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The effect of periodic resistance training on obese patients with type 2 diabetic nephropathy.
Li, S, Yuan, S, Zhang, J, Xu, F, Zhu, F
Scientific reports. 2024;(1):2761
Abstract
Resistance training is an exercise against resistance designed to train the endurance and strength of muscle. To observe the effect of intervention of periodic resistance training on obese patients with type 2 diabetic nephropathy. A total of 60 obese patients with type 2 diabetic nephropathy were randomized into resistance training group and aerobic exercise group (30 patients each group) for observing the changes of blood glucose, body weight, blood lipid, insulin resistance, serum creatinine (Scr), urinary microalbumin, urinary albumin excretion rate (UAER) calculated by urinary creatinine, and glomerular filtration rate (GFR) after 12 weeks of intervention, and relevant significance as well. The number of patients with hypoglycemia during the intervention was also recorded. After 12 weeks of intervention, the weight, Body mass index (BMI), Waist, Triglyceride (TG), Cholesterol (TC), Low-density lipoprotein cholesterol (LDL), Fasting glucose (FBG), Fasting insulin (FINS), Glycosylated hemoglobin (HbA1c) and urine Albumin-Creatinine Ratio (uACR) were decreased and GFR was increased in both groups (P < 0.05), but the effect was more significant in the resistance training group. GFR was increased from 92.21 ± 10.67 mL/(min·1.73 m2) to 100.13 ± 12.99 mL/(min·1.73 m2) in resistance training group (P < 0.05). In the aerobic exercise group, GFR was increased from 89.98 ± 9.48 mL/(min·1.73 m2) to 92.51 ± 11.35 mL/(min·1.73 m2) (P > 0.05). Periodic resistance training can not only control the weight, blood sugar and blood lipid of obese patients with type 2 diabetic nephropathy, but also improve the urinary albumin excretion rate and glomerular filtration rate of early obese patients with type 2 diabetic nephropathy, and delay the progression of diabetic nephropathy. It is an effective non-drug intervention.
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Actively implementing an evidence-based feeding guideline for critically ill patients (NEED): a multicenter, cluster-randomized, controlled trial.
Ke, L, Lin, J, Doig, GS, van Zanten, ARH, Wang, Y, Xing, J, Zhang, Z, Chen, T, Zhou, L, Jiang, D, et al
Critical care (London, England). 2022;(1):46
Abstract
BACKGROUND Previous cluster-randomized controlled trials evaluating the impact of implementing evidence-based guidelines for nutrition therapy in critical illness do not consistently demonstrate patient benefits. A large-scale, sufficiently powered study is therefore warranted to ascertain the effects of guideline implementation on patient-centered outcomes. METHODS We conducted a multicenter, cluster-randomized, parallel-controlled trial in intensive care units (ICUs) across China. We developed an evidence-based feeding guideline. ICUs randomly allocated to the guideline group formed a local "intervention team", which actively implemented the guideline using standardized educational materials, a graphical feeding protocol, and live online education outreach meetings conducted by members of the study management committee. ICUs assigned to the control group remained unaware of the guideline content. All ICUs enrolled patients who were expected to stay in the ICU longer than seven days. The primary outcome was all-cause mortality within 28 days of enrollment. RESULTS Forty-eight ICUs were randomized to the guideline group and 49 to the control group. From March 2018 to July 2019, the guideline ICUs enrolled 1399 patients, and the control ICUs enrolled 1373 patients. Implementation of the guideline resulted in significantly earlier EN initiation (1.20 vs. 1.55 mean days to initiation of EN; difference - 0.40 [95% CI - 0.71 to - 0.09]; P = 0.01) and delayed PN initiation (1.29 vs. 0.80 mean days to start of PN; difference 1.06 [95% CI 0.44 to 1.67]; P = 0.001). There was no significant difference in 28-day mortality (14.2% vs. 15.2%; difference - 1.6% [95% CI - 4.3% to 1.2%]; P = 0.42) between groups. CONCLUSIONS In this large-scale, multicenter trial, active implementation of an evidence-based feeding guideline reduced the time to commencement of EN and overall PN use but did not translate to a reduction in mortality from critical illness. TRIAL REGISTRATION ISRCTN, ISRCTN12233792 . Registered November 20th, 2017.
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Monitoring intraocular proangiogenic and profibrotic cytokines within 7 days after adjunctive anti-vascular endothelial growth factor therapy for proliferative diabetic retinopathy.
