Objective:To evaluate the efficacy of insulin aspart 30 combined with metformin in the treatment of type 2 diabetes. Methods:According to the random number table, 68 patients with type 2 diabetes were randomly divided into two groups, the control group (n=34) and the observation group (n=34). The control group was treated with insulin aspart 30 by hypodermic injection, while the observation group was orally treated with metformin additionally. Results:After the treatment, the levels of FPG, HbA1c and 2hPG, plasma viscosity, blood viscosity and platelet adhesion rate in the two groups were lower than those before the treatment, and those in the observation groups were lower than those in the control group, and the differences were statistically significant (P<0. 05). After the treatment, the levels of TC, TG and LDL-C in the two groups were lower than those before the treatment (P<0. 05), and the levels of TC and TG in the observation groups were lower than those in the control group (P<0. 05). Before and after the treatment, HDL-C and BMI showed no significant differences in the two groups (P>0. 05). The reaching standard time of blood glucose of the observation group was shorter than that of the control group (P <0.05). Compared with the untoward reactions between the two groups, no statistical difference was shown (P<0. 05). Conclusion: Insulin aspart 30 combined with metformin can control blood sugar more effectively, and significantly improve the glucose metabolism of patients, shorten the reaching standard time of blood glucose and improve blood lipid and hemorheology indices, which is worthy of clinical promotion and application.

Objective To investigate the relationships between serum concentration of RBP-4 and the parameters of inflammatory, lipid metabolism, insulin resistance in patients with T2DM. Methods 71 patients newly diagnosed with T2DM and 34 subjects with normal glucose tolerance (NGT) were enrolled in this cross-sectional study. Additionally, another subset analysis was performed. Subjects were divided into normal weight (NW) and overweight or obesity (OW/OB) group on the basis of BMI. Serum RBP-4 was measured with ELISA. Serum concentrations of hs-CRP, free fatty acids (FFA), triglyceride (TG), total cholesterol (TC) and insulin were measured in fasting status. Insulin resistance was assessed by HOMA-IR. Results Ln (HOMA-IR) and the concentrations of TG, FFA, In(hs-CRP) in T2DM were significant-ly higher than that of NGR group[1.20±0.38 vs 0.76±0.34,(2.74±2. 20)mmol/L vs (1.88±1.41),(0. 80±0. 29)mmol/L vs (0.61±0.22)retool/L,0.62±1.00 vs -0. 17±1.07] . InRBP-4 showed a positive relationship with In (HOMA-IR) ( r =0. 382, P <0. 05), but no association with TC, TG, FFA and In(hs-CRP). In the group of T2DM, InRBP-4 showed a positive relationship with FFA ( r =0. 242, P <0.05) and In (hs-CRP) ( r =0.346, P <0.01), but no association with TC, TG and In (HOMA-IR). There were no relationships between InRBP-4 and In (HOMA-IR), TC, TG, FFA and In (hs-CRP)in NW, while in OW/OB group, InRBP-4 showed a positive relationship with In (HOMA-IR) ( r =0. 290,P < 0. 05 ) and In (hs-CRP) ( r = 0. 295, P <0.05 ), but no association with TC, TG and FFA. In a mul-tiple linear regression analysis, In( hs-CRP), TC, TG, FFA or In(HOMA-IR) was not the independent de-terminant of InRBP-4 in any group. Conclusion In patients with T2DM, InRBP-4 is positively correlatedwith In (hs-CRP) and FFA, and it may be a new marker of inflammation.

