1.Effect of Precocious Puberty on Glucose and Lipid Metabolism in Female Rats
Xiaoya LIN ; Baojiang HUANG ; Jun ZHANG ; Song GUO ; Huamei MA ; Yanhong LI ; Minlian DU ; Qiuli CHEN
Journal of Sun Yat-sen University(Medical Sciences) 2024;45(2):233-242
ObjectiveTo explore the effect of precocious puberty on glucose metabolism and lipid metabolism in female rats. MethodsSixty two-day-old female rats were randomly divided into 2 groups. When aged 5 days, the precocious puberty group and normal group were given a single subcutaneous injection of danazol and solvent soybean oil respectively. The vaginal opening of rats was monitored from their 21 days of age. After 12 hours of fasting, all successful modeling rats were randomly executed within 3 days after vaginal opening, when aged 7 and 12 weeks. Then we measured the rats’ body weight and length, determined the concentrations of glucose, insulin, blood lipids, estradiol, leptin and adiponectin with enzyme-linked immunosorbent assay and observed the pathological changes of perirenal fat, uterus and ovary. ResultsFor body weight and length, rats in the precocious puberty group were smaller than those in the normal group within 3 days after vaginal opening, but which did not affect their subsequent growth and development, and there was no significant difference between the two groups at 7 and 12 weeks of age. Within 3 days after vaginal opening, insulin levels had significant difference between the two groups (P = 0.001), the precocious group showed hyperinsulinemia and increased number of perirenal adipocytes. At three execution times, no significant difference was noted in estradiol, leptin and adiponectin levels between the two groups. The same was true in the ratios of ovary or uterus to body weight between the two groups. ConclusionsPrecocious puberty makes earlier onset of pubertal development and allows body maladaptation to the sudden changes of the internal environment. However, the changes due to precocious puberty are temporary and reversible, and they may become normal in adulthood.
2.Analysis and Discussion of Clinical Features of Complete Androgen Insensitivity Syndrome Combined with Müllerian Duct Remnants
Shanjiao QIU ; Yuying XU ; Jun ZHANG ; Delu CHEN ; Cheng XU ; Huamei MA ; Juncheng LIU ; Shaobin LIN
Journal of Sun Yat-sen University(Medical Sciences) 2024;45(6):1026-1035
[Objective]To present a case of complete androgen insensitivity syndrome (CAIS) coexisting with Müllerian duct remnants (MDR) and to review previous reports in the literature to enhance the understanding of the clinical manifestations and pathophysiology of CAIS.[Methods]The study aimed to diagnose complete androgen insensitivity syndrome (CAIS) by conducting physical examinations,chromosomal analysis,whole exome sequencing,laboratory tests including follicle-stimulating hormone (FSH),luteinizing hormone (LH),total testosterone,estradiol,anti-Müllerian hormone (AMH),inhibin B,dehydroepiandrosterone sulfate (DHEAS),androstenedione,17-hydroxyprogesterone,and imaging studies such as pelvic ultrasound and pelvic magnetic resonance imaging (MRI). Laparoscopy revealed the presence of Müllerian duct structures. Additionally,the study reviewed similar cases of CAIS combined with Müllerian duct remnants reported in the literature.[Results]The child presented with female phenotype,elevated levels of FSH,LH,and testosterone. Pelvic MRI showed bilateral cryptorchidism without visible uterus or fallopian tubes. The chromosomal karyotype was 46,XY,and whole exome sequencing identified a pathogenic variant in the androgen receptor (AR) gene,c.2359C>T (p.Arg787*). No abnormalities were found in the AMH and AMHR2 gene tests. Laparoscopic exploration revealed underdeveloped testes and an underdeveloped uterus. Pathology showed the presence of fallopian tube-like structures next to the testicles. A total of 11 cases with genetically confirmed diagnosis of CAIS coexisting with MDR were retrieved from the database. The findings suggest that the initial clinical presentation,biochemical data,and gonadal pathology of CAIS with MDR are similar to those without MDR.[Conclusion]The study reports a patient with CAIS coexisting with MDR,which broadens the clinical spectrum of CAIS and provides a perspective for basic research on Müllerian duct regression that is independent of the AMH-AMHR2 signaling pathway.
