Metabolic outcomes of type 2 diabetes patients with different diabetic durations under the standardized metabolic disease management model / 中华内分泌代谢杂志

Objective:To explore the metabolic outcomes of type 2 diabetes patients with different durations after 1 year treatment under the standardized metabolic disease management model.Methods:(1)From September 2017 to September 2018, 345 type 2 diabetes patients in the Standardized Metabolic Management Center(MMC) of Shanghai General Hospital were recruited and included in this research. They were divided into newly-diagnosed type 2 diabetes(duration≤1 year) and long-term groups(duration>1 year). The general characteristics, blood pressures, glycemic levels, lipids levels, control rates and comprehensive compliance rates(blood glucose, pressure and lipids all reached targets) were compared at baseline between 2 groups.(2)All patients underwent one year standardized management, and metabolic indicators mentioned above and control rates at the time were compared as well.Results:(1) At baseline, compared with long-term group, patients in newly-diagnosed type 2 diabetes group were younger ( P<0.01), and 2 h blood glucose level after glucose loading were higher [(15.20±5.26 vs 13.68±4.94) mmol/L, P<0.01]. (2) After one year standardized management, body weight, blood pressure, glucose and lipids metabolism in all patients were significantly improved. Compared with patients in long-term group, newly-diagnosed type 2 diabetes patients achieved better glycemic level [fasting blood glucose(6.27±1.56 vs 7.63±2.08) mmol/L, P<0.01; glycated hemoglobin(6.33±0.96 vs 7.23±1.37) %, P<0.01] , and had higher HOMA-β [(74.01±56.45 vs 40.17±37.07) %, P<0.01]. The glycemic control, blood pressure and blood lipids control rates in both groups increased significantly in one year. Comprehensive compliance rate of the whole patients increased from 5.80% to 24.06%. The metabolism indexes of the newly-diagnosed type 2 diabetes group were better than those of the long-term group[comprehensive compliance rate: (24.73% vs 17.18%, P=0.087, glycemic control rate(84.62% vs 53.37%, P<0.01)]. Conclusion:Standardized metabolic disease management promoted the overall improvement in blood glucose, blood pressure, and lipids levels in type 2 diabetes patients, especially in terms of blood glucose and those of the newly-diagnosed type 2 diabetes. In the future, we should focus on the early diagnosis and treatment of type 2 diabetes, actively promote the MMC model and stress the integrated management of blood glucose, blood pressure, and blood lipid levels. We should pay more attention to the long-term patients, to improve their awareness and treatment compliance.

Glycemic control of newly-diagnosed type 2 diabetes with different baseline body mass index under the standardized metabolic disease management model / 中华内分泌代谢杂志

Objective@#To explore the glycemic control of newly-diagnosed type 2 diabetes with different levels of baseline body mass index (BMI) after 6 months treatment under the standardized metabolic disease management model.@*Methods@#(1) 163 patients of newly-diagnosed type 2 diabetes were divided into normal weight (BMI 18.5-23.9 kg/m2), overweight (BMI 24.0-27.9 kg/m2), and obese (BMI≥28 kg/m2) groups according to baseline BMI, the blood glucose and lipids levels were compared among 3 groups. (2) The blood glucose levels were compared among 3 groups after 6 months of standardized management. (3) The overweight and obese patients were divided into group weight loss≥5% and group weight loss<5% or weight gain in 6 months. The blood glucose levels were compared.@*Results@#(1) At baseline, overweight and obese groups had higher homeostasis model assessment for insulin resistance and lower high density lipoprotein-cholesterol compared with normal weight group. (2) After 6 months of treatment, HbA1C and HbA1C reduction showed no difference among 3 groups (normal, overweight and obese) after adjusted by baseline HbA1C. The rate of HbA1C<7% among 3 groups were 77.78%, 83.95%, and 80.43% (P>0.05). (3) After 6 months of treatment, 32.28% overweight and obese patients lost weight by ≥ 5%, while HbA1Cand HbA1Creduction showed no difference between 2 groups (weight loss≥5% and weight gain or weight loss<5%) after adjusted by baseline HbA1C. Both groups achieved good glycemic control [(6.27±1.38 vs 6.43±0.66)%], but have no significantly(P>0.05). Group weight loss≥5% had better glucose control (92.68% vs 77.91%, P<0.05).@*Conclusions@#As BMI increased, insulin resistance and lipid disorders were more serious in newly-diagnosed type 2 diabetes. After 6 months of standardized metabolic management, newly-diagnosed type 2 diabetes with different baseline BMI and weight changes both achieved good glycemic control. In addition, patients losing weight equal to or more than 5% achieved higher attainment of HbA1C targets.

