摘要:目的:了解糖尿病患者胰岛素泵强化治疗的护理特点并观察其疗效。方法:对158例糖尿病胰岛素泵治疗的患者进行心理、技术等综合护理。结果:158例患者用胰岛素泵强化治疗后血糖控制良好,生活质量明显提高。结论:胰岛素泵在强化治疗糖尿病方面提供了前所未有的安全、可靠、方便及灵活性,是强化治疗的最佳手段。综合护理是胰岛素泵强化治疗的保障。Abstract: Objective: To understand the insulin pump treatment of diabetes care characteristics and observe the effect. Methods: 158 patients with diabetes insulin pump therapy in patients with psychological, technology and other comprehensive care. Results: 158 patients were treated with insulin pump therapy a good blood sugar control and quality of life improved markedly. Conclusion: The diabetic insulin pump in intensive therapy has provided an unprecedented security, reliability, convenience and flexibility, is to strengthen the best means of treatment. Integrated care is the protection of insulin pump therapy.
Objective To establish a stable colorectal cancer model in liver specific insulin-like growth factor (IGF)-1 deficient (LID) mice and examine the potential relationship between IGF-1 level and risk of mice constitutional colorectal cancer. Methods ①Establishment of a colorectal cancer model: The LID mice, in which IGF-1 level in circulation was 25% of BALB/c mice. Induction of colorectal cancer was achieved by using the 1,1 Dimethylhydrazine (DMH) with hypodermic injection at transverse part. ②Eighty fresh samples of cancer tissues and adjacent tissues were obtained from LID mice (experimental group) and BALB/c mice (control group). The expression of IGF-1 was studied by immunohistochemical assay (SP method). Results ①Weight loss occurred in both experimental group and control group after injection. Compared with the body weight before injection on 18 weeks and 24 weeks in each group, there were significant differences after injection at the same phase in each group (P＜0.05). ②The results of IGF-1 expression in cancer tissues and adjacent tissues: IGF-1 got a diffuse distribution in cancer cell cytoplasm. The positive expressions of IGF-1 in the cancer tissues and their adjacent cancer tissues were 6/7, 2/7 and 13/16, 7/16 respectively in experimental group and control group. There were significant differences between the cancer tissues and adjacent tissues inside both groups (P＜0.05). There were no significant differences inside both of cancer tissues and adjacent tissues respectively between experimental group and control group (Pgt;0.05). Conclusion In the established colorectal cancer model by DMH, IGF-1 plays an important role in the development and progression of colorectal cancer.
Objective To detect the difference of the light sensitivity in the central visual field between normal people and type Ⅱ diabetic patients without diabetic retinopathy, and evaluate the effect of perimetric examination in early diagnosis of diabetic retinopathy. Methods The light sensitivity at the 80 locations in the central field was measured by Dicon field analyzer (model TKS-4000) in 76 normal eyes of 44 normal volunteers aged from 45 to 72 years and 75 eyes of 40 type Ⅱ diabetic patients without retinopathy aged from 46 to 71 years. Results For the diabetic patients without diabetic retinopathy, the light sensitivity of locations decreased by 4-8 dB,and there were some decreased light sensitivity areas. The mean light sensitivity of three zones of the central field had significant reduction in the diabetic patients as compared with the control group(Plt;0.001). Conclusion The retinal neurosensory function of diabetic patients is damaged in some degrees before diabetic retinopathy occured, and no relationship is found between the decrease of retinal light sensitivity and localized blood-retinal barrier leakage. It is suggested that examination of central field with computerized perimetry has certain clinical significance in early diagnosis of diabetic retinopathy. (Chin J Ocul Fundus Dis, 2002, 18: 218-220)
Heat sensitive protein medicines are increasingly exhibiting their critical importance on treatment of various diseases at present. But their popularization and application meet a great challenge because of their heat instability. In the present study, insulin was taken as a heat sensitive protein medicine and amino acid as bio-protective agent in order to investigate if these amino acids can protect the insulin from losing its bioactivity due to desiccation. The experiment was performed by using replica exchange molecular simulation (REMD) method and Gromacs software with Gromos96 (53a6) force field. The REMD results indicated that these amino acids could protect the bioactive structure of insulin during desiccation. The configurations of the protected insulin were preserved very well. Those results proved that amino acid is a kind of good bioactive protective agent for the heat sensitive protein medicines.