3.Adiponectin gene polymorphism and postpartum type 2 diabetes in pregnant women with gestational diabetes mellitus
Xianghua LYU ; Yun CHAI ; Na XIAN ; Yanan ZHANG ; Yaqi FENG ; Danni XU ; Huamei JIANG
Journal of Chinese Physician 2024;26(2):191-195
Objective:To investigate the relationship between adiponectin (ADIPOQ) gene polymorphism and postpartum type 2 diabetes mellitus (T2DM) in pregnant women with gestational diabetes mellitus (GDM).Methods:A retrospective study was conducted on 236 GDM postpartum women admitted to the Affiliated Hospital of Jining Medical College from June 2020 to June 2021 as observation subjects. They were divided into a T2DM group and a non T2DM group based on the occurrence of T2DM after delivery. The clinical data of the two groups were compared. The double deoxygenation end termination method was used to detect the single nucleotide polymorphism (SNP) of the ADIPOQ gene, and the four loci rs17366568, rs822395, rs1501299, and rs2241766 were classified. The relationship between ADIPOQ genotype polymorphism and postpartum T2DM was analyzed using a logistic regression model.Results:The G allele carrying the rs2241766 locus in ADIPOQ gene was negatively correlated with the occurrence of T2DM ( OR=0.71, 0.68, P<0.05). Compared with T2DM patients with TT genotype, the GT+ GG genotype at the rs2241766 locus had a lower risk of occurrence for gestational age ≥2 and HbA 1c>85%. Similarly, T2DM patients with pre pregnancy body mass index (BMI)>25 kg/m 2 were more likely to be carriers of the rs2241766 TT genotype ( P=0.026). The (GT+ TT) genotype carrying the T allele at the rs1501299 locus was a protective factor for gestational age and HbA 1c in T2DM patients. Conclusions:The rs2241766 and rs1501299 polymorphisms of the ADIPOQ gene are associated with susceptibility to postpartum T2DM in GDM women. Individuals with rs2241766 and rs1501299 mutant genotypes belong to the high-risk population for T2DM.
4.Visualization of Brain Abnormal β-Amyloid Deposition in Alzheimer's Disease Based on 18F-Florbetaben PET Imaging
Huamei LIN ; Yunhao YANG ; Jiaying LU ; Zhengwei ZHANG ; Shufen CHEN ; Jingjie GE ; Yihui GUAN ; Chuantao ZUO
Chinese Journal of Medical Imaging 2024;32(5):420-425
Purpose To investigate the characteristics of 18F-Florbetaben(18F-FBB)β-amyloid(Aβ)PET imaging in different brain regions of Alzheimer's disease(AD)patients with different degrees of cognitive impairment,and to explore the correlation between Aβ deposition and cognitive dysfunction.Materials and Methods A total of eighteen patients with a clinical diagnosis of probable AD from August 2022 to October 2023 were retrospectively included in Huashan Hospital.All patients had Aβ abnormal deposition in the brain as confirmed by 18F-FBB PET imaging.According to the severity of symptoms,they were divided into the AD-induced mild cognitive impairment(MCI)group(8 cases)and the dementia group(10 cases).In addition,12 healthy controls were included.First,the standardized uptake value ratio of abnormal Aβ deposition in the frontal lobe,lateral parietal lobe,lateral temporal lobe,anterior and posterior cingulate gyrus,and compound cortex was semi-quantitatively calculated and compared among the three groups based on the subjects'brain MRI and automated anatomical labeling template.The correlation between the degree of Aβ deposition in the brains of AD patients and cognitive scale scores(mini-mental state examination,Montreal cognitive assessment)was then further analyzed.Results The standardized uptake value ratio values of Aβabnormal deposition in the frontal lobe,lateral temporal lobe,lateral parietal lobe,anterior and posterior cingulate cortex and compound cortex in the AD-induced MCI and dementia groups were significantly higher than those in the healthy controls(t=7.442-9.151,all P<0.05).However,there was no significant difference in the standardized uptake value ratio values of Aβ abnormal deposition in the above brain regions between the MCI and dementia groups(t=0.312-0.996,all P>0.05).In addition,there was no significant correlation between the degree of Aβ deposition in the brain and the cognitive scale scores(mini-mental state examination,Montreal cognitive assessment)in the AD-induced MCI and dementia groups(r=-0.049-0.050,all P>0.05).Conclusion Aβ deposition in the brains of AD-induced MCI and dementia is significantly higher than in the healthy controls.However,Aβ deposition cannot identify AD patients with different degrees of cognitive impairment,reflecting that Aβ deposition has certain limitations in assessing the severity of clinical symptoms of AD.
