Different from fasting blood glucose reflecting the basal glucose level of the body, the post-prandial blood glucose gives us the information about the highest glucose level during a day. It has been proved that post-prandial hyperglycemia (PPG) is associated with cardiovascular diseases more closely, which may be caused by oxidative stress, hence the management of PPG is of great meanings. But what is the effect of PPG control on the treat-to-target blood glucose management? This is a question worth discussing.

Objective To discuss the clinical features and treatment strategy of patients with fulminant type 1 diabetes mellitus (FT1 DM).Methods Clinical and laboratory data of 4 patients diagnosed as FT1 DM in our hospital from January 2008 to February 2016 were retrospectively analyzed.Results 2 females and 2 males aged from 22 to 68 years old were included.They were developed to ketoacidosis rapidly after the appearance of diabetic symptoms in 2-6 days.Some cases complicated with shock,acute renal insufficiency and rhabdomyolysis.One case with late pregnancy had a stillbirth.The plasma glucose level was ranged from 35.6 to 67.8 mmol/L,HbA1c ranged from 5.8 % to 6.7%,fasting C peptide ranged from lower than 0.01 to 0.11 ng/mL and 2 -hour postprandial C peptide ranged from lower than 0.01 to 0.12 ng/mL.No improvement in C peptide levels were followed up for 9 -43 months.After acute phase,intensive insulin therapy was used to control blood glucose.The patients had a great glycaemia excursion and were subjected to hypoglycaemia.Conclusion FTlDM is a special type of diabetes developed rapidly with dangerous prognosis.It is often shown as ketoacidosis and the HbA1 c level is normal or mildly elevated.Serious cases are associated with other organ damage,pregnancy fetal death rate is very high.Because the serious impaired islet B -cell function,FTlDM patients has a great glycaemia excursion,continuous subcutaneous insulin infusion is the first choice to control plasma glycemia.

ObjectiveTo explore the effect of single glucocorticoid treatment and glucocorticoid joint cyclophosphamide treatment on thyroid-associated ophthalmopathy.MethodsRetrospective analysis of clinical data of 35patients used single glucocorticoid( single medicine group) and 16 patients used glucocorticoids joint cyclophosphamide(joint group) was carried out.ResultsThe effective rate of joint group(93.8％ ) was significantly higher than single drug group (68.6％) ( x2 =3.87,P ＜ 0.05).Simple using glucocorticoid had significant treatment effect at CAS score,prominent eyes degrees,soft tissue inflammation score,but the curative effect was significantly lower than the joint group ( P ＜ 0.05 ).The adverse reaction rate had no significant difference between two groups.ConclusionCompared to single glucocorticoid treatment,the glucocorticoid joint cyclophosphamide treatment had better effect and lower adverse reaction rate,especially suitable for patients who had no effect or low effect on hormone therapy.

Carotid artery stenosis is one of the most important reasons for stroke. Carotid artery stenting possesses more advantages with less damage and pain for patients, which has becaome the most effective treatment for carotid artery stensis, and the use of review the issues related to te carotid artery stenting under cerebral protection. With the accomplishment of many successful large scale clinical trials carried out by multiple centers, it is believed that carotid artery stenting with cerebral protection plays important orle in the prevevtion and treatment of cerebral stroke initiated by carotid artery stenosis.

Objective To establish an experimental retinal artery occlusion (RAO) model by means of photochemistry therapy with 532 nm frequency-doubled laser, and to evaluate the feasibility of this method. Methods Ten eyes from ten healthy adult New Zealand rabbits were intravenously injected 5% rose bengal solution, then their monocular retinal artery was irradiated by 532 nm frequency-doubled laser. Both eyes of these rabbits were examined by direct ophthalmoscope and fundus photographic camera on the 1st hour, 24th hour and 3rd day. Meanwhile, the experimental eyes were examined by fundus fluorescein angiography (FFA). These rabbits were killed on the 3rd day, experimental eyes were enucleated, the retina was observed under light microscope. Results There were 9 eyes approved having RAO by direct ophthalmoscope and FFA. Thrombi in retinal arterials could be found by light microscope in all these 9 experimental eyes, and the walls of blood vessel were intact without any obvious necrosis or attenuation. Conclusions RAO animal model can be induced by photochemistry therapy with 532 nm frequency-doubled laser. There are thrombi in the retinal artery without trauma of the artery wall. Photochemistry therapy is an efficient, secure and reproducible method to induce animal model of RAO.

Objective To investigate the effect of ropiyacaine combined with intra-spinal epidural anesthesia by using the same volume but different injection speed on anaesthetic level.Methods 80 cases of patients of ASA～Ⅱdegree suitable to use intra-spinal epidural combined anesthesia for gynecologic operation were selected and ran- domly divided into three groups,0.75 % ropivacaine 2mg(15mg)administered,group A the speed of injection was 10 seconds,group B injection speed was 20 seconds,group C injection speed was 30 seconds,the anaesthetic level reached T_(10).The time of highest level in spinal anesthesia,30 minutes after spinal anesthesia MAP,and number of cases need to add epidural drug were all recorded.Results The best effect of anesthesia was found in group B,the block level of anesthesia was satisfactory,blood dynamic was stable,and there was no need to add epidural drug.Conclusion The speed of 0.75 % ropivacaine 2ml spinal epidural combined with anesthesia was suitable at the speed of 20 seconds.

