Phosphoinositide 3-kinases (PI3Ks) are essential for maintaining glucose homeostasis. When these molecules malfunction, it can lead to increased blood glucose levels, which is the primary pathophysiological characteristic of diabetes. New data indicates that the PI3K/AKT signaling pathway is interacting reciprocally with non-coding RNAs (ncRNAs) such as miRNAs, long ncRNAs (lnc RNA), and circRNAs. Thus, it is clear that aberrant ncRNA regulation in the PI3K/AKT axis is connected to clinicopathological characteristics and is required for regulating biological processes. Diabetic retinopathy (DR) is a common complication of diabetes resulting from high blood sugar levels damaging the retina. Consequently, there is a greater need than ever for this prevention and treatment of disease. There has been a lot of interest in treating DR by targeting particular ncRNAs. The pathogenic functions of ncRNAs in DR are the main topic of this review. This review aims to explain the relationship between the PI3K/AKT signaling system and different miRNAs/lncRNAs/circRNAs and their significance in the biology of DR.

Monoclonal antibodies (mAbs) constitute a new form of immunotherapy that has shown great success in long-term tumour control. These injectable drugs are managed and compounded by the Pharmacy Intravenous Admixture Services (PIVAS) staff in a specified sterile environment. This study utilized failure mode and effect analysis (FMEA) as a risk management tool to manage mAb drugs within the PIVAS. The nine-member multidisciplinary team mapped the processes; evaluated the severity, occurrence, and detection of each subprocess; and calculated the risk priority number (RPN). Further corrective actions were taken for high-risk steps, followed by re-evaluation and scoring to achieve a low-risk process. We identified seven major processes and twenty-eight subprocesses involved in the management of mAb drugs in PIVAS. A total of thirteen high-risk failure modes with an assigned RPN 1 were selected. This selection represents the first calculated RPN values, resulting in a total score of 3375. After a first round of evaluation and implementation of corrective actions, the RPN 2 score decreased to 464. Following a second round of the FMEA process, the RPN 3 score was further reduced to 51. Through refinement, we successfully mitigated the occurrence of high-risk failure modes of mAb drugs in PIVAS. These efforts are aimed at enhancing the safety and efficacy of mAb drugs, ultimately ensuring patient safety.

Background Corrected QT (QTc) interval has been reported to be associated with type 2 diabetes. This study aimed to explore the relationship between different glucose tolerance and QTc intervals among middle-aged and older Chinese individuals. Methods We conducted a cross-sectional analysis that included 9898 subjects (3194 men and 6704 women) in a Chinese population. Glucose tolerance was studied during the oral glucose tolerance test (OGTT). Insulin, blood pressure, hemoglobin A1c (HbA1c), serum lipids, hepatic transaminases and waist-to-hip ratio were assessed. The QTc interval was derived from ECG recordings, and the subjects were stratified based on different glucose tolerance. Results QTc interval levels were increased significantly in the subjects with abnormal glucose metabolism compared with the normal glucose regulation group. Multiple regression analyses showed that the QTc interval was significantly associated with fasting plasma glucose, 2-h OGTT plasma glucose and HbA1c. The odds ratio of prolonged QTc was 1.396 for impaired glucose regulation (IFG)/impaired fasting glucose (IGT) (95% CI 0.126–1.730), and 1.342 for type 2 diabetes (95% CI 0.142–1.577) after all potential confounders were adjusted. Conclusions Impaired glucose tolerance (IGR) and diabetes are associated with prolonged QTc intervals among middle-aged and older Chinese individuals. Abnormal glucose regulation can be used to monitor the QTc interval in the population.

