Objective To analyze the diagnostic value of shear wave elastography (SWE) combined with vascular endothelial growth factor B (VEGF-B) and hemoglobin A1c (HbA1c) in early diabetic peripheral neuropathy (DPN). Methods A total of 100 patients with type 2 diabetes mellitus (T2DM) admitted to Mianyang Central Hospital between October 2020 and October 2023 were selected and divided into a T2DM with DPN group (n=31) and a T2DM without DPN group (n=69) based on the presence or absence of DPN. Additionally, 50 healthy individuals from the same hospital’s health examination center were included as a healthy control group. The basic clinical characteristics, mean elasticity (Emean) values of the left and right median and tibial nerves, serum VEGF-B, and HbA1c levels were compared among the three groups. The diagnostic efficacy of SWE, VEGF-B, and HbA1c for DPN was evaluated using receiver operating characteristic (ROC) curves, and Pearson correlation analysis was performed to assess the relationships between median/tibial nerve Emean and VEGF-B/HbA1c. Results The Emean values of the left and right median nerves, Emean values of the left and right tibial nerves, serum VEGF-B, and HbA1c levels in the T2DM with DPN group were significantly higher than those in the T2DM without DPN group and the healthy control group (P<0.05). The Emean values of the left and right median and tibial nerves, Emean values of the left and right tibial nerves, and HbA1c level in the T2DM without DPN group were significantly higher than those in the healthy control group (P<0.05), while no significant difference was observed in serum VEGF-B level between the T2DM without DPN group and the healthy control group (P>0.05). The area under the ROC curve for the combined diagnosis of DPN using SWE, VEGF-B, and HbA1c was 0.859 [95% confidence interval (0.828, 0.955)]. The sensitivity of the combined diagnosis (93.72%) was significantly higher than that of individual diagnoses (78.82%, 75.39%, and 71.05%, respectively; P<0.05), while the specificity (88.64%) showed no significant difference compared to individual diagnoses (80.18%, 78.96%, and 82.88%, respectively; P>0.05). Positive correlations were observed between median/tibial nerve Emean and VEGF-B/HbA1c levels (r=0.428, 0.395, 0.416, and 0.416, respectively; P<0.05). Conclusions Elevated median/tibial nerve Emean, serum VEGF-B, and HbA1c levels are closely associated with DPN. The combination of SWE, VEGF-B, and HbA1c improves diagnostic sensitivity for DPN, demonstrating significant clinical value.
Objective To investigate the correlation between glycosylated hemoglobin A1c (HbA1c) and severity of coronary artery lesions in young men with acute myocardial infarction (AMI). Methods Total 278 young men with AMI less than 45 years old were retrospectively studied, and all of them were admitted to hospital from January 2009 to December 2011, and had undergone coronary angiography. According to the results of coronary angiography, the patients were divided into three groups based on the number of artery lesions: the single group (156 cases), the double group (64 cases) and the triple group (58 cases). The relationship between the severity of coronary artery lesions and the following factors were observed: HbA1c, systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum uric acid (UA), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), body mass index (BMI), smoking history, drinking history and family history of early coronary artery disease. Results a) HbA1c levels were gradually raised in all the three groups, but the single group (6.39±1.67%) was significantly lower than the double group (6.91±1.63%) and the triple group (7.41±2.12%), with significant differences (Plt;0.05); the HbA1c level of the single group was significantly lower than the triple group in both the ST-segment elevation AMI (6.42±1.68% vs. 7.17±1.86%, Plt;0.05) and the non-ST-segment AMI (5.57±0.37% vs. 8.56±2.83%, Plt;0.05); the HbA1c level of the single group was significantly lower than the triple group in patients with diabetes millitus (8.31±1.83% vs. 8.59±2.02%, Plt;0.05) and in patients without diabetes millitus (5.56±0.33% vs. 5.74±0.37%, Plt;0.05); b) There were significant differences in SBP, TC, HDL-C, LDL-C and drinking history between the single group and the other two groups (all Plt;0.05), and there were significant differences in DBP and TG between the single group and the double group (all Plt;0.05); and c) The results of logistic regression analysis showed that, LDL-C (OR=1.790), HbA1c (OR=1.287) and SBP (OR=1.042) were the independent risk factors (all Plt;0.05) for multiple lesions in coronary arteries of young men with AMI. Conclusion Glycosylated hemoglobin A1c is an independent risk factor for multiple lesions in coronary arteries of young men with AMI.
