Ultrasound-guided anhydrous ethanol and microwave ablation for functional parathyroid cyst: a case report / 南方医科大学学报

We report a case of functional parathyroid cyst treated by ultrasound-guided anhydrous ethanol sclerotherapy and microwave ablation. The 63-year-old female patient was diagnosed to have functional parathyroid cyst with hypercalcemia, high PTH and cystic space-occupying lesions in the neck by ultrasound, radionuclide scanning and PTH measurement of the cystic fluid. The patient refused to receive cyst resection, and anhydrous ethanol sclerotherapy with microwave ablation was performed under ultrasound guidance. The procedure was completed smoothly without any complications either during or after the operation. Follow-up examination of the patient at 18 months after the operation showed a significant reduction of the mass and normal blood calcium and iPTH levels, demonstrating a clinical cure of the patient. Ablative treatment of functional parathyroid cyst has not been documented so far. This approach provides a minimally invasive treatment modality for such cases where surgical resection is not an option, but its efficacy and safety need to be evaluated in more cases with longer follow-up time.

A diabetic foot classification model based on radiomics features of fundus photographs / 中华内分泌代谢杂志

Objective:To construct a diabetic foot classification prediction model based on radiomics features of fundus photographs.Methods:A total of 2 035 fundus photographs of patients with type 2 diabetes diagnosed at Nanfang Hospital between December 2011 and December 2018 were retrospectively collected [282 photographs from patients with diabetic foot(DF), and 1 753 from patients with diabetes mellitus(DM)]. All fundus photographs were randomly divided into a training set(1 424 photos) and a test set(611 photos) using a computer generated random number at 7∶3. After pre-processing the fundus photographs, a total of 4 128 texture features based on the gray matrix were extracted by the Radiomic toolkit, and 11 339 other features were extracted using the ToolboxDESC toolkit. The LASSO algorithm was used to select the 30 features most relevant to DF, and then the Bootstrap + 0.632 self-sampling method was used to further select the 7 best combinations. Logistic regression analysis was used to obtain the regression coefficients and establish the final diabetic foot classification prediction model. ROC curve was drawn, and AUC, sensitivity, specificity, and accuracy of the training and test sets were calculated to verify its prediction performance. Results:We screened 7 fundus radiomics markers for diabetic foot patients, and based on this established a DF/DM classification prediction model. The AUC, sensitivity, specificity, and accuracy of the model were 0.958 6, 0.984 0, 0.920 0, and 0.928 0 in the training set, and 0.927 1, 0.988 9, 0.881 0, and 0.896 9 in the test set, respectively.Conclusion:In this study, seven DF fundus markers were screened using radiomics technology. Based on this, a highly accurate and easy-to-use DF/DM classification model was constructed. This technology has the potential to increase the efficiency of DF screening programs.

Efficacy and safety of Changsulin ? compared with Lantus ? in type 2 diabetes: a phase Ⅲ multicenter, randomized, open-label, parallel, controlled clinical trial / 中华内科杂志

Objective:To compare the efficacy and safety of Changsulin ? with Lantus ? in treating patients with type 2 diabetes mellitus (T2DM). Methods:This was a phase Ⅲ, multicenter, randomized, open-label, parallel-group, active-controlled clinical trial. A total of 578 participants with T2DM inadequately controlled on oral hypoglycemic agents were randomized 3∶1 to Changsulin ? or Lantus ? treatment for 24 weeks. The efficacy measures included changes in glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), 2h postprandial plasma glucose (2hPG), 8-point self-monitoring of blood glucose (SMBG) profiles from baseline, and proportions of subjects achieving targets of HbA1c and FPG. The safety outcomes included rates of hypoglycemia, adverse events (AEs) and anti-insulin glargine antibody. Results:After 24 weeks of treatment, mean HbAlc decreased 1.16% and 1.25%, FPG decreased 3.05 mmol/L and 2.90 mmol/L, 2hPG decreased 2.49 mmol/L and 2.38 mmol/L in Changsulin ? and in Lantus ?, respectively. No significant differences could be viewed in above parameters between the two groups (all P>0.05). There were also no significant differences between Changsulin ? and Lantus ? in 8-point SMBG profiles from baseline and proportions of subjects achieving the targets of HbA1c and FPG (all P>0.05). The rates of total hypoglycemia (38.00% and 39.01% for Changsulin ? and Lantus ?, respectively) and nocturnal hypoglycemia (17.25% and 16.31% for Changsulin ? and Lantus ?, respectively) were similar between the two groups (all P>0.05). Most of the hypoglycemia events were asymptomatic, and no severe hypoglycemia were found in both groups. No differences were observed in rates of AEs (61.77% vs.52.48%) and anti-insulin glargine antibody (after 24 weeks of treatment, 6.91% vs.3.65%) between the two groups (all P>0.05). Conclusions:Changsulin ? shows similar efficacy and safety profiles compared with Lantus ? and Changsulin ? treatment was well tolerated in patients with T2DM.

