目的：探究阻塞性冠心病患者中舌象纹理特征与冠周脂肪影像组学的相关性。 方法：收集辽宁中医药大学附属医院131例就诊的疑似冠心病患者，其中阻塞性冠心病63例、非阻塞性冠心病68例，提取临床常规指标、舌象纹理特征及右冠状动脉影像组学参数。独立样本t检验、曼-惠特尼U检验、卡方检验、错误发现率校正用于比较组间差异。使用斯皮尔曼相关性分析舌象纹理特征与冠周脂肪影像组学的相关性。采用弹性网络进行特征筛选,按照7：3的比例随机抽样划分为训练集和测试集，使用BP神经网络模型构建冠周脂肪及冠周脂肪与舌象纹理特征联合模型，使用ROC曲线、准确性、精度、召回率、特异度、F1分数、Kappa系数评估模型。 结果：在疑似冠心病患者中，舌象纹理与冠周脂肪影像组学共检出22组弱负相关、1组中等正相关及23组弱正相关；阻塞性冠心病患者中检出4组中等负相关、4组弱负相关、2组中等正相关及6组弱正相关；非阻塞性冠心病患者中检出1组中等负相关、6组弱负相关、1组中等正相关及10组弱正相关。基于BP神经网络构建诊断模型，联合舌象纹理特征后较单一冠周脂肪影像组学模型测试集AUC有所提升。 结论：舌象纹理特征与冠周脂肪影像组学参数在阻塞性冠心病中存在一定的相关性；舌象纹理信息对冠周脂肪诊断阻塞性冠心病具有增量价值。
Abstract:Objective: To investigate the correlation between tongue image texture features and pericoronary adipose tissue (PCAT) radiomics in patients with obstructive coronary heart disease. Methods: A total of 131 patients with suspected coronary heart disease admitted to the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine were enrolled, including 63 cases of obstructive coronary heart disease and 68 cases of non-obstructive coronary heart disease. Clinical routine indicators, tongue image texture features, and right coronary artery radiomics parameters were extracted. Independent sample t-test, Mann-Whitney U test, Chi-square test, and false discovery rate correction were used to compare intergroup differences. Spearman correlation analysis was employed to examine the correlation between tongue image texture features and PCAT radiomics. Elastic net was applied for feature selection. The dataset was randomly split into training and test sets at a 7:3 ratio. BP neural network models were constructed using PCAT features alone and in combination with tongue image texture features. Model performance was evaluated using receiver operating characteristic (ROC) curves, accuracy, precision, recall, specificity, F1 score, and Kappa coefficient. Results: In patients with suspected coronary heart disease, 22 weak negative correlations, 1 moderate positive correlation, and 23 weak positive correlations were identified between tongue image texture features and PCAT radiomics. In patients with obstructive coronary heart disease, 4 moderate negative correlations, 4 weak negative correlations, 2 moderate positive correlations, and 6 weak positive correlations were detected. In patients with non-obstructive coronary heart disease, 1 moderate negative correlation, 6 weak negative correlations, 1 moderate positive correlation, and 10 weak positive correlations were observed. The BP neural network diagnostic model combining tongue image texture features with PCAT radiomics demonstrated improved performance on the test set compared with the PCAT radiomics model alone. Conclusion: Tongue image texture features exhibit certain correlations with PCAT radiomics parameters in obstructive coronary heart disease, and tongue texture information provides incremental value for the diagnosis of obstructive coronary heart disease when combined with PCAT radiomics.
