Research on related factors for hypoglycemic episodes in patients with type 2 diabetes mellitus based on continuous glucose monitoring system / 复旦学报（医学版）

Objective To identify related factors for hypoglycemic episodes in patients with type 2 diabetes mellitus(T2DM)through continuous glucose monitoring(CGM). Methods The included 147 patients with T2DM were those who had undergone CGM for 5 days in our ward of Department of Endocrinology and Metabolism,Huashan Hospital from Dec 2018 to Oct 2019. The general information, laboratory parameters and CGM parameters of the patients were collected. According to whether there wasan episode of hypoglycemia during the monitoring period,the patients were divided into non-hypoglycemia group and hypoglycemic group. A single hypoglycemia episode was defined as a sensor monitoring blood glucose of less than 3.9 mmol/L and lasting for more than 15 minutes.CGM parameters included the mean blood glucose(MBG),standard deviation(SD),coefficient of variation(CV),the differences between maximum and minimum blood glucose (BG) levels (ΔBG),mean amplitude of glycemic excursions (MAGE)and the percentage of time in range(％TIR)of BG at <3.9 mmol/L,3.9-7.8 mmol/L,>7.8 mmol/L,3.9-10.0 mmol/L,and >10.0 mmol/L. Results Logistic regression analysis showed that lower estimated glomerular filtration rate(eGFR)levels,increased use of insulin and its analogs and lower MBG levels were associated with hypoglycemic episodes. Spearman correlation analysis showed that the MBG level and the ％TIR of BG>7.8 mmol/L and BG>10.0 mmol/L were negatively associated while glycemic variability(GV)levels(SD,CV,ΔBG,MAGE)and ％ TIR of BG at 3.9-7.8 mmol/L were positively associated with hypoglycemic episodes. Pearson correlation analysis showed that the duration of hypoglycemic episodes was positively correlated with the use of sulfonylureas and CV levels. Conclusion Lower eGFR levels,increased treatment with insulin and its analogs and lower MBG levels were related factors for hypoglycemic episodes in patients with T2DM.

A CBCT study of alveolar bone structure around incisors of the patients with verical facial type of skeletal Class Ⅱ / 实用口腔医学杂志

Objective:To investigate the structure of alveolar bone around incisors in patients with verical facial type of skeletal ClassⅡ by CBCT.Methods:60 skeletal Class Ⅱ patients were divided into low angle,average angle and high angle cases(n =20)by FMA.CBCT scanning was made and the thickness of the labial and lingual alveolar bone around the incisors in each subject was meas-ured.The measurements were analyzed using ANOVA.Results:The total width of alveolar bone at the root apical level of maxillary and mandibular incisors,the lingual thickness of alveolar bone at the root midpoint of maxillary incisors and labial thickness of alveolar bone at the root midpoint of mandibular incisors in the high angle cases were thinner than that in the average and low angle cases(P <0.05),but there was no significant difference in labial thickness of alveolar bone at the crest among 3 groups.Conclusion:The alveo-lar bone thickness around incisors of high angle patients is thinner,more attention should be paid for the alveolar bone absorpation and tooth root exposure in these patients.

Craniofacial morphology characeristics of patients with peg-shaped upper lateral incisors / 实用口腔医学杂志

Objective:To analyze the craniofacial morphology characeristics of patients with peg-shaped upper lateral incisors. Methods:1 13 patients,aged 12 ~28 years,with peg-shaped upper lateral incisors were included,lateral cephalograms were taken and analyzed cephalometrically.Data were statistically analysed.Results:The sagittal facial patterns were skeletal Class Ⅰ(40.71%),skeletal Class Ⅱ(9.73%)and skeletal Class Ⅲ(49.56%).The vertical skeletal patterns were average vertical type (41.59%),high vertical type(18.58%)and low vertical type(39.82%).SNA,ANB,Ptm-A(mm),U1-SN,L1-NB,UL-EP were smaller(P<0.05)and SNB,PP-GoGn,SN-MP,Y axis,U1-L1,U1-NA,L1-MP and Z angles were increased(P<0.05).Conclu-sion:Patients with peg-shaped upper lateral incisors show Class Ⅲ skeletal pattern with maxillary retrognathia and mandibular prog-nathism.

