD patients and provide an interpretation of these new criteria.METHODS We conducted a comprehensive database search on PubMed and Google Scholar between January 2012 and September 2023,specifically focusing on lean NAFLD,MAFLD,or MASLD patients.We include original articles with patients aged 18 years or older,with a lean body mass index categorized according to the World Health Organization criteria,using a cutoff of 25 kg/m2 for the general population and 23 kg/m2 for the Asian population.RESULTS We include 85 studies in our analysis.Our findings revealed that,for lean NAFLD patients,the prevalence rate varied widely,ranging from 3.8%to 34.1%.The precise pathogenesis mechanism remained elusive,with associations found in genetic variants,epigenetic modifications,and adaptative metabolic response.Common risk factors included metabolic syndrome,hypertension,and type 2 diabetes mellitus,but their prevalence varied based on the comparison group involving lean patients.Regarding non-invasive tools,Fibrosis-4 index outperformed the NAFLD fibrosis score in lean patients.Lifestyle modifications aided in reducing hepatic steatosis and improving cardiometabolic profiles,with some medications showing efficacy to a lesser extent.However,lean NAFLD patients exhibited a worse prognosis compared to the obese

关键词： Lean Non-obese Non-alcoholic fatty liver disease Metabolic dysfunction-associated fatty liver disease Metabolic dysfunction-associated steatotic liver disease Guidelines Diagnosis Management Pathogenesis Treatment

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Knowledge Graph Enhanced Transformers for Diagnosis Generation of Chinese medicine

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Chinese Journal of Integrative medicine 2024年第3期30卷 267-276页

作者： WANG Xin-yu YANG Tao GAO Xiao-yuan HU Kong-fa School of Artificial Intelligence and Information Technology Nanjing University of Chinese MedicineNanjing210023China School of Information Management Nanjing UniversityNanjing210023China Jiangsu Collaborative Innovation Center of Traditional Chinese medicine in Prevention and Treatment of Tumor Nanjing210023China Jiangsu Province Engineering Research Center of TCM Intelligence Health service Nanjing210023China

Chinese medicine(CM)diagnosis intellectualization is one of the hotspots in the research of CM modernization.The traditional CM intelligent diagnosis models transform the CM diagnosis issues into classification issues,however,it is difficult to solve the problems such as excessive or similar categories.With the development of natural language processing techniques,text generation technique has become increasingly mature.In this study,we aimed to establish the CM diagnosis generation model by transforming the CM diagnosis issues into text generation issues.The semantic context characteristic learning capacity was enhanced referring to Bidirectional Long Short-Term Memory(BILSTM)with Transformer as the backbone network.Meanwhile,the CM diagnosis generation model Knowledge Graph Enhanced Transformer(KGET)was established by introducing the knowledge in medical field to enhance the inferential capability.The KGET model was established based on 566 CM case texts,and was compared with the classic text generation models including Long Short-Term Memory sequence-to-sequence(LSTM-seq2seq),Bidirectional and Auto-Regression Transformer(BART),and Chinese Pre-trained Unbalanced Transformer(CPT),so as to analyze the model manifestations.Finally,the ablation experiments were performed to explore the influence of the optimized part on the KGET model.The results of Bilingual Evaluation Understudy(BLEU),Recall-Oriented Understudy for Gisting Evaluation 1(ROUGE1),ROUGE2 and Edit distance of KGET model were 45.85,73.93,54.59 and 7.12,respectively in this study.Compared with LSTM-seq2seq,BART and CPT models,the KGET model was higher in BLEU,ROUGE1 and ROUGE2 by 6.00–17.09,1.65–9.39 and 0.51–17.62,respectively,and lower in Edit distance by 0.47–3.21.The ablation experiment results revealed that introduction of BILSTM model and prior knowledge could significantly increase the model performance.Additionally,the manual assessment indicated that the CM diagnosis results of the KGET model used in this study were highly consistent with the p

关键词： Chinese medicine diagnosis knowledge graph enhanced transformer text generation

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A comprehensive look at the psychoneuroimmunoendocrinology of spinal cord injury and its progression: mechanisms and clinical opportunities

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Military Medical Research 2024年第2期11卷 228-267页

作者： Miguel A.Ortega Oscar Fraile-Martinez Cielo García-Montero Sergio Haro Miguel Ángel Álvarez-Mon Diego De Leon-Oliva Ana M.Gomez-Lahoz Jorge Monserrat Mar Atienza-Pérez David Díaz Elisa Lopez-Dolado Melchor Álvarez-Mon Department of medicine and Medical Specialities University of Alcala28801 Alcala de HenaresSpain Ramón y Cajal Institute of Sanitary Research(IRYCIS) 28034 MadridSpain Department of Psychiatry and Mental Health Hospital Universitario Infanta Leonor28031 MadridSpain service of Rehabilitation National Hospital for Paraplegic PatientsCarr.de la PeraledaS/N45004 ToledoSpain Immune System Diseases‑Rheumatology service and Internal medicine University Hospital Príncipe de Asturias(CIBEREHD)28806 Alcala de HenaresSpain

Spinal cord injury(SCI)is a devastating and disabling medical condition generally caused by a traumatic event(primary injury).This initial trauma is accompanied by a set of biological mechanisms directed to ameliorate neural damage but also exacerbate initial damage(secondary injury).The alterations that occur in the spinal cord have not only local but also systemic consequences and virtually all organs and tissues of the body incur important changes after SCI,explaining the progression and detrimental consequences related to this condition.Psychoneuroimmunoendocrinology(PNIE)is a growing area of research aiming to integrate and explore the interactions among the different systems that compose the human organism,considering the mind and the body as a whole.The initial traumatic event and the consequent neurological disruption trigger immune,endocrine,and multisystem dysfunction,which in turn affect the patient's psyche and well-being.In the present review,we will explore the most important local and systemic consequences of SCI from a PNIE perspective,defining the changes occurring in each system and how all these mechanisms are interconnected.Finally,potential clinical approaches derived from this knowledge will also be collectively presented with the aim to develop integrative therapies to maximize the clinical management of these patients.

关键词： Spinal cord injury(SCI) Psychoneuroimmunoendocrinology(PNIE) Secondary injury Immunoinflammatory dysfunction Gut microbiota Translational opportunities

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