Skeletal muscle is essential for the glucose disposal in organism, which is one of the major sites of insulin resistance.The over-activity of classical renin-angiotensin system ( RAS) induces the oxidative stress, leads to the impairment of insulin signaling and glucose transport, resulting in insulin resistance of skeleton muscle.The activation of non-classical RAS by inhibiting classical RAS activity, can ameliorate insulin resistance in skeletal muscle tissue.

Objective To study the relationship between insulin resistance and renin-angiotensin-aldosterone system (RASS) in newly diagnosed type 2 diabetes mellitus, and to provide the best treatment for type 2 diabetes mellitus with hypertension . Methods Ninety cases of newly diagnosed type 2 diabetes mellitus were included. After stratified by gender, all the patients were divided into hypertension group and non-hypertension group. According to whether taking hypotensor, the patients with hypertension were further divided into non-medication group, calcium channel blockers (CCB) group, and angiotensin receptor blockers (ARB) group respectively. Results In female patients with hypertension, the IAI, levels of rennin and angiotensin II were higher than those in non-hypertension group and the systolic pressure of female patients taking ARB was lower than those taking CCB. Pearson′s correlation analysis showed that angiotensin II and aldosterone was positively correlated with HOMA-IR but negatively correlated with IAI in females. Conclusions In female newly diagnosed type 2 diabetes mellitus , RASS is related to the development of insulin resistance , so RASS antagonists are the first choice to achieve better blood glucose control in female patients.

Objective To study the expression of Survivin and Caspase-3 in uterine smooth muscle tumour (USMT) and it' s significance. Methods Expression of Survivin and Caspase-3 protein were determined by immunohistochemistry Two-step method on 30 uterine Cellular Uterine Leiomyoma (CUL), 10 normal uterine smooth muscle (NSM), 10 Ordinary Uterine Leiomyoma (OUL), 15 Leiomysarcoma (LMS). Results Survivin level in normal uterine smooth muscle are very low, and in OUL, CUL, LMS was on increasing trend, the OL group and the LCA group have statistical significant difference(P<0.05). Caspase-3 level in NSM, OUL, CUL, LMS was on decreasing trend. The NSM group and the CL group, the NSM group and the LCA group both have statistical significant difference (P<0.05). Conclusion Maybe Survivin can inhibit apoptosis and extend cells lives by inhibit the activity of Caspase-3, so it played an important role in the development progress from benign uterine tumour to malignant uterine tumour. The detect of Survivin and Caspase-3 may be useful in the differential diagnosis of uterine smooth muscle tumours.

A total of 186 type 2 diabetic patients(DM group)and 72 healthy subjects(NDM group)were enrolled. Metabolic parameters and serum irisin levels were measured. The effects of intensity and time of the physical activity were evaluated. According to quartiles of plasma irisin levels,all subjects were divided into four groups and the prevalence of type 2 diabetes mellitus(T2DM) among four groups was compared. The relationship between plasma irisin level and physical activity in DM group was investigated. The results showed that plasma irisin levels were correlated negatively with the prevalence of T2DM(OR=0.984,95% CI 0.973~0.996);also negatively correlated with age(r=-0. 227, P=0. 029) and blood uric acid (r=-0. 225, P=0. 032) in the DM group. When corresponding exercise time was up to grade 4,the intensity of exercise would influence the irisin levels(χ2=7.319, P=0.025). After controlling for potential confounders such as age,metabolic parameters,intensity of work,timing of work,plasma irisin levels in DM group were correlated positively with the intensity of exercise (β=0.326, P=0.014) and negatively with corresponding exercise time(β=-0.454,P=0.001). These results suggest that the prevalence of T2DM decreases with the increase of plasma irisin level. Plasma irisin levels are increased after moderate intensity exercise(5~7 times weekly and 1h each time) or by short-term high-intensity exercise.

