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Objective:To investigate the effect of repeated freezing and thawing on the clinical outcome of embryo transfer.Methods:A total of 48 cycles of twice frozen-thawed embryo (blastocyst) transfer in the reproductive medicine department, Shenzhen Luohu People′s Hospital from 2015 to 2020 were collected as the observation group, and 98 cycles of one frozen-thawed blastocyst transfer in the same period were randomly selected as the control group. The patient′s age, endometrial thickness, average number of transferred embryos, average number of high-quality embryos transferred, embryo recovery rate, implantation rate, clinical pregnancy rate, abortion rate, ectopic pregnancy rate, and live birth rate were compared.Results:There was no significant difference in age, endometrial thickness, number of embryos transferred and high-quality embryos transferred between the two groups (all P>0.05). There was no significant difference in embryo recovery rate, ectopic pregnancy rate, abortion rate and live birth rate between the two groups (all P>0.05). The embryo implantation rate and clinical pregnancy rate in the observation group were significantly lower than those in the control group (32.47% vs 55.70%, 39.58% vs 66.33%, all P<0.05). Conclusions:The clinical pregnancy rate was significantly lower than that of the control group after repeated vitrification of frozen-thawed embryo transfer, which may affect the subsequent developmental potential of embryos.
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Accumulated evidences suggest that reduction in blood pressure may reduce cardiovascular morbidity and mortality in diabetes patients. However, the optimal blood pressure level to which blood pressure should be reduced in diabetes patients have not reached an agreement and significant controversy has surrounded this topic in these years. After reviewing the data from observational studies and clinical trials, we compared the similarities and differences of recommendations about blood pressure target for people with diabetes and hypertension. Based on our study about the 10 years effects of different blood pressure levels on cardiovascular disease events among Chinese adults with different glucose metabolism, we analyzed the critical factors on conducting randomized controlled trials concerning optimal blood pressure level among patients with diabetes or prediabetes.
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ADVANCE study is designed to explore the effects of intensive glucose control and routine blood pressure lowering measures on major macro-and micro-vascular complications in patients with type 2 diabetes.It reveals a series of risk factors of macrovascular disease,and analysis for risk factors will take effective actions to prevent or intervene macrovascular events.
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More and more extrapancreatic actions of incretin-based therapies have been demonstrated and recently case reports have linked glucagon-like peptide-1 (GLP-1) receptor agouist therapy with the improvements in psoriasis.Psoriasis is a common skin disorder characterized by chronic inflammation.Epideminological studies have showed that patients with psoriasis exhibit increased rates of cardiovascular disease,obesity,and type 2 diabetes,owing probably to the enhanced local and (or) systemic inflammation.The observations of anti-inflammatory actions of GLP-1,which exerts direct and indirect actions on immune function,together with the improved psoriasis,offer new insights into the investigation of non-classical anti-inflammatory actions of incretin-based therapeutics and provide a new direction for the research of the novel clinical application of GLP-1.
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Objective To understand patient pathway and clinical characteristics of chronic diseases in urban areas of Shanghai. Methods A total of 10 002 residents were enrolled and assigned to the chronic disease group (including hypertension, diabetes, coronary heart disease, myocardial infarction, and ischemic stroke) and the non-chronic disease group. Body mass index,fasting blood glucose, triglyceride,total cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol were tested.Difference of patient pathway and clinical characteristics of those chronic diseases was compared. Results Above chronic diseases were observed in 37.7% participants. About 2/3 diseases were confirmed and 80% patients were followed up in healthcare units not far away from home. Patients with coronary heart disease and myocardial infarction showed more outpatient visit to tertiary hospitals (P＜0. 05 ). However, patients with ischemic stroke had health check, rehabilitation and pharmacy done mainly in local healthcare centers (P＜0. 05 ). Diastolic blood pressure of patients visiting local doctors was significantly decreased (P＜0. 05). Conclusion Some differences in patient pathway were found in this study. Communication and cooperation between medical institutions should be intensified for effective chronic disease control.
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To analyze and evaluate the knowledge of Chinese Guidelines of Diabetes Prevention and Treatment in Shanghai medical staff. 175 medical staff working in endocrinology or community health were enrolled and evaluated by a questionnaire of guidelines about the state of professional, training, and related knowledge. Only 16. 6% medical staffwere trained about the guidelines( 46. 67% from the general hospitals, 14. 75% from secod-level hospital and 7. 14% persons from the community hospitals, P＜0. 01 ). The total correct answer rate of the guidelines was 37. 36%. The correct rate of community hospitals was lower than others( P＜0. 05 ). The rate of doctors' was higher than nurses'( P＜0. 05 ). There were difference between doctors and nurses with the key point of diabetes care knowledge in different level hospitals. The effective method of clinical training in diabetes care should be explored. We still have to work hard to promote the effect of diabetes control and prevention. Effective training about the guidelines should be enhanced. The cooperation between general hospitals and community health institutions in diabetes prevention and treatment should be enhanced.
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Objective To study the role of pancreatic renin-angiotensin system (RAS) on insulin secretion, proliferation, apoptosis, oxidative stress, and fibrosis of β-cells. Methods The effect of angiotensin Ⅱ on βTC3 cells was studied and the role and mechanism of AT1 R were analyzed with RNAi technology. The expression of AT1 R was measured by Western Blotting. The change of intracellular calcium was detected by microfluorimetry with Furo3-1oaded cells. Peroxide-sensitive fluorescent probe DCFH-DA was used to analyze intracellular ROS by flow cytometry. Real-time PCR was performed to evaluate mRNA levels related to proliferation and fibrosis in βTC3 cells. Apoptosis was detected by flow cytometry and Tunel method. Results Insulin secretion was significantly increased up to four fold and the level of intracellular calcium was sharply increased in response to high glucose in βTC3 cells. Angiotensin Ⅱ has no direct effect on insulin secretion in βTC3 cells and its role in secretion was associated with the role in proliferation. Oxidative stress in βTC3 cells caused by angiotensin Ⅱ may be partially mediated through AT1R, protein kinase C and NAD(P) H. With the decrease of AT1R expression by RNAi technology, apoptosis, and fibrosis of βTC3 cells induced by angiotensin Ⅱ might be ameliorated.Conclusions By means of AT1R, angiotensin Ⅱ plays an important role in insulin secretion, proliferation,apoptosis, oxidative stress and fibrosis in β-cells.
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Betacellulin (BTC) is one of "islets regeneration factors" which received more and more attention these years. BTCe is the C-terminal 50-residue region of mature BTC protein and can bind with erbB-1?erbB-4 receptor. It has the same mitogenic activity on cells as the whole section. BTC and BTCe can improve the level of glucose-stimulated insulin secretion (GSIS) during islets culture in vitro though they had no effect on the acute insulin secretion. BTCe also effectively ameliorated the hyperglycemia of STZ-induced diabetic rats by a single plasmid injection into muscle of rats. It is supposed that BTCe promote the proliferation of PDX-1 positive cells or repair some signal transduction pathway. Perhaps the latter is more important.