Sodium-glucose co-transporter 2 inhibitor: Cardiorenal benefit, bone metabolism, and fracture risk in type 2 diabetes mellitus / 中华内分泌代谢杂志

Type 2 diabetes mellitus is commonly associated with cardiovascular, renal complications, osteoporosis and other comorbidities. Sodium-glucose co-transporter 2 inhibitor (SGLT-2i) can reduce blood glucose level in patients with type 2 diabetes mellitus by promoting urine glucose excretion, and has the effect of weight loss and blood pressure reduction. Large randomized controlled clinical trials have shown that SGLT-2i can improve the prognosis of cardiovascular disease and diabetic nephropathy. This article focuses on the effects of SGLT-2i on cardiorenal outcomes and bone metabolism in addition to the glucose-lowering effect. SGLT-2i can improve the prognosis of patients with coronary atherosclerotic cardiovascular disease, reduce the risk of hospitalization for heart failure, reduce cardiovascular diseases and all-cause mortality, and has renal protective effect. Moreover, the cardiorenal protective effect is proved to be consistent in people without type 2 diabetes. SGLT-2i has a regulatory effect on bone mineral ions and bone metabolism related hormones, and its risk of osteoporosis and fracture deserves attention. Although data suggest that canagliflozin may increase fracture risk, meta-analyses of multiple clinical trials have concluded that SGLT-2i does not significantly increase fracture risk. However, for patients with high risk of fracture, bone mineral density and bone turnover biomarkers should be considered to assess the risk of fracture before prescription.

Transgelin inhibits proliferation and invasion of human thyroid cancer cells by blocking the mitogen-activated protein kinase/extracellular signal-regulated kinase signaling pathway / 中华内分泌代谢杂志

Objective:To explore the role of transgelin(TAGLN) in the occurrence and development of papillary thyroid carcinoma (PTC) and its possible signal pathway.Methods:One hundred cases of PTC tissues and corresponding paracancerous normal thyroid tissues were collected. Realtime quantitative PCR (RT-qPCR), Western blotting, and immunohistochemistry were used to analyze the expression of TAGLN in PTC tissues and corresponding paracancerous normal thyroid tissues. PTC cells were transfected with plasmid and shRNA lentivirus vector respectively to up-regulate or down-regulate the expression of TAGLN in order to detect the effects of them on the proliferation, invasion, and migration by cell proliferation assay(cell counting kit-8, CCK-8)and cell invasion and migration assays (Transwell). The effects of TAGLN on mitogen-activated protein kinase (MAPK)/extracellular-signal regulating kinase (ERK) signal pathway was detected with Western blotting.Results:RT-qPCR showed that there was no difference in the expression of TAGLN mRNA between PTC and corresponding paracancerous normal thyroid tissues ( P>0.05); Western blotting demonstrated that the expression of TAGLN protein in PTC tissues was significantly lower than that in corresponding paracancerous normal thyroid tissues ( P<0.01). Immunohistochemical results revealed that the expression of TAGLN in PTC tissues was significantly lower than that in corresponding paracancerous normal thyroid tissues. Overexpression of TAGLN inhibited the proliferation, invasion, and migration of PTC cells ( P<0.01), but knockdown of TAGLN promoted the proliferation, invasion, and migration of PTC cells ( P<0.01). Overexpression of TAGLN decreased the expression of phosphorylated ERK ( P<0.05), whereas silencing TAGLN increased phosphorylated ERK level in PTC cells( P<0.01). Conclusion:The expression of TAGLN in PTC is significantly decreased. It is related to the occurrence and development of PTC, and its mechanism may be related to MAPK/ERK signal pathway.

