The incidence of depression in patients with rheumatoid arthritis is higher. The concomitant depression will increase medical expense, reduce drug efficacy, lower its compliance, increase the incidence of complication, and affect the cure of rheumatoid arthritis. The influence of depression to rheumatoid arthritis is usually ignored in clinical work. In recent years, the pertinence between depression and immune disease in pathogenesis is found in research: depression will increase the risk of immune diseases in activate inflammation as well as extend and promote the release of inflammatory factors. This article reviews research progress of correlation between depression and rheumatoid arthritis.
ObjectiveTo understand the nutritional status of vitamin D in some children aged 0-14 in Mianyang during the past 3 years and the changes of vitamin D nutritional status under home protection during the coronavirus disease 2019 (COVID-19) epidemic, so as to provide a theoretical basis for the monitoring and reasonable supplementation of vitamin D in children in this area after the epidemic.MethodsThe clinical data of children aged 0-14 who underwent physical examination in the Children’s Health Department of Mianyang Central Hospital from January to April 2018, from January to April 2019 and from January to April 2020 were analyzed retrospectively. High performance liquid chromatography tandem mass spectrometry was used to detect vitamin D, including vitamin D2, vitamin D3 and 25-hydroxyvitamin D [25(OH)D] in children’s serum. The differences in vitamin D components and 25(OH)D between different genders, different age groups, and different years were analyzed.ResultsA total of 12 348 children were included. The average vitamin D2 was (4.89±6.02) ng/mL, the average vitamin D3 was (22.91±9.29) ng/mL, the average 25(OH)D was (27.81±10.53) ng/mL, and 9 434 cases had sufficient 25(OH)D. The differences in vitamin D2, vitamin D3, 25(OH)D and 25(OH)D nutritional status in 2018, vitamin D2 and 25(OH)D in 2019, and vitamin D2 in 2020 between different genders were not statistically significant (P>0.05). There were statistically significant differences in vitamin D3 and 25(OH)D nutritional status in 2019, vitamin D3, 25(OH)D and 25(OH)D nutritional status in 2020 between different genders (P<0.05). From 2018 to 2020, vitamin D2 was the highest in infant group (P<0.05), while vitamin D3, 25(OH)D and 25(OH)D nutritional status were the highest in children group (P<0.05); vitamin D2 (χ2=143.106, P<0.001) showed an overall downward trend, vitamin D3 (F=400.178, P<0.001) and 25(OH)D (F=447.384, P<0.001) showed an overall upward trend; 25(OH)D nutritional status (χ2=103.566, P<0.001) was the highest in 2019.ConclusionsThe overall vitamin D nutritional status of children in Mianyang area is acceptable. Under the home protection, the average level of children’s serum 25(OH)D has little change, while the nutritional status of 25(OH)D has decreased significantly. After the outbreak of COVID-19, more attention should be paid to the monitoring and supplementation of vitamin D in school-age female children.
Objective To explore the association between 25-hydroxyvitamin D (25OHD) level and risk of the onset of metabolic syndrome (MS) in people in Chengdu. Methods In total, 474 participants were selected randomly by cluster sampling from one urban district and two rural villages in Longquanyi district of Chengdu. The data of sociodemographic information, lifestyle and family history were collected by questionnaires. Binary logistic regression was performed to assess the relationship between baseline 25OHD level and incident of MS, while multiple linear regression was conducted to analyze the relationship between baseline 25OHD level and insulin resistance. Results Four hundred seventy-four people were enrolled in the cohort study, 39 of them developed MS, with the incidences of 20.8 events per 1 000 person years. Among women, low 25OHD status was significantly associated with the risk of developing MS (OR=4.29, 95%CI 1.05 to 29.50, P=0.044) after adjustment for multiple potential confounders. In a multiple linear regression analysis, low 25OHD level of baseline was independently associated with the increased HOMA-IR over a 4-year period among Chengdu individuals (P<0.05) and was independently related to the decreased ISIcomp over a 4-year period in female (P<0.05). Conclusions The current prospective study suggests that low 25OHD level may contribute to increase insulin resistance in Chengdu population. Furthermore, low 25OHD level may increase the risk of MS among women in Chengdu.
