Objective To study the change of the eonnxin43 expression in the heart of diabetic mellitus rats. Methods STZ-in-dueed diabetic mellitus in rats were developed. The expression of connexin43 in the heart was detected by immunohistochemistry and image analysis, and the heart function was observed by electrophysiolograph and echocardiogram. Results During the course of diabetic mellitus, the expression of connexin43 in the heart of diabetic rats decreased respectively in the 12th week and 24th week (P<0.01). The values of dp/dtmax and + dp/dtmax in group DM in the 12th week and 24th week were lower than that in normal control group respectively (P<0.01), and the LVEF were also decreased (12w P<0.05,24w P<0.01). The analysis of correlation showed that the expression of con-nexin43 in heart were positively correlated with heart function (P<0.05) . Conclusion The expression of Connexin43 evidently de-creased in the hearts of diabetic rats and it is positively correlated with the heart function.

Objective To compare the effects of two different approaches of insulin delivery on hyperglycemia.Methods 26 poorly controlled diabetic patients were studied by two methods of intensive insulin delivery.⑴Continuous subcutaneous insulin infusion(CSⅡ) group(n=6),including 4 cases of type 1 DM,2cases of type 2 DM;⑵Multiple subcutaneous insulin injection(MSⅡ) group(n=20),including 3 cases of type 2 DM,17 cases of type 2 DM.The target BGs for both groups were premeal and bedtime BG3≥3 6mmol/L ≤7 2mmol/L for at least 3 days.Results Both groups had reached the target BGs,the CSⅡ groups more close to normal level.The average durations of treatment were significantly different;CSⅡ(8 3?1 3)d,MSⅡ(13 6?2 4)d for the two groups (t=5 136,P0 05).The hypoglycemia incidence in CSⅡ was(0 67?1 3)time/case,in MSⅡ(2 15?1 4)time/case(t=2 305,P

BACKGROUND:The main clinical manifestation of senile arteriosclerosis obliterans is lower limb ischemia, which is currently difficult to treat. One method is by autologous stem cell transplantation into the muscles of ischemic limbs to improve the formation of new capillaries and restore lower limb blood flow. Endothelial progenitor cell marker CD34+ cell transplantation has been shown to promote angiogenesis in ischemic limbs. Therefore, we propose that peripheral blood autologous CD34+ cell transplantation in older adult patients with atherosclerotic ischemia could effectively promote angiogenesis.OBJECTIVE:To assume that peripheral blood autologous CD34+ cell transplantation in the elderly with atherosclerotic ischemia could effectively promote angiogenesis.METHODS:This is a prospective, single-center, open-label, randomized, and controlled clinical trial that will be completed at the Qingdao No. 9 People's Hospital, China. Twenty older adult patients with atherosclerotic lower limb ischemia will be randomized into two groups. In the cell transplantation group (n=10), peripheral blood CD34+ cells transfected with vascular endothelial growth factor 165 (VEGF165) gene will be intramuscularly transplanted into the ischemic limbs in older adult patients with atherosclerotic lower limb ischemia. In the control group (n=10), normal saline will be intramuscularly injected into the ischemic limbs. All patients will be followed up for 6 months. The primary outcome will be ankle-brachial indices before and 6 months after transplantation to assess lower limb ischemia in both groups.The secondary outcomes will be the number of microvessels in the lower limb muscles before and 6 months after transplantation, the morphology of new blood vessels revealed by CT angiography, the number of VEGF-immunoreactive cells 6 months after transplantation and the incidence of adverse reactions. The trial was registered at the ClinicalTrials.gov (identifier:NCT03098771), and the study protocol was approved by the Ethics Committee of Qingdao No. 9 People's Hospital of China. All protocols will be in accordance with Declaration of Helsinki,formulated by the World Medical Association. All patients will be informed of study protocols and provide a written informed consent prior to the beginning of the trial.DISCUSSION:This trial will begin in January 2018 and finish in December 2019. We aim to quantify the effects of VEGF165 gene-modified CD34+ cell transplantation in the treatment of older adult patients with atherosclerotic ischemia to develop a new effective treatment of lower limb ischemia.

