Objective To explore the relationship between diabetic retinopathy (DR) and intima-media thickness in newly diagnosed type 2 diabetic patients. Methods A total of 1236 diabetic subjects who were diagnosed within 1 year, including 218 older patients, were enrolled in the study. Intima-media thickness of the right common carotid artery and femoral artery were determined using B mode ultrasonography. All subjects were ophthalmologically examined. Results The intima-media thickness values of the carotid artery and femoral artery[(0.83 ± 0.11)mm, (0. 80 ±0.11)mm] in elderly DR group were higher than those [(0. 78±0.12)mm, (0.75±0.13)mm] in elderly non-DR group(P＜0.05). The prevalences of DR in IMT≥0.8 mm group[20.6%: carotid artery, 18.6%: femoral artery] were higher than those in IMT＜ 0.8mm group [13.0%: carotid artery, 13.6%: femoral artery] (P＜0. 05). Logistic regression analysis also showed DR was associated with IMT. Conclusions DR is associated with IMT in newly diagnosed type 2 diabetic patients, and early changes of retinopathy are associated with increased IMT.

Objective To probe whether the preinduced adult animal hepatocytes (AHH) by phenobarbital sodium (PBS) in vivo could boost the metabolic activity of bilirubin in vitro for seeking the optimal biomaterial for the extracorporeal bioartificial liver support system (EBLSS). Methods Twelve adult male rats with 34g mean weight were randomly divided into preinduce group and control group, the rats of the preinduce group were intraperitoneal injected daily with 45mg/kg PBS for 5 days, while the control group with normal sodium. 0.5g wet weight liver was taken from every rat after 24 hours of last administer, the suspensions were made by mixing six wet weight livers in two groups and put in the cultivate board of 96 apertures, 30ul per aperture, then 50?l jaundice serum and 20?l culture fluid were added into every aperture, which were statically cultured in the incubaton of humidity 95% at 37℃, 5% CO2 for 3 hours, and then revolved, the metabolic activity of bilirubins were determined by Beckmann auto-analyzer. Results The total bilirubins and indirect bilirubins fell 60%, 71.42% respectively in the preinduced group, and 34.78%, 54.87% in the control group (P0.05, t=1.571). There were no obvious changes in direct bilirubins in two groups. Conclusions The preinduced AHH by PBS in vivo can boost the metabolic activity of bilirubin in vitro, it may be the optimal biomaterial for EBLSS.

Objective To compare the prevalences of metabolic syndrome(MS)diagnosed with 4 diagnostic criteria by the World Health Organization(WHO,1999),the Inrernational Diabetes Federation(IDF,2005),the Third Report of the National Cholesterol Education Program Expert Panel on Detection,Evaluation and Treatment of High Blood Cholesterol in Adults(NCEP ATPⅢ,2001)and the Chinese Medical Association Diabetes Branch(CDS)respectively. Methods The interrelated parameters were measured in 1399 patients with newly-diagnosed type 2 diabetes mellitus.All the patients were divided into 2 groups:elderly group(259 cases)and non-elderly group(1140 cases),and the different prevalences diagnosed by 4 diagnostic criteria in 2 groups were compared. Results The MS prevalence was 68.0%,47.9%,46.7%and 54.8%in elderly group by WH0,CDS,IDF and NCEP ATPⅢ respectively.The consistent rate was 76.1% between WHO and CDS,and 70.3%between IDF and CDS,and 81.9% between NCEP ATPⅢ and CDS. Conclusions The WHO definition may be more suitable for MS diagnosis in elderly patients with newly-diagnosed type 2diabetes mellitus.

Objective To evaluate the therapeutic effect of thymosin alpha -1 with glucocorticoid in treat-ment of HBV -related hepatic failure.Methods 130 cases were randomly divided into two groups,they were all giv-en antiviral therapy,protect liver,anti -inflammatory,yellow suit the back support,etc.comprehensive treatment;and patients in treatment group were given thymosin alpha -1 with methyl -prednisone intravenously at the early stage of treating process,and then observed the clinic situation and cure rate of those sufferers,The biochemiccal indicator, PTA and blood serum HBV DNA capacity ending with the period of 4 weeks were tested.Results In both groups,the TBil,TC in serum had apparently improved compared with the baseline after the medication,the difference was signifi-cant (t =3.12,P <0.05 and t =3.05,P <0.05).The time of gastrointestinal symptoms improvement and bilirubin subsided time in treatment group were significantly shorter than those of the control group(t =3.34,P <0.01 and t =4.52,P <0.01 ).During the treatment,there was no significant adverse reaction,and there were no differences between two groups in Alt,PTA,HBV DNA,infection,gastrointestinal bleeding,hepatic encephalopathy and hepatore-nal syndrome.The effective rate of treatment group was 75.2%,which was higher than 50.3% of the control group (χ2 =11.02,P <0.01).Conclusion Patients with HBV -related hepatic failure of short -term application of thy-mosin alpha -1 with glucocorticoid treatment,can quickly improve symptoms,greatly improve the efficiency of survival rate,shortem hospitalization period,reduce side effects and enhance security.