Characteristics of urinary microflora in women with type 2 diabetic peripheral neuropathy without lower urinary tract symptoms / 中华泌尿外科杂志

Objective:To investigate the characteristics of urinary microflora in women with type 2 diabetic peripheral neuropathy without lower urinary tract symptoms.Methods:By completing nerve conduction function and the American Urological Association Symptom Index questionnaire (AUA-SI), a total of 30 cases of women hospitalized with type 2 diabetes and no symptoms of lower urinary tract from May 2017 to August 2018 were included. 17 patients with diabetic peripheral neuropathy were assigned to the DPN group, and 13 patients without diabetic peripheral neuropathy were assigned to the nDPN group. Urine specimens were collected from clean catch midstream urine and processed for extracting DNA. Microbial diversity and composition were analyzed using the Illumina sequencing platform targeting to 16S rDNA gene. Sequencing reads were processed by QIIME. LEfSe algorithm was used to analyze the flora with significant differences between the two groups.Results:The duration of diabetes in the DPN group was lower than that in the nDPN group [(4.12 ± 3.28)years vs.(8.03 ± 6.11)years, P = 0.03], and the retinopathy cases were more in the DPN group than those in the nDPN group (6 vs. 0, P=0.03). Except for above two indicators, there was no significant difference in demographic characteristics between DPN group and nDPN group( P>0.05). The urinary microenvironment of DPN was characterized by increased bacterial richness(sobs index, chao index and aec index, 67.24±40.25 vs.108.69±57.18; 81.36±47.99 vs.122.55±55.70; 88.58±55.03 vs.125.78±53.03, all P<0.05) and by the enrichment of Mycoplasmataceae(Metastats value: 0.52±0.01vs.0.01±0.00001, P=0.02). Beta diversity showed that no significant difference of bacterial composition was found between these two group( P>0.05). LEfSe analysis showed that at the genus level, the relative abundance of eight genera(e.g., Bacillus, Duganella, Leptotrichia, Proteus, Propionibacterium, Pseudoxanthomonas, Bdellovibrio and uncultured_soil_bacterium) in DPN group decreased at the level of genus( P<0.05). Conclusions:Female patients with type 2 diabetes without lower urinary tract symptoms of peripheral neuropathy exhibit a different microbial community compared to nDPN controls. Mycoplasmataceae may be a potential biomarker for patients with DPN.

Effect of glucagon-like peptide 1 receptor agonists on body fat redistribution and muscle mass in overweight and obese type 2 diabetic patients / 南方医科大学学报

OBJECTIVE@#To investigate the effect of glucagon-like peptide 1 receptor agonists (GLP-1RAs) on body fat redistribution and muscle mass in overweight/obese patients with type 2 diabetes (T2DM).@*METHODS@#We retrospectively analyzed the data of 76 patients with body mass indexes (BMI)≥24 kg/m, who had an established diagnosis of T2DM in our department between December, 2014 and September, 2015. We divided these patients according to their BMI in overweight group (BMI of 24-27.9 kg/m, =14), obese group (BMI of 28-31.9 kg/m, =35) and severely obese group (BMI≥32 kg/m, =27). All the patients received treatment with GLP-1RAs (Exenatide or Liraglutide) for 3.0 to 29.0 weeks (mean 8.9 weeks), and their blood glucose, HbA1c and serum lipids were analyzed. For each patient, the fat and muscle masses were analyzed using a human body composition analyzer (JAWON-IOI353, Korea) before and after GLP-1RAs treatment.@*RESULTS@#Treatment with GLP-1RAs significantly decreased BMI and visceral adiposity index (VAI) in all the patients in the 3 groups ( < 0.05). The treatment significantly decreased the body weight in the overweight group and obese group by 2.70 kg (0.60-4.95 kg) and 2.65 kg (1.45-6.40 kg), respectively ( < 0.05), and significantly decreased the waist-to-hip ratio (WHR) in the overweight group ( < 0.05). The obese and severely obese patients showed significantly decreased percentage body fat (including both subcutaneous and visceral fat) and increased muscle mass after the treatment ( < 0.05). Compared with those in the overweight group, the percentage body fat and VAI were significantly decreased in the obese group after the treatment ( < 0.05), and the percentage of subcutaneous fat reduced and the muscle ratio increased more obviously in the obese and severely obese patients ( < 0.05).@*CONCLUSIONS@#GLP-1RAs treatment can significantly lower BMI and improve body fat distribution in obese patients with T2DM, especially in patients with a greater BMI.