目的 探讨2型糖尿病（T2DM）患者葡萄糖目标范围内时间（TIR）与高尿酸血症（HUA）的相关性。方法 纳入2021年10月—2024年10月厦门大学附属第一医院收治的110例T2DM合并HUA的患者，将其分为T2DM并HUA组，另选取同期110例单纯T2DM患者，分为单纯T2DM组，比较两组一般资料及实验室相关指标，采用Logistics回归模型分析T2DM患者HUA发生的影响因素。随后将110例T2DM合并HUA的患者依照其病情严重程度分为轻度组（58例）、中度组（37例）及重度组（15例），比较三组临床相关指标及TIR水平，分析临床相关指标及TIR水平与T2DM患者HUA严重程度的相关性。结果 T2DM并HUA组与单纯T2DM组患者体质指数（BMI）、糖化血红蛋白、总胆固醇、甘油三酯、血肌酐（Scr）、TIR对比差异有统计学意义（P＜0.05）；将具有统计学差异的指标纳入Logistics回归模型，以是否合并HUA作为因变量（合并HUA=1，未合并HUA=0），结果显示，BMI、糖化血红蛋白、总胆固醇、甘油三酯、Scr、TIR为T2DM患者HUA发生的重要影响因素（P＜0.05）；HUA不同严重程度患者临床相关指标及TIR水平对比发现，轻度组、中度组与重度组糖化血红蛋白、总胆固醇、甘油三酯、Scr水平对比差异无统计学意义（P＞0.05），轻度组、中度组与重度组BMI、TIR对比差异显著（P＜0.05），重度组BMI高于轻度组对比差异有统计学意义（P＜0.05），重度组TIR低于轻度组和中度组对比差异有统计学意义（P＜0.05）；Spearman相关分析显示：BMI与HUA严重程度呈正相关，TIR与HUA严重程度呈负相关（P＜0.05）。结论 TIR降低为T2DM患者HUA发生的重要影响因素之一，且TIR水平与HUA严重程度密切相关。
Objective To explore the correlation between time in range（TIR）of glucose and hyperuricemia（HUA）in patients with type 2 diabetes mellitus（T2DM）．Methods From October 2021 to October 2024，110 patients with T2DM complicated with HUA admitted to our hospital were divided into T2DM with HUA group，and 110 patients with T2DM only in the same period were divided into T2DM group．The general data and laboratory related indicators of the two groups were compared，and the influencing factors of the occurrence of HUA in T2DM patients were analyzed by logistic regression model．Subsequently，110 patients with T2DM complicated with HUA were divided into mild group（58 cases），moderate group（37 cases），and severe group（15 cases）according to their severity．The clinical related indicators and TIR levels of the three groups were compared，and the correlation between clinical related indicators and TIR levels and the severity of HUA in T2DM patients was analyzed．Results Body mass index（BMI），glycosylated hemoglobin，total cholesterol，triglyceride，and blood creatinine（Scr）between T2DM with HUA group and T2DM group were significantly different（P＜0.05）．The indicators with statistical differences were included in the logistics regression model to determine whether to merge HUA as the dependent variable（with HUA=1，without HUA=0）．The results showed that，BMI，glycosylated hemoglobin，total cholesterol，triglycerides，Scr，and TIR were important influencing factors for the occurrence of HUA in T2DM patients（P＜0.05）．Comparison of clinical indicators and TIR levels in patients with different degrees of HUA revealed no significant differences in glycosylated hemoglobin，total cholesterol，triglycerides，and Scr levels among the mild，moderate，and severe groups（P＞0.05），while there were significant differences in BMI and TIR levels among the mild，moderate，and severe groups（P＜0.05）．The difference between the severe group and the mild group was statistically significant（P＜0.05），and the difference between the severe group and the moderate group was statistically significant（P＜0.05）．The Spearman correlation analysis results showed that BMI was positively correlated with the severity of HUA，while TIR was negatively correlated with the severity of HUA（P＜0.05）．Conclusions The decrease of TIR is one of the important influencing factors of HUA in T2DM patients，and the level of TIR is closely related to the severity of HUA．
