Objective To compare the clinical efficacy of once daily regimen with Glipizide GITS (Glucotrol XL) and multiple dose regimen with Gliclazide (Diamicron) in the treatment of Chinese patients with type 2 diabetes mellitus. Methods One hundred and fifty one Chinese type 2 diabetic patients meeting the 1985 WHO diagnostic criteria were recruited from 4 clinical centers. The patients were assigned to Glipizide GITS (78 cases) or Gliclazide (73 cases) treatment group. Results The trial consisted of 1 week washout period followed by 6 week dosage regulation period and 6 week dosage maintenance period. Comparing to the baseline, HbA 1c , fasting plasma glucose (FPG) and 24 hour glucose profile levels in two groups were significantly reduced after 3 month treatment. In Glipizide GITS group, the mean reductions of blood HbA 1c and FPG level were 0.55% and 2.05 mmol/L respectively (P

Objective To investigate the insulin and glucagon levels in the patients with different islet cell antibody (ICA) subtypes and to explore the pathogenesis of latent autoimmune diabetes of adult (LADA). Methods Subjects were classified by immunohistology and 29 ICA-peripheral-positive DM patients, 28 ICA-diffused-positive DM patients and 17 controls (ICA-negative) were included. Serum glucose, insulin and plasma glucagon were measured at 0, 30, 60, 120 min after standard meal. Results (1) As compared with controls, glucagon in ICA positive groups were higher (both P

Objective To establish the islet ? cell rat model by the ? cell-deleting technology.Methods Tweenty-four normal male SD rats and 12 weeks old were randomly divided into 3 groups,i.e,a normal diet group(NC,n=8),the model group 1(M1,n=8),and the model group 2(M2,n=8).The rats in M1 and M2 group were injected with 100 mg/kg and 150 mg/kg of streptozocin respectively.Five days later,the rats were sacrificed.The level of insulin(Ins)and Glucagon(Glc)in the pancreatic homogenate was measured.The tail of pancreas were obtained and fixed by Bolins liquid.Immunohistochemistry was performed to evaluate the expression of Ins and Glc in islet cells.Quantitative analysis was executed by image analyzer.Results Compared with the NC group,the total pancreas island areas of beta-cell deleting rats,M1 group and M2 group,are approximately 1/7 of normal control rats.Moreover,the percentages of beta-cell areas from total pancreas island areas decreased from 74.3% down to 5.4% and 5.2%,respectively.The Ins content in pancreas tissue homogenate of beta-cell deleting rats does not reach 3% of normal ones,While the Glc content unexpectedly increases.Less alpha cells distinguished by Glc positive dying through Immunohistochemistry are observed at periphery of pancreas islands of NC group.With beta cellsdeletion,the aggregation of alpha cells from periphery to centre of pancreas islands is found in M1 and M2 groups.Furthermore,the percentages of alpha cells area from total pancreas island areas are promoted from 16.4% to 76.5%、74.4%,respectively.Conclusion The islet ? cell rat model was established by injecting large dose STZ(100 mg/kg and 150 mg/kg).

Objective To compare the efficacy and tolerability of nateglinide with those of acarbose in Chinese type 2 diabetes mellitus (T2DM) patients.Methods This multi-center,randomized,double-blind,parallel-arm study compared the efficacy and tolerability of nateglinide( 120 mg,3/d,n = 119) and those of acarbose( 100 mg,3/d,n = 118) during a 12-week treatment in T2DM patients uncontrolled by diet with glycosylated haemoglobin (HbA1c) 6.5% - 11.0% .Results Monotherapy with nateglinide (120 mg,3/d)or acarbose (100 mg,3/d)decreased HbA1c to a similar extent during 12-week treatment.The mean change from baseline to end-point in HbAlc was ( -0.90±0.98)% and ( -0.83±0.81 )% in patients receiving nateglinide and acarbose,respectively,with no significant difference between the two groups (P>0.05).The decrease in fasting plasma glucose (FPG)was similar between nateglinide and acarbose (P > 0.05).The mean change in 2-hour postprandial plasma glucose ( PG2h ) was ( - 1.45 ± 2.74) mmol/L and ( -2.20±2.21 ) mmol/L in patients receiving nateglinide and acarbose(P =0.0017).Body weight was significantly decreased in both groups at the end-point ( P < 0.05 ),although the decrease was more with acarbese than nateglinide [( -0.66±1.79)kg vs (-2.06±2.00) kg,P=0.0000].And the proportion of patients experiencing any presumed drug related adverse events was not significantly different between the two groups.Conclusions Nateglinide ( 120 mg,3/d) is effective and well tolerated in T2DM patients uncontrolled by diet,demonstrating similar HbA1c reductions as compared with acarbose (100 mg,3/d).

Pancreatic stellate cell (PSC) activation in islet fibrosis of insulin-resistant rats induced by high-fat diet was investigated. After 20 weeks, the glucose infusion rate and glucose-stimulated insulin secretion in high-fat group were significantly decreased while fasting plasma glucose, fasting serum insulin, free fatty acid and the basal glucagon secretion were significantly increased compared with those parameters of the control rats (P< 0.05 or P<0.01). Activated PSC and collagen fiber ( type Ⅰ and Ⅲ) were found in islets of rats fed with high-fat. The result suggests that PSC activation, proliferation and migration to islet may contribute to islet fibrosis in insulin-resistant rats.

