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Bi Y.,Nanjing Medical University | Zhu D.,Nanjing Medical University | Cheng J.,Second Peoples Hospital of Changzhou | Zhu Y.,Peoples Hospital of Jiangsu Province | And 8 more authors.
Clinical Therapeutics | Year: 2010

Objectives: The aims of the study were to determine the following: the status of glycemic control in patients with type 2 diabetes mellitus (DM) at primary, secondary, and tertiary hospitals in the Jiangsu province of China; and the factors associated with achieving glyce-mic targets.Methods: This study, in which patients were enrolled from July 20 to 31, 2009, at 56 diabetes centers, used a multiple-stage, stratified sampling method to select a representative sample of the population with DM in Jiangsu. The sampling process was stratified by geographic and demographic regions, and by the outpatient numbers in the hospitals. A primary hospital was defined as a community medical institution that provided primary health services; a secondary hospital was a local medical institution that provided comprehensive health services; and a tertiary hospital was a regional medical institution that provided comprehensive and specialist health services. In primary hospitals, patients with DM were treated by general physicians; at secondary and tertiary hospitals, they were seen by specialists. Also, primary and tertiary hospitals treated patients in cities, whereas secondary hospitals treated patients from towns or rural areas. Patients with a medical history of type 2 DM for >6 months and registration at each diabetes center for ≥6 months, and who were residents of Jiangsu province, were recruited. During the patient enrollment visit, information about DM complications and comor-bidities, as well as DM management, was obtained by retrospectively reviewing medical records; basic patient data (eg, date of birth, sex, weight, height) were obtained by patient interview. Blood samples were collected for assessment of glycosylated hemoglobin (HbA1c) at a central laboratory.Results: Of 3046 sampled subjects, the analysis was performed in 2966 subjects with complete data. The mean (SD) HbA1c value for analyzed patients was 7.2% (1.6%). The proportion of patients with tight glycemic control was 40.2% (1193/2966) when a threshold of HbA1c <6.5% was used, and 56.1% (1665/2966) when a threshold of HbA1c <7.0% was used. Compared with patients who had inadequate glycemic control, those with tight control were younger (P < 0.001), had shorter duration of DM (P < 0.001), had lower body mass index (BMI) (P = 0.005 for HbA1c <6.5% and P = 0.01 for HbA1c <7.0%), had more education (P < 0.001) and income (P = 0.003 for HbA1c <6.5% and P = 0.008 for HbA1c <7.0%), were more likely to monitor their glucose (P = NS for HbA1c <6.5% and P = 0.043 for HbA1c <7.0%) and attend DM education (P = 0.027 for HbA1c <6.5% and P = 0.002 for HbA1c <7.0%) at least once a month, and were more likely to receive oral antidiabetic drugs (OADs) (P < 0.001). Age, BMI, and DM duration did not differ significantly between hospital types. Compared with primary (36.2%) and secondary hospitals (36.5%), tertiary hospitals (42.2%) had more patients with HbA1c <6.5% (P = 0.043); tertiary hospitals also had more patients with once-monthly glucose self-monitoring (P = 0.001), patients with higher income (P < 0.001) and education (P < 0.001), and those who were more likely to use ≥2 OADs or insulin with OADs (P < 0.001).Conclusion: The overall status of glycemic control was unsatisfactory during the study period, although patients at tertiary hospitals appeared to have better control than those at primary or secondary hospitals. © 2010 Excerpta Medica Inc.

Dong G.-Z.,Second Peoples Hospital of Changzhou | Yun W.-W.,Second Peoples Hospital of Changzhou | Gao P.,Second Peoples Hospital of Changzhou
Journal of Clinical Neurology (China) | Year: 2012

Objective To explore the elinieal significance of the change of serum ferritin level in the early stage of cerebral infarction (CI). Methods According to the score of Scandinavian Stroke Scale, the 642 CI patients were divided into progressing stroke (PS) group (94 cases) and non-PS group (548 cases). The level of serum ferritin in 24 h after onset was detected and compared with control group. Results The level of serum ferritin in PS group [ (325.67 ±98.34) μg/L] was significantly higher than that in non-PS group[ (236. 19 ± 84. 12) μg/L ]( P <0. 01 ) , and both of the 2 groups were significantly higher than control group ( 150. 99 ± 65. 42 ) μg/L (all P < 0. 01 ). Conclusions In the early stage of CI, the level of serum ferritin increased may be suggest that who will be the PS.