目的 探讨不同类型尿结石患者肠道菌群结构与尿酸代谢的相关性研究。方法 随机选取2022年5月—2023年5月广州市第一人民医院泌尿外科住院的尿结石患者60例为研究组, 选取同期体检中心健康体检人群30名为对照组,按照结石成分将研究组患者分为尿酸组和非尿酸组, 每组各30例, 所有入选患者均接受结石样本、尿样本、大便样本、血样本的采集, 所有样本经光谱、质谱、基因测序、尿常规及血生化检测 , 比较入选对象的肠道菌群及血尿生化指标变化。结果 尿酸组和非尿酸组患者的血磷（SNK-q=7.970、3.542）、血BUN（SNK-q=5.647、4.756）、血SUA（SNK-q=8.178、3.623）、血SCr（SNK-q=7.300、5.553）、血LPS（SNK-q=13.101、9.705）及24h尿酸（SNK-q=4.462、6.426）水平均高于对照组, 具有统计学意义（P<0.05）, 尿酸组和非尿酸组患者的血钙水平低于对照组（SNK-q=3.918/3.047, P<0.05）。非尿酸组患者的血磷、血SUA、血LPS均低于尿酸组, 均有统计学意义（SNK-q=4.428、4.555、3.397, P<0.05）。尿酸组和非尿酸组患者肠道中双歧杆菌数量低于对照组, 差异具有统计学意义（SNK-q=3.754、3.143, P<0.05）。非尿酸组患者肠道中乳酸杆菌数量高于对照组和尿酸组（SNK-q=4.105、3.463, P<0.05）, 尿酸组及非尿酸组患者的血尿酸及24 h尿尿酸水平与肠道双歧杆菌数量呈负相关（P<0.05）。结论 肠道双歧杆菌数量对结石患者血尿酸代谢及尿结石形成具有相关性。
Objective To explore the relationship of intestinal flora and uric acid metabolism in different urinary stones patients．Methods From May 2022 to May 2023, 60 patients with urinary stones patients in Guangzhou First People’s Hospital were selected as the study group, and 30 health check-up people in the same period of the medical examination center were selected as the control group．Study group was divided into the uric acid group and the non-uric acid group, 30 cases each group, all patients received stone samples, urine samples, stool samples,blood samples collection, mass spectrometry, gene sequencing, urine routine, blood biochemical detection were performed．Intestinal flora and blood urinary biochemical indicators of the patients were compared．Results The levels of blood phosphorus（SNK-q=7.970, 3.542）, blood BUN（SNK-q=5.647, 4.756）, blood SUA （SNK-q=8.178, 3.623）, blood SCr（SNK-q=7.300, 5.553）, blood LPS（SNK-q=13.101, 9.705）, and 24-hour urine uric acid （SNK-q=4.462, 6.426）in the uric acid group and the non-uric acid group were all higher than those in the control group,and were statistically significant（P<0.05）．The blood calcium levels of the patients in the uric acid group and the non-uric acid group were lower than those in the control group（SNK-q=3.918/3.047, P<0.05）．The blood phosphorus, blood SUA and blood LPS levels of the non-uric acid group were all lower than those of the uric acid group, and the differences were statistically significant （SNK-q=4.428, 4.555, 3.397, P<0.05）．The number of bifidobacteria in the intestines of patients in the uric acid group and the non-uric acid group was lower than that of the control group,and the differences were statistically significant（SNK-q=3.754, 3.143, P<0.05）．The number of lactobacilli in the intestines of patients in the non-uric acid group was higher than that of the control group and the uric acid group（SNK-q=4.105, 3.463, P<0.05）．The levels of blood uric acid and 24-hour urine uric acid in the uric acid group and the non-uric acid group were negatively correlated with the number of Bifidobacterium in the intestines（P<0.05）．Conclusions The number of intestinal bisidobacteria has a significant correlation with the metabolism of blood uric acid and urinary stones in patients with stones．
目的 分析高原地区3~6年级学生屈光状态及屈光参数之间的关系。方法 2023年9月,采用随机抽样方法选取林芝市波密县某两所小学3~6年级535名学生进行校园筛查。计算并记录裸眼远视力（UCVA）,非睫状肌麻痹电脑验光下散光及其轴位、等效球镜（SE）、眼轴（AL）、角膜曲率半径（CR）和眼轴/角膜曲率半径轴率比（AL/CR）。采用SPSS 22.00统计软件分析数据。结果 3~6年级学生AL和AL/CR大体趋势为随年级升高而增长,SE随年级升高而降低。3~6年级学生总体筛查性近视患病率为29.91%,且3~6年级筛查性近视患病率分别为20.35%、25.53%、30.53%和51.38%。总体散光患病率为51.59%,其中顺规散光、逆规散光及斜轴散光分别占90.22%、7.61%及2.17%。视力不良者约40.37%。以非睫状肌麻痹验光SE≤-0.50 D同时UCVA<5.0作为筛查性近视的诊断,AL/CR诊断筛查性近视的灵敏度为0.656、特异度为0.887和Youden指数为0.534,曲线下面积（AUC）为0.802,优于AL评估（AUC=0.764）。结论 高原地区3~6年级学生的筛查性近视患病率随年级升高而快速增长,且散光患病率较高,视力不良者较多。AL／CR值对筛查性近视监测具有一定的临床意义。
