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Objective To observe of the effects of tacrolimus on blood glucose,insulin secretion and the expression of phosphorylated AKT in rats in order to study the mechanism of diabetogenic effects of tacrolimus.Methods 40 male SD rats were randomly divided into two groups.The rats in tacrolimus group were delivered tacrolimus at a dose of 4mg/kg· d.The rats in the control group were given the same amount of saline solution in the same way.The body weights,fasting blood glucose levels and blood concentrations of tacrolimus were measured monthly.After 5 months,all rats were killed.Pancreas and liver tissue were stored in 4％ paraformaldehyde solution.Serum insulin levels were detected by radioimmunoassay method.The expression of phosphorylated AKT in liver were measured by immunohisto-chemical method.Results ①The body weights in tacrolimus group in the 3rd,4th,and 5th month were significantly lower than those in the control group (P＜0.01).②The blood glucose levels in tacrolimus group in the 3rd,4th,and 5th month were significantly higher than those in the control group (P＜0.05).③The insulin secretion and insulin sensitivity index in tacrolimus group were significantly lower than those in the control group (P＜0.01).④The rats in tacrolimus group showed varying degrees of damage in pancreatic duct and pancreatic islet cells.⑤The expression of phosphorylated AKT in liver cells in tacrolimus group were significantly lower than those in the control group (P＜0.05).Conclusions Tacrolimus can induce pancreatic islet cells necrosis,decrease the number of islet cells,reduce insulin secretion and insulin sensitivity,which lead to blood hyperglycemia in rats.In addition,we also find that tacrolimus can reduce expression of phosphorylated AKT in hepatic tissue,which indicates that tacrolimus results insulin resistance through interfering PI3K/ AKT signal transduction pathways.
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ObjectiveTo investigate the association of complement C3 with clinical and serological features of patients with systemic lupus erythematosus.MethodsData was collected by the same methods in the past ten years in fifteen hospitals in Jiangsu Province and then data weres summarized for retrospective analysis.Clinical and laboratory data were selected and then analyzed by Chi-square test,Wilcoxon rank sum test and Logistic regression.ResultsOne thousand four hundred and five patients were investigated.One thousand and forty two had low serum complement C3 level.In this case control study,hospitalization age,disease course,admission times,pleurisy,gastrointestinal involvement,general lymphadenopathy/hepatosplenomegaly,white blood cell count, haemoglobin level,platelet count, serum C-reactive protein level,serum albumin level,serum creatinine level,Urine protein quantification,anti-nuclear antibodies (ANA),anti-dsDNAantibodies, anti-SmantibodiesandSLEDAIscore were possible factors associatedwith complement C3 reduction(P＜0.05).Logistic regression analysis showed that CRP (OR=0.396,0.254-0.617,P=0.000),ANA (OR=2.907,1.267-6.670,P=0.012),urine protein level(OR=1.702,1.043-2.779,P=0.033) and SLEDAI score (OR-0.930, 0.886-0.975,P-0.003) were correlated with complement C3 reduction.Conclusion Complement C3 level is valuable for lupus flare assessment.The complement C3 reduction is a risk factor for renal impairment.