ObjectiveTo screen pathogenic gene mutations of Gitelman syndrome (GS).MethodsPatients with GS diagnosed and treated in the Department of Endocrinology and Metabolism, West China Hospital of Sichuan University from January 2015 to December 2020 and their family members were included. The pathogenic genes were screened by second-generation sequencing combined with first-generation validation.ResultsA total of 15 GS patients were included. Gene analysis of patients indicated SLC12A3 gene mutation, including 9 cases of compound heterozygous mutation and 6 cases of heterozygous mutation. A total of 12 reported pathogenic sites and 8 new pathogenic mutations were found. Among the newly discovered pathogenic mutations, four were missense mutations (c.539C>A, p.T180K; c.1077C>G, p.N359K; c.1967C>T, p.P656L; and c.2963T>C, p.I988T), one was frame shift mutation caused by single base deletion (c.2543delA, p.D848fs), one was nonsense mutation (c.2129C>A, p.S710X), one was large fragment deletion (exon 7-8 partial coding sequence deletion), and one was coding sequence deletion and abnormal base sequence insertion (IVS7-1 to c.976 deletion GCGGACATTTTTG insertion into ACCGAAAATTTT).ConclusionIn this study, 8 new gene mutations leading to GS were found, and the exact pathogenesis of GS remains to be further confirmed.
Objective To demonstrate the efficacy, tolerability, and safety of domestic Acarbose tablet compared with Glucobay (Acarbose tablet produced by Bayer company) in patients with type 2 diabetic patients. Method A multicenter randomized controlled parallel-group comparison study was conducted. 177 Chinese type 2 diabetic patients were recruited from 4 clinical centers. The patients were divided randomly into domestic Acarbose tablet (A group) or Glucoby (B group) treatment group. The trial consisted of a 2-4 weeks equilibrated period followed by an 8 week course of treatment. Results 165 patients have finished the trial (81 in A group and 84 in B group). After 4 weeks of treatment, the mean of fasting blood glucose (FBG) in A and B group were reduced 1.61 and 2.08 mmol/L respectively, and mean of postprandial blood glucose (PBG) lowered 5.06 and 5.09mmol/L respectively. After 8 weeks of treatment, the mean of FBG were reduced 1.95 and 2.62mmol/L respectively, and mean of PBG lowered 4.88 and 5.98 mmol/L, respectively, and mean of HbA1c were lowered 1.13% and 1.20% respectively in A and B group. The differences in reduction of FBG, PBG, and HbA1c between A and B group were no statistic significance. The serum triglyceride levels and BMI were decreased significantly in both A, B groups. 3 patients who drinking wine during trial on A group had asymptomatic elevations in serum transaminases that normalized in 2 weeks after stopped drinking and Acarbose withdrawal. Flatulence was the most common side effect. Conclusions In this multicenter study, domestic Acarbose tablet 50 mg t.i.d. was an effective, safe, and generally well-tolerated therapy as similar as Glucobay in type 2 diabetic patients.
【摘要】 目的 调查成都地区2型糖尿病患者糖耐量正常一级亲属的代谢状态及与胰岛素抵抗、胰岛β细胞功能的相关性。 方法 2007年7-9月共纳入糖耐量正常的一级亲属312例（NGT-FDR组），无家族史的正常对照1 348例（NGT-C组）。测量两组血压、体重、腰围；检测口服葡萄糖耐量试验（OGTT）中0、0.5、2 h血糖、胰岛素水平；测定空腹血脂；计算体重指数、HOMA-胰岛素抵抗指数（HOMA-IR）、胰岛β细胞功能指数（HOMA-β），β细胞早相分泌功能指数（△I30/△G30），并比较两组间上述指标的差异和代谢综合征（MS）及其各组分的发病情况。 结果 ①NGT-FDR组MS发生率高于NGT-C组，发生MS的风险是后者的1.737倍。NGT-FDR组高甘油三酯血症（hypertriglyceridemia，HTG）、空腹血糖偏高（5.6~6.0 mmol/L）的发生率高于NGT-C组，合并4种及以上代谢异常的几率亦高于NGT-C组（Plt;0.05）；②年龄lt;40岁的NGT-FDR中心性肥胖、HTG、空腹血糖偏高和MS均高于同年龄对照；男性NGT-FDR空腹血糖偏高和MS发病率高于男性对照（Plt;0.05）；③腰围、收缩压（SBP）、空腹血糖（FBG）、甘油三酯（TG）及糖尿病家族史同HOMA-IR呈正相关。腰围、SBP、TG及糖尿病家族史同HOMA-β呈正相关，FBG则同HOMA-β呈负相关。 结论 2型糖尿病糖耐量正常一级亲属比无家族史的对照表现出更多的代谢异常，尤其是在年龄lt;40岁及男性中。各种代谢异常可加重胰岛素抵抗，影响胰岛基础分泌功能。故有必要对糖耐量正常的一级亲属进行各项代谢指标的监测和早期预防性干预。