Objective Atherosclerosis is considered a chronic inflammatory condition. The immune system is a key mediator in the initiation and progression of atherosclerosis. In a previous study, we found that the immune system was activated in diabetes and that total white blood cell (WBC) counts were elevated significantly in diabetic patients. To investigate whether WBC subtype counts in newly diagnosed diabetes are risk factors for future cardiovascular disease (CVD) events, we conducted a prospective population-based cohort study. Methods A total of 1498 newly diagnosed diabetic patients aged 40 to 70 years old were followed up for three years. Participants with previous CVD history and abnormal WBC counts were excluded. CVD events were recorded during follow-up. Results We found that the baseline lymphocyte counts were independently associated with cardiovascular events during follow-up, with the Exp (β) (95% CI) at 1.749 (1.084–2.821). Lymphocyte count ≥2.9 (10 9 /L) was significantly associated with the development of CVD (HR, 2.29; 95% CI, 1.12–4.67). The corresponding incidence of CVD per 1000 person-year for the lymphocyte count ≤2.8 (10 9 /L) and lymphocyte count ≥2.9 (10 9 /L) groups were 11.26 and 26.38, respectively. Conclusion We concluded that even in a normal range, higher lymphocyte levels may result in a significantly higher CVD risk among diabetic patients. Lymphocyte count ≥2.9 (10 9 /L) is an independent predictor of developing future CVD events.

Atherosclerosis is considered a chronic inflammatory condition. The immune system is a key mediator in the initiation and progression of atherosclerosis. In a previous study, we found that the immune system was activated in diabetes and that total white blood cell (WBC) counts were elevated significantly in diabetic patients. To investigate whether WBC subtype counts in newly diagnosed diabetes are risk factors for future cardiovascular disease (CVD) events, we conducted a prospective population-based cohort study. A total of 1498 newly diagnosed diabetic patients aged 40 to 70 years old were followed up for three years. Participants with previous CVD history and abnormal WBC counts were excluded. CVD events were recorded during follow-up. We found that the baseline lymphocyte counts were independently associated with cardiovascular events during follow-up, with the Exp (β) (95% CI) at 1.749 (1.084–2.821). Lymphocyte count ≥2.9 (109/L) was significantly associated with the development of CVD (HR, 2.29; 95% CI, 1.12–4.67). The corresponding incidence of CVD per 1000 person-year for the lymphocyte count ≤2.8 (109/L) and lymphocyte count ≥2.9 (109/L) groups were 11.26 and 26.38, respectively. We concluded that even in a normal range, higher lymphocyte levels may result in a significantly higher CVD risk among diabetic patients. Lymphocyte count ≥2.9 (109/L) is an independent predictor of developing future CVD events.

目的:分析腺苷钴胺联合硫辛酸与独活寄生汤对糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)患者疗效及血清超氧化物歧化酶(superoxide dismutase,SOD)、谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-Px)水平的影响.方法:选择DPN患者90例,根据随机数字表分为A组、B组和C组,每组30例.A组静脉滴注硫辛酸;B组在A组治疗措施的基础上给予腺苷钴胺;C组在上述治疗措施的基础上给予独活寄生汤.对3组临床疗效、神经传导速度、神经症状、血清SOD、GSH-Px水平进行评估.结果:总有效率C组最高,B组次之,A组最低,差异有统计学意义(P<0.05);治疗后,正中神经、腓总神经的运动神经传到速率(motor nerve conduction velocity,MNCV)、正中神经、腓总神经的感觉神经传导速率(sural nerve conduction velocity,SNCV)、均呈现C组最快,B组次之,A组最低的态势,差异有统计学意义(P<0.05);治疗后,灼热感、麻木、感觉异常和疼痛等神经症状评分均呈现C组最低,B组次之,A组最高,差异有统计学意义(P<0.05);治疗后,血清SOD、GSH-Px含量均呈现以C组最低,B组次之,A组最高,差异有统计学意义(P<0.05).结论:腺苷钴胺联合硫辛酸与独活寄生汤治疗DPN患者具有确切疗效,能够加快神经传导速度,缓解神经症状,降低血清SOD、GSH-Px水平.

高尿酸血症(hyperuricemia,HUA)指由于嘌呤代谢紊乱和尿酸代谢障碍导致的血液尿酸水平升高.随着生活方式的改变及经济水平的提高,HUA的患病率正在迅速增加[1],已成为全球的公共健康问题.最新荟萃分析显示,中国HUA的总体患病率为13.3％[2],已成为继糖尿病后又一常见代谢性疾病.HUA不仅会引起痛风发作导致关节受损,还使糖尿病、血脂紊乱等代谢性疾病的发生率明显增加,同时也是肾脏损害和心血管事件高发的独立危险因素,早期筛查、诊断、干预尤为重要.上海市社区横断面研究显示,HUA与作为炎症指标之一的白细胞计数相关[3].国外也有研究证实慢性低度炎症参与代谢性疾病的发生[4].本研究旨在通过上海市崇明地区中老年人群前瞻性队列研究,进一步探讨白细胞计数与血尿酸水平之间的相关性,为HUA的早期诊断提供简便的预测手段.

