Objective To investigate the changesof glomerular filtration rate(eGFR)in type 2 diabetic patients with normal serum creatinine(Scr)and serum cystatin C(Cys-C). Methods A total of 166 patients with type 2 diabetes mellitus admitted into our hospital from January 2014 to September 2015 were enrolled in this study and divided into three groups according to the level of Scr and Cys-C:T2DM patients with normal Scr and Cys-C (normal group,n =109),T2DM patients with normal Scr and high level of Cys-C (high Cys-C group,n=40),and T2DM patients with high levels of Scr and Cys-C (high Scr Cys-C group,n=17). Normal group were further divided into two subgroups according to the level of eGFR:eGFR≥90 ml/(min·1.73 m2 )subgroup and eGFR<90 ml/(min·1.73 m2 )subgroup.Clinical characteristics and laboratory datawere collected in all subjects. eGFR were measured by 99mTc-DTPA nephro-dynamic imaging. Results The average value of eGFR were significantly different in normal group(82.68±13.45)ml/(min·1.73 m2 ),high Cys-C group(67.93 ±14.01)ml/(min·1.73 m2 )and high Scr,Cys-C group (50.54±15.10)ml/(min·1.73 m2 ). In normal group,the proportion of patients with eGFR equal or greater than 90 ml/(min·1.73 m2 )was 26.6%,patients with eGFR ranged from 60 to 89 ml/(min·1.73 m2 )was 72.5%,patients with eGFR ranged from 30 to 59 ml/(min·1.73 m2 )was 0.9%. After follow-up for three months,in normal group,the proportion of patients with CKD stage1 was 4.6%,patients with CKD stage 2 was 34.9%,and patients with CKD stage 3 was 0.9%.Multivariate logistic regressionanalysis in normal group showed that female,older age,higher TC,lower LVEF were risk factors for eGFR decline (P <0.05). Conclusion In T2DM patients with normal Scr and Cys-C, 73.4% of them had mild to moderate eGFR decline,and 40.4%entered CKD stage in this study.eGFR should be evaluated especially in T2DM patients with risk factors including female,older age,higher TC and lower LVEF.

AIM:To investigate whether trichostatin A ( TSA) , a new revulsant ,can induce mouse mesenchy-mal stem cells to differentiate into insulin-secreting cells and to explore the appropriate concentration of TSA .METHODS:The mesenchymal stem cell line from C57BL/6 mice was cultured in vitro and divided into 5 groups before treated with dif-ferent concentrations of TSA , ( group A:DMSO;group B~E:treated with 25 nmol/L, 50 nmol/L, 100 nmol/L and 200 nmol/L of TSA, respectively).After exposed to different cultured media for 10 d during the 2 stages, the cells were detec-ted by the following methods:the insulin-secreting cells in each group were identified by dithizone staining and the results were calculated with immunohistochemical half quantitative analysis .The insulin secreted by insulin-secreting cells in each group was identified by immunofluorescence , and the mean fluorescence intensity of insulin was compared .The content of insulin in each group was quantified by ELISA .The appropriate concentration of TSA was determined according to the above results .RESULTS:TSA treatment for 10 d promoted the mouse bone marrow mesenchymal stem cells to differenti-ate into insulin-secreting cells which produced insulin .The immunohistochemistry and immunofluorescence imaging analysis of insulin-secreting cells showed that the insulin staining positive area , positive ratio , total density of insulin expression and mean fluorescence intensity of insulin in group B were significantly higher than those in the other TSA -treated groups .When the concentrations of TSA gradually increased , the content of insulin reduced accordingly .The content of insulin in group B was significantly higher than that in the other TSA-treated groups .CONCLUSION:TSA treatment for 10 d promotes bone marrow mesenchymal stem cells from C57BL/6 mice to differentiate into insulin-secreting cells and the appropriate concen-tration of TSA is 25 nmol/L.

The definition of impaired glucose tolerance (IGT) was first introduced by the National Diabetes Data Group at 1979. Recently the morbidity rate of IGT is soaring. About 10%-15% of patients with IGT will progress to type 2 diabetes mellitus (T2DM) which is approximately more than 100 times comparing with normal glucose tolerance people. Angiopathy can be detected in 40% patients with newly diagnosed IGT. Advanced glycation end products (AGEs) are closely related to angiopathy. Meanwhile there is some connection between IGT and AGEs. In this review, the relationship between IGT, agiopathy and AGEs is discussed.