Experimental study on transplantation of bone morphogenetic protein-2 gene transfected bone mesenchymal stem cells compounded with Pluronic F-127 for promoting bone regeneration in rabbit mandibular distraction / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the promotive effect of transplantation of bone morphogenetic protein-2 (BMP-2) gene transfected bone mesenchymal stem cells (BMSCs) compounded with injectable bone tissue engineering scaffold material Pluronic F-127 on bone regeneration in rabbit mandibular distraction osteogenesis(DO).</p><p><b>METHODS</b>Forty-eight New Zealand's white rabbits were randomized into four groups with twelve in each. All the objects were prepared into DO surgical model. On the 2nd day of consolidation, group A, B, C and D were injected with the same amount of 200 microL of the compound of BMP-2 gene transfected BMSCs with Pluronic F-127, the solution with BMP-2 gene transfected BMSCs, the solution of BMSCs and physiological saline at distraction zone, respectively. Two halves of the objects of all groups were sacrificed at the end of 2nd and 6th week consolidation, respectively. And the specimens of right mandible were prepared for radiological, histomorphological and immunohistochemical examinations to evaluate bone regeneration.</p><p><b>RESULTS</b>Both radiological and immunohistochemical images were analyzed and processed with professional software. At the end of 2nd and 6th week consolidation, the bone mineral density and the expression of BMP-2 protein in distraction area of group A were significantly higher than those of B, C, D group (P<0.01). Group B was significantly higher than that in group C and D (P<0.01). There was no significant difference between group C and D (P>0.05). And the regeneration quality of distraction zone in group A and B were better than those in group C and D, just as that of group A better than group B. Conclusion The transplantation of BMP-2 gene transfected BMSCs compound with Pluronic F-127 could effectively promote bone regeneration in rabbit mandibular DO.</p>

Artificial antigen-presenting cells plus IL-15 and IL-21 efficiently induce melanoma-specific cytotoxic CD8+ CD28+ T lymphocyte responses

OBJECTIVE@#To develop a novel artificial antigen-presenting system for efficiently inducing melanoma-specific CD8(+) CD28(+) cytotoxic T lymphocyte (CTL) responses.@*METHODS@#Cell-sized Dynabeads® M-450 Epoxy beads coated with H-2K(b): Ig-TRP2180-188 and anti-CD28 antibody were used as artificial antigen-presenting cells (aAPCs) to induce melanoma-specific CD8(+)CD28(+) CTL responses with the help of IL-21 and IL-15. Dimer staining, proliferation, ELISPOT, and cytotoxicity experiments were conducted to evaluate the frequency and activity of induced CTLs.@*RESULTS@#Dimer staining demonstrated that the new artificial antigen-presenting system efficiently induced melanoma TRP2-specific CD8(+)CD28(+)CTLs. Proliferation and ELISPOT assays indicated that the induced CTLs rapidly proliferate and produce increased IFN- γ under the stimulation of H-2K(b): Ig-TRP2-aAPCs, IL-15, and IL-21. In addition, cytotoxicity experiments showed that induced CTLs have specific killing activity of target cells.@*CONCLUSIONS@#The new artificial antigen-presenting system including aAPCs plus IL-21 and IL-15 can induce a large number of antigen-specific CD8(+) CD28(+) CTLs against the melanoma. Our study provides evidence for a novel adoptive immunotherapy against tumors.

Expression and significance of nitric oxide synthase in mandibular distraction osteogenesis of canine / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the expression and significance of nitric oxide synthase (NOS) during mandibular distraction osteogenesis and bone trauma healing, to futher study the mechanism of distraction osteogenesis.</p><p><b>METHODS</b>Twenty-eight adult dogs were randomly divided into DO group (12 dogs), acutely lengthening group (12 dogs) and control group (4 dogs). Immunohistochemical examination were carried out to test the expression of NOS during the sixth day in distraction period, the second and eighth week of consolidation.</p><p><b>RESULTS</b>In DO group infiltration of inflammatory cell was found in the distraction gap, more red blood cells (RBC) leak out around vascellum and matrix in the sixth day in distraction period. The expression of local iNOS (inducible NOS) and eNOS (endothelinal NOS) in DO gruoup and acutely lengthening group was higher than that in the control group (P < 0.05), the expression of local iNOS and eNOS in acutely lengthening group was lower than that in DO group (P < 0.05) in the early of distraction period and the consolidation. The expression of local iNOS and eNOS was no statistic difference between three groups (P > 0.05) in the eighth week of consolidation.</p><p><b>CONCLUSION</b>NOS as a sensitive index of tissue trauma are highly expressed, and RBC was found leaking out in the early of distraction, indicating that micro-trauma to some extent may occurr during DO procedure, the micro-trauma may be one of the significant factors which increasing regeneration of bone during DO.</p>

