Gastric cancer(GC)remains a leading cause of cancer-related mortality worldwide,necessitating the identification of reliable prognostic indicators to enhance treatment outcomes.Recent research has highlighted the trig...Gastric cancer(GC)remains a leading cause of cancer-related mortality worldwide,necessitating the identification of reliable prognostic indicators to enhance treatment outcomes.Recent research has highlighted the triglyceride-glucose(TyG)index as a potential surrogate marker for insulin resistance,which may significantly influence the prognosis of patients undergoing immunotherapy combined with chemotherapy.In this context,the study by Yao et al demonstrates that a high TyG index correlates with improved overall survival and progressionfree survival in advanced GC patients receiving sintilimab and chemotherapy.Specifically,patients in the high TyG group had a significantly longer median progression-free survival of 9.8 months[95%confidence interval(CI):9.2-10.9]compared to 8.0 months(95%CI:7.5-8.5)in the low TyG group(hazard ratio=0.58,95%CI:0.43-0.79,P<0.001).Similarly,the median overall survival was significantly longer in the high TyG group at 23.1 months(95%CI:21.2-NA)vs 16.5 months(95%CI:13.9-18.3)in the low TyG group(hazard ratio=0.30,95%CI:0.21-0.42,P<0.001).These findings underscore the strong prognostic potential of the TyG index in guiding treatment strategies for advanced GC.These findings underscore the need for further investigation into the TyG index’s role as a prognostic tool and its underlying mechanisms in influencing treatment efficacy.We advocate for additional multicenter studies to validate these results and explore the TyG index’s applicability across diverse patient populations,ultimately aiming to refine treatment strategies and improve patient outcomes in advanced GC.展开更多
BACKGROUND Detection of early chronic changes in the kidney allograft is important for timely intervention and long-term survival.Conventional and novel ultrasound-based investigations are being increasingly used for ...BACKGROUND Detection of early chronic changes in the kidney allograft is important for timely intervention and long-term survival.Conventional and novel ultrasound-based investigations are being increasingly used for this purpose with variable results.AIM To compare the diagnostic performance of resistive index(RI)and shear wave elastography(SWE)in the diagnosis of chronic fibrosing changes of kidney allograft with histopathological results.METHODS This is a cross-sectional and comparative study.A total of 154 kidney transplant recipients were included in this study,which was conducted at the Departments of Transplantation and Radiology,Sindh Institute of Urology and Transplantation,Karachi,Pakistan,from August 2022 to February 2023.All consecutive patients with increased serum creatinine levels and reduced glomerular filtration rate(GFR)after three months of transplantation were enrolled in this study.SWE and RI were performed and the findings of these were evaluated against the kidney allograft biopsy results to determine their diagnostic utility.RESULTS The mean age of all patients was 35.32±11.08 years.Among these,126(81.8%)were males and 28(18.2%)were females.The mean serum creatinine in all patients was 2.86±1.68 mg/dL and the mean estimated GFR was 35.38±17.27 mL/min/1.73 m2.Kidney allograft biopsy results showed chronic changes in 55(37.66%)biopsies.The sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)of SWE for the detection of chronic allograft damage were 93.10%,96.87%%,94.73%,and 95.87%,respectively,and the diagnostic accuracy was 95.45%.For RI,the sensitivity,specificity,PPV,and NPV were 76.92%,83.33%,70.17%,and 87.62%,respectively,and the diagnostic accuracy was 81.16%.CONCLUSION The results from this study show that SWE is more sensitive and specific as compared to RI in the evaluation of chronic allograft damage.It can be of great help during the routine follow-up of kidney transplant recipients for screening and early detection of chronic changes and selecting patients for allograft biopsy.展开更多
BACKGROUND The hemodynamic alterations seen in liver cirrhosis lead to renal vasoconstriction,ultimately causing acute kidney injury(AKI).The renal resistive index(RRI)is the most common Doppler ultrasound variable fo...BACKGROUND The hemodynamic alterations seen in liver cirrhosis lead to renal vasoconstriction,ultimately causing acute kidney injury(AKI).The renal resistive index(RRI)is the most common Doppler ultrasound variable for measuring intrarenal vascular resistance.AIM To evaluate the association of the RRI with AKI in patients with liver cirrhosis and to identify risk factors for high RRI.METHODS This was a prospective observational study,where RRI was measured using Doppler ultrasound in 200 consecutive hospitalized patients with cirrhosis.The association of RRI with AKI was studied.The receiver operating characteristic(ROC)curve analysis was utilized to determine discriminatory cut-offs of RRI for various AKI phenotypes.Multivariate analysis was conducted to determine the predictors of high RRI.RESULTS The mean patient age was 49.08±11.68 years,with the majority(79.5%)being male;the predominant etiology of cirrhosis was alcohol(39%).The mean RRI for the study cohort was 0.68±0.09,showing a progressive increase with higher Child-Pugh class of cirrhosis.Overall,AKI was present in 129(64.5%)patients.The mean RRI was significantly higher in patients with AKI compared to those without it(0.72±0.06 vs 0.60±0.08;P<0.001).A total of 82 patients(41%)had hepatorenal syndrome(HRS)-AKI,29(22.4%)had prerenal AKI(PRA),and 18(13.9%)had acute tubular necrosis(ATN)-AKI.The mean RRI was significantly higher in the ATN-AKI(0.80±0.02)and HRS-AKI(0.73±0.03)groups than in the PRA(0.63±0.07)and non-AKI(0.60±0.07)groups.RRI demonstrated excellent discriminatory ability in distinguishing ATN-AKI from non-ATN-AKI(area under ROC curve:93.9%).AKI emerged as an independent predictor of high RRI(adjusted odds ratio[OR]:11.52),and high RRI independently predicted mortality among AKI patients(adjusted OR:3.18).CONCLUSION In cirrhosis patients,RRI exhibited a significant association with AKI,effectively differentiated between AKI phenotypes,and predicted AKI mortality.展开更多
BACKGROUND Colorectal polyps(CPs)are frequently occurring abnormal growths in the colorectum,and are a primary precursor of colorectal cancer(CRC).The triglyceride-glucose(TyG)index is a novel marker that assesses met...BACKGROUND Colorectal polyps(CPs)are frequently occurring abnormal growths in the colorectum,and are a primary precursor of colorectal cancer(CRC).The triglyceride-glucose(TyG)index is a novel marker that assesses metabolic health and insulin resistance,and has been linked to gastrointestinal cancers.AIM To investigate the potential association between the TyG index and CPs,as the relation between them has not been documented.METHODS A total of 2537 persons undergoing a routine health physical examination and colonoscopy at The First People's Hospital of Kunshan,Jiangsu Province,China,between January 2020 and December 2022 were included in this retrospective cross-sectional study.After excluding individuals who did not meet the eligibility criteria,descriptive statistics were used to compare characteristics between patients with and without CPs.Logistic regression analyses were conducted to determine the associations between the TyG index and the prevalence of CPs.The TyG index was calculated using the following formula:Ln[triglyceride(mg/dL)×glucose(mg/dL)/2].The presence and types of CPs was determined based on data from colonoscopy reports and pathology reports.RESULTS A nonlinear relation between the TyG index and the prevalence of CPs was identified,and exhibited a curvilinear pattern with a cut-off point of 2.31.A significant association was observed before the turning point,with an odds ratio(95% confidence interval)of 1.70(1.40,2.06),P<0.0001.However,the association between the TyG index and CPs was not significant after the cut-off point,with an odds ratio(95% confidence interval)of 0.57(0.27,1.23),P=0.1521.CONCLUSION Our study revealed a curvilinear association between the TyG index and CPs in Chinese individuals,suggesting its potential utility in developing colonoscopy screening strategies for preventing CRC.展开更多