Advantages and disadvantages of urine alkalinization in patients with hyperuricemia and gout / 中华内分泌代谢杂志

Gout is a metabolic inflammatory disease characterized by hyperuricemia. When serum uric acid concentration(sUA) is greater than 420 μmol/L, monosodium urate(MSU) crystals are formed and deposited in joints and connective tissues, resulting in acute gout arthritis. In addition to the concentration of urate, pH is also one of the factors affecting MSU deposition. Lowering pH can promote MSU crystallization. Urine alkalization can raise the pH to 6.2~6.9, which can increase the solubility of urate to prevent MSU deposition and the formation of uric acid stones. Commonly used clinical medications include citrate, bicarbonate, acetazolamide, tromethamine, etc. Among them, potassium citrate is the most commonly used alkali agent in clinical practice. However, due to adverse drug reactions, clinical medications need to be cautious. In addition to pharmacotherapy, dietary intervention has also become an important means of alkalizing urine. When sufficient attention is paid to the construction of a balanced diet, dietary intervention will become a safe and economical method for the treatment of gout, but the long-term efficacy has not been determined. This article discusses the advantages and disadvantages of urine alkalinization in the application of hyperuricemia and gout from aspects of pharmacological treatment and diet management, and provides a basis for proper medication use.

Association of muscle mass loss with atherosclerosis in elderly patients with type 2 diabetes / 中华内分泌代谢杂志

Objective:To investigate the association of muscle mass loss with atherosclerosis in elderly patients with type 2 diabetes mellitus(T2DM).Methods:A total of 322 patients with T2DM aged≥60 years old were divided into muscle mass loss group( n=152) and non-muscle mass loss group( n=170) according to their appendicular skeletal muscle mass index(ASMI). All participants underwent physical examination, dual-energy X-ray absorptiometry check, carotid and lower extremity ultrasound, as well as laboratory tests. Results:Among 322 patients, 49(15.22%) patients were suffered from sarcopenia and 152(47.2%) patients with reduced muscle mass. The carotid and lower extremity atherosclerosis grades in the muscle mass loss group were significantly higher than those in the non-muscle mass loss group( P<0.05), with lower body mass index(BMI), T-score, ASMI, uric acid, and homeostasis model assessment of insulin resistance index( P<0.05). Multivariate logistic regression analysis showed that carotid atherosclerosis and lower extremity atherosclerosis were risk factors for muscle mass loss while BMI and 25-(OH)D 3 were protective factors for muscle mass loss. There existed a consistency in carotid atherosclerosis grade and lower extremity atherosclerosis grade of elderly patients with T2DM( P<0.01). Conclusion:Atherosclerosis has a predictive value for early sarcopenia in elderly patients with T2DM.

Multivariate analysis of muscle mass loss in patients with type 2 diabetes / 中华内分泌代谢杂志

Objective:To explore the related factors of muscle mass loss in patients with type 2 diabetes mellitus, and to provide evidence for prevention of sarcopenia in type 2 diabetic patients.Methods:A cross-sectional survey was used to select type 2 diabetic patients admitted to the Department of Endocrinology, Affiliated Hospital of Qingdao University from January 2019 to August 2019. All subjects underwent dual-energy X-ray absorptiometry check. According to the diagnostic criteria of the Asian Working Group for Sarcopenia (AWGS), the subjects were divided into a muscle reduction group and a non-muscle reduction group. Data including age, gender, body mass index, course of disease, blood index, urinary albumin-creatinin ration (UACR), and appendicular skeletal muscle index (ASMI) were collected. The relevant clinical data of viscera fat/subcutaneous fat (VAT/SAT), percentage of abdominal fat/percentage of hip fat (A/G), grip strength, and pace were analyzed for the related factors of muscle mass loss in type 2 diabetic patients.Results:A total of 369 patients with type 2 diabetes were enrolled, including 42 patients with sarcopenia (an incidence rate of 11.38%), and 155 patients with reduced muscle mass (an incidence of 42.01%). Age, systolic blood pressure, high density lipoprotein-cholesterol, UACR, VAT/SAT, and A/G in the muscle reduction group were higher than those in the non-muscle reduction group ( P<0.05). The parameter of body mass index, homeostasis model assessment for insulin resistance, estimated glomerular filtration rate (eGFR), ASMI, and grip strength were lower in the muscle reduction group than in the non-muscle reduction group ( P<0.05). Multivariate logistic regression analysis showed age, UACR, A/G, and VAT/SAT were risk factors for muscle loss, body mass index, eGFR, and grip strength were protective factors for muscle mass reduction. Conclusion:It is of great practical significance for type 2 diabetic patients, especially those with advanced age, central obesity, low body mass index, low grip strength, low glomerular filtration rate, and high UACR to perform an early screening and to begin an early intervention.

