Based on the result of oral 75 g glucose tolerance test (OGTT),55 pregnant women during the second trimester (gestational age 24-28 weeks) were selected and divided into gestational diabetes mellitus (GDM)group (n =25) and normal glucose tolerance (NGT) group (n =30).Women with GDM were older than those in NGT group.Blood glucose and insulin levels during the OGTT,incremental area under the glucose curve (AUCGLU) and insulin curve (AUCINs) during the OGTT,and basic insulin secretion index (HOMA-β) in the GDM group were higher compared with those in NGT group (P＜0.05).However,in GDM group,insulin sensitivity index (ISI-Matsuda),dynamic insulin secretion index(Stumvoll 1-and 2-phase insulin secretion indices),and insulin secretion-sensitivity index (ISSI)were lowered (all P＜ 0.05),so was AUCINS/AUCGLU (P ＜ 0.01),as compared with those in NGT group.Blood glucagon levels during OGTF and incremental area under the glucagon curve (AUCGL) showed no significant differences between 2 groups (P ＞ 0.05).Multiple linear regression analysis showed that ISI-Matsuda,ISSI,HOMA-β,Stumvoll 1-and 2-phase insulin secretion indices accounted partially for the change of plasma glucose and ISI-Matsuda was the most important one among them.The function of islet α-cell seems to be normal while the function of β-cell is impaired in the patients with GDM,and failure of insulin secretion to overcome insulin resistance is the main reason for GDM.

Mechanism of diabetes is due to damaged ?-cell or absolute or relative lack of insulin caused by insulin resistance. Stem cells have the potential of proliferation and differentiation into insulin-secreting cells, can also solve the problems of immune rejection. Pancreatic stem cells, embryonic stem cells, bone marrow stem cells and cord blood stem cells can be induced to differentiate into ?-cells, or increased ?-cell regeneration using drugs to play a role in diabetes treatment. Stem cell therapy for diabetes research have made progresses, high blood sugar status have been corrected in some of diabetes animals. But islet development and differentiation mechanisms require deeply studies to gain information for embryonic stem cells induced to differentiate into ? cells. A higher differentiation rate and more mature insulin-secreting cells can be achieved using inducible factor with procedures and application.

To elaborate the the main thoughts and treatment experience of dampness in Medical Origin and Insights, written by Zhang Yuansu. Dampness-resolving drugs and prescriptions were comprehensively and carefully summarized and analyzed. Strengthening spleen and stomach was viewed as guideline, and Rhizoma Atractylodis Macrocephalae as well as its brilliant combinations, was taken as preferred drug to resolve dampness, with the help of brilliant combinations. Emphasis was laid on the treatment according to patterns, positions and characters of diseases. Medical Origin and Insights, essence collector of Zhang’s thoughts, has enriched and developed basic traditional Chinese medicine theories and practices. Thus, it showed guiding significance on dampness treatments.

The islet secretion function in 42 clinically diagnosed diabetic ketosis and ketoacidosis pa- tients,aged 25～39 year-old,were studied.The results showed that the acute insulin responses to L-ARG (AIRarg) was significantly reduced in patients compared to control.As disease prolonged,AIRarg de- creased gradually.In the patients less than three months,the acute insulin responses to glucose(AIRglu) were markedly reduced,although the AIRarg were still sustained to some extent.The fasting blood insulin levels,in the patients more than three months were not different from controls,but C-peptide levels were significantly lower than those of controls.However,the C-peptide responses to L-ARG stimulation were not as evident as the insulin responses.The results suggested that impairment of the insulin secretion exist of in the early stage of DM,and exaggerated as the disease prolonged.Terapy of this type of diabetes mellitus de- pended mainly on insulin.

