Burden of diabetes in the adult Chinese population: A systematic literature review and future projections

Changyu Pan1, Shuhua Shang2, Wilhelm Kirch3, Martin Thoenes2,31Department of Endocrinology, Chinese PLA General Hospital, Beijing, China; 2Medical Department, Sanofi-aventis China, Shanghai, China; 3Institute for Clinical Pharmacology, Technical University Dresden, Dresden, GermanyBackground: The diabetes epidemic in China imposes an increasing burden on the health care system and the economy. We derived prospective diabetes prevalence rates in China until 2016 from a systematic review of the published literature in the period 1987–2007. The results could help to guide resources of the Chinese health care system in order to address the diabetes epidemic.Methods: We selected articles published in the English/Chinese languages from MEDLINE and the China Wanfang Digital Database using the keywords “China”, “diabetes mellitus”, “prevalence”, and “epidemiology” in order to estimate the current diabetes prevalence in China. For projecting future prevalence rates, we considered the population growth, and assumed that China’s diabetes prevalence in first tier cities in 2016 would equal Hong Kong’s diabetes prevalence in 2007.Results: The number of Chinese adults with diabetes is projected to rise from 53.1 million in 2009 to 76.1 million in 2016. The estimated diabetes prevalence rate in China in 2009 was 3.9% (urban 5.2%, rural 2.9%) and is projected to increase to 5.4% (urban 6.9%, rural 3.8%) in 2016, corresponding to an annual consolidated aggregate growth rate of 4.6%.Conclusion: We estimate a considerably higher diabetes prevalence in the adult Chinese population than that reported in previous studies. The diabetes prevalence will continue to rise in the future, which points to the importance of increasing awareness and better diagnosis of diabetes in China.Keywords: diabetes, prevalence, epidemic, China, Chinese, systematic revie

The arabidopsis RCC1 family protein TCF1 regulates freezing tolerance and cold acclimation through modulating lignin biosynthesis

Cell water permeability and cell wall properties are critical to survival of plant cells during freezing, however the underlying molecular mechanisms remain elusive. Here, we report that a specifically cold-induced nuclear protein, Tolerant to Chilling and Freezing 1 (TCF1), interacts with histones H3 and H4 and associates with chromatin containing a target gene, BLUE-COPPER-BINDING PROTEIN (BCB), encoding a glycosylphosphatidylinositol-anchored protein that regulates lignin biosynthesis. Loss of TCF1 function leads to reduced BCB transcription through affecting H3K4me2 and H3K27me3 levels within the BCB gene, resulting in reduced lignin content and enhanced freezing tolerance. Furthermore, plants with knocked-down BCB expression (amiRNA-BCB) under cold acclimation had reduced lignin accumulation and increased freezing tolerance. The pal1pal2 double mutant (lignin content reduced by 30% compared with WT) also showed the freezing tolerant phenotype, and TCF1 and BCB act upstream of PALs to regulate lignin content. In addition, TCF1 acts independently of the CBF (C-repeat binding factor) pathway. Our findings delineate a novel molecular pathway linking the TCF1-mediated cold-specific transcriptional program to lignin biosynthesis, thus achieving cell wall remodeling with increased freezing tolerance

Hypertension Control and Cardiometabolic Risk: A Regional Perspective

Background. We investigated the association between blood pressure control and common cardiometabolic risk factors from a global and regional perspective. Methods. In the present analysis of a large cross-sectional i-SEARCH study, 17.092 outpatients receiving antihypertensive treatment were included in 26 countries. According to clinical guidelines for the management of arterial hypertension, patients were classified based on the level of seated systolic/diastolic blood pressure (SBP/DBP). Uncontrolled hypertension was defined as SBP/DBP ≥140/90 mmHg for non-diabetics, and ≥130/80 mmHg for diabetics. Results. Overall, mean age was 63.1 years, 52.8% were male, and mean BMI was 28.9 kg/m2. Mean SBP/DBP was 148.9/87.0 mmHg, and 76.3% of patients had uncontrolled hypertension. Diabetes was present in 29.1% with mean HbA1c of 6.8%. Mean LDL-cholesterol was 3.2 mmol/L, HDL-cholesterol 1.3 mmol/L, and triglycerides 1.8 mmol/L; 49.0% had hyperlipidemia. Patients with uncontrolled hypertension had a higher BMI (29.4 versus 28.6 kg/m2), LDL-cholesterol (3.4 versus 3.0 mmol/L), triglycerides (1.9 versus 1.7 mmol/L), and HbA1c (6.8 versus 6.7%) than those with controlled blood pressure (P < 0.0001 for all parameters). Conclusions. Among outpatients treated for arterial hypertension, three quarters had uncontrolled blood pressure. Elevated SBP/DBP and uncontrolled hypertension were associated with increasing BMI, LDL-cholesterol, triglycerides, and HbA1c, both globally and regionally

