Very low-density lipoprotein receptor(VLDLR)is a transmembrane lipoprotein receptor and plays an important role in the disorder of lipid metabolism in diabetes.The finding of changes in expression and distribution of two subtypes of VLDLR in diabetes as well as the effective VLDLR gene therapy in hyperlipidemia have drawn attention to the VLDLR as a potential target for prevention of abnormal lipid metabolism in diabetes.

Intraperitoneal glucose tolerance test was performed in the streptozotocin- and high fat-induced diabetic rats and normal rats.The results of RT-PCR and Western blot showed that the expression of 11?- hydroxysleroid dehydrogenase type 1 (11?-HSD1) was higher in the diabetic rats than that in control and was correlated with fasting plasma glucose,insulin and AUC-I/G with respective correlation coefficient (r) of 0.870, - 0.799,- 0.850,suggesting that increased expression of 11?-HSD1 appears to damage?-cell function through magnifying the local effect of glucocorticoids.

Abstract: Objective　To collect and organize malaria case data in Hubei Province from 2017 to 2021, compare and analyze the malaria epidemic characteristics on the before and after malaria elimination, and provide scientific support for Hubei Province to further optimize the comprehensive strategies to prevent re-transmission after the elimination of malaria. Methods The study was conducted by collecting the data of reported malaria cases of Hubei during 2017-2021 from the Infectious Disease Surveillance Reporting and Management System, and conducting the epidemiological characteristics of malaria on pre-elimination (2017-2019) and post-elimination (2020-2021). Results A total of 429 cases of imported malaria were reported in Hubei Province from 2017 to 2021, and the malaria epidemic showed an obvious trend of rising first and then falling. On the pre-malaria elimination, 374 malaria cases were reported, including 262 cases of P.falciparum (70.05%); on the post-malaria elimination, 55 malaria cases were reported, including 25 cases of P.falciparum (45.45%). There was a statistically significant difference in the proportion of infections caused by the four types of malaria parasites before and after the elimination of malaria (χ2=14.248, P<0.05). On the pre-malaria elimination, the peak of disease onset mainly occurred in January, July, and November; on the post-malaria elimination, the peak of disease onset mainly occurred in January to February, and December. Both before and after malaria elimination, the reported cases were mainly concentrated in Wuhan, Yichang, Huangshi, Xiangyang, Shiyan and Huanggang, but the range of cases showed a clear trend of narrowing. Before and after malaria elimination, malaria cases in Hubei Province were mainly among young and middle-aged males aged 30-49. The proportions of workers and migrant workers increased from 37.70% and 9.09% before the elimination to 50.91% and 18.18% after the elimination, respectively, with a statistically significant difference (χ2=17.839, P<0.05). The percentage of interval from onset of illness to initial diagnosis ≥ 5d decreased from 21.66% before the elimination to 10.91% after the elimination (χ2=6.448, P<0.05). The percentage of definitive diagnosis of malaria at initial diagnosis in town clinic increased from 18.18% before the elimination to 50.00% after the elimination. The proportion of malaria cases diagnosed by county-level medical institutions increased from 22.73% before the elimination to 34.55% after elimination. There was no statistically significant difference in the proportion of malaria cases diagnosed by medical institutions at all levels before and after the elimination of malaria (χ2=5.630, P>0.05). The proportion of cases with the interval between initial diagnosis and diagnosis within 24h increased from 43.85% before the elimination to 70.91% after the elimination. There was a statistically significant difference in the proportion of cases with the interval between initial diagnosis and diagnosis before and after the elimination of malaria (χ2=14.006, P<0.05). Before and after malaria elimination, all reported cases were mainly imported from African countries. Conclusions There are imported malaria cases reported every year in Hubei Province before and after the elimination of malaria, which poses a great challenge to the prevention of re-transmission. Therefore, it is necessary to strengthen the surveillance system, detect and standardize the treatment of imported malaria cases in a timely manner, conduct targeted retransmission risk surveys and assessments, and consolidate the achievements of malaria elimination.