Changes in regional homogeneity of brain activity in patients with diabetic peripheral / 南方医科大学学报

OBJECTIVE@#To investigate the abnormalities in regional homogeneity of brain activity in patients with diabetic peripheral neuropathy (DPN) using resting-state functional magnetic resonance imaging (rs-fMRI) and explore the association between brain activity changes and DPN.@*METHODS@#A regional homogeneity (ReHo) approach was used to compare the local synchronization of rs-fMRI signals among 20 patients with painful DPN, 16 patients with painless DPN, and 16 type 2 diabetic patients without DPN (non-DPN group).@*RESULTS@#Compared with the those without DPN, the patients with painful DPN showed high ReHo in the left inferior temporal gyrus and the right central posterior gyrus, and low ReHo in the posterior cingulate gyrus, right inferior parietal gyrus, and the left superior parietal gyrus ( < 0.05);the patients with painless DPN group showed high ReHo in the left inferior temporal gyrus, the right middle temporal gyrus, and the right superior frontal gyrus, and low ReHo in the left thalamus ( < 0.05).No significant differences in ReHo were found between the patients with painful DPN and painless DPN (>0.05).@*CONCLUSIONS@#The patients with DPN have altered ReHo in multiple brain regions and impairment of a default mode network, for which the left temporal gyrus may serve as a functional compensatory brain area. ReHo disturbance in the central right posterior gyrus may play a central role in the pain symptoms associated with painful DPN.

Research advances in the role of long non-coding RNA in diabetic kidney disease / 中国糖尿病杂志

Objective Long non-coding RNA(lncRNA),with more than 200 nucleotides in length,is closely related to many endocrine and metabolic diseases as a functional RNA.Researches has shown that lncRNA can regulate gene expression in multiple levels,including participation in chromatin imprints,in combination with apparent modified complexes or transcription factors to play a transcriptional regulation,and binding with miRNA,mRNA or protein to play the role of post-transcriptional regulation.The disorder of lncRNA expression and the mutation of the primary sequence or variation of the secondary structure are associated with many human diseases.The study of lncRNA in diabetic kidney disease is still in its infancy.In addition,since some lncRNA can be detected in human body fluid and have good specificity and accessibility,it is speculated that lncRNA can be used as a new potential biomarker for the diagnosis and prognosis of diabetic kidney disease.

Efficacy observation of liraglutide combined with glargine insulin in treatment of newly diagnosed type 2 diabetes mellitus / 重庆医学

Objective To investigate the effect of liraglutide combined with glargine insulin in treating the patients with newly diagnosed type 2 diabetes mellitus (T2DM).Methods Sixty-one cases of newly diagnosed T2DM in the endocrinology department of Affiliated Chaozhou Central Hospital of Southern Medical University,from August 2014 to December 2015 were selected and divided into two groups according to the random number table.The observation group (29 cases) was treated with liraglutide combined with glargine insulin and the control group (32 cases) was given the intensive insulin therapy.The curative effects before and after treatment were analyzed and compared between the two groups.Results The fast plasma glucose(FPG),postprandial 2 h blood glucose(PPG),glycosylated hemoglobin(HbA1c),fasting C peptide(FCP),postprandial 2 h C peptide(PCP),insulin resistance index(HOMA-IR),blood lipid indicators and body mass index after 12-week treatment were decreased in the treatment and follow up periods,while pancreatic β cell function index (HOMA-β) and HDL-C were increased,indicating that the two kinds of treatment method all were effective.The effect onset in the observation group was faster,the above indexes after 4-week treatment were significantly improved compared with before treatment.The above indexes after 4-,12-week treatment in the observation group were significantly superior to those in the control group,the difference was statistically significant(P<0.05).Conclusion Liraglutide combined with glargine insulin has better effect in the aspects of reducing blood glucose,regulating blood lipid,decreasing the body mass and islet function recovery than the intensive insulin treatment and is worthy of clinical promotion and application.