An epidemiological study on diabetic retinopathy among type 2 diabetic patients in Shanghai / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the prevalence and risk factors of diabetic retinopathy (DR) among type 2 diabetic patients aged over 30 in Shanghai central area.</p><p><b>METHODS</b>1039 patients diagnosed with type 2 diabetes mellitus (DM) aged over 30 were investigated by randomized cluster sampling in Shanghai central area and data from 767 of those patients were analyzed.</p><p><b>RESULTS</b>(1) Among all of the 1534 digital ocular fundus images from 767 patients, 87.6% of the images from 672 patients were gradable. (2) Among all of the 672 patients with gradable ocular fundus images, the prevalence of non-proliferative diabetic retinopathy (NPDR) was 21.6%, while proliferative diabetic retinopathy (PDR) was 1.3%. The rates of mild, moderate and severe NPDR were 8.8%, 11.2% and 1.6% respectively. (3) DR patients were characterized with elder age, higher HbA1c, urea nitrogen and serum creatinine. DM duration and the level of fasting plasma glucose were risk factors for DR.</p><p><b>CONCLUSION</b>The overall prevalence of DR in type 2 diabetic patients aged over 30 in Shanghai central area was 22.9% and the DR risk factors were found to include duration of diabetes and fasting plasma glucose level.</p>

Cloning of human bone morphogenetic protein-2 gene and the construction of its eukaryotic expression vector / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To clone human bone morphogenetic protein-2 (hBMP2) gene and construct its eukaryotic expression vector pcDNA3.1 -hBMP2.</p><p><b>METHODS</b>Human BMP2 gene was amplified by RT-PCR method from human osteosarcoma cells and constructed into eukaryotic expression vector pcDNA3.1-hBMP2. The gene in the vector pcDNA3.1-hBMP2 was identified by PCR amplification, enzyme digestion and DNA sequencing.</p><p><b>RESULTS</b>The cloned DNA was confirmed to be hBMP-2 gene.</p><p><b>CONCLUSION</b>In this study, hBMP2 gene is successfully cloned and its eukaryotic expression vector pcDNA3.1-hBMP2 is constructed, which provides the foundation of using BMP2 gene therapy to accelerate new bone formation in distraction osteogenesis.</p>

The effect of dog bilateral distraction osteogensis in temporomandibular joint / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the effect of bilateral mandibular distraction osteogenesis in the condyles.</p><p><b>METHODS</b>16 adult hybrid dogs were randomly divided into normal control group and experiment group. Experimental dogs underwent bilateral mandibular osteodistraction at a rate of 1 min/day. 4 dogs were killed respectively in distraction period, 2 and 8 weeks after completion of 10 days distraction. The bilateral condyles specimens were harvested and examined with histological and immunohistochemical methods.</p><p><b>RESULTS</b>Compared with normal control group, various degrees of irregularities and erosion were found in fibrocartilage of condyle in experiment group, including damage in fibrous layer, hyperplasia layer and proliferative layer and osteogenic activity in cartilage layer. A significant increase of TGF-beta1 expression was also found in experiment groups. TGF-beta1 positive staining was noted in hypertrophic cell, matrix and chondroblast, osteoblast and matrix in osteogenic activity areas. These changes were the most obvious in 2 weeks after completion of distraction.</p><p><b>CONCLUSION</b>Gradual bilateral mandibular distraction at a rate of 1 mm/day brought degenerative changes of condyle, but the changes are reversible.</p>

