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[Summary] The aim of the study was to explore the effect and its clinical relevance of short -term intensive insulin treatment on plasma concentrations of lipoprotein-associated phospholipase A 2 ( Lp-PLA2 ) and secretory phospholipase A2(sPLA2) in newly diagnosed type 2 diabetes mellitus (T2DM).Ninety newly diagnosed T2DM patients were recruited and received continuous subcutaneous insulin infusion (CSII) for about 2 weeks.After CSII, sPLA2 levels [173.78 (80.95, 278.09) μg/L] were significantly decreased compared with the levels before [219.33 (130.03, 337.30) μg/L], P <0.01, while no statistic significant changes could be viewed in Lp-PLA2 levels.Correlation analysis showed that the changes of Lp-PLA2 and sPLA2 were both positively correlated with the changes of homeostasis model assessment of insulin resistance(HOMA-IR)after CSII (r=0.537,0.493 respectively, all P<0.05).The Lp-PLA2 and sPLA2 level reduction after CSII might help to protect the patients from diabetic macroangiopathy . Trial registration Chinese Clinical Trial Registry , ChiCTR-TRC-10001618.
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Objective To investigate the features of lipid ratios in patients with newly diagnosed T2DM, and the effects of intensive insulin treatment on them. Methods 90 patients with newly diagnosed T2DM and 58 matched people with normal glucose were enrolled to assess height,weight,waist circumference,blood glucose and lipid profiles. BMI,TC/HDL-C,TG/HDL-C,log(TG/HDL-C),LDL-C/HDL-C,HOMA-B and HOMA-IR were calculated respectively. All the patients received the continuous subcutaneous insulin infusion with insulin pump. The treatment continued for more 10~14 days after blood glucose reached the standard. All the above indi-cators were reexamined after treatment. Results Dyslipidemia in patients with newly diagnosed T2DM mainly showed as hypertriglyceridemia and decreased HDL-C compared to the control group(P<0.05). TC/HDL-C,TG/HDL-C,log(TG/HDL-C)and LDL-C/HDL-C significantly increased in these patients(P<0.01). After short-term intensive insulin therapy,all lipid ratios were significantly decreased and the changes of lipid ratios were positively correlated with the change of HOMA-IR(P<0.05). Conclusion Short-term intensive insulin therapy for patients with newly diagnosed type 2 diabetes can significantly lower the lipid ratios related to HDL-C. The effects may be closely related to improvement of insulin resistance.
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_ Objective_ To evaluate plasma concentrations of lipoprotein-associated phospholipase A2 (LP-PLA2)andsecretoryphospholipaseA2(sPLA2)inpatientswithnewlydiagnosedtype2diabetes,andtoexplore their clinical significance. Methods Oral glucose tolerance test ( OGTT) was carried out in our hospital to all the subjects without history of diabetes. According to the results of OGTT, they were divided into two groups:patients with newly diagnosed type 2 diabetes and subjects with normal fasting glucose and normal glucose tolerance. Anthropometric data such as height, weight, waist circumference, and blood pressure were measured and concentrations of blood glucose, insulin, lipid profile ( including total cholesterol, triglycerides, low density lipoprotein-cholesterol, high density lipoprotein-cholesterol), LP-PLA2, and sPLA2 were determined in both groups. Results Ninety patients with newly diagnosed type 2 diabetes and fifty-eight subjects with normal glucose tolerance were enrolled in our study. As to gender, age, body mass index, blood pressure, and lipid profile, there were no statistically differences between these two groups (P>0. 05). Plasma levels of LP-PLA2 and sPLA2 in diabetic patients were significantly higher than normoglycemic participants [102. 98(76. 34,134. 31) vs 50. 89(23. 71,90. 40) ng/ml, 219. 33 (130. 03,337. 330) vs 78. 55 (75. 15,87. 02) ng/ml, both P<0. 01]. Plasma concentrations of LP-PLA2 and sPLA2 in diabetic patients with atherosclerosis were significantly higher than those without [ 133. 43 ( 111. 54, 145. 17 ) vs 99. 11 ( 63. 02, 130. 85) ng/ml,235. 73 (180. 48, 416. 46) vs 182. 97 (9. 08, 280. 79) ng/ml, both P<0. 05]. LP-PLA2 and sPLA2 were both positively correlated with homeostasis model assessment for insulin resistance (HOMA-IR), while negatively correlated with insulin function index. In a multiple linear regression analysis, LP-PLA2 and sPLA2 were independent correlative factors of HOMA-IR(both P<0. 05). Conclusions Plasma levels of LP-PLA2 and sPLA2 were significantly higher in patients with newly diagnosed type 2 diabetes than in individuals with normal glucose tolerance, even more significant in diabetic patients with atherosclerosis. And their concentrations were both closely related to insulin resistance.
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Objective X-linked adrenoleukodystrophy (X-ALD) is a genetically determined disorder that is characterized by demyelination of central nervous system,and impaired adrenal cortex and abnormal accumulation of very long chain fatty acids in body fluid and tissue.The clinical manifestation,biochemical change,and magnetic resonance imaging were analyzed.Methods Clinical data of 11 cases with X-ALD were summarized and analyzed,including symptoms,signs,and inspection result.Relevant literature was reviewed.Results All cases were males,whose average onset age was (7.2 ± 4.7) year-old.It was (2.4 ± 1.9) years that the mean interval appears from onset to diagnosis.Six cases were with onset of adrenal insufficiency (AI),remaining 5 onset neural symptoms,where plasma very-long-chain fatty acids (VLCFA) was tested in 6 patients,all with abnormally high levels and brain magnetic resonance imaging(MRI) showed demyelination of cerebral white matter in 9 ones.Conclusions ALD is a X-linked genetically determined disorder that mainly affects the nervous system and adrenal gland.Plasma VLCFA test,ALD gene test,and cerebral MRI are reliable diagnostic methods.Early diagnosis and appropriate therapy would improve survival and neurological outcomes.
