Chromium is considered to have positive effects on insulin sensitivity and is marketed as an adjunctive therapy for inducing glucose tolerance in cases of insulin resistance("the glucose tolerance factor"). ...Chromium is considered to have positive effects on insulin sensitivity and is marketed as an adjunctive therapy for inducing glucose tolerance in cases of insulin resistance("the glucose tolerance factor"). Case reports on patients who received prolonged parenteral nutrition indeed showed that the absence of trivalent chromium caused insulin resistance and diabetes. However, whether patients with type 2 diabetes can develop a clinically relevant chromium deficiency is unclear. This review summarizes the available evidence regarding the potential effectiveness of chromium supplementation on glycemic control(Hemoglobin A1c levels) in patients with type 2 diabetes. No studies investigating the longterm safety of chromium in humans were found. All clinical trials that have been performed had a relative short follow-up period. None of the trials investigated whether the patients had risk factors for chromium deficiency.The evidence from randomized trials in patients with type 2 diabetes demonstrated that chromium supplementation does not effectively improve glycemic control. The meta-analyses showed that chromium supplementation did not improve fasting plasma glucose levels. Moreover, there were no clinically relevant chromium effects on body weight in individuals with or without diabetes. Future studies should focus on reliable methods to estimate chromium status to identify patients at risk for pathological alterations in their metabolism associated with chromium deficiency. Given the present data, there is no evidence that supports advising patients with type 2 diabetes to take chromium supplements.展开更多
The American Heart Association considers device-guided breathing as a reasonable treatment modality in their statement on non-pharmacological options for lowering blood pressure. This review discusses all randomized c...The American Heart Association considers device-guided breathing as a reasonable treatment modality in their statement on non-pharmacological options for lowering blood pressure. This review discusses all randomized controlled trials that have investigated the effects of device-guided breathing on blood pressure in patients with hypertension. Thirteen studies were included in this review. In total, 627 patients were in-cluded, of which 365 patients were allocated to device-guided breathing. Only 6 studies used acceptable control groups: listening to music, meditative relaxa-tion exercises, or a sham-device. Two sponsored trials showed beneficial effects of device-guided breathing, both used listening to music as a control group. The remaining 4 studies, which had no employees of the manufacturer listed as co-author, observed no benefi-cial effects on blood pressure. There is only 1 study that used a sham device as a control group. All other studies were to some extend methodologically flawed. Based on the studies with an acceptable methodologi-cal quality, there is no clear evidence supporting a short-term beneficial effect on blood pressure by using device-guided breathing.展开更多
AIM:To evaluate metabolic control and health-related quality of life(HRQOL)in a type 1 diabetes mellitus(T1DM)population.METHODS:As part of a prospective cohort study,283T1DM patients treated with various insulin trea...AIM:To evaluate metabolic control and health-related quality of life(HRQOL)in a type 1 diabetes mellitus(T1DM)population.METHODS:As part of a prospective cohort study,283T1DM patients treated with various insulin treatment modalities including multiple daily injections(MDI)and continuous subcutaneous insulin infusion(CSII)were examined annually.HRQOL was measured using the SF-36 and EuroQol questionnaires.Data regarding HRQOL,glycaemic and metabolic control from baseline and follow-up measures in 2002 and 2010 were analysed.Linear mixed models were used to calculate estimated values and differences between the three moments in time and the three treatment modalities.RESULTS:Significant changes[meanΔ(95%CI)]in body mass index[2.4 kg/m2(1.0,3.8)],systolic blood pressure[-6.4 mmHg(-11.4,-1.3)]and EuroQol-VAS[-7.3(-11.4,-3.3)]were observed over time.In 2010,168 patients were lost to follow-up.Regarding mode of therapy,52 patients remained on MDI,28 remained on CSII,and 33 patients switched from MDI to CSII during follow-up.Among patients on MDI,HRQOL decreased significantly over time:mental component summary[-9.8(-16.3,-3.2)],physical component summary[-8.6(-15.3,-1.8)]and EuroQol-VAS[-8.1(-14.0,-2.3)],P<0.05 for all.For patients using CSII,the EuroQol-VAS decreased[-9.6(-17.5,-1.7)].None of the changes over time in HRQOL differed significantly with the changes over time within the other treatment groups.CONCLUSION:No differences with respect to metabolic and HRQOL parameters between the various insulin treatment modalities were observed after 15 years of follow-up in T1DM patients.展开更多