5.FBN1 gene mutation in a Chinese pedigree of mild Geleophysic dysplasia type 2/Acromicric dysplasia and the exploration of growth-promoting therapy
Mengtian HUANG ; Qiuli CHEN ; Huamei MA ; Yanhong LI ; Jun ZHANG ; Song GUO
Chinese Journal of Endocrinology and Metabolism 2023;39(6):492-498
Objective:To summarize the clinical and genetic features of 7 patients with a mild form of Geleophysic dysplasia type 2(GD2)/Acromicric dysplasia(AD) induced by fibrillin 1(FBN1) gene mutation from one Chinese family.Methods:A Chinese pedigree of mild GD2/AD treated at the Pediatric Endocrinology Department at the First Affiliated Hospital of Sun Yat-sen University between August 2017 and May 2022 was collected. Whole-exome genetic sequencing of the FBN1 gene were performed to establish the diagnosis. Additionally, a literature review was further conducted.Results:In this family, among 13 individuals spanning three generations, there were 7 affected cases, including 1 adult female, 1 adult male, and 5 children. All individuals exhibited postnatal growth failure, severe disproportionate short stature, and lacked typical facial features. Exome sequencing and Sanger sequencing confirmed the presence of a heterozygous missense mutation c. 5099A>G(p.Tyr1700Cys) in exon 42 of the FBNI gene in 6 affected individuals(Ⅱ-1, Ⅲ-1 to Ⅲ-5), which was identified as a pathogenic mutation. This mutation was previously reported in a Chinese classical achondroplasia(AD) family. Based on comprehensive genetic analysis, clinical features, and multisystem evaluation, 3 cases were diagnosed with mild type 2 growth hormone deficiency(GD2), and 4 cases were diagnosed with mild AD. Recombinant human growth hormone(rhGH; 1.1-1.4 IU·kg -1·week -1) was applied to all the 5 children, and additional gonadotropin releasing hormone analogue(GnRHa) was administered to the 2 girls in late puberty, resulting in certain growth-promoting effect. Conclusions:The c. 5099A>G(p.Tyr1700Cys) mutation not only leads to the classical type of achondroplasia(AD) as reported in the literature but also causes the non-classical GD2 or AD(mild GD2/AD). Further research is warranted to investigate the long-term therapeutic effects of rhGH treatment.
6.Hyper-reactive platelets and type 2 diabetes.
Journal of Central South University(Medical Sciences) 2022;47(3):374-383
Type 2 diabetes mellitus is a progressive process. With the course of the disease progress, microvascular and macrovascular complications always happen. Thrombotic events caused by macrovascular complications, including coronary heart diseases and cerebrovascular diseases, are the main fatal factor for the patients with type 2 diabetes. Endothelial dysfunction, coagulative activation, impaired fibrinolysis, together with hyper-reactive platelets contribute to the diabetic prothrombotic state, which is strongly related to the macrovascular complications. In particular, the hyper-reactive platelets play a fundamental role among them. Type 2 diabetes is characterized by several metabolic dysfunctions such as hyperglycemia, insulin resistance and shortage, oxidative stress, systemic inflammation, obesity, and dyslipidemia. These metabolic dysfunctions work together to promote the formation of hyper-reactive platelets, which are distinctive in type 2 diabetes. The regular antiplatelet drugs, like aspirin, show limited inhibitory effect on them. Hence, studying the mechanism behind the hyper-reactive platelets could provide a brand-new view on the prevention of macrovascular complications and cardiovascular events in type 2 diabetes.
Blood Platelets
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Diabetes Mellitus, Type 2/drug therapy*
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Humans
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Hyperglycemia/complications*
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Insulin Resistance
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Obesity/complications*
7.Advances in the treatment of ovarian cancer with BRCA gene mutation
Yadi ZHANG ; Yanli ZHOU ; Huamei LI ; Yanli FENG
Clinical Medicine of China 2021;37(5):470-473
Ovarian cancer is the most fatal malignant tumor in female reproductive system tumors.In most women, it is diagnosed in a late stage, which largely leads to the poor prognosis of ovarian cancer.Breast cancer susceptibility gene (BRCA) is an important DNA homologous repair gene, which plays a major role in the normal cellular DNA repair mechanism.Its mutation will lead to homologous recombination defects, which will affect the stability of the genome and lead to occurrence of tumors.In recent years, BRCA genetic testing has become a key step in the risk assessment, prognosis, treatment and prevention of ovarian cancer.
