Objective To observe the changes in blood glucose,albumin/creatinine ratio and isletβcell function,after calcitriol therapy was used on patients with type 2 diabetes mellitus and microalbuminuria.Methods Sixty patients with type 2 diabetic microalbuminuria were randomly divided into experimental group and control group,each had 30 cases.Patients in the experimental group were given calcitriol 0.25ug once a day for three months,the changes of blood glucose,glycosylated hemoglobin,albumin/creatinine ratio,islet βcell function were observed.Results After the intervention,the albumin/creatinine ratio level in the experimental group was lower than that in the control group ((127.48±139.94) mg/g vs.(151.02±96.25) mg/g,P=0.04).The insulin resistance index in the experimental group was lower than that in the control group ((2.99±1.24) vs.(3.72±2.58),P=0.233),the difference was not statistically significant.Conclusion Calcitriol can reduce microalbuminuria in patients with type 2 diabetes.Calcitriol may be helpful in improving insulin resistance in patients with type 2 diabetes mellitus.

Objective To investigate the relationship between serum 25-(OH) D3 and autoimmune thyroid diseases (AITD).Methods Serum levels of 25-(OH) D3, thyroid antibodies (thyroid stimulating hormone receptor antibody (TRAb), TGAb (thyroid globulin antibody), thyroid peroxidase antibody (TPOAb) and thyroid function of 32 cases patients with Graves' diseases (GD), 17 cases patients without remission of GD,10 cases patients with remission of GD,35 cases patients with Hashimoto's thyroiditis (HT),and 58 cases healthy subjects were measured,and the relationships between serum 25-(OH) D3 and the above clinical index were analyzed.Results The serum level of 25-(OH) D3 in patients with GD or HT were obviously lower than that in healthy subjects((50.75±17.60) μg/L, (36.40±21.65) μg/L, (43.05±19.53) μg/L,P＜0.05).No significant difference of the serum level of 25-(OH) D3 was found between patients refractory of GD and those with GD in remission((32.43±17.50) μg/L, (31.88±14.48) μg/L,P=0.866).However,compared with the normal control group,both diseased groups showed significantly decrease (P＜0.05).No correlation was found between serum 25-(OH) D3 and TRAb, FT3, Fr4 as well as TSH in GD group.No correlation was found between serum 25-(OH) D3 and TGAb, TPOAb (P＞ 0.05).Conclusion Serum vitamin D levels are decreased in patients with AITD, which has been speculated as a potential therapeutic method for AITD, though further investigations are needed to establish the precise role of 25-(OH) D3 in AITD.

Objective To investigate the changes in serum level of myocardial enzymes in patients with primary hypothyroidism and to evaluate the relationship between the level of those enzymes and clinical or experimental parameters.Methods We measured several myocardial enzymes in serum of 108 patients with primary hypothyroidism including 31 cases of Hashimoto's thyroiditis,28 cases of atrophic thyroiditis,24 cases of Graves' hyperthyroidism treated by 131I,and 25 cases of Graves' hyperthyroidism treated by antithyroid drugs,as well as 50 normal controls.Results All the myocardial enzymes,including creatine kinase(CK) and its isoenzyme CK-MB,aspartate aminotransferase(AST),lactate dehydrogenase(LDH) and its isoenzyme HBDH,especially CK,were elevated in serum of patients with hypothyroidism.In addition,significant negative correlations were found between CK and FT3,CK and FT4,CK-MB and FT3,CK-MB and FT4.No difference in enzyme level was found among different hypothyroidism groups.Conclusion Hypothyroidism may cause elevation of myocardial enzymes in serum of the patients.The degree of CK and CK-MB increase was associated with the severity of hypothyroidism,and thus can be regarded as indexes to determine the severity of hypothyroidism.

