Objective To explore the effect of gliclazide and Sig Leo Dean on insulin treatment for poor glycemic control in obese patients with type 2 diabetes mellitus. Methods 80 cases of insulin treatment for poor glycemic control in obese patients with type 2 diabetes mellitus treated in our hospital from March 2015 to January 2017 were randomly divided into two groups,with 40 cases in each group.The control group was treated with gliclazide The observation group was treated with Sig Leo Dean.The therapeutic effects of the two groups were observed and compared. Results 2 hours postprandial blood glucose levels improved in the observation group was better than that of the control group, the body weight, blood pressure, fasting blood glucose of two groups were improved, and there were no significant difference between the two groups; The incidence rate of adverse reactions was 2.5% in the observation group, 10% in the control group, the difference was not statistically significant (P<0.05). Conclusion Analysis of gliclazide and Sig Leo Dean on insulin treatment for poor glycemic control in obese patients with type 2 diabetes mellitus curative effect, Sig Leo Dean for the glycaemic improvement effect is higher, reduce the incidence of adverse reactions, so more medication safety, it is worthy of clinical promotion Application.

Objective To investigate the application value of Tangniaole capsule combined with metformin in patients with newly diagnosed type 2 diabetes mellitus (T2DM).Methods 120 cases of patients with newly diagnosed T2DM were divided into the control group and the observation group.The control group was treated with metformin while the observation group was additionally treated with Tangniaole capsule.Symptoms and signs, changes in blood glucose, urine glucose, insulin resistance index (HOMA-IR) and insulin secretion (HOMA-β) were compared between the two groups.The incidence of adverse reactions was statistically analyzed.Results The curative effect in the observation group was better than control group (P<0.05).After treatment, scores of symptoms and signs, blood glucose, glycosylated hemoglobin (HbA1c), 24 h urine glucose quantitation and HOMA-IR were lower, and HOMA-β was higher in the observation group than in the control group (P<0.05).Conclusion Tangniaole capsule combined with metformin is effective in the treatment of newly diagnosed T2DM, and it can reduce blood glucose, urine glucose and insulin resistance.

Objective To study the analysis of insulin glargine combined with acarbose in type 2 diabetes compared with pre mixed insulin treatment efficacy and safety. Methods 100 patients with type 2 diabetes mellitus treated in our hospital from March 2015 to August 2016 were selected and randomly divided into the control group and the experimental group, with 50 patients in each group. The control group were treated with premixed insulin treatment, the experimental group were treated with basal insulin combined with acarbose. The clinical indexes of the experimental group and the control group were compared and analyzed. Results After the corresponding treatment, the fasting blood glucose level of the control group was (7.56 ± 1.13) nmol / L, and the fasting blood glucose level of the experimental group was (7.01 ± 0.92) nmol / L. The level of fasting blood glucose in the experimental group was significantly lower than that in the control group, with statistical difference (P<0.05). The level of HbA1c in the experimental group was (7.01 ± 0.82)％, significantly lower than that in the control group, and the level of HbA1c (7.45 ± 0.91)％, with statistical difference (P<0.05). Among the 50 patients in the control group, hypoglycemia occurred in 20 patients, the incidence of hypoglycemia was 40％, significantly higher than that in the experimental group, and the incidence of hypoglycemia was 14％, which was statistically significant (P<0.05). Conclusion Basal insulin combined with acarbose compared with premixed insulin treatment of type 2 diabetes treatment can significantly hypoglycemic effect, high safety, with further clinical promotion and application significance.

Objective To study the rationality of hypoglycemic drugs in patients with gastroparesis. Methods The mechanism of gastroparesis was analyzed, and the mechanism, indications, adverse reactions and contraindications of common hypoglycemic agents were studied. Results There were significant differences in the mechanism of gastric hypoglycemia and hypoglycemic therapy. The mechanism of action and the application of the patients were obvious. According to the characteristics of the patients, the selection of the appropriate drugs could improve the clinical curative effect and ensure the safety of the drug. Conclusion The pathogenesis of gastroparesis is more complicated. The clinical practice should be based on the pathogenesis of the patients and the hypoglycemic drug regimen.

