A Prognostic Model of the Development of Cognitive Impairments in Patients with Type 1 Diabetes Mellitus

Neuroscience and Behavioral Physiology - Objective. TO develop a prognostic model of the development of cognitive impairments in patients with type 1 diabetes mellitus using proton magnetic...     

Oxygen-Binding Characteristics of Erythrocyte in Children with Type I Diabetes Mellitus of Different Duration

Oxygen-binding properties of erythrocyte hemoglobin were studied in children with type 1 diabetes mellitus by Raman spectroscopy. The content of hemoglobin-oxygen complexes increased significantly only in children with lasting disease (more than 1 year); oxygen-binding capacity of hemoglobin is significantly changed, while its capacity to release oxygen remained unchanged. These changes were paralleled by alteration of hemoglobin affinity for oxygen. The area and content of hemoglobin were studied by laser interference microscopy. Hemoglobin content increased significantly in erythrocytes of patients with a more than 1-year history of type 1 diabetes mellitus. In these children, a significant inverse correlation between oxyhemoglobin fraction, oxygen binding capacity, and cholesterol content was found, this clinical parameter positively correlated with affinity for oxygen measured by Raman spectroscopy.     

糖维胶囊联合二甲双胍治疗2型糖尿病胰岛素抵抗患者疗效分析

目的:观察糖维胶囊联合二甲双胍对2型糖尿病(T2DM)胰岛素抵抗(IR)患者糖脂代谢、抗氧化功能及胰岛素敏感性的影响。方法:根据不同治疗方法将200例T2DM IR患者分为治疗组和对照组,每组各100例,对照组口服二甲双胍,辅以饮食控制及积极运动,治疗组在对照组的基础上加服糖维胶囊,4周为1个疗程。3个疗程后评价疗效,且对治疗前后中医症候总积分、糖脂代谢指标、抗氧化指标及胰岛素敏感指数(ISI)进行测定,并比较组间差异。结果:治疗组治疗总有效率,显著高于对照组(90.00%vs 75.00%,P0.05);两组治疗后中医症候总积分、空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbAlc)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、丙二醛(MDA)水平均显著下降,ISI、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSHPx)均显著上升,差异有统计学意义(P0.05);治疗组治疗后上述各指标改善效果均显著优于对照组(P0.05);两组均无明显不良反应发生。结论:糖维胶囊联合二甲双胍改善T2DM IR患者糖脂代谢紊乱、提高胰岛素敏感度优于单用二甲双胍,其机制可能与其能增强机体抗氧化功能有关。     

胰岛素抵抗与2型糖尿病

2型糖尿病(T2DM)发病机制多认为由胰岛素抵抗(IR)和B细胞功能缺陷引起,而IR又是T2DM发生的基础,并贯穿于T2DM发生发展的全过程。IR的发生机制十分复杂,不仅与遗传因素高度相关,而且与胰岛素信号传导缺陷、多种脂肪源性细胞因子表达异常、物质代谢异常、炎症介质和氧化应激等诸多因素有关。但目前已发现的多种基因突变和诸多因素尚不能完全解释IR现象,各种因素致IR的确切机制和产生IR的许多环节还不十分清楚,IR不仅存在于外周组织中,B细胞自身也存在IR,并与T2DM相关。     

Ⅰ型糖尿病患者变形的手指甲襞毛细血管周围胶原增多的研究

用定量手指甲襞毛细血管显微镜对25例I型糖尿病患者和27例正常人(对照)进行测量,最后的6个病人和7例健康者做手指甲襞活组织检查。体内毛细血管襻宽度作为毛细血管襻变形参数的结果表明,在糖尿病患者其数值明显高于正常人。组织病理检查表明,糖尿病病人甲襞皮肤乳头胶原沉积明显增加,胶原的沉积与糖尿病患者的甲襞皮肤乳头毛细血管内皮细胞数量和乳头大小相关。由此认为,糖尿病性微血管病,除甲襞毛细血管变形外,胶原沉积可能是代谢紊乱和毛细血管内皮细胞增殖的一个表现。     