Background: In response to the escalating burden of cardiovascular diseases (CVDs) worldwide, exacerbated by lifestyle changes and socioeconomic shifts, acute coronary syndromes (ACS) stand out as a leading cause of m...Background: In response to the escalating burden of cardiovascular diseases (CVDs) worldwide, exacerbated by lifestyle changes and socioeconomic shifts, acute coronary syndromes (ACS) stand out as a leading cause of morbidity and mortality. The pivotal role of insulin resistance in the pathogenesis of atherosclerosis, independent of traditional risk factors, has garnered significant interest. Objective: This review aims to synthesize the recent advancements in the utilization of the triglyceride glucose index (TyG index) as a biomarker for assessing the severity and predicting the prognosis of ACS lesions. Methods: A systematic search was conducted across PubMed, Embase, and Scopus databases, incorporating keywords such as “triglyceride glucose index”, “TyG index”, “acute coronary syndrome”, “cardiovascular disease”, “insulin resistance”, “coronary artery calcification”, “SYNTAX score”, “Gensini score”, and “major adverse cardiac events”. Studies were included from the inception of each database up to July 2024. Selection criteria encompassed observational studies, case-control studies, and randomized controlled trials, with a particular emphasis on evaluating the diagnostic and prognostic value of the TyG index in patients with acute coronary syndromes. Ultimately, 46 publications met the inclusion criteria. Data extraction and quality assessment were performed in accordance with established guidelines. Results: Evidence suggests that the TyG index, reflecting insulin resistance, blood glucose, and lipid levels, is significantly associated with lesion severity in ACS, including coronary artery calcification, SYNTAX score, and Gensini score. Moreover, it demonstrates predictive power for major adverse cardiovascular events, underscoring its potential as a valuable tool in clinical decision-making. Conclusion: The review highlights the emerging role of the TyG index in the assessment and prognosis of ACS, advocating for its incorporation into clinical practice as a complement to existing diagnostic modalities. However, the establishment of standardized reference ranges and further validation across diverse populations are warranted to refine its applicability in personalized medicine. The interdisciplinary approach is essential to advance our understanding of the complex interplay between insulin resistance and cardiovascular disease, paving the way for the development of more effective prevention and treatment strategies.展开更多
ACKGROUND The hemoglobin glycation index(HGI)represents the discrepancy between the glucose management indicator(GMI)based on mean blood glucose levels and laboratory values of glycated hemoglobin(HbA1c).The HGI is a ...ACKGROUND The hemoglobin glycation index(HGI)represents the discrepancy between the glucose management indicator(GMI)based on mean blood glucose levels and laboratory values of glycated hemoglobin(HbA1c).The HGI is a promising indicator for identifying individuals with excessive glycosylation,facilitating personalized evaluation and prediction of diabetic complications.However,the factors influencing the HGI in patients with type 1 diabetes(T1D)remain unclear.Autoimmune destruction of pancreaticβcells is central in T1D pathogenesis,yet insulin resistance can also be a feature of patients with T1D and their coexistence is called“double diabetes”(DD).However,knowledge regarding the relationship between DD features and the HGI in T1D is limited.AIM To assess the association between the HGI and DD features in adults with T1D.METHODS A total of 83 patients with T1D were recruited for this cross-sectional study.Laboratory HbA1c and GMI from continuous glucose monitoring data were collected to calculate the HGI.DD features included a family history of type 2 diabetes,overweight/obesity/central adiposity,hypertension,atherogenic dyslipidemia,an abnormal percentage of body fat(PBF)and/or visceral fat area(VFA)and decreased estimated insulin sensitivity.Skin autofluorescence of advanced glycation end products(SAF-AGEs),diabetic complications,and DD features were assessed,and their association with the HGI was analyzed.RESULTS A discrepancy was observed between HbA1c and GMI among patients with T1D and DD.A higher HGI was associated with an increased number of SAF-AGEs and a higher prevalence of diabetic microangiopathy(P=0.030),particularly retinopathy(P=0.031).Patients with three or more DD features exhibited an eight-fold increased risk of having a high HGI,compared with those without DD features(adjusted odds ratio=8.12;95%confidence interval:1.52-43.47).Specifically,an elevated PBF and/or VFA and decreased estimated insulin sensitivity were associated with high HGI.Regression analysis identified estimated insulin sensitivity and VFA as factors independently associated with HGI.CONCLUSION In patients with T1D,DD features are associated with a higher HGI,which represents a trend toward excessive glycosylation and is associated with a higher prevalence of chronic diabetic complications.展开更多
AIM:To evaluate the clinical significance of cystatin C and renal resistive index for the determination of renal function in patients with liver cirrhosis.METHODS:We conducted a study of 63 patients with liver cirrhos...AIM:To evaluate the clinical significance of cystatin C and renal resistive index for the determination of renal function in patients with liver cirrhosis.METHODS:We conducted a study of 63 patients with liver cirrhosis.A control group comprised of 30 age and gender-matched healthy persons.Serum cystatin C was determined in all study subjects and renal Doppler ultrasonography was made.Estimated glomerular filtration rate from serum creatinine(GFRCr)and cystatin C(GFRCys)was calculated.RESULTS:We confirmed significant differences in val-ues of cystatin C between patients with different stages of liver cirrhosis according to Child-Pugh(P=0.01),and a significant correlation with model of end stage liver disease(MELD)score(rs=0.527,P<0.001).More patients with decreased glomerular filtration rate were identified based on GFRCys than on GFRCr(P<0.001).Significantly higher renal resistive index was noted in Child-Pugh C than in A(P<0.001)and B stage(P=0.001).Also,a significant correlation between renal resistive index and MELD score was observed(rs=0.607,P<0.001).Renal resistive index correlated significantly with cystatin C(rs=0.283,P=0.028)and showed a negative correlation with GFRCys(rs=-0.31,P=0.016).CONCLUSION:Cystatin C may be a more reliable marker for assessment of liver insufficiency.Additionally,cystatin C and renal resistive index represent sensitive indicators of renal dysfunction in patients with liver cirrhosis.展开更多
