Primary biliary cirrhosis (PBC)is characterized by injury of small intrahepatic bile ducts,but its mechanism,especially the role of B cell immunity in this disease,remains unclear.The possible role of B cell immunity in the pathogenesis of PBC is reviewed from the fol-lowing aspects:distribution of B cells and plasma cells in the liver tissues of PBC patients,clearance of B cells,mechanism of abnormal in-crease in serum IgM and its sources among PBC patients,mechanism of production of antimitochondrial antibodies and their possible func-tions in bile duct injury,and typical autoantibodies in PBC.B cell immunity is considered to play a significant role in the pathogenesis of PBC,but there are still many key problems to be clarified.

Objective To investigate the relationships between serum concentration of RBP-4 and inflammatory factors,insulin resistance in patients with gestational diabetes mellitus.Methods20 patients newly diagnosed with impaired glucose tolerance (IGT),27 patients newly diagnosed with gestational diabetes mellitus(GDM) and 50 subjects with normal glucose tolerance(NGT) were enrolled in this cross-sectional study.Additionally,another subset analysis was performed,subjects were divided on the basis of BMI into normal weight (NW) and overweight or obesity (OW/OB).Serum RBP-4 was measured with ELISA;serum concentrations of hs-CRP,free fatty acids (FFA),triglyeride(TG),total cholesterol (TC) and insulin were measured in fasting status.Insulin resistance was assessed by HOMA-IR.ResultsLn(HOMA-IR) and the concentrations of FFA,ln(hs-CRP) in IGT or in GDM were significantly higher than that of NGT(P＜0.05).In the group of OW/OB,FFA[(0.90±0.31)mmol/L vs (0.71±0.28)mmol/L,t＝2.73,P＜0.05)],ln(hs-CRP)(0.62±1.00 vs -0.17±1.07,t＝2.90,P＜0.05),ln(HOMA-IR),lnRBP(0.56±0.27 vs 0.30±0.14,t＝2.86,P＜0.05)were significantly higher than that of NW.In the group of GDM,lnRBP-4 showed a positive relationship with FFA (r＝0.231,P＜0.05)and ln(hs-CRP) (r＝0.237,P＜0.05).There was a positive relationship between lnRBP-4 and FFA(r＝0.371,P＜0.05) or ln(hs-CRP)(r＝0.247,P＜0.05) in the group of OW/OB,but no association in the group of NGT,IGT or NW.There was no relationship between lnRBP-4 and ln(HOMA-IR) in IGT,GDM and NW,while in the group of NGT and OW/OB,lnRBP-4 showed a positive relationship with ln(HOMA-IR) (r＝0.276,0.290,P＜0.05).In a multiple linear regression analysis,ln(hs-CRP),FFA or ln(HOMA-IR) was not the independent factor of lnRBP-4 in any group.ConclusionsIn patients with gestational diabetes mellitus,lnRBP-4 may be a new marker of inflammation.

Thirty-five patients with ketosis-prone diabetes (KPD) and 38 patients with newly-diagonosed common type 2 diabetes mellitus (DM) were treated with insulin for 3 months.The results showed that the existing insulin resistance in patients with KPD was mild as compared with common type 2 DM, and the recovery of insulin sensitivity was less marked in patients with KPD after blood glucose was well controlled.

The latest epidemiological data suggests that the situation of adult diabetes in China is severe, and metabolic diseases have become significant chronic illnesses that have a serious impact on public health and social development. After more than six years of practice, the National Metabolic Management Center(MMC) has developed distinctive approaches to manage metabolic patients and has achieved a series of positive outcomes, continuously advancing the standardized diagnosis and treatment model. In order to further improve the efficiency, based on the first edition, the second edition guideline was composed by incorporating experience of the past six years in conjunction with the latest international and domestic guidelines.