Table of Content

20 January 2023, Volume 38 Issue 1

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Correlation between the gene polymorphisms of interleukin and the susceptibility to pneumonoconiosis: A systematic review and meta-analysis

Zheng Ling, Su Jingying, Wu Dinghui, Yao Xiangyang

2023, 38(1):  5-19.  doi:10.3969/j.issn.1004-583X.2023.01.001

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Objective To investigate the correlationbetween the genepolymorphisms of interleukin and the susceptibility to pneumonoconiosis. Methods Literatures reporting the correlation between the gene polymorphisms of interleukin and the susceptibility to pneumonoconiosis in the PubMed, the Cochrane Library, Embase, CNKI, Wanfang Data, Weipu Database (VIP), and Chinese Biomedical Database (CBM) and other databases, which were published from the establishment of the databases to January 8, 2022 were screened.Two researchers independently extracted data and assessed the risk of bias. Using RevMan 5.2 and Stata 14.0, allelic model, dominant model, recessive model, co-dominant models (2 models), and over-dominant model were used in the meta-analysis on the correlation between interleukin-associated gene polymorphisms and susceptibility to pneumoconiosis. Results A total of 29 eligiblestudies, involving 5 315 pneumoconiosis cases and 5 332 controls were included in the current study. There were 8 literatures reporting the IL-1β-511C/T polymorphism, and the data revealed that the recessive model (OR=1.57, 95%CI=1.06-2.33, P=0.024), and co-dominant model (TT vs CC) (OR=1.80, 95%CI=1.03-3.13, P=0.039) of the IL-1β-511C/T polymorphism were significantly correlated with the susceptibility to pneumonoconiosis. There were 6 literatures reporting the IL-1RA+2018T/C polymorphism, and the data revealed that the allele model(OR=1.65, 95%CI=1.21-2.27, P=0.002), dominant model(OR=1.65, 95%CI=1.11-2.46, P=0.013), recessive model(OR=2.14, 95%CI=1.50-3.06, P=0.000), and co-dominant model (TT vs CC) (OR=2.29, 95% CI=1.58-3.32, P=0.000) of the IL-1RA+2018T/C polymorphism were significantly correlated with the susceptibility to pneumonoconiosis. There were 4 literatures reporting the IL-1α-889C/T polymorphism, and the data revealed that the dominant model(OR=1.75, 95%CI=1.02-3.01, P=0.042), and co-dominant model (CT vs CC)(OR=1.79, 95%CI=1.21-2.636, P=0.004) of the IL-1α-889C/T polymorphism were significantly correlated with the susceptibility to pneumonoconiosis. There were 3 literatures reporting the IL-1α +4845G/T polymorphism, and the data revealed that the allele model(OR=1.59, 95%CI=1.03-2.56, P=0.038) of the IL-1α+4845G/T polymorphism was significantly correlated with the susceptibility to pneumonoconiosis. There were 4 literatures reporting the IL-6 -634C/G polymorphism, and the data revealed that the allele model(OR=0.60, 95%CI=0.47-0.75), dominant model(OR=0.47, 95% CI=0.35-0.64), co-dominant model(OR=0.63, 95%CI=0.42-0.94) (OR=0.36, 95%CI=0.24-0.54) and over-dominant model (OR=2.51, 95%CI=1.71-3.69) of the IL-6 -634C/G polymorphism were significantly correlated with the susceptibility to pneumonoconiosis. There were 2 literatures reporting the IL-8 -781C/T, IL-8-Met31Arg T/G and IL-8 -251A/T polymorphisms, and the data revealed their significant correlation with thesusceptibility to pneumonoconiosis. There was no significant correlation between IL-1β +3953C/T, IL-6 -174G/C and IL-10 -592A/C polymorphisms with the susceptibility topneumoconiosis. Conclusion IL-1RA +2018T/C and IL-6 -634 C/G polymorphisms were significantly correlated with the susceptibility to pneumoconiosis. IL-1α +4845G/T, IL-1β -511C/T and IL-1α -889C/T polymorphisms may be correlated with the susceptibility to pneumoconiosis. IL-1β +3953C/T and IL-6 -174G/C were not correlated with the susceptibility to pneumoconiosis. Our findings should be further validated in multi-center studies with a large sample size.

