Objective To determine the degree of C 4 changes at precede or coincide with changes in systemic lupus erythematosus (SLE) activity by 5 global activity indices(PGA, M-SLEDAI, M-LAI, SLAM, and M-BILAG), and to evaluate the correlation between changes in C 4 levels and SLE activity in individual organ systems.Methods 53 lupus patients were observed monthly for 1 year in a longitudinal study. Lupus disease activity rate and complement levels were measured at each visit. Disease activity rates were calculated for subgroups defined by previous or concurrent changes in C 4 levels. Logistic regression models were used to determine the significance of the correlation between recent changes in complement levels and disease activity, and between changes in C 4 levels and SLE activity increased in specific organ systems.Results Lupus disease activity occurred at 12%,25%,13% and 12% respectively on PGA,M-SLEDAI,M-LAI,SLAM and M-BILAG. Disease activity by the M-LAI were more frequent when there was a concurrent decrease in C 4. Higher disease activity rates by the SLAM were correlated with previous increases in C 4. Decreases in C 4 were correlated with a concurrent increase in renal disease activity,or related to a concurrent decrease in the hematocrit levels and platelet count.Conclusions Reducing serum in C 4 levels were not consistently correlated with SLE disease activity, decrease in C 4 was correlated with a concurrent increases in renal and hematologic SLE activity.

Objective To demonstrate that SLE T cells primary function disordor was related to abnormal [Ca 2+ ]i responses,and to investigate the reason of abnormal [Ca 2+ ]i responses.Methods After cross-linking of anti-CD 3 mAb to sheep anti-mouse IgG and stimulating T cells,the changes of free calciumion [Ca 2+ ]i within T cells under interference of Thapsigarain and EGTA was observed respectively successively for 10 minutes by an adhesion cytometry.The relation between [Ca 2+ ]i responses in SLE T cells and InsP 3 levels was evaluated .Results The basic [Ca 2+ ]i response in T cells from SLE patients was similar to that from normal control(P=0 105),peak and plateau [Ca 2+ ]i responses were significantly higher in the group of SLE patients(P

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Objective To investigate the ultrastructure changes of pancreatic islets alpha cells in rats with impaired glucose tolerance.Methods 16 Wistar rats were randomly assigned into normal glucose tolerance group(NGT group,n =8)and impaired glucose tolerance group(IGT group,n =8).NGT group were fed with routine diet and IGT-group were fed with high-sugar high-fat diet.At the 12th week,IGT models were considered successful if the level of 2-hour peripheral blood glucose(2 h PG)was between 7.8 and 11.1 mmol/L in oral glucose tolerance test and continued for more than a week.The pancreas tail of animals in the NGT group and IGT group rats was removed for ultrastructure observation.Alpha cells were observed under transmission electron microscope.Results The big-plump secretory granule with aureole appeared in pancreatic islets alpha cells of NGT group,and it contained a round dense core.The nuclear chromatin and contents were evenly distributed.Mitochondria and en-doplasmic reticulum arranged tightly and orderly.Compared with NGT group,the quantities of secretory granule increased significantly in IGT group.The gap between dense core and membrane was narrower.The quantities of mitochondria and rough endoplasmic reticulum increased significantly.There was no significant change for the structure of the other cell organelle.Conclusion The pathogenesis of IGT is associated with ultrastructural changes and dysfunction of pancreas islets alpha cells.

Objective To investigate whether systemic lupus erythematosus (SLE) T cell function disorder is related to abnormal biochemical pathways.Methods After cross linking of anti CD3 mAbs to sheep anti mouse IgG and stimulating T cells,the changes of free calcium ion within T cells and these changes under interference of Thapsigargin and EGTA were observed respectively for 10 minutes with an adhesion cytometry.The relation between [Ca 2+ ]i response in SLE T cells and expression of CD3 molecules,or InsP 3 levels was evaluated.Results The base [Ca 2+ ]i response in T cells of SLE patients was similar to that of normal control ( P =0 105).Peak and plateau [Ca 2+ ]i responses were significantly higher in the group of SLE patients ( P

Objective To investigate the effect of glucagon-like peptide-1 agonist (exendin-4) on expression of glucose transporter 4 (GLUT4) in the skeletal muscle of rats with impaired glucose tolerance (IGT).Methodis 54 Wistar rats were randomly assigned into normal glucose tolerance group (NGT group,n =18) and impaired glucose tolerance group(IGT group,n =36).The rats in NGT group were fed with routine diet and the rats in IGT group were fed with high-sugar high-fat diet.At the 12th week,IGT models were tested successful.Then,half of the rats were allocated to intervention group (Ex group) and the rest were set as IGT control group.The rats in Ex group were subject to exendin-4 subcutaneous injection (5 μg/kg,twice daily).Each rat in NGT group and IGT control group was given the same volume of saline as injection.FBG and 2 h BG were measured before intervention and after 4 weeks.The expression of GLUT4 mRNA and GLUT4 in the skeletal muscle were respectively measured by real time quantitative polymerase chain reaction and immunohistochemistry.Inter-group comparison was conducted using analysis of variance (ANOVA) and least square deviation-test (LSD-t).Results Before intervention,compared with NGT-group,the 2 h BG in IGT control group and Ex group were higher,the GLUT4 mRNA of skeletal muscle in IGT control group and Ex group were lower (respectively P ＜ 0.05).The skeletal muscle cells in IGT control group and Ex group were less colored while the skeletal muscle cells in NGT group were colored extensively,and more colored granules.After 4 weeks of exendin-4 intervention,compared with IGT control group and Ex group of non-intervention,the 2 h BG level in Ex group was lower and the expression level of GLUT4 mRNA of skeletal muscle was higher (respectively P ＜ 0.05).After intervened with exendin-4 for 4 weeks,the GLU protein mainly expressed in cytoplasma of skeletal muscle cells.Its expression was higher in Ex group than in IGT group and in Ex group before intervention.Conclusion Exendin-4 may up-regulate the expression of GLUT4,increase glucose intake of the skeletal muscle,and reduce postprandial blood sugar.