大鼠糖尿病模型的建立

目的建立1型和2型大鼠糖尿病模型。方法给Wistar大鼠灌胃脂肪乳10d,记录饮食、饮水、体重变化,用毛细血管法和正糖钳技术判定胰岛素抗性,同时测定血清中空腹血糖、丙二醛（malondialdehydeto,MDA）和游离脂肪酸（freefattyacid,FFA）;大鼠腹腔注射四氧嘧啶。结果通过四氧嘧啶一次腹腔注射建立了Wistar大鼠1型糖尿病的动物模型．通过灌胃脂肪乳建立了伴有胰岛素抵抗的Wistar大鼠2型糖尿病的动物模型。结论成功建立了Wistar大鼠1型和2型糖尿病的动物模型。     

Progress in the Development of Immune-Based Therapies for Type 1 Diabetes Mellitus

Between ten and twenty million people worldwide have type 1 diabetes mellitus (T1DM), which has previously been called juvenile diabetes, childhood diabetes, and insulin-dependent diabetes mellitus. T1DM is undoubtedly a multifactorial disease affecting predisposed individuals with genetic susceptibilities; it is also associated with environmental factors leading to unbalanced immune responses. This chronic disorder is caused by auto-aggressive T lymphocytes entering the pancreatic islets of Langerhans where they destroy the insulin-producing beta-cells. A wide variety of immuno-interventions cure T1DM effectively in different animal models when given early in disease development. However, few of these interventions are efficacious in humans at a later stage of the disease. Indeed, only three immunotherapeutic compounds have demonstrated both safety and efficacy in phase II/III clinical trials. Although much time and resources have been spent on generating potent immune therapies, none of the patients enrolled in these trials have achieved normoglycemia in the absence of insulin injections. Many reasons can account for such a disappointing conclusion. Firstly, the dynamics of disease pathogenesis differs significantly from patient to patient, which directly impacts the therapeutic efficacy. Also, at trial entry, the percentage of remaining pancreatic beta-cells in T1DM patients often reflects the odds of responding positively to treatment. Based on the knowledge we have gained from preclinical studies and clinical trials, several steps have been made in the development of safer and more efficient immune-based therapies. There are, however, a number of concerns that should be addressed in order to improve future therapeutic strategies.     

2型糖尿病患者尿白蛋白排泄率与心自主神经病变的关系

目的 观察2型糖尿病心自主神经病变的患病率及其与尿白蛋白排泄率的相关性.方法 选取T2DM患者200例,根据尿蛋白排泄率分为正常蛋白尿组(80例)、微量蛋白尿组(66例)和大量蛋白尿组(54例);采集临床资料,测定收缩压、舒张压、空腹血糖、糖化血红蛋白及血脂等指标;行心血管反射试验检查,结合临床症状评价糖尿病患者心自主神经病变.结果 三组患者在糖尿病病程、收缩压、甘油三酯、空腹血糖、糖化血红蛋白和心自主神经病变之间的差异有统计学意义.心自主神经病变者分别占1.3％、9.1％、22.2％(两两比较,P均＜0.05).尿蛋白排泄率与糖尿病病程、空腹血糖、糖化血红蛋白、收缩压、甘油三酯、低密度脂蛋白-胆固醇、心自主神经病变呈正相关(P均＜0.05).多元回归分析显示收缩压(X1)、甘油三酯(X2)、心自主神经病变(X3)、糖尿病病程(X4)是UACR的影响因素,回归方程为Y=-398.454+2.789X1 +49.092X2+147.969X3 +5.659X4.结论 随着蛋白尿程度加重,合并心自主神经病变的患病率增加;收缩压、甘油三酯、心自主神经病变、糖尿病病程是尿蛋白排泄率的独立影响因素.     

