Objective To investigate the effect of pancreatic ? cell dysfunction on abnormal glucose tolerance during Graves hyperthyroidism. Methods We investigated 6 healthy people and 36 Graves disease patients with abnormal glucose tolerance, and determined blood sugar and insulin at 0, 60 and 120 minutes after breakfast respectively. Then the HOMA-IR, HOMA-? and ISI were compared between the two groups. Results The HOMA-IR in the Graves disease patients with abnormal glucose tolerance is evidently higher than in the healthy subjects (P

Internal medicine(IntMed) is one of the major subjects in medical undergraduate courses.With the transformation of medical mode from experience medicine to EBM,EBM shall be melted into IntMed teaching to change traditionary teaching mode and improve the teaching quality of IntMed,which helps to culture more new medical talented persons.

Objective To investigate the correlation between levels serum zinc,selenium,chromium,copper and blood glucose in diabetic patients.Methods The 136 cases of type 2 diabetes were enrolled in our hospital during September 2013 to December 2015 in the observation group,and 136 cases of physical health in our hospital during the same period were recruited in the control group.Then the levels of serum zinc,selenium,chromium,copper contents and glycemic index,oxidative stress indicators were detected.Results The serum zinc,selenium content of the observation group were significantly lower than those in the control group(P<0.05),no significant difference were observed in the serum chromium,copper contents between two groups(P>0.05);the levels of FBG,2 h PBG,glycated hemoglobin,MDA,and HOMA-IR of observation group were higher than those of control group,the HOMA-β,I30/G30,SOD,GSH-Px levels were lower than those in the control group(P<0.05);the serum zinc,selenium contents were negatively correlated with FBG,2 h PBG,glycated hemoglobin,MDA levels,and HOMA-IR(P<0.05),while positively correlated with HOMA-β,I30/G30,SOD,GSH-Px(P<0.05).Conclusion Serum zinc,selenium contents in type 2 diabetes significantly decrease and closely be related with blood glucose levels,they can reduce blood sugar,promote insulin secretion,increase insulin sensitivity,and adjust the oxidative stress reaction.

Objective To elucidate the function and regulatory mechanism of LyGDI involved delayed cell death in the human K562 cells and HL-60 cells induced by 60Co γ-rays. Methods Erythrosine B cells staining was used to count the apoptosis rate. PI staining and flow cytometry were applied to check the cell cycle. The expression of LYGDI and Rac1 was resolved by Western blot by using monoclonal antibody of LyGDI and Racl. The distribution of Racl protein in cells was observed with immunofluorescence by using the confocal microscope. Results The K562 cells showed G2/M phase arrest and the percent age was 71.3%. The apoptosis rate was very low at early post-irradiation stage in the K562 cells. The apoptosis rate was 14% in the K562 cells at 24 h post-irradiation with 8 Gy of γ-rays, and delayed cell apoptosis was present. LyGDI was cleaved in the K562 cells irradiated by 4 Gy 60 Co γ-rays after 24 hours post-irradiation. The expression of Racl protein was not altered at all, but the distribution was changed in the irradiated cells while the Racl protein moved to cell membrane and a little in cell nucleus. The Racl was activated with the losing the binding affinity with the LyGDI. Conclusion LyGDI could promote the delayed cell apoptosis, which is through the activation of the Rac1.

Objective To understand the effect of astragalus on serum levels of advanced glycation end products (AGEs),soluble receptor for advanced glycation end products (sRAGE) in newly diagnosed patients with type 2 diabetes.Methods 60 patients of newly diagnosed type 2 diabetes were randomly divided into control group (28 patients) and treatment group (28 patients),the control group was given control of blood glucose,blood pressure,lipids and other necessary treatment,and the treatment group was additionally treated with astmgalus granule based on the control group.The course for both treatments is 12 weeks.Various clinical and biochemical parameters were tested before and after treatment in both groups with enzyme-linked immunosorbent assay for the detection of serum AGEs,sRAGE levels.Results ① Glycosylated hemoglobin (HbA1c) in the control group after treatment (7.28± 0.83)％ was significantly decreased than before treatment (9.57±1.14) ％,the difference was statistically significant (t＝5.75,P＜0.05); glycerin three greases (TG) in the control group after the treatment (1.45± 0.39)mmol/L decreased significantly compared with those before treatment (1.92± 1.01)mmol/L,the difference was statistically significant(t＝2.79,P＜0.05); ② HbA1c (7.16± 0.88) ％ in the treatment group after treatment was significantly decreased than before treatment (9.29± 1.62)％,the difference was statistically significant (t＝6.08,P＜0.05) ; TG (1.53 ± 0.41) mmol/L in the treatment group after treatment was significantly decreased compared with those before treatment (2.11 ± 0.79)mmol/L,the difference was statistically significant (t ＝ 2.40,P ＜ 0.05) ; the levels of serum sRAGE (20.38 ± 8.01) ng/ml in the treatment group after treatment increased obviously compared with those before treatment (15.10 ± 9.22)ng/ml,the difference was statistically significant (t＝-2.29,P＜0.05); ③ The level of serum sRAGE (20.38 ± 8.01) ng/ml in the treatment group after treatment increased obviously than the levels of serum sRAGE (15.13 ± 9.27)ng/ml in the control group after treatment,the difference was statistically significant (t＝-1.17,P＜0.05).Conclusion Astragali can increase serum sRAGE expression in newly diagnosed type 2 diabetic patients.