Gout is a metabolic inflammatory disease characterized by hyperuricemia. When serum uric acid concentration(sUA) is greater than 420 μmol/L, monosodium urate(MSU) crystals are formed and deposited in joints and connective tissues, resulting in acute gout arthritis. In addition to the concentration of urate, pH is also one of the factors affecting MSU deposition. Lowering pH can promote MSU crystallization. Urine alkalization can raise the pH to 6.2~6.9, which can increase the solubility of urate to prevent MSU deposition and the formation of uric acid stones. Commonly used clinical medications include citrate, bicarbonate, acetazolamide, tromethamine, etc. Among them, potassium citrate is the most commonly used alkali agent in clinical practice. However, due to adverse drug reactions, clinical medications need to be cautious. In addition to pharmacotherapy, dietary intervention has also become an important means of alkalizing urine. When sufficient attention is paid to the construction of a balanced diet, dietary intervention will become a safe and economical method for the treatment of gout, but the long-term efficacy has not been determined. This article discusses the advantages and disadvantages of urine alkalinization in the application of hyperuricemia and gout from aspects of pharmacological treatment and diet management, and provides a basis for proper medication use.

Cultured human umbilical vein endothelial cells (HUVECs) were divided and assigned to 6 groups:normal control group,mannitol control group,high glucose group,low dose resveratrol group,medium dose resveratrol group,and high dose resveratrol group.HUVECs were pretreated with or without 30 mmol/L glucose plus various concentrations of resveratrol (0.1,1,10 μmol/L) for 16 hours and then incubated with 5.5 mmol/L glucose for 6 days.The levels of vascular cell adhesion molecule 1 (VCAM-1),monocyte chemotactic protein 1 (MCP-1),and plasminogen activator inhibitor 1 (PAI-1) in the culture supernatant were measured by ELISA.NF-κB expression was detected by Western blot.Compared with normal glucose group,high glucose up-regulated the expression of NF-κB,along with the increased levels of VCAM-1,MCP-1,and PAI-1 (all P＜0.05),which were still maintained at high levels even after withdrawal of high glucose.Resveratrol treatment down-regulated the expression of NF-κB and lowered the levels of VCAM-1,MCP-1,and PAI-1 (all P＜0.05).These results suggest that resveratrol may decrease the secretion of VCAM-1,MCP-1,and PAI-1 and prevent high glucose memory-induced injury to endothelial cell via NF-κB pathway.

Objective To study the abnormal expression of P-AKT in follicular thyroid carcinoma and its relationship with angiogenesis. Methods MVD and expressions of P-AKT, VEGF in 40 specimens of FTC tissues were detected by immunohistochemical PV6000 method. Results The expression rate of P-AKT in FTC was higher than that of non-FTC tissues. The result was of statistical significance (P<0.001). There were correlations between the MVD of FTC tissue and the expression of P-AKT and VEGF (P<0.05). The MVD of P-AKT positive FTC tissue was higher than that of negative tissues (P<0.05). The MVD of VEGF positive FTC tissue was also higher than that of negative tissues(P<0.05). There were correlations between the expression of P-AKT and VEGF(P<0.05). Conclusion The hyperexpression of P-AKT played an important role in the secondary deposits and development of human follicular thyroid carcinoma. AKT/VEGF pathway may exist in FTC, and AKT is the key factor in the pathway which regulated the expression of VEGF.

Objective To investigate the Effects of thyroxine on the level of serum homocysteine and urinary albumin excretion rate in elderly patients with early diabetic nephropathy and subclinical hypothyroidism.Methods Seventy-five patients with early diabetic nephropathy and subclinical hypothyroidism were randomly divided into levothyroxine treatment group and conventional treatment group.Urinary albumin excretion rate (UAER),serum levels of homocysteine,creatinine,and lipids were measured at both pre-and post-treatment of 48 weeks.Results After treatment,serum total cholesterol,low density lipoprotein-cholesterol,triglyceride,thyrotropin,homocysteine,UAER,and serum creatinine in the levothyroxine treatment group were significantly lower than those in the conventional treatment group [(-0.52 ± 0.12 vs 0.31 ± 0.40) mmol/L,(-0.33 ± 0.22 vs 0.24 ± 0.36) mmol/L,(-0.16±0.18 vs0.19±0.29)mmol/L,(-4.4 ± 1.2 vs 1.2 ±0.8)mIU/L,(-1.4 ±2.0 vs0.9± 1.0)mmol/L,(-13 ± 13 vs 10 ± 7) pg/ml,(-2 ± 2 vs 3 ± 2) μmoL/L,respectively,all P＜0.01].Conclusions Treatment with levothyroxine could significantly improve serum lipid profiles and reduce homocysteine,UAER,and creatinine,and exert a protective effect on the kidney in the elderly patients with early diabetic nephropathy and subclinical hypothyroidism.

