Ketosis-prone diabetes mellitus(KPDM) may be a subtype of type 2 diabetes,characterized by fulminant onset,with diabetic ketoacidosis and usually obesity and over-weight,as well as a positive family history of diabetes,but lacking markers of autoimmunity observed in classic type 1 diabetes.Recovery of glucose homeostasis,accompanied by recovery of ?-cell function,follows intensive glycemic regulation by insulin.Because of the mixed features of type 1 and type 2 diabetes,there is no completely agreement on diagnostic criteria and classification according to clinic presentation,metabolic and immunologic features of the novel atypical diabetes.Additional pathophysiological and genetic insight is therefore needed to provide a better understanding of the mechanisms of partially reversible insulin secretary defect in such syndrome,which is critical for its clinical classification and the development of appropriate treatment strategies.

Objective To investigate the clinical characteristics,peripheral insulin sensitivity,and β-cell function in patients with ketosis-prone diabetes(KPD).Methods Thirty-one patients with newly diagnosed ketosisprone diabetes were admitted to West China Hospital from January 2004 to December 2009.They were divided into 2 groups according to their body mass index (BMI):OB-KPD (BMI ≥ 25 kg/m2,n =22) and Lean-KPD (BMI ＜ 23 kg/m2,n =9).10 patients with newly-onset type 2 diabetes free from ketosis (OB-DM:BMI ≥ 25 kg/m2,n =10) were enlisted as control.Detailed assessments of medical history and symptoms of hyperglycemia were performed.The islet cell antibody (ICA),insulin autoantibody (IAA),anti-glutamic acid decarboxylase antibody (GAD-Ab),fasting plasma glucose,serum insulin,C-peptide and free fat acids concentrations were measured.All of the subjects underwent oral and intravenous glucose tolerance tests,euglycemic-hyperinsulinemia and hyperglycemia clamp test,to evaluate the insulin secretion and insulin sensitivity respectively.Insulin sensitivity was determined by glucose disposal rate (GDR) of steady state during euglycemic clamp and acute insulin secretion was calculated by insulin area under curve(AUCins 0-10 min) during IVGTT.Maximal insulin secretion was determined by glucose infusion rate (GIR) and serum insulin concentration of steady state during hyperglycemic clamp test.Results Age,sex,duration of diabetes were matched among groups.A family history of diabetes was strongly associated with those patients with obesity,compared with lean ketosis prone diabetes(16/22 vs 1/9).GDR was (4.91 ± 1.82) mg · kg 1 · min-1 in subjects with OB-KPD,being lower than that in Lean-KPD patients[(6.26 ± 1.89) mg · kg 1 · min-1] and OB-DM group[(6.78-± 1.69) mg · kg 1 · min-1,P＜0.01].Serum insulin and C-peptide in OB-KPD patients were higher than Lean-KPD patients.Area under the insulin curve [AUCins0-10min (183.86 ± 31.1) mIU/L] and GIR[(2.65 ±1.53) mg · kg-1 · min-1] in OB-KPD patients were lower than those in OB-DM group[(697.06-± 231.9) mIU/L,(6.53 ± 2.21)mg · kg 1 · min-1,P＜0.0 1],but slightly higher than the Lean-KPD group [AUCins0 10min (92.1 ±29.8) mUU/L,GIR (2.55 ± 1.49) mg · kg 1 · min-1,P＜0.05].Glucose disposal rate (GDR) was strongly associated with casual plasma glucose (r =-0.502,P＜0.01),HbA1C(r =-0.553,P＜0.0 1) and FFA eoneentrations (r=-0.504,P＜0.01) on admission.Conclusions Insulin resistance and β-cell dysfunction coexist in all KPD patients.OB-KPD patients exhibit more severe insulin resistance,while Lean-KPD patients have lower insulin secretion.KPD patients had severe hyperglycemia,hypertriglyceridemia,and high plasma FFA levels on admission,suggesting that hyperglycemia and elevated FFA levels could result in serious insulin resistance,β-cell dysfunction,and diabetic ketosis in patients with KPD.