Objective To explore different features and influencing factors of 75 g oral glucose tolerance test (OGTT) and glycated hemoglobin Ale (HbAlc) levels in subjects with newly diagnosed diabetes and prediabetes of natural history of type 2 diabetes. Methods All subjects were classified by OGTT into four groups: (1) normal glucose test (NGT), 31 subjects at age of (48. 4±15. 3) yrs (29-75 years old); (2) impaired fasting glucose (IFG), 33 subjects at age of (50. 8±9. 8) yrs (38-72years old) ; (3) impaired glucose tolerance test (IGT), 34 subjects at age of (54. 5±11.4) yrs (33-74years old), (4) T2DM, 117 subjects at age of (54.3 ± 14.1) yrs (29-75 years old). Glucose metabolism was evaluated by results of OGTT and HbAlc levels. The insulin secretion function and insulin resistance (IR) were evaluated by HOMA-β, △I30/△G330, area under curve of insulin (AUCINS)and HOMA-IR respectively. Results (1) Significant changes of HbAlc values among groups were as following order: T2DM(7. 41%)>IGT(5. 85%)>NGT(5.21%) (P<0. 01). HOMA-β value in T2DM, IGT and IFG decreased by 53. 1% (P<0. 01), 29.3% (P<0. 01) and 23.4% (P<0. 05)respectively as compared with NGT group. HOMA-IR value in diabetes group was 1.66-fold of NGT (P<0.01), 1. 29-fold of IFG (P<0.001) and 1.44-fold of IGT (P<0.05). (2) Only 3 h blood glucose concentration (BG) in 75 g OGTT was independently and positively correlated with HbAlc level (r=0. 71, P<0. 01). △I30/△G330 ratio was independently and negatively correlated with both 1 h and 2 h BG of OGTT (P<0.01). AUCins was positively correlated with only 3 h BG of OGTT (P<0.01). HOMA-β was independently and negatively correlated with all OGTT results except 2 h BG(P<0.01). HOMA-IR was an independently and negatively correlative factor of all OGTT results (P<0. 01 or P<0. 05). TG level was independently and positively correlated to only fasting BG (P<0. 05), and waist circumference value had an independent and positive relationship with only 1/2h BG (P<0. 01). Independently correlative factors of OGTT changes included △I30/△G330, AUCINS,HOMA-β, HOMA-IR and circumference values. Only 3 h BG was probably an independent contributor to HbAlc variation. Conclusions There are obvious HbAlc differences among T2DM,IGT and NGT patients. When HbAlc values are over 8%, no significant changes of glucose and insulin levels at 75 g glucose load test are found among subjects.

AIM: To prepare and characterize a mouse anti-human CD40 mutant monoclonal mAb. METHODS: Female BALB/c mice of 6-8 weeks old were immunized with CD40 mutant transfectant (L929-CD40mu) as immunogen. The spleen B cells of the mice were fused with Sp2/0 myeloma cells. The hybridoma cells were screened with CD40 mutant transfectant (L929-CD40mu) by FCM. Faststrip analysis was performed to identify Ig subclass of this mAb. The epitope recognized by this mAb was detected by Bio-5C11 competitive assay. Western blot technique was adopted to identify the mAb. The proliferation of tumor cells in vitro was analyzed by MTT assay and apoptosis of tumor cells in vitro was analyzed by PI-annexin V assay. RESULTS: One hybridoma cell line named 10C5 was obtained, which had the property of secreting anti-human CD40 mutant monoclonal antibody continuously and steadily. This mAb specifically recognized human CD40 mutant molecule and induced the apoptosis of tumor cells in vitro. CONCLUSION: One hybridoma cell line which can secret a mouse anti-human CD40 mutant mAb has been prepared successfully. This mAb can inhibit the growth of tumor cells expressing CD40 mutant and induce their apoptosis in vitro.