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Objective To evaluate the effect of angiotensin Ⅱ ( Ang Ⅱ ),angiotensin- (1-7) [ Ang- ( 1-7 ) ],and co-action of Ang Ⅱ and Ang-( 1-7 ) on β cell insulin signaling pathway.Methods Mouse pancreatic β cell line NIT-1 was incubated with( 1 )0,10-7,10-6,10-s,10-4 mol/L concentrations of Ang Ⅱ for 24 h ; ( 2 )0,10-7,10-6,10 -5,10-4 mol/L concentrations of Ang- ( 1-7 ) for 24 h; ( 3 ) co-administration of Ang Ⅱ and Ang- ( 1-7 ) was divided into control,10-5mol/L Ang Ⅱ,10-6mol/L Ang-( 1-7 ),10-5mol/L Ang Ⅱ + 10-6mol/L Ang-( 1-7 ) group.Tyrosine phosphorylation of insulin receptor β subunit(IR-β-Tyr) and serine phophorylation of protein kinase B(Akt-Ser) were detected by Western blot.ResultsInsulin-stimulated IR-β-Tyr and Akt-Ser phosphorylation was significantly decreased in Ang Ⅱ 10-5 and 10-4 mol/L group; no significant changes in insulin-stimulated IR-β-Tyr and Akt-Ser phosphorylation were detected between Ang-( 1-7 ) treatment groups and control; Ang-( 1-7 ) blocked the inhibitory effect of Ang Ⅱ on Akt-Ser phosphorylation,yet exerted no effect on Ang Ⅱ-induced IR-β-Tyr phosphorylation inhibition.Conclusion Ang Ⅱ significantly inhibits insulin signaling pathway in β cell; Ang-( 1-7 ) reverts the inhibitory effect of Ang Ⅱ on insulin-stimulated Akt-Ser phosphorylation in β cell.
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@#Objective To observe the effect of psychological intervention on nosohemia patients during hematopoietic stem cell collection technique. Methods 44 perioperative nosohemia patients were assigned to experiment group and control group. The experiment group took a psychological intervention. Results Anxiety and depression in the experiment group improved better than in the control group (P<0.05) while there was no significant difference in anxiety and depression in the control group after psychological intervention (P>0.05). Conclusion Psychological intervention could effectively reduced the negative emotion of perioperative nosohemia patients during hematopoietic stem cells collection.
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Comparison of assays of immunoreactive insulin (IRI) and specific insulin in evaluating islet β cell function and insulin sensitivity suggested that there were no significant differences in individuals with different glucose tolerance impairment by two assays. The evaluation of islet β cell function using IRI and insulin sensitivity is still valid in clinical practice.
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@#ObjectiveTo relieve the nausea and vomiting caused by chemotherapy in patients with hematologic diseases, and to secure the completion of chemotherapy.Methods320 cases of hematologic patients were divided randomly into 2 groups: the treatment group (160 cases): ondanseton 4 mg and dexamethone 10 mg I.V.; ondanseton group (160 cases): ondanseton 4 mg I.V.ResultsThe effective rate of the treatment group was 98.75%, and that of the ondansetron group was 43.13%. There was a singificantly difference between two groups (P<0.001).ConclusionOndanseton combined with dexamethone has a good effect on the vomiting and nausea induced by chemotherapy.
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@#Objective To investigate the psychological state of patients with aplastic anemia. Methods 54 patients with aplastic anemia and 50 health persons were tested with the questionnaires of SAS and EPQ. Results The score of anxiety and the incidence of anxiety in aplasitc anemia patients were much higher than that in health persons. The score of N in the EPQ was much higher in aplasitc anemia patients than that in health persons. Conclusion Patients with aplastic anemia obviously have the incline of nervosity. It is the nurse' duty to adjust patients' negative emotion to help them recovering from the disease.
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AIM: To investigate the role of the insulin secretion as well as insulin sensitivity in the onset and development of the type 2 diabetes mellitus (T2DM). METHODS: This study included 38 normal glucose tolerance(NGT) subjects without family history of diabetes, 32 NGT and 36 impaired glucose tolerance(IGT) subjects who were the first-degree relatives of type 2 diabetes, and 35 newly-diagnosed type 2 diabetic patients. ? cell function and insulin sensitivity were examined by using oral glucose-insulin release test (OG-IRT) with SIM reflecting insulin sensitivity and intravenous glucose tolerance test (IVGTT) with AIR3-5 reflecting the first-phase insulin secretion function. AIR3-5 was calculated as the average incremental plasma insulin concentration from the third to the fifth minute after the glucose bolus. AIR3-5 and SIM were compared among the four groups. RESULTS : From NGT, IGT to type 2 diabetes, there was a decreasing tendency of the level of AIR3-5 and SIM, with NGT the highest, IGT the medium and T2DM the lowest. The level of the AIR3-5 in the subjects of NGT who were first - degree relatives of type 2 diabetes were lower than those of NGT without family history of diabetes( P 0.05) . CONCLUSION: Insulin secretion dysfunction may be the primary factor in the onset of type 2 diabetes. Along with the developing of IGT and type 2 diabetes, the insulin secretion and sensitivity decrease.