AIM: To assess the relation between central retinal artery(CRA) resistive index(RI) and retinal nerve fiber thickness measured by optical coherence tomography(OCT) in assessment of disease progress in cases of open an...AIM: To assess the relation between central retinal artery(CRA) resistive index(RI) and retinal nerve fiber thickness measured by optical coherence tomography(OCT) in assessment of disease progress in cases of open angle glaucoma.METHODS: Twenty-three patients with diagnosed open angle glaucoma were included in this study. They were examined by colored duplex ultrasonography of CRA with estimation of RI of CRA and ophthalmic artery(OA)with estimation of CRA/OA RI ratio as well as OCT measurement of the average retinal nerve fiber layer(RNFL) thickness in order to assess the disease progress.RESULTS: There was strong inverse relation between the increased RI in CRA as well as the increased CRA/OA RI ratio and the decrease in average RNFL thickness in cases of open angle glaucoma.CONCLUSION: Assessment of CRA RI can indirectly assess the vascular changes associated with glaucoma and can assess the degree of retinal atrophy helping in evaluating prognosis thus guiding the choice of treatment.展开更多
Aim: To determine the relationship of carotid plaque, intima media thickness (IMT), resistivity index (RI) and pulsatility index (PI) and prevalence of different risk factors with acute ischemic stroke and stroke subt...Aim: To determine the relationship of carotid plaque, intima media thickness (IMT), resistivity index (RI) and pulsatility index (PI) and prevalence of different risk factors with acute ischemic stroke and stroke subtypes in both diabetic and non-diabetic subjects. Materials and methods: 80 cases of acute ischemic strokes and 40 healthy controls were included in the study. The plaque, IMT, RI and PI were measured by carotid duplex ultrasound. Results: 31 subjects were Type 2 diabetic, 54 hypertensive while 25 were both diabetic and hypertensive. 23 cases (28.75%) had lacunar stroke (LACI), 32 (40%) stroke involving partial anterior circulation(PACI), 10(12.5%) stroke in posterior circulation (PACI) and 15(18.75%) stroke involving total anterior circulation(TACI) respectively. The mean IMT (0.88 ± 0.19mm), RI(0.76 ± 0.05) and PI(1.71 ± 0.19) of patients and mean IMT (0.6±0.09mm), RI (0.61 ± 0.06) and PI (1.53 ± 0.11) of controls were statistically significant (p-0.000). The mean values of IMT, PI and RI were significantly higher in diabetics (IMT-0.90 ± 0.16 VS 0.64 ± 0.11, p-0.013;PI-1.76 ± 0.20 VS 1.49 ± 0.09, P-0.000 and RI-0.76 ± 0.04 VS 0.59 ± 0.06, P-0.000) and similarly the mean values for IMT, PI and RI in hypertensives as compared to controls (IMT-0.88 ± 0.16 vs 0.65 ± 0.10, P-0.006;PI1.69 ± 0.18 vs 1.49 ± 0.09, P-0.000 and RI 0.76 ± 0.04 vs 0.59 ± 0.06, P-0.000). The mean IMT, PI and RI were increased significantly in smokers compared to controls (IMT-0.93 ± 0.20 vs 0.63 ± 0.06, P-0.000;PI-1.82 ± 0.22 vs 1.49 ± 0.09, P-0.000 and RI-0.77 ± 0.04 vs 0.59 ± 0.06, P-0.000). Type 3 plaque accounted for 27 (56.2%) cases and Type 2 plaque 12 (25%) cases. The total number of plaques in patients as compared to controls were significantly more (P-0.0034) and the mean plaque area was 46 mm2 for cases and 20 mm2 for control (P-0.0001). TACI was the most common type of ischemic stroke seen in DM (60%), HTN (66.6%) and smokers (66.7%). Plaques (73.3%), IMT (0.90 ± 0.12), PI(1.72 ± 0.14) and RI (0.76 ± 0.13) were more commonly associated with TACI subtype. On multivariate analysis using ANOVA, the mean PI was highly significant (0.000) in relation to types of plaque. Summary and Conclusions: IMT, RI, PI and plaque type are useful diagnostic parameters for acute ischemic stroke and its subtypes. They can be used as noninvasive tools for predicting and preventing ischemic stroke in smokers as well as subjects with DM and hypertension.展开更多
The“super rice”breeding program in China has been successful in developing high-yielding hybrids,including few with high harvest index values.However,there is limited information on the relationship between lodging ...The“super rice”breeding program in China has been successful in developing high-yielding hybrids,including few with high harvest index values.However,there is limited information on the relationship between lodging resistance and harvest index,and the mechanisms underlying the relationship in super-rice hybrids.In this study,a two-year field experiment was conducted to compare lodging resistance and its related traits between two superrice hybrids differing in harvest index,i.e.,Guiliangyou 2(G2)with a high harvest index and Y-liangyou 1(Y1)with a typical harvest index of modern high-yielding rice varieties.Results showed that compared to Y1,G2 was lower in plant height due to its lower aboveground N uptake,and its higher stem breaking resistance(i.e.,lower stem breaking index)resulted from a lower stem height at its center of gravity.Consequently,G2 had a higher lodging resistance(i.e.,lower plant lodging index)than Y1.This study suggests that developing super-rice hybrids with high harvest index values is a possible way to achieve both high grain yield and strong lodging resistance in rice.展开更多
Tight sandstone,with severe diagenesis and complex pore structure,differs greatly from conventional sandstone in terms of rock electrical parameters.In subsurface rock electrical experiments,various electrical paramet...Tight sandstone,with severe diagenesis and complex pore structure,differs greatly from conventional sandstone in terms of rock electrical parameters.In subsurface rock electrical experiments,various electrical parameters are confounded and can only be analyzed qualitatively.The lack of quantitative analysis for each individual electrical parameter presents a challenge for the evaluation of oil and gas saturation in tight sandstone.Based on the 2D pore-throat model and the features of pore structure in the tight sandstone of the Penglaizhen and Shaximiao Formations in the upper and middle Jurassic of the Western Sichuan Depression,this paper presents 3D micro pore-throat models for three types of tight sandstone.It proposes a finite element-based rock electrical simulation method to analyze the influence of pore structure parameters,such as throat radius and throat tortuosity,on electrical parameters such as resistivity,formation factor,and cementation index quantitatively.The research revealed the following results:(1)Throats of tight sandstone usually have lamellar or curved lamellar shapes that are slender and narrow.The lamellar throat used in the proposed porethroat model is more consistent with the features of tight sandstone than the tubular throat used in the original model.(2)The throat determines the conductivity of tight sandstone.The throat parallel to the electric potential has the greatest influence on conductivity,and the throat perpendicular to the potential has the least influence.(3)In tight sandstone grades I to III,as the porosity decreases,the formation factor increases and the cementation index decreases.(4)The results of the rock electrical simulation are consistent with the results of the rock electrical experiment,which indicates that the proposed rock electrical simulation method of tight sandstone is effective and accurate.展开更多