Objective To evaluate the efficacy and safety of biphasic insulin aspart 30 (BIAsp30)plus metformin in type 2 diabetes subjects switching from basal insulin plus oral antidiabetic drugs (OAD)Methods During 16 weeks, multiple-center, open-label, and single-arm study including 2 weeks of screening period,4 weeks of run-in period,and 16 weeks of treatment period were carried out. Subjects with type 2 diabetes mellitus inadequately controlled on basal insulin therapy with or without oral antidiabetic drugs were switched to twice-daily BIAsp30 plus metformin with dose titration to achieve fasting plasma glucose target. Results Of the 293 Chinese subjects exposed to trial drugs [age: ( 54.0±9.6 ) years, diabetes duration: ( 8.54±5.49 ) years, body mass index: (24.89±3.28)kg/m2, baseline HbA1c: 8.16% ±0.89%], 122 were previously treated with basal insulin analogues and 169 with human basal insulin. At end of the trial ,the mean reduction of HbA1 c was 1.30% ±0.96% (P＜0. 01 ). The proportion of patients achieved HbA1c＜7.0% and HbA1c ≤6.5% was 60.4% and 38.9% respectively. 8-point plasma glucose measurements showed significant improvements at all the time points examined ( all P＜0. 01 ) ,and the average value of all 8 points measured decreased from ( 10.53±2.58 ) mmol/L atbaseline to (7.79± 1.58 ) mmol/L at the end of treatment ( P＜0. 01 ), reduced by 2.76 mmol/L. Postprandial glucose increments were significantly reduced after breakfast ( -1.73 mmol/L,P＜0.01 )and dinner ( -1.28 mmol/L,P＜0.01 ), while no significant reduction was observed after lunch ( -0.09 mmol/L, P = 0. 734 5 ). No severe adverse effect and no major hypoglycemia were reported. The overall hypoglycaemia rate was 2.68 events/subject year. The average weight gain was (0. 76 ±0. 14 )kg (P＜0. 0l ). Conclusion Twice-daily BIAsp30 plus metformin is effective and safe to type 2 diabetic subjects inadequately controlled on basal insulin treatment.BIAsp30 treatment should be considered for type 2 diabetic subjects who have unsatisfactory response to previous basal insulin treatment.

The residents who had lived for at least 5 years and aged over 20 years old were sampled from urban to rural districts of Jiangsu Province with a stratified cluster sampling technique. B mode ultrasonography and thyroid function determination were carried out in 6 128 persons. The location, diameter, number, boundary, and calcification in thyroid nodules were described by using 7.5 MHz/50 mm transducer of thyroid ultrasonography. TSH was measured by chemiluminescence immunoassay. Free triiodothyronine(FT3)and free thyroxin(FT4)were measured when TSH was abnormal. The crude prevalence of thyroid nodules was 21.12% in total population, 14.55% in male, and 25.24% in female. The standardized prevalence was 15.69%, 11.20%, and 20.40%, respectively. The prevalence was lower in male than in female, and increased with age(P＜0.05). Thyroid nodules in Jiangsu Province were highly prevalent and more attention should be paid to the follow-up, early diagnosis, and treatment.

Objective To investigate the prevalence and epidemiologic characteristics of hypothyroidism among community population in Jiangsu province. Methods The residents who had lived for at least five years and aged more than 20 years old were sampled from six layers in urban and rural districts of Jiangsu province by a stratified cluster sampling technique. Serum was sampled from 7 122 subjects and sTSH was measured by chemiluminescence immunoassay, and FT3 and FT4 were determined in the subjects with abnormal sTSH level. Results (1) The crude prevalences of overt hypothyroidism and subclinical hypothyroidism were 0.66% and 7.53% respectively in total population, with the respective standardized rates of 0.43% and 6.28%. (2)The prevalences of hypothyroidism and subclinical hypothyroidism were significantly higher in females than in males (both P <0.05). (3) The prevalence of subclinical hypothyroidism was significantly increased with advancing age in both female and males (P<0.05). Conclusion Comparing with hypothyroidism, subclinical hypothyroidism shows higher prevalence in Jiangsu province, and more attention should be paid to the follow-up and diagnosis of subclinical hypothyroidism.