Objective To explore the relationship between the three kinds of urinary proteins and serum magnesium(Mg 2+ ) in diabetic patients. Methods The levels of three kinds of urinary proteins and serum Mg 2+ concentration were measured using Arsenzo-III method and RIA respectively in 246 patients with type 2 diabetes. Results Serum Mg 2+ concentration was associated with the levels of urinary ? 2-microglobulin(? 2-MG), immunoglobulin(IgG) and albumin(Alb), as well as the patients age(P

AIM: To observe the protective effects of losartan and astragalus membranace on the kidney of diabetic rats, and to study their possible mechanisms. METHODS: The diabetic rats were induced by a single intraperitoneal injection of streptozotocin. At the end of 12th week,changes in urinary albumin excretion, urinary ? 2-MG excretion, Ccr,NO,ET-1 levels in blood, urinary and renal tissue were observed. Serum and urinary TGF-? 1 concentration,average volume of glomeruler,average thickness of glomerular basement membrane were also measured. RESULTS: In the treated diabetic rats, urinary albumin excretion, urinary ? 2-MG excretion, Ccr, urinary and renal tissue NO, urinary TGF-? 1, average volume of glomeruler, average thickness of glomerular basement membrane decreased obviously as compared with diabetic untreated rats. These effects were enhanced when losartan was combined with astragalus membranace. CONCLUSION: Losartan or astragalus membranace reversed the injury of renal structure and function in STZ-induced diabetic rats. The protective effects were enhanced when losartan was combined with astragalus membranace. The decrease in NO,ET,TGF-? 1 concentration in renal tissue may be one of mechanisms for this action.

Hematopoietic Stem Cell Transplantation ; Humans ; Societies, Medical ; United States

Diabetic nephropapthy (DN) is a common cause of end-stage renal disease.Early diagnosis and treatment are significant for delaying the development of DN.Smad proteins mediate transforming growth factor β superfamily intracellular signal transduction.Recent studies have found that Smad1 protein plays an important role in the process of renal fibrosis.Urine Smad1 emerges in the early stage of DN,which is expected to be a non-invasive indicator in early diagnosis of DN.

Objective To study the relationship between the diabetic autonomic neuropathy (DAN) and the cerebrovascular disease. Methods The heart rate variability (HRV) was measured in 77cases of type 2 diabetes 〔49 men, 28 women, age (63.1?11.4)years〕. Forty-one cases suffered from DAN (group A), 36 cases without DAN (group B) according to the results of HRV. All the cases received the examination with transcranial Doppler ultrasonography (TCD). Results Compared with group B, the abnormality detected with TCD was higher in group A, cerebrovascular compliance was commonly decreased and cerebrovascular stenosis was also extensively observed. Conclusion DAN seems to be one of the risk fcators in inducing cerebrovascular disease.

Objndve To evaluate the protective effects of specific antagonists of angiotensin II receptor losartan on the kidneys of diabetic rats and study their mechanisms. Methods Changes of urinary albumin, ?2-m excretion, creatinine clearance(Ccr), NO, ET level of plasma, urine and renal tissue, serum and urinary TGF-?1 concentration and mean glomerular volume were measured. Results Losartan could correct elevated urinary albumin, ?2-m excretion, Ccr and mean glomerular volume. Urinary and renal tissue NO, ET concentration decreased after diabetic rats received losartan. Large doses of losartan also reduced urinary TGF-?1 level. Conclusion Losartan can protect the kidney of diabetic rats and the decrease of NO, ET, TGF-?1 concentration in renal tissue may be a mechanism for this action.

The study of isolated coronay heart disease (iCHD) (n=17) and CHD+T2DM (n=17) showed that the serum level of vascular cell adhesion molecule-1 (VCAM-1) and CHD scores increased in CHD+T2DM group than in iCHD grup, and was positively correlated with CHD scores in CHD population (all P<0.01).