Objective To investigate the relationships between serum concentration of RBP-4 and inflammatory factors,insulin resistance in patients with gestational diabetes mellitus.Methods20 patients newly diagnosed with impaired glucose tolerance (IGT),27 patients newly diagnosed with gestational diabetes mellitus(GDM) and 50 subjects with normal glucose tolerance(NGT) were enrolled in this cross-sectional study.Additionally,another subset analysis was performed,subjects were divided on the basis of BMI into normal weight (NW) and overweight or obesity (OW/OB).Serum RBP-4 was measured with ELISA;serum concentrations of hs-CRP,free fatty acids (FFA),triglyeride(TG),total cholesterol (TC) and insulin were measured in fasting status.Insulin resistance was assessed by HOMA-IR.ResultsLn(HOMA-IR) and the concentrations of FFA,ln(hs-CRP) in IGT or in GDM were significantly higher than that of NGT(P＜0.05).In the group of OW/OB,FFA[(0.90±0.31)mmol/L vs (0.71±0.28)mmol/L,t＝2.73,P＜0.05)],ln(hs-CRP)(0.62±1.00 vs -0.17±1.07,t＝2.90,P＜0.05),ln(HOMA-IR),lnRBP(0.56±0.27 vs 0.30±0.14,t＝2.86,P＜0.05)were significantly higher than that of NW.In the group of GDM,lnRBP-4 showed a positive relationship with FFA (r＝0.231,P＜0.05)and ln(hs-CRP) (r＝0.237,P＜0.05).There was a positive relationship between lnRBP-4 and FFA(r＝0.371,P＜0.05) or ln(hs-CRP)(r＝0.247,P＜0.05) in the group of OW/OB,but no association in the group of NGT,IGT or NW.There was no relationship between lnRBP-4 and ln(HOMA-IR) in IGT,GDM and NW,while in the group of NGT and OW/OB,lnRBP-4 showed a positive relationship with ln(HOMA-IR) (r＝0.276,0.290,P＜0.05).In a multiple linear regression analysis,ln(hs-CRP),FFA or ln(HOMA-IR) was not the independent factor of lnRBP-4 in any group.ConclusionsIn patients with gestational diabetes mellitus,lnRBP-4 may be a new marker of inflammation.

Objective To determine the relationship between serum testosterone level and lean body mass, body fat content, and bone mineral density (BMD) . Methods The study involved 185 healthy females in Changsha, aged 45 ～81. Fasting serum testosterone was measured by radioimmu-noassay. Hologic QDR 4500A fan beam X-ray bone densitometer was used to measure the BMD of anteroposterior lumber (AP, L_(1～4)) and total hip, to measure the bone mineral content, BMD, body fat content and muscle tissue weight of head, trunk, ribs, pelvis, spine, upper limbs, lower limbs and the total body. Body weight, lean body mass and body fat percentage were calculated. SPSS 11.0 software was used to conduct regression analysis. Results (1) Serum testosterone showed no correlation with lean body mass, body fat content, and body fat percentage. (2) Serum testosterone was positively related with the BMD of lumbar spine and hip, but showed no correlation with the BMD after adjustment of age and years since postmenopause. (3) Lean body mass showed significant positive correlation with the BMD of different sites. Total body fat content showed positive correlation with the BMD of total hip, while body fat percentage showed negative correlation with the BMD of the whole body. Conclusion Keeping lean body mass benefits postmenopausal women to maintain bone mineral content, and taking androgen should still be cautious.