Objective To explore the effects of insulin-like growth factor-l (IGF-l),insulin-like growth factor binding protein-1 (IGFBP-1) and growth hormone (GH) on the generation, development and treatment of diabetes chronic complications. Methods 20 healthy controls,10 type 1 diabetes mellitus patients and 62 type 2 diabetes mellitus patients were enrolled into the study. IGF-1, IGFBP-1, GH, HbAlc. serum insulin (INS) and serum C-peptide (C-P) were measured. Results ①Serum level of IGF-1 was obviously lower in the diabetes mellitus group than that in controls (type 1 P＜0. 05,type 2 P＜0. 05). ②Serum level of IGFBP-1 was significantly higher in type I diabetes mellitus than that in controls (P＜0. 05),and it was obviously lower in type 2 diabetes mellitus with obesity and hyperinsulinism than that in contris (P＜0. 05). ③Serum level of GH was higher in type 1 diabetes mellitus than that in controls (P＜0. 05 ) and was not significantly different from that in controls (P＞0. 05). ④The level of IGF-l was higher in diabetes nephropathy (DN) patients and diabetes retinopathy (DR) patients than that in controls (P＜0. 05). ⑤The level of IGF1 was negatively correlated with HbAlc (P＜0. 01, type 1r=- 0.73, type 2r=-0. 62). Conclusion Measurement of IGF-1, IGFBP-1 and GH may play an important role in diabetes chronic complications,especially in the generation,development of diabetic microvascular.

Objective To explore the vitamin D nutritional status of urban residents in Jinan,in order to provide the basis for the prevention and treatment of chronic diseases associated with vitamin D insufficiency.Methods 1478 cases aged 30-90 years,including 602 men (59.8± 13.0) years on average and 876 women (57.4±12.9) years on average were selected by a stratified random sampling from 3 community medical care institutions in Jinan.Subjects were divided into six groups according to the 10-year interval.Serum 25-hydroxyvitamin D [25(OH) D] level was measured by enzyme-linked immunosorbent assay (ELISA).Serum [25(OH) D] level ≥ 75 nmol/L was defined as vitamin D sufficient,(50.0 ～ 74.9) nmol/L as vitamin D critical value,25.0 ～ 49.9 nmol/L as vitamin D insufficiency,＜ 25 nmol/L as vitamin D deficiency.All data processing and statistical analysis were finished by SPSS 13.0.Results The average level of [25 (OH) D] was 58.60 nmol/L in males [95％ CI:56.7-60.5 nmol/L] and 54.17 nmol/L in females [95％ CI:52.8-55.8 nmol/L],which were less than 75 nmol/L.The average level of [[25(OH) D] was 49.1nmol/L in females aged 70-79 years (95％CI:45.7～52.5 nmol/L),41.7 nmol/L in females aged 80-90 years (95％CI:38.2 ～46.7 nmol/L),which were less than 50 nmol/L.The percentage of cases with vitamin D deficiency,insufficiency,critical value,and sufficiency was 5.6％,33.4％,36.5％,24.4％ in males,and 6.5％,42.9％,32.6％,18.1％ in female respectively.The incidence of vitamin D deficiency and insufficiency was increased with ageing (male:x2 =33.68 P＜0.01,female:x2 =55.7,P＜0.001).The percentage of vitamin D deficiency and insufficiency was more in females than in males (60-69 years old:x2=9.387,P＜0.05,80-90 years old:x2=8.896,P＜0.05).The [25 (OH) D] level was lowest in winter (48.8 nmol/L,95％CI:46.8～50.9 nmol/L) and highest in autumn (60.2 nmol/L,95％ CI:58.0～62.3 nmol/L).The incidence of vitamin D deficiency and insufficiency was highest in winter (x2 =18.364,P＜0.05).Conclusions Vitamin D deficiency and insufficiency are widely prevalent in urban residents,which is more severe in the elderly and females.Serum [25(OH) D] level is related to season,and the vitamin D deficiency and insufficiency are severe in winter.