Mediation effect of hope on the relationship between inner strength and self-management in patients after percutaneous coronary intervention

BackgroundEffective self-management can enhance a patient’s quality of life and delay disease progression. However, motivating patients to adhere to self-management behavior following percutaneous coronary intervention (PCI) remains a challenge. With the robust development of positive psychology and interdisciplinary research, the role of psychology factors in patients’ health behavior has increasingly garnered attention. This study, focusing on positive psychological qualities, aims to investigate the relationship between inner strength, hope, and self-management in patients post-PCI, and to analyze the mediating role of hope between inner strength and self-management.MethodsA cross-sectional survey was conducted among 216 PCI patients from a tertiary hospital in Nanjing. Research instruments included a self-designed general information questionnaire, the Inner Strength Scale (ISS), the Herth Hope Index (HHI), and the Coronary Self-Management Scale (CSMS). T-test, analysis of variance, Pearson’s correlation analysis, and mediating effect test were utilized for statistical analysis.ResultsThe average scores of the ISS, HHI, and CSMS were 81.46 ± 12.00, 35.94 ± 5.38, and 86.79 ± 14.84, respectively. Inner strength was positively correlated with hope and self-management (r = 0.867, r = 0.630, respectively; all P &lt; 0.05), and hope was positively correlated with self-management (r = 0.671, P &lt; 0.05). Moreover, hope had a complete mediating effect between inner strength and self-management (β = 0.630, P &lt; 0.01).ConclusionThe inner strength, hope, and self-management of patients with PCI are at a moderate level. Inner strength primarily influences patients’ self-management behavior through hope, suggesting that medical staff can target hope to help patients build confidence in life after illness, form and accumulate inner strength, thereby promoting their self-management and improving prognosis

Comprehensive Bibliometric Analysis of the Kynurenine Pathway in Mood Disorders: Focus on Gut Microbiota Research

Background: Emerging evidence implicates the dysregulated kynurenine pathway (KP), an immune-inflammatory pathway, in the pathophysiology of mood disorders (MD), including depression and bipolar disorder characterized by a low-grade chronic pro-inflammatory state. The metabolites of the KP, an important part of the microbiota-gut-brain axis, serve as immune system modulators linking the gut microbiota (GM) with the host central nervous system.Aim: This bibliometric analysis aimed to provide a first glimpse into the KP in MD, with a focus on GM research in this field, to guide future research and promote the development of this field.Methods: Publications relating to the KP in MD between the years 2000 and 2020 were retrieved from the Scopus and Web of Science Core Collection (WoSCC), and analyzed in CiteSpace (5.7 R5W), biblioshiny (using R-Studio), and VOSviewer (1.6.16).Results: In total, 1,064 and 948 documents were extracted from the Scopus and WoSCC databases, respectively. The publications have shown rapid growth since 2006, partly owing to the largest research hotspot appearing since then, “quinolinic acid.” All the top five most relevant journals were in the neuropsychiatry field, such as Brain Behavior and Immunity. The United States and Innsbruck Medical University were the most influential country and institute, respectively. Journal co-citation analysis showed a strong tendency toward co-citation of research in the psychiatry field. Reference co-citation analysis revealed that the top four most important research focuses were “kynurenine pathway,” “psychoneuroimmunology,” “indoleamine 2,3-dioxygenase,” and “proinflammatory cytokines,” and the most recent focus was “gut-brain axis,” thus indicating the role of the KP in bridging the GM and the host immune system, and together reflecting the field’s research foundations. Overlap analysis between the thematic map of keywords and the keyword burst analysis revealed that the topics “Alzheimer’s disease,” “prefrontal cortex,” and “acid,” were research frontiers.Conclusion: This comprehensive bibliometric study provides an updated perspective on research associated with the KP in MD, with a focus on the current status of GM research in this field. This perspective may benefit researchers in choosing suitable journals and collaborators, and aid in the further understanding of the field’s hotspots and frontiers, thus facilitating future research

Five-Axis Tool Path Generation of Injection Mold Represented by T-Spline Surface

Injection molding is widely used in industries to produce polymeric products. At present, compound NURBS surfaces are commonly used to represent freeform surfaces in mold models. This work uses T-spline surface with extraordinary control points instead of NURBS to represent freeform surfaces in mold models. Compared with NURBS, T-splines’ higher-order continuity facilitates the mold quality control especially at the patch boundary. And, its patch layout information can be utilized for tool path planning. We propose an algorithm to determine the patch processing order and generate nonretraction tool path for T-spline surface models. The tool paths are generated patch by patch using isoparametric strategy. Actual machining and injection molding experiments have been conducted. The result shows the feasibility of the proposed method, and the final product is in good quality