AIM: To monitor the course of continuous intraperitoneal insulin infusion (CIPII) and to gain more insight into possible complications. METHODS: A retrospective, longitudinal observational cohort study in patients wit...AIM: To monitor the course of continuous intraperitoneal insulin infusion (CIPII) and to gain more insight into possible complications. METHODS: A retrospective, longitudinal observational cohort study in patients with type 1 diabetes mellitus (T1DM) was performed. Only patients with 'brittle' T1DM who started CIPII between January 1, 2000 and June 1, 2011, and were treated in the only centre inThe Netherlands providing CIPII treatment (Isala clinics, Zwolle) were eligible for inclusion. Outcomes were defined as operation-free period (OFP), rate and type of complications. Subanalyses were made between patients starting CIPII from 2000 to 2007 and from 2007 onwards in order to study possible changes over time in complications and/or OFP. The OFP was calculated as the time from initial implantation to the date of first documented re-operation. If patients had not experi- enced an operation, their data were recorded at the date of last follow up or death. Kaplan-Meier curves were constructed to visualize the OFP. A (two-sided) P value of less than 0.05 was considered statistically significant. RESULTS: Fifty-seven patients were treated with CIPII, although one patient was excluded from analyses because of self-induced complications. In the remaining 56 patients, 70 complications occurred during 283 patient years. Catheter occlusion (32.9%), pump dysfunction (17.1%), pain at the pump site (15.7%) and infections (10.0%) were the most frequent complications. This resulted in a median OFP of 4.5 years (95% confidence interval 4.1-4.8 years) without any difference between the time periods. Fifty re-operations were performed because of complications, one per 5.6 patient years, with a decrease in pump dysfunction (P = 0.04) and pump explantations (P = 0.02) after 2007. In total, 9 episodes of ketoacidosis occurred during follow up and there were 69 hospital re-admissions, with a median duration of 6 d. CIPII was ceased in five patients due to recurrent infections (n = 2), pain (n = 1), inadequate glycaemic control (n = 1) or by own choice (n = 1). No CIPII related mortality was reported. CONCLUSION: The OFP has been stable over the last decade. No CIPII related mortality was reported. A significant decrease in pump dysfunction and explantation was seen after 2007 compared to the period 2000-2007. CIPII remains a safe treatment modality for specific patient groups.展开更多
Background: Natural moisturizing factors (NMFs) are filaggrin-derived components in the cornified layer that are critical for maintaining healthy skin moisturization and barrier function. However, studies have reporte...Background: Natural moisturizing factors (NMFs) are filaggrin-derived components in the cornified layer that are critical for maintaining healthy skin moisturization and barrier function. However, studies have reported conflicting findings on the relationship between NMF levels and aging, while few studies have investigated this relationship clinically. To fill this research gap, we determined the levels of major NMF components such as free amino acids, pyrrolidone carboxylic acid, and urocanic acids, and individually verified their relationships with skin hydration, barrier function, age, and skin aging. Purpose: The objective of this study was to clinically investigate the relationship between NMF components levels and skin aging in facial skin. The main NMF components were obtained from facial skin and quantified. We then selected NMF components showing strong relationships to skin hydration, and analyzed the relationships of the levels of these selected NMF components with signs of skin aging, namely, texture, pores, wrinkles, and dullness (L-value). We also examined the efficacy of treatment with a skin care formula (SK-II Facial Treatment Essence, called SK-II FTE hereafter) including Galactomyces ferment filtrate (GFF, PiteraTM) on the selected NMF component levels associated with skin hydration and barrier function, and the signs of skin aging of texture, pores, wrinkles, and dullness (L-value). Method: We conducted two clinical trials in this research. In Study 1, we measured 23 NMF components using tape-stripped cornified layer to quantify them via an HPLC method in 196 Asian females aged 20 to 59 (mean S.D., 38.6 9.4). Facial visual aging parameters [texture, pores, wrinkles, and dullness (L-value)], as well as elasticity (R7), skin hydration, and TEWL, were quantified using facial skin imaging and skin physical property