Objective To investigate the prevalence of diabetic foot (DF) and the normal,high and low ankle brachial index (ABI) in type 2 diabetic patients and explore the risk factor for abnormal ABI and the clinical predictive value for DF.Methods A total of 2681 type 2 diabetic patients who visited our hospital between January,2007 to December,2009 were enrolled in the study.The clinical data were analyzed and the risk factors for abnormal ABI were determined by logistic regression analysis.Results ABI was normal (0.9-＜ 1.3) in 2362 cases (88.1％),while below 0.9 in 277 cases (10.3％) and equal or over 1.3 in 42 cases (1.6％).The elderly patients (≥ 60 years) had a higher prevalence of low ABI than the non-elderly patients(20.41％ vs.4.10％,P ＜ 0.01).The prevalence of DF was 25.63％,3.05％,26.19％ in ABI ＜ 0.9,0.9-＜ 1.3 and ≥ 1.3 groups,respectively,and the prevalence in groups ABI ＜ 0.9 and ≥ 1.3 was higher than that in group ABI 0.9-＜ 1.3.Similar U-shape distribution was observed in the prevalence of abnormal ABI and DF.ABI was negatively correlated with age,diabetes duration,uric acid (UA),24 hours microalbuminuria,while positively correlated with body mass index (BMI),diastolic blood pressure,triacylglyceride,total cholesterol and glycosylated hemoglobin A1c (HbA1c).Abnormal ABI was independently correlated with age,diabetes duration,HbA1c,UA,24 hours microalbuminuria,diabetic kidney disease,diabetic retinopathy,diabetic peripheral neuropathy and diabetic vascular diseases.Conclusion The prevalence of abnormal ABI is higher in the elderly patients with type 2 diabetes.Abnormal ABI could be an early predictor for DF.

[Summary] Type 2 diabetic patients often have risk factors such as hyperglycaemia ,dyslipidaemia , hypertension ,obesity and insulin resistance ,which increase the risks of vascular endothelial dysfunction and cardiovascular events. GLP-1 analogue and its receptor agonist ,is a novel therapy on diabetes targeting at incretin ,which can effectively control blood glucose and improve vascular endothelial dysfunction. Here we summarize the protective effect of GLP-1 analogue and its receptor agonist on vascular endothelial cell.

Objective:To study the changes of serum advanced oxidation protein products(AOPP) in patients with diabetic nephropathy(DN) and its correlationship with superoxide dismutase(SOD) and glutathione peroxidase(GPx). Methods: Eighty-five diabetes mellitus (DM) patients were divided into 4 groups: non-DN group(DM, n=25), early-stage DN group(DN3, (n=24), )significant DN group(DN4, n=17) and end-stage DN group(DN5, n=17). The concentration of serum AOPP was measured spectrophotometerically, serum SOD was determined by xanthine oxidase test and GPx by DTNB reaction test. (Results:) The concentrations of AOPP in patients of DN5 group (-[117.8?64.8-] ?mol/L) and DN4 group (-[80.0?23.0-] ?mol/L) were significantly higher than that in DM group (-[58.2?17.7-] ?mol/L,P0.05) and negatively correlated with SOD and GPx(r=-0.217, r=-0.374, P

Objective To observe insulin synthesis and secretion in INS-1 under high glucose, and to clarify the effect of PTH1R. Methods After successful construction of recombinant PTH1R-siRNA vectors in INS-1 cell, insulin secretion and intracellular insulin content of control group, siPTH1R-Negative control group, PTHrP group, and siPTH1R group under 25 mmol/L glucose were measured by radioimmunoassay in INS-1 cell. Intracellular calcium were detected by Fluo-3/AM and the capability of glucose transport was calculated by assaying the uptake of [3H]-2-deoxy-D-glucose in cells.Results Compared with control group, and siPTH1R-NC group, PTHrP group showed increased capability of insulin secretion; PTHrP group had higher intracellular insulin levels than others; PTHrP group showed increased intracellular calcium; the uptake of [3H]-2-deoxy-D-glucose under high glucose after 48h of PTHrP group was increased(all P＜0.01). Conclusion There is a close relationship between PTH1R activation and insulin secretion and synthesis, PTH1R activation may be one of the protective mechanisms in maintaining function of β-cell under high glucose.

