Objective To explore the impact of family history of hypertension and diabetes mellitus on the phenotype of insulin resistance and the ?-cell function in normoglycemic subjects. Methods 275 normoglycemic subjects were divided into four groups according to family history of hypertension and diabetes,namely group combined with family history of hypertension and diabetes (H+D+group),group without family history of hypertension and diabetes (H-D-group),group without family history of hypertension but with diabetes (H-D+group),group with family history of hypertension but without diabetes (H+D-group). The homeostasis model assessment of insulin resistance(HOMA-IR) and the function of insulin secretion (HOMA-?) was used to estimate insulin resistance and ?-cell function. Results The mean body mass index,waist to hip ratio,blood pressure,triglycerides,cholesterol and HOMA-IR were significantly higher in H+D+group than those in H-D-group,but HDL,HOMA-? were significantly lower in H+D+group than those in H-D-group (all P

Objective To investigate the difference in EMG peroneal nerve conduction velocity between patients with diabetic foot ulcers and T2DM patients without diabetic foot and its influencing factors.Methods Retrospective analysis was performed on clinical data of a total of 108 patients, including 54 inpatients with diabetic foot and 54 T2DM patients without diabetic foot ulcers, so as to investigate the difference in EMG peroneal nerve conduction velocity between these two groups of patients and its influencing factors.Results Compared with the control group, EMG peroneal nerve conduction velocity was slower in the diabetic foot group, with statistically significant difference (P<0.05).There were significant differences in education attainment, WBC count, neutrophil ratio, hemoglobin, albumin, and ABI between the two groups (P<0.05).Peroneal sensory nerve conduction velocity presented negative correlation with HbA1C, WBC count, and neutrophil ratio(P<0.05), and positive correlation with fasting C-peptide level, hemoglobin, albumin, and ABI (P<0.05).Peroneal motor nerve conduction velocity presented negative correlation with smoking duration, HbA1C, and neutrophil ratio (P<0.05), and positive correlation with hemoglobin and albumin (P<0.05).Conclusion Diabetic perineuropathy is an important risk factor for diabetic foot ulcers.Poor blood glucose control, infection, smoking, poor pancreatic islet function, anemia, hypoproteinemia, and poor lower limb blood supply may contribute to the development or progression of diabetic perineuropathy.In preventing and treating diabetic foot, it is therefore desirable to lay stress on blood glucose control, give active anti-infective treatment, improve or protect pancreatic islet function, and correct anemia and hypoproteinemia;attention should also be paid to patient education on diabetes and foot diseases.

Objective To explore whether adiponectin activates AMP-activated protein kinase(AMPK) via LKB1 pathway or not in skeletal muscle and liver tissues.Methods Male Sprague-Dawley rats ( n =28 ) were divided into normal control diet( NC,n =15 ) and high-fat diet( HF,n =13 ) groups.After 16 weeks feeding,fasting blood free fatty acids( FFA ),triglyceride( TG ),total cholesterol( TC ),fasting plasma glucose( FPG ),fasting insulin(FINS),and adiponectin were determined.The protein levels of AMPKα,phosphorylated AMPKα ( p-AMPK ),and LKB1 in the skeletal muscle and liver tissues were analyzed with Western blot.Cultured primary skeletal muscle cells and hepatic cells were incubated with aditonectin and radicicol.The expression of AMPKα,p-AMPKα,and LKB1 inthese cells were analyzed with immunofluorescence method.Results Compared with NC group,body weight,FFA,TG,FPG,and FINS in rats of HF group were significantly higher( all P＜0.05 ) while serum adiponeetin level was lower( P＜0.05 ).The levels of AMPKα phosphorylation and LKB1 expression in the skeletal muscle and liver tissues of HF group were lower than those in NC group. In primary skeletal muscle cells and hepatic cells,adiponectin significantly increased the levels of AMPKα phosphorylation and LKB1 expression ( all P＜ 0.05 ),which were decreased by radicicol ( P＜0.05 ).Conclusion Adiponectin may activate AMPK via LKB1 pathway in skeletal muscle and liver tissues of rats.

The data collected from 34 type 2 diabetic patients receiving intensive insulin therapy for six years showed that the yearly mean HbA1C was less than 7.0％,and none of the patients showed severe hypoglycemia,occurrence or evident progression of retinopathy or nephropathy,and the islet β cell function gained improvement.The DQOL score,used to evaluate the quality of patients' life had no significant change during the observation ( P ＞0.05 ).It is satisfactory and safe to maintain long-term glycemic control with prolonged intensive insulin therapy in patients with type 2 diabetes,and that such therapy does not induce untoward influence on the quality of diabetic patients life.

