The history for understanding post-prandiai glucose (PPG) was not very long, but it did experience a rapid development, including the cumulation of epidemic and pathophysiological evidence, the invention of drugs for PPG, and also the technology development for rapid glucose monitor. The importance of PPG has currently attracted the attention from international academic organizations. Our Chinese specialists have done numerous studies for PPG during this procedure, and have made great effort to promote the understanding, concern and management of PPG in clinical cases.

Teriparatide is an injectable recombinant human parathyroid hormone (1-34) [rhPTH(1-34)],which has been approved for the treatment of osteoporosis worldwide,including China since 2011.In pre-clinical studies,teriparatide was shown to exhibit anabolic effects on bone with a unique mechanism of action that is distinct from that of antiresorptive agents,including bisphosphonates,selective estrogen receptor modulators (SERMs),calcitonin,and estrogen.This bone-building effect has been supported by clinical trials in men and postmenopausal women,with reductions in fracture risk,and increases in bone turnover markers,including serum osteocalcin and procollagen type Ⅰ N-terminal propeptide (PINP),and bone mineral density (BMD),and improvements in bone quality.Recent studies in Asian patient populations show similar results and support the findings for bone markers and BMD when compared with current antiresorptive medications.

Objective To analyze the clinical and pathological characteristics of thyroid carcinoma in patients from Qilu Hospital of Shandong University in last 7 years,and to explore the changes in disease spectrum.Methods Records of 772 patients with thyroid carcinoma,who underwent thyroidectomy and pathological examination,were reviewed from January 2005 to December 2011.Results (1) Individuals suffering from thyroid carcinoma have increased rapidly during these 7 years.(2) The high incidence of the disease resided in the age group of 30-59 for both men and women,with a male-to-female ratio of 1 ∶ 2.73.(3) The proportion of papillary microcarcinoma showed a growing trend,the rising trends were also apparent in papillary thyroid cancer (PTC) coexisting with nodular goiter or Hashimoto's thyroiditis (HT).Papillary microcarcinoma accounted for27.27％ of all PTC in 2005 and reached 54.22％ in 2011.Coexistence of PTC and HT accounted for 12.38％ of the cases with a male-to-female ratio of 1 ∶ 6.Conclusion The occurrence of thyroid carcinoma,especially papillary microcarcinoma has been increasing in recent years.The coexistence of PTC with nodular goiter or HT showed a trend to increase.

"Diabetes Dialogue" is an international forum of latest cutting-edge research on diabetes. The major topics in the 5th event in 2008 were the novel targets in the treatment of type 2 diabetes. In particular, the latest developments in incretin-based therapies, especially glucagon-like peptide-1 (GLP-1) -based therapies, and their effects on the β-cells have been provided. Studies suggested that type 2 diabetes is characterized by progressively deteriorated β-cell function with the presence of insulin resistance. Owing to its glucose-dependant glucose lowering effect and the effect on improvement of β-cell function, GLP-1 has become the novel target of therapies. Liraglutide, a GLP-1 analogue developed by Novo Nordisk, is one of the novel therapies in the treatment of type 2 diabetes. Many studies have demonstrated that liraglutide showed both an efficacious and sustained effect on glycemic control and a significant improvement of 13-cell function. As a result, recently the role of GLP-1 or GLP-1 analogue in the management of type 2 diabetes has gained more popularity and liraglutide is considered as a promising drug in the treatment of type 2 diabetes.

Objective To investigate the effect of macrophages on podocytes apoptosis in diabetic nephropathy. Methods Differentiated mouse macrophages (RAW264.7) were exposed to normal glucose, high glucose, then the conditioned media (CM) was collected and considered as NC-CM or HG-CM, respectively. Western blotting and immunofluorescent staining were used to detect the specific markers for M1 macrophages (iNOS) and M2 macrophages (MR). ELISA was used to detect the concentration of TNF-α in the CM. Then normal PRMI 1640 media (control), NC-CM or HG-CM was added to podocytes. In some experiments, ROS inhibitors (Tempo), p38 MAPK inhibitor (SB203580), anti-TNF-α neutralizing antibody, and IgG1 isotype control were respectively added to cells with HG-CM. Besides, recombinant mouse TNF-α alone was applied to incubate podocytes. Podocytes apoptosis was accessed by Annexin V-FITC/PI and Hoechst33342 staining. DCFH-DA staining was used to analyse ROS level. Western blotting was used to detect cleaved casepase-3, p38MAPK, and p-p38MAPK protein. Results Macrophages were activated when exposed to high glucose, displaying pro-inflammatory M1 polarization with higher iNOS and lower MR expression. HG-CM but not NC-CM trigged podocytes apoptosis, up-regulated ROS, cleaved casepase-3 and p-p38MAPK. However, the podocytes apoptosis trigged by HG-CM was abolished by either a ROS inhibitor (Tempo) or a p38 MAPK inhibitor (SB203580). Additionally, TNF-α was increased in the HG-CM. TNF-α protein in macrophage was aslo increased when exposed to high glucose. Anti-TNF-α neutralizing antibody blunted the apoptotic response, excess ROS generation and p-p38 MPAK expression in podocytes induced by HG-CM. Moreover, addition of recombinant TNF-α similarly led to podocytes apoptosis, increased ROS and p38 MPAK expression. Conclusion M1 macrophages activated by high glucose released TNF-α to promote podocytes apoptosis via ROS-p38 MAPK pathway.