Effect of DPP4 inhibitor sitagliptin on expressions of early growth response-1 and fibronectin in the kidney of ApoE gene knockout mice / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effects of the DPP4 inhibitor sitagliptin on the expressions of early growth response-1 (Egr-1) and fibronectin in the kidney of ApoE gene knockout mice.</p><p><b>METHODS</b>Eight-week-old male ApoE gene knockout mice were randomly divided into sitagliptin + apoE(-/-) group and apoE(-/-) group (n=6), with 6 C57BL mice as the normal control group. After feeding with high-fat diet and drug treatment for 16 weeks, the mice underwent intraperitoneal glucose tolerance test (IPGTT) and were measured for 24-h urinary albumin using ELISA. All the mice were then sacrificed to examine the changes of blood lipid profile and for detection of Egr-1 and fibronectin mRNA and proteins in the renal tissue using real-time PCR and Western blotting.</p><p><b>RESULTS</b>The mice in both apoE(-/-) group and sitagliptin+apoE(-/-) group all showed prominently increased blood lipids as compared with the control group (P<0.05) without significant differences between the two apoE(-/-) groups. The level of HDL was significantly higher in sitagliptin +apoE(-/-) group than in apoE(-/-) group (P<0.001) and control group (P<0.001). IPGTT showed no significant differences in the levels of blood glucose among the 3 groups. The excretion of urinary albumin was increased in apoE(-/-) group compared with the control group (P<0.01), but was significantly lower in sitagliptin+ apoE(-/-) group than in apoE(-/-) group (P<0.01). Real-time PCR and Western blotting showed significantly decreased mRNA and protein expressions of renal cortical Egr-1 and fibronectin in sitagliptin+apoE(-/-) group compared with apoE(-/-) group.</p><p><b>CONCLUSION</b>Sitagliptin can reduce the renal expression of fibronectin by regulating the expression of Egr-1 to achieve renal protection.</p>

Effects of beraprost sodium on apoptosis in cultured mouse podocyte induced by angiotensin Ⅱ / 实用医学杂志

Objective To explore the effects of beraprost sodium (BPS) on angiotensin Ⅱ(AngⅡ)-induced podocyte apoptosis and the relationship between BPS and peroxisome proliferator activated receptor δ(PPARδ). Methods Differentiated mouse podocytes were exposed to AngⅡ, further treated with BPS (or GSK0660) for 24 h. Podocyte apoptosis was detected by flow cytometry and AnnexinV-FITC staining. Bax , Bcl-2 and PPARδ mRNA were assessed by RT-PCR. Results AngⅡ promoted podocyte apoptosis and Bax mRNA expression significantly, down-regulated Bcl-2 and inhibited PPARδ mRNA (P < 0.05). Conversely, treatment with BPS reduced AngⅡ-induced podocyte apoptosis and Bax mRNA expression and promoted Bcl-s expression significantly resulting in an increase of PPARδ mRNA expression (P < 0.05). With the inhibition of PPARδ, podocyte apoptosis and Bax mRNA expression increased while Bcl-2 mRNA expression reduced. Conclusion BPS can effectively reduce AngⅡ-induced podocyte apoptosis , which is associated with the activation of PPARδand regulation of Bcl-2/Bax mRNA expression.

Metabonomics analysis of effects induced by PCBs and high fat diet combined expo-sure in SD rats / 军事医学

Objective To explore the effect on metabolism of glucose and lipids, potential toxicity mechanism and possible biomarker candidates by analyzing urine metabonome changes of rats after oral administration of polychlorinated biphenyl congeners( PCBs) and high fat diet alone or in combination.Methods Male SD rats were divided randomly into control group,high fat diet group, PCBs group and combination group of PCBs and high fat diet.Urine samples were collected after 6-week treatment, 1 H NMR spectra were performed and analyzed by principal component analysis ( PCA) . Results The PCA scores plot of urine 1 H NMR data showed that the combined group could be easily distinguished from the other three groups, suggesting great difference in metabolism.The loading plot of the PCA revealed significant increase in the levels of lactate, glucose, creatine, 2-hydroxy-isovaleric acid and reduction in the levels of citrate, succinate, taurine, hippurate and trimethylamine oxide ( TMAO) in the combined exposure group after six-week exposure.Conclusion The altered levels of metabolites induced by combined exposure of PCBs and high fat diet may be related to the injury to mitochondrial function, reduction of energy metabolism in tricarboxylic acid cycle (TAC).These effects possibly lead to perturbations in the metabolism of glucose, lipid and amino acids.The altered metabolites may be considered biomarker candidates of toxicity induced by exposure to PCBs and high fat diet.

