This study was conducted to evaluate the relationship between serum insulin levels and the production of insulin antibody (IA) in type 2 diabetes (T2DM).A total of 647 T2DM were included.Among them,20.9％ patients were IA positive,who were elder and had a longer duration,lower BMI,a higher positive rate of glutamic acid decarboxylase antibody(GADAb) and higher serum insulin levels during an insulin secretion test.More patients were treated with insulin in IA positive group than in IA negative group (65.9％ vs 41.0％,P =0.000).Fasting serum insulin level was associated with occurrence of IA in all patients (OR =1.02,P =0.001) and insulin treated patients (OR =1.033,P =0.002).The cut-off point of fasting serum insulin level for predicting IA positive was 17.87 mIU/L (sensitivity 55.1％,specificity 89.0％).Exogenous insulin use is associated with the presence of IA.Fasting serum insulin level can be used as a predictor for the production of IA in insulin-treated patients.

Objective To observe the effect of acupuncture on ghrelin,estradiol (E2) and bone mineral density (BMD) in postmenopausal osteoporosis rats.Methods According to the random number table method,60 female Sprague-Dawley rats aged 3 months,were randomly divided into surgery group (40 rats) and sham group (20 rats).The osteoporosis model was established by bilateral ovariectomy.Three months after the operation,a significant decrease in BMD of lumbar vertebrae and femur of the model rats as measured by dual energy X-ray absorptionmetry against the sham group indicated successful establishment of the osteoporosis model.Then surgery group was randomly divided into a model subgroup,a acupuncture subgroup and an estrogen subgroup,with 10 rats in each subgroup.The acupuncture subgroup was treated with electroacupuncture,estrogen subgroup with subcutaneous injection of estradiol benzoate,sham group and model subgroup without any treatment.After 3 months of intervention all the rats were sacrificed,BMD of the lumbar vertebrae and femur was measured,ghrelin and E2 were determined.Results Serum ghrelin in acupuncture subgroup (399 pg/ml) and estrogen subgroup (276 pg/ml) were significantly lower (P ＜ 0.01) than that in model subgroup (546 pg/ml); serum E2 in acupuncture subgroup (128.02 pg/ml) and estrogen subgroup (182.89 pg/ml) increased significantly (P ＜ 0.05) than that in model subgroup (72.10 pg/ml) ;lumbar vertebrae BMD in acupuncture subgroup (0.212 g/cm2) and estrogen subgroup (0.231 g/cm2) increased significantly (P ＜ 0.05) than that in model subgroup (0.191 g/cm2),but in acupuncture subgroup the effect on improving the level of E2,ghrelin and lumbar vertebrae BMD was less than that in estrogen subgroup (P ＜ 0.05).Conclusions Acupuncture intervention can improve lumbar vertebrae BMD and serum E2 level of postmenopausal osteoporosis rat model,down regulate serum ghrelin level,but the overall effect of acupuncture is less than estrogen.

Objective To observe the effect of electroacupuncture (EA) on intestinal vitamin D receptor (VDR) mRNA and protein expression in ovariectomized rat model,and to explore the possible mechanism of acupuncture treatment for postmenopausal osteoporosis.Methods Sixty 3-month-old female SD rats were randomly divided into operation group and sham group.3 months after osteoporosis model was successfully produced,rats in operation group were randomly divided into model group,EA sham group,EA group and drug group.12 weeks after intervention,bone mineral density (BMD) of lumbar spine and femur were detected,then rats were all sacrificed to extract the small intestinal mucosa.VDR mRNA and protein expressions were determined by real-time quantitative PCR and Western blotting.Results The model of postmenopausal osteoporosis was successfully established.The bone mineral density was significantly improved in EA group and drug group as compared with the model group at 12 weeks after intervention.Western blotting and realtime quantitative PCR showed that small intestinal VDR mRNA and protein expressions were increased in EA group and drug group,but the increment of VDR mRNA expression was less in EA group than in drug group.Conclusions One of the mechanisms of acupuncture treatment for postmenopausal osteoporosis may be related with increasing the intestinal VDR mRNA and protein expression levels and enhancing the bioactivity of vitamin D.