ObjectiveTo explore the association between glycosylated hemoglobin level and poor prognosis in acute ischemic stroke (AIS) patients treated with intravenous thrombolysis.MethodsThe AIS patients treated with recombinant tissue-type plasminogen activator who were hospitalized in the Department of Neurology of the First Affiliated Hospital of Henan University of Science and Technology from September to December 2020 were retrospectively included. According to different levels of glycosylated hemoglobin, they were divided into pre-diabetic group (5.7%≤glycated hemoglobin≤6.4%), diabetic group (previously diabetic or glycosylated hemoglobin≥6.5%), and non-diabetic group (glycated hemoglobin <5.7%). The relevant information of the patients was collected, and a telephone follow-up was conducted 90 days after discharge. According to the modified Rankin Scale (mRS) score, the patients were divided into the good prognosis group (mRS score≤2) and the poor prognosis group (mRS score>2). Logistic regression analysis was used to determine the risk factors for the poor prognosis of intravenous thrombolysis in patients with AIS.ResultEventually 101 patients were included, including 44 in the non-diabetic group, 24 in the pre-diabetic group, and 33 in the diabetic group. And 64 patients were in the good prognosis group and 37 patients were in the poor prognosis group. Regression analysis results showed that diabetes was associated with poor prognosis 3 months after intravenous thrombolysis in patients with AIS [odds ratio=6.518, 95% confidence interval (1.568, 27.096), P=0.010]; and the higher the National Institutesof Health Stroke Scale score at admission was, the higher the risk of poor prognosis would be [odds ratio=1.421, 95% confidence interval (1.231, 1.640), P<0.001].ConclusionIn AIS patients who received intravenous thrombolysis, diabetes is associated with poor prognosis after 3 months.
Objectives To systematically analyze the effect of high-intensity and low-intensity resistance training on glycosylated hemoglobin (HbA1c) in elderly patients with type 2 diabetes. Methods PubMed, EBSCO, Cochrane Library, Web of science, Wanfang, Chinese National Knowledge Infrastructure and Chongqing VIP were searched to collect randomized controlled trials of resistance training intervention in elderly patients with type 2 diabetes. The search time limit was from the establishment of the database to August 28, 2021, and the RevMan 5.3 and Stata 15.0 software were used for meta-analysis. Results A total of 415 patients in 8 articles were included in this study. A subgroup analysis based on control measures showed that compared with the resistance training group, the HbA1c level effect value of the non- training group was weighted mean difference (WMD) = −0.54% [95% confidence interval (CI) (−1.06%, −0.03%), P=0.04)], the HbA1c level effect value of the flexibility training group was WMD=−0.47% [95%CI (−1.05%, 0.12%), P=0.12], the HbA1c level effect value of the aerobic training group was WMD=−0.10% [95%CI (−0.71%, 0.51%), P=0.75]. Subgroup analysis of resistance strength showed that compared with the flexibility or non-resistance training group, both high-intensity [WMD=−0.99%, 95%CI (−1.16%, −0.81%), P<0.00001] and low- and medium-intensity resistance training [WMD=−0.29%, 95%CI (−0.58%, −0.01%), P=0.05] can reduce HbA1c. Compared with the high-intensity resistance training, the HbA1c level effect value of the low- and medium-intensity resistance training was WMD=0.03% [95%CI (−0.33%, 0.39%), P=0.88]. Compared with the low- and medium-intensity resistance training, the HbA1c level effect value of the low- and medium-intensity aerobic training was WMD=−0.10% [95%CI (−0.71%, 0.51%), P=0.75]. Among all the included studies, only the high-intensity resistance training group reported multiple adverse events.ConclusionsCurrent evidence suggests that elderly patients with type 2 diabetes are more suitable to choose low-to-medium-intensity resistance training to control HbA1c. It is recommended that elderly patients with type 2 diabetes take 60% to 75% of the maximum muscle strength of medium-intensity resistance training.
