ObjectiveTo explore the morbidity rate and risk factors of proliferative diabetic retinopathy (PDR) in type 2 diabetes.MethodsThe clinical data of patients, with PDR in 2739 consecutive cases of type 2 diabetes diagnosed in this hospital from 1994 to 2001 were analyed retospectively. The diagnosis of diabetic retinopathy (DR) was confirmed by ophthalmoscopy and fundus fluorescein angiography (FFA). Blood pressure, fasting and postprandial blood sugar, glycosylated haemoglobin（HbA1c）, total serum cholesterol, triglyceride, creatinine, and albumin excretion rate were measured.ResultsThe morbidity rate of type 2 DR was 27.8%（761/2739）, and the morbidity rate of PDR was 4.2%（114/2 739） occupying 15% of the patients with DR. The duration, fasting blood sugar, glycosylated haemoglobin, blood pressure and albumin excretion rate were much higher than those in the control（P＜0.01, glycosylated haemoglobin P＜0.05）. The independent risk factors of PDR were duration of the disease （r=0.15, P＜0.01） and albumin excretion rate （r=0.08, P＜0.05）. The risk factors of PDR were albumin excretion rate and fasting blood sugar (r=0.13, P＜0.05) in patients with longer duration(≥5 years). The morbidity rate of PDR was 2.3%, 5.9% and 12.4% in patients with duration less than 5 years, 5 to 10 years and over 10 years groups, respectively. The morbidity of PDR of the patients in normal albuminuria, microalbuminuria and overt albuminuria group was 2.1%、5.3% and 18.8% respectively.ConclusionsType 2 diabetes accompanied with PDR is relative to the duration of the diabetes, albumin excretion rate, fasting blood sugar, blood pressure, and glycosylated haemoglobin, in which the duration of the disease, albuminuria and fasting blood sugar are the risk factors of occurance of PDR. (Chin J Ocul Fundus Dis, 2003,19:338-340)
摘要:目的:探讨2型糖尿病合并糖尿病足患者与胰岛素抵抗的关系。方法:205例2型糖尿病患伴糖尿病足患者作为观察组,无足部病变的糖尿病患者作为对照组,观察其体重指数、空腹血糖、胰岛素、血脂等指标,两组间进行比较并相关性分析、多元回归分析。胰岛素抵抗指数(HOMAIR)=FPG×FIns/22.5。结果:糖尿病足患者的HOMAIR显著高于无糖尿病的患者(Plt;0.05)。多元回归分析显示糖尿病病程、LDL及BMI是影响2型糖尿病足患者胰岛素抵抗的主要危险因素。结论:糖尿病足患者存在着更严重的胰岛素抵抗。Abstract: Objective: To discuss the relationship between diabetes and pedopathy of type II diabetes and insulin resistance. Methods:The diabetes type II patients were divided into group A (combined with pedopathy) and group B (without pedopathy). The blood glucose and insulin of empty stomach, BMI,Alc and lipid were detected. The insulin resistance index (HOMAIR) was calculated and compared between two groups. Results:The HOMAIR was higher in group A than that in group B (Plt;0.05).The duration of disease,LDL and BMI was positive related with diabetes pedopathy. Conclusion:The insulin resistance was more worse in pedopathy of Type II diabetes.