Objective To investigate the state of oxidative stress in the subjects with different levels of serum uric acid and to explore the cause of endothelial dysfunction induced by hyperuricemia. Methods Male subjects with normal serum uric acid or hyperuricemia were enrolled in this study. According to the levels of serum uric acid,all the partieipante were divided into five groups. Every group consisted of about fifty subjects. Plasma malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase(GSH-Px) were determined. In the mean time plasma nitric oxide(NO) ,plasminogen activator inhihitor-1(PAI-1), endothelin-1 (ET-1) and other biochemical variables were also determined. Results When the serum uric acid level was more than 380 μmol/L, the levels of plasma MDA,SOD,GSH-Px, PAI-1 and ET-1 became higher, while the level NO became lower(P<0.05). However SOD and GSH-Px became much lower when the serum uric acid level was more than 420 μmol/L. Multivariate stepwise regressive analysis showed that PAI-1 was positively related to MDA,UA,HOMA-IR and TG, but negatively related to SOD and NO(t =-3.64 - 6. 08,P < 0.05). ET-1 was positively related to MDA, UA, HOMA-IR and negatively related to NO, GSH-Px and SOD (t = - 4.75 - 6.35,P < 0.05 ). Conclusions It is indicated that oxidative stress became much obvious when the serum uric acid level was more than 380 μmol/L . Oxidative stress,high serum uric acid level and insulin resistance may result in endothelial dysfunction.

Objective To explore the impact of genetic background on pancreatic p-cell first-phase secretion function with L-arginine (L-ARG) stimulation test.Methods Plasma insulin level was detected in 201 cases before and after L-ARG stimulation test.Among them, 61 cases were newly diagnosed type 2 diabetic patients with family history of diabetes ( FH + DM ) , 55 newly diagnosed type 2 diabetic patients without family history of diabetes ( FH - DM) ,31 with normal glucose tolerance and family history of diabetes ( FH + ) 54 with normal glucose tolerance but without family history of diabetes ( FH - ).Homeostasis model assessment ( HOMA) was used to estimate insulin resistance (HOMA-IR).Results It was premised that gender, age and BMI were similar among the 4 groups.(1)TC,TG,fasting plasma glucose,2h plasma glucose,fasting insulin and HOMA-IR in the two groups of newly diagnosed type 2 diabetic patients with or without family history of diabetes were significantly higher than those in the two groups of normal glucose tolerance with or without family history of diabetes.The multiples of the peak level and the base level of insulin secretion in the groups of newly diagnosed diabetes were significantly lower than those in the groups of normal glucose tolerance with and without family history(P <0.05).(2) Insulin secretion reached a peak in 2 minutes and started to decline in 4 minutes in all the four groups.( 3 ) The multiples of the peak level and the base level of insulin secretion in normal glucose tolerance group with family history of diabetes were 20.8% lower than those in the group without family history, being 7.27 and 9.18 respectively ( P < 0.05 ).(4)Two-minute peak insulin secretion, HOMA-IR and age in the newly diagnosed type 2 diabetic group with family history of diabetes was significantly lower than these in the group without family history ( P < 0.05 ).The multiples of the peak level and the base level of insulin secretion in the newly diagnosed type 2 diabetic group with family history of diabetes and that group without family history were 5.18 and 5.31 respectively and there was no significant difference between the two groups( P >0.05).(5) When the normal glucose tolerance subjects with family history of diabetes progressed to suffer from diabetes, the multiples of the peak level and the base level of insulin secretion declined 43.6% (P < 0.05) more than those in the subjects still with normal glucose tolerance without family history.Conclusion In the early course of diabetes, insulin resistance dose not function significantly, but genetic background make the first-phase secretory function of the p-cell to decline gradually and type 2 diabetes occurs easily.In the absence of genetic background, insulin resistance makes first-phase the secretion of insulin to decline relatively slow.