Hu, Z, Cao, X, Chen, L, Su, Y, Ji, J, Yuan, S, Fransisca, S, Mugisha, A, Zou, W, Xie, P, et al
Acta ophthalmologica. 2022;(3):e726-e736
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Abstract
PURPOSE To monitor the intraocular proangiogenic and profibrotic cytokine profiles within 7 days after intravitreous injection of conbercept (IVC) for patients with proliferative diabetic retinopathy (PDR). METHODS This prospective, randomized controlled, consecutive, comparative study included 157 eyes with PDR. Participant eyes underwent sham IVC or IVC and subsequent vitrectomy at days 2, 3, 4, 5, 6, 7 postinjection. The intraocular cytokines profiles were measured using beaded assay methods. RESULTS After IVC, the vascular endothelial growth factor (VEGF)-A level in PDR vitreous decreased rapidly by approximately 10 times at day 2 (p = 0.00001) and kept at a low level at days 3, 4, 5, 6, 7 (p < 0.001, each compared with IVC-sham group). Similar tendency of the change in VEGF-A was observed in aqueous humour. The level of placenta growth factor (PIGF) in aqueous humour decreased 2 days after IVC whereas returned to baseline level after 5 days. The vitreous profibrotic cytokines, tissue growth factor (TGF)-β1, TGF-β2, TGF-β3 and connective tissue growth factor did not increase after IVC in each group. CONCLUSION We observed a remarkable and rapid decrease in intraocular VEGF-A, temporal decrease in PIGF from day 2 to day 4, increase in VEGF-C and VEGF-D from day 2 onwards, but no profibrotic switch in PDR eyes after IVC. The findings might suggest that ideal vitrectomy timing might be around 3 days after IVC.
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The effect of periodic ketogenic diet on newly diagnosed overweight or obese patients with type 2 diabetes.
Li, S, Lin, G, Chen, J, Chen, Z, Xu, F, Zhu, F, Zhang, J, Yuan, S
BMC endocrine disorders. 2022;22(1):34
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Plain language summary
Currently, the ketogenic diet is gaining popularity in managing Type 2 diabetes (T2D). Ketogenic diets replace carbohydrates with fat and include limited carbohydrates and adequate protein. This randomised controlled trial evaluated the effects of the 12-week ketogenic diet on sixty overweight or obese T2D patients. Both the ketogenic and control diabetes diet groups achieved significant reductions in weight, body mass index, waist circumference, triglycerides, total cholesterol, low-density lipoprotein, high-density lipoprotein, fasting blood glucose, fasting insulin, and HbA1c. However, the ketogenic group showed significantly greater reductions in body mass, blood lipids, and blood glucose than the control group. In the ketogenic diet group, serum uric acid levels were higher than those in the control diet group. It was found that the control diet group adhered to the diet for a longer period than the ketogenic diet group, whose willingness to adhere to the diet long-term was weaker. More robust long-term studies are needed to evaluate the long-term effects of a ketogenic diet. In this study, more patients who followed the ketogenic diet experienced hypoglycaemic events during the first four weeks. Healthcare providers should exercise caution when recommending a short term therapeutic ketogenic diet.
Abstract
BACKGROUND The ketogenic diet (KD) is characterized by fat as a substitute of carbohydrates for the primary energy source. There is a large number of overweight or obese people with type 2 diabetes mellitus (T2DM), while this study aims to observe periodic ketogenic diet for effect on overweight or obese patients newly diagnosed as T2DM. METHODS A total of 60 overweight or obese patients newly diagnosed as T2DM were randomized into two groups: KD group, which was given ketogenic diet, and control group, which was given routine diet for diabetes, 30 cases in each group. Both dietary patterns lasted 12 weeks, and during the period, the blood glucose, blood lipid, body weight, insulin, and uric acid before and after intervention, as well as the significance for relevant changes, were observed. RESULTS For both groups, the weight, BMI(body mass index), Waist, TG (triglyceride), TC(cholesterol), LDL (low-density lipoprotein cholesterol), HDL (high-density lipoprotein cholesterol), FBG (fasting glucose), FINS (fasting insulin), HbA1c (glycosylated hemoglobin) were decreased after intervention (P < 0.05), while the decrease rates in the KD group was more significant than the control group. However, UA(serum uric acid) in the KD group showed an upward trend, while in the control group was not changed significantly (P > 0.05).The willingness to adhere to the ketogenic diet over the long term was weaker than to the routine diet for diabetes. CONCLUSION Among the overweight or obese patients newly diagnosed as type 2 diabetes mellitus, periodic ketogenic diet can not only control the body weight, but also control blood glucose and lipid, but long-term persistence is difficult.