Effect of shexiang baoxin pill on the function of vascular endothelium in patients with diabetes mellitus type 2 complicated with angina pectoris / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study the effect of Shexiang Baoxin pill (SBP) on the vascular endothelial function in patients with diabetes mellitus type 2 (DM2) complicated with angina pectoris.</p><p><b>METHODS</b>Two weeks after runin, according to the randomizing table, 111 patients were divided into two groups, the XBP group (56 patients) and the control group (55 patients, treated with delayed-released isosorbide mononitrate, DRIM), they were treated for 6 months. In the treatment period, the episodes of angina attack and condition of rescue medication were recorded in the daily card, and brachial arterial changes of endothelium-dependent relaxing function before and after treatment were measured by B-ultrasonography.</p><p><b>RESULTS</b>Comparison between the two groups in episodes of angina attack and rescue medication were insignificantly different. In the control group, the basal value of brachial arterial inner diameter before and after treatment was 3.68 +/- 0.56 mm and 3.70 +/- 0.58 mm respectively, those before and after responsive congestion was 5.44 +/- 0.81% vs 5.68 +/- 0.83%, and those before and after taking nitroglycerin was 19.8 +/- 4.9% vs 20. +/- 5.2%, all showed insignificant difference (P > 0.05). In the SBP group, the corresponding basal value was 3.73 +/- 0.62 mm vs 3.71 +/- 0.59 mm, and those after taking nitroglycerin 18.8 +/- 4.5 % vs 19.2 +/- 5.8%, also showed insignificant difference, but those before and after responsive congestion (5.69 +/- 0.79 % vs 9.56 +/- 3.82 %) did show significant difference (P < 0.01).</p><p><b>CONCLUSION</b>XBP could improve the vascular endothelial function in patients with DM2 complicated with angina pectoris.</p>

Combining of TNP-470 and 5-Fu in inhibition of adenoid cystic carcinoma in nude mice model / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To study the effect of angiogenesis inhibitor and its combine with chemical drug in suppressing the growth of adenoid cystic carcinoma (ACC).</p><p><b>METHODS</b>Acc-M cells were inoculated subcutaneous into BABL/C nu/nu mice. The mice were divided into control, different dose of TNP-470 treatment groups, 5-Fu treatment group and TNP-470 plus 5-Fu treatment group. Treatments were given 48 hours after inoculation. The mice were sacrificed on the 22nd day and excised tumors were weighted. Tumors were also investigated by immunohistochemistry and ultrastructural observations.</p><p><b>RESULTS</b>TNP-470 100 mg/kg/qod efficiently inhibited the growth of Acc-M tumors. TNP-470 30 mg/kg/qod combined with 50 mg/kg/week 5-Fu also resulted in significant growth inhibit of the tumors. TNP-470 suppressed tumor growth by inhibiting neovascularization, therefore inducing apoptosis of Acc-M cells. All experimental groups had different degrees of VEGF and bFGF express.</p><p><b>CONCLUSION</b>Since ACC is a slow developing tumor, blood supply is not so sufficient as sarcomas. Angiogensis inhibitor may inhibit its growth in high dosage. Combining medium dosage of angiogensis inhibitor with chemical drug may have synergistic result in inhibiting ACC growth.</p>

Expreesion of TGF-?1 in mandibular distraction osteogenesis / 实用口腔医学杂志

Objective:To investigate the expression of transforming growth factor ?1(TGF-?1) in dog mandibular distraction osteogenensis (DO). Methods: Mandibular DO model was established in 12 dogs and nonunion model in another 12 dogs, 4 dogs were used as the no-treatment control. Tissue samples were obtained 6 d,2 and 8 weeks after operation respectively.Immunohistochemistry and enzyme-linked immunosorbent assay (ELISA) were used to determine the expressions of TGF-?1 in the samples.Results: TGF-?1 (ng/g) in control group was 1394.3?20.1,6 d after operation that in DO and nonunion groups was 1928.5?33.5(vs control,P

TNP-40 inhibits the growth of submandibular sarcoma in KM mice / 实用口腔医学杂志

Objective: To study the effect of a potent angiogenic in hi bitor TNP-470 on the growth of sarcoma. Methods:1?10 6 sarcom a S-180 cells 0.1 ml were inoculated into submandibular region in each of 40 K M mice. The mice were divided into control and treatment groups with 10 in each group. Treatment was started 8 hours after inoculation. TNP-40 at 10 mg/kg, 30 mg/kg and 100 mg/kg was given subcutaneously every other day in the 3 treatment groups,total 6 times. On the 12th day, the mice were sacrificed, tumor and mice were weighted. Apoptosis of tumor cells was observed by TUNEL method and transmi ssion microscope. Express of VEGF, bFGF were detected by immunohistochemical sta ining. Results:Sarcoma was developed in all of the mice. The sa rcoma cells invaded deep into adjacent organs and tissues such as muscle, subman dibular gland, parotid and facial nerve. 10 mg/kg, 30 mg/kg and 100 mg/kg TNP- 470 inhibited the growth of the tumor by 27.62%,63.81% and 85.71% respective ly, increased the apoptosis cell number by 54.46%,156.69% and 432.48% respect ively (P