measurement devices. Study 2 was performed to evaluate whether the facial application of SK-II FTE affects the NMF levels and skin aging parameters in 63 Asian female volunteers aged 20 to 55 (38.4 9.03). During the course of Study 2, 0.6 mL of SK-II FTE was applied to the face twice daily in the morning and afternoon. Skin measurements were performed at the start of the day (baseline) and at week 8. Results: In Study 1, we examined the stratum corneum levels of 23 NMF components comparing to the skin hydration status in 196 female subjects. The subjects were divided into two groups using the median of each measured NMF component. Skin hydration values were compared between the two groups defined for each NMF component. The results showed that subjects with higher levels of six amino acids, alanine, arginine, asparagine, glutamine, glycine, and histidine, exhibited significantly higher skin hydration than those with lower amino acid levels. No significant differences in skin hydration values were found for the other 17 NMF components. We then analyzed whether the sum of these six amino acid NMF components (called 6-AA-NMFs, hereafter) is affected by aging. The 6-AA-NMF level peaked in the subjects aged 25-29, and then gradually and significantly decreased with age. Interestingly, the 6-AA-NMF level was significantly correlated with the skin hydration value, but not with TEWL. In addition, the 6-AA-NMF level demonstrated significant correlations with the signs of skin aging of texture, pores, wrinkles, and dullness (L-value). Then, in Study 2, we examined whether the daily application of SK-II FTE affects the 6-AA-NMF level and visual aging parameters in 63 females. SK-II FTE demonstrated significant increases of the levels of 6-AA-NMFs and each of its components associated with hydration and barrier function, and improvements of skin texture, pores, wrinkles, and dullness (L-value) during the 8 weeks of treatment of facial skin. Conclusion: These clinical studies with large numbers of subjects across a wide age range revealed that six amino acids as NMF components were highly correlated with facial skin hydration in the stratum corneum. The levels of these six NMF components were also found to decrease at ages after the 30 s and were significantly correlated with major signs of skin aging. Notably, these six NMF components (6-AA-NMFs) were increased by SK-II FTE treatment associated with improvements of skin hydration and signs of skin aging, namely, texture, pores, wrinkles, and dullness (L-value). These studies were limited by the lack of investigation of why some NMF components were not associated with skin hydration. More clinical trials examining various NMF components and their relationship with aging are anticipated.展开更多
A 1342-nm oscillator was successfully demonstrated by using a semiconductor saturable absorber mirror with the repetition rate of 65 MHz.The output coupler with appropriate transmission was chosen to suppress Q-switch...A 1342-nm oscillator was successfully demonstrated by using a semiconductor saturable absorber mirror with the repetition rate of 65 MHz.The output coupler with appropriate transmission was chosen to suppress Q-switched mode-locking.At the pumping power of 1.7 W,the stable continuous-wave mode locked pulse was observed.The average output power was 140 mW and pulse width was measured to be 17.2 ps.展开更多
A 46-W laser diode end-pumped amplifier is demonstrated by using a SESAM passively mode-locked oscillator and a compact LD stack end-pumped slab amplifier.For the oscillator,a 5-W picosecond mode-locked laser with a r...A 46-W laser diode end-pumped amplifier is demonstrated by using a SESAM passively mode-locked oscillator and a compact LD stack end-pumped slab amplifier.For the oscillator,a 5-W picosecond mode-locked laser with a repetition frequency of 79MHz is obtained with beam quality factors of M^(2)<1.3.A beam shaping system made up of cylindrical lens is designed according to different sizes of the active medium in both directions,and a plane-plane cavity is used in the amplifier for high efficiency.At the absorbed pumping power of 174 W,the highest output power of 46 W is obtained with the slope efficiency of 29.5%.The beam quality factors M2 in both directions are measured to be 1.43 and 1.76,respectively.展开更多
Let I with |I| = k be a matching of a graph G (briefly, I is called a k-matching). If I is not a proper subset of any other matching of G, then I is a maximal k-matching and m(gk, G) is used to denote the number of ma...Let I with |I| = k be a matching of a graph G (briefly, I is called a k-matching). If I is not a proper subset of any other matching of G, then I is a maximal k-matching and m(gk, G) is used to denote the number of maximal k-matchings of G. Let gk be a k-matching of G, if there exists a subset {e1, e2,…, ei} of E(G) \ gk, i (?)1, such that (1) for any j ∈ {1, 2,…,i}, gk + {ej} is a (k + l)-matching of G; (2) for any f ∈ E(G) \ (gk ∪ {e1,e2,…,ei}), gk + {f} is not a matching of G; then gk, is called an i wings k-matching of G and mi(gk,G) is used to denote the number of i wings k-matchings of G. In this paper, it is proved that both mi(gk,G) and m(gk,G) are edge reconstructible for every connected graph G, and as a corollary, it is shown that the matching polynomial is edge reconstructible.展开更多