Objective To understand the current status of paragonimiasis epidemic in western mountain areas in Hubei Prov-ince. Methods Four counties(cities)of Western Hubei Province(Xingshan,Enshi,Yunxi,Baokang)were selected as the investigation sites for active surveillance. Crabs were captured and the metacercariae of Paragonimus were detected. Meanwhile, the blood samples were collected from the residents in the surveillance sites and the unique IgG and IgM antibodies against Para-gonimus in the sera were detected by ELISA. In addition,a questionnaire survey about knowledge and behavior of prevention and control of paragonimiasis was taken among the residents. Results A total of 1143 residents were investigated in the active surveillance,the total positive rate of the serology test was 1.84%(21/1143),while the rates of the male and the female were 1.78%(10/562)and 1.89%(11/581),respectively,with no statistical significance between them(χ2=0.002,P>0.05). The average weight of 161 fresh-water crabs captured was 11.72 g,with the positive rate of 9.32%(15/161)and the infective density of 7.07 metacercariae per positive crab. The positive rates of the male and female crabs were 11.54%(9/78)and 7.23%(6/83), respectively(χ2=0.884,P>0.05),and the infective densities were 6.67 and 7.67 metacercariae per positive crab,respective-ly. Totally 1143 residents were investigated by questionnaires,and 0.44%of them had the behavior of eating raw or half-done fresh-water crab,and 0.87% of them had the behavior of drinking un-boiled stream water. Conclusions The transmission chain of paragonimiasis still exists in the nature environment of mountain area in Western Hubei Province. The positive rate of the second intermediate host rebounds in some investigation sites. Therefore,the measures of continuous surveillance and health education should be taken to avoid the appearance of the prevalence or outbreak.

Objective To analyze 10 years survival status of urban female patients with corpus uteri cancer and its influencing factors in Liaoning Province. Methods Based on Liaoning cancer register database, 426 patients with corpus uteri cancer in Shenyang, Anshan and Benxi from 2000 to 2002 were randomly selected. They were followed up passively and actively. Life table method and Ederer Ⅱ method were used to calculate the observed survival rate (OSR), the expected survival rate (ESR) and the relative survival rate (RSR). Results We finally included 218 corpus uteri patients. The diagnosis proportions of stage Ⅰ-Ⅳ were 59.2%, 11.5%, 11.0% and 8.7%, respectively. Ten-year RSR and OSR were 59.6% and 67.9%. The diagnosis stage was negatively correlated with 10-year RSR. The 10-year RSR of patients treated with surgery was 71.3%, which was 6.6 times that of non-surgical treatment (10.8%). The 1-year RSR to 10-year RSR ranged from 88.4% to 67.5%. The RSR of each stage was Ⅰ-Ⅱ(95.7%-77.9%) > Ⅲ (71.4%-44.5%) > Ⅳ (58.4%-11.0%). Multivariate Cox model analysis showed that age > 55 years old, late diagnosis stage and non-surgical treatment were the main factors affecting the 10-year survival rate. Conclusion Early diagnosis and surgical treatment can significantly improve the long-term survival rate of patients. Therefore, we should strengthen the early detection and treatment of corpus uteri cancer, standardize and strengthen the screening program.

OBJECTIVETo investigate the correlative factors affecting the IIEF-5 scores of the patient with type 2 diabetic mellitus (T2DM).

METHODSA total of 149 T2DM patients were investigated for the relationships between their IIEF-5 score and such factors as age, body mass index (BMI), fasting plasma glucose (FPG), 2hPG, insulin (INS), GHbA1c, C-peptide, nitric oxide (NO), testosterone (T), estradiol (E2), the ratio of testosterone to estradiol (T/E), erythrocyte aldose reductase (AR), drinking, smoking, concomitant diseases, complications and medication.

RESULTSThe scores of the groups of smoking, complication, medication and concomitant disease were significantly lower than those of the controls. There was significant negative correlation between IIEF-5 scores and age, BMI, FPG, 2hPG, INS, GHbA1c and AR (P < 0.05), and significant positive correlation between IIEF-5 scores and NO (P < 0.05). But there was no correlation between drinking, T, E2 and T/E2 (P > 0.05).