ObjectiveTo investigate the protective effect of exogenous insulin on relative adrenal insufficiency (RAI) in rats with severe acute pancreatitis (SAP).MethodsEighty SPF SD rats were randomly divided into 5 groups (n=16): sham operation (SO) group, SAP group, low-dose insulin intervention (low-dose) group (0.05 U/100 g body weight), medium-dose insulin intervention (medium-dose) group (0.1 U/100 g body weight), and high-dose insulin intervention (high-dose) group (0.2 U/100 g body weight). The five groups were randomly divided into two subgroups: cosyntropin stimulation test (CST) subgroup and non-CST subgroup. SAP model was established by retrograde injection of 5% sodium taurocholate into biliopancreatic duct. The rats were sacrificed 3 hours after the establishment of SAP model. The levels of amylase (AMY), alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea (Ur) and creatinine (Cr) were detected by automatic biochemical analyzer. The serum levels of tumor necrosis factor-α (TNF-α) and corticosterone (Cor) were detected by ELISA kit. The pathological changes of pancreas and adrenal gland were observed under light microscope. The lipid content of adrenal gland was observed by oil red O staining.ResultsCompared with the SO group, the serum levels of Amy, ALT, AST, Ur, Cr, TNF-α and Cor in the SAP group were significantly increased (P<0.05), typical pathological damages occurred in pancreas and adrenal gland, and pathological scores were significantly increased (P<0.05). Compared with the SAP group, the levels of AMY, ALT, AST, Ur, Cr, TNF-α and Cor in the low-dose group were not significantly changed (P>0.05); the levels of AMY, ALT, AST, Ur, Cr and TNF-α in the medium-dose group and the high-dose group were significantly decreased (P<0.05), and Cor levels were significantly increased (P<0.05). Compared with the low-dose group, AMY, ALT, AST, Cr, TNF-α in the medium-dose group and the high-dose group were significantly decreased (P<0.05), Cor level were significantly increased (P<0.05), Ur level had no significant change. There were no significant difference in AMY, ALT, AST, Ur, Cr, TNF-α and Cor levels between the medium-dose group and the high-dose group (P>0.05). After CST intervention, there were no significant change in serum Cor levels in the SAP group and the low-dose group (P>0.05), but the serum Cor levels in the SO group, the medium-dose group and the high-dose group were significantly increased (P<0.05).ConclusionAppropriate dose of exogenous insulin can improve SAP related adrenal injury and RAI, but the specific mechanism still needs further study.
Objective To detect the difference of the light sensitivity in the central visual field between normal people and type Ⅱ diabetic patients without diabetic retinopathy, and evaluate the effect of perimetric examination in early diagnosis of diabetic retinopathy. Methods The light sensitivity at the 80 locations in the central field was measured by Dicon field analyzer (model TKS-4000) in 76 normal eyes of 44 normal volunteers aged from 45 to 72 years and 75 eyes of 40 type Ⅱ diabetic patients without retinopathy aged from 46 to 71 years. Results For the diabetic patients without diabetic retinopathy, the light sensitivity of locations decreased by 4-8 dB,and there were some decreased light sensitivity areas. The mean light sensitivity of three zones of the central field had significant reduction in the diabetic patients as compared with the control group(Plt;0.001). Conclusion The retinal neurosensory function of diabetic patients is damaged in some degrees before diabetic retinopathy occured, and no relationship is found between the decrease of retinal light sensitivity and localized blood-retinal barrier leakage. It is suggested that examination of central field with computerized perimetry has certain clinical significance in early diagnosis of diabetic retinopathy. (Chin J Ocul Fundus Dis, 2002, 18: 218-220)
Exercise is vital for diabetics to improve their blood glucose level. However, the quantitative relationship between exercise modes (including types, intensity, time, etc.) and the blood glucose is still not clear. In order to answer these questions, this paper established a blood glucose metabolic model based on ordinary differential equation method. Furthermore, a silico method was adopted to study the effects of different aerobic exercise intensities (light, moderate and vigorous) on blood glucose and optimal strategies of insulin infusion for type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). Additionally, the universality of proposed model and insulin infusion strategies was verified based on 1 000 virtual diabetes patients’ simulation. The experimental results showed that: (1) Vigorous-intensity aerobic exercise may result in hypoglycemia (< 3.89 mmol/L), which was so harmful to health that diabetics should avoid. Compared with moderate-intensity exercise, the light-intensity aerobic exercise intuitively lowered blood glucose slowly and caused a relative long high-blood-glucose (> 6.11 mmol/L) period, however, its overall blood glucose risk index (BGRI) was lower. (2) Insulin dosage of the optimized strategies decreased by 50% and 84% for T1DM and T2DM when they did moderate intensity exercise. As for light intensity exercise, the dosage of insulin was almost the same as they didn’t do exercise, but BGRI decreased significantly. (3) The simulations of 1 000 virtual diabetic patients manifested that the proposed model and the insulin infusion strategies had good universality. The results of this study can not only help to improve the quantitative understanding about the effects of aerobic exercise on blood glucose of diabetic patients, but also contribute to the regulation and management of blood glucose in exercise mode.