Objective To evaluate the risk factors for diabetic foot in patients with type 2 diabetic mellitus (T2DM).Methods One hundred and forty-three patients with T2DM including 63 cases with diabetic foot(DF) and 80 cases with non-diabetic foot (NDF) were recruited.All possible risk factors for diabetic foot were documented,including low density lipoprotein-cholesterol (LDL-C),homocysteine (Hcy),diabetic polyneuropathy(DPN),diabetic retinopathy(DR),peripheral vascular disease(PVD) and so on.Results (1) There were significant differences between DF group and NDF group in terms of general clinical data,including age(65.38±11.58) years old and (60.12±9.92) years old,precious history of foot ulcer(28.6％ (18/63) and 3.8％(3/80)),serum homocysteine(Hcy) ((23.24± 11.77) μmol/L and (18.62±7.74) μmol/L)),glycosylated hemoglobin(HbA1c) ((10.22±2.81) ％ and (8.67±2.30) ％),blood albumin (Alb) ((32.45±5.83) g/L and (38.58±4.71) g/L),LDL-C ((2.15±0.72) mmol/L and (2.60±0.78) mmol/L),diabetic nephropathy (DN) (77.8％ (49/63) and 45.0％ (36/80)),diabetic retinopathy (DR) ((73.0％ (46/63) and 33.8％ (27/80)),diabetic peripheral vascular disease (PVD) (93.7％ (59/63) and 65.0％ (52/80)) and diabetic peripheral neuropathy (DPN) (77.8％ (46/63) and 60.0％ (48/80)) (P ＜0.05).(2) Logistic regression analysis showed that the development of diabetic foot was significantly correlated with age(OR =1.09,95％ CI:1.02-1.16,P =0.01),Hcy (OR =1.12,95％ CI:1.03-1.22,P =0.01),DR(OR=8.47,95％CI:1.85-38.87,P=0.01),PVD(OR=8.73,95％CI:1.07-70.92,P =0.04) and precious history of foot ulcer (OR =12.28,95％ CI:1.57-96.28,P =0.02).Conclusion Complications due to multiple factors of Diabetic foot,and Hcy is another risk factor for that.

An ever increasing number of drugs directed as epidermal growth factor receptor tyrosine kinase inhibi-tor (EGFR-TKI) bring a new revolution for non-small cell lung cancer (NSCLC) therapy, and many large scales of studies show that only people with EGFR-sensitive mutation can benefit from these drugs. The main method of EGFR mutation detection is to analyze the DNA sequence of EGFR, which can be the lung cancer tissue, pleural fluid tumor cells, circulating tumor cells and peripheral blood free DNA obtained by surgery or puncture, the biggest drawback is that the heterogeneity of EGFR muta-tion cannot be analyzed. However, with the development of molecular imaging, the development of EGFR-targeted molecular probes based on positron emission computed tomography-computed tomography (PET-CT) has made it possible to reveal the EGFR mutations in lung cancer tissues in vivo, and can detect the heterogeneity of EGFR mutations. This article reviews all the results and progress of molecular probes targeting EGFR mutations.

Objective:To analyze the expression level of hepcidin in urine of patients with type 2 diabetic kidney disease (DKD) in different stages and its relationship with DKD and related indicators.Methods:From June 2022 to December 2023, 139 inpatients with type 2 diabetes mellitus in the Department of Endocrinology, Zhoupu Hospital Affiliated to Shanghai Health Medical College were selected as the research objects. The stage of DKD was judged by urinary albumin/creatinine ratio (UACR): UACR <30 mg/g in stage A1, UACR ≥30 mg/g~≤300 mg/g in stage A2. DKD in stage A3 was UACR >300 mg/g. According to the stage of DKD, there were 50 patients with stage A1 (group A1), 47 patients with stage A2 (group A2), and 42 patients with stage A3 (group A3). Urinary hepcidin was determined by enzyme-linked immunosorbent assay, and fasting blood glucose, total cholesterol, triglyceride, alanine aminotransferase (ALT), serum creatinine and hemoglobin A1c (HbA1c) were measured and compared. The correlation between urinary hepcidin and other markers, the risk factors of DKD and the evaluation of diagnostic value were analyzed. Measurement data with normal distribution were expressed as xˉ± s, mean comparison among the three groups, if the variance was homogeneous, the analysis of variance test was used; if the variance was not homogeneous, the Welch test was used; the proportion or rate of enumeration data among the groups was tested by χ2 test; Pearson correlation analysis was used for correlation analysis; binary Logistic regression model was used for multivariate analysis; The value of urinary hepcidin in the diagnosis of DKD was analyzed by receiver operating characteristic curve. Results:Urinary hepcidin was (5.3±1.0) μg/L in group A1, (7.7±2.5) μg/L in group A2, and (10.1±2.7) μg/L in group A3. There was significant difference among the three groups ( F=58.92， P<0.001), and urinary hepcidin increased with the severity of DKD; Urinary Hepcidin was related to UACR ( R=0.684, P<0.001), serum creatinine ( R=0.590, P<0.001), course of disease ( R=0.485, P<0.001), triglyceride ( R=0.264, P=0.002), age ( R=0.235, P<0.001), P=0.005), total cholesterol ( R=0.224, P=0.008), systolic pressure ( R=0.194, P=0.022), glomerular filtration rate ( R=-0.540, P<0.001) and BMI ( R=-0.175, P=0.040); There was no correlation with fasting blood glucose, HbA1c, ALT and diastolic blood pressure (all P>0.05). Secondly, the increase of urinary hepcidin level was a risk factor for DKD by binary Logistic regression analysis ( OR=4.147,95% CI: 2.154-7.984, P<0.001). Finally, receiver operating characteristic curve analysis showed that the optimal cut-off point of urinary hepcidin was 6.35 μg/L, with a sensitivity of 0.831 and a specificity of 0.880. Conclusion:Urinary hepcidin increases with the severity of DKD, which may be a biomarker for early diagnosis of DKD.

