ObjectiveTo understand the relation between blood glucose regulating hormones and gastric cancer, so as to provide some new ideas for diagnosis and treatment of gastric cancer. MethodBy reviewing and screening relevant domestic and foreign literatures, the latest researches on the relation between blood glucose regulating hormones and gastric cancer were summarized. ResultsThe insulin, glucagon, adrenaline, growth hormone, and the other blood glucose regulating hormones all played the roles in promoting the occurrence and development of gastric cancer. However, glucocorticoids and somatostatin were protective hormones that maintained gastric homeostasis and inhibited the proliferation of gastric cancer cells. ConclusionBlood glucose regulating hormones play some roles in diagnosis and treatment of gastric cancer, but specific mechanisms such as interaction between blood glucose regulating hormones, role of glucose metabolism in biological behavior of gastric cancer, and effect of blood glucose regulating hormones on oncogene initiation are unclear, so prospective clinical control studies still need to be studied.
Objective To investigate the long-term dynamic changes of liver function and glucose-lipid metabolism in human immunodeficiency virus (HIV)-infected patients with metabolic dysfunction-associated fatty liver disease (MAFLD) after antiretroviral therapy (ART). Methods HIV-infected patients who visited Public Health Clinical Center of Chengdu between October 1st, 2012 and June 30th, 2013 were recruited and divided into two groups according to whether they had MAFLD or not. All of them were treated with the first-line regimen of tenofovir + lamivudine + efavirenz for 156 weeks, and the anthropometric indices, liver function, and levels of glucose, lipids and uric acid were measured at baseline and at each follow-up time point. In addition, the long-term dynamic characteristics of liver function and glucose and lipid metabolism parameters of the two groups were compared during the 156 weeks of ART treatment. Results A total of 61 male HIV-infected patients were enrolled. The prevalence of MAFLD in them was 31.1% (19/61) at baseline and increased by 4.9 percentage points per year after ART. Before the start of follow-up (week 0), the levels of alanine aminotransferase (ALT) [(46.23±27.09) vs. (28.00±17.43) U/L, P=0.002] and γ-glutamyl transpeptidase (GGT) [(41.46±9.89) vs. (24.02±10.72) U/L, P<0.001] were higher in the MAFLD group than those in the non-MAFLD group, while the between-group differences in the levels of aspartate aminotransferase (AST) [(33.33±15.61) vs. (28.98±12.43) U/L, P=0.248] and alkaline phosphatase [(85.30±21.27) vs. (83.41±24.47) U/L, P=0.773] were not statistically significant. During the 156-week follow-up period, the 4 items of liver function gradually increased in the MAFLD group, especially from week 120 onwards, 3 of which (ALT, AST and GGT) were significantly higher than those in the non-MAFLD group (P<0.05). In addition, the levels of fasting blood glucose, triglyceride, total cholesterol, and low-density lipoprotein were also significantly higher in the MAFLD group than those in the non-MAFLD group at some time points during the 156-week follow-up period (P<0.05). Conclusions Compared with HIV-infected patients without MAFLD, HIV-infected patients with MAFLD are more likely to develop impaired liver function and disorders of glucose and lipid metabolism during long-term tenofovir + lamivudine + efavirenz regimen ART treatment. Therefore, close clinical monitoring of liver function and glucose and lipid metabolism related parameters is required for such patients.