文摘Chromium is considered to have positive effects on insulin sensitivity and is marketed as an adjunctive therapy for inducing glucose tolerance in cases of insulin resistance("the glucose tolerance factor"). Case reports on patients who received prolonged parenteral nutrition indeed showed that the absence of trivalent chromium caused insulin resistance and diabetes. However, whether patients with type 2 diabetes can develop a clinically relevant chromium deficiency is unclear. This review summarizes the available evidence regarding the potential effectiveness of chromium supplementation on glycemic control(Hemoglobin A1c levels) in patients with type 2 diabetes. No studies investigating the longterm safety of chromium in humans were found. All clinical trials that have been performed had a relative short follow-up period. None of the trials investigated whether the patients had risk factors for chromium deficiency.The evidence from randomized trials in patients with type 2 diabetes demonstrated that chromium supplementation does not effectively improve glycemic control. The meta-analyses showed that chromium supplementation did not improve fasting plasma glucose levels. Moreover, there were no clinically relevant chromium effects on body weight in individuals with or without diabetes. Future studies should focus on reliable methods to estimate chromium status to identify patients at risk for pathological alterations in their metabolism associated with chromium deficiency. Given the present data, there is no evidence that supports advising patients with type 2 diabetes to take chromium supplements.
文摘The American Heart Association considers device-guided breathing as a reasonable treatment modality in their statement on non-pharmacological options for lowering blood pressure. This review discusses all randomized controlled trials that have investigated the effects of device-guided breathing on blood pressure in patients with hypertension. Thirteen studies were included in this review. In total, 627 patients were in-cluded, of which 365 patients were allocated to device-guided breathing. Only 6 studies used acceptable control groups: listening to music, meditative relaxa-tion exercises, or a sham-device. Two sponsored trials showed beneficial effects of device-guided breathing, both used listening to music as a control group. The remaining 4 studies, which had no employees of the manufacturer listed as co-author, observed no benefi-cial effects on blood pressure. There is only 1 study that used a sham device as a control group. All other studies were to some extend methodologically flawed. Based on the studies with an acceptable methodologi-cal quality, there is no clear evidence supporting a short-term beneficial effect on blood pressure by using device-guided breathing.
文摘AIM:To evaluate metabolic control and health-related quality of life(HRQOL)in a type 1 diabetes mellitus(T1DM)population.METHODS:As part of a prospective cohort study,283T1DM patients treated with various insulin treatment modalities including multiple daily injections(MDI)and continuous subcutaneous insulin infusion(CSII)were examined annually.HRQOL was measured using the SF-36 and EuroQol questionnaires.Data regarding HRQOL,glycaemic and metabolic control from baseline and follow-up measures in 2002 and 2010 were analysed.Linear mixed models were used to calculate estimated values and differences between the three moments in time and the three treatment modalities.RESULTS:Significant changes[meanΔ(95%CI)]in body mass index[2.4 kg/m2(1.0,3.8)],systolic blood pressure[-6.4 mmHg(-11.4,-1.3)]and EuroQol-VAS[-7.3(-11.4,-3.3)]were observed over time.In 2010,168 patients were lost to follow-up.Regarding mode of therapy,52 patients remained on MDI,28 remained on CSII,and 33 patients switched from MDI to CSII during follow-up.Among patients on MDI,HRQOL decreased significantly over time:mental component summary[-9.8(-16.3,-3.2)],physical component summary[-8.6(-15.3,-1.8)]and EuroQol-VAS[-8.1(-14.0,-2.3)],P<0.05 for all.For patients using CSII,the EuroQol-VAS decreased[-9.6(-17.5,-1.7)].None of the changes over time in HRQOL differed significantly with the changes over time within the other treatment groups.CONCLUSION:No differences with respect to metabolic and HRQOL parameters between the various insulin treatment modalities were observed after 15 years of follow-up in T1DM patients.
