Objective To investigate the effects of exenatide on insulin sensitivity in type 2 diabetics.Methods 42 diabetics of secondary failure of sulfonylurea were recruited in the study,and were distinguished to the exenatide group and the glargine group.Besides being treated with diabetic conventional and original treatments,the two groups were given respectively exenatide before breakfast and dinner,or glargine before sleeping by subcutaneous injection for five weeks.Insulin sensitivity of the two groups was elevated by euglycemic-hyperinsulinemic clamps before and after treatment.The metabolic indices were determined.Results Compared with baseline levels,after treatment the glucose metabolic rate was improved [(5.12 ± 0.35) vs (2.94 ± 0.41)] mg · kg-1 · min-1,P ＜ 0.05],the BMI and HMOA-IR was reduced[4.51 (1.32 ～ 6.12) vs 1.96 (1.32 ～ 6.12)],in the exenatide groups,which were better than the glargine group (P ＜ 0.05).Gastrointestinal adverse reactions,which were tolerable and decreased,were appeared in nearly 31.42％ of subjects.There were no severe hypoglycemic events in both groups.Conclusion Short-term treatment with exenatide could improve the insulin sensitivity of type 2 diabetics.

ObjectiveTo explore the effects of short-term high-fat diet on expression of peroxisome proliferator-activated receptor-γ-coactivator 1α (PGC1α) in hypothalamus of rats. Methods18 male SD rats were randomly divided into 2 groups: the normal control group (NC) and the high-fat group (HF). After two-week adaptive feeding, the 2 groups were given control diet and high-fat diet respectively for 3 days. Body weight and energy intake were recorded every day. Random blood glucose of caudal vein was measured before and after intervention. The mRNA and protein levels of PGC1α, UCP2 and CPT1a in hypothalamus were detected by quantitative RT-PCR and Western Blot. ResultsAfter the three-day treatment, the energy intake in HF group was significantly increased compared with that in NC group (75.7 ±5. 02 vs 60.4 ±4.53 kcal/d, P ＜0.05). However,the body weight, food intake and blood glucose level were not significantly changed. The mRNA level of PGC1α was significantly decreased (P ＜0.05 ), while no significant difference was observed in protein levels. Conclusion Short-term high-fat diet downregu]ates the expression of PGC1α mRNA in hypothalamus of rats.

Objective To observe and compare the association of serum levels of of complement component 3(C3)and high-sensitive C-reactive protein(hs-CRP)with insulin resistance in non-diabetic subjects. Methods 587non-diabetic Chinese were recruited. Weight, height, blood pressure, waist circumference, fasting plasma glucose,fasting serum insulin, blood lipids, C3 and hs-CRP were measured. HOMA index(HOMA2-IR)was calculated.Insulin resistance was defined as the upper quartile of HOMA2-IR. Results C3 and hs-CRP were significantly higher in subjects with insulin resistance compared with subjects without insulin resistance. After controlling for age, gender,body mass index, and waist circumference, C3 was positively and significantly correlated with HOMA2-IR(r = 0.19,P＜0.01). As C3 increased, subjects were 3.78(OR= 3.78, P＜0.05)times more likely to suffer from insulin resistance, after adjustment for age, gender, systolic blood pressure, diastolic blood pressure, total cholesterol,triglycerides,high-density lipoprotein cholesterol, and waist circumference. However, hs-CRP was not significantly correlated with insulin resistance. Conclusions Serum complement component 3 has a more marked association with insulin resistance than hs-CRP in non-diabetic Chinese.

Objective To assess if the ratio of ApoB/ApoA1 is related to the metabolic syndrome and its components. Methods 709 adults living in Chongqing were enrolled. Weight, height, blood pressure, waist circumferences, fasting plasma glucose(FPG) , fasting serum insulin(FIns) and lipids were measured. ApoB/ApoA1 ratio, BMI and insulin resistance index were calculated. Results ApoB/ ApoA1 ratio was increased in subjects with insulin resistance(IR)and MS. Compared with the low ApoB/ ApoA1 ratio group, the high ApoB/ApoA1 ratio group was more likely to get MS(OR=3.5)and IR(OR =2.3) (P<0.001). Conclusions ApoB/ApoA1 ratio is strongly associated with IR, MS and its components, and a high ApoB/ApoA1 ratio is a valuable marker of MS.

Objective:To explore the application of microteaching combined with hierarchical training in the teaching of standardized training for nurses in the department of endocrinology.Methods:A total of 80 nurses in the endocrinology department from February 2020 to February 2021 were selected and randomly divided into a control group and a study group, with 40 ones in each group. The control group adopted traditional teaching and the research group adopted microteaching combined with hierarchical training. After the standardized training, the two groups of nurses were subjected to theoretical assessment, practical skills assessment, clinical practice ability improvement, the satisfaction of the assessment team and inpatients with the nurses, and the incidence of adverse events during the standardized training of the two groups of nurses. SPSS 22.0 was performed for t test and chi-square test. Results:After the training, the research group's theoretical and practical skills assessment scores were better than those of the control group, with statistically significant differences ( P<0.001); the improvement of clinical practice ability of the research group was better than that of the control group, with statistical significance ( P<0.001); the satisfaction rate of nurses in the research group (assessment group and patients) was better than that of the control group, and the differences were statistically significant ( P<0.001). During the standardized training of nurses, there were statistically significant differences in the incidence of adverse events between the two groups of nurses ( χ2=5.165, P=0.023). Conclusion:The application of microteaching combined with hierarchical training can help improve the level of theoretical and practical skills of nurses in the endocrinology department, improve nurses' clinical work ability and patient satisfaction rate, effectively reduce the incidence of adverse events, and build a harmonious relationship between doctors, nurses and patients.