Objective To compare the effects of two different approaches of insulin delivery on hyperglycemia.Methods 26 poorly controlled diabetic patients were studied by two methods of intensive insulin delivery.⑴Continuous subcutaneous insulin infusion(CSⅡ) group(n=6),including 4 cases of type 1 DM,2cases of type 2 DM;⑵Multiple subcutaneous insulin injection(MSⅡ) group(n=20),including 3 cases of type 2 DM,17 cases of type 2 DM.The target BGs for both groups were premeal and bedtime BG3≥3 6mmol/L ≤7 2mmol/L for at least 3 days.Results Both groups had reached the target BGs,the CSⅡ groups more close to normal level.The average durations of treatment were significantly different;CSⅡ(8 3?1 3)d,MSⅡ(13 6?2 4)d for the two groups (t=5 136,P0 05).The hypoglycemia incidence in CSⅡ was(0 67?1 3)time/case,in MSⅡ(2 15?1 4)time/case(t=2 305,P

Objective To study the change of the eonnxin43 expression in the heart of diabetic mellitus rats. Methods STZ-in-dueed diabetic mellitus in rats were developed. The expression of connexin43 in the heart was detected by immunohistochemistry and image analysis, and the heart function was observed by electrophysiolograph and echocardiogram. Results During the course of diabetic mellitus, the expression of connexin43 in the heart of diabetic rats decreased respectively in the 12th week and 24th week (P<0.01). The values of dp/dtmax and + dp/dtmax in group DM in the 12th week and 24th week were lower than that in normal control group respectively (P<0.01), and the LVEF were also decreased (12w P<0.05,24w P<0.01). The analysis of correlation showed that the expression of con-nexin43 in heart were positively correlated with heart function (P<0.05) . Conclusion The expression of Connexin43 evidently de-creased in the hearts of diabetic rats and it is positively correlated with the heart function.

BACKGROUND:The main clinical manifestation of senile arteriosclerosis obliterans is lower limb ischemia, which is currently difficult to treat. One method is by autologous stem cell transplantation into the muscles of ischemic limbs to improve the formation of new capillaries and restore lower limb blood flow. Endothelial progenitor cell marker CD34+ cell transplantation has been shown to promote angiogenesis in ischemic limbs. Therefore, we propose that peripheral blood autologous CD34+ cell transplantation in older adult patients with atherosclerotic ischemia could effectively promote angiogenesis.OBJECTIVE:To assume that peripheral blood autologous CD34+ cell transplantation in the elderly with atherosclerotic ischemia could effectively promote angiogenesis.METHODS:This is a prospective, single-center, open-label, randomized, and controlled clinical trial that will be completed at the Qingdao No. 9 People's Hospital, China. Twenty older adult patients with atherosclerotic lower limb ischemia will be randomized into two groups. In the cell transplantation group (n=10), peripheral blood CD34+ cells transfected with vascular endothelial growth factor 165 (VEGF165) gene will be intramuscularly transplanted into the ischemic limbs in older adult patients with atherosclerotic lower limb ischemia. In the control group (n=10), normal saline will be intramuscularly injected into the ischemic limbs. All patients will be followed up for 6 months. The primary outcome will be ankle-brachial indices before and 6 months after transplantation to assess lower limb ischemia in both groups.The secondary outcomes will be the number of microvessels in the lower limb muscles before and 6 months after transplantation, the morphology of new blood vessels revealed by CT angiography, the number of VEGF-immunoreactive cells 6 months after transplantation and the incidence of adverse reactions. The trial was registered at the ClinicalTrials.gov (identifier:NCT03098771), and the study protocol was approved by the Ethics Committee of Qingdao No. 9 People's Hospital of China. All protocols will be in accordance with Declaration of Helsinki,formulated by the World Medical Association. All patients will be informed of study protocols and provide a written informed consent prior to the beginning of the trial.DISCUSSION:This trial will begin in January 2018 and finish in December 2019. We aim to quantify the effects of VEGF165 gene-modified CD34+ cell transplantation in the treatment of older adult patients with atherosclerotic ischemia to develop a new effective treatment of lower limb ischemia.