Objective: To establish a method for the determination of metamizole sodium and chlorphenamine malete in zhongganling Tablets. Methods: The sample was determined by ion pair HPLC after it was purified on Sep Pak C 18 microcolumn. The chromatographic conditions included: Hypersil DBS C 18 chromatographic column (250mm?4.6mm, i.d.5?m) as an anlaytical column, methanol mixed solution of sodium heptanesulfonate and glacial acetic acid (600∶400) as a mobile phase, the detection wavelength at 264nm and 1.0mL?min -1 of flow rate. Results: The average recoveries of metamizole sodium and chlorphenamine maleate were 99.6% (RSD was 2.1% and n was 6) and 98.0% (RSD was 1.5% and n was 6), respectively. Conclusion: Metamizole sodium and chlorphenamine maleate can be determined respectively by HPLC with the same mobile phase when Sep Pak C 18 microcolumn solid phase extraction method is used to substitute for the traditional sample pretreatment methods refluxing, extracting and concentrating, and sodium heptanesulfonate ion pair reagent in acid condition is selected.

The effects of elevated levels of glucose and (or) free fatty acids on insulin secretion were studied in obese rats by intravenous glucose tolerance test and isolated pancreas perfusinn. The results showed that both glucose- and arginine-stimulated insulin secretions were severely impaired by glucolipotoxicity and the production of ketone was increased dramatically.

Objective:To explore the relationship of NSCL/P with MTHFR gene polymorphism in Xinjiang Uyghur and Han popula-tion and the ethnic difference.Methods:rs1801131 and rs1801133 polymorphism was detected by SNaPshot genotype method in 170 children with NSCL/P and 100 healthy controls of Uyghur and Han population.Results:Rs1801133 TT and T allele was statistically difference between 2 nationalities(P <0.05),Rs1801133 CT and CT +TT genotypes in total case group and control group were sta-tistically different(P <0.05);Rs1801131 and rs1801133 conjoint analysis showed that between the 2 nationalities and between case and control groups of total population were statistically different(P <0.05);rs1801131 genotype between 2 nationalities or total cases and controls were not statistically different(P >0.05).Conclusion:Rs1801133 TT and T allele in Han nationality are more likely to suffer from NSCL/P than in Uyghur,rs1801133 CT and CT +TT genotypes are protective factors.Rs1801131AC and rs1801133CC conjoint is relevant to NSCL/P,and the risk in Uyghur is higher than in Han.MTHFR rs1801131 gene polymorphism may not be relat-ed with NSCL/P in Uyghur or Han.

Pharmaceutical researchers at home and abroad have been working in pursuit of an effective, easy-to-use and safe way of non-injecting insulin administration. Oral insulin was considered to be one of the ideal administration ways for the treatment of diabetes mellitus. In this review, we introduce the clinical value and progress of oral insulin delivery in recent years. The mechanisms, therapeutic effect, limitations of oral insulin delivery, and the future perspectives in this research field are also discussed.
Administration, Oral ; Animals ; Diabetes Mellitus ; drug therapy ; Drug Carriers ; Drug Delivery Systems ; Humans ; Insulin ; administration & dosage

