28 research outputs found

    Associations of comorbid depression with cardiovascular-renal events and all-cause mortality accounting for patient reported outcomes in individuals with type 2 diabetes: a 6-year prospective analysis of the Hong Kong Diabetes Register

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    BackgroundPsychosocial status and patient reported outcomes (PRO) [depression and health-related quality-of-life (HRQoL)] are major health determinants. We investigated the association between depression and clinical outcomes in Chinese patients with type 2 diabetes (T2D), adjusted for PRO.MethodsUsing prospective data from Hong Kong Diabetes Register (2013-2019), we estimated the hazard-ratio (HR, 95%CI) of depression (validated Patient Health Questionnaire 9 (PHQ-9) score≥7) with incident cardiovascular disease (CVD), ischemic heart disease (IHD), chronic kidney disease (CKD: eGFR<60 ml/min/1.73m2) and all-cause mortality in 4525 Chinese patients with T2D adjusted for patient characteristics, renal function, medications, self-care and HRQoL domains (mobility, self-care, usual activities, pain/discomfort, anxiety/depression measured by EQ-5D-3L) in linear-regression models.ResultsIn this cohort without prior events [mean ± SD age:55.7 ± 10.6, 43.7% women, median (IQR) disease duration of 7.0 (2.0-13.0) years, HbA1c, 7.2% (6.6%-8.20%), 26.4% insulin-treated], 537(11.9%) patients had depressive symptoms and 1923 (42.5%) patients had some problems with HRQoL at baseline. After 5.6(IQR: 4.4-6.2) years, 141 patients (3.1%) died, 533(11.8%) developed CKD and 164(3.6%) developed CVD. In a fully-adjusted model (model 4) including self-care and HRQoL, the aHR of depression was 1.99 (95% confidence interval CI):1.25-3.18) for CVD, 2.29 (1.25-4.21) for IHD. Depression was associated with all-cause mortality in models 1-3 adjusted for demographics, clinical characteristics and self-care, but was attenuated after adjusting for HRQoL (model 4- 1.54; 95%CI: 0.91-2.60), though HR still indicated same direction with important magnitude. Patients who reported having regular exercise (3-4 times per week) had reduced aHR of CKD [0.61 (0.41–0.89)]. Item 4 of PHQ-9 (feeling tired, little energy) was independently associated with all-cause mortality with aHR of 1.66 (1.30-2.12).ConclusionDepression exhibits significant association with CVD, IHD, and all-cause mortality in patients with diabetes, adjusting for their HRQoL and health behaviors. Despite the association between depression and all-cause mortality attenuated after adjusting for HRQoL, the effect size remains substantial. The feeling of tiredness or having little energy, as assessed by item Q4 of the PHQ-9 questionnaire, was found to be significantly associated with an increased risk of all-cause mortality after covariate adjustments. Our findings emphasize the importance of incorporating psychiatric evaluations into holistic diabetes management

    Evaluation of HIV protease and nucleoside reverse transcriptase inhibitors on proliferation, necrosis, apoptosis in intestinal epithelial cells and electrolyte and water transport and epithelial barrier function in mice

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    <p>Abstract</p> <p>Background</p> <p>Protease inhibitors (PI's) and reverse transcriptase drugs are important components of highly active antiretroviral therapy (HAART) for treating human acquired immunodeficiency syndrome (AIDS). Long-term clinical therapeutic efficacy and treatment compliance of these agents have been limited by undesirable side-effects, such as diarrhea. This study aims to investigate the effects of selected antiretroviral agents on intestinal histopathology and function <it>in vivo </it>and on cell proliferation and death <it>in vitro</it>.</p> <p>Methods</p> <p>Selected antiretroviral drugs were given orally over 7 days, to Swiss mice, as follows: 100 mg/kg of nelfinavir (NFV), indinavir (IDV), didanosine (DDI) or 50 mg/kg of zidovudine (AZT). Intestinal permeability measured by lactulose and mannitol assays; net water and electrolyte transport, in perfused intestinal segments; and small intestinal morphology and cell apoptosis were assessed in treated and control mice. <it>In vitro </it>cell proliferation was evaluated using the WST-1 reagent and apoptosis and necrosis by flow cytometry analysis.</p> <p>Results</p> <p>NFV, IDV, AZT and DDI caused significant reductions in duodenal and in jejunal villus length (p < 0.05). IDV and AZT increased crypt depth in the duodenum and AZT increased crypt depth in the jejunum. NFV, AZT and DDI significantly decreased ileal crypt depth. All selected antiretroviral drugs significantly increased net water secretion and electrolyte secretion, except for DDI, which did not alter water or chloride secretion. Additionally, only NFV significantly increased mannitol and lactulose absorption. NFV and IDV caused a significant reduction in cell proliferation <it>in vitro </it>at both 24 h and 48 h. DDI and AZT did not alter cell proliferation. There was a significant increase in apoptosis rates in IEC-6 cells after 24 h with 70 ug/mL of NFV (control: 4.7% vs NFV: 22%) while IDV, AZT and DDI did not show any significant changes in apoptosis compared to the control group. In jejunal sections, IDV and NFV significantly increased the number of TUNEL positive cells.</p> <p>Conclusion</p> <p>The PI's, NFV and IDV, increased cell apoptosis <it>in vivo</it>, water and electrolyte secretion and intestinal permeability and decreased villus length and cell proliferation. NFV was the only drug tested that increased cell apoptosis <it>in vitro</it>. The nucleoside reverse transcriptase inhibitors, AZT and DDI, did not affect cell apoptosis or proliferation. These findings may partly explain the intestinal side-effects associated with PI's.</p