Objective To study the interferencing and anti-tumor effects of lentiviral vector of siRNA targeting IGF1R and EGFR gene of the liver cancer cell. Methods The complementary DNA containing both sense and antisense Oligo DNA of the targeting sequence was designed, synthesized and connected to the pLVTHM vector, named pLVTHM-IGF1R, into whom the EGFR-siRNA expression frame containing H1 promotor synthesized by RT-PCR was cloned to generate pLVTHM-IGF1R-EGFR-siRNA. The 293T cells were cotransfected by 3 plasmids of pLVTHM-IGF1R-EGFR-siRNA, psPAX2 and pMD2G to enclose LVTHM-IGF1R-EGFR-siRNA, which was amplified in large amount and purified by caesium chloride density gradient centrifugation for measurement of virus titer. SMMC7721 cells infected by LVTHM-IGF1R-EGFR-siRNA were infection group, the untreated SMMC7721 cells and blank vector plasmid LVTHM were two control groups (SMMC7721 cell group and blank vector group). The effect of LVTHM-IGF1R-EGFR-siRNA on IGF1R and EGFR expressions of SMMC7721 cells were detected by RT-PCR and Western blot. The antitumor potential of LVTHM-IGF1R-EGFR-siRNA to SMMC7721 cells was evaluated by Cell Counting Kit-8 assay for cell growth and TUNEL for apoptosis respectively. Results LVTHM-IGF1R-EGFR-siRNA was constructed successfully. Functional pfu titers of LVTHM-IGF1R-EGFR-siRNA was 4.58×109 pfu/ml. Protein and mRNA expression of IGF1R and EGFR of infection group were less than those of blank vector group and SMMC7721 cell group （P＜0.05）, LVTHM-IGF1R-EGFR-siRNA was more effective to inhibit the proliferation and promote apoptosis of SMMC7721 cells （P＜0.05）. Conclusion LVTHM-IGF1R-EGFR-siRNA expressing IGF1R-EGFR-siRNA can inhibit the expression of IGF1R and EGFR, and may be used for further investigation of gene therapy of liver cancer.
ObjectiveTo investigate the expressions of glucose transporter-4 (GLUT-4) and secreted protein acidic and rich in cysteine (SPARC) in adipose tissue of Goto-Kakizaki (GK)/Wister rats after gastric bypass operation (GBP), and to explore the possible mechanism of GBP improving insulin resistance.MethodsHealthy male GK rats were randomly divided into diabetic operation group (DO group, underwent GBP), diabetic sham operation group (DS group, underwent sham-operation), and diabetic control group (DC group, received no-treatment), Wister rats were set as normal control group (NC group, received no-treatment). The weight, fasting blood glucose (FPG), fasting serum insulin (Fins), and HbA1c were measured before operation and at the 1st, 2nd, 4th, and 8th week after operation. Quantitative insulin sensitivity check index (QUICKI) was measured in before operation and at the 8th week after operation, and the expressions of GLUT-4 and SPARC protein in adipose tissues were measured by Western Blot method at the 8th week after operative too.Results① Weight: the weight of the DO group was lower than preoperative at the 2nd and 4th week after GBP (P<0.05), but increased to the normal level at the 8th week after GBP (P>0.05). The weight of the DO group was lower than those of the DS group, DC group, and NC group at the same time point of 2nd, 4th, and 8th week (P<0.05). ② FPG: the FPG level of the DO group was lower than preoperative at the 2nd, 4th, and 8th week after GBP (P<0.05), and lower than those of the DS group and the DC group from 2nd to 8th week after GBP (P<0.05). The FPG level