Objective:To analyze the correlation between simple thyroid nodule and blood lipid and glucose metabolism and iodine nutrition level.Methods:A cross-sectional study was conducted by collecting data of the population undergoing epidemiological investigation in Jinshan District, Shanghai from July to December 2015, to calculate the prevalence of thyroid nodules and analyze relevant functional indicators.Results:Simple thyroid nodules were detected in 603 subjects, with a prevalence of 22.6% (603/2 669). There were 358 female patients with simple thyroid nodules, with a prevalence rate of 26.9%, and 245 male patients with simple thyroid nodules, with a prevalence rate of 18.3%. The prevalence of simple thyroid nodule in female was higher than that in male, and the difference was statistically significant (χ 2=27.686, P<0.001). In addition, the prevalence of simple thyroid nodules increased with age (13.1% (92/704) and 20.2% (104/514) and 25.1% (145/578) and 24.4% (107/439) and 36.3% (98/270) and 34.8% (57/164), χ 2=83.872,P<0.001). In the ≤30 years group (8.0% (30/704) vs. 18.8% (62/331), χ 2=35.716, P<0.001), >30 to ≤40 years old group (14.1% (37/263) vs. 26.7% (67/251), χ 2=12.683, P<0.001), >60 to ≤70 years old group (26.2% (33/126) vs. 45.1% (65/144), χ 2=10.435, P<0.001), and the 70-year-old group (24.4% (21/86) vs. 46.2% (36/78), χ 2=8.521, P<0.001). The prevalence of simple thyroid nodules in males was lower than that in females. In the simple positive thyroid nodule group, Fasting blood glucose (5.12 (4.80, 5.69) and 5.02 (4.72, 5.48)), total cholesterol (1.24 (0.85, 1.86) and 1.13 (0.77, 1.76)), triglyceride (4.77 (4.09, 5.48) and 4.49 (3.92, 5.16)), low density lipoprotein((2.79 (2.26, 3.36) and 2.63 (2.19, 3.16)), and high density lipoprotein cholesterol (1.41 (1.18, 1.66) and 1.35 (1.13, 1.61)) were higher than those in the negative group ( U values were 554 818, 578 468, 535 622, 556 067 and 567 960, respectively, all P<0.01). The BMI index grade distribution of thyroid nodule positive group was higher than that of negative group, and the difference was statistically significant (3.7% (77/2 066), 50.1% (1 034/2 066), 32.4% (669/2 066), 13.8% (286/2 066), 3.2% (19/603), 43.6% (263/603), 38.1% (230/603), 15.1% (91/603), χ2=9.5201, P=0.023). The prevalence of simple thyroid nodules was significantly lower in the iodized salt group than in the non-iodized salt group (20.7% (436/2 102) vs. 29.5% (167/567), χ 2=19.376, P<0.001). The urinary iodine level in the positive thyroid nodule group was significantly lower than that in the negative group (148.4(100.2, 213.7) vs. 169.5(115.4, 241.75), U=545 129.5, P<0.001). After Logistic regression screening, age ( OR=1.57, 95% CI: 1.292-1.908, P<0.001), gender ( OR=1.278, 95% CI: 1.193-1.368, P<0.001), BMI grade ( OR=1.166, 95% CI: 1.022-1.330, P=0.022), total cholesterol ( OR=1.105, 95% CI: 1.005-1.214, P=0.040), iodized salt ( OR=0.689, 95% CI: 0.556-0.854, P=0.001) were independent influencing factors of thyroid nodule. Conclusion:The prevalence of simple thyroid nodules in Shanghai is relatively low. Age, sex, BMI level, total cholesterol and iodized salt are independent factors causing thyroid nodules. In addition, blood glucose level may also be related to the prevalence of thyroid nodules.

