Postprandial hyperglycemia is one of the characteristics of glucose profiles in Chinese T2DM patients. High-ratio premix insulin analogues with advantages of excellent pharmacokinetic characteristics and flexible and convenient administration provide a comprehensive solution for Chinese T2DM patients to effectively control postprandial glucose and reduce blood glucose fluctuation. This paper is a literature review on its clinical evidence and experience.

A lot of functions of mitofusin 2 have been found,such as promoting mitochondria fusion,inhibiting cell proliferation and protecting cell avoid of apoptosis.Now,more and more evidence suggest that it is involved in insulin resistance.

Objective To study the relationship of free fatty acids and oxLDL-C with diabetic retinopathy(DR).Methods The 108 type 2 diabetes cases with(n=68)and without(n=40)DR were enrolled,and compared with 42 health control.FFA was determined by copper chromogenic method.oxLDL-C was determined by ELISA with kits provided.The correlation of risk factors with retinopathy was analyzed by logistic regression analysis.Results FFA and ox LDL-C levels were higher in DR group than in groups of DM and control.Logistic regression analysis showed that as the independent risk factors for DR pathogenesis,LDL-C,FFA,oxLDL-C and course of disease entered into regression equation.Conclusions FFA and oxLDL-C are the important risk factors for DR.

[Summary] Considerable efforts have been made to understand the cellular and molecular mechanisms of metformin ,a potent antihyperglycemic agent now recommended as the first‐line treatment of patients with T2DM. The main effect of this drug is to reducethe hepatic glucose output ,primarily through inhibition of the mitochondrial respiratory chain complex Ⅰ and then activating AM P‐activated protein kinase (AMPK) ,which provide a generally acceptable mechanism for the action of metformin on hepatic gluconeogenesis. Beyond its effect on glucose metabolism ,metformin has been reported to improve ovarian function of patients with polycystic ovary syndrome (PCOS) and to reduce the risk of microvascular and macrovascular complications in patients with T2DM. In addition ,metfomin has also recently been suggested as an adjuvant treatment of cancer. Here we reviewed the progress of mechanism research and clinical application of metformin.

[Summary] Activating transcription factor 4 (ATF4) is an alkaline leucine zipper transcriptional factor ,which is involved in many physiological metabolism processes such as stress response ,inflammation and tumor growth. Moreover ,recent studies have shown that ATF4 also plays a key role in regulating lipid and glucose metabolism ,insulin secretion and insulin sensitivity ,which may related to pathways such as endoplasmic reticulum stress (ERS ) ,peroxisome proliferator‐activated receptor gamma coactivator (PGC1α) and target of rapamycin (TOR). This article summarized the recent research progress of ATF4 in regulating glucose and lipid metabolism.

BACKGROUND:Under certain conditions, stem cel s can be induced to differentiate into vascular endothelial cel s, which can promote the angiogenesis of ischemic lower limbs and the establishment of effective circulation and improve distal blood supply of the ischemic limbs. OBJECTIVE:To review the biological characteristics and pro-angiogenesis mechanism of umbilical cord mesenchymal stem cel s and to investigate the current status of umbilical cord mesenchymal stem cel s in the repair of neuropathy and chronic wounds. METHODS:PubMed, VIP and Wanfang databases were searched for relevant articles published from 2000 to 2015 using the keywords of“stem cel s transplantation, umbilical cord mesenchymal stem cel , diabetic angiopathies”in English and Chinese, respectively. RESULTS AND CONCLUSION:Compared with peripheral blood stem cel s and bone marrow mesenchymal stem cel s, umbilical cord mesenchymal stem cel s are characterized as more widespread sources, easy col ection, stronger amplification ability, no immunogenicity, and no ethical controversy, which have become ideal target and seed cel s for pro-angiogenesis and gene therapy in ischemic diseases. Umbilical cord mesenchymal stem cel s can differentiate into vascular endothelial cel s and fibroblasts involved in wound healing. In addition, these cel s can promote the production and expression of neurotrophic factors, promote nerve regeneration in ischemic tissues, and participate in tissue repair and accelerate healing of ulcers by paracrine and autocrine cytokines, anti-inflammation and immunomodulation. Therefore, umbilical cord mesenchymal stem cel s have a broad prospect in the improvement of diabetic lower limb ischemia, repair of diabetic peripheral neuropathy and promotion of chronic ulcer healing. Compared with stem cel transplantation alone, umbilical cord mesenchymal stem cel s transplantation combined with gene therapy can further enhance cel survival and pro-angiogenesis.