Objective To explore the changes of mTOR signaling in LPS/D-gal-induced acute hepatitis in mice . Methods Twenty-six healthy adult female ICR mice were divided into two groups:the control group and experimental group, 13 mice in each group .LPS/D-gal was used to induce acute hepatitis in the mice .The survival of mice was moni-tored within 24 hours after LPS/D-gal challenge .At 6 hours after challenge , samples of serum and liver tissue were collect-ed for further analysis.Results Injection of LPS/D-gal resulted in acute death of the mice within 24 hours.At 6 hours post LPS/D-gal injection , the blood levels of ALT and AST were significantly increased .The mRNA expression of inflammatory cytokines Tnfa and Il6 was up-regulated in LPS/D-gal-induced hapatitis , in which DNA fragmentation and activation of caspase-3 were subsequently observed .Immunoblot analysis showed that both mTOR pathway and NF-κB pathway were ac-tivated.Unexpectedly , inhibition of mTOR signaling could neither decrease the apoptosis in the liver nor increase the sur -vival of mice .Conclusions The results of the present study indicate that mTOR signaling may play pleiotropic roles in the pathogenesis of LPS/D-gal-induced hepatitis .

Objective To evaluate measurement of the submucosal thickness with endoscopic ultrasonography (EUS) for activity of Crohn disease (CD).Methods Ten patients with active stage of CD and 10 healthy controls (HC) underwent EUS.Simple endoscopic score for Crohn disease(SES-CD)and submucosal thickness at the most severe lesions were measured and recorded.Submucosal thickness of the same region in CD patients were measured at remissive stage.In order to analyze the relationship between submucosal thickness and the stage of CD, submucosal thickness were compared among patients at active stage of CD, remissive stage of CD and HC.And the cut-off value of submucosal thickness was calculated to diagnose the stage of CD.Results The mean submucosal thicknesses of active stage and remissive stage of CD were 6.48±1.95 mm and 2.47±1.08 mm,respectively (P<0.01).The correlation analysis showed that submucosal thickness had a positive correlation with Crohn disease activity index(CDAI)(r=0.708,P<0.01) and SES-CD(r=0.807,P<0.01).Receiver operating characteristic curve analysis was used for 10 cases of CD patients and the area under the curve was 0.985(P<0.01).The cut-off value of submucosal thickness to diagnose active stage of CD was 3.85 mm, and the sensitivity and specificity reached 100% and 90% respectively.The Youden index was 0.9.Conclusion Measurement of gastrointestinal submucosal thickness by EUS could contribute to evaluate the stage of CD and to guide clinical treatment.

