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Objective To investigate the feasibility of evaluating the pancreatic fat deposition with ultrasound,and analyze the relationship of pancreatic fat deposition with the risk factors for diabetes.Methods Two hundred and ninety-four subjects were recruited in the diabetes epidemic survey of Shanghai Sixth Peoples' Hospital,Shanghai Jiaotong University from Oct 2015 to Jan 2016,including 111 diabetes mellitus (DM) cases,54 sugar metabolic abnormalities (IGR) cases,and 129 healthy cases as control group.The general data were collected.Biochemical indicators including ALT,AST and insulin in fasting blood samples were detected,and insulin resistance index (HOMA2-IR) and insulin secretion index (HOMA-IS) were calculated.The pancreatic fat deposition was evaluated by the ultrasound,and pancreas echoes were divided into three levels (1,2,3),by comparing with the echo of the rectus.The Chi-square test was used to analyze the pancreatic fat deposition rate,while the Logistic regression was used to figure out the diabetes high-risk factors influencing the pancreatic fat deposition.Results Forty-two subjects were found to have the pancreatic fat deposition in the healthy group (33.3％),of whom 19 cases,16 cases and 8 cases were categorized into level 1,2 and 3,respectively.Thirty subjects were found to have the pancreatic fat deposition in the IGR group (55.6％),of whom 14 cases,11 cases and 5 cases were categorized into level 1,2 and 3,respectively.Sixty-seven subjects were found to have the pancreatic fat deposition in the DM group (60.4％),of whom 37 cases,18 cases and 12 cases,were categorized into level 1,2,3,respectively.The pancreatic fat deposition rates of the 3 groups were statistically significantly different (P＜0.01).Multivariate Logistic regression analysis showed that body mass index (BMI),HOMA2-IR,high triglycerides (TG),and total cholesterol (TC) may be the-risk factors for the pancreatic fat deposition in IGR and T2DM patients.Conclusions The ultrasound evaluation on pancreatic fat deposition was feasible,and the pancreatic fat deposition was related to multiple high-risk factors for diabetes.
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Objective:To explore application of targeted contrast enhanced ultrasonography in diagnosis of early stage vascular endothelial injury and diabetic nephropathy.Methods:Targeted SonoVue-TM microbubble was prepared by attaching anti-TM monoclonal antibody to the surface of ordinary micro-bubble SonoVue by biotin-avidin bridge method and ultrasonic instrument was used to evaluate the developing situation of targeted microbubble in vitro. Twenty 12-week-old male GK rats and 20 Wistar rats were enrolled in this study, and were randomly divided into targeted angiography group and ordinary angiography group. Targeted microbubbles SonoVue-TM or general microbubble SonoVue were rapidly injected to the rats via tail vein; the developing situation of the two contrast agents in rats kidneys was dynamically observed. Time intensity curve was used to analyse rat kidney perfusion characteristics in different groups. Results:Targeted ultrasound microbubble SonoVue-TM was successfully constructed, and it could be used to develop an external image. Targeted microbubbles SonoVue-TM enabled clear development of experimental rat kidney. Time intensity curve shapes of rat kidney of the two groups showed as single apex with steep ascending and slowly descending branch. Compared with the control group, the rising slope of the GK rat renal cortex, medulla in targeted angiography group increased(P<0.05); the peak intensity of medulla increased (P<0.05), and the total area under the curve of medulla increased (P<0.05). Compared with control group, the ascending branch of the GK rat in renal cortex, medulla in ordinary angiography group increased (P<0.05). The peak intensity of the curve increased (P<0.05), and the total area under the curve increased (P<0.05). Compared with the ordinary angiography group, the peak of GK rat medullacurve in targeted angiography group intensity increased (P<0.05), and the total area under the curve increased (P<0.05).Conclusions:Targeted microbubbles SonoVue-TM can make a clear development of experimental rat kidney, its stable performance meet the requirement of ultrasonic observation time limit, and it can reflect early changes of blood perfusion in GK rat kindey.
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<p><b>OBJECTIVE</b>To examine the proportion and influencing factors on HIV-infected individuals who rejecting the antiretroviral therapy among all the HIV positives, in Dehong prefecture, Yunnan province.</p><p><b>METHODS</b>A cross-sectional analysis was conducted on all the local HIV-infected survivals aged over 16 year old who refused to receive antiretroviral therapy (ART) by the end of 2013 in Dehong prefecture.</p><p><b>RESULTS</b>The proportion of those rejecting the ART among HIV-infected survivals and aged over 16 years old in Dehong prefecture, was 7.4% (605/8 136). Factors related to the 'rejection' among the 605 refusals would include: being male (72.9%), aged 31-45 years (57.2%), peasants (75.4%), married (52.2%), with minor ethnicity (41.3%), illiterate or only having primary school education (58.7%), infected through sexual contacts (61.2%), and with CD4(+)T cell counts >350 cells/mm(3) (66.6%). Data from the multiple logistic regression analysis indicated that rejecting the ART was significantly associated with areas, gender, age, ethnicity and CD4(+)T cell counts of the HIV patients. Those who were from Yingjiang county, female, aged 31-45 years old had lower proportions of ART refusals than those who were from Ruili city, male, aged ≤30 year old. Those who were of Dai minority and had no records on CD4(+)T cell counts, had higher proportions of ART refusals than those who were of Han ethnicity and had CD4(+)T cell counts ≤350 cells/mm(3). Reasons for the 605 HIV-infected patients with rejection to the ART would include fear of disclosure of HIV infection status (84, 13.9%), misunderstandings of the effectiveness and side effects of ART (111, 18.3%), self-realized wellness(340, 56.2%) and others (70, 11.6%). Of them, reasons for the 181 patients with CD4(+)T cell counts ≤350 cells/mm(3) that rejecting ART would include fearfulness on the disclosure of HIV infection status(40, 22.1%), misunderstandings of the effectiveness and side effects of ART (36, 19.9%), self-realized wellness (84, 46.4%) and others (21, 11.6%). Among those who rejected ART, reasons for that would vary by areas, gender, age, marital status and routes of HIV transmission, according to the results from Chi-squared tests.</p><p><b>CONCLUSION</b>A substantial proportion of HIV-infected individuals rejected ART in Dehong prefecture of Yunnan province. It was urgently needed to enhance health education programs of ART tailored for those HIV-infected patients, according to different characteristics and reasons for rejection, so as to promote the ART in this prefecture.</p>