Objective To investigate the effects of high-fat diet on fatty acid metabolism, expression and activity of acetyl coenzyme A carboxylase (ACC) in skeletal muscle in rats. Methods Male Wistar rats aged 22-24 months were randomly divided into old control (OC) group and high-fat diet (HF) group. Male Wistar rats aged 4-5 months were selected as young control (YC) group. The rats in OC and YC groups were fed with basic diet, and the rats in HF group received high-fat diet. Insulin sensitivity was evaluated by hyperinsulinemic-euglycemic clamp technique. Skeletal muscle triglyceride was extracted and measured by an automated biochemistry analyzer. Long-chain acetyl coenzyme A (LCACoAs) were extracted from muscle and measured by a fluorospectrophotometer. Protein expressions of ACC and P-ACC were measured using SDS-PAGE and Western blot techniques. Results (1)Fasting blood glucose (FBG), fasting insulin (FINS) and free fatty acid were higher in OC group than in YC group and they increased significantly in HF group. Triglyceride (TG) and total cholesterol (TO levels were also elevated after high-fat feeding. (2)Glucose infusion rates (GIR) were reduced in OC group than in YC group, and decreased significantly after high-fat feeding. GIR was lower at the end of the 8th week than at the end of the 4th week in HF group. (3) Compared with YC group, skeletal muscle triglyceride and LCACoAs increased in OC group and increased significantly in HF group. (4)No alterations of protein levels of ACC in skeletal muscle were detected among three groups (P>0.05). The protein levels of P-ACC in skeletal muscle were lower in OC group, and much lower in HF group than in YC group (P<0.05 or P<0.01). Conclusions Compared with young rats, abnormal fatty acid metabolism and insulin resistance always exist in aged rats. High-fat feeding results in a significant increase in lipid content in skeletal muscle. Alterations of ACC activity may contribute to fat accumulation in skeletal muscle and insulin resistance.

Objective To study the significance of Helicobacter pylori (Hp) infection and the expression of caudal-related homeobox transcription factor 2 (CDX2),mucin 2 (MUC2) proteins in gastric cancer,and elucidate the prognostic significance of CDX2,MUC2 proteins in gastric cancer.Methods Ninety cases of gastric cancer were available for the study.Hp was studied by Warthin-Starry bacterium stain and CDX2 and MUC2 proteins were studied by immunohistochemical stain.Results There was no Hp infection and no expression of CDX2 and MUC2 proteins in normal gastric mucosa.The positive rate in the cases of intestinal-type gastric cancer was 67.86%(38/56) for Hp,75.00% (42/56) for CDX2,and 66.07%(37/56) for MUC2,respectively,and it was higher than that in the cases of diffuse-type gastric cancer,which was 35.29%(12/34),41.18%(14/34) and 38.24%(13/34) respectively (P<0.01 or < 0.05).In intestinaltype gastric cancer,the positive rate of CDX2 and MUC2 proteins was also higher in Hp positive cases than that in Hp negative cases,and it was the same as CDX2 protein in diffuse-type gastric cancer.Higher positive rates of CDX2 and MUC2 proteins were observed in the cases of early gastric cancer than those in the cases of advanced gastric cancer (P < 0.01 or < 0.05),also it was observed in the cases of no lymph node metastasis than in the cases of lymph node metastasis (P < 0.01 or < 0.05).Moreover,the positive rate of CDX2 protein in the cases of stage Ⅰ～Ⅱwas higher than that in the cases of stage Ⅲ～Ⅳ (P < 0.05).Conclusions Hp infection and the expression of CDX2 and MUC2 proteins are related with gastric cancer,and has close relationship with intestinal-type gastric cancer.The expressions of CDX2 and MUC2 proteins may inhibit the infiltration and metastasis of gastric cancer.

Corresponding author: SONG Guang yao Human umbilical venous endothelial cells (HUVEC) were incubated with free fatty acids (FFAs) of various degrees of saturation. C18:1 and C18:2 inhibited the synthesis of nitric oxide (NO) and endothelin (ET) in HUVEC, and ET synthesis was inhibited much more than NO synthesis, and C18:0 increased ET synthesis in HUVEC, suggesting that the effects of FFAs on HUVEC were related to their degree of saturation.

Objective To observe the effect of fenofibrate intervention on high-fructose-feeding-induced liver steatosis in rats and explore the possible mechanism. Methods Male Wistar rats were randomly divided into control group ,high fructose group and fenofibrate group[fenofibrate intervention started after 8 weeks of high fructose feeding ,30 mg/(kg · d)]. Rats were sacrificed after 12-week of high fructose feeding. Serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),total cholesterol(TC),free triglyceride(TG)and liver TG content were determined;protein levels of fatty acid synthase(FAS),endoplasmic reticulum stress mark-er Bip and autophagy markers such as Atg7,Beclin1,LC3 and the related pathway mTOR in liver tissues were de-tected. Results Compared with those in control group and fenofibrate group,serum AST,serum total cholesterol, blood free TG and hepatic TG were significantly increased in high-fructose group(P < 0.01). The protein expres-sion of Fas,Bip and mTOR were significantly increased in high-fructose group compared with those in control group and fenofibrate group;the protein expression of Atg7,beclin1 and LC3 were significantly decreased in high-fructose group compared with those in control group and fenofibrate group. Conclusions Long-term high-fructose-feeding induces fatty liver and liver cell injury ,and may affect ERS and autophagy. High-fructose-feeding-in-duced fatty liver may be improved by fenofibrate and its underlying mechanism might be associated with Fas,ERS and autophagy in liver.