CONCLUSIONMany factors may affect the IIEF-5 scores of T2DM patients.

Adult ; Age Factors ; Aged ; Aldehyde Reductase ; blood ; Body Mass Index ; Diabetes Mellitus, Type 2 ; epidemiology ; physiopathology ; Erectile Dysfunction ; epidemiology ; Factor Analysis, Statistical ; Glucose Tolerance Test ; Humans ; Male ; Middle Aged ; Nitric Oxide ; blood ; Penile Erection ; physiology ; Regression Analysis ; Surveys and Questionnaires

OBJECTIVETo investigate the role of insulin receptor substrate 2 (IRS2) and Bax on mouse islet cell apoptosis in the presence of high glucose in vitro.

METHODSThe pancreatic islet cells were isolated from Kunming mice and divided into 6 groups (G1-G6 groups) for a 72-h culture in the media containing different concentrations of glucose (5.6, 7.8, 11.1, 16.7, 22.2, and 27.6 mmol/L, respectively). Insulin secretion by the cells was evaluated by radioimmunoassay, and the expressions of IRS2 and Bax were detected using immunocytochemistry and immunofluorescence assay, respectively. Hoechst33342 staining was employed to observe the cell apoptosis.

RESULTSExposure to 5.6-11.1 mmol/L glucose resulted in increased insulin secretion and progressive elevation of IRS2 and Bax expression, whereas the cell apoptosis underwent no obvious changes. In the presence of glucose above 16.7 mmol/L, the percentages of apoptotic islet cells increased with glucose concentration, but insulin secretion and IRS2 expression decreased; Bax expression significantly increased in the presence of high-concentration glucose.

CONCLUSIONProlonged exposure of mouse islet cells to high glucose induces apoptosis and impairs insulin secretion of the cells. Decreased IRS2 expression and increased Bax expression may play an important role in the glucotoxicity in mouse islet cells.

Animals ; Apoptosis ; Cells, Cultured ; Glucose ; pharmacology ; Insulin Receptor Substrate Proteins ; metabolism ; Islets of Langerhans ; drug effects ; metabolism ; Mice ; Mice, Inbred Strains ; bcl-2-Associated X Protein ; metabolism

Food intake has a great influence on blood glucose in patients with diabetes.This study was to determine the glycemic index (GI) and glycemic load (GL) of a particular pomelo named Majia pomelo and its effects on postprandial glucose (PPG) in patients with type 2 diabetes (T2D).Twenty healthy subjects and 20 T2D patients (controlled on lifestyle measures and/or metformin) were tested on 2 separate days with 50 g of glucose and 50 g equivalent of carbohydrates from Majia pomelo for GI measurement.To test effects of Majia pomelo on PPG,19 hospitalized T2D patients (controlled on insulin therapy) were selected for a 9-day study.The dose of insulin for each patient was adjusted on the first 3 days.A total of 100 mg Majia pomelo was consumed per meal in the last 3 tested days.Blood glucose was measured to evaluate the glycemic excursions.The GIs for Majia pomelo in healthy individuals and T2D patients were 78.34± 1.88 and 72.15±1.95 respectively.The value of GL was as low as 4.23 in diabetic patients with serving size of 100 g pomelo,indicting Majia pomelo as a high GI but low GL fruit.Consumption of Majia pomelo in hospitalized T2D patients did not cause significant glucose fluctuation.It was concluded that high GI pomelo can serve as a low GL fruit if it is consumed with a limited daily amount and thus can be supplied to diabetic patients.These results may mean more varieties of food choices for T2D patients.

OBJECTIVETo evaluate the results of surgical procedures for pulmonary embolism.

METHODSFifty-four patients of pulmonary embolism received surgical treatment from October 1994 to June 2007, of which 9 were acute pulmonary embolism underwent pulmonary embolectomy and 45 patients were chronic thromboembolic pulmonary hypertension (CTEPH) underwent pulmonary thromboendarterectomy.