Objective To analyze the relationship between refractive status and refractive parameters of students in grades three-six in plateau area．Methods In September,2023,a random sampling method was used to select 535 students from grades three-six of two primary schools in Bomi County,Nyingchi City,for school screening．Distance uncorrected visual acuity（UCVA）,astigmatism and its axis position,equivalent spherical（SE）,axial length（AL）,corneal radius（CR）,and axial length/corneal radius ratio（AL/CR）were calculated and recorded．The data was analyzed using the statistical software SPSS 22.00. Results The general trend of AL and AL/CR for grade three-six students was increased with grade increasing,while SE decreased with grade increasing．The overall prevalence of screening myopia was 29.91%,and the prevalence of screening myopia in grades three to six was 20.35%,25.53%,30.53% and 51.38%,respectively．The overall prevalence rate of astigmatism was 51.59%,including 90.22%,7.61% and 2.17% for astigmatism with the rule,astigmatism against the rule and oblique astigmatism,respectively．About 40.37% of the students had poor vision．Screening myopia was diagnosed using non-cycloplegic optometry with SE ≤-0.50 D combined with UCVA<5.0．The sensitivity and specificity of AL/CR for screening myopia were 0.656 and 0.887,respectively,with a Youden index of 0.534 and an area under the curve（AUC）of 0.802．This was superior to the AL evaluation,which had an AUC of 0.764．Conclusions The prevalence of screening myopia increased rapidly with the increase of grade in grade 3 to 6 in plateau area．And there were high prevalence of astigmatism and more poor vision．AL/CR value has a certain clinical significance in the monitoring of screening myopia．
目的 探讨眼底豹纹斑密度（FTD）及视盘旁萎缩弧（PPA）与眼轴长（AL）的相关性,为眼底定量化在儿童近视防控的应用提供科学依据。方法 本研究随机抽取广州市荔湾区两所小学三年级学生作为研究对象,在校园视力筛查的过程中同时采集AL、CR和眼底彩照。使用AI软件对眼底彩照进行量化分析,量化指标包括不同区域和范围的FTD及PPA面积大小,根据眼轴长度分为三组：A组（AL<23 mm）;B组（23 mm≤AL<24 mm）;C组（24 mm≤AL）。结果 共有398例右眼被纳入统计分析,年龄范围8~11岁,中位数是9岁,男性人数占55.1％。三组组间AL、AL/CR和SE比较均有统计学差异（P<0.05）。A组与B组相比,FTD在后极部整体范围、黄斑中心3 mm区域、黄斑中心3 mm区域上方区域具有统计学差异（P<0.05）,C组与B组相比,PPA面积及FTD在后极部整体范围、视盘为中心4.5 mm范围、黄斑为中心直径3 mm和6 mm范围均具有统计学差异（P<0.05）,Spearman相关性分析表明,AL与PPA（r=0.443）和FTD（r=0.322）呈正相关（P<0.001）。亚组相关性分析表明,A组仅黄斑为中心直径3 mm上方范围FTD与AL呈正相关（P=0.028）,B组PPA、黄斑中心直径3 mm及其上方范围FTD与AL呈正相关（P<0.05）,C组仅PPA与AL呈正相关（P=0.005）。结论 眼底定量对于儿童近视防控具有潜在价值,PPA和FTD与AL呈正相关性,不同区域和范围FTD与AL相关性具有一定差异性,黄斑中心直径3 mm范围及其上方范围与眼轴相关性最强。FTD在短眼轴阶段就可以作为生物标记物预测近视严重程度,而PPA主要在长眼轴阶段体现生物标记物的作用。
Objective To investigate the correlation between fundus tessellated density（FTD）and peripapillary atrophy（PPA）with axial length（AL）,providing a scientific basis for the application of fundus quantification in the prevention and control of myopia in children．Methods This study randomly selected third-grade students from two primary schools in Liwan District,Guangzhou City,as research subjects．Axial length（AL）,corneal radius（CR）,and fundus color photographs were collected simultaneously during the school vision screening process．AI software was utilized to perform quantitative analysis on the fundus color photographs,with quantification indicators including the area size of PPA and FTD in different regions and ranges．