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Objective To explore the relationship between the impairment of hematological system and disease activity,immunological parameters,and the prognosis of systemic lupus erythematosus (SLE).Methods The clinical and laboratory data of in-patients with SLE in Jiangsu Province were investigated and all patients were hospitalized between 1999-2009.The impairment of hematological system was assessed and the relationship between hematological system damage and disease activity,immunological parameters,mortality rate of patients with SLE were analyzed.Statistic method used was X2 test.Results One thousand nine hundred and fifty eight cases of SLE were included in the study,in which,1836 were female and 122 were male.One thousand five hundred and forty nine (79.1%) patients complicated with hematological system damage,62.3% were anemia,45.5% with leucopenia and 29.4% with thrombocytopenia.There were significant differences in hematological system damage rate among patients with mild activity group,moderate activity group,severe activity group and almost no activity group,compared respectively with almost no activity group.The P values were P=0.01 and P＜0.01 respectively.The incidence of hematological system damage in elevated ESR,low complement C3 level,anti-dsDNA antibody group was higher than that in patients who had normal ESR,complement C3 level and anti-dsDNA group.(P＜0.01).During follow-up,166 patients died,of which the mortality rate(91.6%) in patients had hematological system damage,was obviously higher than those without hematological damage(8.4%)(P＜0.01 ).Among the 166 deceased patients,38.6% died of severe infection,22.9% died ofrenal failure,15.1% died ofnervous system damage,10.2% died of cadiovascular damage and 13.3% died from other causes.Conclusion Hematological system is one of the most commonly involved system in patients with SLE,of which anemia is the most common,and the incidence of leukopenia follows.The impairment of hematological system is closely related to lupus activity.Patients with abnormal immune parameters tend to have secondary hematological system damage.Severe infection is the main cause of death in patients with lupus,followed by nervous system damage and kidney damage.The mortality rate in patients with lupus that complicated hematological system damage is higher than patients who have no hematological system damage.
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Objective To investigate the initial manifestation and disease onset feature of systemic lupus erythematosus(SLE) in the past ten years in fifteen hospitals in Jiangsu Province.Methods Data was collected by the same Methodsin all the participated hospitals and then it was summarized for retrospective analysis.Two groups were compared by chi-square test.Results ① One thousand nine hundred and fifty eight patients were investigated and the male-to-female ratio was 1∶15.0.② One thousand seven hundred and ninty eight patients had clear initial manifestations.The most common initial manifestations were skin and mucosal lesions(769 cases,42.8％ ) and arthritis (697 cases,38.8％ ).The main skin lesion was malar rash (706 cases).Arthritis was found to be more common in female than male.③ All hospitalized patients at their first admission showed multiple organ/system involvement:the most common involvement was skin and mucous membrane (82.3％),hematologic damage (74.0％),in which at least one series of blood cells were involved,arthritis (1156 cases,56.5％ ) much more than myositis (51 cases),proteinuria 1046 cases and hematuria in 385 cases.Renal biopsy pathology showed type Ⅳ glomerulonephritis.Conclusion ① SLE patients are mainly female and the male to female ratio is 1∶15.0.② The most common initial manifestations are skin and mucosal lesions.③ The most commonly involved organ/system are skin and mucous membrane,blood,joint and kidney.The most common pathological changes shown in renal biopsy is type Ⅳ glomerulonephritis.
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OBJECTIVE To study the features of isolated bacteria from sputum specimens in the patients with hospital acquired pneumonia (HAP). METHODS Identification of bacteria specimen and drug sensitivity test were performed in specimens from the lower respiratory tract of patients with HAP from Jan 2007 to Dec 2007. The test results and clinical data were analyzed. RESULTS There were 136 patients with HAP,among them the old persons who were more than 60 years old and 75% of them were infected much more than others. The main pathogens were Gram-negative bacilli (57.62%). CONCLUSIONS Gram-negative bacilli are the major pathogens with high resistance rate and the multi pathogen infection is increasing and difficult to control. To decrease the infection rate,it is necessary to use antibiotic reasonably and control high risk factors.
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Objective To improve the level of the diagnosis and treatment of gastric ectopic pancreas. Methods We reviewed the data of endoscopic ultrasonography(EUS) examination of gastric submucosal mass from 2000 to 2004 and analyze the EUS features of gastric ectopic pancreas. Results Among 241 cases of gastric submucosal mass, 105 cases were diagnosed as benign stromal tumors, 23 as malignant stromal tumors, 48 as lipomas,45 as ectopic pancreas and 20 as cysts. The EUS features of gastric ectopic pancreas included submucosal lesions (39 cases), clear boundary (37cases),hy-perechoic heterogenous internal echo(42 cases), hypoechoic(3 cases), echoless in the center of the lesions (32 cases). After resection,26 cases confirmed by pathology had no complications. Conclusion EUS examination is helpful to confirm the diagnosis'of gastric ectopic pancreas. Resection under endoscopiy is a an effective measure of treatment.