Objective To observe the effectiveness and safety of basal insulin plus oral antidiabetic drugs (OADs) in treating the patients with type 2 diabetic mellitus (T2DM ) ,who were poor blood sugar control by premixed insulin with or without OADs . Methods 32 cases of T2DM and poor blood sugar control by premixed insulin combinated with or without OADs stopped the premixed insulin therapy and changed to insulin glargine plus OADs for 16 weeks .Glycosylated haemoglobin (HbA1c) ,fasting blood glucose(FBG) ,postprandial blood glucose(PBG) ,body mass index (BMI) and mean daily insulin dose were compared among patients .And the episodes of hypoglycemia events were recorded .Results After 16‐week treatment ,HbA1c ,FBG ,PBG and BMI were all significantly decreased comapared with before treatment (P<0 .01) .The mean insulin glargine daily dose was significantly decreased compared with the premixed insulin dose at admission .2 cases (6% )appeared twice hypoglycemia episodes during the treatment period ,all were general hypoglycemia .Conclusion Basal insulin once daily can effectively improve the sugar metabolism in T2DM patients failed by premixed insulin with or without OADs ,moreover the body mass is not increased .

OBJECTIVETo analyze the changes of patients with type 2 diabetes in different stages in glucagon (GC) and free fatty acid (FFA) in fasting, OGT and L-Arg experiments, and discusses the role of pancreatic alphabeta cells in diabetes pathogenesis by studying the relations among indexes such as glucagon (GC), free fatty acid (FFA) and blood glucose (BG), insulin, insulin homeostasis model (HOMA) and glucose metabolism hormone secretion curve, in order to provide theoretical basis for the treatment of diabetes.

METHODStudy objects were divided into the T2DM group (45 cases), the IGT group (28 cases) and the NGT group (30 cases) for an OGTT experiment and then an L-Arg experiment on the next day. Under the fasting state, their blood glucose (FBG), insulin (F), glucagon (FGC), free fatty acid (FFA) were detected to calculate HOMA-beta, insulin sensitivity index (ISI) and HOMA-IR of different groups. Meanwhile, efforts were made to calculate different time quantum detected in OGTT and L-Arg experiments and area under the curve AUC(BG), AUC(INS) and AUC(GC).

RESULTObvious overall differences were observed in FFA and FGC of the three groups. FGC of each group was negatively correlated with HOMA-beta and ISI. Among all of the 103 study objects, FGC was positively correlated with FBG and HOMA-IR and negatively correlated with HOMA-beta and ISI, with no correlation with FINS; FFA was positively correlated with FBG, HOMA-IR and negatively correlated with FINS, HOMA-beta, ISI. FGC and FFA were positively correlated in the T2DM group and the IGT group, but with no statistical correlation in the NGT group. The sequence of the three study objects was T2DM > IGR > NGT in AUC(GC) in the OGTT experiment and T2DM > IGR > NGT in in AUC(GC) in the L-Arg experiment, with the significant positive correlation between AUC(GC) and AUC(BG) and significant negative correlation with AUC(INS).

CONCLUSIONGlucagon and free fatty acid of T2DM and IGT patients increased, which was positively correlated with blood glucose and HOMA-IR and negatively correlated with INS, HOMA-beta and ISI. The increase in glucagons of T2DM and IGT patients indicated inappropriate secretion of pancreatic alphabeta cells among patients with type 2 diabetes.

Adult ; Blood Glucose ; metabolism ; Diabetes Mellitus, Type 2 ; metabolism ; Fatty Acids, Nonesterified ; metabolism ; Female ; Glucagon ; blood ; Humans ; Insulin ; secretion ; Islets of Langerhans ; secretion ; Male ; Middle Aged