摘要:目的:探讨经尿道前列腺电切术中糖尿病患者血糖变化以及处理对策。方法:2006年7月~ 2009年1月共对80例患有前列腺增生合并糖尿病患者行TURP,同期对80例单纯性前列腺增生患者进行相同手术,回顾分析其术前、术中30 min、60 min、90 min 指尖血糖变化及干预情况。结果:治疗组80例患者,51例术中血糖值明显低于术前,分别为1.8～3 mmol/L;对照组术前与术中血糖值基本一致,血糖波动于4.5～5.6 mmol/L。结论:糖尿病患者糖的储备能力差,在行经尿道电切术中易发生低血糖综合征,术中及时的血糖监测及干预对保证患者的安全有重要意义。Abstract: Objective: To study the changes and measures against the glucose in the operation of the Diabetes by TURP. Methods:Eighty patients with prostate combining diabetes operated from July 2006 to Jan. 2009 were reviewed, and 80 prostate treated at the same period with the same operation measure were selected as control. The preoperative glucose, intraoperative glucose (30′, 60′,90′) of fingertip, and countermeasures were studied and compared between the two groups. Results:Fiftyone cases of the experimental group of intraoperative blood glucose was significantly lower than preoperative values, respectively 1.83 mmol/ L; control group preoperative and intraoperative blood glucose values were basically the same, blood glucose fluctuations in the 4.55.6 mmol/L. Conclusion: The capacity in patients with diabetes is poor, easy to hypoglycemia syndrome in the act of TURP surgery, intraoperative blood glucose monitoring and timely intervention to ensure patient safety significance.
ObjectiveTo explore the relationship between blood glucose variability index and persistent organ failure (POF) in acute pancreatitis (AP). MethodsWe prospectively included those patients who were diagnosed with AP with hyperglycemia and were hospitalized in the West China Center of Excellence for Pancreatitis of West China Hospital of Sichuan University from July 2019 to November 2021. The patients were given blood glucose monitoring at least 4 times a day for at least 3 consecutive days. The predictive value of blood glucose variability index for POF in patients with AP was analyzed. ResultsA total of 559 patients with AP were included, including 95 cases of POF. Comparing with those without POF, patients with AP complicated by POF had higher levels of admission glucose (11.0 mmol/L vs. 9.6 mmol/L), minimum blood glucose (6.8 mmol/L vs. 5.8 mmol/L), mean blood glucose (9.6 mmol/L vs. 8.7 mmol/L), and lower level of coefficient of variation of blood glucose (16.6 % vs. 19.0 %), P<0.05. Logistic regression analyses after adjustment for confounding factors showed that the risk of POF increased with the increase of admission glucose [OR=1.11, 95%CI (1.04, 1.19), P=0.002], minimum blood glucose [OR=1.28, 95%CI (1.10, 1.48), P=0.001] and mean blood glucose [OR=1.18, 95%CI (1.04, 1.33), P=0.010]; with the higher level of coefficient of variation of blood glucose [OR=0.95, 95%CI (0.92, 0.99), P=0.021], the risk of POF decreased. The results of area under the curve (AUC) of the receiver operator curves showed that AG [AUC=0.787, 95%CI (0.735, 0.840)] had the highest accuracy in predicting POF, with sensitivities of 60.0% and specificities of 84.7%. ConclusionHigh admission glucose, minimum blood glucose, mean blood glucose, and low coefficient of variation of blood glucose were risk factors for the development of POF in patients with hyperglycemic AP on admission.
Existing near-infrared non-invasive blood glucose detection modelings mostly detect multi-spectral signals with different wavelength, which is not conducive to the popularization of non-invasive glucose meter at home and does not consider the physiological glucose dynamics of individuals. In order to solve these problems, this study presented a non-invasive blood glucose detection model combining particle swarm optimization (PSO) and artificial neural network (ANN) by using the 1 550 nm near-infrared absorbance as the independent variable and the concentration of blood glucose as the dependent variable, named as PSO-2ANN. The PSO-2ANN model was based on two sub-modules of neural networks with certain structures and arguments, and was built up after optimizing the weight coefficients of the two networks by particle swarm optimization. The results of 10 volunteers were predicted by PSO-2ANN. It was indicated that the relative error of 9 volunteers was less than 20%; 98.28% of the predictions of blood glucose by PSO-2ANN were distributed in the regions A and B of Clarke error grid, which confirmed that PSO-2ANN could offer higher prediction accuracy and better robustness by comparison with ANN. Additionally, even the physiological glucose dynamics of individuals may be different due to the influence of environment, temper, mental state and so on, PSO-2ANN can correct this difference only by adjusting one argument. The PSO-2ANN model provided us a new prospect to overcome individual differences in blood glucose prediction.