Distribution of pathogens in diabetic foot osteomyelitis and risk factors of osteomyelitis / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the distribution and antibiotic resistance of pathogens in lesions of diabetic foot osteomyelitis (DFO) and analyze the risk factors causing osteomyelitis.</p><p><b>METHODS</b>A total of 372 patients with diabetic foot infections hospitalized between January 2011 and December 2014, including 203 with osteomyelitis (OM group) and 169 without osteomyelitis (non-OM group), were examined for the distribution and antibiotic resistance profile of the pathogens in the wounds. Logistic regression analysis was used to analyze the risk factors causing osteomyelitis.</p><p><b>RESULTS</b>Gram-negative bacteria were the predominant pathogens (53.7%) in the infected wounds in OM group, whereas Gram-positive bacteria were the most frequently found (56.7%) in non-OM group (P=0.001). Among the Gram-positive bacteria, Staphylococcus was the dominating flora (35.1%). The resistance rate to oxacillin and cefoxitin of the isolated bacteria in OM group (64.9% and 68.5%, respectively) was significantly higher than that in non-OM group (29.2% and 32.6%, respectively; P<0.05). Among the gram-negative bacteria, Enterobacteriaceae was the dominating flora (62.4%), with a higher resistance rate to Cefepime and Aztreonam in OM group (30.1% and 38.6%, respectively) than in non-OM group (15.1% and 22.2%, respectively; P<0.05). Logistic regression analysis indicated that the infection by multi-drug resistant bacteria and an wounds area >4 cm(2) were the risk factors for osteomyelitis in patients with diabetic foot infections (P<0.05).</p><p><b>CONCLUSION</b>In addition to an empirical anti-infection therapy, clinicians should choose specific antibiotics against Gram-negative bacteria according to the microbial spectrum and antibiotic resistance of pathogens in patients with DFO; patients with diabetic foot infections by multi-drug resistant bacteria and those with a wound area exceeding 4 cm(2) are exposed to an increased risk of osteomyelitis.</p>

Risk factors for diabetic kidney diseases in inpatients with type 2 diabetes / 中华内分泌代谢杂志

Objective To analyze risk factors for diabetic kidney disease (DKD) in inpatients with type 2 diabetes.Methods A total of 930 inpatients with type 2 diabetes were enrolled in the study and grouped according to different levels of estimated glomerular filtration rate (eGFR),albuminuria,and diabetic retinopathy.Logistic regression analysis was adopted to explore the risk factors for DKD in inpatients with type 2 diabetes.Results (1) The prevalence of albuminuria in patients with type 2 diabetes mellitus was increased with declining eGFR (P ＜ 0.05).(2) The prevalences of DKD and non-diabetic renal disease (NDRD) in patients with type 2 diabetes mellitus were 22.26％ and 8.92％,respectively.Compared with patients with NDRD,patients with DKD had longer diabetic duration,higher levels of systolic blood pressure,serum creatinine,and urinary albumin excretion,and lower levels of hemoglobin[(125.40 ± 21.95 vs 138.18 ± 19.67) g/L],serum albumin[(37.45 ± 5.54 vs 40.55 ± 3.55) g/L],and eGFR[(89.66 (59.10-108.25) vs 103.15 (85.39-114.88) ml · min-1 · (1.73 m2)-1,all P＜0.05].(3) Logistic regression analysis showed that age,diabetic duration,systolic blood pressure,serum uric acid,diabetic retinopathy,and hypertension are the independent risk factors for diabetic kidney disease in inpatients with type 2 diabetes,while serum albumin was the protective factor (all P＜0.01).Conclusions A variety of clinic risk factors were associated with DKD.Better control of blood pressure,serum uric acid,and hypoalbuminemia should be performed to delay the progress of DKD.