ObjectiveTo study the correlation of postoperative cognitive dysfunction (POCD) with type-2 diabetes and glycosylated hemoglobin (HbA1c) levels in elderly patients. MethodsA total of 140 elderly patients who were going to undergo non-cardiothoracic surgery in our hospital between January 2011 and February 2013 were included in this study.ASA classification was between I and Ⅲ.There were 78 males and 62 females,aged between 65 and 86 years old.Group A had 70 patients with diabetes,while group B had another 70 corresponding patients without diabetes.One day before surgery and a week after surgery,Mini-mental State Examination (MMSE) and Montreal Cognitive Functioning Scale (MoCA) were used to test patients'cognitive function,and the incidence of POCD was compared between the two groups.Group A patients,according to HbA1c levels,were divided into group AH (HbA1c>7.5%) and group AL (HbA1c<7.5%).And we compared the relationship between group AL and group B,and the relationship between group AH and group B. ResultsThe incidence of POCD in group A was significantly higher than that in group B (P<0.05).Group AH had a significantly higher incidence of POCD than group AL (P<0.05).No significant difference was found in fasting plasma glucose among the groups. ConclusionElderly diabetic patients with poor glycemic control is a risk factor for POCD occurrence,but fasting glucose as a predictor of POCD is not as good as HbA1C.
ObjectiveTo study the relationship between preoperative pan-immune-inflammation value (PIV), preoperative hemoglobin, albumin, lymphocyte and platelet score (HALP) and tumor pathological features and microsatellite status of colorectal cancer, and to analyze the predictive value of HALP and PIV for microsatellite status. MethodsThe clinicopathological data of 156 patients who underwent radical colorectal cancer resection admitted to the Second Hospital of Shanxi Medical University from May 2021 to February 2024 were retrospectively analyzed. HALP and PIV were calculated by preoperative related laboratory indicators, and then the patients were divided into high HALP/low HALP (HHALP/LHALP) group (n=78) and high PIV/low PIV (HPIV/LPIV) group (n=78) according to the median of their calculated values. The correlation between preoperative HALP and PIV and clinicopathologic features of colorectal cancer was analyzed. According to the results of microsatellite stability detection, the patients were divided into microsatellite standard/microsatellite instability-high（MSS/MSI-H）group. The correlation between preoperative HALP and PIV and microsatellite stability was analyzed. The predictive value of HALP and PIV for microsatellite status was analyzed by using receiver operating characteristic (ROC) curve. ResultsThere were statistically significant differences in tumor diameter, tumor location, HALP, T stage and microsatellite status between the HPIV group and the LPIV group (P<0.05), and high PIV was more common in patients with right-sided colon cancer and MSI-H, and the tumors were larger and had higher T stage. The differences in gender, body mass index（BMI）, tumor diameter, tumor location, PIV, T stage and microsatellite status between the HHALP group and the LHALP group were statistically significant (P<0.05), and low HALP was more common in women, patients with right-sided colon cancer, and MSI-H, and had a low BMI, large tumors, and high T stage. There were statistically significant differences in HALP and PIV between MSS group and MSI-H group (P<0.05), and patients with MSI-H tended to have low HALP and high PIV, and the area under curve of HALP and PIV in predicting MSI-H for colorectal cancer was 0.848 9 and 0.851 6, respectively, and the optimal cut-off value was 26.84 scores and 507.04, respectively, and the sensitivity was 1.000, 0.923, specificity 0.643, 0.817, respectively. ConclusionLow HALP and high PIV are more common in patients with right-sided colon cancer and MSI-H, who have poor nutritional and immune status, severe inflammation, larger tumors, deeper invasion, and predictive value for MSI-H, which can assist in the formulation of clinical treatment plans to a certain extent.
Spectrophotometry is a simple hemolytic evaluation method commonly used in new drugs, biomedical materials and blood products. It is for the quantitative analysis of the characteristic absorption peaks of hemoglobin. Therefore, it is essential to select the correct detection wavelength when the evaluation system has influences on the conformation of hemoglobin. Based on the study of changes in the characteristic peaks over time of the hemolysis supernatant in four systems, namely, cell culture medium, phosphate buffered saline (PBS), physiological saline and banked blood preservation solution, using continuous wavelength scanning, the selections of detection wavelength were proposed as follows. In the cell culture medium system, the wavelength of 415 nm should be selected within 4 h; , near 408 nm should be selected within 4~72 h. In PBS system, within 4 h, 541 nm, 577 nm or 415 nm should be selected; 4~72 h, 541 nm, 577 nm or near 406 nm should be selected. In physiological saline system, within 4 h, 414 nm should be selected; 4~72 h, near 405 nm should be selected; within 12 h, 541 nm or 577 nm could also be selected. In banked blood preservation solution system, within 72 h, 415 nm, 540 nm or 576 nm should be selected.