Diabetes mellitus concurrent aspergillus pneumonia: One case report / 中华内分泌代谢杂志

Diabetic patients with poor glycemic control are exposed to media containing mold spores, and spores enter the body, which may lead to refractory infections. This article combines case and literature reviews, proposes the diagnosis and treatment method of mold infection, and provides some guidances for subjects who long-term exposure to mold groups such as farmers and immunocompromised people.

Diabetes mellitus concurrent aspergillus pneumonia: One case report / 中华内分泌代谢杂志

Diabetic patients with poor glycemic control are exposed to media containing mold spores, and spores enter the body, which may lead to refractory infections. This article combines case and literature reviews, proposes the diagnosis and treatment method of mold infection, and provides some guidances for subjects who long-term exposure to mold groups such as farmers and immunocompromised people.

Relationship between methylation of RSK4 gene and papillary thyroid carcinoma / 中华内分泌代谢杂志

Objective To detect the methylation status of ribosomal S6 kinase 4 ( RSK4 ) in papillary thyroid carcinoma ( PTC) and to study its correlation with mRNA expression and clinical features. Methods 134 cases PTC tissues and corresponding paracancerous thyroid tissues were collected. DNA methylation status of RSK4 gene in PTC tissues and corresponding paracancerous tissues were analyzed by methylation specific PCR and bisulfite genomic sequencing, and mRNA expression was detected by quantitative realtime PCR. The relationship of DNA methylation status with mRNA expression and clinical features was analyzed. Results The methylation rate of RSK4 in PTC tissues was significantly higher than that in paracancerous tissues by methylation specific PCR ( P<0.05) and bisulfite genomic sequencing ( P<0. 01 ) . The RSK4 mRNA level in PTC tissues was significantly lower than that in paracancerous tissues ( P<0.01) . In PTC tissues, RSK4 mRNA expression in methylation group was lower than that in unmethylation group ( P<0.01) . The RSK4 mRNA level in PTC of methylation was lower than that in paracancerous tissues of methylation ( P<0. 01);the RSK4 mRNA level in PTC of unmethylation was also lower than that in paracancerous tissues of unmethylated ones ( P<0. 01 ) . There was relationship of RSK4 hypermethylation with lymphatic metastasis and TNM grade ( P<0. 05 ) . Serum concentration, of thyroid stimulating hormone, thyroid peroxidase antibody, and thyroglobulin antibody in methylation group were higher than those in unmethylation group ( P<0.05) . Conclusion The hypermethylation of RSK4 promoter's CpG islands might be one of the mechanisms for poor expression of RSK4 in PTC, which may serve as a molecular target of early diagnosis and treatment.

Repeated epistaxis caused by primary hyperparathyroidism with multiple brown tumors: One case report / 中华内分泌代谢杂志

To report the clinical, imaging and pathological feature of a case of primary hyperparathyroidism(PHPT) with multiple brown tumors whose complain was repeated epistaxis, and to conduct a retrospective analysis with relevant literatures. A postmenopausal middle-aged woman, with a history of joint pain, fracture, and kidney stone which were neglected due to the lack of specificity of symptoms for years, went to hospital due to repeated epistaxis. Laboratory results showed high blood calcium, hypophosphatemia, alkaline phosphatase(ALP), and parathyroid hormone(PTH) levels, as well as increased urinary calcium. Imaging examination showed systemically multiple brown tumors and extensive osteoporosis. Meanwhile an abnormal mass was found behind the right thyroid. Taking all findings into account, the diagnosis was made with PHPT, and the histopathology further confirmed that the lesion was a parathyroid adenoma. This case seems to be a rare case of multiple brown tumor caused by parathyroid adenoma, which compressed and destructed nasal blood vessels, thus induced a repeated nasal discharge. After resection of parathyroid adenoma, the patient experienced a transient hypocalcemia and PTH level elevation. After 5-month follow up, part of the brown tumors spontaneously regressed, bone density increased, and her clinical symptoms were mostly relieved.