Objective To investigate the effects of chronic high glucose on α-cells glucagon releasing in relation to insulin resistance induced by high glucose. Methods TC1-6 cells, an α-cell line, were incubated separately in DMEM containing high (25.0 mmol/L), medium (11.1 mmol/L) and low (5.5 mmol/L) concentrations of glucose for 1 to 5 days. The secretion and gene expression of glueagon were measured. When TC1-6 cells had been cultured for 5 days, three different concentrations of insulin were added for 6 h and then glucagon secretion was detected. Western blot was used for 1 and 3 days to confirm the effect of high glucose on phosphorylation of Akt in TC1-6 cells. Results (1) Exposure of TC1-6 cells to 11.1 and 25.0 mmol/L glucose resulted in a slight increase of glucagon secretion compared with those incubated with 5.5 mmol/L. However, after 5 days in media containing 25.0 mmol/L glucose, glucagan secretion was significantly increased as compared to cells treated with low glucose [(136.80±10.94 vs 78.62±4.72 ) ng/106 cells, P<0.05]; moreover, in TC1-6 cell cultured with high glucose glucagon mRNA expression was increased significantly. (2) 10-7 mol/L insulin reduced significantly glucagon secretion of TC1-6 ceils exposed to low glucose [(21.59±1.30 vs 55.12±3.86) ng/106 cells], but just scarcely inhibited glucagon secretion of cells incubated with high glucose [(106.58±8.53 vs 117.18±10.55) ng/106 cells]. When insulin concentration was increased to 10-5 mol/L, glucagon secretion of TC1-6 cells in high glucose was also reduced [(46.55±3.72 vs 118.61±10.68 )ng/106 cells]. (3) After treated with 10-5 mol/L insulin for 2h, the levels of Akt phosphorylation in both groups of TC1-6 cells were increased by 180% and 70%, while the level in high glucose group was significantly lower than that in low glucose group. In the presence of phosphoinositide 3 kinase inhibitor, the levels of Akt phosphorylation were both lowered, but the inhibition in low glucose group was more significant than in high glucose group. Conclusion High glucose induces hypersecretion of glucagon, which may be due to the a-cell insulin resistance.

Objective To evaluate the clinical efficacy and safety of sibutramine (Reductile )in Chinese obese patients. Methods Obese adults (BMI 27～45 kg/m 2) in six research centers received sibutamine 10 mg or placebo one tablet each day with a controlled-energy diet for 24 weeks by randomized, double-blinded, placebo-controlled study. Results For intent-to-treat analysis, 125 sibutramine-treated subjects and 126 placebo-treated subjects were evaluated. After 24 weeks, sibutramine-treated patients lost more weight (6.52?3.95)kg than placebo-treated patients (3.18?3.59)kg(P

Objective To study effects of bivalirudin and heparin plus tirofiban on plasma P-selectin in patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI) and compare the clinical effects on bleeding and thrombosis.Methods 260 hospitalized patients with acute STEMI who accepted emergency PCI were enrolled in the study.They were randomly divided into the bivalirudin group (129 cases) and the heparin plus tirofiban group (131 cases).Blood samples were taken before operation,during operation (about 20 minutes after medicacion injection) and after operation (three hours after the end of operation).Serum P-selectin levels were measured.All patients were followed-up for 30 days.The main events included hemorrhage within 30 days,acquired thrombocytopenia and stent thrombosis.Results The level of P-selectin increased significantly in the heparin group during operation compared to the preoperative level and remained statistically higher at three hours after the end of operation than preoperative level (P ＜ 0.05).Compared with preoperative level,the P-selectin level of the bivalirudin group was significantly lower than that of heparin group (P ＜ 0.05).After 30 days of follow-up,bivalirudin had lower rates bleeding events compared to the heparin group(5.4％ vs.15.3％,P =0.009).The need of medical intervention for bleeding events (BRAC2-5 hemorrhage) was less in the bivalirudin group(0.8％ vs.5.3％,P =0.029).There was no significant difference in the major bleeding events between the 2 groups (BRAC3-5 hemorrhage) (0 vs.0.8％,P =0.32).No significant difference found between the two groups in acquired thrombocytopenia (P ＞ 0.05).Conclusion Bivalirudin may reduce P-selectin levels in STEMI patients undergone emergency PCI during perioperative period.Heparin increases perioperative P-selectin.Bivalirudin may reduce the bleeding events.

Objective: To investigate the influencing factors of preschoolers hyperopia reserve, and to provide a scientific basis for preschoolers to prevent myopia. Methods: Visual screening and a questionnaire survey were conducted on 5 087 4-year old children in Suzhou High-tech Zone from September to December in 2020. The influencing factors of children s hyperopia reserve were analyzed by univariate analysis and Logistic regression model. Results: A total of 997(19.6%) children had hyperopia reserve deficiency. Logistic regression showed that the negative factors associated with hyperopia reserve included being girl( OR=0.81, 95%CI =0.70-0.93), no food allergy( OR=0.78, 95%CI =0.63-0.96); and the positive factors included father myopia( OR=1.20, 95%CI =1.03-1.39), mother myopia( OR=1.17, 95%CI =1.01-1.36), exposure of night lights(for less than 1 hour: OR=1.53, 95%CI =1.21-1.92; for 1 to 3 hours: OR=1.48, 95%CI =1.09-2.00), insufficient vegetable intake( OR=1.26, 95%CI =1.07- 1.46 )( P <0.05). Conclusion Parental myopia, nighttime sleep environment and dietary factors have potential associations with hyperopia reserve deficiency among children. Corresponding measures should be actively taken to improve the preschoolers hyperopia reserve.