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Objective To evaluate the safety and efficacy of endoscopic ultrasound (EUS) guided ethanol ablation of benign insulinoma and compare its' advantages and disadvantages with surgical treatment. Methods From April 2011 to February 2016, clinical data of 38 patients with benign insulinoma treated by EUS-guided ethanol ablation or surgical treatment were retrospectively analyzed. Results 97.4% (37/38) patients had a typical clinical manifestation of Whipple's triad, and the I/G ratio of 82.9% patients (29/35) was more than 0.3 with their onset of hypoglycemia. The positive preoperative etiologic diagnosis rates of transabdominal ultrasonography, CT, MRI, PET/CT and EUS were 50.0%, 67.6%, 66.7%, 75.0%, 89.7% respectively. In the current study, 18 patients underwent EUS-guided ethanol ablation (EUS-FNI group) and 20 patients received surgicaltreatment (surgical group). Compared with the surgical group, the operation time, intraoperative hemorrhage volume, postoperative complications, length of stay and hospitalization costs were significantly reduced in the EUS-FNI group (P < 0.05). No treatment-related complications was observed in EUS-FNI group, while 40.0% (8/20) patients in surgical group had complications. During the follow-up period, all these patients maintained stable blood glucose without taking medication, and there's no recurrence of insulinoma in EUS-FNI group after the last treatment with alcohol injection; In surgical group, only 90.0% (18/20) patients had no recurrence, episode of hypoglycemia was less after the operation in 10.0% (2/20) patients. Conclusion EUS-guided ethanol ablation of benign insulinoma is safe and effective, compared with traditional surgical treatment, EUS-guided ethanol ablation is minimally invasive, costs less, recovers fast after treatment and has fewer complications.
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Objective Stem cell transplantation is a new approach to the treatment of lower limb ischemia ( LLI) .This study was to investigate the therapeutic effect of the transplantation of autologous bone marrow mesenchymal stem cells ( BM-MSCs) in the treatment of LLI. Methods We established the left LLI model in 12 New Zealand rabbits and divided them into a control and a trial group of equal number.The control animals were injected with DMEM, while the rabbits in the trial group with autologous BM-MSCs, into the ischemic skeletal muscle.Four weeks after injection, we performed CT angiography and perfusion imaging of both lower limbs of the rabbits and conducted HE staining of the paraffin sections of the skeletal muscle of the ischemic limbs. Results Dynamic ob-servation revealed different degrees of ecderon necrosis in 2 of the LLI models in the control group, even with toenail coloboma, but no necrosis in the trial group except for some slight muscular atrophy. Both collateral arteries and blood perfusion were obviously increased in the ischemic lower limbs in the trial than in the control group.HE stai-ning showed a significantly higher density and percentage of capillaries in the skeletal muscle fibers in the former than in the latter ([6.500 ± 1.049]/HP vs [3.670 ±0.816]/HP, [9.68 ±0.56]%vs [5.87 ± 0.86]%, P<0.01), with no necrosis in either group, nor hematoma, bony tissue, or fibroid tumor in the trial group. Conclusion Autologous transplantation of BM-MSCs can improve neovascularization in ischemic lower limbs in rabbits and can be used as a safe and effective treatment of limb ischemia.
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Objective To establish rat model of type 2 diabetes through a single subcutaneous injection of lipopolysaccharide which induced chronic inflammation.Methods The male Wistar rats(n = 30)were randomly divided control group (n = 10)and model group (n=20).Model group with LPS (300 μg·kg-1 ·day-1 )subcutaneous injection of eight weeks,rats in control group received isometric stroke-physiological saline solution injection in the same way.The changes in appearance,weight and fasting blood glucose (FBG)of rats were observed every week.At the end of the 8th week,thelevels of tumor necrosis factor a (TNF-α), interleukin-1(IL-1),interleukin-6 (IL-6),monocyte chemotactic protein-1(MCP-1)and fasting insulin(FINS)were measured.Oral glucose tolerance test (OGTT)and insulin release test(IRT)were also performed.The successful rat model was determined by the standards that FBG was ≥11.1 mmol/L.Results Model group rats reached the standard of type 2 diabetes after six weeks of LPS injection.Model group blood sugar is significantly higher than the control group (P <0.05).In addition,model group′s expression level of inflammatory cytokines in serum TNF-α,IL-1,IL-6,MCP-1 and FINS were significantly higher than control group (P <0.05).Oral glucose tolerance test,blood glucose levels higher than normal in model group,the insulin peak is lower than the normal group (P <0.05).Conclusion The success of establishing the animal model of type 2 diabetic rats which were injected of low dose of LPS by subcutaneous may be provide certain help for the etiology of diabetes research.