Objective:To explore the dynamic changes of three-dimensional morphology of laryngeal soft tissue and its clinical value in the unilateral vocal fold paralysis (UVFP) patients through dynamic CT scanning during the process from inspiration to phonation.Methods:From October 2017 to July 2019, a retrospective study was performed in 18 patients with UVFP (10 males and 8 females with the range of age from 29 to 75 years old) and 10 normal subjects (5 males and 5 females with the range of age from 25 to 58 years old) in Department of Voice-Otolaryngology Head and Neck Surgery, Section Two, Zhongshan Hospital Xiamen University. The laryngeal dynamic computed tomography (CT) of cine mode was performed. Ten dynamic sequence images of vocal folds movements were obtained during the process from inspiration to phonation. Based on the dynamic changes of glottic area and the displacement of cricoid cartilage. The above dynamic sequence images were divided into inspiratory phase and phonation phase as well as open phase and closed phase. The soft tissue parameters were measured respectively, including vocal folds length, width, thickness and subglottal convergence angle. Independent-sample t test was used to analyze between UVFP group and control group. Results:During the process from inspiration to phonation, the morphology of vocal folds in control group was relatively stable at inspiratory phase and closed phase in phonation. When open phase and closed phase of phonation were switching, the morphology of vocal folds changed obviously. The length of vocal folds became longer (1.19±0.10) mm, the width became wider (2.19±0.17) mm, the thickness became thinner (2.66±0.56) mm, and the subglottal convergence angle decreased (31.45±4.78)°. Compared with the controll group, in the open phase, the thickness and width of the vocal fold on affected side in the UVFP group were thinner ( t=10.25, P<0.001) and wider ( t=5.25, P<0.001).While in the closed phase, the subglottal convergence angle was larger ( t=4.41, P=0.001).The width of the healthy side vocal fold in the UVFP was wider ( t=2.54, P=0.026) than that in the control group. The differences in other parameters were not statistically significant. Conclusions:Dynamic laryngeal CT scanning provides a simple and non-invasive method for the objective and quantitative measurement of the dynamic changes of laryngeal morphology from inspiration to phonation. Compared with the control group, the characteristic dynamic changes among UVFP were observed during this particular process, which included changes of subglottal convergence angle and thickness of vocal muscle due to denervation. In addition, in UVFP group, the width of the vocal fold healthy side in the closed phase may be used to assess its compensatory function.