Objective To investigate the effect of super-selective intracoronary administration on acute myocardial in farction patients.Methods A total of 240 patients with ST-segment elevation myocardial infarction who received emergency percutaneous coronary intervention in our department from March 2012 to January 2014 were selected and divided into the intravenous drug administration group (n=77),the conventional intracoronary drug administration group (n=81) and the super-selective intracoronary drug administration group (n=82).Parameters,including the Thrombolysis in Myocardial Infarction (TIMI) classification,ST segment resolution after operation,peak values of creatine kinase MB (CK-MB) and troponin-I (cTn-I),left ventricular ejection fraction,left ventricular end-diastolic diameter (LVEDD),major adverse cardiovascular events and bleeding events,were compared between the groups.Results There were no significant differences in TIMI flow grade between the three groups (x2 =0.14,P=0.529).The percentage of patients with complete ST segment resolution after operation was higher in the super-selective intracoronary drug administration group than in the intravenous drug administration and conventional intracoronary drug administration groups (74.4％ vs.62.3％,61.7％,x2 =8.24,P＜0.05).Peak values of CK-MB and cTn-I were lower in the super-selective intracoronary drug administration group than in the other groups (P＜0.05).There were no significant differences in left ventricular ejection fraction and LVEDD between the three groups after operation,but left ventricular ejection fraction and the incidence of angina pectoris significantly improved in the super-selective intracoronary drug administration group than in the other groups after a three month follow-up (P＜0.05).There were no significant differences in target lesion revascularization,nonfatal myocardial infarction and druginduced thrombocytopenia between the three groups (P ＞ 0.05).Conclusions Super-selective intracoronary drug administration can significantly enhance cardiac function and alleviate angina pectoris in patients with acute myocardial infarction,and should be a recommended method.

Background It has not been reported that if the visual cortex M receptor changed during the development of myopia and how it changed if given acupuncture treatment.Objective The aim of this study was to observe the effect of electroacupuncture stimulation on the expression of acetylcholine receptors M1 (AchRM1) in visual cortex of guinea with lens-induced myopia (LIM).Methods Forty-eight three-week-old healthy guinea pigs were randomized into the normal control group,the LIM model group and the LIM electroacupuncture group.The right eyes of the guinea pigs were selected as the experimental eyes.LIM was created by monocularly wearing of-10 D lens for 4 weeks in the right eyes in the LIM model group and LIM electroacupuncture group,and then the acupuncture at the temple and hegu point was performed for 30 minutes per day for consequent 4 weeks,in the LIM electroacupuncture group.The fellow eyes of the guinea pigs were used as the self-control eyes.The refractive power and axial length were examined with retinoscopy and A-type sonography before and 4 weeks after modeling,respectively.The animals were sacrificed by excessive anesthesia at the fourth week after acupuncture and visual vertex tissue was obtained.The expression of M1 receptor mRNA in visual vertex was detected by fluorescence quantitative PCR,and the content of M1 receptor protein in visual vertex was assyed by ELISA.The study protocal was approved by Animal Ethic Committee of Shandong University of Traditional Chinese Medicine,and the use and care complied with Statement of the Association for Research in Vision and Ophthalmology.Results At the fourth week after modeling,the mean diopters were (-3.24±0.28) D and (-3.30±0.45) D in the LIM model group and the LIM eleetroacupuncture group,which were significantly higher than (0.83 ±0.86)D in the normal control group (both at P=0.000),and there was no significant difference in the diopter between the LIM model group and the LIM electroacupuncture group (t =0.200,P =0.659).The mean axial lengths were (8.67 ±0.14) mm and (8.60±0.06) mm in the LIM model group and the LIM electroacupuncture group,which were considerably increased in comparison with (8.33±0.08)mm in the normal control group (both at P＜0.05).The relative expression levels of AchRM1 mRNA in visual cortex were 0.79±0.18,1.36±0.23 and 1.13±0.13 in the normal control group,LIM model group and LIM electroacupuncture group,and the relative expression level of AchRM1 mRNA in the LIM electroacupuncture group was significantly higher than that of the normal control group and lower than that of the LIM model group (both at P＜0.05).In addition,the contents of AchRM1 receptor protein in the visual cortex were 248.00±33.31,455.17±42.40 and 396.17±47.57 in the normal control group,LIM model group and the LIM electroacupuncture group,with a similar pattern among the groups (both at P＜0.05).Conclusions A electroacupuncture stimmulation do not affect the myopic diopter and axial length in LIM model.The AchRM1 and AchRM1 receptor in the visual cortex up-regulate in LIM eyes,infering that electroacupuncture stimmulation can improve vision by decreasing the level of AchRM1 receptor in visual cortex in LIM eyes in guinea pigs.

