Maffucci syndrome: a case report and review of the literature / 中华内分泌代谢杂志

Maffucci syndrome is characterized by multiple enchondromas and multiple hemangiomas. Here we report on a 24-year-old woman who was diagnosed with Maffucci syndrome. Our report reviews the literature and outlines of the treatment and management plans for patients with this rare and potentially dangerous disease.

A case of atypical cholesterol side chain defect possibly caused by CYP11A1 heterozygous mutation / 中华内分泌代谢杂志

This paper reports a case of atypical cholesterol side chain enzyme deficiency caused possibly by CYP11A1p.A359V heterozygous mutation. The patient was diagnosed as congenital adrenal hyperplasia because he was born with gonadal dysplasia and there were manifestations of salt losing and pigment changing, combined with high level of plasma ACTH. Further genetic screening revealed CYP11A1p.A359V heterozygous mutations in patients with a final diagnosis of cholesterol side chain enzyme deficiency which was treated effectively to glucocorticoid.

Subclinical hypothyroidism and endocrine metabolic characteristics in women with polycystic ovary syndrome / 中南大学学报(医学版)

Objective:To explore associations of subclinical hypothyroidism (SCH) with endocrine metabolic characteristics in women with polycystic ovary syndrome (PCOS).Methods:A total of 321 women who were newly diagnosed as PCOS were recruited from two endocrine outpatient clinics.The diagnosis of PCOS was established according to the 2003 Rotterdam consensus criteria.Thyroid function was examined by chemiluminescent immunoassay.Patients who had normal free thyroxine (FT4) were divided into different SCH subgroups according to two thyroid stimulating hormone (TSH) cutoffpoints (4.2 and 2.5 mU/L).Endocrine metabolic characteristics in different subgroups were compared and analyzed.Results:In PCOS women with normal FT4,the patients with TSH ≥ 4.2 mU/L had higher prolactin (PRL),luteinizing hormone-to-follicle stimulating hormone ratio,and visceral adipose index (all P<0.05).There were trends toward an increase in triglyceride (P=0.085) and a decrease in high-density lipoprotein cholesterol (HDL-C) (P=0.060) in the patients with TSH ≥ 4.2 mU/L compared with that in the patients with TSH<4.2 mU/L.Also in PCOS women with normal FT4,the patients with TSH ≥ 2.5 mU/L had higher body mass index,PRL,triglyceride,visceral adipose index and lower HDL-C in comparison of that in the patients with TSH<2.5 mU/L (all P<0.05).Conclusion:SCH is associated with more severe endocrine abnormality,dyslipidemia,and visceral obesity in PCOS women.PCOS women with normal FT4 and endocrine metabolic characteristics are more prone to be different between the SCH group and the euthyroid group when setting 2.5 mU/L as a TSH cutoff for SCH,indicating that 2.5 mU/L is a good TSH cutoff for SCH in PCOS women.

Biphasic insulin aspart 30 improved glycemic control in Chinese patients with type 2 diabetes poorly controlled on oral glucose-lowering drugs: a subgroup analysis of the A₁chieve study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The effectiveness and safety of initiating biphasic insulin aspart 30 in patients who were poorly controlled on oral glucose-lowering drugs were studied in randomized controlled trials, while results from clinical practice remain limited. This subgroup analysis was to provide such findings from a large-scale non-interventional study.</p><p><b>METHODS</b>A1chieve was a multinational, prospective, open-label, non-interventional, 24-week study in patients with type 2 diabetes initiating insulin analogues in 28 countries across Asia, Africa, Europe, and Latin America. After physician had taken the decision to use this insulin, any patient with type 2 diabetes who was not treated with or who had started the study insulin within 4 weeks before inclusion was eligible. Patients were treated with study insulin alone or in combination with oral glucose-lowering drugs. Data on adverse drug reactions, hypoglycemia and glycemic control were collected at baseline, week 12 and 24. This is a report of a Chinese subgroup analysis from the A1chieve study.</p><p><b>RESULTS</b>Totally, 4 100 patients constituted this subgroup. No serious adverse drug reactions were reported. Rates of total, major, nocturnal hypoglycemic events (events/patient per year) were 1.47, 0.10, 0.31 at baseline and 1.35, 0.00, 0.22 at week 24, respectively. Glycemic control was improved as measured by hemoglobin A1c (mean 9.3% to 7.0%, reduction -2.3%), fasting plasma glucose (mean 10.2 to 6.8 mmol/L, reduction -3.5 mmol/L) and postprandial plasma glucose (mean 14.4 to 8.8 mmol/L, reduction -5.6 mmol/L), all P < 0.001. Change in mean body weight was +0.3 kg (P < 0.001).</p><p><b>CONCLUSION</b>In this subgroup analysis of the A1chieve study, biphasic insulin aspart 30 improved glycemic control with low risk of hypoglycemia.</p>

Metformin and rosiglitazone maleate tablets ameliorate insulin resistance and hyperandrogenism in obese and nonobese women with polycystic ovarian syndrome / 中华内分泌代谢杂志

Objective To evaluate the therapeutic effects of metformin hydrochloride and rosiglitazone maleate tablets on insulin resistance and androgen concentration in obese and nonobese women with polycystic ovarian syndrome (PCOS).Methods Seventy women with PCOS were enrolled into this study according to the diagnostic criteria of Rotterdam conference (2003).The women with PCOS were divided into the over weight/obese group (body mass index ≥ 25 kg/m2,n =34) and the nonobese group (body mass index＜25 kg/m2,n =36).All women with PCOS took metformin hydrochloride and rosiglitazone maleate tablets twice daily for 3 months.The following indexes were measured before and after the treatment:height,weight,waist circumference,hip circumference,fasting plasma glucose,fasting plasma insulin,luteinizing hormone (LH),follicle stimulating hormone (FSH),total testosterone,free testosterone,follicular number and ovarian area,body mass index,waist to hip ratio,and homeostasis model assessment for insulin resistance (HOMA-IR) were calculated.Results (1) Compared with the nonobese group,dramatic increases in HOMA-IR and follicle number were observed in over weight/obese group(P＜0.05),while LH,LH/FSH,total testosterone,free testosterone showed no significant difference between two groups.(2) After the treatment with metformin hydrochloride and rosiglitazone maleate tablets,weight,body mass index,fasting plasma glucose,fasting plasma insulin,HOMA-IR significantly decreased in two groups (P ＜ 0.05).There were also significant declines of LH,LH/FSH,free testosterone,ovarian area,follicular number,especially in the over weight/ obese women with PCOS (P＜0.05),while total testosterone and FSH did not change significantly.(3) The incidence of gastrointestinal adverse reactions in nonobese and over weight/obese group was 9.3％ and 6.3％ respectively,and no liver toxicity,edema,hypoglycemia and other adverse reactions was observed during treatment.Conclusion Compared with the nonobese group,there were severer insulin resistance and more marked polycystic change of ovary in over weight/obese women with PCOS,while total testosterone and free testosterone showed no significant difference between two gruops.Metformin hydrochloride and rosiglitazone maleate tablets can ameliorate insulin resistance and polycystic ovary,and also reduce body mass index and free testosterone in women with PCOS particularly in the over weight/obese individuals.

Effect of blood glucose fluctuation and the sustained high blood glucose on renal pathological change and collagen IV expression in diabetic rats / 中南大学学报(医学版)

Objective:To observe the effect of blood glucose lfuctuation and the sustained high blood glucose on renal pathological change and collagen IV (Col IV) expression in diabetic rats. Methods:hTe 60 male Sprague-Dawley (SD) rats were randomly assigned into a normal control group (NC) and a model group (DM). hTe rats in the normal control group were fed with normal diet, while the rats in the model group were fed with high-sucrose-high-fat diet for 6 weeks. Atfer that,streptozocin (STZ, 30 mg/kg) was injected to induce diabetic model. The model group was then randomly divided into 2 subgroups:a sustained high blood glucose group and a fluctuation blood glucose group (animals in the latter group were subcutaneously injected with insulin twice daily). Rats were sacriifced atfer 3 months and kidney tissues were dissected for HE and PAS staining, Col IV immunohistochemistry and Western blot. Results:Compared with the normal control group, the renal glomeruli and capillary basal membrane in the diabetic rats was getting larger and thicker, respectively;the capsular space and ground substance was extended and increased, respectively;the volume of renal tubule, kidney hypertrophy index, glomeruler sclerosis index and Col IV content were all increased in the diabetic rats (P Conclusion:The capillary basal membrane of kidney in diabetic rats is thicker and the ground substance is increased. The degree of glomeruler sclerosis is more serious in the blood glucose lfuctuation group compared with the sustained high blood glucose group, which is conifrmed by the increased level of Col IV.

Knowledge of blood sugar control standard brings the higher attainment rate of HbA1c / 中南大学学报(医学版)

Objective:To analyze the important controllable factors which affect the glycemic control of diabetes. Methods:A cross-sectional study was carried out to examine the role of relevant characteristics in glycemic control by a sampling investigation of 430 diabetic patients in Hunan, China. A questionnaire was designed for personal interviews to collect data. Univariate regression analysis and multiple linear regression analysis were used to evaluate the effects of various factors on glycated hemoglobin A1c (HbA1c) control. Results:hTe level of HbA1c in 430 patients was (8.7±2.6)%, and the value in 34%patients among them was ≤7.0%. Base on univariate regression analysis some factors were associated with good HbA1c control, including age, diabetic education, self monitoring of blood glucose, knowledge of blood sugar control standard, living environment, and self-owned glucometer. However, the upgraded treatment was associated with poor control. Based on multiple linear regression analysis, the ifrst four factors mentioned above were protective factors for HbA1c while upgraded treatment was risk factor for HbA1c. Conclusion:Knowledge of blood sugar control standard, diabetic education and self monitoring of blood glucose are important controllable factors for better glycemic control of diabetes.

Effect of intermittent high glucose on synthesis of nitric oxide in human umbilical vein endothelial cells and its mechanism / 中南大学学报(医学版)

OBJECTIVE@#To compare the effect of intermittent and constant high glucose media on the synthesis of vascular relaxing factor nitric oxide (NO) in cultured human umbilical vein endothelial cells (HUVECs), and to investigate its mechanism.@*METHODS@#HUVECs were exposed to 5.5 mmol/L glucose (normal control), 20 mmol/L glucose (constant high glucose), and 5.5 mmol/L alternating with 20 mmol/L glucose (intermittent high glucose) for 7 days. The NO level was measured using Griess Reaction in cell culture supernatants; the expressions of PI3K, PKB and eNOS mRNA and protein were measured with RT-PCR or Western blot.@*RESULTS@#NO level in the intermittent high glucose group was significantly lower than that in the constant high glucose group (P<0.05). The expression of PI3K, PKB, and eNOS in the intermittent high glucose group was significantly lower than that in the constant high glucose group (P<0.05).@*CONCLUSION@#Intermittent high glucose could be more deleterious to endothelial cells than constant high glucose, and may lead to decrease synthesis of NO by inhibiting PI3K/PKB/eNOS pathway activation.

Involvement of JNK signal transduction pathway in endothelial cell apoptosis induced by intermittent high glucose / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the effect of intermittent high glucose on the apoptosis of human umbilical vein endothelial cells (HUVECs) and its mechanism.@*METHODS@#Intermittent high glucose and constant high glucose were applied to HUVEC-12 for 7 days. Flow cytometer and fluorescent staining with Hoechst 33258 were used to detect apoptosis of HUVEC-12. The superoxide dismutase (SOD) activity and the content of malonaldehyde (MDA) in culture solution were detected with colorimetry, and the changes of p-JNK level were examined by Western blot.@*RESULTS@#The apoptosis rate was obviously higher in the intermittent high glucose group than that in the constant high glucose group (P < 0.05). The SOD activity was significantly lower in the intermittent high glucose group (P < 0.05), but MDA level was higher than those of constant high glucose(P < 0.05). SP600125, the inhibitor of JNK, decreased the apoptosis rate induced by intermittent high glucose (P < 0.05). Antioxidant (Vitamin C) inhibited the p-JNK, decreased the apoptosis rate (P < 0.05).@*CONCLUSION@#Intermittent high glucose is easier to worsen the proapoptotic effects on HUVECs than that of constant high glucose, which may account for the increased oxidative stress, and then activates JNK signal transduction pathway.

Association of PTP1B gene polymorphism with obesity in Chinese children / 中南大学学报(医学版)

Objective To investigate the distribution characteristics of protein tyrosine phosphatase 1B (PTP1B) gene IVS6+G82A and Pro303Pro polymorphisms in Chinese children and determine the effect of PTP1B gene IVS6+G82A and Pro303Pro polymorphisms on the pathogenesis of childhood obesity. Methods A total of 147 Chinese obese and 118 healthy children were randomly selected and enrolled to identify IVS6+G82A and Pro303Pro genotypes by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) assay. Waist circumference (WC), waist to hip ratio (WHR), percentage of body fat (%BF),systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG), serum triglycerides (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), plasma fasting insulin (FINS), homeostasis model assessment for insulin resistance (HOMA-IR), and plasma leptin were examined. Results The allele frequencies of IVS6+G82A and Pro303Pro were 59.5% and 19.4% in obese children, and 53.4% and 11.0% in healthy children, respectively. There were significant differences in allele frequencies of Pro303Pro polymorphism between the obese and the control group. Pro303Pro polymorphism was associated with body mass index, WC, TG, and LDL C in the obese subjects. There was not di fference in the genotype distributions or allele frequencies of IVS6+G82A polymorphism between the obese and the control group. Further analysis showed no association between the genotypes of IVS6+G82A and clinical characteristics in the obese subjects. The linkage disequilibrium analysis for IVS6+G82A and Pro303Pro (D′: 0.441, r2: 0.027) was weak.Conclusion PTP1B gene Pro303Pro polymorphism might be associated with the pathogenesis of obesity in children and could affect the lipid metabolism in Chinese obese children.

Effects of glucose on apoptosis of endothelial progenitor cells from human peripheral blood / 中国医师杂志

Objectives To investigate the effects of glucose on apoptosis rate of cultured endothelial progenitor cells (cEPCs). Methods The peripheral blood of healthy adults was isolated by density gradient centrifugation, and mononuclear cells (MNCs) were inducted to differentiate at cultured conditions.EPCs were identified by Dil-acLDL and FITC-UEA-1 as double fluorescent-positive cells. The effectsof glucose at different concentrations on apoptosis rate of the harvested EPCs were measured by fluorescent microscope and fluorescence-activated cell sorting (FACS) after staining with Annexin V-FITC and PI. Results No significant differences were observed in apoptosis rate between samples treatedwith 5.6mmol/l glucose and 11. 1 mmol/l. P ＞0. 05). 25.5 mmol/L glucose enhanced the EPCsapoptosis rate in a time-dependent manner( P ＜0. 05). Conclusion High concentration glucose can accelerate apoptosis rate of EPCs in a time-dependent manner.

Establishment of blood glucose fluctuation diabetic rats model / 中国医师杂志

Objective To establish the blood glucose fluctuation diabetic rat model by subcutaneous injecting insulin. Method The male Sprague-Dawley (SD) rats were randomly assigned into two groups, normal group ( n =20) and model group ( n =40). Normal group rats were fed with normal diet, model group rats were fed with a high-sucrose-high-fat diet. After 6 weeks, a low dose of streptozotocin ( STZ ,30mg/kg) was injected to induce hyperglycemia in model group rats. And then the model group rats were ran-dom divided into two subgroups, diabetic group ( n = 20) and blood glucose fluctuation group ( n = 20). Blood glucose fluctuation group rats were induced by subcutaneous injecting insulin twice daily. All rats were executed after intervening for 3 months, metabolic cages were used to collect 24-hour urine one week before all rats were executed. Results The average blood glucose levels (MBG), the standard deviation of daily aver-age blood glucose (SDBG) and the largest amplitude of glycemic excursions (LAGE) were significant differ-ent (P<0. 05) among normal group, diabetic group and blood glucose fluctuation group. The 24 hours, pro-teinuria of diabetic group and blood glucose fluctuation group was higher than that in normal group[( 100. 38±7. 99)mg/24h vs (18. 13±1.41)mg/24h, (123. 71±11.23) mg/24h vs (18.13 ± 1.41 ) mg/24h, P <0.01] , and blood glucose fluctuation group was higher than diabetic group[(123. 71 ± 11.23 )mg/24h vs(100.38±7.99)mg/24h, P <0.05] . Conclusions The blood glucose fluctuation diabetic rats model was successfully induced by the method of subcutaneous insulin injection in diabetic rats twice daily.

Simple screening table for primary osteoporosis in senior people / 中南大学学报(医学版)

OBJECTIVE@#To develop a simple screening table for primary osteoporosis (POP) in senior men and women.@*METHODS@#Questionnaires were designed to obtain the risk factors associated with osteoporosis and bone mineral density (BMD), which were measured in 146 community residents over 60. The multiple stepwise regression was used to find out the risk factors and establish the screening index. Then the cut-off point of sensitivity and specificity were obtained. Simple screening table for POP in senior people was established according to the screening index and the cut-off point. Validity and reliability of the simple screening table for POP in senior people were testified by 61 outpatients whose BMD was measured with dual energy X-ray (DEXA).@*RESULTS@#Percentage of the height loss,body weight, age, and gender were selected with multiple stepwise regression.Percentage of height loss and body weight were selected to develop the simple screening table for POP in senior people. The cut-off point was 270, sensitivity was 88.9 %, specificity was 75.7 %, the agreement rate was 75.4%,and the Kappa value was 0.489.@*CONCLUSION@#The simple screening table for POP in senior people based on the percentage of height loss and body weight is simple, economic, suitable for both men and women, and is useful in basic public health.

Expression and meaning of pro-angiogenic factors in retinopathy of diabetic rats / 中南大学学报(医学版)

Objective To detect the expression of vascular endotheilal growth factor (VEGF), stromal cell-derived factor-1α (SDF-1α), and its receptor CXCR-4 in the retinopathy of diabetic rats, and to explore the relationship between those factors and diabetic-retinopathy(DR). Methods Diabetes was induced in 40 rats with a single intraperitional injection of streptozotocin(STZ). Experimental rats were randomly divided into M1 (diabetic for 1 month), M3 (diabetic for 3 months), and M5 (diabetic for 5 months) groups, and another 10 rats served as a normal control group (NC). Retinal vascular status was observed by transmission electron microscope. After retinal stretched preparation, VEGF, SDF-1α and CXCR-4 immunohistochemistry were done. Retinal VEGF, SDF-1α, and CXCR-4 mRNA were detected by semi-quantitative RT-PCR. Protein expression was measured by Western blot. Results Under transmission electron microscope, change in vascular status was found in M1 to M5 groups, but not in the NC group. The changes became increasingly serious with the prolongation of the disease. By immunohistochemistry, we found the expression of VEGF, SDF-1α, and CXCR-4 on the retina increased gradually. It increased after injecting STZ for 1 month and increased significantly after 5 months.VEGF, SDF-1α, and CXCR-4 mRNA expression increased obviously after injecting STZ for 1 month and increased significantly after 5 months. Western blot showed that protein of VEGF, SDF-1α, and CXCR-4 had no change after injecting STZ for 1 month. It began to increase in the M3 group and increased most in the M5 group. Conclusion The expression of VEGF, SDF-1α, and CXCR-4 on the retina in retinopathy of diabetic rats increases gradually with the prolongation of the disease. It is an important factor for diabetic retinopathy.

The effect of the interaction of mesangial cells and endothelial cells on diabetic nephropathy / 中国医师杂志

Objective To study the effect of high glucose and lysophosphatidylcholine (LPC) on the role of fibronectin and plate-let activating factor (PAF) via the interaction of endothelial cells and mesangial cells. Methods The model of intercellular interaction be-tween endothelial cells and mesangial cells was established and divided into 4 groups: control, mannitol, high glucose and LPC, and BN52021 group. The level of fibronectin and PAF were determined by enzyme linked immunosorbent assay in the culture media. Results The level of fibronectin and PAF of high glucose and LPC group were higher than those of control group in co-culture and monolayer cell cul-ture (P<0.05). Intervened by high glucose and LPC, the level of fibronectin and PAF of co-culture were higher than those from monolay-er cell culture (P<0.05). The level of fibrocentin in the BN52021 group was lower than that of high glucose and LPC (P<0.05). Con-clusions Exposed to high glucose and LPC, endothelial cells and mesangial cells can interact with each other to produce more fibrocentin and PAF. The increase of fibronectin is partly concerned with PAF.

Effect of high glucose on the role of fibronectin, collagen Ⅳ and platelet activating factor of mesangial cells / 中国医师杂志

promoted by high glucose, which can enlarge the biological effect of PAF.

Effect of Astragalus Membranaceus on the Interaction of Mesangial Cells and Endothelial Cells / 中国中医药信息杂志

Objective To study the effect of astragalus membranaceus on the interaction of mesangial cells and endothelial cells in the media of high glucose and lysophosphatidylcholine. Methods The model of intercellular interaction between endothelial cells and mesangial cells of diabetic nephropathy was established and divided into 4 groups:control, mannitol, high glucose and lysophosphatidylcholine, intervented with astragalus membranaceus. Endothelial cells and mesangial cells were co-cultured in DMEN with or without astragalus membranaceus in high glucose and lysophosphatidylcholine media up to 24 hours. The level of collagen Ⅳ and fibrocentin were determined by enzyme linked immunosorbent assay in the culture media. Results The level of collagen Ⅳ and fibrocentin of high glucose and lysophosphatidylcholine group was markedly higher than that of control group in co-culture and the ordinary monolayer cell culture (P

The Clinical Characteristics of 452 Cases of Type 2 Diabetic Patients with Diabetic Neuropathy / 中国医师杂志

Objective To sum up the clinical characteristics of diabetic neuropathy (DN), and explore the risk factors of DN. Methods The Clincial characteristics of 452 cases of type 2 diabetic patients with DN were reviewed retrospectively, and the factors related with DN were statistically analyzed. Results Peripheral neuropathies were more common than automatic neuropathies in type 2 diabetes mellitus. Lipidic metabolism disturbance, long course of disease and poor control of postprandial hyperglycemia were positive correlation with the frequency of DN. Conclusion Peripheral neuropathy is the most common one in DN. The risk factors of DN include lipidic metabolism disturbance, long course of diabetes and bad control of systolic pressure.

Relationship of Plasma TNF-? Levels and Insulin Resistance in the Patients with Type2 Diabetes / 中国医师杂志

Object To investigate the relationship between plasma tumor necrosis factor ?(TNF-?) and insulin resistance in the patients with non obese type 2 diabetes.Methods The levels of plasma TNF-? and serum insulin were measured in 38 patients with type 2 diabetes and 30 healthy subjects by immuno-radioassay. Insulin sensitive index (ISI) and body mass index(BMI) were also calculated. The correlation analysis was done between TNF-? and ISI.Results ⑴ The levels of plasma TNF-? in type 2 diabetes were 30 79?6 64fmol/ml, and higher than those in controls (P

The Effect of Rosiglitazone on Glycemia and ?-Cell Function in Type 2 Diabetic Patients / 中国医师杂志

Objective To investigate the effects of rosiglitazone (RSG) on glycemia and ?-cell function in type 2 diabetic patients. Mothods Open-label and self-match trial was carried out. 31 cases of type 2 diabetic patients were divided into RSG monotherapy group (n=13), RSG plus metformin group (n=9), and RSG plus sulphonylureas group. All the patients received treatment for 12 weeks. Weight, body mass index, FBG, FINS, blood pressure, TG, Tch, HDL, LDL, ALT, AST and TBIL were determined before and after therapy. The insulin resistance (HOMA-IR) and ?-cell function (HOMA-?) of the patients were evaluated using homeostasis model assessment (HOMA). Results Compared with before treatment, there was a significant improvement in FBG, FINS, HOMA-? and HOMA-IR in all the patients after treatment (FBG 8.89?2.49mmol/L, FINS 17.89?5.78mU/L, HOMA-? 79.75?41.28,HOMA-IR 7.15?3.40 vs FBG 7.27?2.26mmol/L, FINS 14.33?3.82mU/L,HOMA-? 120.84?140.66,HOMA-IR 4.63?1.81, respectively,P