between the DS group and the DC group had no statistical significance (P>0.05). ③ Fins: the Fins level of the DO group was higher than preoperative at the 2nd week after GBP (P<0.05), and decreased gradually at 4th and 8th week but not significantly differed from the NC group at the same time point. At the 2nd week after GBP, the Fins level of the DO group was higher than those of the DS group and the DC group (P<0.05), but there was no statistical significance between the DS group and the DC group (P>0.05). ④ HbA1c: the HbA1c level of the DO group started to decrease but there was no statistical significance between preoperative and all time after GBP (P>0.05). There was no statistical significance among the 4 groups at the 8th week after GBP (P>0.05). ⑤ QUICKI: at the 8th week, the QUICKI value of the DO group was higher than preoperative (P<0.05), and at the same time, the QUICKI value of the DO group and the NC group were higher than those of the DS group and the DC group (P<0.05), but there was no statistical significance between the DO group and the NC group (P>0.05), as well as the DS group and the DC group (P>0.05). ⑥ GLUT-4 protein and SPARC protein: the expression of GLUT-4 protein of the DO group was dramatically higher than those of the DC, DS, and NC group (P<0.05), and the expression of SPARC protein of the DO group was dramatically lower than those of the DC, DS, and NC group (P<0.05) at the 8th week. But the expressions of GLUT-4 and SPARC protein had no statistical significance among the DS, DC, and NC group at the 8th week after GBP (P>0.05).ConclusionGBP may improve and increase the sensitivity of insulin resistance by regulating the expressions of GLUT-4 and SPARC protein in adipose tissue of GK rats.
摘要:目的: 观察格列美脲对2型糖尿病患者心血管的保护作用并探讨其可能的机制。 方法 :112例T2DM患者随机分为格列美脲组(格列美脲+二甲双胍)和对照组(格列本脲+二甲双胍),观察治疗前后两者空腹及餐后两小时血糖(FBG,2hPBG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、HOMA模型胰岛素抵抗指数(HOMAIR)、甘油三脂(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDLC)、同型半胱氨酸(HCY)、血浆脂联素的变化。 结果 :两组患者的TC、LDLC、TG、FBG、2hPBG都较治疗前降低,连续服用6个月以上格列美脲的T2DM患者其血浆HCY、HOMAIR、血糖水平明显下降,血浆脂联素水平明显升高,与对照组相比差异有统计学意义(〖WTBX〗P lt;005)。 结论 :格列美脲能降低多项心血管危险因子水平,对血脂、HCY和动脉粥样硬化都有良性调节作用,其作用基础可能与改善胰岛素抵抗,增加血浆脂联素相关。Abstract: Objective: To observe the protective effects and to explore mechanisms of glimepiride on cardiovascular system of Type 2 Diabetes Mellitus. Methods : 112 patients with type 2 diabetes mellitus were randomly divided into treatment group (glimepiride combined with metformin) and control group (glibenclamide combined with metformin). The fasting blood glucose (FBG), 2hPBG, hemoglobin A1c (HbA1c), FINS, HOMAIR, blood lipid (TC, TG, LDLC and HDLC), HCY (homocysteine) and adiponectin were detected before and after treatment. Results : In all cases, the level of TC、LDLC、TG、FBG、2hPBG were decreased after treated with glimepiride or glibenclamide combined with metformin for 6 monthes. Moreover, the level of HCY, HOMAIR and blood glucose were decreased and the level of adiponectin was increased significantly than that of in control group (Plt;005). Conclusion : Glimepiride showed the effective on decreasing the risk factor of cardiovascular system disease with regulation of blood lipid, HCY, and improve the atherosclerosis. The effective of glimepiride on cardiovascular system was relation to improved the insulin resistance and increase the adiponectin.