OBJECTIVE: To investigate the effect of body composition on bone mineral density (BMD) in males with different glucose tolerance. METHODS: A total of 87 male subjects aged 35~64 years were divided into 2 groups by glucose tolerance test, 57 diagnosed T2DM and 30 with normal glucose tolerance(NGT). BMDs of anteroposterior lumbar vertebrae (AP), left femur neck (FN), total hip (T-hip), and total bone mineral density(TBMD)were measured by dual-energy-X-ray absorptiometry (DEXA). Body composition was also measured by DEXA, while fat tissue mass(FTM), lean tissue mass(LTM), percentage of truncal fat (Tru-fat%) and total fat (Fat%) were computed. The effect of body composition on the BMD of the 2 groups was analyzed. RESULTS: LTM and FN-BMD had a positive correlation in the NGT group, but no correlation in the T2DM group. The percentage of fat showed a negative relationship with the BMD of AP in the T2DM group, but not in the NGT group. The percentage of fat and total BMD had a negative association in both the NGT and the T2DM groups. In the NGT group, LTM was the independent predictor of BMD of AP,FN and hip (b=0.509, 0.411, and 0.585; P<0.01 or 0.05; R2=0.169~0.342). In the T2DM group, LTM was the independent predictor of BMD of AP (b=0.330, P<0.05, R2=0.109) and hip (b=0.462, P<0.01,R2=0.213), but not FN. CONCLUSION LTM has an attenuated effect on the BMD in male patients with T2DM compared with patients with NGT. An increased percent of fat percent is harmful to preserve bone mass in male adults, regardless of normal glucose tolerance or T2DM.
Absorptiometry, Photon ; Adipose Tissue ; metabolism ; Adult ; Blood Glucose ; metabolism ; Body Composition ; Bone Density ; Case-Control Studies ; Diabetes Mellitus, Type 2 ; metabolism ; Glucose Tolerance Test ; Humans ; Male ; Middle Aged

OBJECTIVE: To determine the relation between serum concentration of retinol binding protein (RBP) 4 and markers of bone metabolism, bone mineral density (BMD) in patients with type 2 diabetes mellitus (T2DM). METHODS: A total of 82 patients newly diagnosed with T2DM and 46 subjects with normal glucose tolerance (NGT) enrolled in the cross-sectional study. Subset analyses were performed, dividing subjects on the basis of gender into M-T2DM, F-T2DM, M-NGT, and F-NGT. The serum concentrions of RBP4, osteocalcin (OC) and C-terminal telopeptide of collagen type I (CTX) were measured with ELISA. The BMD was measured by dual-energy X-ray absorptiometry (DXA) with a Hologic QDR4500A device. RESULTS: In both the T2DM groups, lnRBP4 showed a positive relationship with lnCTX (M-T2DM, r=0.564, P<0.01; F-T2DM, r=0.386, P=0.018), but no association with lnOC. After adjusting for age, smoking, creatinine clearance rate (CCr), and waist-to-hip ratio (WHR), lnRBP4 still showed a strong association with lnCTX in the M-T2DM group (r'=0.536, P<0.01), but not in F-T2DM (r'=0.317, P=0.072). In the NGT group, there was no relation between lnRBP4 and lnCTX or lnOC. LnRBP4 showed no association with BMD in all groups. CONCLUSION The level of serum RBP4 may be correlated with the bone metabolism in patients with T2DM.
Adult ; Aged ; Bone Density ; Bone and Bones ; metabolism ; Collagen Type I ; blood ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2 ; blood ; metabolism ; Female ; Humans ; Male ; Middle Aged ; Osteocalcin ; blood ; Peptides ; blood ; Retinol-Binding Proteins, Plasma ; metabolism