Objective To assess the renal protective effects of triptolide treatment in type 2 diabetic rats and its possible mechanisms.Methods Wistar rats were randomized to receive following approach control (n=7),dia- betic model without treatment (n=7) and diabetic group treated with triptolide[200 ?g/(kg?d),n=7].Plasma glucose (PG),serum creatinine (Scr),total cholesterin (TC),triglyeride (TG),kidney mass (KM),index number of kidney hypertrophy (KM/body mass,KM/BM),and 24 hours urinary albumin (24 h UAL) were determined. The protein expression of monocyte chemoattractant protein-1 (MCP-1),osteopontin (OPN) and ED-1 in renal tissue were determined by immunohistochemical technique.The mRNA expressions of MCP-1 and OPN in kidney tissue were assessed by reverse transcription-polymerase chain reaction (RT-PCR).Results Elevated 24 h UAL was markedly attenuated by triptolide treatment [24 h UAL,triptolide:2.32?0.29 vs diabetic model group:3.89? 0.51 mg/mgCr,P

Objective To study the life quality of 2 - 3 years old survivors in Neonatal Intensive Care Unit (NICU). Methods Severe neonates were randomly assigned to intervention group (group 1,30 cases) and non- intervention group (group 2,30 cases) depending on the early intervention applied or not,as well as 30 healthy newborns as normal controls. The physical,neurological conditions and intelligence test were taken regularly. To investigate the psychological state, actions, temperament and family conditions when they were2-3 years old.Results Mental development index(MDI) and physical development index(PDI) in early interventional group were significant higher than those in group 2(P

Objective To investigate the potential clinical factors associated with the prognosis and relapse of adult onset Still's disease(AOSD).Methods The factors possibly influencing the prognosis and relapse of AOSD were analyzed by logistic regression and COX regression in the cohort study.Ninety-six con- secutive inpatients of AOSD diagnosed based on Yamaguchi criteria in the hospital from March 1996 to September 2004 were included in the study.Results Nine cases(9.4%)were lost during the follow-up. Eleven patients(12.6%)were diagnosed as other diseases(5 with other rheumatic diseases,4 with tumor and 2 with infections)in the 87 follow-up cases.In 76 cases,3 patients(3.9%)died and 33 patients(43.4%) got remission over one year after treatment.Splenomegaly(OR=3.14,95%CI=1.01～9.74)and treated with methotrexate(OR=0.22,95%CI=0.07～0.67)were associated with the prognosis from the logistic regression analysis of the 76 cases.The serum ferritin(RR=I.05,95%CI=1.01～1.08)and treated with methotrexate (RR=0.13,95%CI=0.02～0.76)were associated with relapse from the COX regression analysis of the 61 remis- sion cases.Conclusion We need to be very cautious in the follow-up of AOSD patients because some of them may change to other diseases.Methotrexate may be an importent therapy of AOSD not only in improve- ment the prognosis but also in reduction of relapse.

Objective To explore the clinical features of mitochondrial encephalomyopathy lactic acidosis and strokelike episodes (MELAS) syndrome in fratemal twins brothers.Methods The clinical data,the results of laboratory examinations,electroencephalogram (EEG),imaging,and gene detection,and the process of diagnosis and treatment were retrospectively analyzed the fraternal twin brothers with MELAS syndrome.Results The proband,a 7-year-old male,had intermittent headaches,vomit and twitching at onset.He suffered from exercise intolerance,fatigue,accompanied by short stature and hairy.The fasting blood lactic acid level was increased.Multiple video EEG showed the slowdown of background activity.Head MRI showed recurrent lesions with the characteristics of migration and variation.The point mutation rate of mtDNA A3243G was 34.7％.The diagnosis of MELAS was confirmed.At the same time,his fraternal twin brother was screened and found that his point mutation rate of A3243G was 30.0％.Although there was no clinical symptom at that time,he was onset with convulsion after 3 years.Conclusions Gene detection and family screening are helpful for the early diagnosis of MELAS.The mutation rate of A3243G is very high,which can cause an early onset and serious clinical symptoms.