The morphological characters, physiological characters, yield traits and yield per plant of total 49 rice cultivars from Ningxia were investigated under conditions of water stress and non-water stress so as to determi...The morphological characters, physiological characters, yield traits and yield per plant of total 49 rice cultivars from Ningxia were investigated under conditions of water stress and non-water stress so as to determine the relationship between each trait and yield per plant under water stress and the relationship between each relative character and drought resistance coefficient under water stress and non-water stress. The correlation, grey correlation, stepwise regression and path analyses showed that the tiller number per plant, plant height, grain density, effective panicle number per plant and grain number per panicle, total 5 traits, were significantly correlated with the drought resistance of rice, and they could be used to identify the drought resistance of rice in Ningxia. In addition, the drought resistance of rice was graded qualitatively according to the subordinate function value of corresponding drought resistance coefficient. The results showed that among the 49 rice cultivars from Ningxia,6 rice cultivars were highly drought resistant, and 9 rice cultivars were moderately drought resistant, suggesting that the evaluation method was feasible and effective.展开更多
Objective: To prospectively evaluate the diagnostic utility of interlobar renal arterial resistive index values, in predicting the presence of vesicoureteral reflux in children with sonographically normal appearing ki...Objective: To prospectively evaluate the diagnostic utility of interlobar renal arterial resistive index values, in predicting the presence of vesicoureteral reflux in children with sonographically normal appearing kidneys. Methods: We investigated 35 children with a history of urinary tract infection with grayscale and color Doppler ultrasound (US) fol-lowed by a standard voiding cystouretherogram to assess the presence of vesicoureteral reflux. All renal units (individ-ual kidneys) were morphologically normal without evidence of hydronephrosis. Resistive index (RI) was measured at the level of the interlobar arteries. Results: Of a total of 67 kidney units, 3 kidney units yielded no diagnostic results due to technical factors (crying, agitation). 46 kidney units (69%) were not associated with any degree of reflux. 17 kidney units (25%) were associated with low-mid grade reflux (grades I - III). 4 kidney units (6%) were associated with high grade reflux (grades IV - V). No statistically significant correlation was found between the interlobar resistive indices of sonographically normal appearing kidneys and the presence, absence, or degree of vesicoureteral reflux. Conclusions: The results of this study suggest that resistive index measurements taken in the interlobar arteries of sonographically normal appearing kidneys cannot be used to predict the presence or absence of vesicoureteral reflux.展开更多
Background: One of the most common causes of renal impairment and development of chronic kidney disease is diabetes mellitus type 2 (DM 2). The aim of this prospective study was to determine the role of Resistive Inde...Background: One of the most common causes of renal impairment and development of chronic kidney disease is diabetes mellitus type 2 (DM 2). The aim of this prospective study was to determine the role of Resistive Index (RI) as a non-invasive marker for the evaluation of renal impairment in patients with DM 2. Material and Methods: 47 patients with DM 2 in mean age 62.66 ± 10.081 years were included in the study for the period of one year. All of them were with well-compensated diabetes mellitus (HbA1c Results: Patients with RI 0.05 for all). There was significant difference between the groups according to serum creatinine (p = 0.026), GFR (p = 0.044) and the degree of proteinuria (p = 0.001). There was a positive correlation between RI and serum creatinine (r = 0.418;p = 0.001) and between RI and proteinuria (r = 0.396;p = 0.004). A negative correlation relationship between RI and GFR values was found (r = –0.413;p = 0.011). Conclusions: RI may be used as an indicator for the assessment of the severity of renal impairment in patients with DM 2. It correlates well with serum creatinine, GFR and proteinuria, which are proven biochemical parameters indicating the degree of renal damage in patients with DM 2.展开更多
Background:In the 21st century,as globalization accelerates and global public health crises occur,the One Health approach,guided by the holistic thinking of human-animal-environment and emphasizing interdisciplinary c...Background:In the 21st century,as globalization accelerates and global public health crises occur,the One Health approach,guided by the holistic thinking of human-animal-environment and emphasizing interdisciplinary collaboration to address global health issues,has been strongly advocated by the international community.An immediate requirement exists for the creation of an assessment tool to foster One Health initiatives on both global and national scales.Methods:Built upon extensive expert consultations and dialogues,this follow-up study enhances the 2022 global One Health index(GOHI)indicator system.The GOHI framework is enriched by covering three indices,e.g.external drivers index(EDI),intrinsic drivers index(IDI),and core drivers index(CDI).The comprehensive indicator system incorporates 13 key indicators,50 indicators,and 170 sub I-indicators,utilizing a fuzzy analytic hierarchy process to ascertain the weight for each indicator.Weighted and summed,the EDI,IDI,and CDI scores contribute to the computation of the overall GOHI 2022 score.By comparing the ranking and the overall scores among the seven regions and across 160 countries/territories,we have not only derived an overall profile of the GOHI 2022 scores,but also assessed the GOHI framework.We also compared rankings of indicators and sub Iindicators to provide greater clarity on the strengths and weaknesses of each region within the One Health domains.Results:The GOHI 2022 performance reveals significant disparities between countries/territories ranged from 39.03 to 70.61.The global average score of the GOHI 2022 is 54.82.The average score for EDI,IDI,and CDI are 46.57,58.01,and 57.25,respectively.In terms of global rankings,countries from North America,Europe and Central Asia,East Asia and Pacific present higher scores.In terms of One Health domains of CDI,the lowest scores are observed in antimicrobial resistance(median:43.09),followed by food security(median:53.78),governance(median:54.77),climate change(median:64.12)and zoonotic diseases(median:69.23).Globally,the scores of GOHI vary spatially,with the highest score in North America while lowest in sub-Saharan Africa.In addition,evidence shows associations between the socio-demographic profile of countries/territories and their GOHI performance in certain One Health scenarios.Conclusion:The objective of GOHI is to guide impactful strategies for enhancing capacity building in One Health.With advanced technology and an annually updated database,intensifying efforts to refine GOHI's data-mining methodologies become imperative.The goal is to offer profound insights into disparities and progressions in practical One Health implementation,particularly in anticipation of future pandemics.展开更多
