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【Objective】 To explore the effect of massive blood transfusion on inflammatory factors, islet B cell function, incidence and mortality of multiple organ dysfunction syndrome (MODS) in patients with severe traumatic hemorrhage. 【Methods】 214 traumatic hemorrhage patients who received blood transfusion and were hospitalized in the Third People′s Hospital of Xingtai from January 2015 to June 2019 were enrolled and divided into the routine blood transfusion group (n=118) and massive blood transfusion group (n=96) according to the amount and method of blood transfusion. The changes of the inflammatory factors such as TNF α and IL-6, the functional indexes of Islet B cells such as HOMA-B and Δ INS30 / Δ GLU30, and the incidence and mortality of MODS in two groups 3 d after blood transfusion were observed. 【Results】 The level of TNF α(ng/L), IL-6(ng/L), HOMA-B and Δ INS30 / Δ GLU30 were (64.21±8.41) vs (30.75±5.26), (216.52±17.99) vs (152.45±16.26) (58.55±10.23) vs (103.47±17.48) and (2.95±0.69) vs (5.87±1.30) in the massive transfusion group and routine transfusion group, respectively (P<0.01). The incidence of MODS was 63.54%(61/96) vs 40.07%(52/118)(P<0.01) while the mortality of MODS was 46.88%(40/118) vs 33.90% (P>0.05). 【Conclusion】 The massive blood transfusion could increase the incidence of MODS in patients with severe traumatic hemorrhage by promoting inflammatory reaction and dysfunction of islet B cells.
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Objective To investigate the effect of tacrolimus on the function of islet beta cells in mature SD rats.Methods 72 Healthy SD rats were divided into 4 groups by random number table:High dose group (group H),middle dose group (group M),low dose group (group L) and control group,18 for each group.Measured body weight every 3 days and monitored fasting blood glucose every month.Fasting serum insulin levels (FINS) was determined by enzyme-linked immunoasaay (ELISA) after 1 month and 4 months later.The histological structure of islets were observed by HE staining.Results The clinical symptoms of polydipsia and polyuria in rats after 4 months in group H and M group tacrolimus irrigation group were presented,and the weight growth rate was lower than earlier;There was no significant change in blood glucose within one month of each group,as the duration of drug administration was extended,the blood glucose levels of the experimental groups gradually increased significantly and were positively correlated with the concentration;In the early stage of insulin level,the insulin secretion was negatively correlated with the concentration of tacrolimus;After 1 month,HE staining the pancreatic structure was clear and the islet structure was intact,After 4 months,the pancreatic tissue structure of H and M group was destroyed.Conclusion The short-term use of tacrolimus will not cause damage to the function of beta cells of the islet,but long-term use may gradually lead to the damage of beta cell function,and these changes are closely related to the concentration of tacrolimus.
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OBJECTIVE:To evaluate the improvement effects of sitagliptin on islet B-cell function in type 2 diabetic patients systematically,and to provide evidenced-based reference. METHODS:Retrieved from PubMed,Cochrane library,EMBase, CJFD,Wanfang database,VIP and CBM,RCTs about sitagliptin alone or combined with routine plan(trial group)vs. placbo alone or combined with routine plan(control group)in the treatment of type 2 diabetes were collected. Two reviewers independent-ly screened studies according to exclusion and inclusion criteria,extracted data,and assessed the methodological quality according to Cochrane Manual 5.1.0. Meta-analysis was performed by using RevMan 5.3 software. RESULTS:A total of 5 RCTs were includ-ed,involving 1253 patients. The result of Meta-analysis showed that changes of islet B cell function index(Homa-B)[sitagliptin alone group:MD=9.21,95%CI(4.16,14.25),P<0.001;drug combination group:MD=7.24,95%CI(0.80,13.68),P=0.03] and changes of insulin resistance index(Homa-IR)[sitagliptin alone group:MD=-0.40,95%CI(-0.44,-0.36),P<0.001;drug combination group:MD=-0.35,95%CI(-0.63,-0.07),P=0.02] of trial group were significantly better than those of control group,with statistical significance. CONCLUSIONS:Sitagliptin shows certain therapeutic efficacy in improving islet B cell func-tion and insulin resistance.
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OBJECTIVE:To observe the effectiveness and safety of liraglutide combined with insulin and glipizide in the treat-ment of subclinical hypothyroidism(SCH)complicated with type 2 diabetes in the elderly patients. METHODS:Totally 82 elderly patients with SCH complicated with type 2 diabetes were selected from our hospital during Dec. 2013-Dec. 2015,and then divided into trial group(40 cases)and control group(42 cases)according to random number table. Control group was given Insulin in-jection+Glipizide tablets. Trial group was additionally given Liraglutide injection 0.6 mg,sc,qd,on the basis of control group. Treatment courses of 2 groups lasted for 12 weeks. The levels of blood glucose [fasting glucose,postprandial 1 h and 2 h glucose,mean of daily differences(MODD),mean amplitude of glycemic excursions(MAGE)],glycosylated hemoglo-bin,body weight,total cholesterol,blood pressure [systolic blood pressure(SBP),diastolic blood pressure(DBP)],thyroid stimulating hormone(TSH)and homeostasis model assessment(HOMA-B)were observed in 2 groups before and after treat-ment. The occurrence of ADR was recorded. RESULTS:Totally 4 patients of control group withdrew from the study,and no one withdrew from the study in trial group. Before treatment,there was no statistical significance in the levels of blood glu-cose,glycosylated hemoglobin,body weight,total cholesterol,blood pressure,TSH and HOMA-B (P>0.05). After treat-ment,body weight and total cholesterol level of trial groups were significantly decreased and lower than those of control group,with statistical significance (P0.05). CONCLUSIONS:Liraglutide com-bined with insulin and glipizide for elderly patients with SCH complicated with type 2 diabetes can effectively reduce blood glucose level,keep blood glucose stable,control the increase of body weight and improve islet B cell function with good safety.