Objective:To identify pathogenicity of the potential splicing variants in two Chinese Han patients with osteogenesis imperfecta.Methods:Genomic DNA was extracted using the conventional phenol-chloroform method; whole exome sequencing (WES) was used to analysis the disease-related variants in the two probands; Minigene assay was used to identify pathogenicity of the variants found in the patients' genome that possibly affect RNA splicing.Results:Two potential splicing variants, c.858+1_858+5delGTAAG in intron 12 of COL1A1 and c.1405-7C>T in intron 24 of COL1A2, were found in proband 1 and proband 2, respectively. In addition, a missense mutation, c.2972G>T (p.G991V) in exon 45 of COL1A2, was detected in proband 2. Minigene assay revealed that the variant in proband 1 caused the skipping of exon 12, while the variant in proband 2 did not lead to aberrant splicing. G199 of the COL1A2 in proband 2 was a highly conserved amino acid site, and the results suggested that c.2972G>T (p.G991V) may be the real pathogenic variant by the means of bioinformatics analysis.Conclusion:The variant c.858+1_858+5delGTAAG in COL1A1 was a causative variant that led to OI in proband 1, while the missense variant c.2972G>T (p.G991V) in COL1A2 was the cause of OI in proband 2, instead of the variant c.1405-7C>T. Minigene assay for potential splicing variants detected by WES could not only validate the pathogenicity of the candidate variants and enrich the mutation spectrum of OI, but also lay the foundation for patients' prenatal diagnosis and subsequent mechanism research.

OBJECTIVETo research serum level of interleukin-17 (IL-17) associated with the progression of hepatic injury in the chronic patients with hepatitis B.

METHODSThe serum level of IL-17 was measured by ELISA and the serum levels of IL-6, IL-8 were measured by RIA in patient groups and healthy group, the patient groups including 42 mild patients, 37 moderate patients and 38 severe patients.

RESULTSIL-17,IL-6 and IL-8 levels in patient patients were significantly higher than those in healthy people (P < 0.01). There is no significant difference among mild patients and moderate patients. Compared with mild patients and moderate patients,the cytokines lever were significantly higher in severe patients (P < 0.01).

CONCLUSIONIL-17 as a new cytokine probably play a multiple role as immune factor and inflammation element in the progression of the chronic hepatitis B disease. Maybe, it can provide a new approach to the therapy of the chronic hepatitis B.

Adult ; Aged ; Case-Control Studies ; Female ; Hepatitis B, Chronic ; blood ; pathology ; Humans ; Interleukin-17 ; blood ; Interleukin-6 ; blood ; Interleukin-8 ; blood ; Male ; Middle Aged

OBJECTIVETo understand the genotypic mapping of Mycobacterium leprae identified in China and to compare with those from other countries to select suitable alleles for epidemiological investigation in the transmission chain of leprosy.

METHODSVarious number of tandem repeat(VNTR) in genomic DNA of Mycobacterium leprae was used in the present genotyping study. 33 skin biopsies from Wenshan prefecture,Yunnan province and 17 from other parts of China were studied. DNA extracted from skin biopsies of leprosy patients was subjected to PCR followed by agarose gel analysis and DNA sequencing to determine the number of repeats.

RESULTSLoci GGT-5,12-5,21-3 and 23-3 were as highly homogenous as 100%; The homogeneity of loci AC-8, 18-8, 27-5 and rpoT were 97%, 94%, 97% and 85% respectively. Loci GTA-9, AC-9 and 6-7 showed significant allelic diversity in isolates and the diversity of GTA-9 in Mycobacterium leprae isolated from China was also different from those identified other countries. We had subjected loci GTA-9 and the ten loci to phylogenetic tree analysis respectively.

CONCLUSIONThe present study revealed that the genotype of Mycobacterium leprae identified from China was close to the strains from the Philippines and India although a few loci were somehow differentiate. Locus 12-5 manifested as only 3 copies in China whereas 4-5 copies predominating in other countries. 12-5 locus might serve as a useful marker to diffrentiate Chinese strains from those in other countries. However, further study on the diversity of GTA-9 was needed in China. The molecular typing of Mycobacterium leprae from different geographic areas might be useful in studying the transmission of leprosy.

Alleles ; China ; epidemiology ; DNA, Bacterial ; Genotype ; Humans ; Leprosy ; epidemiology ; transmission ; Molecular Epidemiology ; Mycobacterium leprae ; genetics ; isolation & purification ; Polymerase Chain Reaction ; Skin ; microbiology

OBJECTIVEWe aim to investigate the sonodynamic effect induced by hydroxyl acetylated curcumin (HAC) on THP-1 macrophages.

METHODSTHP-1 derived macrophages (1 x 10(5) per milliliter) were cultured with HAC at a concentration of 5 µg/mL for 4 h and then exposed to pulse ultrasound treatment (0.5 W/cm2) for 5 min. Six hours later, cell viability analysis was performed with CCK-8 assay, apoptosis and necrosis analysis were detected with Annexin V/PI staining by flow cytometery.

RESULTSThe cell viability of THP-1 macrophage decreased significantly in the group treated with the combination of HAC and ultrasound (P < 0.01), and HAC-SDT induced both apoptosis and necrosis in THP-1 macrophages, the apoptotic rate was higher than the necrotic rate with appropriate conditions, the maximum apoptosis/necrosis ratio was detected in sonodynamic therapy (SDT) group (P < 0.01).

CONCLUSIONhAC-SDT was effective to induce THP-1 macrophages apoptosis.

Apoptosis ; Cell Line ; Cell Survival ; Curcumin ; pharmacology ; Humans ; Macrophages ; cytology ; drug effects ; Necrosis ; Ultrasonics