Ketosis-prone diabetes mellitus(KPDM) may be a subtype of type 2 diabetes,characterized by fulminant onset,with diabetic ketoacidosis and usually obesity and over-weight,as well as a positive family history of diabetes,but lacking markers of autoimmunity observed in classic type 1 diabetes.Recovery of glucose homeostasis,accompanied by recovery of ?-cell function,follows intensive glycemic regulation by insulin.Because of the mixed features of type 1 and type 2 diabetes,there is no completely agreement on diagnostic criteria and classification according to clinic presentation,metabolic and immunologic features of the novel atypical diabetes.Additional pathophysiological and genetic insight is therefore needed to provide a better understanding of the mechanisms of partially reversible insulin secretary defect in such syndrome,which is critical for its clinical classification and the development of appropriate treatment strategies.

Objective To investigate the clinical characteristics,peripheral insulin sensitivity,and β-cell function in patients with ketosis-prone diabetes(KPD).Methods Thirty-one patients with newly diagnosed ketosisprone diabetes were admitted to West China Hospital from January 2004 to December 2009.They were divided into 2 groups according to their body mass index (BMI):OB-KPD (BMI ≥ 25 kg/m2,n =22) and Lean-KPD (BMI ＜ 23 kg/m2,n =9).10 patients with newly-onset type 2 diabetes free from ketosis (OB-DM:BMI ≥ 25 kg/m2,n =10) were enlisted as control.Detailed assessments of medical history and symptoms of hyperglycemia were performed.The islet cell antibody (ICA),insulin autoantibody (IAA),anti-glutamic acid decarboxylase antibody (GAD-Ab),fasting plasma glucose,serum insulin,C-peptide and free fat acids concentrations were measured.All of the subjects underwent oral and intravenous glucose tolerance tests,euglycemic-hyperinsulinemia and hyperglycemia clamp test,to evaluate the insulin secretion and insulin sensitivity respectively.Insulin sensitivity was determined by glucose disposal rate (GDR) of steady state during euglycemic clamp and acute insulin secretion was calculated by insulin area under curve(AUCins 0-10 min) during IVGTT.Maximal insulin secretion was determined by glucose infusion rate (GIR) and serum insulin concentration of steady state during hyperglycemic clamp test.Results Age,sex,duration of diabetes were matched among groups.A family history of diabetes was strongly associated with those patients with obesity,compared with lean ketosis prone diabetes(16/22 vs 1/9).GDR was (4.91 ± 1.82) mg · kg 1 · min-1 in subjects with OB-KPD,being lower than that in Lean-KPD patients[(6.26 ± 1.89) mg · kg 1 · min-1] and OB-DM group[(6.78-± 1.69) mg · kg 1 · min-1,P＜0.01].Serum insulin and C-peptide in OB-KPD patients were higher than Lean-KPD patients.Area under the insulin curve [AUCins0-10min (183.86 ± 31.1) mIU/L] and GIR[(2.65 ±1.53) mg · kg-1 · min-1] in OB-KPD patients were lower than those in OB-DM group[(697.06-± 231.9) mIU/L,(6.53 ± 2.21)mg · kg 1 · min-1,P＜0.0 1],but slightly higher than the Lean-KPD group [AUCins0 10min (92.1 ±29.8) mUU/L,GIR (2.55 ± 1.49) mg · kg 1 · min-1,P＜0.05].Glucose disposal rate (GDR) was strongly associated with casual plasma glucose (r =-0.502,P＜0.01),HbA1C(r =-0.553,P＜0.0 1) and FFA eoneentrations (r=-0.504,P＜0.01) on admission.Conclusions Insulin resistance and β-cell dysfunction coexist in all KPD patients.OB-KPD patients exhibit more severe insulin resistance,while Lean-KPD patients have lower insulin secretion.KPD patients had severe hyperglycemia,hypertriglyceridemia,and high plasma FFA levels on admission,suggesting that hyperglycemia and elevated FFA levels could result in serious insulin resistance,β-cell dysfunction,and diabetic ketosis in patients with KPD.