This study was aimed to evaluate the efficacy and safety of acupuncture treatment for diabetic peripheral neuropathy.MEDLINE, EMBASE, China National Knowledge Infrastructure (CNKI), and Wanfang database were searched. The study endpoints included clinical total efficacy, peripheral nerve conduction velocity and adverse reactions. The Review Manager software 5.2 was used in the bias and risk assessment as well as efficacy. GRADE profiler software was used to evaluate quality of evidences. The results showed that there were 18 randomized controlled trials (RCTs) with 1158 patients included. The clinical total efficacy rate of acupuncture treatment was obviously better than the drug control group [RR: 1.38, 95%CI (1.25, 1.53),P < 0.000 01]. The sensory nerve conduction velocity was that for nervus medianus, the acupuncture treatment group was superior to the drug control group [MD = 2.55, 95%CI (1.23, 3.87),P = 0.000 1]; for nervus peroneus communis, the acupuncture treatment group was superior to the drug control group [MD = 3.42, 95%CI (2.56, 4.28),P < 0.000 01]. The motor nerve conduction velocity was that for nervus medianus, the acupuncture treatment group was superior to the drug control group [MD= 4.10, 95%CI (1.01, 7.19),P = 0.009); for the nervus peroneus, the acupuncture treatment group was superior tothe drug control group [MD = 3.09, 95%CI (1.99, 4.19),P < 0.000 01]. The adverse reactions and safety indicators were that no adverse reaction was reported in both studies with no abnormal safety indicator. The quality of evidence showed that the sensory nerve conduction velocity for nervus peroneus communis was moderate; the motor nerve conduction velocities for nervus medianus and nervus peroneus communis were low. While, the clinical efficacy rate and the quality of evidence for sensory nerve conduction velocity of nervus medianus were relatively low. It was concluded that the current clinical evidences were uncertain for the efficacy and safety of acupuncture in diabetic peripheral neuropathy treatment.

Objective To determine the effects of glucose concentration on G 6PD activity and respiratory burst of normal hu-man′s neutrophils in vitro .Methods Normal human′s neutrophils were cultured in different glucose concentration for 8 hours ,as-sayed G6PD activity by spectrophotometric method and determining ROS content by fluorescent probe DCFH-DA .Results G6PD activity and ROS of 15 mmol/L group and 25 mmol/L group were significant lower than before ,when the 5 mmol/L group and L-GLU group didn′t have significant change with time goes by .And G6PD activity and ROS of 25 mmol/L group were the lowest in all groups(P<0 .01) .Conclusion High glucose may induce G6PD activity decreased and cause respiratory burst dysfunction as a stimulating factor .The stimulation intensity was increased with the increase of glucose concentration .It′s the probable mechanism on susceptibility to infections in patients with diabetes mediated by dysfunction of respiratory burst in leucocyte .

Objectives To study the relationships between methylenetetrahydrofolate reductase(MTHFR) gene polymorphism and diabetic retinopathy (DR) in Chinese Han race. Methods With polymerase chain reaction and restriction fragment length polymorphism (PCR RFLP), MTHFR gene 677 T mutation (cytosine is replced by thymine in No.677 site) was detected in 85 health controls, 62 with DR and 117 without DR of type 2 diabetics comfrimed by ophthalmoscope. Results The frequency of MTHFR variant genotypes and alleles of DR in Chinese Han race.patients were signigicantly higher than those without retinopathy and healthy controls (P