Efficacy and safety of tirzepatide in patients with type 2 diabetes mellitus: A meta-analysis

Xie Feifei, Zhang Weijian

2023, 38(1):  20-36.  doi:10.3969/j.issn.1004-583X.2023.01.002

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Objective To systematically evaluate the efficacy and safety of tirzepatide in the treatment of type 2 diabetes mellitus (T2DM). Methods CNKI, Wanfang, VIP, Pubmed, Embase and Cochrane Library were retrieved to collect randomized controlled trails (RCTs), which met inclusion criteria. Results Seven RCTs representing 7163 T2DM patients were included. Meta-analysis results showed that the tirzepatide 5 mg, 10 mg and 15 mg was superior to the control groups (glucagon-like peptide-1 receptor agonist [GLP-1RA], insulin and placebo) in reducing glycosylated hemoglobin A1c (HbA₁c) and weight loss. The curative effect appeared to be highly dose-dependent, it showed greater efficacy with increasing dose. The decrease of HbA₁c in the tirzepatide 5 mg, 10 mg and 15 mg was (MD=-0.98, 95%CI [-1.34, -0.62], (MD=-1.21, 95%CI[-1.53,-0.89]) and (MD=-1.37, 95%CI[-1.70,-1.03]), respectively. The weight loss ranges were (MD=-6.05, 95%CI[-8.58,-3.52]), (MD=-8.56, 95%CI[-11.14, -5.98]) and (MD=-10.60, 95%CI[-13.24, -7.97]) (all P<0.01), respectively. The tirzepatide 10 mg and 15 mg was superior to the control groups (GLP-1RA, insulin and placebo) in reducing fasting plasma glucose (FPG). The curative effect appeared to be dose-dependent, and the extent of FPG reduction with the tirzepatide 10 mg and 15 mg was (MD=-1.47, 95%CI[-2.23, -0.70]) and (MD=-1.55, 95%CI[-2.27, -0.83]), (all P<0.01), respectively. The tirzepatide 5 mg was more effective in reducing FPG than placebo. No difference was significant in reducing FPG between tirzepatide 5 mg and the control group (GLP-1RA or insulin). There was also a dose dependence on the compliance rate of HbA₁c<7%, HbA₁c≤6.5%, HbA₁c<5.7% and the proportion of weight loss≥5%, weight loss≥10%, weight loss≥15%. However, there was no significant in compliance rate of HbA₁c and the proportion of weight loss increased. The safety of tirzepatide in incidence of hypoglycemia was similar to that of GLP-1RA and placebo, but lower than that of degludec/glargine insulin. The proportion of gastrointestinal adverse reactions of tirzepatide 5 mg, 10 mg and 15 mg was higher than that of placebo, the proportion of gastrointestinal adverse reactions of tirzepatide 10 mg and 15 mg was higher than that of the control group (GLP-1RA or insulin), but there was no significant difference in gastrointestinal adverse reactions between the control group and tirzepatide 5 mg. Conclusion Compared with placebo, GLP-1RA and insulin, tirzepatide has significant dose-dependent advantages in reducing HbA₁c, FPG and weight loss, and does not increase the risk of hypoglycemia, but tirzepatide 10 mg and 15 mg are associated with increased incidence of gastrointestinal adverse events.

Correlation between ratio of salivary uric acid to blood uric acid and diabetic peripheral neuropathy

Ju Yan, Guo Peng, Wu Botao, Liu Xinyu

2023, 38(1):  37-41.  doi:10.3969/j.issn.1004-583X.2023.01.003

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Objective To explore the dynamic change of blood uric acid (BUA) and salivary uric acid (SUA) in type 2 diabetes mellitus (T2DM) patients with diabetic peripheral neuropathy (DPN), and to study the correlation between ratio of SUA to BUA (SUA/BUA) and DPN, and its predictive value. Methods The clinic data of 164 T2DM patients in the Department of Endocrinology of our hospital from January 2021 to December 2022 was analyzed, and the patients were assigned to the DPN group (n=103) and the simple T2DM group (n=61) based on the clinical symptoms and electromyography results. The general data, SUA and SUA/BUA were compared. The DPN-related factors and their predictive value were respectively assessed by the multiple Logistic regression and receiver operator characteristic (ROC) curve. Results Logistic regression analysis showed that the risk factors of DPN were glycosylated hemoglobin (HbA₁c), SUA, and SUA/BUA. ROC curve analysis showed that areas under curve (AUC), sensitivity, specificity, and optimal cut-off point of HbA₁c were 0.637, 50.8%, 78.6%, and 8.15, respectively, those of SUA were 0.698, 52.4%, 83.6%, 388.43, respectively, and those of BUA were 0.762, 86.4%, 73.8%, 1.01, respectively. Conclusion SUA/BUA is closely associated with DPN, and with a certain predictive value in diagnosis of DPN.