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Objective To study the effects of benzyl propionate nandrolone (BPN ) on the nicotinamide phosphoribosyl transferase (Nampt), insulin receptor substeate-2 (IRS-2 )and pancreatic duodenal homeobox-1 (PDX-1)expressions, cell cycle changes as well as insulin secretion in pancreatic islet cell NIT-1 lines, and to explore the influence of BPN in the Nampte xpression in NIT-1 cells and insulin signaling molecules in high glucose oxidation stress.Methods The NIT-1 cells were cultured with different concentrations (5.6,11.1,16.7,and 27.6 mmol·L-1)of glucose,then they were treated with 10 mg·L-1 BPN for 48 h with no BPN treatment as corresponding control groups.The expression levels of Nampt,IRS-2,and PDX-1 were tested by Western blotting assay.The changes of cell cycle were determined by FCM and the cell insulin secretion levels were measured with radioimmunoassay.Results Compared with corresponding control groups,the expression levels of Nampt,IRS-2, and PDX-1 proteins in the NIT-1 cells in various BPM groups were increased (P<0.05 or P<0.01).The G0/G1 phase arrest was relieved (P<0.01)when the cells was cultured in low glucose (5.6 mmol·L-1 )condition,and the G2/M block was remitted significantly in high glucose (27.6 mmol·L-1 )condition (P<0.01),furthermore, the cell insulin secretion was promoted compared with control groups except 1 1.1 mmol· L-1 glucose group (P<0.01).Conclusion BPN can promote the expression levels of Nampt,ISR-2 and PDX-1 proteins in NIT-1 cells. There is close relationship between the Nampt expression in NIT-1 cells and insulin signaling pathway and BPN prevents the cells from insulin resistance.
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Objective To study the expressions of nicotinamide phosphoribosyl transferase (Nampt)in main energy metabolism organs (liver, pancreas, skeletal muscle, and kidney ) of the rats with type 2 diabetes mellitus (T2DM),and to explore the correlation between the expression and distribution of Nampt and the occurrence of diabetes.Methods The SD rat diabetes model was established by injecting with streptozotcin (STZ).The SD rats were randomly divided into diabetes group and control group. Immunohistochemical Envision staining assay was used to detect the distribution and protein expressions of Nampt in liver,pancreas,muscle,and kidney tissues of the rats,at the same time the blood glucose and serum insulin levels were also be detected. Results The blood glucose level of the rats in diabetes group was significantly higher than that in control group (P<0.01),and the fasting insulin level was lower than that in control group (P<0.01).The Nampt expression in the liver tissue of the rats in diabets group was significantly increased,which distributed near the hepatic sinus in diabetes rats,and the Nampt expression was also increased in skeletal muscle in which the whole cell was thick dying;the Nampt expression mainly distributed in the renal tubular epithelial cells. Compared with control group, the positive expression rates of Nampt in liver,skeletal muscle,and kidney tissues of the rats in diabets group were significantly increased (P<0.05 or P<0.01).There was nearly no Nampt expression in pancreas tissue of the rats in diabetes group and the Nampt expression level was significantly lower than that in control group (P<0.01). Conclusion The Nampt expressions are much different in main energy metabolic organs of the rats with diabetes.It is suggested that Nampt may be used as a specific indicative marker in the process of diabetes.
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The roles of NF-kappaB (NF-kappaB) expression, Bax activity and cytochrome C (Cyt C) release, apoptosis of islet cells induced by high concentration glucose were explored in vitro. Pancreatic islet cells, which were isolated from Kunming mice, were cultured with different concentrations of glucose in DMEM, and divided into the following groups: G1, G2, G3, G4, G5, and G6 groups, corresponding to the glucose concentrations of 5.6, 7.8, 11.1, 16.7, 22.5, and 27.6 mmol/L, respectively. After culture for 120 h, insulin secretion was evaluated by radioimmunoassay, and the NF-kappaB expression was detected by immunocytochemistry. Bax activity and Cyt C release were measured by immunofluorescence, and apoptosis was examined by Hoechst33342 assay. The results showed that in G1, G2 and G3 groups, insulin secretion was enhanced with the increase of glucose concentration, and the NF-kappaB expression was also increased (P<0.05), but Bax activity, Cyt C release and apoptosis rate showed no significant difference among them. However, in G4, G5, and G6 groups, apoptosis rate of islet cells, NF-kappaB expression, Bax activity, and Cyt C release were all significantly increased, and insulin secretion was impaired as compared with G1, G2, and G3 groups (P<0.05). It was concluded that the exposure of islet cells to high glucose could induce islet cells apoptosis as well as impaired insulin secretion. The NF-kappaB signaling pathway and mitochondria pathway in islet cells might play some roles in the progressive loss of islet cells in diabetes. The inhibition of the NF-kappaB expression could be an effective strategy for protecting pancreatic islet cells.
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Objective To study the correlation between serum human cytomegalovirus (HCMV) DNA and peripheral T cell subsets as well as islet function in type 1 diabetic patients.Methods HCMV DNA levels in sera from 20 type 1 diabetic patients and 40 controls were measured by quantitative polymerase chain reaction (PCR),then the comparison and correlation analysis were made between HCMV DNA and T cell subsets,blood glucose (BG),insulin (Ins) and C peptide (C P).Results The positive rate and levels of HCMV DNA in type 1 diabetic patients were significantly higher than those of controls respectively.The percentage of CD 8 and the levels of fasting BG and BG 2 hours after meal in type 1 diabetic patients with positive HCMV DNA were by far higher than those in controls,while the percentage of CD 4,the ratio of CD 4/CD 8,the levels of fasting Ins,Ins and C P 2 hours after meal were significantly lower than those of controls.There existed the linear positive correlation between HCMV DNA and CD 8 or fasting BG,negative correlation between HCMV DNA and CD 4/CD 8,fasting Ins or fasting C P.Differences were not so significant between type 1 diabetic patients with negative HCMV DNA and controls compared with those between patients with positive HCMV DNA and controls.Conclusion HCMV infection is associated with dysfunction of islet and T cell mediated immunity in type 1 diabetic patients.