Objective To understand the serum levels of advanced glycation end products (AGEs),soluble receptor for advanced glycation end products (sRAGE) in newly diagnosed patients with type 2 diabetes.Methods 60 patients of newly diagnosed type 2 diabetes were chosen from 2010 September to 2011 December in Department of Endocrinology Changshou Chinese medicine hospital in Jiangsu Province,and 30 healthy people were screened as control group.Various clinical and biochemical parameters were detected,using enzyme-linked immunosorbent assay for the detection of serum AGEs and sRAGE levels.Results The levels of serum AGEs in newly diagnosed type 2 diabetic patients and control group were (1379.2 ± 431.8) and (1154.5 ±326.4) pg/ml,and there were significant differences between two groups (P＜0.05).The levels of serum sRAGE in newly diagnosed type 2 diabetic patients and control group were (14.6± 9.3)and (19.5 ± 8.9)ng/ml,and there were also significant differences between two groups (P＜0.05).The level of serum AGEs in newly diagnosed type 2 diabetic patients was positive correlation with glycosylated hemoglobin (HbA1c),and the level of serum sRAGE was associated with low density lipoprotein cholesterol (LDL-C) negative correlation.Conclusion The level of serum AGEs increase in newly diagnosed type 2 diabetic patients,and the level of serum sRAGE decrease in newly diagnosed type 2 diabetic patients.

Objective To understand the effect of astragalus on insulin resistance and plasma amylin levels in newly diagnosed type 2 diabetic patients.Methods 88 patients of newly diagnosed type 2 diabetes were randomly divided into three groups:Group A (lifestyle intervention group) contained 30 patients,Group B (metformin treatment group) also contained 30 Patients,and Group C (astragalus and metformin treatment group) contained 28 Patients.Patients in group A were intervened with the control of diet,blood pressure and lipids level; patients in group B were additionally treated with metformin on the basis of group A; patients in group C were additionally treated with metformin and astragalus on the basis of group A.The course for both treatments were 8 weeks.Various clinical and biochemical parameters were detected before and after the treatment in all three groups and enzyme-linked immunosorbent assay was adopted for the detection of plasma amylin.Results Fasting blood glucose levels were significantly decreased after treataent in the three groups (t=-2.696、-4.029、-3.995,P＜0.05) ; insulin resistance index reduced in group B and group C (t=-2.599、-3.813,P＜0.05),the difference between group C and group B was statistically significant (t=-2.334,P＜0.05) ;treatments of group B and group C could improve the beta cell function index (t=2.303、2.384,P＜0.05),and they also could increase the plasma amylin level (t=2.341、3.045,P＜0.05).Conclusion Astragalus and metformin can improve insulin resistance index and increase plasma amylin levels in newly diagnosed type 2 diabetic patients.