Correlation between hyperhomocysteinemia and early renal disease in patients with type 2 diabetes mellitus

Wang Cui, Lin Hao, Wu Pingping, Zhang Yali, Ren Jian, Xu Ting, Dong Guoyu, Zai Guotian

2023, 38(1):  42-45.  doi:10.3969/j.issn.1004-583X.2023.01.004

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Objective To study the effect of hyperhomocysteinemia on the risk of early renal disease in hospitalized patients with type 2 diabetes mellitus (T2DM). Methods It was a retrospective study involving 306 T2DM patients admitted to Nanjing Jiangbei Hospital from October 2020 to June 2022. According to the diagnostic criteria of diabetic kidney disease (DKD), they were assigned into simple T2DM group (n=252) and early DKD group (n=54). The clinical data of the two groups were compared. Results The prevalence of early DKD in T2DM patients was 17.6%. Compared with those of simple T2DM group, T2DM patients in early DKD group were significantly older, with longer duration of T2DM, higher level of homocysteine, and higher proportions of hyperhomocysteinemia and hypertension (all P<0.05). Multivariate logistic regression analysis showed that hyperhomocysteinemia significantly increased the risk of early DKD in T2DM patients by 5.361 times (OR=6.361, 95%CI: 3.043-13.296, P<0.05), and the level of homocysteine was dose-dependently correlated with the risk of early DKD in T2DM patients, that was, for every 1 μmol/L increase in homocysteine level, the risk of early DKD in T2DM patients increased by 14.1%(OR=1.141, 95%CI: 1.061-1.227, P<0.05). Conclusion Hyperhomocysteinemia in T2DM patients significantly increases the risk of early DKD, and the level of homocysteine has a dose-response relationship with the increased risk of early DKD.

Correlation between coronary artery lesion and insulin resistance in patients with coronary heart disease combined with type 2 diabetes mellitus

Zhang Shangshi, Zhu Hongyan, Li Nan, Chen Yingxi

2023, 38(1):  46-49.  doi:10.3969/j.issn.1004-583X.2023.01.005

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Objective To investigate the correlation between the ischemic degree of coronary artery and calcification and insulin resistance in patients with coronary heart disease combined with type 2 diabetes mellitus (T2DM). Methods From January 1, 2020 to January 1, 2022, 80 patients with coronary heart disease combined with T2DM treated in the Shangrao People’s Hospital were recruited. According to the insulin resistance index in a homeostasis model (HOMA-IR), patients were divided into group A (HOMA-IR>2.69, n=42), and group B (HOMA-IR≤2.69, n=38).The length and arc of calcified vessels, number of coronary artery lesions, length of stent covering coronary arterylesions and Gensini score between the two groups were compared. The correlation between HOMA-IR and the above indicators was identified. Results Compared with those of group B, significantly longer length of calcified vessels and stent covering coronary artery lesions, larger arc of calcified vessels and number of coronary artery lesions, and higher Gensini scores were detected in group A (all P<0.05).Pearson correlation analysis showed that the length and arc of calcified vessels, number of coronary artery lesions, length of stent covering coronary arterylesions and Gensini scorewere positively correlated with HOMA-IR ( r=0.75, 0.51, 0.43, 0.38, and 0.59, respectively, all P<0.05). Conclusion There is a positive correlation between insulin resistance and coronary artery ischemia and calcification in patients with coronary heart disease combined with T2DM.

Effects of anxiety and depression on the composition and properties of coronary plaque in patients with coronary heart disease