Objective:To investigate effects of implantation of pectoralis major fascia combined with serratus anterior fatty fascia flap prosthesis on breast reconstruction after early breast cancer surgery.Methods:A total of 62 patients with early breast cancer undergoing breast reconstruction in Dongguan People's Hospital of Guangdong Province from July 2017 to December 2019 were selected and randomly divided into two groups, 31 cases in each group. The control group was treated with pectoralis major fascia covering prosthesis for breast reconstruction, and the observation group was treated with pectoralis major fascia combined with serratus anterior fatty fascia flap covering prosthesis for breast reconstruction. The clinical data of the two groups were recorded, the postoperative aesthetic appearance of breast was evaluated. According to the function assessment of cancer therapy-breast cancer (FACT-B) was used to evaluate the score of quality of life before and after operation, and postoperative complications were also observed.Results:In the control group and the observation group, the intraoperative blood loss was (82.61±12.38) ml, (88.76±13.57) ml, respectively; and drainage tube extubation time was (3.51±0.62) d and (3.64±0.58) d, respectively; there was no statistically significant difference between the two groups ( t value was 1.864, 0.853, respectively, all P > 0.05). The operation time of the observation group was longer than that of the control group [(2.59±0.29) h vs. (1.72±0.32) h, t = 11.217, P < 0.001]. The amount of drainage of the control group was higher than that of the observation group [(215.45±47.69) ml vs. (151.36±31.67) ml, t = 6.233, P < 0.001]; the length of hospital stay of the control group was longer than that of the observation group [(14.51±2.32) d vs. (10.79±1.86) d, t = 6.965, P < 0.001]. The excellent and good rate of postoperative breast appearance of the observation group was higher than that of the control group [96.77% (30/31) vs. 74.19% (23/31), χ 2adjusted=4.679, P = 0.031]. There were no statistical differences in all items including health, emotion, function, society/family and other conditions scores of FACT-B and total scores in both groups before the operation (all P > 0.05); all items scores and total scores of both groups after the operation were higher than those before the operation (all P < 0.001), and the sores after the operation of the observation group were higher than those of the control group (all P < 0.001). The total incidence of postoperative complications was 6.45% (2/31) of the observation group, 22.58% (7/31) of the control group, and the difference was not statistically significant (χ 2adjusted=2.080, P = 0.149). Conclusion:Breast reconstruction with implantation of pectoralis major fascia combined with serratus anterior fatty fascia flap prosthesis after early breast cancer surgery can shorten the postoperative hospital stay, improve the aesthetic appearance of breast, improve the long-term quality of life, and has a high safety.

Objective:To study the efficacy and safety of CT guided percutaneous transhepatic microwave ablation (PTPMWA) for primary liver cancer (PLC) in liver segment 9.Methods:A retrospective study was conducted on PLC patients between October 2013 and March 2019 at Dongguan People’s Hospital, Southern Medical University. Of 41 patients who entered into the study, there were 36 males and 5 females, with an average age of 59.1 years. These patients were diagnosed to have PLC in segment 9. The surgical related data and follow-up results were collected and analyzed.Results:All patients enrolled in the study completed the treatment procedure. CT scan was performed immediately after ablation which showed that the tumor areas to be completely covered by ablation. The duration of operation ranged from 45 to 260 (mean 91) min. The amount of bleeding during treatment was 1.0 to 5.0 (mean 1.4) ml. The complete response rate was 97.6% (40 patients) and the partial response rate was 2.4% (1 patient). The cumulative survival rates at 1, 2, 3, 4 and 5 years were 95.1%, 85.4%, 75.3%, 45.2% and 45.2%, respectively. Only 4 patients (9.8%) developed recurrence after treatment. The timings of recurrence were 1, 6, 13 and 67 months after treatment, respectively. The recurrent lesions were ablated again and complete response was obtained in all patients. There were no serious problems related to complications from ablation. The rate of postoperative complication was 7.3% (3 patients).Conclusion:PTPMWA is a novel treatment for patients with PLC in liver segment 9, the advantages of this treatment include good safety, high efficacy, low complications and local recurrence. The treatment is worthy of further future studies.