BACKGROUND Invasive functional evaluation by fractional flow reserve(FFR)is considered as a gold standard for the evaluation of intermediate coronary stenosis.However,in patients with diabetes due to accelerated progr...BACKGROUND Invasive functional evaluation by fractional flow reserve(FFR)is considered as a gold standard for the evaluation of intermediate coronary stenosis.However,in patients with diabetes due to accelerated progression of atherosclerosis the outcome may be worse even in the presence of negative functional testing.CASE SUMMARY We present a case of 55-year-old male diabetic patient who was admitted for chest pain.Diagnostic coronary angiography disclosed 2 intermediate stenoses of the obtuse marginal branch with no evidence of restenosis on previously implanted stent.Patient undergone invasive functional testing of intermediate lesion with preserved FFR(0.88),low coronary flow reserve(1.2)and very high index of microvascular resistance(84).Due to discrepancy in invasive functional parameters,intravascular imaging with optical coherence tomography showed fibrotic stenoses without signs of thin-sup fibroatheroma.Because of the preserved FFR and no signs of vulnerable plaque,the interventional procedure was deferred and the patient continued with optimal medications.CONCLUSION Combined functional and anatomic imaging of intermediate coronary stenosis in diabetic patients represent comprehensive contemporary decision pathway in the management of the patients.展开更多
文摘Gastric cancer(GC)remains a leading cause of cancer-related mortality worldwide,necessitating the identification of reliable prognostic indicators to enhance treatment outcomes.Recent research has highlighted the triglyceride-glucose(TyG)index as a potential surrogate marker for insulin resistance,which may significantly influence the prognosis of patients undergoing immunotherapy combined with chemotherapy.In this context,the study by Yao et al demonstrates that a high TyG index correlates with improved overall survival and progressionfree survival in advanced GC patients receiving sintilimab and chemotherapy.Specifically,patients in the high TyG group had a significantly longer median progression-free survival of 9.8 months[95%confidence interval(CI):9.2-10.9]compared to 8.0 months(95%CI:7.5-8.5)in the low TyG group(hazard ratio=0.58,95%CI:0.43-0.79,P<0.001).Similarly,the median overall survival was significantly longer in the high TyG group at 23.1 months(95%CI:21.2-NA)vs 16.5 months(95%CI:13.9-18.3)in the low TyG group(hazard ratio=0.30,95%CI:0.21-0.42,P<0.001).These findings underscore the strong prognostic potential of the TyG index in guiding treatment strategies for advanced GC.These findings underscore the need for further investigation into the TyG index’s role as a prognostic tool and its underlying mechanisms in influencing treatment efficacy.We advocate for additional multicenter studies to validate these results and explore the TyG index’s applicability across diverse patient populations,ultimately aiming to refine treatment strategies and improve patient outcomes in advanced GC.
文摘BACKGROUND Detection of early chronic changes in the kidney allograft is important for timely intervention and long-term survival.Conventional and novel ultrasound-based investigations are being increasingly used for this purpose with variable results.AIM To compare the diagnostic performance of resistive index(RI)and shear wave elastography(SWE)in the diagnosis of chronic fibrosing changes of kidney allograft with histopathological results.METHODS This is a cross-sectional and comparative study.A total of 154 kidney transplant recipients were included in this study,which was conducted at the Departments of Transplantation and Radiology,Sindh Institute of Urology and Transplantation,Karachi,Pakistan,from August 2022 to February 2023.All consecutive patients with increased serum creatinine levels and reduced glomerular filtration rate(GFR)after three months of transplantation were enrolled in this study.SWE and RI were performed and the findings of these were evaluated against the kidney allograft biopsy results to determine their diagnostic utility.RESULTS The mean age of all patients was 35.32±11.08 years.Among these,126(81.8%)were males and 28(18.2%)were females.The mean serum creatinine in all patients was 2.86±1.68 mg/dL and the mean estimated GFR was 35.38±17.27 mL/min/1.73 m2.Kidney allograft biopsy results showed chronic changes in 55(37.66%)biopsies.The sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)of SWE for the detection of chronic allograft damage were 93.10%,96.87%%,94.73%,and 95.87%,respectively,and the diagnostic accuracy was 95.45%.For RI,the sensitivity,specificity,PPV,and NPV were 76.92%,83.33%,70.17%,and 87.62%,respectively,and the diagnostic accuracy was 81.16%.CONCLUSION The results from this study show that SWE is more sensitive and specific as compared to RI in the evaluation of chronic allograft damage.It can be of great help during the routine follow-up of kidney transplant recipients for screening and early detection of chronic changes and selecting patients for allograft biopsy.
文摘BACKGROUND The hemodynamic alterations seen in liver cirrhosis lead to renal vasoconstriction,ultimately causing acute kidney injury(AKI).The renal resistive index(RRI)is the most common Doppler ultrasound variable for measuring intrarenal vascular resistance.AIM To evaluate the association of the RRI with AKI in patients with liver cirrhosis and to identify risk factors for high RRI.METHODS This was a prospective observational study,where RRI was measured using Doppler ultrasound in 200 consecutive hospitalized patients with cirrhosis.The association of RRI with AKI was studied.The receiver operating characteristic(ROC)curve analysis was utilized to determine discriminatory cut-offs of RRI for various AKI phenotypes.Multivariate analysis was conducted to determine the predictors of high RRI.RESULTS The mean patient age was 49.08±11.68 years,with the majority(79.5%)being male;the predominant etiology of cirrhosis was alcohol(39%).The mean RRI for the study cohort was 0.68±0.09,showing a progressive increase with higher Child-Pugh class of cirrhosis.Overall,AKI was present in 129(64.5%)patients.The mean RRI was significantly higher in patients with AKI compared to those without it(0.72±0.06 vs 0.60±0.08;P<0.001).A total of 82 patients(41%)had hepatorenal syndrome(HRS)-AKI,29(22.4%)had prerenal AKI(PRA),and 18(13.9%)had acute tubular necrosis(ATN)-AKI.The mean RRI was significantly higher in the ATN-AKI(0.80±0.02)and HRS-AKI(0.73±0.03)groups than in the PRA(0.63±0.07)and non-AKI(0.60±0.07)groups.RRI demonstrated excellent discriminatory ability in distinguishing ATN-AKI from non-ATN-AKI(area under ROC curve:93.9%).AKI emerged as an independent predictor of high RRI(adjusted odds ratio[OR]:11.52),and high RRI independently predicted mortality among AKI patients(adjusted OR:3.18).CONCLUSION In cirrhosis patients,RRI exhibited a significant association with AKI,effectively differentiated between AKI phenotypes,and predicted AKI mortality.
基金Supported by Suzhou Municipal Science and Technology Program of China,No.SKJY2021012.