Objective To establish hepatocellular carcinoma (HCC) cell lines which olig-expressed IGF1R gene stably． Methods An eukaryotic expressing vector pSUPER-IGF1R-siRNA that could block IGF1R expressing was transferred into hepatocellular carcinoma cell lines SMMC7721 and Hep3B with Lipofectamine 2000 reagents． After transferred, cells were selected with G418 to obtain positive clones. The expressions of IGF1R, cyclin D1 and cyclin B1 were detected by RT-PCR and Western-blot． Cell growth curve were painted. Results Two cell lines clones were screened olig-expressing IGF1R gene stably． The experimental cell lines grew more slowly than control cell lines and the expression of cyclin D1 decreased (P＜0.05). Conclusion The HCC cell lines for olig-expressing IGF1R gene stably are established successfully．The plasmid pSUPER-IGF1R-siRNA can inhibit the growth of SMMC7721 and Hep3B cell lines, and the expression of cyclin D1.
Heat sensitive protein medicines are increasingly exhibiting their critical importance on treatment of various diseases at present. But their popularization and application meet a great challenge because of their heat instability. In the present study, insulin was taken as a heat sensitive protein medicine and amino acid as bio-protective agent in order to investigate if these amino acids can protect the insulin from losing its bioactivity due to desiccation. The experiment was performed by using replica exchange molecular simulation (REMD) method and Gromacs software with Gromos96 (53a6) force field. The REMD results indicated that these amino acids could protect the bioactive structure of insulin during desiccation. The configurations of the protected insulin were preserved very well. Those results proved that amino acid is a kind of good bioactive protective agent for the heat sensitive protein medicines.
Objective To evaluate the efficacy of glucose-insul in-potassium (GIK) in patients with acute myocardialinfarction (AMI). Methods Both foreign language databases including The Cochrane Library (issue 4, 2007), PubMed, EMBASE and Chinese databases involving CBM, VIP and CJFD were searched to identify randomized controlled trials (RCTs) that reported the effect of GIK on the heart function (left ventricular ejection fraction LVEF, ST changes, left ventricular remodel ing) of patients with AMI. Two reviewers assessed the qual ity of each trial and extracted data independently. The Cochrane Collaboration’s RevMan 4.2.10 software was used for statistical analysis. Results Five RCTs were included, all of which came from abroad. The methodological qual ity of the included studies was good. The basel ine data of each trial were comparable. Meta-analyses showed that no significant difference was observed in the improvement of LVEF between the GIK group and the control group (WMD=1.87, 95%CI -0.32 to 4.06, P =0.09), whereas GIK was more beneficial in decreasing ST (OR=1.92, 95%CI 1.25 to 2.96,P =0.003) and preventing left ventricular remodel ing (OR=0.08, 95%CI 0.01 to 0.68, P=0.02). Conclusion Based on the above evidence, although GIK may, to some extent, be beneficial for both ST decreasing and long-term prognoses in patients with AMI, it can not yet be concluded that GIK can improve the heart function of those patients. Therefore, it is imperative to design and implement further stricter, large-scale RCTs, so as to accurately identify the therapeutic effect of GIK solution in patients with myocardial infarction.