RESULTSThe mortality rate was 44.4% in acute pulmonary embolism group and 13.3% in CTEPH group (P < 0. 05). Thirteen patients had residual pulmonary hypertension and 23 patients had severe pulmonary reperfusion injury postoperatively. The pulmonary artery systolic pressure changed from (89.4 +/- 36.3) mm Hg (1 mm Hg =0.133 kPa) preoperative to (55.6 +/- 22.4) mm Hg postoperative. The pulmonary vascular resistance changed from (89. 7 +/- 56.7) kPa L(-1) S(-1) preoperative to (38.9 +/- 31.1) kPa L(-1) S(-1) postoperative. The arterial partial pressure of oxygen changed from (52. 3 +/- 6.7 ) mm Hg preoperative to (87.6 +/- 6.5) mm Hg postoperative. The arterial oxygen saturation changed from (88.9 +/- 4.5)% preoperative to (95.3 +/- 2.8 )% postoperative (P < 0.05). With the follow-up of (41.8 +/- 36.4) months, there were 4 patients died. According to NYHA, there were 28 patients for class I , 10 patients for class II and 2 patients for class III. According to Kaplan-Meier survival curve, the 3-year, 4-year, 5-year and 8-year survival rate were (97.1 +/- 2.8 )%, (94.0 +/- 4.1)%, (90.8 +/- 5.2)% and (85.0 +/- 7.3)% respectively. Linear rate of bleeding and thromboembolic related to anticoagulation were 0. 63% patient-years and 0. 62% patient-years respectively.

CONCLUSIONSThe operational mortality of acute pulmonary embolism is significantly higher than CTEPH, and the mid-long term survival rate is agreeable and the complication rate related to anticoagulation is relatively low.

Adolescent ; Adult ; Aged ; Embolectomy ; methods ; Endarterectomy ; methods ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Pulmonary Artery ; surgery ; Pulmonary Embolism ; pathology ; surgery ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVETo compare the efficacy of conservative or pulmonary thromboendarterectomy (PTE) therapy for chronic thromboembolic pulmonary hypertension (CTEPH) patients according to a new clinical classification scheme.

METHODSThis retrospective study analyzed 63 cases of CTEPH admitted to our hospital from February 1995 to October 2007 and 45 cases were treated surgically (Group A) and 18 cases received conservative therapy (Group B). Results were analyzed using Fisher exact test and t test according to San Diego medical center quartering classification scheme and Anzhen Hospital modified bifurcate classification scheme.

RESULTSThere were 6 operational deaths in Group A and 2 deaths during hospital stay in Group B. During follow-ups (mean 3.6 +/- 2.5 years), there were 4 deaths in Group A and 9 deaths in Group B. the totality survival rate is significantly higher in Group A than that in Group B (P < 0.05). For patients with San Diego Type I CTEPH, survival rate was significantly higher in Group A compared with Group B (P = 0.009) and was similar for patients with type II and III and IV CTEPH between the two groups (P = 0.338, 0.455, 0.800). Survival rate was significantly higher in Group A than that in Group B for patients with Anzhen central type CTEPH (P = 0.009), but was similar between the two groups for patients with Anzhen peripheral type CTEPH (P = 0.125). The Kaplan-Meier survival curve 5 years survival rate in the Group A was (91.7 +/- 8.0)% for Anzhen central type and (76.0 +/- 8.5)% for Anzhen peripheral type (P = 0.04), and the 5 years Kaplan-Meier survival rate in the Group B was (42.9 +/- 18.7)% for Anzhen central type and (56.2 +/- 10.8)% for Anzhen peripheral type (P = 0.851).

CONCLUSIONAnzhen Hospital modified bifurcate classification scheme is a simple and effective classification to predict the prognosis and choose treatment method of CTEPH.

Adult ; Chronic Disease ; Female ; Humans ; Hypertension, Pulmonary ; mortality ; surgery ; therapy ; Male ; Middle Aged ; Prognosis ; Pulmonary Embolism ; surgery ; therapy ; Retrospective Studies ; Survival Rate ; Treatment Outcome