Objective: To establish a method for the determination of metamizole sodium and chlorphenamine malete in zhongganling Tablets. Methods: The sample was determined by ion pair HPLC after it was purified on Sep Pak C 18 microcolumn. The chromatographic conditions included: Hypersil DBS C 18 chromatographic column (250mm?4.6mm, i.d.5?m) as an anlaytical column, methanol mixed solution of sodium heptanesulfonate and glacial acetic acid (600∶400) as a mobile phase, the detection wavelength at 264nm and 1.0mL?min -1 of flow rate. Results: The average recoveries of metamizole sodium and chlorphenamine maleate were 99.6% (RSD was 2.1% and n was 6) and 98.0% (RSD was 1.5% and n was 6), respectively. Conclusion: Metamizole sodium and chlorphenamine maleate can be determined respectively by HPLC with the same mobile phase when Sep Pak C 18 microcolumn solid phase extraction method is used to substitute for the traditional sample pretreatment methods refluxing, extracting and concentrating, and sodium heptanesulfonate ion pair reagent in acid condition is selected.

The effects of elevated levels of glucose and (or) free fatty acids on insulin secretion were studied in obese rats by intravenous glucose tolerance test and isolated pancreas perfusinn. The results showed that both glucose- and arginine-stimulated insulin secretions were severely impaired by glucolipotoxicity and the production of ketone was increased dramatically.

Objective:To explore the relationship of NSCL/P with MTHFR gene polymorphism in Xinjiang Uyghur and Han popula-tion and the ethnic difference.Methods:rs1801131 and rs1801133 polymorphism was detected by SNaPshot genotype method in 170 children with NSCL/P and 100 healthy controls of Uyghur and Han population.Results:Rs1801133 TT and T allele was statistically difference between 2 nationalities(P <0.05),Rs1801133 CT and CT +TT genotypes in total case group and control group were sta-tistically different(P <0.05);Rs1801131 and rs1801133 conjoint analysis showed that between the 2 nationalities and between case and control groups of total population were statistically different(P <0.05);rs1801131 genotype between 2 nationalities or total cases and controls were not statistically different(P >0.05).Conclusion:Rs1801133 TT and T allele in Han nationality are more likely to suffer from NSCL/P than in Uyghur,rs1801133 CT and CT +TT genotypes are protective factors.Rs1801131AC and rs1801133CC conjoint is relevant to NSCL/P,and the risk in Uyghur is higher than in Han.MTHFR rs1801131 gene polymorphism may not be relat-ed with NSCL/P in Uyghur or Han.

Pharmaceutical researchers at home and abroad have been working in pursuit of an effective, easy-to-use and safe way of non-injecting insulin administration. Oral insulin was considered to be one of the ideal administration ways for the treatment of diabetes mellitus. In this review, we introduce the clinical value and progress of oral insulin delivery in recent years. The mechanisms, therapeutic effect, limitations of oral insulin delivery, and the future perspectives in this research field are also discussed.
Administration, Oral ; Animals ; Diabetes Mellitus ; drug therapy ; Drug Carriers ; Drug Delivery Systems ; Humans ; Insulin ; administration & dosage

Objective To determine the influence of gender on the association between serum uric acid and branchial-ankle pulse wave velocity (baPWV).Methods Cross-sectional data from 1418 adults who underwent routine laboratory tests and baPWV measurements were analyzed in a gender-specific manner.BaPWV≥ 1400 cm/s was defined as abnormality.The individuals were assigned to four groups (Q1,Q2,Q3 and Q4) according to the gender-specific quartiles of serum uric acid.The relationship between serum uric acid and the baPWV values was assessed by Spearman's correlation coefficients.In female,the relationship of serum uric acid quartiles with baPWV was evaluated by logistic regression analysis.Results In male and female,diastolic blood pressure,fasting blood glucose,triglyceride and body mass index were increased with serum uric acid level,in contrast to high-density lipoprotein cholesterol.The Spearman's correlation coefficient for the relationship between serum uric acid and baPWV was 0.18 in female and-0.05 in male (P =0.16).In female,univariate logistic regression analysis showed that in comparison with group Q1,odds ratio (OR) value of baPWV abnormality of group Q4 was 2.45 (95％confidence interval (CI) 1.48 to 4.06).In multivariate logistic regression,after adjusting for creatine and estimated glomerular filtration rate,OR value of baPWV abnormality of group Q4 was 2.45 (95％ CI 1.48 to 4.06) when compared with group Q1.However,after adjustment for age and other risk factors of cardiovascular diseases,there were no significant differents in ORs among serum uric acid quartile groups.Conclusions The association between serum uric acid level and baPWV in female may depend on age and metabolic syndrome components.