Objective To determine the influence of gender on the association between serum uric acid and branchial-ankle pulse wave velocity (baPWV).Methods Cross-sectional data from 1418 adults who underwent routine laboratory tests and baPWV measurements were analyzed in a gender-specific manner.BaPWV≥ 1400 cm/s was defined as abnormality.The individuals were assigned to four groups (Q1,Q2,Q3 and Q4) according to the gender-specific quartiles of serum uric acid.The relationship between serum uric acid and the baPWV values was assessed by Spearman's correlation coefficients.In female,the relationship of serum uric acid quartiles with baPWV was evaluated by logistic regression analysis.Results In male and female,diastolic blood pressure,fasting blood glucose,triglyceride and body mass index were increased with serum uric acid level,in contrast to high-density lipoprotein cholesterol.The Spearman's correlation coefficient for the relationship between serum uric acid and baPWV was 0.18 in female and-0.05 in male (P =0.16).In female,univariate logistic regression analysis showed that in comparison with group Q1,odds ratio (OR) value of baPWV abnormality of group Q4 was 2.45 (95％confidence interval (CI) 1.48 to 4.06).In multivariate logistic regression,after adjusting for creatine and estimated glomerular filtration rate,OR value of baPWV abnormality of group Q4 was 2.45 (95％ CI 1.48 to 4.06) when compared with group Q1.However,after adjustment for age and other risk factors of cardiovascular diseases,there were no significant differents in ORs among serum uric acid quartile groups.Conclusions The association between serum uric acid level and baPWV in female may depend on age and metabolic syndrome components.

Objective To analysis the result of tumor screening for health examination participants.Methods Tumor screening was applied for 15 863 health examination participants without malignant tumor disease history.Clinical examination,laboratory tests and imaging studies were comprehensively analysed combining the results of other medical items.The cancer detection rate and asymptomatic rate were compared among groups of different age,gender and existence of relevant clinical symptoms,respectively.χ2 test and Fisher exact test were adopted for statistical analysis.Results Among 475 tumor patients with a definite diagnosis,116 were malignant tumor;The total detection rate of the group who were younger than 35 year-old(0.617%)was higher than other groups,the detection rate of intracranial neoplasms of the two groups who were younger than 45 year-old (0.206% and 0.132%,respectively)was higher than other groups,the total detection rate of 75-85 group (0.248%)was lower than other groups; The detection rate of lung cancer,liver cancer of the male(0.228% and 0.080%,respectively)was higher than the female,The detection rate of breast cancer and intracranial neoplasms of the female(0.366% and 0.100%,respectively)was higher than the male; There are 67 patients without correlated clinical symptoms,the asymptomatic rate was 57.8%.Conclusions Tumor screening was of importance in health management,which should be carried out actively in health examination.

AIM: To investigate the effect of sitagliptin on the autopaghy and the expression of extracellular matrix in mesangial cells induced by advanced glycation end products (AGEs).METHODS: The cells were divided into 5 groups: control group, AGE group, and sitagliptin (5, 10 and 20 μmol/L) groups.After 48 h, the cell viability was measured by MTT assay, and the content of collagen (Col) Ⅳ in the supernatant of the cell culture was detected by ELISA.The protein levels of beclin-1, adenosine monophosphate-activated protein kinase (AMPK), p-AMPK, p70S6K and p-p70S6K were determined by Western blot.RESULTS: Compared with control group, the viability and the expression of Col IV induced by AGEs in the cultured mesangial cells were significantly increased (P<0.01).Sitagliptin decreased the viability and the expression of Col IV induced by AGEs in the mesangial cells in a dose-dependent manner.AGEs significantly inhibited the protein levels of beclin-1 and p-AMPK, but significantly increased the protein level of p-p70S6K.Compared with AGE group, sitagliptin significantly reversed the above results in a dose-dependent manner.CONCLUSION: Autophagy may mediate the protective effect of sitagliptin on mesangial cells induced by AGEs.

Objective To present the clinical effect of dorsal carpometacarpal island flap with fascia, vessel and nerve to repair soft tissue defected. Methods The island flap was designed with root of fascia, dorsal metalcarpals artery and nerve.The flap to soft tissue defected in the nearby area was applied, including 30 cases in the last segment of thumb, 4 cases in the first segment of thumb, 1 case in the IP articulation of thumb, 1 case in the first segment of middle finger, 1 case in the carpometacarpal dorsal area and 1 case in the back of index finger. Results Thirty-eight cases were survived. All cases obtained good appearance and sensory recovery approach normally with little affection in supply area. Conclusions This method has advantage of simple, practical, high survive rate, low impairment, sensible and good appearance.