Relationship between methylation of RSK4 gene and papillary thyroid carcinoma / 中华内分泌代谢杂志

Objective@#To detect the methylation status of ribosomal S6 kinase 4 (RSK4)in papillary thyroid carcinoma (PTC)and to study its correlation with mRNA expression and clinical features.@*Methods@#134 cases PTC tissues and corresponding paracancerous thyroid tissues were collected. DNA methylation status of RSK4 gene in PTC tissues and corresponding paracancerous tissues were analyzed by methylation specific PCR and bisulfite genomic sequencing, and mRNA expression was detected by quantitative realtime PCR. The relationship of DNA methylation status with mRNA expression and clinical features was analyzed.@*Results@#The methylation rate of RSK4 in PTC tissues was significantly higher than that in paracancerous tissues by methylation specific PCR (P<0.05)and bisulfite genomic sequencing (P<0.01). The RSK4 mRNA level in PTC tissues was significantly lower than that in paracancerous tissues (P<0.01). In PTC tissues, RSK4 mRNA expression in methylation group was lower than that in unmethylation group (P<0.01). The RSK4 mRNA level in PTC of methylation was lower than that in paracancerous tissues of methylation (P<0.01); the RSK4 mRNA level in PTC of unmethylation was also lower than that in paracancerous tissues of unmethylated ones (P<0.01). There was relationship of RSK4 hypermethylation with lymphatic metastasis and TNM grade (P<0.05). Serum concentrations of thyroid stimulating hormone, thyroid peroxidase antibody, and thyroglobulin antibody in methylation group were higher than those in unmethylation group (P<0.05).@*Conclusion@#The hypermethylation of RSK4 promoter′s CpG islands might be one of the mechanisms for poor expression of RSK4 in PTC, which may serve as a molecular target of early diagnosis and treatment.

Addison disease as presenting manifestation of one patient with adrenoleukodystrophy and identification of a novel ABCD1 gene mutation / 中华内分泌代谢杂志

Objective@#To identify the clinical manifestations, imaging findings, and genetic mutation characteristics in a rare case of adrenoleukodystrophy(ALD)with adrenocortical dysfunction(Addison′s disease)as the first manifestation.@*Methods@#The clinical data of the proband and his family members were comprehensively collected, and ABCDl gene sequencing was meticulously performed for the proband and his mother using high-throughput sequencing method.@*Results@#The patient presented with systematical skin pigmentation accompanied by fatigue in early stage, arose stroke-like episodes manifested as a sudden loss of consciousness and incontinence induced by high fever, and followed by progressive unclear speech, unstable walking and worsening vision. Serum very long-chain fatty acid(VLCFA)concentration increased over normal range. The brain MRI showed an abnormal signal of the symmetric distribution of the bilateral corpus callosum. A new c. 874_876del GAG hemizygous variation in the patient′s ABCD1 gene was detected, while his mother had a nucleotide heterozygous variation to this site .@*Conclusion@#The diagnosis of ALD requires a combination of clinical manifestations, imaging examination, and serum VLCFA level measurement, while the detection of ABCD1 gene mutations is considered to be the most reliable approach.

One case of adrenoleukodystrophy with initial Addison disease and identification of a novel ABCD1 gene mutation / 中华内分泌代谢杂志

Objective To identify the clinical manifestations, imaging findings, and genetic mutation characteristics in an uncommon case of adrenoleukodystrophy ( ALD) with adrenocortical dysfunction ( Addison's disease) as the first manifestation. Methods The clinical data of the proband and his family members were comprehensively collected, and ABCDl gene sequencing was meticulously performed for the proband and his mother using high-throughput sequencing method. Results The patient presented with systematical skin pigmentation accompanied by fatigue in early stage, arose stroke-like episodes manifested as a sudden loss of consciousness and incontinence induced by high fever, and followed by progressive unclear speech, unstable walking and worsening vision. Serum very long-chain fatty acid (VLCFA) concentration increased over normal range. The brain MRI showed an abnormal signal of the symmetric distribution of the bilateral corpus callosum. A new c. 874 876del GAG hemizygous variation in the patient's ABCD1 gene was detected, while his mother had a nucleotide heterozygous variation to this site . Conclusion The diagnosis of ALD requires a combination of clinical manifestations, imaging examination, and serum VLCFA levels, while the detection of ABCD1 gene mutations is considered to be the most reliable approach.