Objective To evaluate the functional magnetic resonance (MR) imaging in the assessment of renal involvement and pathological changes in patients with lupus nephritis (LN).Methods Seventeen patients with LN and 10 healthy controls underwent coronal echo-planar diffusion-weighted (DW) MR imaging and blood oxygen level dependent (BOLD) MR imaging of the kidneys with a single breath-hold time of 16 s.The apparent diffusion coefficient (ADC) and R2* value of the kidneys were calculated with high b values (b=500 s/mm2).The correlation between the renal injury variables and the ADCs or R2* values was evaluated.Results The mean ADC value of kidneys in patients with LN was (2.43+0.24)×10-3 mm2/s,the mean R2* values of the renal cortex and medulla were (11.72+2.35)/s and (13.07+2.35)/s respectively,which were all significantly lower than those in volunteers (P=0.045,P=0.048and P=0.001,respectively).In the patients with LN,the mean ADC values were positively correlated with estimated glomerular filtration rate (eGFR) (r=0.558,P＜0.05).There was a negative correlation between the ADC values of the right kidneys and pathological chronic indexes (r=-0.493,P＜0.05).Moreover,the R2*values of the renal medulla were negatively correlated with 24 hours proteinuria,serum creatinine,pathological active indexes.The patients were assigned to group A (class Ⅲ,Ⅳ,Ⅴ,n=8) and group B class Ⅴ + Ⅲ and Ⅴ + Ⅳ,n=9).The tubulointerstitial lesions in group B were more severe than those in group A,while the mean ADC values and R2* values of the renal cortex in group B were lower as compared to group A.Conclusion DW MR imaging and BOLD MR imaging may be used to non-invasively monitor the disease activity and evaluate the efficacy in lupus nephritis.

ObjectiveTo analyze the differential expression of microRNA (miRNA) and its significance in patients with neonatal necrotizing enterocolitis (NEC).MethodsTwenty-five patients diagnosed with NEC with Bell stage≥Ⅱ, and 25 non-NEC patients as control group admitted to Guangzhou Women and Children's Medical Center between October 2014 and November 2015 were collected. White blood cells were extracted from the peripheral blood. Five samples were selected randomly each from NEC group and control group, and sequenced by second-generation Illumina high-throughput sequencing, screened for differentially expressed miRNA and analyzed for target genes prediction and biological function. The rest samples of the two groups were detected by real-time fluorescent quantitative polymerase chain reaction technology (RT-qPCR), the results were used to validate the results of high-throughput sequencing. Differentially expressed miRNA in the two groups of data was analyzed using DEGseq software.P<0.05 was considered statistically significant.P<0.01,q<0.001 and丨Log2 Ratio丨≥1 were taken as criteria for screening the differential expression. The differential expressions of miRNA in NEC group and control group were analyzed by cluster analysis using MeV4.6 software.ResultsA total of 482 miRNAs were differentially expressed in the two groups, with significant difference (P<0.05). Among them, 126 were known miRNAs with significantly differential expression in the two groups, with 58 being up-regulated and 68 being down-regulated. The results of up-regulated miRNAs (hsa-miR-223-5p,-183-3p,-222-5p) and down-regulated miRNAs (hsa-miR-23b-5p,-150-5p,-146a-3p,-1298-5p) were confirmed to be consistent with the results of sequencing. Bioinformatics analysis showed that the target genes with differential miRNA expression mainly involved Toll-like receptor signal transduction pathway, mitogen-activated protein kinase pathway, JAK-STAT and other signal transduction pathways.ConclusionsThere are significantly differential expressions of miRNAs in peripheral white blood cells of NEC neonates. These miRNs may be involved in the occurrence and development of NEC via adjusting different target genes to regulate the signal pathway.

AIM: To determine EGF contents in human milk, frech cow's milk and cow's milk-based infant formulas and the relationship between EGF content of human milk and neonatal maturity.METHODS: EGF contents in 57 human colostrum from mothers delivering prematurely and at term, 4 different fresh cow's milk and 8 different cow's-milk-based infant formulas with hydrolyzed and non-hydrolyzed proteins were determined by radioimmunoassay (RIA). RESULTS: Human milk from mothers of premature infants had higher EGF content compared to that from mothers of term infants[(28.2?10.3) nmol/L vs(17.3?9.6) nmol/L]. There was a negative correlation between EGF content of human milk and gestational age, birth weight of neonates. The values in fresh cow's milk [(16.6?3.8) nmol/L]were similar to that in human term milk. The contents in non-hydrolyzed protein formulas[(7.5?1.9) nmol/L]were much lower than that in human milk and fresh cow's milk. No immunoreactive EGF was detected in all hydrolyzed protein formulas. CONCLUSION: The occurrence of high EGF concentration in premature milk may represent a maternal compensatory mechanism to accelerate the growth and maturation in immature infants. Lack of EGF in formulas suggests that they may not suitable for those newborns with immature or damaged gastrointestinal tract.