Glycemic control of newly-diagnosed type 2 diabetes with different baseline body mass index under the standardized metabolic disease management model / 中华内分泌代谢杂志

Objective To explore the glycemic control of newly-diagnosed type 2 diabetes with different levels of baseline body mass index ( BMI ) after 6 months treatment under the standardized metabolic disease management model. Methods ( 1) 163 patients of newly-diagnosed type 2 diabetes were divided into normal weight (BMI 18.5-23.9 kg/m2), overweight (BMI 24.0-27.9 kg/m2), and obese (BMI≥28 kg/m2) groups according to baseline BMI, the blood glucose and lipids levels were compared among 3 groups. ( 2) The blood glucose levels were compared among 3 groups after 6 months of standardized management. ( 3) The overweight and obese patients were divided into group weight loss≥5％and group weight loss<5％ or weight gain in 6 months. The blood glucose levels were compared. Results ( 1) At baseline, overweight and obese groups had higher homeostasis model assessment for insulin resistance and lower high density lipoprotein-cholesterol compared with normal weight group. ( 2) After 6 months of treatment, HbA1C and HbA1C reduction showed no difference among 3 groups ( normal, overweight and obese) after adjusted by baseline HbA1C. The rate of HbA1C<7％among 3 groups were 77.78％, 83.95％, and 80.43％(P>0.05). (3) After 6 months of treatment, 32.28％ overweight and obese patients lost weight by ≥5％, while HbA1C and HbA1C reduction showed no difference between 2 groups ( weight loss≥5％and weight gain or weight loss<5％) after adjusted by baseline HbA1C. Both groups achieved good glycemic control [(6.27±1.38 vs 6.43±0.66)％], but have no significantly(P>0.05). Group weight loss≥5％ had better glucose control (92.68％ vs 77.91％, P<0.05) . Conclusions As BMI increased, insulin resistance and lipid disorders were more serious in newly-diagnosed type 2 diabetes. After 6 months of standardized metabolic management, newly-diagnosed type 2 diabetes with different baseline BMI and weight changes both achieved good glycemic control. In addition, patients losing weight equal to or more than 5％achieved higher attainment of HbA1C targets.

Electrocardiogram analysis of 339 patients with abnormal blood potassium / 中国医师进修杂志

Objective To research the electrocardiogram (ECG) manifestations of common electrolyte disturbance and to discuss the accuracy of ECG diagnosis. Methods One hundred and sixty-nine hospitalized patients with hyperkalemia and 170 patients with hypokalemia were selected and the results of ECG were analyzed. Results In mild hyperkalemia patients (serum potassium concentration 5.5- 6.5 mmol/L), the ECG abnormal rate was 91.4% (64/70). In mild hypokalemia patients (serum potassium concentration 3.0-3.5 mmol/L), the ECG abnormal rate was 56.9% (41/72). There was significant difference (P < 0.05). The greater the deviation of serum potassium concentration, the more obvious the characteristic changes of ECG. Conclusions In addition to the blood biochemical test, ECG is also a kind of check tool that can help to diagnose abnormal blood potassium.

The effect of community comprehensive in prevention and treatment of hypertension / 中国基层医药

Objective To analyze the clinical effect of community comprehensive intervention in the prevention and treatment of hypertension.Methods A total of 160 cases of patients were randomly divided into two groups,the control group (80 cases)were treated with conventional antihypertensive drug treatment;the observation group 80 cases of patients were treated with comprehensive community intervention on the basis of treatment of the control group.Two groups of patients before and after the intervention of blood pressure changes were observed and recorded,treatment effect and medication compliance were comparative analysized.Results The total effective rate of patients in the observation group was 86.25%,which was significantly higher than that in the control group (57.5%),the difference was statistically significant (χ2 =20.44,P <0.05).DBP,SBP after intervention of patients in the observation group were significantly lower than those before intervention and in the control group after the intervention,the differences were statistically significant (t =18.48,6.06,all P <0.05).Conclusion The effect of community comprehensive intervention on hypertension patients is significant,it can effectively control the patient's blood pressure level,improve the quality of life of patients,which is worth promoting.

