Objective To explore the clinical characteristics and death factors of elderly male with type 2 diabetes mellitus(T2DM)complicated with coronavirus infectious disease 2019(COVID-19).Methods A total of 55 hospitalized elderly male T2DM patients with COVID-19 were enrolled in this study from December 2022 to February 2023.All the patients were divided into survival group(n=32)and death group(n=23).The clinical indicators were compared between the two groups and evaluated by multifactor analysis to clarify their clinical characteristics and death risk factors.Results Age,T2DM duration,C-RP,procalcitonin,serum creatinine,creatine kinase,myoglobin,BNP,troponin,D-dimer,FPG and HbA1c were higher(P＜0.05 or(P＜0.01),while lymphocyte count and PaO2 were lower(P＜0.05)in death group than in survival group.The advanced age,C-RP,procalcitonin,serum creatinine,troponin,BNP,D-dimer,increase of FPG and HbA1c,and the reduction of lymphocyte count and PaO2 were risk factors for death(P＜0.05).Conclusion Age,blood glucose control,cardiac renal and pulmonary functions,and risk of thrombosis in elderly male T2DM with COVID-19 have important significance inevalu-ating the prognosis.

Objective To evaluate glycemic control,complication and influence factors of glycosylated hemoglobin(HbA1c) in type 2 diabetic(T2DM) patients with hypertension in retired and veteran of military communities in Kunming.Methods Cross-sectional study was conducted and 216 T2DM patients with hypertension were enrolled in current study.A self-made questionnaire was used to collected information including age,course of the disease,complication,hypoglycemic agents and status of glucose controlling.The levels of HbA1 c,fasting blood-glucose (FBG),2h postprandial blood glucose (2hPBG),total cholesterol (TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol (LDL-C),Blood urea nitrogen(BUN),creatinine(Cr) and uric acid(UA) were measured.Relative factors of HbA1c were analyzed.Patients were divided into the standard (HbA1c ＜ 7％) and substandard groups (HbA1c ≥ 7％) according to the level of HbA1c,and divided into the oral-medication,insulin-treatment and oral medication combined insulin groups according to therapeutic regimens.Results The goal attainment rate of HbA1c(HbA1c ＜7％) in retired and veteran of military communities in Kunming was 44.9％ (97/216).The levels of FBG,postprandial plasma glucose(PPBS) and TG in standard group were (6.1 ± 1.2) mmol/L,(9.4 ± 1.8) mmol/L and (1.9 ± 1.3) mmol/L,significant different from those in substandard groups [(7.8 ± 1.6) mmol/L,(11.5 ±2.2) mmol/L and (2.4 ± 1.3) mmol/L],and the differences were significant (t =11.6,9.1,2.2; P ＜ 0.05 or P ＜ 0.01).Meanwhile,the rate of cardiovascular disease,cerebrovascular disease,proteinuria,peripheral neuropathy and retinopathy were 69.8％,34.5 ％,20.5％,20.5％,29.6％,respectively,significantly different between the standard and substandard groups (P ＜ 0.05).HbA1 c level was linear correlated with FBG (r =0.76,P ＜ 0.01),PBG (r =0.61,P ＜ 0.01),TG (r =0.24,P ＜ 0.05) and the frequency of glucose monitoring (r =-0.55,P ＜ 0.01).As the increasing of the stage of diabetes,the selected therapeutic regimen were oral anti-diabetic agents,followed by insulin and insulin combined oral antidiabetic agents.The levels of PBG and serum creatinine in patients with insulin monotherapy were higher than those in other groups (P ＜0.05).Conclusion The level of glucose controlling of retired and veteran of military communities in Kunming is better.The prevalence of diabetic chronic complications is higher in patients with poor glucose controlling.HbA1c level is correlated with FBG,PBG,TG and the frequency of glucose monitoring.Oral antidiabetic agents is the primary therapeutic regimen.

Objective To investigate the effects of altitude,race,gender and age on blood glucose and glycosylated hemoglobin(HbA1 c) of type 2 diabetes.Methods A total of 410 patients with type 2 diabetes (T2DM) who resided at different altitudes in Jinghong,Kunming and Lijiang city for over 5 years and received antidiabetic treatment without adjustments for over 3 months were enrolled.To compare blood glucose,hemoglobin (Hb) and HbA1 c levels of T2DM among different altitudes,different races,different genders and different ages,The correlation between races and HbA1c was evaluated with Pearson's correlation analysis.Results No significant differences were observed in fasting blood glucose (FBG) (P =0.49,P =0.1,P =0.09,P =0.3),2 h postprandial blood glucose (2 h PBG) (P =0.33,P =0.4,P =0.7,P =0.1),and HbA1 c (P =0.47,P =0.28,P =0.2,P =0.07) levels between patients at different altitudes,different races,different genders and different ages.However,there were significant differences in Hb (P ＜0.01).There was no significant correlation between races and HbA1c levels(r =0.003,P =0.6).Conclusions There were effects of altitude,race,gender and age on hemoglobin of type 2 diabetes,but no effects on glycosylated hemoglobin.