Objective To investigate the correlation between stress hyperglycemia ratio (SHR) and acute ischemic stroke (AIS) 1-year prognosis, to provide more clinical basis to improve the prognosis of AIS patients and to target and control the influencing factors. MethodsThe patients with AIS diagnosed for the first time and received treatment at the Shijiazhuang Fifth Hospital between May 2019 and January 2022 were retrospectively and continuously included. According to the Modified Rankin Scale score 1-year after the onset of the disease, the patients were divided into a good prognosis group and a poor prognosis group. Also the patients were divided into 2 groups based on the median of SHR. The correlation between SHR and stress blood glucose was analyzed, and the factors affecting the prognosis of AIS patients were identified. The predictive value of SHR and stress blood glucose on the prognosis of AIS patients was compared using receiver operating characteristic. Results A total of 206 patients were included. Among them, there were 125 cases (60.7%) in the good prognosis group and 81 cases (39.3%) in the poor prognosis group. The median SHR (lower quartile, upper quartile) is 1.20 (1.08, 1.33). There were statistically significant differences between the two groups in the scores of the National Institutes of Health Stroke Scale, diabetes history, hypertension history, low-density lipoprotein cholesterol, stress blood glucose, age, SHR and SHR classification (P<0.05). There was no statistically significant difference in the other indicators compared between the two groups (P＞0.05). Stress blood glucose was positively correlated with SHR (7.95±1.78 vs. 1.21±0.19; r=0.294, P<0.001). Multivariate logistic analysis showed that stress blood glucose and SHR were independent factors influencing the 1-year prognosis of AIS patients (P<0.05), and the interaction between SHR and diabetes was not significant (P>0.05) After adjusting for confounding factors, the area under the receiver operating characteristic curve of SHR for the prognosis of AIS patients was higher than that of stress blood glucose [0.682 (0.614, 0.745) vs .0.585 (0.515, 0.653); Z=2.042, P=0.041]. Conclusions SHR and stress blood glucose are independent risk factors for 1-year prognosis in AIS patients. However, SHR has a better predictive value for 1-year prognosis in AIS patients than stress blood glucose. Whether the patient has diabetes or not, the impact of SHR on the prognosis of AIS patients is consistent.
ObjectiveTo explore the influence factors of gallstone. MethodsClinical data of 511 patients who were admitted to our hospital from Apr. 2015 to Apr. 2016 were retrospectively analyzed. ResultsOf 511 patients, there were 274 patients with gallstone (gallstone group) and 237 patients without gallstone (control group). Univariate analysis results showed that, no significant difference of age, gender, and diabetes was found between gallstone group and control group (P > 0.050), but the levels of serum total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL-C), and fasting blood glucose (FBG) were significantly higher in patients of gallstone group (P < 0.050), but the level of serum high density lipoprotein (HDL-C) was significantly lower in patients of gallstone group (P=0.001). Logistic regression results showed that four factors including diabetes〔OR=4.491; 95% CI is (2.021, 9.976); P < 0.001〕, the serum TC〔OR=2.548; 95% CI is (1.944, 3.338); P < 0.001〕, HDL-C〔OR=0.115; 95% CI is (0.056, 0.237); P < 0.001〕, and FBG〔OR=1.277; 95% CI is (1.086, 1.502); P=0.003〕 entered the final regression model after controlling confounding factors. The results showed that patients who combined with diabetes, high levels of serum TC and FBG, and low level of serum HDL-C, had higher ratio of galls-tone. ConclusionDiabetes, high-level of serum TC and FBG, low-level of serum HDL-C were risk factors of gallstone.
ObjectiveTo investigate the change of blood glucose and its clinical significance in patients with acute pancreatitis (AP). MethodsThe regularity of blood glucose change and the relation between the regularity and the prognosis were analyzed in 115 patients with AP and hyperglycemia.ResultsBlood glucose was increased with a median (M) of 8.7 mmol/L，18.45 mmol/L and 27.22 mmol/L, which gradually decreased to normal value within 3-17 days, 7-26 days and 24-46 days after treatment,respectively in patients with mild AP, type Ⅰ of severe acute pancreatitis (SAP) and type Ⅱ of SAP. There was marked statistical difference among the three groups. A smaller dose of regular insulin was used for 36 patients with mild AP; however, a larger dose of regular insulin was used for all 30 patients with SAP.ConclusionThe level of blood glucose, the dose of regular insulin and the duration of hyperglycemia increase with the severity of AP.