Objective:To explore the anger emotional state,traits and expression characteristics in patients with schizophrenia with violent behavior in community.Methods:Twenty-five patients with schizopnrenia with a history of violent behavior among the community rehabilitation institutions were selected as the violent behavior group,and 74 patients with schizopnrenia without a history of violent behavior were selected as the nonviolent behavior group.The Brief Psychiatric Rating Scale(BPRS)was used to assess psychiatric symptoms,and the State-Trait An-ger Expression Inventory(STAXI)was used to assess anger characteristics.Results:Compared with the nonviolent behavior group,the violent behavior group had significantly higher scores in the trait of anger(patient dimension score,rational dimension score)and expression of anger(total score,restraint dimension score)[(28.0±23.8)vs.(19.6±13.3),(55.0±30.6)vs.(40.0±21.5),(34.2±11.6)vs.(27.3±10.7),(56.0±26.1)vs.(33.7±21.1),Ps＜0.05].Higher scores of rationality dimension of anger trait(OR=3.69,95％CI:1.43-7.98)and re-straint dimension of anger expression(OR=3.25,95％CI:1.39-7.47)were risk factors for violent behaviors.Conclusion:Compared with patients with schizopnrenia without violent behavior,patients with violent behavior history may show more lack of rationality,and poorer anger restraint.

Objective To investigate correlation between serum bilirubin levels of different subtypes and diabetic nephropathy(DN)in patients with type 2 diabetes mellitus(T2DM).Methods Clinical data of 494 patients with T2DM admitted to Suizhou Central Hospital Affiliated to Hubei Medical University from January 2019 to May 2023 were retrospectively analyzed,and they were divided into DN group(175 cases)and non-DN group(319 cases)according to whether they had DN.Correlation between levels of total bilirubin(TBil),direct bilirubin(DBil),indirect bilirubin(IBil)in serum and the occurrence of DN were analyzed.Results There were statistically significant differences on age,course of diabetes,hypertension,coronary heart disease,smoking,drinking,TBil,DBil,IBil,alanine aminotransferase(ALT),blood urea nitrogen(BUN),serum creatinine(SCr),uric acid(UA),total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL),high density lipoprotein(HDL),glycosylated hemoglobin(HbA1c),body mass index(BMI),systolic blood pressure,fasting plasma glucose(FPG)and estimated glomerular filtration rate between two groups.Age,course of diabetes,hypertension,coronary heart disease,TBil,DBil,IBil,ALT,BUN,SCr,UA,TC,TG,HDL,LDL,HbA1c,BMI and FPG were influencing factors of DN in female T2DM patients(P<0.05).Age,course of diabetes,hypertension,coronary heart disease,smoking,alcohol consumption,TBil,DBil,IBil,ALT,BUN,SCr,UA,TC,TG,HDL,LDL,HbA1c,BMI and FPG were influencing factors of DN in male T2DM patients(P<0.05).TBil,DBil and IBil were significantly correlated with development of DN in patients with T2DM(P<0.001).Risk of developing DN gradually decreased with increasied TBil(1-15 μmol/L),IBil(1-10 μmol/L)and DBil(1-4 μmol/L),but after TBil>15 μmol/L,IBil>10 μmol/L and DBil>4 μmol/L,increased in TBil,DBil and IBil levels no longer reduced risk of developing DN.Conclusion There is a non-linear correlation between levels of TBil,DBil,IBil and risk of DN in patients with T2DM.Within a certain range,TBil,DBil and IBil are independent protective factors for occurrence of DN,and reaching a certain level will no longer reduce risk of DN.There is no significant difference between serum bilirubin and risk of DN in different genders.