Research progress of protective effect of GLP-1 receptor agonist on vascular endothelial cell / 中国糖尿病杂志

[Summary] Type 2 diabetic patients often have risk factors such as hyperglycaemia ,dyslipidaemia , hypertension ,obesity and insulin resistance ,which increase the risks of vascular endothelial dysfunction and cardiovascular events. GLP-1 analogue and its receptor agonist ,is a novel therapy on diabetes targeting at incretin ,which can effectively control blood glucose and improve vascular endothelial dysfunction. Here we summarize the protective effect of GLP-1 analogue and its receptor agonist on vascular endothelial cell.

Risk factors of albuminuria in type 2 diabetic nephropathy patients / 实用医学杂志

Objective To investigate the risk factors of albuminuria in type 2 diabetes nephropathy patients. Methods 870 hospitalized patients with type 2 diabetes mellitus were included in the study. The patients were divided into normal buminuria group (n = 634) and persistent albuminuria group (n = 236) according to the 24h urinary albumin excretion. Diabetic chronic complication and related biochemical indicators were analyzed. Independent risk factors associated with diabetic nephropathy were analyzed. Results The differences in duration of diabetes, age, SBP, DBP, Hb, HbA1C, UA, TG, CHOL-C, HDL-C, diabetic retinopathy (DR), cardiovascular and cerebrovascular disease were statistically significant between two groups (P < 0.01). Regression analysis showed that independent risk factors of albuminuria of DN included duration of diabetes, SBP, Hb, UA, TG and DR. Conclusions Such risk factors of duration of diabetes, SBP, UA, TG, Hb and DR may be associated with the occurrence and severity of albuminuria of DN.

Inlfuence on Acupuncture Treatment of Diabetic Peripheral Neuropathy-A Systematic Review of Randomized Controlled Trials / 世界科学技术-中医药现代化

This study was aimed to evaluate the efficacy and safety of acupuncture treatment for diabetic peripheral neuropathy.MEDLINE, EMBASE, China National Knowledge Infrastructure (CNKI), and Wanfang database were searched. The study endpoints included clinical total efficacy, peripheral nerve conduction velocity and adverse reactions. The Review Manager software 5.2 was used in the bias and risk assessment as well as efficacy. GRADE profiler software was used to evaluate quality of evidences. The results showed that there were 18 randomized controlled trials (RCTs) with 1158 patients included. The clinical total efficacy rate of acupuncture treatment was obviously better than the drug control group [RR: 1.38, 95%CI (1.25, 1.53),P < 0.000 01]. The sensory nerve conduction velocity was that for nervus medianus, the acupuncture treatment group was superior to the drug control group [MD = 2.55, 95%CI (1.23, 3.87),P = 0.000 1]; for nervus peroneus communis, the acupuncture treatment group was superior to the drug control group [MD = 3.42, 95%CI (2.56, 4.28),P < 0.000 01]. The motor nerve conduction velocity was that for nervus medianus, the acupuncture treatment group was superior to the drug control group [MD= 4.10, 95%CI (1.01, 7.19),P = 0.009); for the nervus peroneus, the acupuncture treatment group was superior tothe drug control group [MD = 3.09, 95%CI (1.99, 4.19),P < 0.000 01]. The adverse reactions and safety indicators were that no adverse reaction was reported in both studies with no abnormal safety indicator. The quality of evidence showed that the sensory nerve conduction velocity for nervus peroneus communis was moderate; the motor nerve conduction velocities for nervus medianus and nervus peroneus communis were low. While, the clinical efficacy rate and the quality of evidence for sensory nerve conduction velocity of nervus medianus were relatively low. It was concluded that the current clinical evidences were uncertain for the efficacy and safety of acupuncture in diabetic peripheral neuropathy treatment.

Effects of metformin on apoptosis induced by advanced glycation end-products and expressions of caspase-3, Bax and Bcl-2 in human dermal fibroblasts in vitro / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of metformin in protecting against advanced glycation end products (AGEs)-induced apoptosis in human primary dermal fibroblasts.</p><p><b>METHODS</b>Fibroblasts were exposed to 100, 200, or 300 µg/mL AGEs, 300 µg/mL bovine serum albumin (BSA), or 300 µg/mL AGEs and 1 mmol/L metformin for 24, 48, or 72 h. The exposed cells were examined for cell apoptosis using a cell counting kit. The expressions of caspase-3, Bax and Bcl-2 protein in the fibroblasts treated for 72 h were detected with Western blotting.</p><p><b>RESULTS</b>AGEs exposures caused significant dose- and time-dependent apoptosis in the fibroblasts. A 72-h exposure to 300 µg/mL AGEs resulted in obviously increased apoptosis of the fibroblasts compared to the control group (0.72 ± 0.02 vs 1 ± 0.04, P<0.05), and metformin significantly decreased AGEs-induced apoptosis (0.98 ± 0.02 vs 0.72 ± 0.02, P<0.05). The expressions of caspase-3 and Bax protein were significantly increased (P<0.05) and Bcl-2 protein expression was decreased (P<0.05) with a lowered Bcl-2/Bax ratio in AGEs-treated fibroblasts (P<0.05), and such changes were significantly reversed by metformin treatment (P<0.05).</p><p><b>CONCLUSION</b>Metformin can antagonize AGEs-induced apoptosis in human dermal fibroblasts by regulating the expressions of caspase-3, Bax and Bcl-2.</p>