目的 研究和分析注射用奥美拉唑钠药液不同调配方法对奥美拉唑钠含量产生的影响.方法 应用高效液相色谱法对不同调配方法瓶内奥美拉唑钠残留量进行测定和对比.结果 甲组及乙组药液调配完成后1.5 h、3 h以及4.5 h奥美拉唑含量明显低于调配完成即刻(P<0.05),丙组药液调配完成后1.5 h、3 h以及4.5 h奥美拉唑含量与调配完成即刻差异不显著(P>0.05).结论 注射用奥美拉唑钠药液不同调配方法对奥美拉唑钠含量可产生较大的影响,应用0.9％NS10 mL定容至100 mL的方式调配注射用奥美拉唑药液能够为临床用药有效性以及安全性提供保障.

Objective To investigate the association between hemoglobin A1c (HbA1c) 7.0%–8.0% and cardiovascular disease (CVD) risk among Chinese patients with type 2 diabetes mellitus (T2DM) with different baseline 10-year atherosclerotic CVD (ASCVD) risk stratification. Research design and methods A prospective population-based cohort of 10 060 adults aged 40–70 years in Chongming District of Shanghai was established in 2011. These participants were followed up for 3.25 years and CVD information was recorded. We investigated this association between HbA1c categories and incident CVD stratified by the 10-year ASCVD risk using multiple Cox regression analysis among 1880 patients with T2DM without CVD history. CVD events were defined as cardiovascular death, non-fatal myocardial infarction or non-fatal stroke. Results The corresponding incidence of CVD per 1000 person-years for the HbA1c≤6.5%, 6.6%–6.9%, 7.0%–8.0% and >8.0% groups were 12.5, 21.8, 22.9 and 28.9, respectively. The HbA1c>8.0% group was significantly associated with a higher CVD risk in patients with T2DM. The HbA1c 7.0%–8.0% group was significantly associated with a higher CVD risk in patients with T2DM with moderate baseline ASCVD risk (HR 2.48; 95% CI 1.15 to 5.32). Conclusion HbA1c of 7.0%–8.0% may result in a significantly higher CVD risk among patients with T2DM with moderate baseline ASCVD risk, which support the use of HbA1c combined with baseline ASCVD risk assessment to determine future glucose-lowering treatment decisions among patients with T2DM with basic to moderate risk.

Objective:To investigate the relationship of hemoglobin level with type 2 diabetes in middle-aged and elderly population in Shanghai Chongming District.Methods:A populational-based array research with multiple stage stratified cluster and random sampling was performed to study 7 534 residents from a community in Shanghai Chongming District. The standardized questionnaires, physical examinations and related laboratory tests were undertaken. The hemoglobin concentration was determined by cyanmethemoglobin spectrophotometry. The participants were divided into non-diabetic group, newly diagnosed diabetic group and previously diagnosed diabetic group according to the 1999 WHO diagnostic criteria and medical history; the participants were also divided into non-anemia group and anemia group according to the 1999 WHO anemia diagnostic criteria. Binary logistic regression models were used to estimate the odds ratios (ORs) and confidence intervals (CIs) for diabetes mellitus for every quartile of hemoglobin compared to the lowest quartile. Spearman correlation analysis was used to estimate the association of all related metabolic parameters with hemoglobin.Results:The prevalence of anemia in the non-diabetic group [275 (4.9%)] was higher than that in the newly diagnosed diabetic group and the previously diagnosed diabetic group [23 (1.9%) and 22 (2.9%)] ( P<0.01). The prevalence of anemia in the previously diagnosed diabetic group was higher than that in the newly diagnosed diabetic group ( P<0.01). Hemoglobin levels were positively correlated with waist（ r=0.257）, hip（ r=0.155）, BMI（ r=0.141）, FPG（ r=0.232）, 2 h PG（ r=0.140）, HbA 1C（ r=0.028）, insulin（ r=0.036）, HOMA-IR（ r=0.102）, LDL-C（ r=0.056）, TC（ r=0.054） and TG（ r=0.202）( P<0.05). Non-diabetic people at baseline were quartile according to hemoglobin level. At follow-up, the incidence of diabetes, fasting blood glucose and 2 h plasma glucose after glucose loading were higher in the highest hemoglobin quartile population than the lowest quartile population. After adjusting for other influencing factors, binary logistic regression analysis showed that the highest quartile hemoglobin was associated with increased risk of T2DM, with a fully adjusted odds ratio ( OR) of 1.415 (95% confidence interval ( CI), 1.087 to 1.841, P<0.01). Conclusions:There is a significant positive correlation between hemoglobin and the incidence of diabetes. Increased level of hemoglobin level is an independent risk factor and potential predictor for incidence of type 2 diabetes in middle-aged elderly population in this study.