Construction and Validation of a Predictive Model for the Risk of Ventilator-Associated Pneumonia in Elderly ICU Patients

Background. Ventilator-associated pneumonia (VAP) is among the most important hospital-acquired infections in an intensive-care unit setting. However, clinical practice lacks effective theoretical tools for preventing VAP in the elderly. Aim. To describe the independent factors associated with VAP in elderly intensive-care unit (ICU) patients on mechanical ventilation (MV) and to construct a risk prediction model. Methods. A total of 1851 elderly patients with MV in ICUs from January 2015 to September 2019 were selected from 12 tertiary hospitals. Study subjects were divided into a model group (n = 1219) and a validation group (n = 632). Two groups of patients were divided into a VAP group and a non-VAP group and compared. Univariate and logistic regression analyses were used to explore influencing factors for VAP in elderly ICU patients with MV, establish a risk prediction model, and draw a nomogram. We used the area under the receiver operating characteristic curve (AUROC) and the Hosmer–Lemeshow goodness-of-fit test to evaluate the predictive effect of the model. Findings regarding the length of ICU stay, surgery, C-reactive protein (CRP), and the number of reintubations were independent risk factors for VAP in elderly ICU patients with MV. Predictive-model verification results showed that the area under the curve (AUC) of VAP risk after MV in the modeling and verification groups was 0.859 and 0.813 (P<0.001), respectively, while P values for the Hosmer–Lemeshow test in these two groups were 0.365 and 0.485, respectively. Conclusion. The model could effectively predict the occurrence of VAP in elderly patients with MV in ICUs. This study is a retrospective study, so it has not been registered as a clinical study

Evidence in support of chromosomal sex influencing plasma based metabolome vs APOE genotype influencing brain metabolome profile in humanized APOE male and female mice

Late onset Alzheimer's disease (LOAD) is a progressive neurodegenerative disease with four well-established risk factors: age, APOE4 genotype, female chromosomal sex, and maternal history of AD. Each risk factor impacts multiple systems, making LOAD a complex systems biology challenge. To investigate interactions between LOAD risk factors, we performed multiple scale analyses, including metabolomics, transcriptomics, brain magnetic resonance imaging (MRI), and beta-amyloid assessment, in 16 months old male and female mice with humanized human APOE3 (hAPOE3) or APOE4 (hAPOE4) genes. Metabolomic analyses indicated a sex difference in plasma profile whereas APOE genotype determined brain metabolic profile. Consistent with the brain metabolome, gene and pathway-based RNA-Seq analyses of the hippocampus indicated increased expression of fatty acid/lipid metabolism related genes and pathways in both hAPOE4 males and females. Further, female transcription of fatty acid and amino acids pathways were significantly different from males. MRI based imaging analyses indicated that in multiple white matter tracts, hAPOE4 males and females exhibited lower fractional anisotropy than their hAPOE3 counterparts, suggesting a lower level of white matter integrity in hAPOE4 mice. Consistent with the brain metabolomic and transcriptomic profile of hAPOE4 carriers, beta-amyloid generation was detectable in 16-month-old male and female brains. These data provide therapeutic targets based on chromosomal sex and APOE genotype. Collectively, these data provide a framework for developing precision medicine interventions during the prodromal phase of LOAD, when the potential to reverse, prevent and delay LOAD progression is greatest.Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Development and Validation of a Hydrophilic Interaction Liquid Chromatography Tandem Mass Spectrometry Method for the Determination of Asparagine in Human Serum

L-Asparagine (ASN) is the catalyze substrate of L-asparaginase (ASNase), which is an important drug for acute lymphoblastic leukemia (ALL) patients. The ASN level is found to be closely associated with the effectiveness of ASNase treatment. In this study, a hydrophilic interaction liquid chromatography tandem mass spectrometry (HILIC-MS/MS) method was developed for the determination of ASN in the human serum using a stable isotope-labeled internal standard (ASN-D3). Serum samples were prepared by a one-step precipitation procedure using methanol and separated by an Agilent HILIC Plus column with the mobile phase of methanol-water (95 : 5, v/v, containing 5 mM ammonium formate and 0.1% formic acid), at a constant flow rate of 0.3 mL/min. Mass spectrometric analysis was conducted using multiple-reaction monitoring in the positive electrospray ionization mode. Serum ASN concentrations were determined over a linear calibration curve range of 2–200 μM, with acceptable accuracies and precisions. The validated HILIC-MS/MS method was successfully applied to the quantification of ASN levels in the serum from patients with ALL. Collectively, the research may shed new light on an alternative rapid, simple, and convenient quantitative method for determination of serum ASN in ALL patients treated with ASNase