Objective To evaluate the accuracy of newer-generation home blood glucose meter (Accu-Check? Integra) in patients with impaired glucose regulation (IGR) and newly-diagnosed type 2 diabetes mellitus. Methods A cross-sectional study was performed on 109 cases with newly-diagnosed type 2 diabetes or IGR who were asked to take oral glucose tolerance test (OGTT), while paired samples, that were Accu-Check? Integra in capillary blood glucose (CBG) and laboratory glucose in venous plasma glucose (VPG ), were taken simultaneously. Taking VPG as the reference value, the accuracy of the home glucose meter was assessed according to the international standardization organization (ISO), including, the accuracy was studied by means of Median absolute difference (Median AD) and Median absolute relative difference (Median RAD), the consistency of CBG and VPG was studied by Clarke Error Grid analysis, the correlation of CBG and VPG was analyzed according to liner regression analysis, and the sensitivity and specificity for hyperglycemia were also calculated. Results There were 292 VPG values paired with CBG values, among which 93.49% of CBG values met ISO home glucose meter criteria, the median AD was 7.2 mg/dL, and the median RAD was 4.76%. Paired glucose measurements from the Accu-Check Integra meter and laboratory glucose measurement demonstrated that 100% of paired points in the overall subject population fell in zones A and B of the Clarke Error Grid. The CBG value was well correlated to VPG value in the overall level, and the sensitivity and specificity were 94.6% and 95.7% respectively for hyperglycemia. Conclusion The newer-generation home blood glucose meter (Accu-Check? Integra) demonstrates a high degree of accuracy, and it can precisely report the real value of blood glucose.
Objective To investigate the application effect of ndividualized dietary care based on a multidisciplinary collaboration model on glycemic control, neurological recovery, dietary self-management, and satisfaction in stroke patients with abnormal blood glucose. Methods Patients with stroke and abnormal blood glucose admitted to the Department of Neurology, Shangjin Hospital, West China Hospital, Sichuan University between March and October 2024 were enrolled. Using SPSS 26.0 software, a random allocation sequence was generated to divide participants into an observation group and a control group. The control group received comprehensive nursing interventions, while the observation group received additional multidisciplinary collaboration model based individualized dietary care. Both groups were intervened until discharge. Glycemic indicators [glycated albumin (GA), fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hPG)], neurological recovery, dietary adherence, and patient satisfaction were compared pre-intervention and post-intervention (at discharge). Results A total of 112 patients were included, with 56 patients in each group. At the post-intervention stage, GA, FBG and 2hPG in the observation group were lower than those in the control group (P<0.05), and the scores of the Dietary Compliance Scale for Type 2 Diabetes were higher than those in the control group (P<0.05). Except for admission (3.27±0.86 vs. 3.25±0.90, P＞0.05), the modified Rankin Scale scores of the observation group were lower than those of the control group at discharge (3.14±0.86 vs. 3.17±0.86), 30-days follow-up (2.93±0.76 vs. 3.02±0.84), and 90-days follow-up (1.05±0.80 vs.1.43±1.01) (P<0.05). The comparison results within the group showed that, there were significant differences in GA, FBG, 2hPG, modified Rankin Scale scores and Dietary Compliance Scale for Type 2 Diabetes between admission and discharge (P<0.05). The satisfaction rate of the observation group was higher than that of the control group (97.78% vs. 86.76%; χ2=3.877, P=0.049). Conclusion Multidisciplinary collaboration model based individualized dietary care improves short-term glycemic control, promotes long-term neurological recovery, enhances dietary adherence, and increases patient satisfaction in stroke patients with abnormal blood glucose, demonstrating clinical value for widespread application.