文摘AIM: To monitor the course of continuous intraperitoneal insulin infusion (CIPII) and to gain more insight into possible complications. METHODS: A retrospective, longitudinal observational cohort study in patients with type 1 diabetes mellitus (T1DM) was performed. Only patients with 'brittle' T1DM who started CIPII between January 1, 2000 and June 1, 2011, and were treated in the only centre inThe Netherlands providing CIPII treatment (Isala clinics, Zwolle) were eligible for inclusion. Outcomes were defined as operation-free period (OFP), rate and type of complications. Subanalyses were made between patients starting CIPII from 2000 to 2007 and from 2007 onwards in order to study possible changes over time in complications and/or OFP. The OFP was calculated as the time from initial implantation to the date of first documented re-operation. If patients had not experi- enced an operation, their data were recorded at the date of last follow up or death. Kaplan-Meier curves were constructed to visualize the OFP. A (two-sided) P value of less than 0.05 was considered statistically significant. RESULTS: Fifty-seven patients were treated with CIPII, although one patient was excluded from analyses because of self-induced complications. In the remaining 56 patients, 70 complications occurred during 283 patient years. Catheter occlusion (32.9%), pump dysfunction (17.1%), pain at the pump site (15.7%) and infections (10.0%) were the most frequent complications. This resulted in a median OFP of 4.5 years (95% confidence interval 4.1-4.8 years) without any difference between the time periods. Fifty re-operations were performed because of complications, one per 5.6 patient years, with a decrease in pump dysfunction (P = 0.04) and pump explantations (P = 0.02) after 2007. In total, 9 episodes of ketoacidosis occurred during follow up and there were 69 hospital re-admissions, with a median duration of 6 d. CIPII was ceased in five patients due to recurrent infections (n = 2), pain (n = 1), inadequate glycaemic control (n = 1) or by own choice (n = 1). No CIPII related mortality was reported. CONCLUSION: The OFP has been stable over the last decade. No CIPII related mortality was reported. A significant decrease in pump dysfunction and explantation was seen after 2007 compared to the period 2000-2007. CIPII remains a safe treatment modality for specific patient groups.
文摘Background: Natural moisturizing factors (NMFs) are filaggrin-derived components in the cornified layer that are critical for maintaining healthy skin moisturization and barrier function. However, studies have reported conflicting findings on the relationship between NMF levels and aging, while few studies have investigated this relationship clinically. To fill this research gap, we determined the levels of major NMF components such as free amino acids, pyrrolidone carboxylic acid, and urocanic acids, and individually verified their relationships with skin hydration, barrier function, age, and skin aging. Purpose: The objective of this study was to clinically investigate the relationship between NMF components levels and skin aging in facial skin. The main NMF components were obtained from facial skin and quantified. We then selected NMF components showing strong relationships to skin hydration, and analyzed the relationships of the levels of these selected NMF components with signs of skin aging, namely, texture, pores, wrinkles, and dullness (L-value). We also examined the efficacy of treatment with a skin care formula (SK-II Facial Treatment Essence, called SK-II FTE hereafter) including Galactomyces ferment filtrate (GFF, PiteraTM) on the selected NMF component levels associated with skin hydration and barrier function, and the signs of skin aging of texture, pores, wrinkles, and dullness (L-value). Method: We conducted two clinical trials in this research. In Study 1, we measured 23 NMF components using tape-stripped cornified layer to quantify them via an HPLC method in 196 Asian females aged 20 to 59 (mean S.D., 38.6 9.4). Facial visual aging parameters [texture, pores, wrinkles, and dullness (L-value)], as well as elasticity (R7), skin hydration, and TEWL, were quantified using facial skin imaging and skin physical property measurement devices. Study 2 was performed to evaluate whether the facial application of SK-II FTE affects the NMF levels and skin aging parameters in 63 Asian female volunteers aged 20 to 55 (38.4 9.03). During the course of Study 2, 0.6 mL of SK-II FTE was applied to the face twice daily in the morning and afternoon. Skin measurements were performed at the start of the day (baseline) and at week 8. Results: In Study 