Objective To analysis the result of tumor screening for health examination participants.Methods Tumor screening was applied for 15 863 health examination participants without malignant tumor disease history.Clinical examination,laboratory tests and imaging studies were comprehensively analysed combining the results of other medical items.The cancer detection rate and asymptomatic rate were compared among groups of different age,gender and existence of relevant clinical symptoms,respectively.χ2 test and Fisher exact test were adopted for statistical analysis.Results Among 475 tumor patients with a definite diagnosis,116 were malignant tumor;The total detection rate of the group who were younger than 35 year-old(0.617%)was higher than other groups,the detection rate of intracranial neoplasms of the two groups who were younger than 45 year-old (0.206% and 0.132%,respectively)was higher than other groups,the total detection rate of 75-85 group (0.248%)was lower than other groups; The detection rate of lung cancer,liver cancer of the male(0.228% and 0.080%,respectively)was higher than the female,The detection rate of breast cancer and intracranial neoplasms of the female(0.366% and 0.100%,respectively)was higher than the male; There are 67 patients without correlated clinical symptoms,the asymptomatic rate was 57.8%.Conclusions Tumor screening was of importance in health management,which should be carried out actively in health examination.

Objective To compare the efficiency of intra-articular injection of tranexamic acid (TXA) and autolo-gous transfusion drain on the blood loss after total knee arthroplasty (TKA). Methods A total of 124 patients (124 knees) with varus knee osteoarthritis, who were performed TKA,were retrospectively analyzed. Patients included 24 males and 100 females. The mean age was(65.03±6.84)years. Due to the blood loss control method, patients were divided into two groups including TXA application group (test group, n=49) and autologous transfusion drain group (control group, n=75). The data of blood routine examination, blood loss and blood transfusion after TKA were analyzed. Results The blood transfusion rates were 10.20%(5/49) in test group and 17.33%(13/75) in control group 7 days after TKA surgery. There was no signifi-cant difference between two groups (P>0.05). There were significant differences in red blood cell (RBC), hemoglobin (Hb) and haematocrit (HCT) between groups and effects of interaction in the two groups (P＜0.01). There were significantly higher values of RBC, Hb and HCT at 1, 3 and 7 days after surgery in test group than those of control group (P＜0.05).The total blood loss 1 and 3 days after TKA was significantly lower in test group than that of control group (P＜0.05). There was no sig-nificant difference in the blood loss 7 days after surgery between two groups (P>0.05). Conclusion The single dose intra-articular injection of tranexamic acid is a safe and effective procedure for hemostasis after TKA.

Objective To assess the changes of humidity and ammonia concentration in rat and mouse individually ventilated cages (IVC) based on macroenvironmental humidity and air ventilation changes .Methods Three kinds of rat and mouse IVC in barrier facilities were set as research objective .The changes of micronvironmental humidity and ammonia concentration at 40 times/h and 60 times /h air changes were detected continuously for a 7-days-cycle relative to low (40%), moderate (50%), and high (60%) macroenvironmental humidity.Results Mouse and rat IVC with 40 times /h air changes under low macroenvironmental humidity condition , mouse IVC with 40 times/h and rat IVC with 60 times/h air changes under moderate macroenvironmental humidity condition , mouse IVC with 60 times /h air changes under high macroenvironmental humidity condition , basically meet the GB14925-2010 requirements.While under macroenvironmental high humidity condition, the microenvironments of rat and mouse IVC with 60 times/h air changes could not satisfy the requirements.Conclusions The environmental humidity and ventilation frequency are the key index of IVC microenvironment.Only on the basis of external environment conditions to set up reasonable IVC ventilation frequency in order to better maintain the IVC microenvironment so that to achieve the goal of effective management .