文摘BACKGROUND Colorectal polyps(CPs)are frequently occurring abnormal growths in the colorectum,and are a primary precursor of colorectal cancer(CRC).The triglyceride-glucose(TyG)index is a novel marker that assesses metabolic health and insulin resistance,and has been linked to gastrointestinal cancers.AIM To investigate the potential association between the TyG index and CPs,as the relation between them has not been documented.METHODS A total of 2537 persons undergoing a routine health physical examination and colonoscopy at The First People's Hospital of Kunshan,Jiangsu Province,China,between January 2020 and December 2022 were included in this retrospective cross-sectional study.After excluding individuals who did not meet the eligibility criteria,descriptive statistics were used to compare characteristics between patients with and without CPs.Logistic regression analyses were conducted to determine the associations between the TyG index and the prevalence of CPs.The TyG index was calculated using the following formula:Ln[triglyceride(mg/dL)×glucose(mg/dL)/2].The presence and types of CPs was determined based on data from colonoscopy reports and pathology reports.RESULTS A nonlinear relation between the TyG index and the prevalence of CPs was identified,and exhibited a curvilinear pattern with a cut-off point of 2.31.A significant association was observed before the turning point,with an odds ratio(95% confidence interval)of 1.70(1.40,2.06),P<0.0001.However,the association between the TyG index and CPs was not significant after the cut-off point,with an odds ratio(95% confidence interval)of 0.57(0.27,1.23),P=0.1521.CONCLUSION Our study revealed a curvilinear association between the TyG index and CPs in Chinese individuals,suggesting its potential utility in developing colonoscopy screening strategies for preventing CRC.
文摘Background: In response to the escalating burden of cardiovascular diseases (CVDs) worldwide, exacerbated by lifestyle changes and socioeconomic shifts, acute coronary syndromes (ACS) stand out as a leading cause of morbidity and mortality. The pivotal role of insulin resistance in the pathogenesis of atherosclerosis, independent of traditional risk factors, has garnered significant interest. Objective: This review aims to synthesize the recent advancements in the utilization of the triglyceride glucose index (TyG index) as a biomarker for assessing the severity and predicting the prognosis of ACS lesions. Methods: A systematic search was conducted across PubMed, Embase, and Scopus databases, incorporating keywords such as “triglyceride glucose index”, “TyG index”, “acute coronary syndrome”, “cardiovascular disease”, “insulin resistance”, “coronary artery calcification”, “SYNTAX score”, “Gensini score”, and “major adverse cardiac events”. Studies were included from the inception of each database up to July 2024. Selection criteria encompassed observational studies, case-control studies, and randomized controlled trials, with a particular emphasis on evaluating the diagnostic and prognostic value of the TyG index in patients with acute coronary syndromes. Ultimately, 46 publications met the inclusion criteria. Data extraction and quality assessment were performed in accordance with established guidelines. Results: Evidence suggests that the TyG index, reflecting insulin resistance, blood glucose, and lipid levels, is significantly associated with lesion severity in ACS, including coronary artery calcification, SYNTAX score, and Gensini score. Moreover, it demonstrates predictive power for major adverse cardiovascular events, underscoring its potential as a valuable tool in clinical decision-making. Conclusion: The review highlights the emerging role of the TyG index in the assessment and prognosis of ACS, advocating for its incorporation into clinical practice as a complement to existing diagnostic modalities. However, the establishment of standardized reference ranges and further validation across diverse populations are warranted to refine its applicability in personalized medicine. The interdisciplinary approach is essential to advance our understanding of the complex interplay between insulin resistance and cardiovascular disease, paving the way for the development of more effective prevention and treatment strategies.
基金Supported by the National Key R D Program of China,No.2022YFC2010102Natural Science Foundation of Hunan Province,No.2021JC0003+1 种基金National Natural Science Foundation of China,No.82070812the Sinocare Diabetes Foundation,No.LYF2022039.
文摘ACKGROUND The hemoglobin glycation index(HGI)represents the discrepancy between the glucose management indicator(GMI)based on mean blood glucose levels and laboratory values of glycated hemoglobin(HbA1c).The HGI is a promising indicator for identifying individuals with excessive glycosylation,facilitating personalized evaluation and prediction of diabetic complications.However,the factors influencing the HGI in patients with type 1 diabetes(T1D)remain unclear.Autoimmune destruction of pancreaticβcells is central in T1D pathogenesis,yet insulin resistance can also be a feature of patients with T1D and their coexistence is called“double diabetes”(DD).However,knowledge regarding the relationship between DD features and the HGI in T1D is limited.AIM To assess the association between the HGI and DD features in adults with T1D.METHODS A total of 83 patients with T1D were recruited for this cross-sectional study.Laboratory HbA1c and GMI from continuous glucose monitoring data were collected to calculate the HGI.DD features included a family history of type 2 diabetes,overweight/obesity/central adiposity,hypertension,atherogenic dyslipidemia,an abnormal percentage of body fat(PBF)and/or visceral fat area(VFA)and decreased estimated insulin sensitivity.Skin autofluorescence of advanced glycation end products(SAF-AGEs),diabetic complications,and DD features were assessed,and their association with the HGI was analyzed.RESULTS A discrepancy was observed between HbA1c and GMI among patients with T1D and DD.A higher HGI was associated with an increased number of SAF-AGEs and a higher prevalence of diabetic microangiopathy(P=0.030),particularly retinopathy(P=0.031).Patients with three or more DD features exhibited an eight-fold increased risk of having a high HGI,compared with those without DD features(adjusted odds ratio=8.12;95%confidence interval:1.52-43.47).Specifically,an elevated PBF and/or VFA and decreased estimated insulin sensitivity were associated with high HGI.Regression analysis identified estimated insulin sensitivity and VFA as factors independently associated with HGI.CONCLUSION In patients with T1D,DD features are associated with a higher HGI,which represents a trend toward excessive glycosylation and is associated with a higher prevalence of chronic diabetic complications.
基金Supported by Ministry of Education,Science and Technological Development,Belgrade,Republic of Serbia,Project No.175036
文摘AIM:To evaluate the clinical significance of cystatin C and renal resistive index for the determination of renal function in patients with liver cirrhosis.METHODS:We conducted a study of 63 patients with liver cirrhosis.A control group comprised of 30 age and gender-matched healthy persons.Serum cystatin C was determined in all study subjects and renal Doppler ultrasonography was made.Estimated glomerular filtration rate from serum creatinine(GFRCr)and cystatin C(GFRCys)was calculated.RESULTS:We confirmed significant differences in val-ues of cystatin C between patients with different stages of liver cirrhosis according to Child-Pugh(P=0.01),and a significant correlation with model of end stage liver disease(MELD)score(rs=0.527,P<0.001).More patients with decreased glomerular filtration rate were identified based on GFRCys than on GFRCr(P<0.001).Significantly higher renal resistive index was noted in Child-Pugh C than in A(P<0.001)and B stage(P=0.001).Also,a significant correlation between renal resistive index and MELD score was observed(rs=0.607,P<0.001).Renal resistive index correlated significantly with cystatin C(rs=0.283,P=0.028)and showed a negative correlation with GFRCys(rs=-0.31,P=0.016).CONCLUSION:Cystatin C may be a more reliable marker for assessment of liver insufficiency.Additionally,cystatin C and renal resistive index represent sensitive indicators of renal dysfunction in patients with liver cirrhosis.