Objective To compare and explore impact of subclinical hypothyroidism on metabolic risk factors of type 2 diabetes mellitus.Methods A total of 204 inpatients with type 2 diabetes mellitus.The patients were divide into two groups according to whether complicated with subclinical hypothyroidism:combination of simple type 2 diabetes mellitus (150 cases) and type 2 diabetes mellitus with SCH group(54 cases),two groups of age,gender,duration were no statistical difference.and collecting the clinical data of two groups of patients by Professional people,detection of blood lipids,glycated hemoglobin (HbA1c),uric acid (UA),Oral glucose tolerance test (OGTT),insulin and C peptide releasing test were taken in all groups.The improvement of insulin,C peptide index [HOMR-islet(CP)] and whole body insulin sensitivity index (ISIcomp) were used to estimate insuhn sensitivity,and improvement of insulin,C peptide secretion index [HOMR-isle (CP)] was used to evaluate the function of pancreatic islet β cell.T test was used for statistic alanalysis.Risk factors of type 2 diabetes mellitus with microvascular Complication by using Logistic regression analysis.Results (1) Compared with type 2 diabetes mellitus group,blood pressure,body mass index (BMI),triglycerides(TC),Low density lipoprotein cholesterol (LDL-C),UA,fasting C peptide(C-P0),postprandial 120 min C peptide(C-Pm),HOMA-IR(CP) were increased (P ＜ 0.05),while fasting blood glucose(FPG),bloods glucose in postprandial 120 min (G120),HbA1c,ISI-comp were decreased (P ＜ 0.05).(2) The incidence of diabetic nephropathy was higher in diabetic patents with subclinical hypothyroidism than those without subchnical hypothyroidism,the difference was statistically significant (P ＜ 0.05).(3) Logistic analysis showed that duration,SBP,TSH were the major risk factors of type 2 diabetes mellitus with nephropathy (P ＜ 0.05).Conclusions Type 2 diabetes mellitus patients with subclinical hypothyroidism compared to pure insulin resistance is more obvious,the degree of lipid metabolism disorders more severe.Elevated TSH can predict the occurrence of diabetic nephropathy in type 2 diabetes mellitus.

Objective To explore the clinical features,auxiliary examinations,therapies and prognoses of patients with antibodies against contactin-associated protein-like 2 (CASPR2).Methods The clinical data of 11 anti-CASPR2 encephalitis patients who were admited to the People's Hospital of Zhengzhou University from March 2015 to April 2018 were retrospectively analyzed.Results The age of these 11 cases was (35.6± 19.4) years (ranged 20-74 years),and eight cases were females.There were seven cases with limbic encephalitis which included six cases of epilepsy,four cases of memory impairment,two cases of mental and behavioral abnormalities.Four cases had peripheral nerve hyperexcitability.Four cases had neuropathic pain.There were six cases with autonomic dysfunction including five cases of constipation,three cases of tachycardia,two cases of hyperhidrosis,two cases of urinary disorder.Seven cases had sleep disorder.Four cases had weight loss.Two cases showed cerebellar symptoms and two cases had hyponatremia.Magnetic resonance imaging scan of the brain showed abnormal signal in two cases,mainly involved medial temporal lobe and the hippocampus.Six cases underwent 18F-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) examination,and three cases showed abnormalities,including two with temporal hypermetabolism and one with cortical hypermetabolism.Chest enhanced CT and PET-CT showed thymoma in one case.All cases received immunotherapy,and after treatment their symptoms were improved.Long-term follow-up was performed in nine cases,and three cases relapsed.Conclusions The major clinical manifestations of anti-CASPR2 encephalitis were limbic encephalitis,peripheral nerve hyperexcitability,neuropathic pain,autonomic dysfunction,insomnia and so on.Immunotherapy was effective and some patients may have recurrence.

Objective To analyze the clinical characteristics,imaging manifestations and prognoses of anti-GABAB receptor antibodies encephalitis.Methods The clinical manifestations,laboratory findings and radiological data of 13 patients with anti-GABAB receptor encephalitis,admitted to our hospital from September 2015 to March 2017,were retrospectively analyzed.Modified Rankin scale (mRs) was performed to evaluate the prognoses (good prognosis:mRs scores ＜ 2;poor prognosis mRs scores≥3).Results These 13 patients had an average age of 58 years (ranged 49-76 years) with a male to female ratio of 12:1.The major clinical features,including epileptic seizure,were found in 12 patients,psychiatric symptoms in 11 patients,cognitive disorder in 7 patients,and disturbance of consciousness in 4 patients.Brain MR imaging showed abnormal signal in 5 patients:4 were located in the hippocampus and amygdaloid,and one in the pons and left temporal lobe.Five patients showed abnormalities in PET-CT,including 4 with temporal hypermetabolism and 1 with cortical hypometabolism.Chest CT showed lung occupying lesions in 4 patients,of which 2 patients were diagnosed as having small cell lung cancer (SCLC) by pathological examination.Ten patients received immunomodulatory therapy,and three were with supportive care.After the average of 8 months of follow-up,7 patients had good prognosis,5 patients had poor prognosis and one patient lost of follow up.Conclusions Anti-GABAB receptor encephalitis frequently occurs in elderly male subjects and the main characteristic includes prominent refractory epilepsy and shows neurological improvement on immunotherapy.It can accompany by SCLC and have a relatively poor prognosis.