1, we examined the stratum corneum levels of 23 NMF components comparing to the skin hydration status in 196 female subjects. The subjects were divided into two groups using the median of each measured NMF component. Skin hydration values were compared between the two groups defined for each NMF component. The results showed that subjects with higher levels of six amino acids, alanine, arginine, asparagine, glutamine, glycine, and histidine, exhibited significantly higher skin hydration than those with lower amino acid levels. No significant differences in skin hydration values were found for the other 17 NMF components. We then analyzed whether the sum of these six amino acid NMF components (called 6-AA-NMFs, hereafter) is affected by aging. The 6-AA-NMF level peaked in the subjects aged 25-29, and then gradually and significantly decreased with age. Interestingly, the 6-AA-NMF level was significantly correlated with the skin hydration value, but not with TEWL. In addition, the 6-AA-NMF level demonstrated significant correlations with the signs of skin aging of texture, pores, wrinkles, and dullness (L-value). Then, in Study 2, we examined whether the daily application of SK-II FTE affects the 6-AA-NMF level and visual aging parameters in 63 females. SK-II FTE demonstrated significant increases of the levels of 6-AA-NMFs and each of its components associated with hydration and barrier function, and improvements of skin texture, pores, wrinkles, and dullness (L-value) during the 8 weeks of treatment of facial skin. Conclusion: These clinical studies with large numbers of subjects across a wide age range revealed that six amino acids as NMF components were highly correlated with facial skin hydration in the stratum corneum. The levels of these six NMF components were also found to decrease at ages after the 30 s and were significantly correlated with major signs of skin aging. Notably, these six NMF components (6-AA-NMFs) were increased by SK-II FTE treatment associated with improvements of skin hydration and signs of skin aging, namely, texture, pores, wrinkles, and dullness (L-value). These studies were limited by the lack of investigation of why some NMF components were not associated with skin hydration. More clinical trials examining various NMF components and their relationship with aging are anticipated.
基金Supported by the National High-Technology Research and Development Programme of China under Grant No 2011AA030205the International Cooperation Project(2010DFR50650).
文摘A 1342-nm oscillator was successfully demonstrated by using a semiconductor saturable absorber mirror with the repetition rate of 65 MHz.The output coupler with appropriate transmission was chosen to suppress Q-switched mode-locking.At the pumping power of 1.7 W,the stable continuous-wave mode locked pulse was observed.The average output power was 140 mW and pulse width was measured to be 17.2 ps.
基金Supported by the National High-Technology Research and Development Program of China under Grant No 2011AA030205the International Cooperation Program of China under Grant No 2010DFR50650.
文摘A 46-W laser diode end-pumped amplifier is demonstrated by using a SESAM passively mode-locked oscillator and a compact LD stack end-pumped slab amplifier.For the oscillator,a 5-W picosecond mode-locked laser with a repetition frequency of 79MHz is obtained with beam quality factors of M^(2)<1.3.A beam shaping system made up of cylindrical lens is designed according to different sizes of the active medium in both directions,and a plane-plane cavity is used in the amplifier for high efficiency.At the absorbed pumping power of 174 W,the highest output power of 46 W is obtained with the slope efficiency of 29.5%.The beam quality factors M2 in both directions are measured to be 1.43 and 1.76,respectively.
基金Research supported partially by NSFC (10001035) and(10371055)
文摘Let I with |I| = k be a matching of a graph G (briefly, I is called a k-matching). If I is not a proper subset of any other matching of G, then I is a maximal k-matching and m(gk, G) is used to denote the number of maximal k-matchings of G. Let gk be a k-matching of G, if there exists a subset {e1, e2,…, ei} of E(G) \ gk, i (?)1, such that (1) for any j ∈ {1, 2,…,i}, gk + {ej} is a (k + l)-matching of G; (2) for any f ∈ E(G) \ (gk ∪ {e1,e2,…,ei}), gk + {f} is not a matching of G; then gk, is called an i wings k-matching of G and mi(gk,G) is used to denote the number of i wings k-matchings of G. In this paper, it is proved that both mi(gk,G) and m(gk,G) are edge reconstructible for every connected graph G, and as a corollary, it is shown that the matching polynomial is edge reconstructible.