Abstract: Objective To study the impact of different kinds of mechanical circulation support devices on plasma free hemoglobin(FHb). Methods From Mar. 2004 to Dec. 2005, 20 patients received mechanical circulation support in Fu Wai Hospital, who were divided into 4 groups according to the different type of supporting devices. 9 got extracorporeal membrane oxygenation (ECMO) treatment, 8 received BVS5000 left ventricular support, 2 got MEDOS left ventricular support and 1 received AB5000 left ventricular support. Random control group included 9 cardiotomy patients after CPB supporting and 9 patients with offpump coronary artery bypass grafting during the same period. Parameters such as FHb, Tbil, Dbil, Cr and BUN were monitored throughout the supporting term. The results were compared according to the different types of mechanical circulation support devices. Results The elevation of FHb caused by CPB could be decreased to normal within 1d. However, in BVS5000 group, the elevated FHb level decreased to normal till 2 days later. The others mechanical circulation support devices such as ECMO, MEDOS, AB5000 elevated the FHb throughout the whole supporting period. Compared with those in ECMO group, the patients in BVS5000 group had obviously lower level of FHb since the third day after the beginning of supporting. In patients who got ECMO treatment, there was a trend that the elevation degree of FHb was lower in those with support flow rate less than 2.5 L/min. For most patients got devices support, there was also an elevation of Tbil and BUN level during the supporting period. Conclusion Mechanical circulation support devices, such as ECMO, BVS5000, MEDOS and AB5000, can cause red cell destruction in acceptable level. BVS5000 has much smaller impact on cell destruction than others do in postoperative patients.
Objective To discuss the screening and diagnostic value of nocturnal oximetry saturation monitoring combined with clinical score (CS) for patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods A total of 106 snorers were recruited in the analysis whose general information and medical history were collected respectively. All patients received polysomnography (PSG) and oximeter monitoring. The patients were divided into a non-OSAHS group and an OSAHS group according to apnea hypopnea index (AHI). A correlation analysis was made between PSG-AHI and oximeter-ODI to analyze the diagnostic sensitivity and specificity of different ODI combined with CS for OSAHS. Results The AHI, ODI, CS for the non-OSAHS group were 1.8±1.4 times/h, 2.6±3.5 times/h and 1.0±0.8; while for the OSAHS group they were correspondingly 37.3±23.9 times/h, 31.0±24.1 times/h, 2.6±1.1. There was a significant correlation between ODI and AHI (r=0.943, P<0.01). The sensitivity and specificity of ODI≥5 times/h combined with CS≥2 for diagnosis of OSAHS were 91.7% and 94.1% respectively, which had the value of preliminary screening. The sensitivity and specificity of ODI≥10 times/h combined with CS≥2 for diagnosis of OSAHS were 77.8% and 100.0% respectively, which would not result in misdiagnose for severe patients with AHI >30 times/h, so it could be an index of severe OSAHS screening. Conclusion Nocturnal oxyhemoglobin saturation monitoring combined with clinical score is of significant value for initial diagnosis of OSAHS.
Objective To study the correlation of preoperative hemoglobin amount with venous thromboembolism (VTE) after surgical treatment of bronchiectasis and the clinical significance. Methods A retrospective study was performed on patients with bronchiectasis who underwent surgical treatment in our center from June 2017 to November 2021. The differences in blood parameters between the VTE patients and non-VTE patients were compared. The relationship between preoperative hemoglobin and VTE was confirmed by quartile grouping and receiver operating characteristic (ROC) curve. Results A total of 122 patients were enrolled, including 50 males and 72 females, with a mean age of 52.52±12.29 years. The overall incidence of VTE after bronchiectasis was 9.02% (11/122). Preoperative hemoglobin amount (OR=0.923, 95%CI 0.870-0.980, P=0.008) and D-dimer amount (OR=1.734, 95%CI 1.087-2.766, P=0.021) were independent influencing factors for VTE after bronchiectasis. The incidence of VTE after bronchiectasis decreased gradually with the increase of preoperative hemoglobin amount. The area under the ROC curve (AUC) of postoperative D-dimer alone was 0.757, whereas the AUC of postoperative D-dimer combined with preoperative hemoglobin amount was 0.878. Conclusion Low preoperative hemoglobin is an independent risk factor for postoperative VTE. Postoperative D-dimer combined with preoperative hemoglobin amount has a better predictive performance compared with postoperative D-dimer alone for postoperative VTE.