Pancreatic Pathology in Type 1 Diabetes Mellitus

Type 1 diabetes is a multifactorial disease resulting from a complex interplay between host genetics, the immune system and the environment, that culminates in the destruction of insulin-producing beta cells. The incidence of type 1 diabetes is increasing at an alarming rate, especially in children under the age of 5 (Gepts in Diabetes 14(10):619-613, 1965; Foulis et al. in Lancet 29(5):267-274, 1986; Gamble, Taylor and Cumming in British Medical Journal 4(5887):260-262 1973). Genetic predisposition, although clearly important, cannot explain this rise, and so, it has been proposed that changes in the ‘environment’ and/or changes in ‘how we respond to our environment’ must contribute to this rising incidence. In order to gain an improved understanding of the factors influencing the disease process, it is important, firstly, to focus on the organ at the centre of the illness—the pancreas. This review summarises our knowledge of the pathology of the endocrine pancreas in human type 1 diabetes and, in particular, explores the progression of this understanding over the past 25 years.     

Extract of Ginkgo Biloba Ameliorates Streptozotocin-Induced Type 1 Diabetes Mellitus and High-Fat Diet-Induced Type 2 Diabetes Mellitus in Mice

Diabetes mellitus (DM) is caused by either destruction of pancreatic β-cells (type 1 DM) or unresponsiveness to insulin (type 2 DM). Conventional therapies for diabetes mellitus have been developed but still needs improvement. Many diabetic patients have complemented conventional therapy with alternative methods including oral supplementation of natural products. In this study, we assessed whether Ginkgo biloba extract (EGb) 761 could provide beneficial effects in the streptozotocin-induced type 1 DM and high-fat diet-induced type 2 DM murine model system. For the type 1 DM model, streptozotocin-induced mice were orally administered EGb 761 for 10 days prior to streptozotocin injection and then again administered EGb 761 for an additional 10 days. Streptozotocin-treated mice administered EGb 761 exhibited lower blood triglyceride levels, lower blood glucose levels and higher blood insulin levels compared to streptozotocin-treated mice. Furthermore, liver LPL and liver PPAR-α were increased whereas IL-1β and TNF-α were decreased in streptozotocin-injected mice treated with EGb 761 compared to mice injected with streptozotocin alone. For the type 2 DM model, mice were given high-fat diet for 60 days and then orally administered EGb 761 every other day for 80 days. We found that mice given a high-fat diet and EGb 761 showed decreased blood triglyceride levels, increased liver LPL, increased liver PPAR-α and decreased body weight compared to mice given high-fat diet alone. These results suggest that EGb 761 can exert protective effects in both type 1 and type 2 DM murine models.     

Adherence Behavior Among Adolescents with Type I Insulin-Dependent Diabetes Mellitus: The Role of Cognitive Appraisal Processes

Guided by a transactional stress and coping model, this studyexamined the contribution of cognitive appraisal processes todiabetes adherence behavior among adolescents 12 to 18 yearsold (n=40). Multiple hierarchical regression analyses indicatedthat esteem related to physical appearance accounted for a significant16% of the variance in checking one's blood sugar. Perceivedcontrol when ill and attributional style for negative eventseach accounted for significant increments of variance as well(10 and 6% respectively), yielding a total of 32% of the varianceexplained by appraisal processes. Results suggest that adolescentswho (a) have a negative perception of their bodies, (b) perceivelittle internal control over health when ill. and (cJ have anexternal attributional style for negative events were at greatestrisk for poor compliance as indicated by Lss frequent checkingof blood sugar.     

