patients with type 2 diabetes mellitus was carried out. The results indicate that tai chi is favourable in improving outcomes in some areas, e.g. fasting plasma glucose, glycosylated haemoglobin (HbA1c), total cholesterol, balance, and quality of life. However, differences between study methods limit the conclusions regarding some outcomes. Tai chi might be a suitable complementary therapy for individuals with type 2 diabetes mellitus.Objective: To systematically synthesize and critically evaluate evidence on the effects of tai chi for patients with type 2 diabetes mellitus. Data sources: Seven electronic databases (Wan Fang, SinoMed, China National Knowledge Infrastructure, VIP, PubMed, Embase, and Cochrane Library) were systematically searched from their inception to March 2018. Study selection: Randomized controlled trials investigating the effects of tai chi on individuals with type 2 diabetes mellitus were eligible. Data extraction: Biomedical outcomes (fasting plasma glucose, glycosylated haemoglobin (HbA1c), fasting insulin, insulin resistance, body mass index, total cholesterol, blood pressure) as well as balance and quality of life-related outcomes were extracted independently by 2 reviewers. Stata 12.0 software was used to synthesize data if there was no or moderate heterogeneity across studies. Otherwise, narrative summaries were performed. Data synthesis: A total of 23 studies (25 articles) involving 1,235 patients were included in this meta-analysis. Significant changes in tai chi-related effects were observed in lowering fasting plasma glucose (standardized mean difference; SMD -0.67; 95% confidence interval (95% CI) -0.87 to -0.47; p < 0.001), HbA1c (mean difference; MD-0.88%; 95% CI -1.45% to -0.31%; p =0.002) and insulin resistance (MD -0.41; 95% CI -0.78 to -0.04; p = 0.029). Beneficial effects of tai chi were also found in decreasing body mass index (MD -0.82 kg/ m 2 ; 95% CI -1.28 to -0.37 kg/m 2 ; p < 0.001) and total cholesterol (SMD -0.59; 95% CI -0.90 to -0.27; p < 0.001). In addition, tai chi reduced blood pressure (systolic blood pressure (MD -10.03 mmHg; 95% CI -15.78 to -4.29 mmHg; p = 0.001), diastolic blood pressure (MD -4.85 mmHg; 95% CI -8.23 to -1.47 mmHg; p = 0.005)) and improved quality of life-related outcomes (physical function (MD 7.07; 95% CI 0.79-13.35; p = 0.027), bodily pain (MD 4.30; 95% CI 0.83-7.77; p = 0.015) and social function (MD 13.84; 95% CI 6.22-21.47; p < 0.001)). However, no impact was exerted on fasting insulin (SMD -0.32; 95% CI -0.71 to 0.07; p = 0.110) or balance (MD 2.71 s; 95% CI -3.29 to 8.71 s; p = 0.376). Conclusion: Tai chi is effective in controlling biome-dical outcomes and improving quality of life-related outcomes in individuals with type 2 diabetes mellitus, although no effects were observed on balance and fasting insulin. Further high-quality research is needed to elucidate the effects of different types of tai chi, the long-term effects of tai chi, the impact on respiratory function, and the association between tai chi and the risk of developi...