Objective To investigate the effect of vacuum-assisted closure(VAC)on the circulating number of endothelia progenitor cell(EPCs)in diabetic patients with mild to moderate degrees of ischemic foot ulcer and their related factors. Methods A total of 84 diabetic patients with foot ulcer duration for at least 4 weeks and ankle brachial index(ABI)0.5~0.9 were selected and divided into and assigned to two groups according to 2: 1 randomization:vacuum-assisted closure(VAC)treatment group(n=56)and Non-VAC treatment group(n=28). The control group (NC) was composed of 18 patients who had normal glucose tolerance and lower extremity ulcer without arteriovenous disease. VAC was performed on the ulcer wound after debridement for 1 week in both VAC group and NC group,and the patients in Non-VAC group received conventional treatment process. The circulating number of EPCs was measured before and after various treatments and the influencing factors of their changes were analyzed. Results After VAC treatment,the circulating number of EPCs significantly increased in both VAC group and NC group[(85.3 ± 18.1)vs(34.1 ± 12.5)/106cells,(119.9 ± 14.4)vs(66.1 ± 10.6)/106cells,both P<0.05]. By contrast,the circulating number of EPCs had no significant change in Non-VAC group[(45.2 ± 19.4)vs(34.7 ± 16.8)/106cells, P>0.05]. In addition,the circulating levels of vascular endothelial growth factor(VEGF)and the protein expressions of VEGF and stromal cell-derived factor-1α(SDF-1α)in the granulation tissue also significantly increased after VAC treatment in both VAC group and NC group,but no significant change in Non-VAC group. Compared with Non-VAC group,the changes of VEGF and SDF-1α levels in the sera and granulation tissue were all significantly higher in both VAC group and NC group(P<0.05 or P<0.01). There were no significant differences in changes of the circulating number of EPCs, and VEGF and SDF-1α in the sera and granulation tissue between VAC group and NC group. Correlation analysis showed that the change of the circulating number of EPCs was correlated with the changes of VEGF and SDF-1α levels in the sera and granulation tissue of VAC group and NC group(P<0.05). Conclusion VAC treatment may increase the circulating number of EPCs in diabetic patients with mild to moderate ischemic foot ulcer as in non-diabetic controls,which may be attributed to the upregulation of systemic and local VEGF and SDF-1α levels.

Objective : To analyze the changes of serum C-type lectin domain family 11 member A ( Clec11a) in the progression of diabetic kidney disease (DKD) and evaluate its value in bone metabolism． Methods : The clini- cal data of 184 patients with type 2 diabetes (T2DM) were collected and serum Clec11a levels were detected．Ac- cording to the UACR , patients were divided into non-albuminuria group of 76 cases，microalbuminuria group of 72 cases and macroalbuminuria group of 36 cases．In the same period，50 healthy subjects were selected as control group．The general clinic data，bone mineral density and bone metabolism indexes of all groups were measured．The correlation between Clec11a level and bone metabolism indexes of DKD patients was analyzed. Results : Levels of Clec11a and eGFR in all T2DM subgroups were significantly lower than those in normal control group (P＜0. 05) . Levels of Clec11a and eGFR in T2DM subgroups significantly decreased with the increasement of UACR ( P < 0. 05) ．Bone mineral density ( BMD) of neck of femur and Clec11a levels in microalbuminuria group were lower than those in non-albuminuria group (P＜0. 05) ．The levels of Clec11a and BMD of lumbar vertebra in macroalbu- minuria group were lower than those in microalbuminuria group (P＜0. 05) ．Bone metabolism indexes such as 25 hydroxyvitamin D［25 ( OH) D］，N-terminal fragment of osteocalcin，amino terminal peptide of type Ⅰ procollagen， parathyroid hormone，and β collagen degradation products were not significantly different between microalbuminuria group and non-albuminuria group．BMD，25 ( OH) D and Clec11a levels were negatively correlated with UACR levels (P＜0. 05) ．Clec11a had the strongest correlation with UACR. Conclusion Serum Clec11a levels in T2DM pa- tients significantly decreased with the increasement of UACR. Compared with other bone metabolism indexes， Clec11a showed a stronger negative correlation with UACR. Regular detection of serum Clec11a levels for DKD pa- tients is conducive to identify bone loss early.

Objective : To investigate the effects of hypothyroidism and drug intervention on the cognitive function of rat offspring through the establishment of a rat model of experimental hypothyroidism in pregnancy. Methods : A total of 20 SD female rats were randomly divided into control group ( CON group) and hypothyroid group ( PTU group) . The hypothyroid model was established by propylthiouracil ( PTU) , the thyroid hormone levels of female mice were detected by electrochemiluminescence immunoassay , and the differences between the two groups were compared. After successful modeling , the male mice were mated in cages , and the hypothyroid group was randomly divided into no intervention group ( group I) , first trimester intervention group ( group II) and second and third trimester intervention group ( group III) . The Morris water maze ( MWM) experiment was used to test the learning and memory ability of the rats. The morphological structure of hippocampal neurons , the expression of nucleoprotein (NeuN) and synapse⁃associated protein ( SYN) in mature neurons were observed by hematoxylin⁃eosin staining (HE) , Nissl staining and immunohistochemistry. Results : ① Compared with the CON group , the female mice in the PTU group had a significant increase in TSH and a significant decrease in FT4 (P < 0. 05) . ② In the positioning navigation test , the evasion latency of the pups in each group was gradually shortened. On the 5th day , the incubation period of group I was significantly longer than that of groups CON , II , III (P < 0. 05) . There was little change between groups II and III and CON groups (P > 0. 05) . ③ The residence time of group II was significantly different from that in group I during the space exploration stage (P < 0. 05) . There was a significant difference between the number of pups crossing the platform in group I and groups CON , II and III (P < 0. 05) . ④ There was no significant difference between HE staining and Nissl staining in hippocampal tissues of rats in each group. However, compared with the CON group , the average absorbance of NeuN and SYN proteins in the hippocampus of mice in groups I , II and III was significantly reduced (P < 0. 05) . Conclusion Hypothyroidism will have adverse effects on the cognitive function and hippocampal neuron development of pregnant rats , and the effects of intervention on the cognitive function of offspring at different stages of pregnancy are different , the earlier the intervention , the smaller the damage to cognitive function.