BACKGROUND: Impaired glucose tolerance(IGT) is mainly related to genetic factors and environmental factors including excessive calorie intake and obesity. Insulin resistance(IR) plays a major role in the onset of IGT.OBJECTIVE: To investigate the relationship between erythrocyte insulinase activity(EIA) and IR in patients with IGT soas to provide theoretic basis for improving IR in patients with IGT by exercise.DESIGN: Observational and comparative study based on IGT patients as the subjects and adults with normal glucose tolerance as controls.SETTING: Department of endocrinology of a hospital affiliated to a military medical university.SUBJECTS: The study was conducted in the Department of Endocrinology of Nanfang Hospital, First Military Medical University of Chinese PLA, from January 2001 to April 2003. A total of 50 inpatients and outpatients with IGT, 26 males and 24 females aged(52 ± 7) years, were randomly selected. Inclusion criteria: those whose diagnosis met the WHO 1999 for criteria oral glucose tolerance test (OGTT) and whose heart, liver and kidney functions and blood test were within the normal range without taking any antidiabetics. Exclusion criteria: those who had liver and kidney diseases, infection, malignant tumor, coronary heart disease, cerebrovascular disorder and connective tissue disease. The patients with IGT were divided into 2 subgroups according to the presence of abnormal fasting plasma glucose (FPG).Subgroup A consisted of 20 patients (9 males and 11 females) with IGT accompanied with impaired FPG. Subgroup B was composed of 30 IGT patients (17 males and 13 females) with normal FPG. Twenty adults with normal glucose tolerance were set as control group(20 females and 10 males) with the age of(48 ± 12)years.METHODS: EIA was measured with the method of radioenzymatic assay in all subjects. Blood sugar, serum insulin and glycosylated hemoglobin were also measured, and homeostasis model analysis-insulin resistance (HOMA-IR) index was calculated for estimation of insulin sensitivity.MAIN OUTCOME MEASURES: The differences and correlation between EIA and HOMA-IR in IGT patients of each group.RESULTS: EIA, serum fasting insulin and HOMA-IR indexes of the patients with IGT were significantly higher than those of the controls ( P < 0.01 or P < 0.05) . EIA and HOMA-IR of the patients in subgroup A was significantly higher than those in subgroup B ( P < 0. 01 ). Linear regression analysis showed that EIA had significant positive correlation with serum fasting insulin, glycosylated hemoglobin and HOMA-IR indexes( r = 0.51, 0.44,0.49, P <0.01).CONCLUSION: The degradation rate of erythrocyte insulinase in patients with IGT tolerance is significantly higher than that of normal persons, and is closely related to the onset and development of insulin resistance.

ObjectiveTo investigate the relationship between the oxidative injury induced by low glucose and mitochondrial membrane potential in HUVEC-12 cells. Methods Human umbilicalvein endothelial cells HUVEC-12 were cultured in low concentration glucose for 4 h.Cell viability of HUVEC-12 cell was assessed with MTT assay.Dihydroethidium (DHE) was used as a reactive oxygen species (ROS)capture, which was detected the mean fluorescence intensity of samples and Rhodamine 123 as a fluorescence detector was to measure the level of mitochondrial membrane potential (MMP) in cells.Results Comparing to HUVEC-12 cells viability in 5.5 mmol/L glucose group (96.80 ±3.20)％, cells exposed to 2.8 mmol/L glucose group (66.40 ± 1.60) ％ and 0 mmol/L glucose group (58.93 ± 1.67) ％ were decreased by 32％ and 40％ respectively (P ＜ 0.01).ROS level of 5.5 mmoL/L glucose group, 2.8 mmol/L glucose group and 0 mmol/L glucose group were 0.59 ± 0.02, 0.74 ± 0.04 and 0.88 ± 0.05,respectivdy, increased by 25％ in cells exposed to 2.8 mmol/L glucose and by 48％ in cells without glucose exposure comparing to 5.5 mmol/L glucose group (P ＜0.01) ; MMP levels of 5.5 mmol/L glucose group,2.8 mmoL/L glucose group and 0 mmoL/L glucose group were 148.83 ± 3.51, 271.07 ± 19.54 and357.74 ±51.32 respectively, increased to 1.8 times in cells exposed to 2.8 mmol/L glucose and to 2.4times in cells without glucose exposure comparing to 5.5 mmoL/L glucose group (P ＜ 0.01).Conclusion Low glucose leads to injury in HUVEC-12 cells, which is probably induced by the oxidative stress via the increasing MMP.

The influence of MRI on severity grading and activity staging in thyroid associated ophthalmopathy (TAO) was evaluated.The results showed that MRI had a higher detection rate in abnormal extraocular muscle than NOSPECS scores(χ~2 = 19.37,P = 0.000).MRI had higher sensitivity,specificity,and accuracy in detection of active TAO than clinical activity score (100% vs 95.7%,88.2% vs 35.3%,96.9% vs 79.7%,respectively).Therefore,MRI improves early detection of atypical grade 4 cases.Signal intensity elevation in adipose suppressed T2WI is helpful to define active stage.