Objective To investigate the expression and clinical significance of FoxA 2(hepatocyte nuclear factor 3β)in human non-small cell lung cancer(NSCLC)tissues and adjacent normal lung tissue.Methods The expressions of FoxA 2 protein in 80 cases with NSCLC tissues and adjacent normal lung tissue were tested by immunohistochemistry,the expressions of mRNA was detected by RT-PCR.Results The expressions of FoxA 2 both on protein and mRNA in NSCLC lung tissue were significantly less than those of adjacent normal lung tissue(protein expression comparison t value was 187.51,186.43,178.24 respectively;mRNA expression comparison t value was 236.70,260.13,126.27,respectively,P ＜ 0.05).However there was no difference on histopathological variability.F value equal to 1.86 and 1.69,P ＞ 0.05).In low differentiated group,the group of Ⅲ stage,with lymph node metastasis,the expression of FoxA 2 protein and mRNA was less than that in the group of high differentiated,the group of Ⅰ-Ⅱ stage,the group of non lymph node metastasis(pretein expression t values were 4.31,3.92,341,mRNA expression t values were 5.44,3.28,5.07,P＜0.05).Conclusion FoxA 2 might inhibit progression of human NSCLC.It may participate in the process of tumor tissue differentiation and lymph node metastasis in NSCLC.

OBJECTIVE: To investigate the correlation between CYP2C8 gene polymorphisms and the adverse reactions of paclitaxelin in cancer patients.METHODS: Fifty-two patients who received paclitaxel chemotherapy from January 2016 to May 2018 were selected as experimental subjects. The CYP2C8 genotypes of the selected patients were tested and the adverse reactions of paclitaxel were observed, collected and recorded to explore the relationship between adverse reactions and genetic polymorphism.RESULTS: In this study, 25 gene loci were detected, only 7 gene loci had mutation, and the remaining 18 gene loci were all wild-type.In the polymorphism of CYP2C8 gene,the incidence of thrombocytopenia and pain in patients with CYP2C8*1B(-271C>A) wild-type (CC) was significantly higher than that in mutant (CA+AA) (P<0.05). And the incidence of hepatotoxicity in patients with CYP2C8*2/*3(32299C>T) wild-type gene (CC) was significantly lower than that in mutant gene (CT+TT) (P<0.05).CONCLUSION: The polymorphism of CYP2C8 gene may be associated with the adverse reaction of paclitaxel.

A anaerobic hydrogen-producing strain HR-1 was isolated from compost. Phylogenetic analysis based on 16S rRNA sequence similarity indicates that strain HR-1 is the closest relative to Clostridium ace- tobutylicum ATCC 824, with the similarity of 96%. Biological characteristics and phylogenetic analysis of 16S rRNA gene indicate that HR-1 is a new species named Clostridium sp. HR-1. Cells are Gram-positive, mobile rod-shaped. Spores and flagellums were no observed. Temperature range for growth is 10?C to 45?C (optimum temperature 37?C~39?C), and range pH for growth is 4.0 to 10.0 (optimum pH 7.5~8.0). H2, CO2, acetate, butyrate and a little ethanol are the end products of PYG fermentation. Strain HR-1 has the ability to use organic nitrogen and inorganic nitrogen sources for growth and hydrogen production, and yeast extract is the optimum nitrogen source for hydrogen production. Strain HR-1 produces hydrogen from xylose (3 g/L) at 37?C and initial pH 6.5, the hydrogen yields and maximal hydrogen production rate are 1.84 mol-H2/mol-xylose and 10.52 mmol-H2/h?g-cdw, respectively. Strain HR-1 is able to utilize glucose, galactose, fructose, mannose and cellobiose for hydrogen production and the hydrogen yields from glucose is 2.36 mol-H2/mol-glucose.

The expression of musclin gene in skeletal muscle of rats fed with high-fat diet and its correlation to insulin resistance.diabetes mellitus and GLUT4 were explored.The results showed that musclin expressin was up-regulated(1.39±0.36 vs 0.31±0.07,P<0.01)in skeletal muscle of rats fed with high-fat diet, suggesting that this finding may be related with insulin resistance and involvement of GLUT-4 expression(1.27 4± 0.32 vs 1.84±0.24.P<0.01).