Subjects were divided into three groups based on axial length：Group A（AL<23 mm）;Group B（23 mm≤AL<24 mm）;Group C（AL≥24 mm）．Results A total of 398 right eyes were included in the statistical analysis,with an age range of 8 to 11,a median age of 9,and 55.1% were male．There were significant statistical differences in AL,AL/CR,and spherical equivalent（SE）among the three groups（P<0.05）．Compared with Group B,Group A showed significant statistical differences in FTD in the overall posterior pole,the 3 mm diameter area centered on the fovea,and the superior area of the 3 mm foveal center（P<0.05）．Compared with Group B,Group C showed significant differences in PPA area and FTD in the overall posterior pole,the 4.5 mm diameter area centered on the optic disc,and the 3 mm and 6 mm diameter areas centered on the fovea（P<0.05）．Spearman correlation analysis indicated that AL was significantly positively correlated with PPA（r=0.443）and FTD（r=0.322）（P<0.001）．Subgroup correlation analysis showed that in Group A,only the FTD in the superior area of the 3 mm diameter centered on the fovea was significantly positively correlated with AL（P=0.028）．In Group B,PPA and FTD in the 3 mm diameter and superior area centered on the fovea were significantly positively correlated with AL（P<0.05）．In Group C,only PPA was significantly positively correlated with AL（P=0.005）．Conclusions Fundus quantification holds potential value for the prevention and control of myopia in children．PPA and FTD show significant positive correlations with AL,with varying degrees of correlation in different regions and ranges of FTD with AL．The 3 mm diameter area centered on the fovea and its superior area have the strongest correlation with the eye axis．FTD can serve as a biomarker to predict the severity of myopia in the early stages of eye axis elongation,while PPA primarily manifests as a biomarker in the later stages of elongation．
目的 探讨载脂蛋白E（ApoE）基因多态性与卒中后认知障碍的相关性,即大动脉粥样硬化型脑梗塞的严重程度。方法 采用病例——对照研究的方法,收集九江学院附属医院神经内科的100例急性缺血性脑卒中且病因分型为大动脉粥样硬化型患者（脑梗死组）和50例性别、年龄匹配的非缺血性脑卒中患者（对照组）。检测患者的 ApoE 基因型、血脂、美国国立卫生院卒中量表（NIHSS）、卒中后6个月简易智力状态检查量表（MMSE）等,采用多因素方差分析等统计学方法分析他们之间的关联性。结果 ApoE 3/4基因型频率与Ɛ3、Ɛ4等位基因频率,在脑梗死组别中高于对照组（P<0.05）。同时,携带Ɛ3等位基因患者的低密度脂蛋白水平高于携带Ɛ2、Ɛ4等位基因的患者;进一步分析发现含Ɛ3等位基因的脑梗死患者NIHSS评分更高、卒中后认知障碍更严重（P<0.05）。结论 ApoE基因型为Ɛ3/4、等位基因Ɛ3、Ɛ4更易罹患大动脉粥样硬化型脑梗死,提示该基因型是脑梗死的易感基因,脑梗死后认知障碍患者Ɛ3等位基因的频率较高,可能是卒中后认知障碍的易感因素。
Objective To explore the relationship between ApoE gene polymorphisms and post-stroke cognitive impairment,the severity of large artery atherosclerotic cerebral infarction．Methods A case-control research study was conducted,gathering data from 100 individuals diagnosed with large artery atherosclerotic cerebral infarction according to the TOAST classification,who admitted to the Neurology Department of the Affiliated Hospital of Jiujiang University．Additionally,50 non-ischemic stroke patients,matched for gender and age,were included as the control group．The patients were assessed for ApoE genotype,blood lipid,NIHSS,and MMSE scale at 6 months post-stroke,and statistical methods were used to analyze their associations．