Yi Xin, Liu Canzhang, Liu Qiang, Wang Cong, Gao Teng, Yan Jie

2023, 38(1):  50-54.  doi:10.3969/j.issn.1004-583X.2023.01.006

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Objective To investigate the effect of anxiety and depression on the composition and properties of coronary plaque in patients with coronary heart disease (CHD). Methods Totally 76 CHD patients underwent coronary angiography and virtual histology-intravascular ultrasound (VH-IVUS) in the Department I of cardiovasology, North China University of Science and Technology Affiliated Hospital from January 2021 to January 2022 were enrolled. The situation and degree of anxiety and depression were evaluated by the hospital anxiety and Depression Scale (HADS), including total anxiety and Depression Scale (HADS-t), anxiety subscale (HADS-a) and depression subscale (HADS-d). The proportion of each component in the plaque was measured by VH-IVUS technology, including the proportion of necrotic core (NC), dense calcium (DC), fibrous (FI) and fibro-fatty (FF), and whether the plaque was thin-cap fibroatheroma (TCFA). According to HADS scale, the patients were assigned to the control group, the simple anxiety group, the simple depression group, and the anxiety and depression group. The differences in the proportion of plaque components among the four groups were compared. Pearson correlation analysis was used to analyze the correlation between HADS score and various components of plaque. Results The proportion of necrotic core in the anxiety and depression group significantly was significantly higher than that in the control group, the simple anxiety group and the simple depression group (P<0.01). The proportion of TCFA in the simple anxiety group, the simple depression group and the anxiety depression group was significantly higher than that in the control group (P<0.01). Pearson correlation analysis showed that HADS score was positively correlated with the proportion of necrotic tissue (HADS-a: r=0.259, P=0.025; HADS-d: r=0.299, P=0.009; HADS-t: r=0.302, P=0.008, respectively). Conclusion CHD patients with anxiety and depression have more necrotic components in coronary plaque and stronger vulnerability.

Comparative analysis on pathological results of preoperative & postoperative colorectal intraepithelial neoplasia and early colorectal cancer endoscopic therapies

Shi Yujuan, Wang Jing, Xu Ping

2023, 38(1):  55-59.  doi:10.3969/j.issn.1004-583X.2023.01.007

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Objective To provide reference for the improved pathological diagnosis of lesions of the tissues by exploring pathological differences of preoperative and postoperative endoscopic polypectomy for colorectal intraepithelial neoplasia and early colorectal cancer. Methods One hundred and twenty nine patients receiving both biopsies and surgeries based on the inclusion and exclusion criteria were selected as study samples, the specimen data and preoperative pathology biopsy data of 129 patients diagnosed with high-grade colorectal intraepithelial neoplasia or early colorectal cancer patients under endoscopic mucosal resection (EMR)/ endoscopic submucosal dissection (ESD) were retrospectively analyzed, differences in preoperative and postoperative pathological results were compared, and the risk factors associated with pathological differences in preoperative and postoperative endoscopic therapies were analyzed. Differences in the accuracy of pathological biopsies and EMR/ESD samples of patients with different parts (ascending colon, transverse colon, descending colon, sigmoid colon, rectum), lesion morphology (pedicled, sessile and lateral developmental morphology), maximum diameter of lesions, gender and age were observed. Results The diagnostic accordance rate of the postoperative pathological diagnosis of preoperative colonoscopy biopsies and endoscopic EMR/ESD therapies was 17.1% (22/129), the number of postoperative pathological ascending and descending lesions of endoscopic therapies amounted to 103 cases (79.8%) and 4 cases (3.1%), respectively, the mild-severity judgment rate of sites was 82.4%, 80.0%, 85.7%, 80.9% and 76.7%, respectively, and differences weren’t statistically significant (P>0.05). The results of single-factor Logistic regression analysis showed that the phenomenon of mild-severity judgments on preoperative biopsies was more obvious in patients with pedunculated polyps, and difference was statistically significant (P<0.05), while difference in mild-severity judgment rate for preoperative biopsies was not statistically significant for the lesion site, maximum diameter, sex, and age (P>0.05). Conclusion Both the preoperative pathological biopsy diagnosis and postoperative EMR/ESD pathological diagnosis with low compliance rate provide certain basis for selection on endoscopic follow-up and surgical treatment. Patients with pedunculated polyps are vulnerable to mild severity judgment for preoperative biopsies. Therefore, patients with pedunculated polyps are subject to intraepithelial neoplasia diagnose via biopsies, EMR/ESD surgery is supported to be selected based on the conditions in combination with narrow band imaging and magnifying endoscopy technique, and necessities for follow-up treatment and endoscopic follow-up time are supported to be determined by combining the pathological diagnosis on postoperative specimens.