Objective To explore the possible anti-inflammatory mechanism of intensive insulin therapy （IIT） by studying the effect of IIT on the levels of TNF-α, IL-6, C-reactive protein （CRP） and APACHE Ⅱ score in biliary pyemia. Methods Twenty eight patients with biliary pyemia who were admitted by our department and given an operation within 24 h form Jan. 2005 to Dec. 2008 were randomly divided into two groups by using random number table numbers: one group treated with IIT （IIT group, n=14） and another group treated with routine insulin therapy （RIT group, n=14）. The inflammatory factors, such as TNF-α, IL-6 and CRP were detected dynamically and the APACHEⅡ score was calculated. ResultsThe level of CRP and APACHEⅡ score on day 5 and 7 and the levels of TNF-α and IL-6 on day 3, 5 and 7 after operation in IIT group were significantly lower than those in RIT group （P＜0.05, P＜0.0１）. Compared with preoperative levels, the IL-6 and APACHEⅡ score in IIT group commenced to decrease on day 3 after operation （P＜0.05）, that was earlier than control group. Conclusion The treatment with IIT can suppress the composition of TNF-α, IL-6 and CRP, protect impaired hepatic cells, and reduce APACHEⅡ score, the degree of systemic inflammation and incidence of MODS.
ObjectiveTo analyze the clinical data of 5 cases of congenital hyperinsulinemia with sizures as the initial symptoms. MethodsRisk factors in perinatal period, clinical manifestation, laboratory examination, treatment and follow-up visits of 5 cases of congenital hyperinsulinemia with sizures as the initial symptoms were analyzed retrospectively, who were admitted to Department of Neurology of Jiangxi Children's Hospital from July 2012 to August 2016. Results5 children were all male. The onset time varied from 3 to 9 mouths old. All the cases presented seizures as the main clinical manifestations, persistent hypoglycemia, hyperinsulinemia, low free fatty acid and hypoketonemia. During follow-up, treatment with diazoxide and dietary therapy was effective in 3 cases, pure dietary therapy ineffective in 2 cases. 3 cases manifested as acute symptomic seizures, 2 cases as remote symptomic epilepsy. During follow-up, 1 cases showed normal intelligence, 3 cases developmental delay, and 1 case dropout. ConclusionMost of the infants with congenital hyperinsulinemia presented seizures as initial symptoms. Severe hypoglycemia and long duration would damage brain, and early management may significantly improve the prognosis. The early diagnosis can be made by measuring fasting blood glucose, insulin, free fatty acid and, plasma β-hydroxybutyric acid, C peptide and so on. The majority of children were effective by diazoxide.
Objective To evaluate the feasibility of hyperinsulinemic normoglycemia strategy in critically ill patients. Methods Between January 2020 and October 2021, the critically ill patients with stress hyperglycemia in the Emergency Intensive Care Unit of the Fourth People’s Hospital of Langfang were randomly assigned into a trial group or a control group. The trial group adopted hyperinsulinemic normoglycemia therapy, while the control group adopted conventional glucose control therapy. The mean and variability (standard deviation) of blood glucose, incidences of severe hypoglycemia and abnormal hyperglycemia, as well as the percentage of blood glucose values within the target range were compared between the two groups, to evaluate the feasibility of hyperinsulinemic normoglycemia strategy in critically ill patients from the perspective of safety and effectiveness. The non-normally distributed measurement data were presented as median (lower quartile, upper quartile). Results A total of eighty patients were included, with forty cases in each group. The mean blood glucose level [6.00 (5.74, 6.70) vs. 9.51 (8.74, 10.01) mmol/L, P<0.001], the standard deviation of glucose level [1.58 (1.11, 2.15) vs. 2.20 (1.21, 2.76) mmol/L, P=0.028], and the glycemic lability index [175.52 (100.51, 346.69) vs. 408.51 (205.56, 651.91) mmol2/(L2·h·d), P<0.001] were all smaller in the trial group than those in the control group. The percentage of blood glucose values within the target range was 77.34% in the trial group and 5.33% in the control group, respectively, and the difference was statistically significant (P<0.001). No patients experienced severe hypoglycemia. There was a significant difference in the incidence of abnormal hyperglycemia between the two groups (5.08% vs. 36.16%, P<0.001). Conclusions Hyperinsulinemic normoglycemia strategy can effectively and safely provide normoglycemia, reduce glycemic variability, and achieve good glycemic control in critically ill patients. Hyperinsulinemic normoglycemia strategy may be a new approach to glycemic control in critically ill patients.