Results Significant differences were observed in the ApoE 3/4 genotype frequency and Ɛ3、Ɛ4 allele frequency between patients with cerebral infarction and the control group,with a notably higher incidence of cerebral infarction in the former．Furthermore,patients carrying the Ɛ3 allele exhibited significantly higher LDL levels than those carrying Ɛ2 or Ɛ4．The analysis also revealed that patients with the Ɛ4 allele experienced higher NIHSS and severer post-stroke cognitive impairment．Conclusions The findings suggest that the ApoE genotype Ɛ3/4 and allele Ɛ3、Ɛ4 may predispose individuals to develop large atherosclerotic cerebral infarction,indicating a susceptibility gene for cerebral infarction．Additionally,the Ɛ3 allele was associated with a higher frequency of cognitive deficits after cerebral infarction,implying that it may be a predisposing factor for post-stroke cognitive impairment．
目的 探讨长病程2型糖尿病（T2DM）患者体质指数（BMI）与胰岛β细胞功能间的相关关系。方法 选取2023年12月—2024年3月于承德市中心医院内分泌风湿免疫科住院的260例长病程（病程≥10年）T2DM患者作为研究对象,依据BMI将其分成正常组、超重组和肥胖组,比较三组间一般资料、检验学指标及检查的差异,分析胰岛β细胞功能与各指标间的相关性。结果 三组研究对象在空腹静脉血糖（FPG）、空腹C肽（FCP）、胰岛素抵抗指数（HOMA-IR）、尿酸（UA）、甘油三酯（TG）等上差异有统计学意义（P<0.05）,在胰岛β细胞功能指数（HOMA-β）比较差异无统计学意义（P>0.05）;肥胖组的FPG、FCP、HOMA-IR、UA、TG均高于正常组（P<0.05）,超重组的UA、TG均高于正常组（P<0.05）,肥胖组的FPG、HOMA-IR、UA高于超重组（P<0.05）,Spearman相关分析结果显示HOMA-β与体质量指数（BMI）无相关性（r=0.046,P=0.461）,HOMA-β与UA（r=0.226,P<0.001）、TG（r=0.148,P=0.017）呈正相关,HOMA-IR与BMI（r=0.279,P<0.001）与、UA相关（r=0.284,P<0.001）及TG（r=0.349,P<0.001）呈正相关,多元线性回归分析显示UA是HOMA-β的影响因素（P<0.05）,BMI、UA、TG是HOMA-IR的影响因素（P<0.05）。结论 长病程的T2DM患者,其胰岛素抵抗水平随着BMI的增加逐渐升高,而胰岛β细胞功能指数与BMI的相关性不显著。同时,UA和TG也是长病程T2DM患者胰岛β细胞功能的影响因素。
Objective To explore the correlation between body mass index（BMI）and islet β cell function in patients with long course type 2 diabetes mellitus（T2DM）．Methods A total of 260 patients with T2DM with a long course of disease（course≥10 years）admitted to the Department of Endocrinology and Rheumatology of Chengde Central Hospital from December 2023 to March 2024 were selected as the study objects,and were divided into normal group,overweight group and obese group according to BMI．Comparison among the three groups in general data,inspection index and and the difference of the islet β cell function were performed,and the correlation among the indexes was analyzed．Results There were statistically significant differences in fasting plasma glucose（FPG）,fasting C peptide（FCP）,homeostasis model assessment-insulin resistance（HOMA-IR）,uric acid（UA）and triglycerides（TG）among the three groups（P<0.05）,but no statistically significant differences in homeostatic model assessment of β-cell function（HOMA-β）（P>0.05）．The levels of FPG,FCP,HOMA-IR,UA and TG in the obese group were higher than those in the normal group（P<0.05）;the levels of UA and TG in the overweight group were higher than those in the normal group（P<0.05）;the levels of FPG,HOMA-IR and UA in the obese group were higher than those in the overweight group（P<0.05）．Spearman correlation analysis showed that HOMA-β was not correlated with BMI（r=0.046,P=0.461）,but was positively correlated with UA and TG（r=0.226,P<0.001;r=0.148,P=0.017）,HOMA-IR was positively correlated with BMI,UA and TG（r=0.279,P<0.001;r=0.284,P<0.001;r=0.349,P<0.001）．Multiple linear regression analysis showed that UA was the influencing factor of HOMA-β（P<0.05）,BMI,UA and TG were the influencing factors of HOMA-IR（P<0.05）． Conclusions In T2DM patients with long disease course,the level of insulin resistance increased gradually with the increase of BMI,but the correlation between β-cell function index and BMI was not significant．At the same time,UA and TG are also factors affecting the function of islet β cells in patients with long-course T2DM．