Objective To investigate the association between hepatitis B virus (HBV)genotype, the mutations in HBV basic core gene promoter(BCP), pre C/C gene region and treatment response to interferon (IFN)α-1b. Methods Hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) patients were treated with IFNα-Ib for 6 months and were followed up for 6 months after the end of treatment. Restriction Fragment Length Polymorphism (RFLP) was used for determining HBV genotype. HBV DNA was amplified by polymerase chain reaction (PCR) and analyzed for BCP and pre C/C gene region by sequencing. Measurement data were compared using t test and analysis of variance. Enumeration data were compared using chi-square test, Fisher exact probability test.Logistic regression analysis was utilized for multi-factor analysis. Results There were 39 patients who completed the treatment and follow up in this study. At the end of treatment, 16(41.0%) patients showed response to the IFNα-lb treatment. At the end of follow-up, four out of 16 patients who achieved on treatment response relapsed. Among 3a patients, 29 (74.4 %) were infected with genotype B and 10 (25. 6%) with genotype C. The treatment response rates were not significant different between the groups with different genotypes. The double mutation pattern (T1762/A1764) was found in eight (20. 5%) patients. The response rates to IFNα-lb treatment were not significant different between the group with and without double mutation pattern. A1896 mutation was detected in eight patients at baseline. Three of them became HBeAg negative at the end of treatment and returned to HBeAg positive during follow-up. The non-lyphocyte epitope mutations, L60V and I97L, were found in 15 patients (38. 5%) and 14 patients (35.9%), respectively. At the end of follow-up, the patients with 60V had a significantly lower HBeAg seroconversion rate and HBV DNA undetectable rate compared to the patients with 60L (Fisher exact probability test; P = 0.0126 and 0.0069,respectively). The HBV DNA undetectable rates in the patients with 97I were significantly lower than those in patients with 97L both at the end of treatment and the end of follow-up (Fisher exact probability test; P= 0.0484 and 0. 0024, respectively). Logistic regression analysis results showed that there was no association between the above viral mutations and the treatment response to IFNαlb. Conclusions There is no association between HBV genotype, BCP double mutation pattern and IFN-α treatment response. The non-lyphocyte epitope mutations, L60V and I97L, may have impact on IFN-α treatment response.

Objective To observe the incidence and awareness of dyslipidemia in newly diagnosed elderly type 2 diabetic patients,and to determine the efficacy and safety of simvastatin and Xuezhikang in the treatment of dyslipidemia.Methods Totally 255 newly diagnosed type 2 diabetic patients aged 60 to 75 years in CDCPS research were included and the incidence of dyslipidemia were retrospectively analyzed.Patients were divided into 3 groups:the group 1 was given simvastatin (20 mg/d); the group 2 was given Xuezhikang (0.6～ 1.2 g/d); the group 3 was given no lipid-lowering drugs.All the three groups were given lifestyle intervention and blood pressure and blood sugar control.All patients were followed up monthly and TG,TC,LDL-C,BUN,ALT and creatinine were examined at 7th,14th,and 20th months.Results The incidence of dyslipidemia and the rate of awareness in the study cohort was 62％ and 55.7％.Hypertriglyceridemia was the most common type of dyslipidemia (29％).Among 88 patients with dyslipidemia,25 (28.4％) patients had been treated with lipid-lowering drugs before our study,in whom,8(32％) patients had normal serum lipid levels and only 3 (12％)patients reached to the control standards.20 months after the treatment,the decrement scales of TG,TC and LDL-C were 1.8％,10.5 ％ and 20 ％ respectively in group 1;5.5 ％,15.0％ and 15.7％ respectively in group 2;2.7％,8.7％ and 4.5％ respectively in group 3.The long-term lifestyle intervention and blood pressure and blood sugar control reduced serum lipid to some degree.In the patients with dyslipidemia,lipid-lowering drugs had a better effect on serum lipid reduction than did the lifestyle intervention (P=0.0047,0.0433).There was no significant difference between simvastatin and Xuezhikang.The function changes of liver and kidney had no difference before and after drug intervention (P＞0.05).Conclusions Serum lipid should be monitored and early medicine intervention should be taken in newly diagnosed elderly type 2 diabetic patients.Medicine intervention has a better effect on serum lipid reduction than lifestyle intervention,and there are no significant differences in efficacy and safety between simvastatin and Xuezhikang.

