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Objective To study the diagnostic value of endoscopic retrograde cholangiopancreatography (ERCP) combined with intraductal ultrasonography (IDUS) for bile duct stricture diseases.Methods The results of endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography,intraductal uhrasonography,bile duct brushing cytology,the liquid-based cytology and the histopathological examination were analyzed retrospectively.The final diagnosis was made based on clinical data,histopathology and follow-up results(≥4 months).Results Twenty-one patients were diagnosed as having malignant biliary diseases,including 9 biliary tract carcinoma,4 duodenal papilla carcinoma,4 pancreatic cancer infiltrated common bile duct,4 cancer of the liver infiltrated common bile duct ; 15 were diagnosed as having benign biliary diseases,including 9 bile duct stones,4 liver fluke disease,lbile duct inflammatory stenosis,1 bile duct stricture caused by external compression.The accuracy rate of the EUS,ERCP,IDUS and ERCP + IDUS in the differential diagnosis of the bile duct stricture disease were 77.8％,88.9％,91.7％ and 94.4％,respectively.The accuracy rates of IDUS,ERCP,ERCP combined with IDUS were significantly higher than that of EUS (P ＜ 0.05).The sensitivity,specificity,positive predictive value and negative predictive value of ERCP combined with IDUS were 95.2％,93.3％,95.2％ and 93.3％ respectively which were higher than those of EUS,ERCP and IDUS.After the bile duct brushing cytology and the liquid-based cytology or histopathological examination,19 patients were diagnosed as having malignant biliary diseases,17 were benign biliary diseases.The sensitivity,specificity and accuracy of the procedures for malignant bile duct stricture disease were 90.5％,100.0％,94.4％ respectively.Conclusion ERCP combined with IDUS can improve the diagnostic accuracy.The diagnostic positive rate will be higher with the help of ERCP,IDUS and targeted brush.
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AIM To study the glucose and lipids metabolis m and insulin sensitivity of MSG rats during their growing period, and to evalua te the effects of insulin sensitizer pioglitazone on the model rats. MET HODS Body weights were measured regularly, and glucose and insulin tole rance tests were taken. In their 3 and 10 months old, rats were given insulin se nsitizer pioglitazone orally, then the effects on serum glucose, triglyceride, c holesteral, free fatty acid and insulin concentrations were determined. RESULTS Compared with normal rats, a slight but significant increase of glucose in MSG rats was revealed. The serum triglyceride, cholesteral, free fat ty acid and insulin concentrations were significantly higher in model rats. More over, gluconeogenesis increased significantly, and insulin tolerance showed abno rmal. However, glucose tolerance was nearlly normal. Pioglitazone could ameliora te all these metabolic disorders. CONCLUSION Obesity and insuli n resistance were induced by injecting monosodium glutamate (MSG) to neonatal Wi star rats. Pioglitazone can significantly improve the insulin sensitivity of MSG rats. These results suggested that MSG obese rats can be used as an easily acce ssible and inexpensive insulin resistance animal model for evaluating the effica cy and mechanisms of antidiabetic agents.
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Peroxisome proliferator activated receptor(PPAR), a member of the hormone receptor superfamily, is a key regulating factor in adipocyte differentiation and lipids metabolism. Recently, with the increased understanding of the precise mechanisms of TZD, thiazolidinedione class of insulin sensitizer, PPAR? has also been identified as the major functional receptor for the drugs. In the study of the relationship between PPAR and insulin resistance, considerable gaps appeared. TZD induced activation of PPAR? is known to promote insulin sensitivity. More interestingly, however, PPAR? +/- heterozygous mice were shown to be less susceptible to insulin resistance. These findings suggest that the relationship between PPAR activation and insulin sensitivity improvement is not simplely positively related. A better understanding of the role of PPAR in insulin action system will be critical in developing more efficacious and safe agents that act on PPAR and benefit patients with type 2 diabetes.
ABSTRACT
AIM To study the glucose and lipids metabolism and insulin sensitivity of MSG rats during their growing period, and to evaluate the effects of insulin sensitizer pioglitazone on the model rats. METHODS Body weights were measured regularly, and glucose and insulin tolerance tests were taken. In their 3 and 10 months old, rats were given insulin sensitizer pioglitazone orally, then the effects on serum glucose, triglyceride, cholesteral, free fatty acid and insulin concentrations were determined. RESULTS Compared with normal rats, a slight but significant increase of glucose in MSG rats was revealed. The serum triglyceride, cholesteral, free fatty acid and insulin concentrations were significantly higher in model rats. Moreover, gluconeogenesis increased significantly, and insulin tolerance showed abnormal. However, glucose tolerance was nearlly normal. Pioglitazone could ameliorate all these metabolic disorders. CONCLUSION Obesity and insulin resistance were induced by injecting monosodi- um glutamate (MSG) to neonatal Wistar rats. Piogli- tazone can significantly improve the insulin sensitivity of Msc rats. These results suggested that MSG obese rats can be used as an easily accessible and inexpensive insulin resistance animal model for evaluating the efficacy and mechanisms of antidiabetic agents.
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Vanadium (V) is one of the trace elements It exists in many oxidation states which exhibit different biological activities. Our results in alloxan diabetic mice suggest that NaVO3 and VOSO4 can decrease blood glucose level. The hy-poglycemic effest of VOSO4 was found to be weaker than that of NaVO3, the toxicity ofVOSO4 is also lower. However VOSO4; showed no effect in normal mice. The mechanism of the hypoglycemic effect of VOSO4 appears to be similar to that of insulin.
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The therapeutic effect of a natural foodstuffs--Wei-Luo powder (WLP)composed of high protein, various essential amino acids, vitamins (B1, B2 and E), and trace elements (Fe, Zn, etc), on both monosodium glutamate (MSG) induced obese mice and alloxan diabetic mice were tested. After 16 days of feeding with WLP diet, the body weight and accumulation of fat in liver and adipose tissue (Lee index) in MSG mice were decreased significantly, WLP diet also caused significant reduction in carbohydrate tolerance of mice as compared with wheat diet. In addition, improvement of hyperglycemia and diabetic symptoms (polydipsia, polyuria and hyperphagia) in alloxan diabetic mice were observed. These results suggest that WLP diet may be beneficial for obesity and diabetic patients.
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The therapeutic effects of a high fibre diet composed of naturally high fibre foodstuffs containing protein, various essential amino acids and trace elements (Zn, Cr etc.) on diabetics were tested both experimentally and clinically. The high fibre diet or steamed bread (for control) with identical carbohydrate content was taken by normal mice, alloxan diabetic mice and nine healthy volunteers. The high fibre diet caused significant reduction in the blood glucose area (carbohydrate tolerance) as compared with the steamed bread. In another study, eighteen non-insulin dependent diabetic patients (10 females, 8 males) were administered the high fibre diet for 34 days, the average fasting and 2 h postprandial blood glucose level were significantly lower than those before the test, but no difference was observed in blood electrolytes. This implied that no malabsorption occurred during the testing period. At the same time, 16 of the 17 overweight patients were found to have a reduction of weights. In addition, improvement of symptoms (poly-dipsia polyuria, constipation etc) both in diabetic animals and in patients was observed. This study indicates that the high fibre diet is benificial for diabetic patients.