目的 探究25-羟维生素D[25-（OH）D]水平预测糖尿病周围神经病变发生的相关性。方法 选取2021年6月—2021年12月间在上海市静安区南京西路社区卫生服务中心就诊的200例2型糖尿病患者为研究对象,根据体格检查、血液生化、神经症状评分、肌电图等方法分为无周围神经病变组（n=153）和周围神经病变组（n=47）,对比两组患者的一般资料及血清基线25-（OH）D水平,分析25-（OH）D与糖尿病周围神经病变的相关性,采用Logistic回归分析25-（OH）D对糖尿病周围神经病变的预测价值。结果 两组患者基线25-（OH）D水平、空腹血糖、糖化血红蛋白（HbA1c）、收缩压对比差异有统计学意义（P<0.001）,而年龄、性别、BMI、腰围、餐后血糖值、谷草转氨酶、空腹C肽、总胆固醇、高密度脂蛋白胆固醇、甘油三酯、低密度脂蛋白胆固醇（LDL-C）、血肌酐、血尿酸、舒张压对比无明显差异（P>0.05）;基线25-（OH）D水平与密歇根糖尿病周围神经病变评分（MDNS）呈负相关（r=-0.583,P<0.001）,空腹血糖与MDNS评分呈正相关（r=0.303,P<0.001）;Logistic回归分析提示,25-（OH）D每增加一个单位,糖尿病周围神经病变风险下降25%,校正性别、年龄、HbA1c、LDL后,相关性依然存在。结论 25-（OH）D水平与糖尿病周围神经病变呈负相关,与该病的发生及发展密切相关,血清25-（OH）D水平可作为预测尿病周围神经病变发生、发展的重要指标。
Objective To explore the correlation of 25-hydroxyvitamin D[25-（OH）D] level in predicting the occurrence of diabetic peripheral neuropathy．Methods A total of 200 patients with type 2 diabetes mellitus（T2DM）who were admitted to Community Health Service Center of West Nanjing Road,Jing’an District,Shanghai from June 2021 and December 2021 were selected as the study subjects．According to physical examination,blood biochemistry,neurological symptom score and electromyography,the patients were divided into two groups：no peripheral neuropathy group（n=153）and peripheral neuropathy group（n=47）．The general data and serum baseline 25-（OH）D levels of the two groups were compared to analyze the correlation between 25-（OH）D and diabetic peripheral neuropathy．The predictive value of 25-（OH）D in diabetic peripheral neuropathy was analyzed by Logistic regression．Results There were significant differences in baseline 25-（OH）D level,fasting blood glucose（FBG）,HbA1c and SBP between two groups（P<0.001）,but no significant differences in age,sex,BMI,waist circumference,postprandial plasma glucose,AST,C-peptid total cholesterol,HDL-C,triglyceride,LDL-C,Scr,UA and DBP between two groups（P>0.05）．Baseline 25-（OH）D level was negatively correlated with MDNS score（r=-0.583,P<0.001）,and FBG was positively correlated with MDNS score（r=0.303,P<0.001）．Logistic regression analysis showed that the DPN risk decreased by 25% for every unit increase of 25-（OH）D,and the correlation remained after timely adjustment for sex,age,HbA1c,and LDL-C．Conclusion sThe level of 25-（OH）D is negatively correlated with the occurrence and development of diabetic peripheral neuropathy,and the detection of serum 25-（OH）D level can be used as an important indicator to predict the occurrence and development of urinary peripheral neuropathy．
目的 探讨人外周血中炎症因子的表达与炎性衰老的相关性。方法 通过招募年轻和老年志愿者,检测外周血中炎症因子IL-6、IL-8、TNF-α和IL-1β的mRNA表达水平和蛋白水平。结果 显示老年个体组中IL-6,IL-8和TNF-α的mRNA表达水平高于年轻组,且蛋白水平呈现相同的趋势,比较差异均有统计学意义（P<0.05）。此外,通过热图分析了炎症因子mRNA和蛋白水平的相对表达谱,也发现相同的结果。结论 当年龄超过65岁以后,随着年龄的增长,体内的炎症因子表达水平会升高,这一结果具有成为炎性衰老生物标志物的潜力,对评估老年人的健康状况和疾病风险具有重要意义。