Effects of glucose concentration on G6PD activity and respiratory burst of normal human′s neutrophils in vitro / 重庆医学

Objective To determine the effects of glucose concentration on G 6PD activity and respiratory burst of normal hu-man′s neutrophils in vitro .Methods Normal human′s neutrophils were cultured in different glucose concentration for 8 hours ,as-sayed G6PD activity by spectrophotometric method and determining ROS content by fluorescent probe DCFH-DA .Results G6PD activity and ROS of 15 mmol/L group and 25 mmol/L group were significant lower than before ,when the 5 mmol/L group and L-GLU group didn′t have significant change with time goes by .And G6PD activity and ROS of 25 mmol/L group were the lowest in all groups(P<0 .01) .Conclusion High glucose may induce G6PD activity decreased and cause respiratory burst dysfunction as a stimulating factor .The stimulation intensity was increased with the increase of glucose concentration .It′s the probable mechanism on susceptibility to infections in patients with diabetes mediated by dysfunction of respiratory burst in leucocyte .

Neuropad test for sudomotor function to predict the risk of diabetic foot ulceration / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the predictive value of Neuropad test on occurrence of diabetic foot ulceration (DFU) among type 2 diabetic patients.</p><p><b>METHODS</b>We divided 725 cases of type 2 diabetic patients into the high-risk and the non-high-risk groups of DFU based on the results of vibration perception thresholds(VPT) examination, which was widely used as a criteria for predicting DFU. Receiver operating characteristic (ROC) analysis was used to compare the effectiveness of Neuropad with 10 g Semmes-Weinstein monofilament (10 g SWMF) testing in predicting the risk of DFU.</p><p><b>RESULTS</b>Among 725 patients of type 2 diabetes, 6.1% were at a high risk of DFU. Compared to non-high-risk group, patients in high-risk group had older age, longer diabetes duration, higher values of complete colour change time (CCC time) of Neuropad and higher abnormal rate of 10 g SWMF (P<0.01). CCC time of Neuropad was shown to be better in predicting the risk of DFU than 10 g SWMF, and the area under the ROC curve was about 0.8, and the best cut-off value was 22.25 min.</p><p><b>CONCLUSION</b>Neuropad is an effective means for predicting of the risk of DFU, and can be used to prevent diabetic foot ulceration.</p>

Effects of glucose variation on hexose monophosphate shunt and leucocyte respiratory burst in patients with type 2 diabetes / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of blood glucose instability on respiratory burst of leukocytes in patients with type 2 diabetes (T2DM).</p><p><b>METHODS</b>Forty-five patients with T2DM were divided into 3 groups after continuous glucose monitoring for 72 h with glucose wavy coefficient <1.5 (n=11), between 1.5 and 3.0 (n=19), and >3.0 (n=15). Peripheral blood neutrophils were isolated from the diabetic patients and normal control subjects for assay of glucose 6-phosphate dehydrogenase (G6PD) with a spectrophotometric method, detecting G6PD mRNA expression by real-time PCR, and determining reactive oxygen species level using the fluorescent probe DCFH-DA.</p><p><b>RESULTS</b>Compared with the normal control group, the diabetic patients showed significantly lowered G6PD activity (F=78.739, P<0.05) and ROS level (F=384.962, P<0.05) but significantly increased G6PD mRNA expression (F=269.612, P<0.01). These changes were significantly correlated with the blood glucose wavy coefficients.</p><p><b>CONCLUSION</b>The fluctuation of blood glucose in T2DM patients can decrease G6PD activity and lead to functional decline of the respiratory burst.</p>