To investigate the effect of the jianpi-jiedu formula (JPJD) on the expression of angiogenesis-relevant genes in colon cancer.
 Methods: Crude extract was obtained from JPJD by water extract method. The effect of JPJD crude extract on colon cancer cell proliferation capacity was determined by MTT assays. The IC50 value was calculated by GraphPad Prism5 software. Affymetrix gene expression profiling chip was used to detect significant differences in expressions of genes after JPJD intervention, and pathway enrichment analysis was performed to analyze the differentially expressed genes. Ingenuity Pathway Analysis software was applied to analyze differentially expressed genes relevant to tumor angiogenesis based on mammalian target of rapamycin (mTOR) signaling pathway and then the network diagram was built. Western blot was used to verify the protein levels of key genes related to tumor angiogenesis.
 Results: JPJD crud extract inhibited the proliferation capacity in colon cancer cells. The IC50 values in 24, 48, and 72 hours after treatment were 13.060, 9.646 and 8.448 mg/mL, respectively. The results of chip showed that 218 genes significantly upgraded, and 252 genes significantly downgraded after JPJD treatment. Most of the genes were related to the function of biosynthesis, metabolism, cell apoptosis, antigen extraction, angiogenesis and so on. There were 12 differentially expressed angiogenesis genes. IPA software analysis showed that the JPJD downregulated expression of sphingomyelin phosphodiesterase 3 (SMPD3), VEGF, vascular endothelial growth factor A (VEGFA), integrin subunit alpha 1 (ITGA1), cathepsin B (CTSB), and cathepsin S (CTSS) genes, while upregulated expressions of GAB2 and plasminogen activator, urokinase receptor (PLAUR) genes in the colorectal cancer cell. Western blot results demonstrated that JPJD obviously downregulated expressions of phospho-mTOR (P-mTOR), signal transducer and activator of transcription 3 (STAT3), hypoxia inducible factor-1α (HIF-1α), and VEGF proteins, while obviously upregulated the level of phospho-P53 (P-P53) protein.
 Conclusion: JPJD may inhibit colorectal tumor angiogenesis through regulation of the mTOR-HIF-1α-VEGF signal pathway.
Animals ; Blotting, Western ; Cathepsin B ; drug effects ; metabolism ; Cathepsins ; drug effects ; metabolism ; Cell Line, Tumor ; drug effects ; Colorectal Neoplasms ; blood supply ; genetics ; Down-Regulation ; Drugs, Chinese Herbal ; pharmacology ; Gene Expression Profiling ; methods ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; drug effects ; metabolism ; Integrin alpha Chains ; drug effects ; metabolism ; Neovascularization, Pathologic ; genetics ; Receptors, Urokinase Plasminogen Activator ; drug effects ; metabolism ; STAT3 Transcription Factor ; drug effects ; metabolism ; Signal Transduction ; Sphingomyelin Phosphodiesterase ; drug effects ; metabolism ; TOR Serine-Threonine Kinases ; drug effects ; metabolism ; Tumor Suppressor Protein p53 ; drug effects ; metabolism ; Up-Regulation ; Vascular Endothelial Growth Factor A ; drug effects ; metabolism

To investigate the effect of jianpi-jiedu (JPJD) prescription-contained serum on colorectal cancer SW48 cell proliferation and the underlying mechanisms.
 Methods: Crude extract from JPJD was made by water extract method and the main components of crude extract from JPJD were analyzed by ultra-performance liquid phase high resolution time of flight mass spectrometry (UPLC-Q-TOF/MS). The low, medium, and high-concentration of JPJD-contained serum were prepared by the serum pharmacological method. The effect of serum containing JPJD on SW48 cell proliferation was determined by MTT assay. The cell cycle was detected by flow cytometric method. The protein levels of mammalian target of rapamycin (mTOR), phospho-mTOR, P-P53, and -P21, and the mRNA level of mTOR were examined by Western blot and RT-PCR, respectively.
 Results: Seven compounds including calycosin-7-glucoside, astragaloside, ginsenoside-Re, ginsenoside-Rb1, glycyrrhizinic acid, apigenin, atractylenolide-II were identified. MTT assays demonstrated that the SW48 cell proliferation was inhibited by medium and high concentration of JPJD-contained serum and the percentages of cells at G1 phase in SW48 cell cultured in the medium and high concentration of JPJD serum group were significantly higher than those in the control group (P<0.05). Meanwhile, the levels of mTOR mRNA and phospho-mTOR protein in the medium and high concentration of JPJD serum groups were substantially lower than those in the control group (P<0.05). Conversely, the expressions of phospho-P53 and P21 protein were significantly increased in the medium and high concentration of JPJD serum group compared with those in the control group.
 Conclusion: JPJD prescription-contained serum can inhibit SW48 cell proliferation, which may be related to mTOR-P53-P21 signaling pathways.
Animals ; Apigenin ; Blotting, Western ; Cell Cycle ; Cell Division ; Cell Proliferation ; drug effects ; genetics ; Colorectal Neoplasms ; Cyclin-Dependent Kinase Inhibitor p21 ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Flow Cytometry ; Ginsenosides ; Glycyrrhizic Acid ; Humans ; Lactones ; Phosphorylation ; genetics ; RNA, Messenger ; Saponins ; Sesquiterpenes ; Signal Transduction ; TOR Serine-Threonine Kinases ; drug effects ; Triterpenes ; Tumor Suppressor Protein p53 ; drug effects