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Objective@#This paper studies the nutritional and vision health status of Tibetan migrant students and the differences between the local students in Lanzhou and them to provide a theoretical basis for nutrition intervention and vision protection for students.@*Methods@#Cluster sampling method was used to select 2 434 students migrating from Gannan Tibetan Autonomous Prefecture to a boarding middle school, and 3 291 students from three middle schools in Qilihe District of Lanzhou from September to December 2020. All the students were administered physical and visual examination. Proportion of nutritional status, poor eyesight and myopia by gender and age groups between Tibetan migrant students and local students were analyzed.@*Results@#The detection rate of overweight and obesity in Tibetan migrant boys(2.8%,5.7%) and girls(11.0%,8.3%) was lower than that of local students of the same sex(5.6%,8.3%;24.9%,20.9%) ( χ 2=12.17,7.21, P <0.05; χ 2=81.33,91.34, P <0.05); The detection rate of malnutrition in Tibetan migrant boys(9.9%) was higher than that in local boys(7.2%) ( χ 2=6.65, P <0.05). The detection rate of poor vision in Tibetan migrant boys was lower than that in local boys ( χ 2=3.93, P <0.05). The detection rate of myopia was significantly lower than that of local students ( χ 2=975.82, P <0.01). The detection rate of abnormal color vision in Tibetan migrant boys was higher than that in local boys ( χ 2=8.38, P <0.05). The detection rate of abnormal color vision in Tibetan migrant girls was lower than that in local girls ( χ 2=8.08, P <0.05). The detection rate of mild and moderate visual impairment was lower among Tibetan migrant boys than local boys ( χ 2=3.88, 8.32, P <0.05); the detection rate of mild, moderate and severe myopia was lower than local boys ( χ 2= 13.72 ,55.96, 338.50, P <0.05). The detection rate of mild, moderate and severe myopia was lower among Tibetan migrant girls than local girls ( χ 2=7.62, 37.79,424.00, P <0.05).@*Conclusion@#Tibetan migrant students was lower than that of local students. More attention should be paid to nutrition intake of Tibetan boys to prevent malnutrition. The detection rate of myopia in Tibetan migrant students is low,but the detection rate of severe poor vision among Tibetan students in the junior high school group is higher than that of local students, and attention should be paid to the visual health of Tibetan students in junior high school.
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Objective To observe the efficacy and safety of pigolitazone/metformin fixed-dose combination therapy replacing metformin alone or combined with other anti-diabetes drugs in type 2 diabetes with poor glycemic control.Methods 80 cases were recruited,with an average age of (54.79±13.99)years,diabetes history of (9.76±6.59) and baseline HbA1c (9.06±1.34)％.All participants received pigolitazone/metformin instead of metformin without other treatment changes.Glycemic control (level of fast blood glucose,HbA1c) was evaluated at 12 weeks,as well as lipid profiles,liver and renal function,adverse events and body weight.Results 8 cases were lost to visit,4 cases were withdrawn for edema,only 68 subjects finished the study.Compared to the baseline,after 12-week treatment,FPG decreased for (2.06+0.16) mmol/L,HbA1c decreased for (0.84+0.23)％,both of the differences were statistically significant (P＜0.001,P＜0.001).Body weight increased (0.34+1.13)kg,with no difference compared to the baseline.The lipid profile presented elevated high density lipoprotein cholesterol (P=0.012)and decreased total cholesterol,low density lipoprotein cholesterol,triglyceride,while the latter three items showed no differences (P＞0.05,P＞0.05,P＞0.05).Indexes reflecting liver and renal function,such as ALT,AST,TBIL,DBIL,Urea,UA,Cr showed no differences compared with the baseline.Adverse events analysis showed at the end of the study,no severe hypoglycemia and serious cardiovascular events occurred,6 cases suffered edema,among whom 4 patients exited the study for severe lower limb edema.No extra gastrointestinal symptom happened.Conclusion Pigolitazone/metformin fixed-dose combination exhibits an excellent efficacy and safety for T2DM,with satisfying tolerability and compliance,which is a selection for those patients with poor glycemic control.
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Objective To observe the effects of cyclosporin A on the expression of phosphorylated AKT in hepatocytes, and to investigate the mechanism of insulin resistance caused by cyclosporin A. Methods This study included two parts. 1. In vitro experiment:Human hepatocyte HL77022 cell line was cultured at different concentrations of cyclosporin A (0?1 μmol/L, 1 μmol/L, 5 μmol/L) for 48 hours. The expressions of phosphorylated AKT ( P?AKT) in HL77022 cells were measured by Western blot assay. 2. Rat in vivo experiment: SD rats were randomly divided into 2 groups. The rats in the control group were administrated with distilled water 1 mL/Kg/d. The rats in the cyclosporine group were administrated with cyclosporine 25 mg/Kg/d. The total experiment time was 5 months. The levels of fasting blood glucose and insulin were tested at the end of the experiment. The insulin resistance index and insulin sensitivity index were calculated. The expression of P?AKT in the rat hepatocytes was measured by immunohistochemistry. Results 1. Each group of the HL7702 cells treated by CsA ( 0?1 μmol/L, 1 μmol/L, 5 μmol/L ) showed a significantly decreased expression of P?AKT (P<0?05, P<0?01, and P<0?01). 2. After 5 months of therapy, the fasting blood glucose level of rats in the cyclosporine group was 9?28 mmol/L, indicating that cyclosporine?induced diabetic rat models were established. The insulin sensitivity index in the cyclosporine group was lower than that in the control group ( P<0?05 ) . The expression of P?AKT in liver in the cyclosporine group was significantly lower than that in the control group ( P <0?05) . Conclusions Therapeutic dose of cyclosporine has hyperglycemic effects on rats. Cyclosporine can reduce the expression of phosphorylated AKT in hepatic tissue in rats and also decrease the expression of P?AKT in human hepatocyte HL77022 cells, which indicate that cyclosporine may cause insulin resistance by interfering PI3K/AKT signal transduction pathway.