Objective To investigate the impact of experimental stress on serum glucose , insulin, glucagon, cortisol, and ep-inephrine in diabetic rats and its intervention with insulin and fluoxetine .Methods Type 2 diabetic rats model was induced by feeding with high sugar and high fat diet , and intraperitoneal injection of streptozotocin (STZ).The rats were divided into normal group , dia-betic control group , diabetic treated with insulin , and diabetic treated with fluoxetine .All the rats were exposed to multiple stressors (forced swimming, cold stimulation, rotation, restrain, and crowding) for 8 weeks.The rat blood sera collected from each group were analyzed with multiple parameters including glucose , insulin, glucagon, cortisol, and epinephrine at the 4th and 8th week.Results After experimental stress, the levels of glucose [(16.7 ±3.5)mmol/L vs (5.1 ±1.1)mmol/L, t =13.9, P <0.01], glucagon [(158.5 ±50.2)ng/L vs (120.8 ±38.7)ng/L, t =2.5, P <0.05], epinephrine [(203.8 ±48.6)pg/ml vs (158.7 ±42.6)pg/ml, t =2.9, P <0.01], cortisol [(21.3 ±4.8)ng/ml vs (18.2 ±3.8)ng/ml, t =2.1, P <0.05], and HOMA-IR (10.9 ±2.6 vs 3.3 ±0.8 , t =12.3 , P <0.01 ) of diabetic rats were significantly increased .The glucose level [ ( 9.7 ±2.1 ) mmol/L vs ( 16.7 ± 3.5)mmol/L, t =7.0, P <0.01] was significantly improved after treated with insulin .The levels of epinephrine [(158.8 ±37.5 ) pg/ml vs (203.8 ±48.6)pg/ml, t =3.0, P <0.01], and cortisol [(15.7 ±4.2)ng/ml vs (21.3 ±4.8)ng/ml, t =3.5, P <0.01 ] were significantly improved after treated with fluoxetine .Conclusions Experimental stress increased the levels of glucose , en-docrine hormone , and insulin resistance of diabetic rats .Treatment with insulin improved the glucose level and treatment of fluoxetine improved the endocrine hormone level .

Objective To explore the correlation between glycosylated hemoglobin(HbA1c) level and hemoglobin(Hb),fasting blood glucose (FBG),two-hour postmeal blood glucose (PBG2h) levels in type 2 diabetic patients on plateau.To evaluate influencing factors of HbA1c and effects of Hb level on HbA1c and blood glucose levels.Methods A total of 101 type 2 diabetic patients with no change antidiabetic treatment above 3 months and living in Lijiang city(at altitude 2420 m) above 5 years were investigated.The mean value of FBG,PBG2h,HbA1c and Hb were determined.The correlation between HbA1c and Hb,FBG,PBG2h were studied by scatter diagram,Pearson correlation analysis and the regression analysis.HbA1c,FBG,PBG2h levels were compared between high hemoglobin group and normal hemoglobin group.Results The HbA1c level was positively correlated with the FBG (r =0.82,P ＜ 0.001) and the PBG2h (r =0.29,P =0.003) levels.The regression equation between HbA1c and FBG,PBG2h was Y =2.674 + 0.52X1 + 0.018X2.There was no correlation in HbA1c and Hb level(r =-0.06,P =0.551).There was no difference on HbA1c,FBG,PBG2h levels between high hemoglobin group and normal hemoglobin group (P ＞ 0.05).Conclusion The major influencing factors of HbAlc are FBG and PBG2h.The hemoglobin level has no obvious effects on HbA1c and blood glucose levels.