. Acute hyperglycemia exacerbates myocardial ischemia/reperfusion injury and blunts cardioprotective effect of GIK. Am J Physiol Endocrinol Metab 293: E629-E635, 2007. First published May 22, 2007; doi:10.1152/ajpendo.00221.2007.-There is a close association between hyperglycemia and increased risk of mortality after acute myocardial infarction (AMI). However, whether acute hyperglycemia exacerbates myocardial ischemia/reperfusion (MI/R) injury remains unclear. We observed the effects of acute hyperglycemia on MI/R injury and on the cardioprotective effect of glucose-insulin-potassium (GIK). Male rats were subjected to 30 min of myocardial ischemia and 6 h of reperfusion. Rats were randomly received one of the following treatments (at 4 ml ⅐ kg Ϫ1 ⅐ h Ϫ1 iv): Vehicle, GIK (GIK during reperfusion; glucose: 200g/l, insulin: 60 U/l, KCL: 60 mmol/l), HG (high glucose during ischemia; glucose:500 g/l), GIK ϩ HG (HG during I and GIK during R) or GIK ϩ wortmannin (GIK during R and wortmannin 15 min before R). Blood glucose, plasma insulin concentration and left ventricular pressure (LVP) were monitored throughout the experiments. Hyperglycemia during ischemia not only significantly increased myocardial apoptosis (23.6 Ϯ 1.7% vs. 18.8 Ϯ 1.4%, P Ͻ 0.05 vs. vehicle), increased infarct size (IS) (45.6 Ϯ 3.0% vs. 37.6 Ϯ 2.0%, P Ͻ 0.05 vs. vehicle), decreased Akt and GSK-3␤ phosphorylations (0.5 Ϯ 0.2 and 0.6 Ϯ 0.1% fold of vehicle, respectively, P Ͻ 0.05 vs. vehicle) following MI/R, but almost completely blocked the cardioprotective effect afforded by GIK, as evidenced by significantly increased apoptotic index (19.1 Ϯ 2.0 vs. 10.3 Ϯ 1.2%, P Ͻ 0.01 vs. GIK), increased myocardial IS (39.2 Ϯ 2.8 vs. 27.2 Ϯ 2.1%, P Ͻ 0.01 vs. GIK), decreased Akt phosphorylation (1.1 Ϯ 0.1 vs. 1.7 Ϯ 0.2%, P Ͻ 0.01 vs. GIK) and GSK-3␤ phosphorylation (1.4 Ϯ 0.2 vs. 2.3 Ϯ 0.2%, P Ͻ 0.05 vs. GIK). Hyperglycemia significantly exacerbates MI/R injury and blocks the cardioprotective effect afforded by GIK, which is, at least in part, due to hyperglycemia-induced decrease of myocardial Akt activation.Akt; glucose-insulin-potassium IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION (AMI), stress hyperglycemia can commonly be observed. An association between hyperglycemia and an increased risk of mortality and poor prognosis after AMI was well noted in patients with or without diabetes (1, 21). Mechanisms for the association between stress hyperglycemia and adverse outcomes after AMI in nondiabetic patients are not well understood. Additional studies showed that acute hyperglycemia in AMI patients without diabetes was independently associated with larger enzymatic infarct size and higher long-term mortality rates after AMI (22). These results suggest that poor outcomes of patients with AMI may be related to hyperglycemia. However, direct evidence to support a causative role of acute hyperglycemia in exacerbating myocardial ischemia/reperfusion (MI/R) injury is not currently available, and the underlying mechanisms remain unidentified.Glucose-insulin-potassiu...

The high economic burden raised by diabetes and its complications challenges the Chinese health-care system. It implicates an urgent need of intervention to prevent the development of long-term complications among the diabetic population, especially on the development of complications in high-cost body system.

Nonsyndromic cleft lip with or without cleft palate (nsCL/P) is one of the most common congenital anomalies in humans. The pathogenesis of nsCL/P involves both genetic and environmental factors. On the basis of linkage data suggesting that 14q21-24 is one of the chromosomal regions that affects nsCL/P and data locating the BMP4 gene to 14q22-23, we performed a case-control study to evaluate whether BMP4 538T/C polymorphism, resulting in an amino acid change of Val/Ala (V152A) in the polypeptide, is associated with nsCL/P in a Chinese children population. Genotypes of 184 patients with nsCL/P and 205 controls were detected using a PCR-RFLP strategy. The results showed significant differences in the genotype and allele distribution of 538T/C polymorphisms of the BMP4 gene among the cases and controls. The 538C allele carriers were associated with a significantly increased risk of nsCL/P as compared with the noncarriers (odds ratio = 1.52; 95% confidence interval, 1.13-2.03; p = 0.005). Hence, our results support the hypothesis that this polymorphism contributes to risk of nsCL/P, which suggests that BMP4 538T/C polymorphisms could be used as genetic susceptibility markers of nsCL/P.

Despite their crucial role in HIV infection and transmission, commercial sex male clients (CSMCs) are rarely studied. The purpose of this study was to examine the relationship between peer norms and consistent condom use with female sex workers (FSWs) among CSMCs in Sichuan province, China. Male clients with peers who had paid for sex (n=562) were recruited by local health workers through snowball sampling. Measures of peer norms included 1) descriptive norms which were evaluated by perceptions of peer's condom attitudes and behaviors with FSWs; 2) injunctive norms which were assessed by the perceived peer approval of using condoms with FSWs; and 3) communication of HIV-related topics with peers. The outcome was consistent condom use with FSWs. Results of multivariate logistic regression models revealed that consistent condom use with FSWs was significantly more likely among male clients who perceived more pro-condom descriptive and injunctive norms among their peer groups. In addition, the pattern of commercial sex visits moderated the relations between peer norms and consistent condom use with FSWs. More peer approval of condom use and more HIV-related communication were significantly associated with consistent condom use among clients who visited FSWs with friends but not among those who visited FSWs alone. The findings suggest that social activities surrounding commercial sex visits may provide an entry point for HIV prevention intervention with men who patronize FSWs and that such efforts should tap into existing dynamics of social interaction to promote pro-condom norms.