ObjectiveTo investigate the effect of daphnetin (DAP) combined with insulin-like growth factor 1 (IGF-1) gene transfection on chondrogenic differentiation of adipose-derived mesenchymal stem cells (ADSCs) in rats.MethodsRat ADSCs were isolated and amplified by enzymatic digestion. The third generation ADSCs were treated with IGF-1 gene transfection as experimental group and normal ADSCs as control group. The cells of the two groups were treated with different concentrations of DAP (0, 30, 60, 90 μg/mL), respectively. Cell proliferation was detected by cell counting kit 8 (CCK-8) after cultured for 72 hours. After 14 days, real-time fluorescence quantitative PCR and Western blot were used to detect the mRNA and protein expressions of chondrocyte markers (collagen type Ⅱ and Aggrecan) in each group; and toluidine blue staining and collagen type Ⅱ immunohistochemical staining were performed.ResultsCCK-8 assay showed that with the increase of DAP concentration, the cell absorbance (A) value of the control group and the experimental group increased gradually (P<0.05). At the same DAP concentration, the cell A value of the experimental group was significantly higher than that of the control group (P<0.05). Real-time fluorescence quantitative PCR and Western blot showed that with the increase of DAP concentration, the relative mRNA and protein expressions of collagen type Ⅱ and Aggrecan in the control group did not change significantly, and there was no significant difference among the different concentration groups (P>0.05). But the mRNA and protein expressions of collagen type Ⅱ and Aggrecan in the experimental group increased gradually, and the 60 and 90 μg/mL DAP concentration groups were significantly higher than 0 μg/mL DAP concentration group (P<0.05). At the same DAP concentration, the relative mRNA and protein expressions of collagen type Ⅱ and Aggrecan were significantly higher in the experimental group than in the control group (P<0.05). Toluidine blue staining showed that with the increase of DAP concentration, there was no significant difference in cell staining between the control group and the experimental group. At the same DAP concentration, the cells in the experimental group were slightly darker than those in the control group. Immunohistochemical staining of collagen type Ⅱ showed that with the increase of DAP concentration, there was no significant difference in the cytoplasmic brown-yellow coloring of the cells in the control group. The cytoplasmic brown-yellow coloring of the cells in the experimental group gradually deepened, with 60 and 90 μg/mL DAP concentration groups significantly deeper than 0 μg/mL DAP concentration group. At the same DAP concentration, the color of the cells in the experimental group was significantly deeper than that in the control group.ConclusionDAP can promote the proliferation of ADSCs in rats. The differentiation of ADSCs into chondrocytes induced by DAP alone was slightly, but DAP combined with IGF-1 gene transfection has obvious synergistic effect to promote chondrogenic differentiation of ADSCs.
Objective?To compare the effect of continuous subcutaneous insulin infusion (CSII) with that of multiple daily insulin injections (MDI) in the patients with newly-diagnosed type 2 diabetes, and to provide evidence for clinical treatment. Methods?We searched MEDLINE and Chinese Science and Technology Full-text Database up to Dec. 2009 to identify randomized controlled trials (RCTs) that had been conducted with patients with newly diagnosed type 2 diabetes mellitus. The selection of studies, data extraction and assessment of methodological quality were performed independently by two reviewers. Meta-analyses were performed using RevMan 5.0.23 software. The following outcomes were assessed: glycaemic control, insulin requirements, HOMA-IR, HOMA-β, hypoglycaemia and diabetic remission after follow-up. Results?Eight RCTs involving 597 newly-diagnosed type 2 diabetic patients were included. The methodological quality of the most studies was lower. The funnel plot comparing insulin requirement of CSII therapy with that of MDI therapy showed asymmetry, indicating that there was publication bias. The results of meta-analyses showed that: CSII had the same effect on improving fasting blood glucose (WMD= –0.21, 95%CI –0.42 to 0.00, P=0.05) and postprandial blood glucose (WMD= –0.24, 95CI% –0.57 to 0.08, P=0.14) as MDI in newly-diagnosed type 2 diabetes. CSII therapy took 2.74 days fewer than MDI therapy (WMD= –2.74, 95CI% –3.33 to –2.16, Plt;0.000 01) and needed lower insulin requirements (reducing 7.78 units per day) (WMD= –7.78, 95CI% –9.25 to –6.31, Plt;0.000 01) to get target glucose control. The rate of hypoglycaemia of CSII therapy decreased 69% (OR= 0.31, 95%CI 0.12 to 0.80, P=0.01) compared with that of MDI. The rate of diabetes remission after short-term intensive insulin therapy increased 46% (OR=1.46, 95%CI 1.01 to 2.10, P=0.04) in CSII therapy compared with that in MDI therapy. Conclusion?In newly-diagnosed type 2 diabetes, CSII therapy is better than MDI therapy. But because of the low quality of the included studies, the conclusion should be combined with patients and physicians’ experience, advantages and disadvantages in the clinical application.