Objective To conduct the standardized management on the advanced age(≥75 years old)outpatients with type 2 diabetes mellitus(T2DM)by adopting the staged diabetes targeted management(SDTM)mode,and to observe the correlation between the follow up frequency and death.Methods The ad-vanced age patients with T2DM participating in the SDTM mode in the diabetes clinic of a tertiary hospital in Jiangsu Province from September 2009 to September 2022 were retrospectively selected and divided into the survival and death groups according to whether or not the patient died.The correlation between the follow up frequency and death was analyzed.Results A total of 947 advanced age patients with T2DM participated in the follow up,the mean age was(82.1±4.7)years old,and the mean follow-up time was(7.5±3.2)years.A total of 169 cases died with a death rate of 17.8％.The Cox regression analysis showed that the annual average follow up frequency had the correlation with death;after correcting the factors such as age and gender,the an-nual average follow-up frequency of the patients was correlated with death(HR=0.880,95％CI:0.854-0.907,P＜0.001).Conclusion Using the SDTM mode to conduct the standardized management on the advanced age patients with T2DM and increasing the follow-up frequency could reduce the death rate of the patients and im-prove their survival rate.

This study was aimed to observe the effect of emodin on cisplatin-induced renal tubular epithelial cells (NRK-52E) injury,in order to explore its possible molecular mechanisms.Firstly,effects of emodin on cisplatin-induced morphological changes in NRK-52E cells were observed.Secondly,the apoptosis-related protein expression of Caspase-3 and cleaved Caspase-3 were detected after the treatment of cisplatin alone or cisplatin together with emodin by western blot.Then,the expression of microtubule-associated protein 1 light chain 3 (LC3) Ⅱ/Ⅰ was detected after the treatment of emodin or rapamycin at different time points by western blot.Changes of pmRFP-LC3 fluorescent particles were observed by fluorescence microscopy.And effects of rapamycin on cellular morphological changes were observed in the environment of cisplatin.Finally,effects of emodin on the activation of AMPK and mTOR signal pathway were further observed,which is considered as the upstream of autophagy signaling pathway.The results showed that cisplatin can induce morphological changes in NRK-52E cell,which was obviously ameliorated by the intervention of emodin.Additionally,the increased protein expression of cleaved Caspase-3 induced by cisplatin was obviously reduced after the intervention of emodin.The LC3-Ⅱ/LC3-Ⅰ ratio was significantly increased after the treatment of emodin or rapamycin at different time points.Rapamycin can significantly ameliorate NRK-52E cell apoptosis induced by cisplatin.Simultaneously,the number of pmRFP-LC3 fluorescent particles increased after the treatment of emodin.As the extension of time by intervention of emodin,the protein expression of p-mTOR was significantly reduced.In contrast,the protein expression of p-AMPK was significantly increased.It was concluded that emodin can ameliorate cisplatininduced apoptosis in NRK-52E cells.Its potential mechanism may be attributed to the activation of autophagy by regulating AMPK/mTOR signaling pathway.And thus,it played a role in renal protective effects.

This study was conducted to evaluate the relationship between serum insulin levels and the production of insulin antibody (IA) in type 2 diabetes (T2DM).A total of 647 T2DM were included.Among them,20.9％ patients were IA positive,who were elder and had a longer duration,lower BMI,a higher positive rate of glutamic acid decarboxylase antibody(GADAb) and higher serum insulin levels during an insulin secretion test.More patients were treated with insulin in IA positive group than in IA negative group (65.9％ vs 41.0％,P =0.000).Fasting serum insulin level was associated with occurrence of IA in all patients (OR =1.02,P =0.001) and insulin treated patients (OR =1.033,P =0.002).The cut-off point of fasting serum insulin level for predicting IA positive was 17.87 mIU/L (sensitivity 55.1％,specificity 89.0％).Exogenous insulin use is associated with the presence of IA.Fasting serum insulin level can be used as a predictor for the production of IA in insulin-treated patients.

Objective To observe the effect of electroacupuncture (EA) on intestinal vitamin D receptor (VDR) mRNA and protein expression in ovariectomized rat model,and to explore the possible mechanism of acupuncture treatment for postmenopausal osteoporosis.Methods Sixty 3-month-old female SD rats were randomly divided into operation group and sham group.3 months after osteoporosis model was successfully produced,rats in operation group were randomly divided into model group,EA sham group,EA group and drug group.12 weeks after intervention,bone mineral density (BMD) of lumbar spine and femur were detected,then rats were all sacrificed to extract the small intestinal mucosa.VDR mRNA and protein expressions were determined by real-time quantitative PCR and Western blotting.Results The model of postmenopausal osteoporosis was successfully established.The bone mineral density was significantly improved in EA group and drug group as compared with the model group at 12 weeks after intervention.Western blotting and realtime quantitative PCR showed that small intestinal VDR mRNA and protein expressions were increased in EA group and drug group,but the increment of VDR mRNA expression was less in EA group than in drug group.Conclusions One of the mechanisms of acupuncture treatment for postmenopausal osteoporosis may be related with increasing the intestinal VDR mRNA and protein expression levels and enhancing the bioactivity of vitamin D.

The pathomechanisms of glomerulosclerosis in diabetic nephropathy (DN) are considered to be related with glycometabolism disorder, podocyte injury, intra-renal hemodynamics abnormality, fibrogenic cytokines over-expression, oxidative stress and inflammatory reaction. Chinese herbal medicine could delay the progression of glomerulosclerosis in DN by ameliorating the harmful factors of these pathological changes. Therefore, it is possible to postpone the progress of DN to end-stage renal disease through the treatment with Chinese herbal medicine.
Animals ; Diabetic Nephropathies ; drug therapy ; immunology ; metabolism ; prevention & control ; Drugs, Chinese Herbal ; therapeutic use ; Glomerulonephritis ; drug therapy ; immunology ; metabolism ; prevention & control ; Humans ; Oxidative Stress ; drug effects

Animals ; Anthraquinones ; isolation & purification ; pharmacology ; Cytokines ; metabolism ; Diabetic Nephropathies ; metabolism ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Emodin ; isolation & purification ; pharmacology ; Humans ; Interleukin-6 ; metabolism ; Plants, Medicinal ; chemistry ; Rheum ; chemistry ; Superoxide Dismutase ; metabolism ; Thromboxane B2 ; metabolism ; Transforming Growth Factor beta ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism