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BackgroundDysimmunity plays a key role in diabetes, especially type 1 diabetes mellitus. Islet-specific autoantibodies (ISAs) have been used as diagnostic markers for different phenotypic classifications of diabetes. This study was aimed to explore the relationships between ISA titers and the clinical characteristics of diabetic patients.MethodsA total of 509 diabetic patients admitted to Department of Endocrinology and Metabolism at the Affiliated Hospital of Nantong University were recruited. Anthropometric parameters, serum biochemical index, glycosylated hemoglobin, urinary microalbumin/creatinine ratio, ISAs, fat mass, and islet β-cell function were measured. Multiple linear regression analysis was performed to identify relationships between ISA titers and clinical characteristics.ResultsCompared with autoantibody negative group, blood pressure, weight, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), visceral fat mass, fasting C-peptide (FCP), 120 minutes C-peptide (120minCP) and area under C-peptide curve (AUCCP) of patients in either autoantibody positive or glutamate decarboxylase antibody (GADA) positive group were lower. Body mass index (BMI), waist circumference, triglycerides (TGs), body fat mass of patients in either autoantibody positive group were lower than autoantibody negative group. GADA titer negatively correlated with TC, LDL-C, FCP, 120minCP, and AUCCP. The islet cell antibody and insulin autoantibody titers both negatively correlated with body weight, BMI, TC, TG, and LDL-C. After adjusting confounders, multiple linear regression analysis showed that LDL-C and FCP negatively correlated with GADA titer.ConclusionDiabetic patients with a high ISA titer, especially GADA titer, have worse islet β-cell function, but less abdominal obesity and fewer features of the metabolic syndrome.
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BackgroundDysimmunity plays a key role in diabetes, especially type 1 diabetes mellitus. Islet-specific autoantibodies (ISAs) have been used as diagnostic markers for different phenotypic classifications of diabetes. This study was aimed to explore the relationships between ISA titers and the clinical characteristics of diabetic patients.MethodsA total of 509 diabetic patients admitted to Department of Endocrinology and Metabolism at the Affiliated Hospital of Nantong University were recruited. Anthropometric parameters, serum biochemical index, glycosylated hemoglobin, urinary microalbumin/creatinine ratio, ISAs, fat mass, and islet β-cell function were measured. Multiple linear regression analysis was performed to identify relationships between ISA titers and clinical characteristics.ResultsCompared with autoantibody negative group, blood pressure, weight, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), visceral fat mass, fasting C-peptide (FCP), 120 minutes C-peptide (120minCP) and area under C-peptide curve (AUCCP) of patients in either autoantibody positive or glutamate decarboxylase antibody (GADA) positive group were lower. Body mass index (BMI), waist circumference, triglycerides (TGs), body fat mass of patients in either autoantibody positive group were lower than autoantibody negative group. GADA titer negatively correlated with TC, LDL-C, FCP, 120minCP, and AUCCP. The islet cell antibody and insulin autoantibody titers both negatively correlated with body weight, BMI, TC, TG, and LDL-C. After adjusting confounders, multiple linear regression analysis showed that LDL-C and FCP negatively correlated with GADA titer.ConclusionDiabetic patients with a high ISA titer, especially GADA titer, have worse islet β-cell function, but less abdominal obesity and fewer features of the metabolic syndrome.
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Background@#Dysimmunity plays a key role in diabetes, especially type 1 diabetes mellitus. Islet-specific autoantibodies (ISAs) have been used as diagnostic markers for different phenotypic classifications of diabetes. This study was aimed to explore the relationships between ISA titers and the clinical characteristics of diabetic patients. @*Methods@#A total of 509 diabetic patients admitted to Department of Endocrinology and Metabolism at the Affiliated Hospital of Nantong University were recruited. Anthropometric parameters, serum biochemical index, glycosylated hemoglobin, urinary microalbumin/creatinine ratio, ISAs, fat mass, and islet β-cell function were measured. Multiple linear regression analysis was performed to identify relationships between ISA titers and clinical characteristics. @*Results@#Compared with autoantibody negative group, blood pressure, weight, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), visceral fat mass, fasting C-peptide (FCP), 120 minutes C-peptide (120minCP) and area under C-peptide curve (AUCCP) of patients in either autoantibody positive or glutamate decarboxylase antibody (GADA) positive group were lower.Body mass index (BMI), waist circumference, triglycerides (TGs), body fat mass of patients in either autoantibody positive group were lower than autoantibody negative group. GADA titer negatively correlated with TC, LDL-C, FCP, 120minCP, and AUCCP.The islet cell antibody and insulin autoantibody titers both negatively correlated with body weight, BMI, TC, TG, and LDL-C. After adjusting confounders, multiple linear regression analysis showed that LDL-C and FCP negatively correlated with GADA titer. @*Conclusion@#Diabetic patients with a high ISA titer, especially GADA titer, have worse islet β-cell function, but less abdominal obesity and fewer features of the metabolic syndrome.
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Objective To investigate the management of Graves' disease in Jiangsu province. Methods According to the 2011 management of GD survey from American Thyroid Association and the 2013 survey from European Thyroid Association, a questionnaire was designed for this survey to acquire the diagnosis, treatment, and follow-up of Graves' disease among endocrinologists from 35 tertiary hospitals in Jiangsu province. Results A total of 476 valid questionnaires were collected. For patients with symptoms of hyperthyroidism, a large majority of respondents monitored serum FT3 , FT4 , TSH, thyroid peroxidase antibody, thyroglobulin antibody, TSH receptor antibody, and finding of thyroid ultrasound, accounted for 95. 6％, 95. 0％, 95. 4％, 95. 8％, 90. 3％, 90. 5％, and 93. 9％physicians, respectively. 91.2％ of physicians preferred anti-thyroid drugs as the first-line treatment, and 92. 6％ of them gave priority to the use of methimazole. For the duration of anti-thyroid drugs therapy, 41.2％of endocrinologists chose 24 months, while 20％ chose 18 months. When patients have moderate and active ophthalmopathy, most respondents with medium or senior professional titles preferred anti-thyroid drugs, while most resident physicians chose radioactive iodine plus corticosteroids. When pregnancy was confirmed in the patients of Graves' disease, 88％ of respondents preferred propylthiouracil during the first trimester of pregnancy, and 58. 4％ of them would continue propylthiouracil into the second trimester. Conclusions The mastering of basic perception of Graves' disease knowledge is satisfactory among the endocrinologists. But by comparing to the American and European survey results and related guidelines, there are still some differences in diagnosis and treatment. Therefore, physicians should notice those differences and make improvement on standardized treatment for patients to raise the response ratio while reducing the recurrent events.
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OBJECTIVE: To establish a method for detecting hydrazine in the air of workplace by high performance liquid chromatography with benzaldehyde derivatization. METHODS: The air samples were collected by glass fiber filter impregnated with sulfuric acid solution and desorbed by sodium dihydrogen phosphate-ethylenediamine tetraacetic acid disodium salt buffer solution. Desorption solution was derived from 1.00% benzaldehyde-acetonitrile solution, then separated by C18 liquid chromatographic column and detected by diode array detector. RESULTS: The linearity range of hydrazine mass was 12.50-150.00 μg, and the correlation coefficient was 0.999 7. The average elution efficiency of hydrazine was 89.28%-95.52%. The within-run and the between-run relative standard deviation were 1.09%-1.86% and 3.63%-4.00% respectively. The samples could be stored at 4 ℃ in a refrigerator for at least 25 days. CONCLUSION: This method has high sensitivity, precision and simple sample preparation. It can be used for detecting hydrazine in the air of workplace.
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Objective@#To discuss calculation method of detection limit and quantitative limit of occupational health biological monitoring.@*Methods@#The detection limit and the quantitative limit of phenyl glyoxylic acid and Mandelic acid were calculated by using three different methods of IUPAC, NIOSH and OSHA respectively.@*Results@#The IUPAC, NIOSH and OSHA methods were used to calculate the detection limit and the quantitative limit of the phenyl glyoxylic acid and Mandelic acid, and the results are different.@*Conclusion@#To calculate the detection limit and quantitative limit of occupational health biological monitoring methods, the standard curve method is adopted to ensure that the rate of detection in the vicinity of detection limit and more than 75% of the quantitative limits are used.
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Objective To investigate the glycemic control situation and risk factors characteristics of macrovascular complica-tions in the patients with early onset type 2 diabetes mellitus(EDM).Methods A total of 520 consecutive patients with type 2 dia-betes mellitus(T2DM)in this hospital from January 2015 to August 2016 were retrospectively analyzed.The patients were divided into two groups:EDM group(n=200)and late onset group(n= 320)according to the age at which diabetes was diagnosed.The general condition,blood glucose,blood fat and blood pressure were analyzed in the two groups;the occurrence rate of complications in the two groups was analyzed.The Logistic regression analysis was used to analyze the independent risk factors affecting macro-vascular complications in the EDM group.Results Compared with the late onset group,the proportions of smoking,diabetes posi-tive family history and proportion of combining with insulin treatment in the EDM group were increased;the age,disease course and diagnosis age were decreased;diastolic pressure,systolic pressure,HbAlc and total cholesterol,HDL-C in the EDM group were increased.The morbidity rates of cardiovascular diseases,brain vascular diseases,neck artery atherosclerosis,electromyographic ab-normality and positive rate of urine protein in EDM group were lower than those in the late onset group.The univariate analysis showed that age,BMI,SBP,HbA1c,FPG,2hPG,TG,TC,HDL-C and smoking in the EDM group were correlated with macrovascu-lar complication occurrence.The multivariate analysis showed age,BMI,TG,HbA1C,2hPG,SBP and smoking in the EDM group were the independent risk factors of macrovascular complications.Conclusion The patients with EDM are easier to be complicated with macrovascular complications.The control of high risk factors in the patients with EDM should be strengthened.
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Objective@#To revise the standard method for the determination of phenylglyoxylic acid(PGA)and mandelic acid(MA) in urine by ultra-performance liquid chromatography.@*Methods@#The original standard method was evaluated by experiment, and the chromatographic column, the detection limit,quantitation limit and stabilityof the method were studied.@*Results@#The samples were separated by BEH Phenyl(50mm×2.1mm×1.7μm)column and the internal standard working curve method was used. The regression equations were y=3.660 7x+0.066 3 and y=5.161 2x-0.007 3 for MA and PGA respectively. Linear correlation coefficients were 0.999 3 and 0.999 1. Linearity ranges were 0.10-1.00 mg/ml,0.04-0.40 mg/ml. The recoveries of PGA and MA were 91.6%-97.1% and 84.3%-99.0%,the precision were 0.9%-4.6% and 0.5%-1.9%. The detection limit and quantitation limit of the method were 1.1 mg/L and 3.7 mg/L for PGA, 5.4 mg/L and 17.9 mg/L for MA.@*Conclusion@#The method uses the phenyh modified chromatographic column, determines the detection limit. The method can improve quantitation limit, the detection accuracy and meet the detection of occupational population samples.
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Objective To investigate the effects of bone morphogenetic protein-7 ( BMP7 ) on insulin signaling transduction in C2C12 myotubes and HepG2 hepatocytes, and the underlying mechanisms were studied preliminarily.Methods The C2C12 myotubes and HepG2 cells were treated with BMP7 at different concentrations.The insulin signal transduction was analyzed by Western blot.Meanwhile, total RNA was extracted and quantitative PCR was employed for detecting the effects of BMP7 on gene expressions of effectors involved in insulin signal pathway.Furthermore, JNK signal pathway was also measured.Results The protein levels of p-IR, p-Akt and p-GSK3β, as well as glucose uptake, were significantly stimulated by insulin in the C2C12 myotubes and HepG2 cells.However, these stimulations induced by insulin were largely attenuated by BMP7.The mRNA levels of Akt1, Igf1r, Insr, and Irs1 were not altered by the treatment of BMP7.The JNK signal pathway was activated by a 5-min exposure of BMP7 in the HepG2 cells, and this activation was gradually reduced along with the treating time.Conclusion BMP7 attenuates the insulin signal transduction in the HepG2 cells and C2C12 myotubes, and this attenuation effect may be through JNK activation.
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Objective To investigate the feasibility and superiority of the lecture based learning (LBL)combined problem-based learning (PBL)for endocrinology teaching practice. Methods Totally 150 clinic medical undergraduates were randomly divided into three groups:LBL group (n=50),PBL group (n=50)and LBL+PBL group (n=50). Questionnaires,written and oral tests were employed to evaluate the teaching effect. ANOVA was used to compare the indicator scores and chi-square test was used to compare grades and passing rate. Results Teaching efficiency,mater of knowledge,capabilities of analysis,teaming and collaboration ability and medical diagnosis thinking cultivation were better in LBL and PBL group than in the other two groups. There were statistical differences in total score(F=4.69, P=0.010)and passing rate(χ2=8.94,P=0.030)among three groups. Conclusions LBL+PBL guarantee the teaching quality and cultivate the comprehensive quality of students; therefore it is superior to LBL and PBL.
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Objective To investigate the prevalence of depression and its risk factors in type 2 diabetes mellitus.Methods Beck Depression Inventory (BDI) was used to evaluate depression in 2 966 type 2 diabetes mellitus patients [ male 1 463,female 1 503,age ( 56.4 ± 11.2 ) years,diabetes duration ( 6.3 ± 5.7 ) years ].Depression criteria:≤4 points,no depression group; 5-13 points,mild depression group; 14-20 points,moderate depression group; 21 points or higher,severe depression group.Meanwhile,the demographic and metabolic data and diabetes-related health behaviors were also investigated.The risk factors associated with depression were screened by logistic regression.Results 51％ patients had depression,including 38％ with mild,8％ with moderate,and 5％ with severe depression.Compared with no depression group,depression was correlated with female sex,low-annual income,diabetes education,diabetes treatment,with insulin and peripheral neuropathy( P＜0.01 ).More smoking and younger age were found in severe depression( P＜0.05 ).Partial correlation analysis showed that depression in type 2 diabetes mellitus was positively correlated with female sex,diabetes education,and peripheral neuropathy ; and negatively correlated with age (P＜0.05).Conditional logistic regression equation showed that gender( OR =1.37 ),age ( 20-40 years,OR =1.52 ),diabetes education ( OR =1.51 ),and peripheral neuropathy ( OR =1.87 ) were risk factors for depression.Conclusion Depression is common in type 2 diabetes mellitus.More attention should be paid to screening depression in clinical practice.
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Objective To determine the status of glycemic control in type 2 diabetic patients in Jiangsu province. Methods Survey was conducted among outpatients with type 2 diabetes mellitus from 56 diabetes centers including 23 tertiary hospitals, 18 secondary hospitals and 15 primary hospitals, covering 13 cities in Jiangsu province. Data were obtained by patient interview and by reviewing medical records of the most recent laboratory assessment and clinical examinations. Blood samples were collected during patient′s visits for assessment of HbA1C. Results The mean HbA1Cof 2 966 patients was 7.18%±1.58%. Mean age of patients was(56.4±11.2) years, mean duration of diabetes was(6.3±5.7) years, and mean body mass index was(24.5±3.3) kg/m2. The proportion of good control was 40.2% defined as HbA1C＜6.5%. 42.2% of the patients in the tertiary hospitals, 36.5% of the cases in the secondary hospitals, and 36.2% of cases in the primary hospitals achieved that goal with HbA1C＜6.5%, while age, body mass index, and duration of diabetes revealed no difference among these 3 groups of patients. Conclusions The status of glycemic control in Jiangsu province has been improved as compared with the result from national survey performed 3 years ago. Patients from tertiary hospitals are better controlled than those from secondary and primary hospitals. Structural interventions to improve diabetes care in secondary and primary hospitals are needed.
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Objective To observe the effect of treatment of the diabetide foot with the fresh skin of the bufo bufo gargarizans cantor. Methods 42 diabetic foot patients were randomized into the control group and the treatment group with 21 patients in each. In the control group the patients were treated with disinfection routinely and dressing changing. In the treatment group the patients were treated with the fresh skin of the bufo bufo gargarizans cantor covering the infected feet after routine disinfection treatment. The treatment effect, the healing time and the length of antibiotics treatment course were compared between the two groups. Results The treatment effect of the treatment group was 100.00%, significantly higher than 80.95% of the control group. The healing time of the treatment group was (9.05 ±4.09) days, shorter than (17.41±4.20)days of the control group. The length of the antibiotics treatment course of the treatment group was(9.33±4.73)days, shorter than (17.10±4.83) days of the control group. Conclusions The fresh skin of the bufo bufo gargarizans cantor can improve the recovery rate, shorten the healing time and the length of the antibiotics treatment course by covering the infected feet.
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This study was designed to observe the clinical value of low-density lipoprotein immune complexes (LDL-ICs) in patients with type 2 diabetes mellitus (T2DM). Fifty-four patients with type 2 diabetes + macroangiopathy (DM-MA group), 48 patients with type 2 diabetes (DM group), 45 patients with macroangiopathy ( MA group), and 30 normal controls ( NC group) were enrolled. LDL-ICs levels in the DM-MA group were significantly higher than those in the other three groups. The levels of LDL-ICs in the MA group were higher than those in the NC and DM groups. There was a significant difference in LDL-ICs between the DM and NC groups. LDL-ICs levels were positively related with body mass index (BMI), glycesylated hemoglobin Alc(HbAlc), blood pressure, total cholesterol, and triglyceride. There was no significant relationship between low-density lipsprotcin cholesterol and LDL-ICs. A significantly negative correlation was recorded between high-density lipoprotein cholesterol and LDL-ICs. Our study suggests that LDL-ICs, blood pressure, and HbAlc may be risk factors of macroangiopathy in type 2 diabetic patients.