Augmented Cardiac Formation of Oxidatively-Induced Carbonylated Proteins Accompanies the Increased Functional Severity of Post-Myocardial Infarction Heart Failure in the Setting of Type 1 Diabetes Mellitus

SummaryHeart failure (HF) is a dominant cause for the higher mortality of diabetics after myocardial infarction (MI). In the present investigation, we have discovered that higher levels of oxidative stress (OS)-induced carbonylated proteins accompany worsening post-MI HF in the presence of type 1 diabetes. These findings provide a mechanistic link between amplified OS and exacerbation of post-infarction HF in diabetes.BackgroundType 1 diabetes mellitus (DM) patients surviving myocardial infarction (MI) manifest an increased incidence of subsequent heart failure (HF). We have previously shown that after MI, type 1 DM is associated with accentuated myocardial oxidative stress (OS) and concomitant worsening of left ventricular (LV) function. However, the precise mechanisms whereby type 1 DM-enhanced OS adversely affects HF after MI remain obscure. As carbonylation of proteins is an irreversible post-translational modification induced only by OS that often leads to the loss of function, we analyzed protein-bound carbonyls in the surviving LV myocardium of MI and DM+MI rats in relation to residual LV function.MethodsType 1 DM was induced in rats via administration of streptozotocin. Two weeks after induction of type 1 DM, MI was produced in DM and non-DM rats by coronary artery ligation. Residual LV function and remodeling was assessed at 4 weeks post-MI by echocardiography. Myocardial carbonylated proteins were detected through OxyBlot analysis, and identified by mass spectrometry.ResultsCompared with MI rats, DM+MI rats exhibited significantly poorer residual LV systolic function and elevated wet to dry weight ratios of the lungs. Protein carbonyl content in cardiac tissue and isolated heart mitochondria of DM+MI rats was 20% and 48% higher, respectively, versus MI rats. Anti-oxidative enzymes and fatty acid utilization proteins were among the carbonylated protein candidates identified.ConclusionsThese findings implicate myocardial protein carbonylation as part of the molecular pathophysiology of aggravated HF in the type 1 diabetic post-infarction heart.     

Chronobiology of Cardiac Ventricular Fibrillation Development in Experimental Acute Coronary Failure

Numerous experiments on simulation of acute coronary failure in initially intact rabbits showed that under the same experimental conditions irreversible ventricular fibrillation developed in some animals and did not develop anothers. We hypothesize that the probability of fibrillation development was determined by the time of the day, during which acute coronary failure developed. The study was carried out on 2 groups of rabbits in winter in Moscow. In group 1, the failure was induced by ligation of the left descending coronary artery at the interface between its middle and lower thirds at 11.00-18.00 with 30-min intervals. In group 2, the microcirculatory status of the left-ventricular myocardium was studied by light microscopy and morphometry at 12.00 and 18.00. Induction of coronary failure during the period from 15.30 to 18.00 led to irreversible ventricular fibrillation and death in 100% cases. Modeling of the condition from 11.00 to 15.00 caused no ventricular fibrillation in 89% cases, and the animals survived. The area of left-ventricular myocardial capillaries at 12.00 virtually 2-fold surpassed that at 18.00. Presumably, the electrolyte balance and metabolic characteristics of the myocardium switch over to the nocturnal mode of functioning at 15.30 due to changes in blood filling of the myocardium. The appearance of an ischemic focus in the myocardium during this period inevitably leads to the development of irreversible ventricular fibrillation.     

两种心身疾病患者的述情障碍及相关因素研究

目的：探讨心身疾病患者的述情障碍及相关因素。方法：采用多伦多述情障碍量表（TAS）,艾森克成人个性问卷（EPQ）,SIMH精神卫生自评量表（SCL－90）测查了42例原发性高血压患者,40例2型糖尿病患者,并以45例正常人作对照。结果：两组患者均有述情障碍;原发性高血压患者描述情感的能力欠缺,不易认识和区别情绪和躯体感受,多属外向型思维;2型糖尿病组除以上三方面述情障碍外,还具有缺乏纪想和想象力的特点。多元相关分析发现,原发性高血压组,个性越内倾,描述情感能力越欠缺;2型糖尿病组,个性越内倾,越难以认识和区分情绪和躯体的感受;两组情绪越不稳定,对情感的描述能力以及认识,区别情绪和躯本的感受的能力越低下。多元逐步回归分析发现,心怀敌意及情绪不稳定的个性缺陷是原发性高血压患者述情障碍的重要因素。偏执和精神质个性缺陷是2型糖尿病患者述情障碍的重要因素。结论：原发性高血压和2型糖尿病患者普遍存在述情障碍,且与个性特征及心理卫生状况有密切关系。     