Objective:To analyze the feasibility and efficacy of ultrasound-guided percutaneous biopsy and radiofrequency ablation of gallbladder polyps.Methods:From April 2019 to January 2021, 25 patients with gallbladder polyps underwent ultrasound-guided biopsy and radiofrequency ablation in the ultrasound department of the First Affiliated Hospital of Zhengzhou University were collected, the maximum diameter of the lesion was 11.00(10.00, 12.50)mm. Under general anesthesia, ultrasound-guided injection of water into the gallbladder serosa layer was performed to make the gallbladder edema thicker than or equal to 10 mm. Percutaneous biopsy and radiofrequency ablation of gallbladder polyps were performed to ablate the gallbladder mucosa layer of polyps and polyp attachment.Intraoperative contrast-enhanced ultrasound was used to evaluate the need for supplementary ablation.The operation time, intraoperative and postoperative conditions were recorded. The complete ablation rate of gallbladder polyps, the reduction rate of lesion volume after ablation, the incidence of complications and the effect of operation on gallbladder wall thickness and gallbladder contraction rate were evaluated.Results:Biopsy and radiofrequency ablation of gallbladder polyps were successfully performed in 25 patients.There were 14 cases of cholesterol polyp, 5 cases of adenoma, 5 cases of inflammatory polyp and 1 case of gallbladder adenomyosis. Twenty-nine gallbladder polyps showed changes after ablation, and the lesion volume was reduced to varying degrees. In the first, third and sixth months, the volume reduction rates of ablation focus were 70.74%(58.55%, 77.56%), 89.47%(85.04%, 96.87%) and 100%(95.68%, 100%) respectively, and the differences were statistically significant ( P<0.05). There were no significant differences in gallbladder wall thickness and gallbladder contraction rate before and 1 month after operation ( P>0.05). The operation time was 14-39(23.32±6.68)min. During the operation, 3 patients(12.0%) had a decrease in heart rate, 2 patients(8.0%) had mild abdominal pain and 1 patient(4.0%) had obvious abdominal pain, which was relieved after treatment. No bleeding, gallbladder perforation, abdominal infection and other complications occurred. All patients were followed up for 1 to 22 months, with a median of 6 (3, 7) months. No patients were lost or follow-up, polyp recurrence, or new polyps, or secondary gallstone. Conclusions:Ultrasound-guided biopsy and radiofrequency ablation of gallbladder polyps is a feasible choice for gallbladder preserving treatment of gallbladder polyps with low complication rate.

Objective To analyze the initial treatment strategies, blood glucose control and reaching standard status of newly diagnosed type 2 diabetes mellitus (T2DM) in the middle-aged and elderly. Methods The 771 patients diagnosed with T2DM newly or within one year, aged 50-70 years, selected from Chinese Diabetes Complication Prevention Study (CDCPS) were enrolled in this study. The correlations of initial treatment strategies with blood glucose control (target value of glycated hemoglobin was less than 7.0%) and reaching standard status were analyzed retrospectively. Based on the same lifestyle intervention, the therapy was further divided into group A (without medication), group B (single oral hypoglycemic agent), group C (combined oral hypoglycemic agents), group D (treatment including insulin). Results Although receiving the different treatments, the 771 patients had a similar mean glycated hemoglobin level, from 7.2% to 7.7%, among the four kinds of intervention before entering the study. The increased intensity and complexity after therapy adjustment along with the increased glycated hemoglobin level was observed at baseline. The corresponding relationships between medication and HbA1c were as follow: without medication-6.1%, single oral hypoglycemic agent-7.2%, combined oral hypoglycemic agents-7.7%, treatment including insulin-9.2%. After 20 months of follow-up, the mean fasting glucose and glycated hemoglobin were 6.6 mmol/L and 6.2%, separately. According to the target glycated hemoglobin level of less than 7.0%, all four-kinds of therapies had high achievement rates, which were all above 80% except that was 63.2% in group D. Sulphonylurea and biguanide as initial single oral hypoglycemic agent therapy had the similar effectiveness on glucose control and target glycated hemoglobin achievement. Conclusions According to the levels of glucose and glycated hemoglobin, multiple individual therapies should be enacted at the beginning of treatment. The strategy mainly based on sulphanylurea and biguanide is proved to be persistently effective in newly-diagnosed middle-aged and elderly diabetic patients in China.