Correlation of serum ferritin, erythrocyte parameters and D-dimer with sepsis in children

Zhou Lijuan, Zhu Pengwei, Cao Mei, Cheng Zhenmei, Wu Qiaowei, Li Yong

2023, 38(1):  60-63.  doi:10.3969/j.issn.1004-583X.2023.01.008

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Objective To investigate the evaluation value of erythrocyte parameters, D-dimer (DD) and serum ferritin (SF) on the state and prognosis of sepsis in children, and to explore their relationship. Methods We carried out a retrospective analysis on 173 children with sepsis who visited Wuxi Children's Hospital of Jiangsu Province from July 2015 to June 2022, including Hemoglobin(Hb), red blood cell distribution width(RDW), DD, SF, the severity of illness and the prognosis, and explored its interrelation and related mechanism. Results There were 82 cases in non-severe group, 64 cases in severe group and 27 cases in extremely severe group. Hb was decreased and RDW, DD and SF were increased gradually with increased severity of illness, with statistically significant differences (P<0.01). Hb was negatively correlated with RDW and DD (r=-0.527 and -0.629, P<0.05). RDW was positively correlated with DD(r=0.587, P<0.05). SF was negatively correlated with Hb(r=-7.324, P<0.05). SF was positively correlated with RDW and DD (r=0.513 and 0.697, P<0.05). Among 173 children with sepsis, there were 21cases in death group and 152 cases in survival group. Hb in death group was significantly lower than that in survival group and RDW, DD and SF in death group were significantly higher than those in survival group (P<0.01). There were 124 children in sepsis group and 49 children in septic shock group. Hb in sepsis group was significantly higher than that in septic shock group, and RDW, and DD and SF were significantly lower than those in septic shock group (P<0.01). Conclusion Hb, RDW, DD and SF have some evaluation value on the state and prognosis of sepsis in children, and the erythrocytes damaged by microcirculation disturbance may be the main source of SF.

Congenital insensitivity to pain with anhidrosis: A case report and literature review

Pang Shu, Zhang Mingkai, Bai Hongmei, Wu Yongdong

2023, 38(1):  64-67.  doi:10.3969/j.issn.1004-583X.2023.01.009

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Objective To investigate the clinical characteristics, diagnosis and treatment of congenital insensitivity to pain with anhidrosis. Methods The clinical data and gene detection results of a patient with congenital insensitivity to pain with anhidrosis in our hospital was analyzed retrospectively. The related literature were reviewed and summarized. Results A 10-year-old female patient had rough skin, repeated fractures and swelling of the left knee joint for 3 years. The clinical features are rough skin, insensitivity to pain, oral ulcer, absence of finger (toe) nail, Charcot joint of left knee, slight valgus of left knee, repeated falls and fractures, and repeated fever. The results of gene sequencing indicated that the patient had a homozygous variation of C.575-19G>A of NTRK1 gene. She was diagnosed as congenital insensitivity to pain with anhidrosis. Conclusion There are various clinical manifestations of congenital insensitivity to pain with anhidrosis, and there is no radical cure. Prevention and treatment of complications is the main method to improve the survival rate of these patients.

Gabapentin treatment in olanzapine-induced restless legs syndrome: Two cases report and literature review

Sun Zhenxiao, Zhao Lin

2023, 38(1):  68-70.  doi:10.3969/j.issn.1004-583X.2023.01.010

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Objective To explore the therapeutic efficacy of gabapentin on olanzapine-induced restless legs syndrome (RLS). Methods The clinical data, diagnosis and treatment of 2 cases of olanzapine-induced RLS treated with gabapentin were analyzed retrospectively, and the related literatures were reviewed. Results During the treatment with olanzapine, two patients with schizophrenia both suffered from unspeakable discomfort in their lower limbs at night. They uncontrollably wanted to move their legs and got up and walked, otherwise they would feel uncomfortable and difficult to fall asleep. Patting with their hands or walking out of bed could alleviate the discomfort. They were diagnosed as olanzapine-induced RLS and successfully treated with gabapentin. Conclusion Gabapentin can be used to treat olanzapine-induced RLS.

Familial Holt-Oram syndrome: Report of a case & literature review

Liu Yuqing, Cheng Ji

2023, 38(1):  71-74.  doi:10.3969/j.issn.1004-583X.2023.01.011

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Objective To explore the clinical manifestations and prognosis of Holt-Oram syndrome. Methods Echocardiography and imaging examination were performed for children with skeletal malformation of upper, and the whole-exome sequencing and whole-genome sequencing were performed for parents and children. Results The patient was born with congenital heart disease, the fragment heterozygosis loss (FHL) sized in approximate 0.6 Kb was detected in proband’s 12q24.21 region, and FHL was inherited from the mother, while Holt-Oram syndrome was diagnosed in combination with the clinical manifestations. Conclusion It is necessary to pay attention to Holt-Oram syndrome and possibility of heart disease in children with skeletal malformation of upper, with the aim of promoting early diagnosis & treatment and genetic counseling on children.