The study intended to evaluate the atherosclerotic plaque burden and composition among symptomatic patients with and without type 2 diabetes mellitus.Total 262 symptomatic patients, including 79 with type 2 diabetes and 183 without, underwent multislice computed tomography coronary angiography.The extent of coronary atherosclerosis and 3 plaque types were studied.Patients with diabetes showed more diseased coronary segments ( P ＜ 0.01 ) and more nonobstructive segments ( P ＜ 0.05 ) than non diabetic patients.Compared to non diabetic patients,diabetic patients had a higher number of coronary segments with non-calcified ( P = 0.005 ) and calcified ( P = 0.016 ) plaques, but not for mixed plaques.The results indicate that type 2 diabetic patients have higher coronary plaque burden.

Objective To investigate the correlation between serum neuregulin 4(Nrg4)level and metabolic associated fatty liver disease(MAFLD)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 240 T2DM patients admitted to the Department of Endocrinology of Second People's Hospital of Yichang from June 2021 to August 2022 were collected and divided into simple T2DM group(n=120)and MAFLD group(MAFLD,n=120).120 healthy individuals were selected as the normal control(NC)group.Results The serum Nrg4 decreased gradually from NC group,T2DM group to MAFLD group(P＜0.05).Pearson correlation analysis showed that serum Nrg4 was negatively correlated with WC,HOMA-IR and hs-CRP(P＜0.05),and positively correlated with HDL-C(P＜0.05).Logistic regression analysis showed that Nrg4,WC,HOMA-IR and hs-CRP were the influencing factors of MAFLD.After adjusting for age,sex,smoking history,BMI,TC,TG,HDL-C,LDL-C,FPG,FIns,HbA1c and other factors,serum Nrg4 was still the influencing factor of MAFLD.Conclusion The decrease of serum Nrg4 is a risk factor for T2DM combined with MAFLD.

Objective:To observe the expression of serum nuclear factor-κB (NF-κB) and monocyte chemotactic protein-1 (MCP-1) in patients with early diabetic nephropathy (EDN) and the effect of pioglitazone on the expression of inflammatory factors and renal protective mechanism.Methods:A retrospective case-control study was conducted.From January 2019 to December 2019, the patients were divided into pioglitazone group ( n=35) and glimepiride group ( n=34). At the same time, 30 healthy people in the physical examination center of our hospital were selected as the control group.The levels of serum NF-κB and MCP-1 were detected by immunohistochemistry.The changes of fasting glucose, Hemoglobin A1C (HbA1c), renal function, urinary albumin excretion rate (UAER), and hypersensitive C-reactive protein(hsCRP), interleukin-6(IL-6), homeostasis model insulin Resistance index (HOMA-IR) were detected and compared among the three groups before treatment, pioglitazone group and glimepiride treatment group after treatment.To observe the effect of pioglitazone on serum NF-kB and MCP-1 expression in patients with early type 2 diabetic nephropathy. Results:Serum NF-κB, MCP-1, UAER, fasting blood glucose, HbA1c, HOMA-IR, hsCRP, IL-6 were significantly higher in the diabetic nephropathy group than those in the control group before treatment ( t values were 9.16, 7.61, 16.99, 17.01, 17.05, 12.01, 8.69, 6.28, all P<0.01). After 12 weeks of treatment, the levels of NF- κB, MCP-1, HOMA-IR, hsCRP, IL-6 and UAER in pioglitazone group were lower than those in glimepiide group ( t values were -5.03, -4.63, -2.35, -8.03, -3.06, -2.10, P<0.05 or P<0.01). After treatment, there were no statistically significant differences in fasting blood glucose and HbA1c between the pioglitazone group and the glimepiide group (all P>0.05). Serum NF-κB, MCP-1, HbA1c, HOMA-IR and UAER in EDN group were significantly positively correlated ( R values were 0.568, 0.532, 0.521, 0.466, all P<0.05). Conclusion:The expression of NF - κ B and MCP-1 in serum of EDN patients was increased, which indicated that there was chronic inflammation in patients.Pioglitazone could down regulate the expression of NF - κ B and MCP-1, so as to play an anti-inflammatory and renal protective role.

Clinical pharmacists actively participated in the glucose-lowering therapy for three type 2 diabetes patients with obesity and hepatic insufficiency to explore the role of clinical pharmacists in clinical treatment. Through the participation in the formulation of drug treatment by clinical pharmacists, GLP-1 preparation was used for hypoglycemic treatment, and the effect was promising. There was no significant change in the patients' liver function. By actively participating in the formulation of glucose-lowering therapy, clini-cal pharmacists can improve the effectiveness and safety of drug treatment.