8.Evaluation of the consistency and detection capability of seven domestic 2019-nCoV nucleic acid detection kits
Dan XIONG ; Lijuan KAN ; Mengmeng WANG ; Huamei TANG ; Wei WU ; Guiqing YANG ; Fei ZHUO ; Xiaowen DOU ; Dayang CHEN ; Xiang JI ; Zengyan ZONG ; Xiuming ZHANG
Chinese Journal of Laboratory Medicine 2020;43(8):787-793
Objective:To compare the consistency and detection capability of seven 2019-nCoV nucleic acid detection kits, and provide reference for detection method selection of clinical laboratory and diagnosis of new coronavirus pneumonia.Methods:Two batches of pharyngeal swab samples were collected from tenpatients with confirmed infection of 2019-nCoV and 10 suspected patients with negative 2019-nCoV test results during January 29 to February 5, 2020 in Shenzhen Luohu People′s Hospital. Seven kinds of kits were labeled as ato g and used for nucleic acid detection respectively to evaluate the consistency of the test results of the clinical samples. A 2019-nCoV positive specimen was selected and diluted to 5-concentration gradient plates (Level-1 to 5) with RNase-free water. The positive detection rate and intra-batch repeatability of different brands of kits were compared.Results:The negative and positive coincidence rates of twenty clinical samples tested by six kinds of kits were 100%, and the positive and negative coincidence rate was 8/10 and 10/10 for the other kit, respectively. The results of intra-batch repeatability showed the CVs of viral loads tested by these seven kits were all less than 5%. In the concentration range of Level-1 to 3, the detection capability for open reading frame (ORF)1ab gene of Kit b,d and f was lower than Kit a,c,e and g, and the detection capability of kit e and g was the highest (14/15). The detection capability for N gene of Kit a (15/15) was higher than the other 5 kits. The comprehensive analysis of the detection capability for ORF1ab and N gene showedthat Kit d had the lowest detection capability (ORF1ab:40%,N:53%), and there was no significant difference in the detection capability of Kit a, b, c, e, and f.Conclusions:There was no significant difference in the accuracy and repeatability of the seven kits for positive samples with high viral loads, and the detection performance was good; but some kits had poor detection capability for weak positive samples. It is suggested that the weak positive samples should be rechecked by at least two manufacturers′ kits to ensure the accuracy of the results.
9.A survey on standardized training of trauma surgeons in Shanghai
Li ZHU ; Ying XU ; Yanyun CHEN ; Jian FAN ; Huamei YAN ; Li ZHANG
Chinese Journal of Orthopaedic Trauma 2020;22(11):983-988
Objective:To investigate the current state of standardized training in trauma surgeons in medical institutions in Shanghai.Methods:Questionnaire surveys, focus discussions and expert conferences were conducted to investigate the professional background, status of standardized training on trauma care knowledge, training needs and suggestions in 236 trauma surgeons in 25 Shanghai medical institutions.Results:The investigation revealed that only 59.3% (140/236) of the trauma surgeons had received a standardized training on trauma care knowledge. Of them, those who participated in the training by an international, domestic and local medical institution accounted for 26.4% (37/140), 47.1% (66/140) and 84.3%(118/140), respectively. Only 83 surgeons (70.3%) received regular training and most of them 66.3% (55/83) did in a low frequency of 1-2 times a year. Only 12.7% (15/118) of the surgeons received a training course of ≥48 classes (45 min per class) in the past 3 years. The training courses by medical institutions were mostly lectures on theoretical knowledge and training of a single skill while the simulated scenario drills accounted for less than 48.3%(57/118). The surgeons who had received a standardized training on trauma care were more likely to use their training knowledge to grade and score the patients with trauma, significantly more than those who had not( P<0.05). Conclusions:The coverage, time or frequency of standardized training on trauma care was not enough in Shanghai. The standardized training of trauma care surgeons should be strengthened in all medical institutions and be supervised by the management administration. A set of standardized materials and assessment standards for trauma care training should be formulated as soon as possible which fits the domestic conditions in China. Training bases should be established in Shanghai for standardized care of severe trauma and trauma specialists. A training system for trauma specialists should be established to promote traumatology in shanghai.

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