格列美脲联合吡格列酮治疗老年2型糖尿病合并 高血压患者的疗效分析

摘要:目的 探讨格列美脲联合吡格列酮治疗老年2型糖尿病合并高血压患者的疗效。方法 选取2017年6月~2018年5月我院收治的2型糖尿病合并高血压患者120例,按随机数字表法分为观察组和对照组,各60例。对照组给予吡格列酮,观察组在对照组的基础上给予格列美脲,比较两组治疗前、治疗后第6个月的血糖、血脂、血压水平以及不良反应发生率。结果 治疗后,观察组FPG、HbA1c低于对照组[（6.25±0.79）mmol/L vs（6.73±0.81）mmol/L、（5.90±1.12）% vs（6.39±1.33）%],差异有统计学意义（P＜0.05）。观察组TC、TG低于对照组[（4.76±0.96）mmol/L vs（5.22±1.01）mmol/L、（1.60±0.64）mmol/L vs（1.60±0.64）mmol/L],差异有统计学意义（P＜0.05）;两组LDL-C、HDL-C比较,差异无统计学意义(P＞0.05)。观察组SBP低于对照组[（125.36±12.87）mmHg vs （132.35±13.58）mmHg],差异有统计学意义（P＜0.05）;两组DBP比较,差异无统计学意义(P＞0.05)。观察组不良反应发生率为6.67%,低于对照组的10.00%,但差异无统计学意义（P＞0.05）。结论 吡格列酮联合格列美脲能有效改善老年2型糖尿病合并高血压患者的血糖、血脂和血压水平,且联合用药改善效果优于单独用药,且具有较高的安全性。     

Association of Toll-Like Receptor 4 Polymorphisms with Type 2 Diabetes Mellitus

Type 2 diabetes mellitus (T2DM) is characterized by a chronic low-grade inflammatory state. Toll-like receptor 4 (TLR4) is a critical mediator of innate immunity. Polymorphisms in TLR4 gene have been shown to be associated with impaired inflammatory response. Here, we investigated the association of TLR4 polymorphisms with T2DM. Four TLR4 polymorphisms (+986A/G, +1196C/T, +3725G/C, and +11367G/C) were genotyped in a total number of 822 T2DM patients and 835 healthy controls. Results showed that the +986A/G and +1196C/T polymorphisms did not exist in the Han Chinese population. The prevalence of TLR4 +3725GC and CC genotypes were significantly decreased in T2DM cases than in controls (odds ratio (OR)?=?0.62, 95 % confidence interval (CI)?=?0.50–0.78, p?=?3.48?×?10^?5, and OR?=?0.36, 95 % CI?=?0.22–0.59, p?=?1.55?×?10^?5, respectively). Also, the frequency of TLR4 +3725C allele was significantly lower in T2DM patients (p?=?2.46?×?10^?9). When analyzing the TLR4 +11367G/C polymorphism, the +11367CC genotype revealed lower numbers in patients compared to healthy controls (OR?=?0.46, 95 % CI?=?0.27–0.78, p?=?0.0032). Analysis of the clinical features on the control subjects demonstrated no correlations between these TLR4 polymorphisms and sex, age, body mass index, etc. (p?>?0.05). In conclusion, these data indicate that TLR4 +3725G/C and +11367G/C polymorphisms may be novel protective factors against T2DM in the Chinese population.     