Effect of liraglutide on glucagon secretion in obese type 2 diabetic patients / 中华内科杂志

Objective To investigate the effect of liraglutide on glucagon release in obese type 2 diabetes (T2DM). Methods A multi-center, prospective, and self-comparison study was conducted in four hospitals in Qingdao. Twenty-four patients with T2DM were selected and treated with liraglutide for 12 weeks. Glucagon levels before and after treatment were detected before and 30 min, 60 min and 120 min after meals. Results After 12 weeks of treatment, the overall level of glucagon decreased, in which the differences in glucagon levels at 30 min [(220±79) ng/L vs. (203±77) ng/L, P<0.05] and 60 min [(248±119) ng/L vs. (203±82)ng/L, P<0.05] reached significance, respectively, comparing to those before treatment. The area under the curve of glucagon after treatment was significantly lower than that before treatment (438±190 vs. 389 ± 153, P<0.05). In contrast, after treatment, the overall level of C-peptide increased, especially the levels at 30 min [(1.53±1.02) nmol/L vs.(2.03±1.29) nmol/L ], 60 min [(1.93±1.19) nmol/L vs. (2.48±1.75) nmol/L] and 120 min [(2.36±1.47) nmol/L vs. (2.96±1.84) nmol/L], all P<0.05. The area under C-peptide curve increased significantly (3.6±2.2 vs. 4.6±2.9, P<0.05). Fasting plasma glucose, postprandial 2 h plasma glucose and glycosylated hemoglobin A1c were all lower than before, and the differences were statistically significant (P<0.05). Waist circumference and body mass index were significantly lower than before (P<0.05). The amount of insulin used for the treatment decreased by approximately 55.1% compared with that before liraglutide, and the difference was statistically significant (P<0.05). Conclusions Liraglutide inhibits glucagon secretion and lowers blood glucose. It can also reduce body weight, improve islet cell function and reduce insulin use in T2DM.

Regulating effect of Siwei-Jianghuangtang powder on PI3K/Akt signaling pathway in diabetic nephropathy rats / 国际中医中药杂志

Objective To explore the protective effect of Siwei-Jianghuangtang powder on kidney of diabetic nephropathy rats and its influences on phosphatidyl inositol 3-kinase/protein kinase B signaling pathway (PI3K/Akt). Methods The SD rats were divided into 6 groups, sham operation group, model group, Siwei-Jianghuangtang powder low, middle and high dose groups (12, 24, 48 mg/kg Siwei-Jianghuangtang powder) and positive group (Captopril, 30mg/kg), with 12 rats in each group. The 24h urinary protein in urine of rats was measured after 4 weeks and 8 weeks of administration. The enzyme linked immunosorbent assay was used to detect serum lipid level and renal function. After the last administration, the renal tissue was obtained, and the renal hypertrophy index was measured. The HE and Masson staining were used to observe the histopathological changes of kidney in rats, and the ultrastructural changes of renal tissue were observed by electron microscope. The western blot (WB) was used to analyze the expressions of IRS-2, p-PI3K and p-Akt in renal tissues, and the immunohistochemistry was used to detect the positive expressions of nephrin and podocin protein in kidney. Results Compared with the model group, the p-PI3K protein (0.42 ± 0.06, 0.61 ± 0.09, 0.76 ± 0.05 vs. 0.21 ± 0.03), the IRS-2 protein (0.34 ± 0.03, 0.61 ± 0.10, 0.78 ± 0.09 vs. 0.24 ± 0.03) and the P-Akt protein (0.28 ± 0.06, 0.43 ± 0.07, 0.69 ± 0.05 vs. 0.15 ± 0.03) in Siwei-Jianghuangtang powder low, middle and high dose group significantly increased (P<0.05). The positive expression rate of Nephrin (31.78% ± 3.14%, 42.54% ± 5.15%, 50.97% ± 7.13% vs. 22.86% ± 3.07%) and the positive expression rate of Podocin (33.67% ± 4.59%, 50.54% ± 11.41%, 61.03% ± 7.55% vs. 22.64% ± 2.97%) significantly increased (P<0.05). Conclusions The Siwei-Jianghuangtang powder can relieve renal injury of diabetic nephropathy rats. Its mechanism may be related to activating PI3K/Akt signaling pathway and alleviating podocyte injury.