目的 探究雷贝拉唑和艾司奥美拉唑对十二指肠溃疡患者的治疗效果.方法 选取接受治疗的十二指肠溃疡患者80例,随机分为艾司奥美拉唑组、雷贝拉唑组各40例,艾司奥美拉唑组患者使用艾司奥美拉唑进行治疗,雷贝拉唑组患者使用雷贝拉唑进行治疗.对两组患者治疗前后H+-K+-ATP酶活性、胃内酸碱值、C反应蛋白(CRP)、白细胞介素-8(IL-8)、白细胞介素-6(IL-6)以及T淋巴细胞亚群水平进行检测,统计对比两组患者溃疡愈合情况、治疗效果及不良反应发生情况.结果 治疗后雷贝拉唑组患者H+-K+-ATP酶活性低于艾司奥美拉唑组,胃内酸碱值高于艾司奥美拉唑组(P<0.05).治疗后雷贝拉唑组患者CRP、IL-8、IL-6水平均低于艾司奥美拉唑组(P<0.05).治疗后雷贝拉唑组患者CD3+、CD4+水平高于艾司奥美拉唑组,CD8+水平低于艾司奥美拉唑组(P<0.05).雷贝拉唑组患者治疗总有效率、溃疡愈合率显著高于艾司奥美拉唑组(P<0.05).雷贝拉唑组患者不良反应发生率略低于艾司奥美拉唑组,但两组比较差异无统计学意义(P>0.05).结论 使用雷贝拉唑和艾司奥美拉唑对十二指肠溃疡患者进行治疗,均具有一定的治疗效果,使用雷贝拉唑进行治疗的患者炎症因子下降幅度更加明显,H+-K+-ATP酶活性、胃内酸碱值受到明显调控,溃疡愈合情况更加理想.

The association between white blood cell (WBC) and nonalcoholic fatty liver disease (NAFLD) has been studied before, but whether different WBC subtypes were related to NAFLD was not detailed. The aim of our study was to investigate the relationship between WBC subtypes and NAFLD cross-sectionally and prospectively. The detailed research design has been described previously. At baseline, there were 9930 participants who had complete information, in the end a total of 8079 participants (2588 men and 5491 women) were eventually included in this study. Hepatic ultrasound examination was performed on each participant at baseline and at the end of follow-up. Alcohol abuse and hepatitis were excluded. WBC subtypes and other serum indices were measured at baseline. We found that the total WBC, neutrophil, and lymphocyte counts were independently associated with the prevalence and incidence of NAFLD. After multiple adjustments for age, gender, body mass index (BMI), insulin, HOMA-IR, TG, TC, LDL, and HDL, increased odds ratios (ORs) for new onset NAFLD were observed from the 1st to the 4th quartiles of WBC, neutrophil, and lymphocyte (all P < 0.001 for trend). In conclusion, total WBC counts, neutrophils, and lymphocytes were all independent risk factors for NAFLD in the rural Chinese population. The association was independent of insulin resistance.

Subjects with metabolic syndrome (MetS) had lower FVC and FEV1 than non-MetS subjects and decreased gradually with the increasing number of MetS components. After adjusting for potential risk factors, the lowest quartile of FVC and FEV1 was associated with increased risk of MetS.

Elevated resting heart rate (RHR) has been reported to be associated with metabolic syndrome and type 2 diabetes. The aim of this study was to explore whether a positive relationship exists between RHR and impaired glucose regulation (IGR) among middle-aged and older Chinese individuals.