载脂蛋白E基因多态性与2型糖尿病的关系

目的:探讨载脂蛋白E基因型与2型糖尿病的易感性。方法:应用multi-ARMS快速分型法对316例T2DM患者、512例健康对照人群的ApoE基因第4外显子112位Cys/Arg和158位Arg/Cys进行检测;随机抽取分型标本进行DNA测序法验证。结果:ε2/2、ε2/3、ε3/3、ε4/2、ε4/3、ε4/4基因型在二组中的频率分布为:0.6%,5.7%,72.8%,1.9%,14.9%,4.1%(T2DM组);0.6%,9.4%,70.1%,1.8%,17.0%,1.2%(对照组)。二组间差异有显著性统计学意义(χ2=11.45,P<0.05),T2DM组ε4/4基因型频率明显高于对照组(4.11%VS1.17%)。结论:ApoEε4/4基因型可能与T2DM的易感性有关。     

Characterization of Motor Activity of Spermatozoa in Adult Progeny of Female Rats with Experimental Type 1 Diabetes Mellitus

Bulletin of Experimental Biology and Medicine - We studied the influence of maternal experimental streptozotocin-induced type 1 diabetes mellitus on motility of spermatozoa in adult progeny. A...     

99Tcm-MIBI门控心肌灌注显像评价2型糖尿病心功能的临床价值

目的 回顾性分析2型糖尿病患者门控心肌灌注显像左心室功能参数变化及其与心肌缺血的关系.方法 75例确诊2型糖尿病且能耐受踏车运动负荷试验的患者,接受2日法运动负荷及静息门控心肌灌注显像,采用目测法评估左室心肌缺血节段,以及QPS 17节段定量分析SSS评分评估左心室各壁段心肌缺血情况.根据SSS评分将75例患者分为缺血组及对照组.QGS定量分析左心室心功能参数包括LVEF、EDV、ESV、PFR及PER;比较心功能参数与各自正常参考值的差异,以及缺血组与对照组之间各心功能参数的差异.统计分析软件SPSS19.0,计量资料用t检验,计数资料用χ2检验.结果 目测法与QPS定量分析法评估心肌缺血之间比较差异有统计学意义(χ2=13.19,P<0.001).与各自正常参考值比较:LVEF[(45.43±11.92)%,P<0.01]及PFR(2.51±0.43,P<0.05)差异有统计学意义;PER(2.78±0.33,P>0.05)差异无统计学意义.缺血组与对照组心功能参数比较:LVEF(t=-7.62,P<0.001)、EDV(t=-5.29,P<0.01)及PFR(t=-2.53,P<0.05)差异有统计学意义;ESV(t=-0.85,P>0.05)及PER(t=-1.69,P>0.05)无统计学意义.结论 99Tcm-MIBI门控心肌灌注显像可用于评价2型糖尿病患者左室心功能.     

长效胰岛素联合口服降糖药治疗2型糖尿病的 疗效与安全性评价

目的 探究对2型糖尿病患者采用长效胰岛素联合口服降糖药治疗的效果。方法 抽取在我院接受治疗的2型糖尿病患者78例,使用电脑随机数字表法分为对照组和治疗组,各39例,对照组予以常规口服降糖药物治疗,治疗组在此基础上联合长效胰岛素进行治疗,比较两组患者的空腹血糖、餐后2 h血糖、糖化血红蛋白、尿微量改善情况及不良反应发生率。结果 治疗后,治疗组患者的尿微量（30.57±1.67）kg/m3、糖化血红蛋白（6.32±0.35）%及空腹血糖值（6.52±0.42）mmol/L、餐后2 h血糖值（10.68±0.87）mmol/L改善情况优于对照组的尿微量（26.31±2.85）kg/m3、糖化血红蛋白（9.04±1.45）%、空腹血糖值（8.02±0.78）mmol/L、餐后2 h血糖值（12.63±1.21）mmol/L,差异均有统计学意义（P＜0.05）;治疗组患者经药物治疗后的不良反应发生率为2.56%,低于对照组的20.51%,差异有统计学意义（P＜0.05）。结论 对2型糖尿病患者采用口服降糖药联合长效胰岛素进行治疗,能有效促进患者机体血糖得到调节与提升血糖控制率,且安全性高。