Prevalence of diabetes mellitus and prediabetes: Changes during past 10 years in Shandong coastal area / 中华内分泌代谢杂志

Objective To determine the changes in the prevalence of type 2 diabetes mellitus and prediabetes in residents aged over 20 years in Shandong coastal areas during years 2004-2014. Methods A random stratified cluster sampling was conducted, and 3 944 inhabitants were investigated in Qingdao, Yantai, Weihai, and Rizhao regions. Results (1)The standardized rate of diabetes mellitus prevalence was 10.36% in 2014, increased by 2.38% as compared with 2004 and 0.85% as compared with 2009 (P<0.05). There were 341 newly diagnosed diabetes mellitus patients, accounting for 57.4% of the diabetes mellitus patients, increased by 6.09% as compared with 2004 and decreased by 4.11% as compared with 2009 (P<0.05). The standardized rate of prediabetes was 12.47% in 2014, increased by 2.63% as compared with 2004 and 0.61% as compared with 2009 (P<0.05). (2) The prevalence of diabetes mellitus and impaired glucose regulation in individuals aged under 50 years in 2014 was significantly higher than that in 2004, but lower than that in 2009 (P<0.05). (3) Compared with 2004 and 2009, the levels of diastolic blood pressure, total cholesterol, low density lipoprotein-cholesterol (LDL-C), and high density lipoprotein-cholesterol in subjects with prediabetes and diabetes mellitus increased significantly in 2014 (all P<0.05). The levels of serum uric acid in subjects with prediabetes and diabetes mellitus decreased significantly in 2014 (P<0.05). (4) The logistic regression analysis showed that the age, body mass index, waist-hip ratio, triglyceride, LDL-C, systolic blood pressure, and diabetic family history were the risk factors for abnormal glucose regulation, while total cholesterol was the protective factor. Conclusions The prevalence of diabetes mellitus and prediabetes increased during 10 years (2004-2014), but the growth rate dropped precipitously during last five years as compared with the first five years. The age of diabetes mellitus onset is getting older in residents of Shandong coastal area, especially in females. Aging, overweight, hypertension, lipid disorders, and diabetic family history were the risk factors of diabetes mellitus.

Molecular mechanism of familial hypertriglyceridemia caused by lipoprotein lipase gene mutation (C310R/E396V) / 中华内分泌代谢杂志

Objective The purpose of this study is to investigate the molecular mechanisms of p.C310R(c.T928C) and p.E396V(c.A1187T) lipoprotein lipase(LPL) gene mutations in vitro, which may help to construct the spectrum of LPL gene mutations and phenotype. It also can provide accurate early diagnosis for high-risk population of familial hypertriglyceridemia and provide the basis for the development of gene targeted therapy. Methods Genomic DNA was extracted from proband′s family members′ peripheral blood cells and screened by whole-exome sequencing to verify candidate gene variations. PCR products were afterwards directly sequenced again to confirm corresponding LPL variants. At the cellular level, lentiviruses containing LPL mutations were constructed and then transfected into COS-1 cells. Functional significance of the mutants was corroborated by analyzing LPL activity and mass in the cell medium and lysates via ELISA and enzyme-fluorescent method. mRNA was assayed by RT-PCR to confirm the effect on gene transcription. Results DNA sequence analysis revealed that the proband was a heterozygote for a novel c.T928C mutation in exon 6 of LPL gene, while his nephew was a compound heterozygote for the c.T928C mutation in exon 6 and a novel c.A1187T mutation in exon 8. In vitro studies, these two mutations can cause decreased activity and mass of extracellular LPL(P<0.05). Moreover, further investigation indicated that LPL C310R mutation tremendously affected post-transcriptional modification of LPL gene, whereas LPL E396V mutation dampened intracellular LPL trafficking. Conclusion Both the mutations are pathogenic by reducing the activity and mass of LPL in the plasma, which affected normal metabolism of triglycerides.