The feature of nonalcoholic fatty liver disease (NAFLD) is pathological excessive liver lipid accumulation of subjects who without history of alcohol abuse. Calf circumference is a proxy for lower-body fat and screening method for the identification of subjects with acatastatic lipid accumulation. The objective of this study was to examine the association between calf circumference and NAFLD.

Selenium exposure can induce liver insulin resistance and increased liver triglyceride concentrations in animals, which may link to an increased risk of nonalcoholic fatty liver disease (NAFLD). However, epidemiological studies investigating the association between elevated plasma selenium levels and NAFLD were not available. We aimed to investigate the association of selenium levels with the prevalence of NAFLD in Chinese adults. This was a cross-sectional study of 8550 Chinese adults aged 40 yr or older in Shanghai, China. A questionnaire, anthropometric measurements, and laboratory tests were conducted. NAFLD was diagnosed by hepatic ultrasound after the exclusion of alcohol abuse and other liver diseases. Plasma selenium concentration was assessed by inductively coupled plasma mass spectroscopy. The median concentration of plasma selenium was 213.0 μg/L. Elevated plasma selenium levels were associated with higher triglycerides, LDL-cholesterol, fasting plasma glucose, post-loading plasma glucose, A1c, HOMA-IR, as well as ALT, AST and γ-GT (all P < 0.05). The odds ratios were substantially higher for NAFLD (OR = 1.54, 95% CI 1.13–2.18) in the highest selenium quartile compared with those in the lowest quartile, after adjustment for potential cofounder. The results of this study provided epidemiological evidence that increased plasma selenium level is associated with elevated prevalence of NAFLD.

Recent study showed periostin play a pivotal role in abnormal liver triglyceride (TG) accumulation and in the development of obesity-related liver fat accumulation. However, little is known regarding whether periostin plays a key role in the heightened prevalence of NAFLD and other metabolic phenotypes among large-scale populations. A cross-sectional sample of 8850 subjects aged 40 yr or older from China were evaluated in this study. Serum periostin was measured by ELISA methods. The diagnosis of NAFLD by liver ultrasonic examination. Among overweight and obese subjects, NAFLD subjects had higher serum periostin levels than those without NAFLD (126.75 ng/ml vs. 75.96 ng/ml, p < 0.001). Periostin was associated with a higher risk for NAFLD (OR 1.75 for each SD increase in periostin, 95% CI 1.04–3.37, p < 0.001) among overweight and obese subjects after confounder adjustment. Furthermore, periostin levels among overweight and obese subjects were correlated with aspartate aminotransferase (r = 0.102, p = 0.004), alanine aminotransferase (r = 0.108, p = 0.003), waist circumference (r = 0.111, p = 0.002), homeostasis model assessment index-insulin resistance (r = 0.154, p < 0.001) and fasting plasma insulin (r = 0.098, p = 0.006), TG (r = 0.117, p = 0.001). Elevated circulating periostin level was associated with an increased risk of having NAFLD and insulin resistance among overweight and obese individuals.

Associations between metabolic syndrome (MetS) and osteoporotic fracture have been reported. However, the epidemiological studies are not conclusive. The objective of the study was to determine whether metabolic syndrome associates with osteoporotic fracture.

High osteoprotegerin (OPG) has been reported in association with insulin resistance and type 2 diabetes. We aimed to evaluate the association of serum OPG with impaired glucose regulation (IGR) and microalbuminuria among middle-aged and older Chinese.

目的 制备葡萄籽原花青素磷脂复合物,考察其理化性质,研究磷脂复合物制剂成型工艺.方法 以葡萄籽原花青素与磷脂的复合率为评价标准,再以复合率为指标确定复合物制备工艺；研究原花青素B2磷脂复合物的理化性质包括脂水分配系数及溶解性能等；探讨葡萄籽原花青素磷脂复合物的制剂成型工艺.结果 优化工艺的复合率可达97％.原花青素B2磷脂复合物的油水分配系数与原花青素B2相比明显增大,预示其体内吸收有可能提高.原花青素磷脂复合物流动性尚可,但黏性强,相对临界湿度小,引湿性较强.结论 确定了制备葡萄籽原花青素磷脂复合物的最佳工艺,该复合物明显改善了原药的理化性质.