【Abstract】 Objective To investigate the metabolic status of the normal glucose-tolerant first-degree relatives (NGT-FDR) of type-2 diabetic patients and its relationship with insulin resistance (IR) and β-cell function in Chengdu area. Methods From July to September 2007, a total of 312 NGT-FDR of type-2 diabetic patients and 1 348 normal glucose tolerant controls without positive family history of diabetes (NGT-C) were enrolled in this study. Blood pressure, weight, waists, plasma glucose at hour 0, 1/2 and 2 in oral glucose tolerance test (OGTT), insulin levels and fasting blood lipids were measured. Body mass index (BMI), HOMA-IR, HOMA-β and the early insulin secreting index (△I30/△G30) were calculated. Then, we compared the above-mentioned data and the incidence of metabolic syndrome (MS) between the two groups. Results ①The incidence of MS, hypertriglyceridemia (HTG), higher fasting blood glucose (FBG) (5.6-6.0 mmol/L) in the NGT-FDR group were all significantly higher than those in the NGT-C group. The risk of developing MS in the NGT-FDR group was 1.737 times as high as that in the NGT-C group. Furthermore, the incidence of 4 or more than 4 co-existent metabolic disorders in the NGT-FDR group was also significantly higher than that in the NGT-C group (Plt;0.05); ②For subjects less than 40 years old, the incidence of central obesity, HTG, higher FBG and MS in the NGT-FDR group were all higher than those in the NGT-C group. In male subjects, the rates of higher FBG and MS were all significantly higher in the NGT-FDR group than those in the NGT-C group. (Plt;0.05); ③Waists, FBG, systolic blood pressure (SBP), triglycerides (TG) and diabetic family history were positively correlated with HOMA-IR. Waists, SBP, TG and diabetic family history were positively correlated with HOMA-β. Conclusion NGT-FDR present significantly increased metabolic disorders than NGT controls, especially in the less than 40-year-old and the male subjects. The metabolic disorders can aggravate insulin resistance and influence islet β-cell secretion function, so it is necessary to monitor the metabolic status of the NGT-FDR of type-2 diabetic patients and provide early preventive interventions.
Objective To investigate the efficacy on clinical condition assessment and the safety of ultrasound-guided osteofascial chamber puncture manometry in evaluating the pressure of the osteofascial chamber in patients with venomous snake bites. Methods Patients with venomous snake bites admitted to the Department of Emergency Medicine of West China Hospital of Sichuan University between April 2021 and January 2023 were prospectively included, and their basic information, physiological indicators (heart rate, blood pressure), laboratory examination indicators, physical signs, treatment methods and prognosis were collected. The patients whose extremal pressure was measured by osteofascial chamber puncture under ultrasound guidance were selected as the manometry group. Patients who were bitten by venomous snakes at the same time without puncture pressure measurement were randomly selected as the control group at a ratio of 1∶1. The bleeding, infection, nerve injury, length of hospital stay and long-term prognosis of the two groups were compared to explore the safety of ultrasound-guided osteofascial chamber puncture manometry. The correlation between the pressure measured in the manometry group and creatine kinase (a representative index of acute poisoning severity score) was analyzed to explore the efficacy of ultrasound-guided osteofascial chamber puncture manometry in evaluating the disease. Results There was no significant difference between the manometry group and the control group in new or aggravated infection, bleeding, nerve injury (such as numbness and anesthesia), hospital treatment time, final detumescence time of the affected limb, or final adverse prognosis (P>0.05). There was a positive correlation between the measured pressure and creatine kinase (rs=0.286, P=0.002). Conclusions The higher pressure measured by ultrasound-guided osteofascial chamber puncture manometry is, the more serious the poisoning condition may be. In addition, ultrasound-guided osteofascial chamber puncture manometry does not prolong the hospital time of patients or the final swelling reduction time of the affected limb, and does not increase the incidence of bleeding, infection, nerve damage or eventual adverse prognosis events. It has clinical practicability and feasibility.