Résumé
Objective To investigate the effects of local application of NGF combined with Insulin on wound healing with Ⅱ degree deep scald and the expression of HIF-1α and VEGF in diabetic rats. Methods 60 male Wistar rats were used in the study by intraperitoneal injection of streptozotocin (STZ). Deep partial thickness scalding was engendered on the back of the rats after one month. Then these rats were random divided into group B (scalding of the rats with diabetes, n = 15), C (insulin control, n = 15), D ( NGF control, n = 15) and E ( NGF and insulin supplementation, n = 15). And group A ( nomal control,n = 15) was created by normal rats of partial thickness scalding. The wound area, wound healing rate, and grey of HIF-1α and VEGF immunohistochemistry staining were determined on the 3rd, 7th, 15th, and 21st day post scalding days (PSDs). Results Compared to those in groups A, B, C and D, the wound healing rate in group E increased significantly since the 7th PSD [(25.33 ± 2. 32 ) %, P ＜ 0.05]. The wound healing rate in group C and D increased significantly compared with group B [( 16. 68 ± 1.95 ) %, ( 18.29±1. 70)%, P ＜0.05]. Compared to group A, the group D increased significantly since the 15th PSD [(54. 84 ±3.60)%, P ＜0. 05]. The expression of HIF-1α and VEGF in group E began to increase slower than other groups after the 7th day ( P ＜0. 05 ). Conclusion Local application of NGF combined with Insulin could be beneficial to the regeneration of capillary vessel in the burn wounds of the rats with diabetes,as well as to accelerate wound healing by redress anoxia and decrease the expression of HIF-1α and VEGF.
Résumé
Objective To investigate the effect of intensive insulin therapy on long-term remittance of the islet β-cell function in newly diagnosed type 2 diabetic patients. Methods 120 newly diagnosed type 2 diabetic patients were randomly divided into four groups, and intensive insulin therapy was given for 15 days, 30 days, 60 days and 90 days respectively. The islet β-cell function were measured before and 1 or 2 years after treatment, and the differences were compared among each group. Results The plasma glucose was controlled well and the islet β-cell function was significantly improved in each group after treatment. The ratio value of △I30/△G30 in groups of 30 days,60 days and 90 days were higher than group of 15 days[(1.48±0.43 )mmol/L vs (1.25±0.40) mmol/L, t＝2.40,P＜0.05, (1.83±0.37) mmol/L vs (1.25±0.40) mmol/L, t＝2.85,P＜0.01, (1.90±0.41) mmol/L vs (1.25±0.40) mmol/L, t＝2.97,P＜0.01]. The indexes of the islet β-cell secretion function all gradually declined in each group after treatment for 2 years, but still higher than before treatment, the ratio value of △I30/△G30 in groups of 60 days and 90 days were higher than group of 15 days and 30 days[(1.44±0.51)mmol/L vs (0.87±0.47) mmol/L,t＝2.92, P＜0.01, (1.44±0.51)mmol/L vs (1.09±0.55) mmol/L, t＝2.44,P＜0.05, (1.52±0.44) mmol/L vs (0.87±0.47) mmol/L, t＝2.86, P＜0.01, (1.52±0.44) mmol/L vs (1.09±0.55) mmol/L, t＝2.50, P＜0.05], there was no difference between group of 60 days and 90 days. The ratio of remittance in groups of 60 days and 90 days was very high. Conclusions Intensive insulin therapy can significantly improve the islet β-cell function of newly diagnosed type 2 diabetic patients,anddelay the natural process. An appropriate extension of treatment can further prevent the descending rate of islet β-cell function, and easily get the long-term remission.
Résumé
Objective To observe the clinical effects of intensive insulin therapy on postoperative infection, inflammatory response and prognosis in the non-diabetic patients of different ages undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB). Methods 60 cases of non-diabetic patients (>60) undergoing coronary artery bypass grafting with cardiopulmonary bypass between June 2005～June 2010 were selected and analyzed retrospectively. 60 patients were divided into 2 groups, the previous 24 cases were included in a routine treatment group and later 36 cases were included in the intensive therapy group. The blood sugar of intensive therapy group was strictly controlled starting from the anesthesia. The routine treatment group was controlled starting from backing to ICU according to blood glucose results. Patients were assigned to the routine therapy group with the blood glucose maintained at 10.0～11.1 mmol/L and the intensive therapy group received tight glycemic control with the target blood glucose maintained at 4.4～6.1 mmol/L. Postoperative infection, mechanical ventilation time, hospital stay and mortality indicators were compared between the 2 groups. Results There were no significant difference (P＞0.05) in gender, body weight, disease diagnosis and combined surgical methods and surgical materials such as cardiopulmonary bypass time between the 2 groups. Neutrophil count［(12.6±2.8)×109/L vs (18.8±3.1)×109/L］, blood infections, respiratory tract infection(6/36 vs 10/24) and wound infectionrates(2/36 vs 6/24) and other indicators of intensive of insulin therapy group were lower than the regular therapy group (P＜0.05). The postoperative hospital stay of intensive therapy group［(12.2±3.7)d vs (15.6±5.4)d)］ was statistically significant shorter compared with the conventional treatment group (P＜0.05). There was no significant difference in postoperative mortality between the 2 groups (P＞0.05). Conclusions Intensive insulin therapy may significantly reduce postoperative infection rate in the old age patients, thus leading to an improved prognosis in the non-diabetic patients undergoing coronary artery bypass grafting with cardiopulmonary bypass.