Weimin Wang

AIMS: To assess the prevalence of diabetic peripheral neuropathy (DPN) and its risk factors in the type 2 diabetes mellitus (T2DM) population. METHODS: This cross-sectional study enroled patients with T2DM between July and December 2017 from 24 provinces in China. Diabetic peripheral neuropathy and its severity were assessed by the Toronto clinical scoring system, neuropathy symptoms score (NSS) and neuropathy disability score. The prevalence of DPN and its risk factors were analysed. RESULTS: A total of 14,908 patients with T2DM were enroled. The prevalence of DPN was 67.6%. Among 10,084 patients with DPN, 4808 (47.7%), 3325 (33.0%), and 1951 (19.3%) had mild, moderate, and severe DPN, respectively. The prevalence of DPN in females was higher than in males (69.0% vs. 66.6%, P = 0.002). The prevalence of DPN increased with age and course of diabetes and decreased with body mass index (BMI) and education level (all P for trend <0.05). The comorbidities and complications in patients with DPN were higher than in those without DPN, including hypertension, myocardial infarction, diabetic retinopathy, and diabetic nephropathy (all P < 0.001). Age, hypertension, duration of diabetes, diabetic retinopathy, diabetic nephropathy, glycated haemoglobin, high-density lipoprotein cholesterol, and lower estimated glomerular filtration rate were positively associated with DPN, while BMI, education level, fasting C-peptide, and uric acid were negatively associated with DPN. CONCLUSIONS: Among patients with T2DM in China, the prevalence of DPN is high, especially in the elderly, low-income, and undereducated patients.

The Small Tailed Han sheep and Hu sheep are two prolific local sheep in China. In this study, the polymorphisms of BMPR-IB (Bone morphogenetic protein receptor IB), BMP-15 (Bone morphogenetic protein 15) and FSHR (follicle stimulating hormone receptor) were investigated to check whether they are associated with litter size in Small Tailed Han sheep and Hu sheep. Consequently, three polymorphisms, FecB mutation in BMPR-IB (c.746A>G), FecG mutation in BMP-15 (c.718C>T) and the mutation (g. 47C>T) in FSHR were found in the above two sheep breeds with a total number of 1630 individuals. The single marker association analysis showed that the three mutations were significantly associated with litter size. The ewes with genotype FecBB/FecBB and FecBB/FecB+ had 0.78 and 0.58 more lambs (p < 0.01) than those with genotype FecB+/FecB+, respectively. The heterozygous Han and Hu ewes with FecXG/FecX+ genotype showed 0.30 (p = 0.05) more lambs than those with the FecX+/FecX+ genotype. For FSHR gene, the ewes with genotype CC had 0.52 (p < 0.01) and 0.75 (p < 0.01) more lambs than those with genotypes TC and TT, respectively. Combined effect analyses indicated an extremely significant interaction (p < 0.01) between the random combinations of BMPR-IB, BMP-15 and FSHR genes on litter size. In addition, the Han and Hu ewes with BB/G+/CC genotype harbor the highest litter size among ewes analyzed in current study. In conclusion, BMPR-IB, BMP-15 and FSHR polymorphisms could be used as genetic markers in multi-gene pyramiding for improving litter size in sheep husbandry.

Although diabetic glomerulopathy is a characteristic of diabetic kidney disease (DKD), manifesting as a thickened glomerular basement membrane, mesangial expansion with increased matrix, capillary microaneurysms, hypocellular nodules, and even glomerulosclerosis, accumulating data has shown that diabetic tubulopathy (DT) exists from the beginning of hyperglycemia and throughout the duration of diabetic mellitus (DM), playing a pivotal role in the pathogenesis of DKD. Under hyperglycemic conditions, proximal tubular epithelium cells (PTECs) disturbs the tubule-globular glucose, lipid, and protein feedback metabolism, then initiates a series of pathophysiological events, such as volume overload, glomerular hyperfiltration, reactive oxidative stress, and hyperoxide overproduction, which result in hypertrophy, senility, autophagy dysfunction, and PTEC apoptosis in the early stage of DM, as well as tubule atrophy, atherosclerosis tubulointerstitial inflammation, and fibrosis in the development of DKD. Clinically, DT contributes to hyperglycemia, hypertension, proteinuria, dyslipidemia, and hyperuricemia, which accelerate DKD. The biomarkers released from injured tubules are better able than albuminuria to predict early-stage DKD. Therapeutic approaches targeting tubulointerstitial disorders ( e.g. acute interstitial nephritis, chronic interstitial nephritis, acute tubular necrosis and tubulointerstitial fibrosis) in DKD have highlighted the comprehensive pathogenesis of DT and the need for early diagnosis of and intervention in DKD.

OBJECTIVES: This study explored the correlation between clinical explorations, including modified Mallampati score and Müller's maneuver, with drug-induced sleep endoscopy (DISE) findings regarding retrolingual obstruction. METHODS: One hundred forty-two obstructive sleep apnea patients were enrolled in this prospective study. All of the patients received clinical explorations including modified Mallampati scoring and Müller's maneuver in the clinic. Drug-induced sleep endoscopy was further evaluated in the operating room. RESULTS: A significant relationship was noted between modified Mallampati score and retrolingual obstruction during DISE. In contrast, no significant relationship was noted between Müller's maneuver and DISE findings regarding retrolingual obstruction. CONCLUSIONS: A significant discrepancy existed between retrolingual airway collapse evaluated by modified Mallampati score and Müller's maneuver. Modified Mallampati score is more correlated with DISE regarding retrolingual obstruction compared to Müller's maneuver. It should therefore be used as an initial evaluation of retrolingual obstruction when DISE is unavailable.