ObjectiveTo evaluate the effects on serum homocysteine(Hcy) level,vascular function and carotid intima-media thickness(IMT) in metformin-treated diabetic patients with or without supplementation with folate and Vitamin B12.MethodsA total of 100 newly diagnosed diabetic type 2patients were divided into two groups by random digits table with 50 cases each,90 patients completed study.Forty-seven participants (control group) received a 6-month course of metformin treatment,43 patients (treatment group) received mefformin,folate and Vitamin B12 treatment.The levels of serum Hcy,endothelin-1 (ET-1),carotid IMT,large or small arterial elasticity index (C1,C2),flow-mediated dilatation (FMD) of the brachial artery were evaluated before and after treatment.ResultsThe level of serum Hcy in control group significantly increased compared with before treatment[ (13.4 ± 2.7)μ mol/L vs.(11.1 ± 1.9)μ mol/L],hut the level of serum Hcy in treatment group significantly decreased compared with before treatment [ (9.2 ± 1.8 ) μ mol/L vs. ( 11.3 ± 2.0) μ mol/L ],there was significant difference(P ＜ 0.05 ).A beneficial effect was observed in the serum ET-1,FMD,carotid IMT and C2 in treatment group[ (20.0 ± 6.2)ng/L,( 15.8 ± 7.6)％,(0.8 ± 0.2) mm,(4.1 ± 2.1 ) ml/mm Hg ( 1 mm Hg =0.133 kPa) × 100 vs. (31.3 ±10.1 ) ng/L,(9.7 ± 4.5)％,( 1.1 ± 0.4) mm,(2.3 ± 1.0) ml/mm Hg × 100 ] (P ＜ 0.05).The levels of ET-1,FMD,carotid IMT and C2 after treatment in control group [ (24.8 ± 6.8) ng/L,( 12.9 ± 6.3 )％,(0.9 ± 0.3)mm,(3.0 ± 1.4) ml/mm Hg × 100] had significant difference compared with before treatment [ (30.6 ± 8.7)ng/L,(9.8 ± 4.6)％,( 1.0 ± 0.3) mm,(2.2 ± 0.9) ml/mm Hg × 100](P＜ 0.05).However,the results were improved significantly in treatment group than those in control group (P ＜0.05).In treatment group,significant correlation were detected between changes of Hcy and ET- 1 (r =0.43,P ＜ 0.05 ),carotid IMT(r =0.56,P ＜ 0.05),FMD (r =-0.54,P ＜ 0.05 ),C2 (r =-0.37,P ＜ 0.05 ).ConclusionsAdministration of folate and Vitamin B12 can reduce the levels of serum Hcy and ET-1 in metformin-treated type 2 diabetic patients,which exert beneficial effect on carotid IMT,FMD and C2.

Objective To construct recombinant human Bcl-2 adenoviral vector. Methods Sense human Bcl-2 cDNA fragment from plasimid pcDNA3 1/bcl-2 was cloned into adenovirus shuttle vector pAdCMV. pAdCMV/bcl-2 and plasmid pJM17 were cotransfected into 293 cells with lipofectamine 2000. Replication defective adenovirus was reproduced and purified. Adenoviral virus DNA was detected with polymerase chain reaction(PCR), and plaque assay was performed to determine the titer of virus. Results Recombinant adenovirus containing bcl-2 target gene was obtained. The titer of virus was 2 0?10 10 pfu/ml. Conclusion High titer of adenovirus containing target gene was successfully obtained by recombinant adenovirus vector.

Objective To explore the effect of hyperglycemia on the survival time, duration of disease remission and complications during induction chemotherapy for acute lymphocytic leukemia(ALL). Methods The treatment-related complications in 98 adult ALL patients with or without hyperglycemia were retrospectively analyzed. Survival time and complete remission duration(CRD) were evaluated using Kaplan-Meier method. Cox regression analysis was used to examine whether hyperglycemia was an independent predictor of disease recurrence and death. Results ALL patients with hyperglycemia were found to be older, and more likely to occur thrombocytopenia. ALL patients with hyperglycemia had a shorter CRD and survival time, and were more likely to develop infection and neuropathy. Conclusion Hyperglycemia during induction chemotherapy for ALL increased the frequency of infection and the risk of disease recurrence and death.

Objective To investigate the toxic effect of immunosuppressive drugs on apoptosis of rat pancreatic islet cells in vitro and the protective action of Bcl-2.Methods Islet cells expressing Bcl-2 and the control islet cells were cultured at different concentrations of tacrolimus and the apoptosis rate of islet cells and insulin accumulation in the culture medium were detected after 48h.Results Low and high concentrations of tacrolimus induced the apoptosis of islet cells and decreased insulin secretion.The Bcl-2 inhibited the apoptosis of islet cells induced by tacrolimus and improved the insulin secretion.Conclusion Tacrolimus may directly damage to isolated rat islet cells and the expression of Bcl-2 can protect the cells from the damage of immunosuppressive drugs.

Objective To investigate the effects of antithyroid drug(ATD) on oxidative stress in Graves disease patients with and without infiltrative ophthalmopathy.Method The levels of superoxide dismutase(SOD),glutathione peroxidase(GPx) and catalase(CAT) in erythrocytes of Graves disease patients(18 with and 20 without infiltrative ophthalmopathy) were measured before and after treatment with ATD.Results Compared with the normal control group,the levels of SOD,GPx and CAT were significantly higher in Graves disease patients with and without infiltrative ophthalmopathy.After euthyroidism was achieved with the treatment of ATD,the levels of SOD,GPx and CAT were normalized in the patients without infiltrative ophthalmopathy,but oxidative stress was still present in the patients with infiltrative ophthalmopathy.Conclusion The oxidative stress is obvious in patients with Graves ophthalmopathy,which suggests that oxidative stress is involved in orbital inflammation.