文摘AIM: To assess the relation between central retinal artery(CRA) resistive index(RI) and retinal nerve fiber thickness measured by optical coherence tomography(OCT) in assessment of disease progress in cases of open angle glaucoma.METHODS: Twenty-three patients with diagnosed open angle glaucoma were included in this study. They were examined by colored duplex ultrasonography of CRA with estimation of RI of CRA and ophthalmic artery(OA)with estimation of CRA/OA RI ratio as well as OCT measurement of the average retinal nerve fiber layer(RNFL) thickness in order to assess the disease progress.RESULTS: There was strong inverse relation between the increased RI in CRA as well as the increased CRA/OA RI ratio and the decrease in average RNFL thickness in cases of open angle glaucoma.CONCLUSION: Assessment of CRA RI can indirectly assess the vascular changes associated with glaucoma and can assess the degree of retinal atrophy helping in evaluating prognosis thus guiding the choice of treatment.
文摘Aim: To determine the relationship of carotid plaque, intima media thickness (IMT), resistivity index (RI) and pulsatility index (PI) and prevalence of different risk factors with acute ischemic stroke and stroke subtypes in both diabetic and non-diabetic subjects. Materials and methods: 80 cases of acute ischemic strokes and 40 healthy controls were included in the study. The plaque, IMT, RI and PI were measured by carotid duplex ultrasound. Results: 31 subjects were Type 2 diabetic, 54 hypertensive while 25 were both diabetic and hypertensive. 23 cases (28.75%) had lacunar stroke (LACI), 32 (40%) stroke involving partial anterior circulation(PACI), 10(12.5%) stroke in posterior circulation (PACI) and 15(18.75%) stroke involving total anterior circulation(TACI) respectively. The mean IMT (0.88 ± 0.19mm), RI(0.76 ± 0.05) and PI(1.71 ± 0.19) of patients and mean IMT (0.6±0.09mm), RI (0.61 ± 0.06) and PI (1.53 ± 0.11) of controls were statistically significant (p-0.000). The mean values of IMT, PI and RI were significantly higher in diabetics (IMT-0.90 ± 0.16 VS 0.64 ± 0.11, p-0.013;PI-1.76 ± 0.20 VS 1.49 ± 0.09, P-0.000 and RI-0.76 ± 0.04 VS 0.59 ± 0.06, P-0.000) and similarly the mean values for IMT, PI and RI in hypertensives as compared to controls (IMT-0.88 ± 0.16 vs 0.65 ± 0.10, P-0.006;PI1.69 ± 0.18 vs 1.49 ± 0.09, P-0.000 and RI 0.76 ± 0.04 vs 0.59 ± 0.06, P-0.000). The mean IMT, PI and RI were increased significantly in smokers compared to controls (IMT-0.93 ± 0.20 vs 0.63 ± 0.06, P-0.000;PI-1.82 ± 0.22 vs 1.49 ± 0.09, P-0.000 and RI-0.77 ± 0.04 vs 0.59 ± 0.06, P-0.000). Type 3 plaque accounted for 27 (56.2%) cases and Type 2 plaque 12 (25%) cases. The total number of plaques in patients as compared to controls were significantly more (P-0.0034) and the mean plaque area was 46 mm2 for cases and 20 mm2 for control (P-0.0001). TACI was the most common type of ischemic stroke seen in DM (60%), HTN (66.6%) and smokers (66.7%). Plaques (73.3%), IMT (0.90 ± 0.12), PI(1.72 ± 0.14) and RI (0.76 ± 0.13) were more commonly associated with TACI subtype. On multivariate analysis using ANOVA, the mean PI was highly significant (0.000) in relation to types of plaque. Summary and Conclusions: IMT, RI, PI and plaque type are useful diagnostic parameters for acute ischemic stroke and its subtypes. They can be used as noninvasive tools for predicting and preventing ischemic stroke in smokers as well as subjects with DM and hypertension.
基金This study was supported by the National Natural Science Foundation of China(31771722)the Open Fund of the Guangxi Key Laboratory of Rice Genetics and Breeding(2018-15-Z06-KF17).
文摘The“super rice”breeding program in China has been successful in developing high-yielding hybrids,including few with high harvest index values.However,there is limited information on the relationship between lodging resistance and harvest index,and the mechanisms underlying the relationship in super-rice hybrids.In this study,a two-year field experiment was conducted to compare lodging resistance and its related traits between two superrice hybrids differing in harvest index,i.e.,Guiliangyou 2(G2)with a high harvest index and Y-liangyou 1(Y1)with a typical harvest index of modern high-yielding rice varieties.Results showed that compared to Y1,G2 was lower in plant height due to its lower aboveground N uptake,and its higher stem breaking resistance(i.e.,lower stem breaking index)resulted from a lower stem height at its center of gravity.Consequently,G2 had a higher lodging resistance(i.e.,lower plant lodging index)than Y1.This study suggests that developing super-rice hybrids with high harvest index values is a possible way to achieve both high grain yield and strong lodging resistance in rice.
基金the Open Fund of State Key Laboratory of Oil and Gas Reservoir Geology and Exploitation(Southwest Petroleum University)(Grant No.PLN201719)the Open Fund of Shandong Provincial Key Laboratory of Depositional Mineralization&Sedimentary Mineral(Shandong University of Science and Technology)(Grant No.DMSM2018050)+2 种基金the Scientific Research Starting Project of SWPU(Grant No.2017QHZ004)the Preferential Funded Technological Project for Overseas Talents Returned to Sichuan ProvinceThe supports are gratefully acknowledged.
文摘Tight sandstone,with severe diagenesis and complex pore structure,differs greatly from conventional sandstone in terms of rock electrical parameters.In subsurface rock electrical experiments,various electrical parameters are confounded and can only be analyzed qualitatively.The lack of quantitative analysis for each individual electrical parameter presents a challenge for the evaluation of oil and gas saturation in tight sandstone.Based on the 2D pore-throat model and the features of pore structure in the tight sandstone of the Penglaizhen and Shaximiao Formations in the upper and middle Jurassic of the Western Sichuan Depression,this paper presents 3D micro pore-throat models for three types of tight sandstone.It proposes a finite element-based rock electrical simulation method to analyze the influence of pore structure parameters,such as throat radius and throat tortuosity,on electrical parameters such as resistivity,formation factor,and cementation index quantitatively.The research revealed the following results:(1)Throats of tight sandstone usually have lamellar or curved lamellar shapes that are slender and narrow.The lamellar throat used in the proposed porethroat model is more consistent with the features of tight sandstone than the tubular throat used in the original model.(2)The throat determines the conductivity of tight sandstone.The throat parallel to the electric potential has the greatest influence on conductivity,and the throat perpendicular to the potential has the least influence.(3)In tight sandstone grades I to III,as the porosity decreases,the formation factor increases and the cementation index decreases.(4)The results of the rock electrical simulation are consistent with the results of the rock electrical experiment,which indicates that the proposed rock electrical simulation method of tight sandstone is effective and accurate.