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Effect of modified electroconvulsive therapy on neuro metabolites and magnetic resonance spectroscopy imaging signals in patients with refractory obsessive-compulsive disorder.
Liu, D, Liang, R, Bai, S, Lan, B, Liu, G, Wang, D, Yuan, S, Sun, W, Li, G
Journal of affective disorders. 2022;:616-621
Abstract
OBJECTIVE This study was aimed to investigate the effect of modified electroconvulsive therapy (MECT) on neurometabolites and magnetic resonance spectroscopy imaging (MRSI) signals in patients with refractory obsessive-compulsive disorder (OCD). METHODS From January 2018 to January 2020, 64 patients with OCD consecutively treated in the Psychiatric Department of our hospital were randomly divided into a study group treated with MECT and a control group treated with drugs alone. The obsessive-compulsive state, anxiety and depression, MRSI signals, neuro metabolite ratio, and quality of life were all observed in both groups. RESULTS After treatment, the scores of compulsive behaviors, obsessive thoughts, Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD) in the study group were lower than those of the control group. The N-acetylaspartate to creatine ratio (NAA/Cr) value was increased in the study group while it was decreased in the control group. In addition, the choline/creatine (Cho/Cr) ratio was decreased in the study group, whereas it was increased in the control group (P < 0.05). Compared to the control group, the study group's social and physiological functions, role limitations, and overall health scores were significantly higher. The amplitudes of low-frequency fluctuations were reduced considerably following MECT treatment in the right anterior cerebellar lobe, left inferior parietal lobule, right paracentral lobule, and right precentral gyrus. CONCLUSIONS MECT can effectively relieve obsessive-compulsive symptoms, regulate neuro metabolite levels, improve quality of life, reduce anxiety and depression, and is linked to changes in right brain functional activities.
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Effects of single-dose L-theanine on motor cortex excitability.
Yuan, S, Brown, JC, Gold, M, Tirrell, E, Jones, RN, Carpenter, LL
Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology. 2021;(9):2062-2064
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Comparison of Cardioprotective Effects of Propofol versus Sevoflurane in Pediatric Living Donor Liver Transplantation.
Weng, Y, Yuan, S, Li, H, Yu, W
Annals of transplantation. 2020;:e923398
Abstract
BACKGROUND Our study compared the myocardiac protective effect of propofol vs. sevoflurane in pediatric patients receiving living donor liver transplantation (LDLT) surgery. MATERIAL AND METHODS We randomly and equally divided 120 children who underwent LDLT into a sevoflurane group and a propofol group. Preoperative, intraoperative, and postoperative data were collected and compared between the 2 groups. The concentrations of cTnI, CK-MB, IL-6, TNF-alpha, and HMGB1 at 5 min after induction (T0), 30 min in the anhepatic period (T1), and 3 h after reperfusion (T2), and at the end of surgery (T3) were measured. RESULTS There was no statistically significant difference in the characteristics of children in the 2 groups. Compared with T0, the levels of IL-6 and TNF-alpha at T1, T2, and T3 were higher, while the HMGB1 at T2 and T3 were higher (P<0.05). A similar trend for IL-6, TNF-alpha, and HMGB1 at different time points in the 2 groups was observed. Compared with T0, the cTnI and CK-MB at T2 and T3 were significantly higher (P<0.05), but there was no significant difference at different time points in the 2 groups. For the adverse events, there was no significant difference between the 2 groups. CONCLUSIONS Our study shows that the cardioprotective effect in pediatric patients undergoing living donor liver transplantation is similar with propofol and sevoflurane anesthesia.
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Thin Rigid Contact Lens Used in Vitreous-Retinal Surgery for Corneal Protection: A Randomized Controlled Trial.
Hu, Z, Ding, Y, Zheng, X, Yuan, S, Li, J, Xie, P, Liu, Q
Eye & contact lens. 2018;:S355-S360
Abstract
PURPOSE To design a rigid contact lens (CL) to be used in combination with a wide-angle viewing system and analyze its protection for corneal epithelial during vitreous-retinal surgery. METHODS A thin and lightweight rigid CL was designed and constructed. The impact of the CL on the visualized fundus range was evaluated using a concrete eye model. Patients with severe proliferative diabetic retinopathy (PDR) were randomized to either the CL group, corneal protective agent (CPA) group, or balanced salt solution (BSS) group. All patients underwent phacoemulsification and a standard 23-gauge three-port vitrectomy. Surgery time and corneal fluorescein staining score (FSS) postoperatively were mainly measured. RESULTS In the eye model, a larger area of fundus was visualized with the use of our CL under 128 D or 60 D Resight lens. The mean surgery time was 51.36±8.06 min, 50.89±8.26 min, and 55.46±9.14 in CL, CPA, and BSS group, respectively (F=2.325, P=0.105). In eight eyes in the BSS group, corneal epithelial layer was peeled off because the dryness of the cornea could not maintain a clear fundus image. The FSS in BSS group was markedly higher than that of CL and BSS group 1 day (P<0.001), 3 days (P<0.001), and 7 days (P=0.002) postoperatively. There was no statistical significance of the FSS between CL and CPA group at each follow-up endpoint. CONCLUSIONS The CL that we designed can slightly enlarge the visible fundus range and efficiently protect corneal epithelium during vitrectomy for patients with PDR.