Objective To explore the correlation between the expression of inflammatory factors in human peripheral blood and inflamm-aging．Methods In this experiment,the young and old volunteers were recruited to detect mRNA and protein levels of IL-6,IL-8,TNF-α and IL-1β in peripheral blood．Results The results indicated that mRNA expression levels of IL-6,TNF-α and IL-8 in the old individuals were higher than the young individuals,and the protein concentration followed the same trend,with acceptable P value suggesting a great statistically significant difference．In addition,the relative expression profiles of mRNA and protein concentrations of inflammatory cytokines were analyzed by heat map,and the same results were found．Conclusions It shows that the expression level of inflammatory cytokines up-regulates along with age goes on over 65,which has the potential of inflammatory biomarkers of aging．
目的 探讨与研究白介素-33（IL-33）、白介素-37（IL-37）、亮氨酸富集的核苷酸结合寡聚结构域-3（NLRP-3）及自然杀伤（NK）细胞/树突状细胞（DC）比值与慢性乙型肝炎（CHB）患者病情的相关性。方法 研究时间为2020年2月—2022年9月,选择在本院诊治的86例CHB患者作为肝炎组,同期选择86名体格检查健康者作为对照组。检测2组血清IL-37、IL-33、NLRP3含量,并计算NK/DC比值。对所有入选者的血清谷丙转氨酶（ALT）、谷草转氨酶（AST）、总胆红素（TBIL）含量进行检测并实施相关性分析。结果 与对照组相比,肝炎组的血清ALT、TBIL、AST有的增高趋势（P<0.05）,肝炎组的血清IL-33、IL-37、NLRP3含量更高（P<0.05）,NK/DC比值下降（P<0.05）。在肝炎组中,Pearson分析显示IL-33、IL-37、NLRP3、NK/DC比值与ALT、TBIL、AST均存在相关性（P<0.05）。在肝炎组中,ROC曲线分析显示IL-33、IL-37、NLRP3、NK/DC比值预测CHB病情的曲线下面积为0.705（95%CI：0.404~1.123）、0.690（95%CI：0.372~1.057）、0.670（95%CI：0.378~1.043）、0.685（95%CI：0.415~1.107）,联合检测预测病情的曲线下面积为0.895（95%CI：0.532~1.216）,与单独检测相比,联合检测具有更高的特异度与灵敏度。结论 CHB患者多伴随有血清IL-33、IL-37、NLRP3的高表达,并且NK/DC比值会降低,IL-33、IL-37、NLRP3及NK/DC比值与CHB患者病情存在相关性,联合检测对患者病情具有一定的预测性。
Objective To explore and study the correlation between interleukin-33(IL-33),interleukin-37(IL-37),leucine-enriched nucleotide-binding oligomeric domain(NLRP)- 3,the ratio of natural killer(NK)cells/dendritic cells(DC)and the conditions of patients with chronic hepatitis B(CHB). Methods From February 2020 to September 2022,86 patients with CHB treated in our hospital were selected as hepatitis group,and 86 healthy patients were selected as control group during the same period. The contents of IL-37,IL-33 and NLRP3 in serum of the two groups were detected,and NK/DC ratio was calculated. Serum alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBIL)of all the selected subjects were detected and correlation analysis was carried out. Results Compared with the control group,the serum ALT,TBIL and AST in hepatitis group were significantly increased(P<0. 05),the contents of IL-33,IL-37 and NLRP3 were higher(P<0. 05),and the NK/DC ratio was significantly decreased(P<0. 05). In the hepatitis group,Pearson analysis showed that IL-33,IL-37,NLRP3 and NK/DC ratios were correlated with ALT,TBIL and AST(P<0. 05). In the hepatitis group,ROC curve analysis showed that the maximum areas under the curve of IL-33,IL-37,NLRP3 and NK/DC ratios were 0. 705(95%CI：0. 404-1. 123),0. 690(95%CI：0. 372-1. 057),0. 670(95%CI：0. 378-1. 043)and 0. 685(95%CI：0. 415-1. 107),and the maximum area under the curve of combined detection was 0. 895(95%CI：0. 532-1. 216). Compared with single detection,combined detection had higher specificity and sensitivity. Conclusions The patients with CHB are often accompanied by the high expression of serum IL-33,IL-37 and NLRP3,and the NK/DC ratio will be significantly reduced. IL-33,IL-37,NLRP3 and NK/DC ratio are correlated with the condition of patients with CHB,and can also predict the condition of patients.