基金Supported by Natural Science Foundation of Ningxia(NZ1189)National Rice Industrial Technology System(CARS-01-84)
文摘The morphological characters, physiological characters, yield traits and yield per plant of total 49 rice cultivars from Ningxia were investigated under conditions of water stress and non-water stress so as to determine the relationship between each trait and yield per plant under water stress and the relationship between each relative character and drought resistance coefficient under water stress and non-water stress. The correlation, grey correlation, stepwise regression and path analyses showed that the tiller number per plant, plant height, grain density, effective panicle number per plant and grain number per panicle, total 5 traits, were significantly correlated with the drought resistance of rice, and they could be used to identify the drought resistance of rice in Ningxia. In addition, the drought resistance of rice was graded qualitatively according to the subordinate function value of corresponding drought resistance coefficient. The results showed that among the 49 rice cultivars from Ningxia,6 rice cultivars were highly drought resistant, and 9 rice cultivars were moderately drought resistant, suggesting that the evaluation method was feasible and effective.
文摘Objective: To prospectively evaluate the diagnostic utility of interlobar renal arterial resistive index values, in predicting the presence of vesicoureteral reflux in children with sonographically normal appearing kidneys. Methods: We investigated 35 children with a history of urinary tract infection with grayscale and color Doppler ultrasound (US) fol-lowed by a standard voiding cystouretherogram to assess the presence of vesicoureteral reflux. All renal units (individ-ual kidneys) were morphologically normal without evidence of hydronephrosis. Resistive index (RI) was measured at the level of the interlobar arteries. Results: Of a total of 67 kidney units, 3 kidney units yielded no diagnostic results due to technical factors (crying, agitation). 46 kidney units (69%) were not associated with any degree of reflux. 17 kidney units (25%) were associated with low-mid grade reflux (grades I - III). 4 kidney units (6%) were associated with high grade reflux (grades IV - V). No statistically significant correlation was found between the interlobar resistive indices of sonographically normal appearing kidneys and the presence, absence, or degree of vesicoureteral reflux. Conclusions: The results of this study suggest that resistive index measurements taken in the interlobar arteries of sonographically normal appearing kidneys cannot be used to predict the presence or absence of vesicoureteral reflux.
文摘Background: One of the most common causes of renal impairment and development of chronic kidney disease is diabetes mellitus type 2 (DM 2). The aim of this prospective study was to determine the role of Resistive Index (RI) as a non-invasive marker for the evaluation of renal impairment in patients with DM 2. Material and Methods: 47 patients with DM 2 in mean age 62.66 ± 10.081 years were included in the study for the period of one year. All of them were with well-compensated diabetes mellitus (HbA1c Results: Patients with RI 0.05 for all). There was significant difference between the groups according to serum creatinine (p = 0.026), GFR (p = 0.044) and the degree of proteinuria (p = 0.001). There was a positive correlation between RI and serum creatinine (r = 0.418;p = 0.001) and between RI and proteinuria (r = 0.396;p = 0.004). A negative correlation relationship between RI and GFR values was found (r = –0.413;p = 0.011). Conclusions: RI may be used as an indicator for the assessment of the severity of renal impairment in patients with DM 2. It correlates well with serum creatinine, GFR and proteinuria, which are proven biochemical parameters indicating the degree of renal damage in patients with DM 2.
基金supported by China Medical Board[No.20–365]Bill&Melinda Gates Foundation[No.INV-046218]the National Natural Science Foundation of China[No.72204160].
文摘Background:In the 21st century,as globalization accelerates and global public health crises occur,the One Health approach,guided by the holistic thinking of human-animal-environment and emphasizing interdisciplinary collaboration to address global health issues,has been strongly advocated by the international community.An immediate requirement exists for the creation of an assessment tool to foster One Health initiatives on both global and national scales.Methods:Built upon extensive expert consultations and dialogues,this follow-up study enhances the 2022 global One Health index(GOHI)indicator system.The GOHI framework is enriched by covering three indices,e.g.external drivers index(EDI),intrinsic drivers index(IDI),and core drivers index(CDI).The comprehensive indicator system incorporates 13 key indicators,50 indicators,and 170 sub I-indicators,utilizing a fuzzy analytic hierarchy process to ascertain the weight for each indicator.Weighted and summed,the EDI,IDI,and CDI scores contribute to the computation of the overall GOHI 2022 score.By comparing the ranking and the overall scores among the seven regions and across 160 countries/territories,we have not only derived an overall profile of the GOHI 2022 scores,but also assessed the GOHI framework.We also compared rankings of indicators and sub Iindicators to provide greater clarity on the strengths and weaknesses of each region within the One Health domains.Results:The GOHI 2022 performance reveals significant disparities between countries/territories ranged from 39.03 to 70.61.The global average score of the GOHI 2022 is 54.82.The average score for EDI,IDI,and CDI are 46.57,58.01,and 57.25,respectively.In terms of global rankings,countries from North America,Europe and Central Asia,East Asia and Pacific present higher scores.In terms of One Health domains of CDI,the lowest scores are observed in antimicrobial resistance(median:43.09),followed by food security(median:53.78),governance(median:54.77),climate change(median:64.12)and zoonotic diseases(median:69.23).Globally,the scores of GOHI vary spatially,with the highest score in North America while lowest in sub-Saharan Africa.In addition,evidence shows associations between the socio-demographic profile of countries/territories and their GOHI performance in certain One Health scenarios.Conclusion:The objective of GOHI is to guide impactful strategies for enhancing capacity building in One Health.With advanced technology and an annually updated database,intensifying efforts to refine GOHI's data-mining methodologies become imperative.The goal is to offer profound insights into disparities and progressions in practical One Health implementation,particularly in anticipation of future pandemics.
文摘BACKGROUND Invasive functional evaluation by fractional flow reserve(FFR)is considered as a gold standard for the evaluation of intermediate coronary stenosis.However,in patients with diabetes due to accelerated progression of atherosclerosis the outcome may be worse even in the presence of negative functional testing.CASE SUMMARY We present a case of 55-year-old male diabetic patient who was admitted for chest pain.Diagnostic coronary angiography disclosed 2 intermediate stenoses of the obtuse marginal branch with no evidence of restenosis on previously implanted stent.Patient undergone invasive functional testing of intermediate lesion with preserved FFR(0.88),low coronary flow reserve(1.2)and very high index of microvascular resistance(84).Due to discrepancy in invasive functional parameters,intravascular imaging with optical coherence tomography showed fibrotic stenoses without signs of thin-sup fibroatheroma.Because of the preserved FFR and no signs of vulnerable plaque,the interventional procedure was deferred and the patient continued with optimal medications.CONCLUSION Combined functional and anatomic imaging of intermediate coronary stenosis in diabetic patients represent comprehensive contemporary decision pathway in the management of the patients.