Diabetic foot one -step overall treatment based on transluminal technology / 中国基层医药

Objective To investigate one -step overall treatment to improve the condition of diabetic foot ulcers based on transluminal technology.Methods The patients with diabetic foot ulcers were treated with percutaneous transluminal angioplasty(PTA)to open blood flow,intensively control patients'blood glucose,application of sensitive antibiotics,erode debridement and dressing change according to wound bed preparation(WBP)and moist wound heal, vacuum aspiration was applied in large wound.Results Eighty -two patients(eighty -five lower limbs)underwent PTA,the successful rate was 100.0%.Of 116 ulcers,106 cases were effective (91.4%),10 cases were invalid (8.6%).Their ankle -brachial index (ABI)increased from preoperatively (0.41 ±0.12)to postoperatively (0.75 ± 0.09).Transcutaneous oxygen pressure(TcPaO2 )increased from preoperatively (14.6 ±4.8)mmHg to postopera-tively (51.6 ±8.9)mmHg.Conclusion One -step treatment regarding multi disciplinary team on endocrine section can improve the treatment of diabetic foot and lower the amputation rate.

Relationship between TSH and pregnancy outcomes during the first half of pregnancy in women / 中华内分泌代谢杂志

[Summary] A total of 352 pregnant women were selected in Affiliated Hospital of Qingdao University. Serum levels of TSH and FT4 were determined and pregnancy outcome were observed in all subjects. According to the standard of American Thyroid Association(ATA) published in 2011 and the Chinese Guideline of Gestation Thyroid Disease published in 2012, the subjects were grouped into control(0. 1≤TSH≤2. 5 mIU/ L), observation(2. 55. 17 mIU/ L)during first-trimester(T1)and control(0. 2≤TSH≤3. 0 mIU/ L), observation(3. 05. 22 mIU/ L) during second-trimester(T2). The results showed that the rupture of membranes, preterm labor, and total obstetrical adverse events in the observation group were significantly higher than those in control group during T1(all P<0. 05), no statistical significance between control group and treatment group. The rupture of membrances in the observation group was significantly higher compared with control group during T2 ( P < 0. 05), no significant difference in other adverse pregnancy outcomes between these two groups. Compared with control group during T1, the proportion of adverse pregnancy outcomes in observation group during T1 was significantly increased(P<0. 05). The elevated TSH is one of the risk factors for the increased incidence of adverse pregnancy outcomes at the first half of pregnancy, especially during T1. L-T4 treatment reduces the incidence of adverse pregnancy outcomes.

Association of BCAS3 rs11653176 gene polymorphism with the occurrence of gout / 中华内分泌代谢杂志

Objective To explore the relationship between the polymorphisms of the primary gout predisposing gene (BCAS3) rs11653176 locus and the incidence of gout in Han Chinese men in coastal areas of Shandong Province. Methods One hundred and fifty-two cases of patients with gout remission,68 cases of acute stage,252 patients with hyperuricemia, and 280 healthy subjects, total males, were enrolled. Genotyping the rs11653176 locus of BCAS3 gene by TaqMan probe technique. The expression level of BCAS3 gene mRNA in each PBMC was measured by RT-qPCR. The levels of tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), and interleukin-18(IL-18)in serum were measured by ELISA. Results The change of allele frequency of rs11653176 locus in BCAS3 gene was associated with gout(P<0.01). BCAS3 mRNA in patients with gout was significantly higher than that of healthy people and patients with hyperuricemia(P<0.01). In gout patients, the expression level of BCAS3 gene containing C allele was higher than that of T allele(mRNA,P<0.05). The inflammatory factors in the acute phase of gout were significantly higher than those in phases of remission and hyperuricemia(P<0. 01). Conclusion Changes in the allele frequency of BCAS3 alleles rs11653176(high C, low T)may contribute to the expression of this gene,and lead to gout. And the onset of gout is closely related to the production of inflammatory factors.