Objective:To investigate the effect of triptolide on the apoptosis of human melanoma A375 cells through the inositol-requiring enzyme 1 (IRE1) /c-Jun N-terminal kinase (JNK) signaling pathway, and to explore its possible mechanisms.Methods:Cultured A375 cells were treated with triptolide at different concentrations of 0, 50, 100, 200 nmol/L (experimental control group, 50, 100, 200 nmol/L triptolide groups, respectively), and a blank control group (DMEM high-glucose medium without cells) was set up. Methyl thiazol tetrazolium (MTT) assay was performed to evaluate the cell viability at 24, 48, and 72 hours after the start of treatment, flow cytometry to detect cell apoptosis at 24 hours after the start of treatment, and real-time fluorescence-based quantitative PCR (RT-qPCR) and Western blot analysis were conducted to determine mRNA and protein expression of IRE1, JNK, and c-Jun, respectively. After pretreatment with the JNK inhibitor SP600125 for 72 hours, some A375 cells were then treated with 100 nmol/L triptolide for 24 hours (SP600125 + 100 nmol/L triptolide group), and the A375 cells only treated with 100 nmol/L triptolide served as control group (100 nmol/L triptolide group). Effects of triptolide on the mRNA expression of IRE1, JNK, and c-Jun in A375 cells, as well as on cell apoptosis, were investigated. Statistical analysis was performed using two-way analysis of variance, one-way analysis of variance, and Dunnett′s test.Results:After the treatment with different concentrations of triptolide for different durations, the cell viability was significantly lower in all triptolide groups than in the experimental control group ( Ftriptolide concentration = 18.36, P = 0.002), and gradually decreased over time ( F time = 8.54, P = 0.018). After 24-hour treatment, the apoptosis rate of A375 cells significantly differed among the 4 groups treated with different concentrations of triptolide ( F = 5 234.97, P < 0.001) ; additionally, the apoptosis rate was significantly higher in the 50, 100, and 200 nmol/L triptolide groups (16.99% ± 0.33%, 30.78% ± 0.40%, 38.91% ± 0.51%, respectively) than in the experimental control group (4.33% ± 0.02%, all P < 0.05), and gradually increased with the rising concentrations of triptolide. The mRNA expression levels of IRE1, JNK, and c-Jun were all significantly higher in the 50, 100, and 200 nmol/L triptolide groups than in the experimental control group (all P < 0.05), and gradually increased with the increase of triptolide concentration. Moreover, the protein expression levels of IRE1, JNK, c-Jun, p-JNK, and p-c-Jun in A375 cells in the triptolide groups also showed the same trend. After pretreatment with the JNK inhibitor SP600125 for 72 hours, the apoptosis rate was significantly lower in the SP600125 + 100 nmol/L triptolide group (21.88% ± 0.55%) than in the 100 nmol/L triptolide group without SP600125 pretreatment (30.78% ± 0.40%, t = -22.51, P < 0.001), and the mRNA expression levels of IRE1, JNK, and c-Jun were also significantly decreased in the SP600125 + 100 nmol/L triptolide group compared with the 100 nmol/L triptolide group (all P < 0.05) . Conclusion:Triptolide may induce apoptosis of human melanoma A375 cells by activating the IRE1/JNK signaling pathway.

Objective To investigate the iodine intake level and the prevalence of thyroid nodules in Harbin City,and to study the correlation between the concentration of urinary iodine and the prevalence of thyroid nodules.Methods In Harbin,18 communities were randomly selected and specimens were collected from fasting morning urine from 2015 to 2017.The urine iodine concentration (UIC) was detected by arsenic cerium catalytic spectrophotometry,and the thyroid nodule was examined by B ultrasound.Results A total of 2 552 residents aged (45.79 ± 12.06) years old agreed to participate in the study,including 371 males and 2 181 females.The median UIC in all participants was 159.8 μg/L,there was a significant difference in urine iodine frequency distribution among age groups (x2 =40.097,P ＜ 0.01).Furthermore,the median UIC in male was 166.6 μg/L,and in female was 156.2 μg/L.There was a significant difference in UICs between male and female (U =2.122,P ＜ 0.05).The prevalence of total thyroid nodules in all participants was 48.75％ (1 244/2 552),and the standardized rate was 40.55％.Significant difference in the detection rate of thyroid nodules was observed among age groups (x2 =114.922,P ＜ 0.01),and there was a positive and significant correlation between the detection rate of thyroid nodules and increasing age (xtrand =111.746,P ＜ 0.01).Furthermore,in male,41.24％ (153/371) had thyroid nodules,with standardized prevalence rate of 41.13％,and in female,50.02％ (1 091/2 181) had thyroid nodules,with standardized prevalence rate of 49.20％.Likewise,there was a significant difference in the detection rate of thyroid nodules between male and female(x2 =9.790,P ＜ 0.01).The detection rate of thyroid nodules in the iodine deficient population (urinary iodine was 0-＜ 100 μg/L) was 55.58％ (244/439),and the incidence of thyroid nodules in the iodine adequate or optimal population (urinary iodine was 100-＜ 200 μg/L) was 46.68％ (591/1 266).Conclusions The total iodine level of the population in Harbin City of Heilongjiang Province is at adequate level.The detection rate of thyroid nodules is high and it is increased with age.The detection rate of thyroid nodules is higher in female than male.Regular detection of urine iodine and adjusting iodine nutrition will help prevent thyroid nodules.