Zhang X.,Jiangsu University | Xu H.,Jiangsu University | Zhang T.,Jiangsu University | Shen M.,Jiangsu University | And 5 more authors.
Panminerva Medica | Year: 2014

Aim. The aim of this paper was to observe the metabolic mode of 32P at the level of sub-target nuclides. Methods. Twenty-one cancer patients were locally injected with32P-labelled glass microspheres and then observed to determine the equalization of 32P radionuclide metabolism in the tumor target. We imaged 3 sub-target regions of interest (ROI) 1/3 the size in both the anterior and posterior directions by bremsstrahlung single-photon emission computed tomography (SPECT) X-ray imaging. The radiation dose parameters of the beta rays including the initial dose rate, the effective half-life, and the effective half-life of the cumulative radiation dose were then calculated. Results. The radionuclide metabolism of the 21 complete tumor targets complied with the mono-compartmental model of index metabolism, but the level of tumor control did not correlate with radiation dose parameters. In contrast, the radionuclide metabolism of the 63 sub-targets did not comply with the mono-compartmental model. Instead, 32 sub-targets were better represented by bi-compartmental or tri-compartmental metabolic models. None of the remaining 31 sub-targets complied with index metabolism. Conclusion. The complexity of the radiation dose at the sub-target level partially explains poor local tumor control. Future studies will be required to improve the expression of internal exposure to radiation dose parameters.

Wu Q.-Y.,Second Peoples Hospital of Changzhou | Wang Y.,Second Peoples Hospital of Changzhou | Tong J.-C.,Second Peoples Hospital of Changzhou | Zhang M.,Second Peoples Hospital of Changzhou | Zhang K.,Second Peoples Hospital of Changzhou
International Journal of Clinical and Experimental Medicine | Year: 2015

Objective: To investigate the relationship between Tiam1 gene expression and the invasion and metastasis of esophageal cancer. Methods: By RT-PCR technique, Tiam1 mRNA expression levels in 49 cases of esophageal cancer tissues and normal esophageal tissues were detected. Results: Average Tiam1 mRNA expression level in 49 cases of esophageal cancer tissues (1.83 ± 0.73) was significantly higher than that in normal esophageal tissues (0.87 ± 0.45) (P < 0.01); High Tiam1 mRNA expression rate in esophageal cancer tissues was positively correlated with clinical stage and T stage; Tiam1 mRNA expression rate was 59.38% (19/32) in patients with lymph node metastasis, and in patients without lymph node metastasis it was 23.53% (4/17), with statistically significant differences (P < 0.05). Conclusion: Tiam1 gene expression in esophageal cancer tissues was significantly higher than that in normal esophageal tissues, and its overexpression was positively correlated with invasion and metastasis of esophageal cancer. © 2015 E-Century Publishing Corporation. All rights reserved.

Wang M.,Second Peoples Hospital of Changzhou | Sun S.,Second Peoples Hospital of Changzhou | Qian K.,Second Peoples Hospital of Changzhou | Min H.,Second Peoples Hospital of Changzhou | And 2 more authors.
Chinese Journal of Clinical Oncology | Year: 2013

Objective: This work aimed to investigate the relationships of the serum levels of IL-17 and TGF-β with the carcinogenesis and progression of colorectal cancer (CRC), as well as the clinical significance of these serum levels. Methods: Data of 30 healthy subjects, 59 patients with simple CRC and 44 CRC patients with postoperative (post-op) metastasis were recruited in this study. The patients were respectively divided into group A (30 healthy subjects as the control group), group B (59 CRC patients without distant metastasis after surgery), and group C (44 CRC patients with post-op metastasis). The patients in each group had a mean age of 53.8 ± 20.8, 62.0 ± 11.8, and 64.0 ± 15.7 years, respectively. All patients were confirmed by pathological diagnosis. The serum levels of IL-17 and TGF-β were measured by enzyme-linked immunosorbent assay. All quantitative data were analyzed using SPSS 13.0. Results: The IL-17 serum level was significantly higher in groups B and C than in group A. The preoperative (pre-op) serum level of IL-17 was significantly higher than the post-op serum level in group B (P<0.05). No significant difference was observed in the TGF-β serum levels between groups A and B, as well as between the pre-op and post-op serum levels in group B (P>0.05). However, the TGF-β serum level in group C was significantly higher than that in groups A and B (P<0.05). No significant correlation was observed in the serum level IL-17 or TGF-β between colon and rectum cancers in groups B and C. Conclusion: The serum level of IL-17 is significantly correlated with that of CRC. The serum level IL-17 increases with the aggravation of CRC and increased tumor burden. A strong correlation exists between the serum level of TGF-β and metastasis of CRC. Cytokine IL-17 and TGF-β may play an important role in the progression and metastasis of CRC.

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