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Objective To investigate the effects of Nrf2/ARE pathway activator upregulating the expression of phase Ⅱ detoxifcation enzymes and antioxidant enzymes in islet B cell on its morphological structure in type 2 diabetic rats.Methods Type 2 diabetic rats were divided into diabetes model group (DM group),and tertiary-Butylhydroquinone intervention group(tBHQ group).At the same time,the normal control group (NC group)was set up.All rats were killed after eight-week continuous intervention.Fasting blood glucose (FBG) and fasting insulin (FINS) level were determined.Morphological structure of islet cells and apoptosis were observed.ELISA was used to determine MDA,TNF-α and T-SOD levels in serum and pancreatic tissues and Western blot was used to detect the protein expression levels of total Nrf2 and nulear Nrf2 in pancreatic tissues.Results Compared with NC group,FBG and FINS levels significantly increased and decreased in DM group respectively (all P=0.000).Compared with DM group,FBG and FINS levels significantly decreased and increased in tBHQ group respectively (all P=0.000).Compared with NC group,the number of islet cells significantly decreased and swelling,necrosis and apoptosis occurred in DM group.Islet cells in tBHQ group were significantly better than those in DM group.Compared with NC group,MDA and TNF-α levels in serum and pancreatic tissue significantly increased and TSOD levels significantly decreased in DM group (all P=0.000).Compared with DM group,MDA and TNF-α levels in serum and pancreatic tissue significantly decreased and T-SOD levels significantly increased in DM group(all P=0.000).Total Nrf2 and nulear Nrf2 in protein expression in DM group were significantly lower of than those in NC group (P()=0.000,P nulear Nrf2=0.006).Rats in tBHQ group had significantly higher protein expression of total Nrf2 and nulear Nrf2 than in DM group (all P=0.000).Conclusions Activating Nrf2/ARE pathway can reduce injury of oxidative stress and chronic inflammation on islet B cells further through upregulating the expression of phase Ⅱ detoxifying enzymes and antioxidant enzymes in islet B cells.
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The impact of hypofunction of kidney on evaluating of islets β cell function in patients with type 2 diabetes was investigated. 635 type 2 diabetic patients with normal liver function were grouped using Cockcroft-Gault. Following the decrease in kidney function, blood C-peptide concentration was increased with decreased urinary exeretion of C-peptide(P<0. 05). It is proposed to pay an attention to renal function while evaluating islets β cell function in the patients.
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Objective To study the effects of sulodexide on islet B-cell function in streptozocin induced di-abetic rats. Methods Sprague-Dawley(SD) rats were randomly divided into normal control group (group C), dia-betic group without treatment(group D), and suledexide treatment group(group S), a single dose of streptozotocin were abdominally injected to establish the diabetic rat models. Each animal in sulodexide treated group was addition-ally fed with sulodexide of 10 mg/(kg·d) for 12 weeks,while the remained group (group C and D) were given normal water in the same period. After 12 weeks of treatment, fasting plasma glucose(FPG),fasting plasma insulin (FINS), activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), triglyceride (TG), Low-density lipoprotein cholesterol (LDL-C), serum creatinine rates (SCr) and alanine aminotransferase (ALT) were measured. Insulin sensitivity index(ISI) and insulin resistant index (HOMA-IR) were calculated. Results After 12 weeks, the levels of TG, LDL-C and ALT had no significant difference between group D and group S, but were higher than those in group C (P <0.05);There were no significant difference of SCr levels among the three groups. Compared with the group C, APTT, PT, TT and ISI in group D and S were significantly decreased, HOMA-IR were significantly increased (P < 0.05). APTT, PT, TT and ISI in group S had significantly increased compared with that in group D, HOMA-IR was significantly decreased in group S compared with that in group D (P < 0.01). Conclusions Sulodexide can reduce insulin resistant, improve hypercoagulability and insulin sensitiv-ity in streptozocin induced diabetic rats. The effects to blood lipid, liver and renal functions in diabetic rats are not obvious.
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The response of normal islet β cells to insulin resistance is compensatory insulin hypersecretion in order to maintain normoglycemia. The mechanisms involved in the compensation process including the expansion of β cell mass and enhanced β cell performance via various molecular cascades, signaling pathway sand their interactions have been extensively investigated in recent years.
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Objective To investigate the role of islet B cell dysfunction in the pathogenesis of type 2 diabetes mellitus. Methods FBG and fasting plasma insulin of 49 healthy subjects and 125 first-degree relatives of type 2 diabetes mellitus were determined. HOMA model was used to calculate HOMAIR as an index of insulin resistance and HOMAB as an index of B cell function of pancreatic islet.The insulin sensitivity index(ISI) and early-stage secretion index of islet ?cell(△I_ 30 /△G_ 30 )were calculated. Results The HOMAB and △I_ 30 /△G_ 30 of the group of normal first-degree relatives were higher (P