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Clinical Trial of the Potassium Channel Activator Diazoxide for Major Depressive Disorder Halted Due to Intolerability.
Kadriu, B, Yuan, S, Farmer, C, Nugent, AC, Lener, MS, Niciu, MJ, Park, M, Yazdian, A, Ballard, ED, Henn, FA, et al
Journal of clinical psychopharmacology. 2018;(3):243-246
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BACKGROUND Some glutamatergic modulators have demonstrated rapid and relatively sustained antidepressant properties in patients with major depressive disorder. Because the potassium channel activator diazoxide increases glutamate uptake via potassium channel activation, we hypothesized that it might exert antidepressant effects by increasing the removal of glutamate from the synaptic cleft, thereby reducing excessive glutamate transmission. METHODS This randomized, double-blind, placebo-controlled, crossover, single-site inpatient clinical study was conducted at the National Institute of Mental Health to assess the efficacy and safety of a 3-week course of diazoxide (200-400 mg daily, twice a day) versus a 3-week course of placebo in 6 participants with treatment-refractory major depressive disorder. The primary clinical outcome measure was change in Montgomery-Asberg Depression Rating Scale score from baseline to posttreatment. Quantitative insulin sensitivity check index, as well as concomitant imaging measures (electroencephalography, proton magnetic resonance spectroscopy, magnetoencephalography), were used as potential surrogate markers of target (KATP channel) engagement. RESULTS The study was halted due to severe adverse effects. Given the small sample size, statistical evaluation of the effect of diazoxide on Montgomery-Asberg Depression Rating Scale scores or the imaging measures was not pursued. Visual inspection of the quantitative insulin sensitivity check index test revealed no evidence of target engagement. CONCLUSIONS Although the results are negative, they are an important addition to the literature in this rapidly changing field.
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Low-Level Tragus Stimulation for the Treatment of Ischemia and Reperfusion Injury in Patients With ST-Segment Elevation Myocardial Infarction: A Proof-of-Concept Study.
Yu, L, Huang, B, Po, SS, Tan, T, Wang, M, Zhou, L, Meng, G, Yuan, S, Zhou, X, Li, X, et al
JACC. Cardiovascular interventions. 2017;(15):1511-1520
Abstract
OBJECTIVES The aim of this study was to investigate whether low-level tragus stimulation (LL-TS) treatment could reduce myocardial ischemia-reperfusion injury in patients with ST-segment elevation myocardial infarction (STEMI). BACKGROUND The authors' previous studies suggested that LL-TS could reduce the size of myocardial injury induced by ischemia. METHODS Patients who presented with STEMI within 12 h of symptom onset, treated with primary percutaneous coronary intervention, were randomized to the LL-TS group (n = 47) or the control group (with sham stimulation [n = 48]). LL-TS, 50% lower than the electric current that slowed the sinus rate, was delivered to the right tragus once the patients arrived in the catheterization room and lasted for 2 h after balloon dilatation (reperfusion). All patients were followed for 7 days. The occurrence of reperfusion-related arrhythmia, blood levels of creatine kinase-MB, myoglobin, N-terminal pro-B-type natriuretic peptide and inflammatory markers, and echocardiographic characteristics were evaluated. RESULTS The incidence of reperfusion-related ventricular arrhythmia during the first 24 h was significantly attenuated by LL-TS. In addition, the area under the curve for creatine kinase-MB and myoglobin over 72 h was smaller in the LL-TS group than the control group. Furthermore, blood levels of inflammatory markers were decreased by LL-TS. Cardiac function, as demonstrated by the level of N-terminal pro-B-type natriuretic peptide, the left ventricular ejection fraction, and the wall motion index, was markedly improved by LL-TS. CONCLUSIONS LL-TS reduces myocardial ischemia-reperfusion injury in patients with STEMI. This proof-of-concept study raises the possibility that this noninvasive strategy may be used to treat patients with STEMI undergoing primary percutaneous coronary intervention.