Glucagon like peptide-1 increases visfatin expression in 3T3-L1 adipocytes via PKA pathway / 中华内分泌代谢杂志

Objective To test whether glucagon like peptide-1 (GLP-1) would regulate the expression of visfatin in adipocytes,and to explore the mechanism of this effect.Methods Fully differentiated 3T3-L1 adipocytes were treated with GLP-1.Total RNA was extracted for analyzing the level of visfatin mRNA by quantitative RT-PCR.The media were collected for measuring the level of visfatin protein by enzyme linked immuno-assay (ELISA).In order to test the involvement of PKA pathway,the adipocytes were pretreated with a specific pharmacological PKA inhibitor H89 for 30 min before GLP-1 was added.Results GLP-1 increased visfatin expression in a time-and dose-dependent manner.The level of visfatin significantly increased at the concentration of 10 10 mol/L GLP-1 (P＜0.05),and reached the peak at 10-9 mol/L (P＜0.01).After incubation for 18 hours,GLP-1 dominantly increased the level of visfatin (P＜0.05).Inhibition of PKA pathway by H89 partially blocked the effect of GLP-1 on visfatin expression.Conclusions GLP-1 may enhance the expression of visfatin in 3T3-L1 adipocyte via the PKA pathway,which might contribute to the improvement in glucose homeostasis.

The new applied research on the multifunctional tubular pipeline in femoral artery and vein / 中国医学装备

Objective:To do research on designing the new applied multifunctional integrated tubular pipeline in femoral artery and vein which combined with blood transfusion, fluid infusion, blood sampling, administration, measurement of central venous pressure. Methods: Pipeline is consisted of three parts, which are blood transfusion part and fluid infusion part, including three way switch and three way extended tube. The first way connected with the injection is for blood sampling and doses, the second way connected with the central venous is for measurement of central venous pressure, and the third way connected with the blood transfusion set and fluid infusion set is for blood transfusion and fluid infusion. In a standard thoraco-abdominal combined injury and revivification of 31 beagle, compare the time effect. Results: In the injury and revivification test, the average time cost in 532 times nursing care operation with the multifunctional integrated tubular pipeline is 19+5.1 seconds, the average time cost in 31 times individual nursing care operation of 5 procedure is 80+12 seconds. The multifunctional integrated tubular pipeline can quickly and effectively work on blood transfusion, fluid infusion, blood sampling, administration, measurement of central venous pressure. Conclusion:The multifunctional integrated tubular pipeline in femoral artery and vein saves time and human resources and reduces the infection rate in repeated venous puncture and works quickly and conveniently on animal experiment and acute fatal injury, so it is worthy a further clinical application.

Evaluation of the relationship of SMT injection and cytokines expression for temporomandibular joint osteoarthrosis / 中国基层医药

Objeetlve To evaluate the relationship between temporomandibular joint(TMJ)osteoarthrosis (OA)and cytokines.Methods 20 rabbits were enrolled in this study.They were divided into either experiment(n=10)or control group(n=10).The modeh of TMJ osteoarthrosis were formed by injection SMT into upper joint compartment of the TMJ.Cytokines in the aspirated synovial fluid,induding interleukin(IL-1),IL-6,tumor necrosis faetor(TNF-α),were tested before and after SMT iniection.Results The level of IL-1β,IL-6 and TNF-α in experiment group decreased significantly after treatment,there was significance(P＜0.05);and the level of IL-1β,IL-6 and TNF-α in control group is lower after treatment,there was no significance(P＞0.05).Conclusion The cytokines,including IL-1β,IL-6,TNF-α,decreased significantly by injection SMT into upper joint compartment of the TMJ with OA.

Islet autoantibodies and type 1 diabetes mellitus / 中华内分泌代谢杂志

The positive rate of autoantibodies was 29.7% in 1617 diabetic patients. The positive rate of monoautoantibody was lower than that of combined assay with 3 autoantibodies. Combined assay of multiple autoantibodies may enhance the positivity of early diagnosis of type 1 diabetes mellitus. Glutamic acid decarboxylase antibody (GADA) may be a better screening test for predicting insulin dependency, the prediction of GADA combined with protein tyrosine phosphatase antibody may approximate to 100%, whereas islet cell antibody assay may be needed in the adolescent patients.