The change in blood glucose levels in tuberculosis patients before and during anti-tuberculosis treatment in China.

OBJECTIVE: We aimed to observe (i) changes in fasting blood glucose (FBG) in tuberculosis (TB) patients before and during anti-TB treatment, (ii) whether FBG levels were stable or unstable and (iii) baseline characteristics associated with an unstable FBG. METHOD: TB patients consecutively attended six clinics or hospitals. FBG measurements were made at months 0, 2 and 6. Data analysis was performed using the chi-square test and multivariate logistic regression. RESULTS: Of 232 patients without diabetes mellitus (DM) whose initial FBG < 6.1 mmol/L, over 90% maintained FBG < 6.1 mmol/L during treatment and no patient developed DM. Of 17 patients without DM and initial FBG between 6.1 and 6.9 mmol/L, over half had FBG < 6.1 mmol/L during treatment and no patient had DM at the end of treatment. Eight DM patients with already known DM had their FBG controlled at < 7.0 mmol/L during treatment. There were 13 DM patients newly diagnosed with FBG ≥ 7.0 mmol/L, and 69% continued to have FBG ≥ 7.0 mmol/L. After adjustment for confounding, the odds for an unstable FBG were higher for HIV-positive status, already having DM, smoking and coming to hospitals rather than clinics. CONCLUSION: TB patients who do not have DM based on FBG measurements do not develop DM during anti-TB treatment. Those newly diagnosed with DM on screening in general maintain their DM status with high FBG and need to be better managed

Characteristics and mechanism of winter marine heatwaves in the cold tongue region of the South China Sea

Marine Heatwaves (MHWs) are persistent anomalous sea surface temperature warming events that can affect the marine ecological environment and ecosystems. Here, we study the winter MHWs in the cold tongue region of the South China Sea (SCS) from 1982 to 2022. Our results show that the winter MHWs in the cold tongue region have the strongest cumulative intensity in the SCS, exceeding 45°C·day/time. These strong MHWs are due to their high mean intensity and long duration. Significant interannual variations are observed in these MHWs, with extreme MHW events occurring in the El Niño winters of 97/98 and 15/16. By employing a mixed layer heat budget analysis, we reveal that the extreme MHW event in the winter of 97/98 is caused primarily by the surface heat flux term, and secondarily by the vertical entrainment term. While the 15/16 extreme event is caused by a combination of the surface heat flux term, the vertical entrainment term and the horizontal advection term

Long-term trends and extreme events of marine heatwaves in the Eastern China Marginal Seas during summer

Marine heatwaves (MHWs) are a type of widespread, persistent, and extreme marine warming event that can cause serious harm to the global marine ecology and economy. This study provides a systematic analysis of the long-term trends of MHWs in the Eastern China Marginal Seas (ECMS) during summer spanning from 1982 to 2022, and occurrence mechanisms of extreme MHW events. The findings show that in the context of global warming, the frequency of summer MHWs in the ECMS has increased across most regions, with a higher rate along the coast of China. Areas exhibiting a rapid surge in duration predominantly reside in the southern Yellow Sea (SYS) and southern East China Sea (ECS, south of 28°N). In contrast, the long-term trends of mean and maximum intensities exhibit both increases and decreases: Rising trends primarily occur in the Bohai Sea (BS) and Yellow Sea (YS), whereas descending trends are detected in the northern ECS (north of 28°N). Influenced jointly by duration and mean intensity, cumulative intensity (CumInt) exhibits a notable positive growth off the Yangtze River Estuary, in the SYS and southern ECS. By employing the empirical orthogonal function, the spatio-temporal features of the first two modes of CumInt and their correlation with summer mean sea surface temperature (SST) and SST variance are further examined. The first mode of CumInt displays a positive anomalous pattern throughout the ECMS, with notable upward trend in the corresponding time series, and the rising trend is primarily influenced by summer mean SST warming. Moreover, both of the first two modes show notable interannual variability. Extreme MHW events in the SYS in 2016 and 2018 are examined using the mixed layer temperature equation. The results suggest that these extreme MHW events originate primarily from anomalous atmospheric forcing and oceanic vertical mixing. These processes involve an anomalous high-pressure system over the SYS splitting from the western Pacific subtropical high, augmented atmospheric stability, diminished wind speeds, intensified solar radiation, and reduced oceanic mixing, thereby leading to the accumulation of more heat near the sea surface and forming extreme MHW events