    Phosphine ligand for indole skeleton as well as preparation method and application of phosphine ligand

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    Inventor name used in this publication: 邝福儿Inventor name used in this publication: 苏秋铭Inventor name used in this publication: 周永健Inventor name used in this publication: 原安莹Title in Traditional Chinese: 一種吲哚骨架的膦配體及其制備方法和應用China202212 bcchVersion of Recor

    Surface characterization of saimeterol xinafoate powders by inverse gas chromatography at finite coverage

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    In our previous studies, surface analysis by inverse gas chromatography (IGC) at infinite dilution (zero coverage) was performed on four salmeterol xinafoate (SX) powdered samples, viz, two supercritical CO2-processed Form I (SX-I) and Form II (SX-II) polymorphs, a commercial granulated SX (GSX) raw material and its micronized product (MSX). Both GSX and MSX are also of the same Form I polymorph. To further probe the differences in surface properties between the samples, the present study has extended the IGC analysis to the finite concentration range of selected energy probes. The adsorption isotherms of the SX samples were constructed using (nonpolar) octane, (polar acidic) chloroform, and (polar basic) tetrahydrofuran as liquid probes. Type II adsorption isotherms with weak knees were observed with each probe for all SX Form I samples. The extents of probe adsorption by the samples at various relative pressures follow the rank order: SX-II > GSX approximate to MSX > SX-I, indicating that the SX-I has fewer high-energy adsorption sites than GSX and MSX. Type III isotherms were observed for SX-II with the two polar probes, indicative of weak adsorbate-adsorbent interactions. The additional information generated shows that IGC analysis at finite coverage is a valuable complementary tool to that at infinite dilution. (C) 2005 Wiley-Liss, Inc

    Comparative study on anti-cancer and anti-liver fibrosis between bear bile and botanic Chinese medicines

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    2010中西醫結合防治腫瘤國際會議暨第六屆龐鼎元國際中醫藥研討會, 香港, 2010年11月26-28日.The 2010 International Conference on Integrate Medicine Against Cancer cum the 6th Pong Ding Yuen International Symposium on Traditional Chinese Medicine, Hong Kong, 26-28 November 2010

    Comparative study on bear bile and coptis

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    Handbook with programme 1

    Evaluation of a fourth-generation subcutaneous real-time continuous glucose monitor (CGM) in individuals with diabetes on peritoneal dialysis

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       Objective: To evaluate the performance of a real-time continuous glucose monitor (CGM) in individuals with diabetes on peritoneal dialysis (PD).  Research Design and methods: Thirty type 2 diabetes participants on continuous ambulatory peritoneal dialysis (CAPD) wore a Guardian Sensor™ 3 on the upper arm paired with Guardian Connect™ for 14 days. We compared CGM readings against Yellow Springs Instrument (YSI) venous glucose during an 8-hour in-clinic session with glucose challenge.  Results: The mean absolute relative difference (MARD) was 10.4% (95% confidence interval: 9.6, 11.7) from 941 CGM-YSI matched pairs; 81.3% of readings were within 15/15% of YSI values in the full glycemic range. Consensus error grid analysis showed 99.9% of sensor values in zones A and B. There were no correlations between pH, uremia, hydration status and MARD.  Conclusion: We showed satisfactory performance of a real-time CGM sensor in  PD patients with diabetes, supporting future use to facilitate treatment decisions.</p
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