To analyse the familial aggregation and genetic predisposition of Shen-yin deficiency syndrome (SYDS) in families with diabetes mellitus type 2 (DM2). Methods One hundred and forty-one DM2 patients were collected from 32 family lines in Nanjin area, in which the probands were differentiated as DM2 with SYDS. On them, genetic analysis on the characteristics of SYDS was conducted using pedigree analysis, morbidity and heritability of the first-degree relatives of the probands were calculated, and the action of familial SYDS factor on the genesis of the syndrome was assessed by multiple factors regression analysis. Results The morbidity rate of SYDS in the first-degree relatives of the probands was 33.71%, and the heritability, calculated by Falconer formula, was 80.6%. The fitting result of regression analysis showed that familial factor played an important role in SYDS genesis (OR = 5.61, P = 0.001), but DM2 itself is not an independent risk factor for it. Conclusion DM2 with SYDS shows the tendency of familial aggregation and genetic predisposition, genetic factor is associated with the genesis of the syndrome. Pedigree research is a good method for exploring the relationship between syndrome and genetic factor.
Adult ; Diabetes Mellitus, Type 2 ; genetics ; Diagnosis, Differential ; Female ; Genetic Predisposition to Disease ; Humans ; Male ; Medicine, Chinese Traditional ; Pedigree ; Yin Deficiency ; genetics

Objective: To construct a female TCM management platform that integrates pulse diagnosis information to facilitate women's health status identification and conditioning of menstrual cycle related health problems. Methods:Using cloud computing technology, taking the EHR and knowledge base as the core, designing the TCM health information collection questionnaire according to the characteristics of women.s menstrual cycle related health problems, and incorporating the data collected by the Chinese medicine pulse diagnosis bracelet, the knowledge base can assist the development of a health management plan, designing a platform framework for combining the PC side of the doctor with the patient mobile APP. Results: The platform was conducive to the realization of more objective TCM consultation and pulse diagnosis information collection and long-term continuous monitoring, and can assist in the identification of women's menstrual problems and the development of health conditioning plans. Conclusion: The platform has good operability and practicability for the implementation of TCM health management for women with menstrual problems.

Objective: To fulfill the TCM (traditional Chinese medicine) health management needs of female through constructing the intervention knowledge base, explore the long-term development mechanism of intervention knowledge base. Methods: The structure of female TCM Health Intervention Knowledge was designed base according to the characteristics of TCM health status of females. The inferential mechanism by studying the relation between the female health status and the diet therapy scheme was explored based on syndrome differentiation. A Long-term development mechanism of TCM health intervention knowledge database was designed based on big data and effect feedback mechanism. Results: The classification standard of the TCM Health Intervention Knowledge base of female includes the state of the viscera functions, qi and blood, yin and yang, and pathogenic properties of the body under the illness and health condition. The dietary therapy formula inference engine can provide food material according to the region, natures, function of tonifying, evil eliminating, to match the female health status, and constantly adjusting and improving the Intervention plan according to the feedback. Conclusion: The study proves the construction plan of TCM Health Intervention Knowledge base of female is able to meet the needs of female TCM health management intervention, and the method of constantly adjusting and improving the intervention plan according to the feedback helps to realize the precise recommendation and long-term development of intervention knowledge base.

Narcolepsy is the most common cause of excessive daytime sleepiness (EDS) following obstructive sleep apnea. Its treatment aims to reduce EDS and cataplexy, improve nighttime sleep disturbance, sleep paralysis and sleep-related hallucinations. Pitolisant (a histamine H3 receptor antagonist) and solriamfetol (a norepinephrine reuptake inhibitor) have recently been approved effective for narcolepsy in the United States and the European Union. Pitolisant has proved to be effective for both EDS and cataplexy. Besides being effective on EDS, solriamfetol seems to have advantages in abuse potential and withdrawal syndrome. As potential treatments for EDS and cataplexy associated with narcolepsy, several new drugs are being developed and tested. These new drugs include new hydroxybutyrate preparations (controlled release sodium hydroxybutyrate FT218, low sodium hydroxybutyrate JZP-258), selective norepinephrine reuptake inhibitor (AXS-12), and modafinil combined with astroglial junction protein inhibitor (THN102). This paper reviews the recently approved drugs and potential treatments for narcolepsy.