Objective To explore the effect of nicotinaide nucleotide transhydrogenase(NNT) mutation on glucose homeostasis in C57BL/6 mice with mix background. Methods We generated wild type NNT homozygous, mutant NNT homozygous and heterozygous by mating the C57BL/6J (with NNT mutation) and 6N (without NNT mutation). At the age of 4 weeks, those mice were randomly assigned to normal control diet(NCD) or high-fat diet(HFD) for 4 weeks. The body weight was measured every week. At the age of 8 weeks, an intraperitoneal glucose tolerance test(IPGTT) and an intraperitoneal insulin tolerance test (ITT) were performed. Results The body weight growth was not affected by NNT mutation during an HFD fed. NNT mutant mice showed significant glucose intolerance. After 4 weeks of high fat diet, the NNT mutant mice showed a decreased insulin sensitivity, while the glucose excursion curve was not elevated in the heterozygous mice. Conclusion NNT mutation had a significant influence on the phenotype of glucose metabolism and insulin resistance of mice, in particular under a metabolic stress. The phenotypes of heterozygous and homozygous mutant ones differed from each other. When using mice with C57BL/6J and C57BL/6N mixed background in research, NNT mutation should be carefully screened in all metabolic studies.

Objective To observed the impact of selenium supplementation therapy on the thyroid perioxidase antibody(TPO-Ab) levels and serum oxidative stress[malondialdehyde(MDA, glutathione peroxidase(GPx), and superoxide dismutase(SOD)] in patients with Hashimoto′s thyroiditis. Methods 79 patients with Hashimoto′s thyroiditis were randomly divided into trial group(n=44) and placebo group(n=35) .The double-blind treatment was for 24 weeks. The thyroid hormone levels, serum TPO-Ab levels, and oxidative stress indexes(MDA, GPx, and SOD) of both groups were detected before and after treatment. Results (1)There was no change of thyroid hormone levels either before or after treatments of both groups(P>0.05). (2)TPO-Ab of the trial group decreased significantly after the treatment(P<0.05). While the placebo group has little change. Group with TPO-Ab≤200 IU/ml and the course≤1 year manifested the most obvious declines by 29.98% and 26.63% respectively. (3)The oxidative stress level of trial group significantly decreased after 24 weeks. There was significantly positive correlation between the oxidative stress indexes and TPO-Ab. However the placebo group was with little change. Conclusion Selenium supplementation may reduce the level of TPO-Ab titers and oxidative stress in patients with Hashimoto′s thyroiditis, especially for those with lower antibody titers and short course.

Objective To investigate serum lipid profiles in newly diagnosed patients with polycystic ovary syndrome (PCOS) using lipidomics and correlate these features with hyperinsulinemia and hyperandrogenism associated with PCOS and obesity. Methods 32 newly-diagnosed PCOS women and 34 controls were enrolled and divided into obese and lean subgroups according to the body mass index (BMI). Anthropometric, biochemical, and hormonal parameters were collected. Serum lipid profiles including phospholipids, free fatty acids (FFAs), and bioactive lipids were analyzed using GC-MS and LC-MS. Results PCOS patients, in particular, the obese ones with fatty liver, have abnormal phosphatidylcholine (PC)/lysophospholipid (LPC) metabolism. PC was increased (16∶0, 18∶0, 18∶1, 18∶2, and 20∶4), while LPC was decreased (16∶0, 18∶0, and 18∶1; all P<0.05). Serum polyunsaturated fatty acids (PUFAs), were decreased significantly, and the long chain saturated fatty acid was increased. We also found that insulin stimulated the metabolism of PUFAs, but the androgen inhibits the metabolism of PUFAs by measuring their metabolites. Conclusion PCOS patients have metabolic disorders of phospholipids and PUFAs. Insulin stimulated while androgen inhibited PUFAs metabolism.

Bariatric surgery is one of the most effective way to lose weight,which suppresses appetite through the central nervous system. The mechanisms of appetite change may include gut hormones, adipokines, as well as microbiota in the intestine.

The prevalence of prediabetes is increasing rapidly in China, and with higher prevalence in coronary heart disease and hypertension patients. Diabetes can be controlled and prevented, previous studies have confirmed that lifestyle interventions and drug interventions can delay the progression of prediabetes to diabetes, and acarbose can be used for the primary prevention of cardiovascular events in impaired glucose tolerance(IGT) and diabetic patients, but benefits of drug intervention for secondary prevention of cardiovascular disease in IGT population are uncertain. The Acarbose Cardiovascular Evaluation(ACE) Study is a multicentre, randomized, placebo-controlled, double-blind study, with the aim of assessing the use of acarbose to reduce the risk of cardiovascular events and the onset of diabetes in IGT patients with cardiovascular disease in China , the results will be very meaningful and valuable for the prevention and treatment of diabetes. We will predict the results of ACE Study based on previous evidences.