超声对糖尿病患者颈动脉硬化程度评价

目的 利用超声技术评价Ⅱ型糖尿病人颈动脉硬化程度.方法 测定72例Ⅱ型糖尿病患者的颈动脉内-中膜厚度(IMT)及斑块形成情况,并与健康组对照.结果 Ⅱ型糖尿病组颈动脉IMT(1.2±0.11) mm较正常组(0.76±0.16) mm明显增厚;斑块检出率为69%,较正常组检出率15%明显增高.结论 Ⅱ型糖尿病患者颈动脉硬化斑块形成情况明显高于正常组,利用超声检测可早期评价Ⅱ型糖尿病患者的硬化情况,并指导临床诊断及治疗.     

The Length of the CTLA-4 Microsatellite (AT)N-Repeat Affects the Risk for Type 1 Diabetes: For the Swedish Childhood Diabetes Study Group

CTLA-4 is important to down-regulating T cell responses and has been implicated in type 1 (insulin dependent) diabetes mellitus in both linkage and association studies. The aim of our study was to relate the polymorphic (AT)_n microsatellite in the 3′ untranslated sequence of the CTLA-4 gene to diabetes risk. We studied 616 consecutively diagnosed 0-34 year-old Swedish patients and 502 matched controls by PCR-based genotyping to determine the length of the 3′-end (AT)_n repeat region of the CTLA-4 gene and categorizing alleles as predominantly monomorphic short (S) or highly polymorphic (in length) long (L) alleles. The odds of type 1 diabetes of subjects with the L/L genotype was estimated to be 1.84 times that of subjects with the S/S genotype (95% CI 1.44-2.73, p=0.002). Further analysis of the long alleles, partitioned into intermediate (I) length and very long (VL) alleles, suggested that L alleles act recessively in conferring diabetes risk (p=0.0009). This study suggests that the 3′-end (AT)_n repeat region of the CTLA-4 gene represents a recessive risk factor for type 1 diabetes     

Clinical evaluation of the shape of the suprascapular notch—an ultrasonographic and computed tomography comparative study: Application to shoulder pain syndromes

The most common site of suprascapular nerve compression and injury is the suprascapular notch. The aim of this study was to assess the sensitivity and specificity of sonography in determining the type of suprascapular notch (SSN). Thirty randomized patients (60 upper extremities) underwent USG examination of the shoulder area. The results were further compared with three‐dimensional reconstructions of the scapulae obtained through CT examination to place the SSNs within a fivefold classification. For identification of type I, the sensitivity was 73.3% and the specificity 97.8%. For identification of type III, the values was 96.9% and 85.7%, respectively. Type II was not found in USG examination. Discrimination between type IV and V was not possible. The mean distance between the line connecting the edges of the SSN and the skin was 38 mm in right‐handed patients and 34 mm in ambidextrous subjects. Ultrasonographic examination of the SSN is characterized by high specificity for type I, and high sensitivity for type III SSN. Discrimination between type IV and V of the SSN is not recommended based on sonographic evaluation. Clin. Anat. 28:774–779, 2015. © 2015 Wiley Periodicals, Inc.     

Ⅱ型糖尿病所致终末期肾病患者并发脑卒中的分析

目的探讨Ⅱ型糖尿病(DM)患者所致终末期肾病(ESRD)脑卒中的发生率以及相关危险因素对其的影响。方法应用回顾性方法对我院肾内科Ⅱ型DM所致ESRD接受血透患者(Ⅰ组,n=36)进行了分析,对照组为年龄和性别匹配的Ⅱ型DM肾功代偿期尚不需透析患者(Ⅱ组,n=59)和非糖尿病肾病(DN)所致ESRD接受血透患者(Ⅲ组,n=50)。收集以上患者的年龄、性别、病程、透析龄、血糖、血肌酐、脉压差(PP)、脑卒中发生类型、周围血管病变、血清胆固醇(CHOL)、高密度脂蛋白胆固醇(HDL)等临床资料,并进行多因素逐步回归分析。结果各组相比:Ⅰ组脑卒中总发生率最高,为22.2%,Ⅱ组为10.2%,Ⅲ组仅为4%;I组、Ⅱ组的脑梗塞发生率明显高于Ⅲ组(P<0.05);Ⅰ组脑出血发生率虽显著高于Ⅱ组(P<0.05),但该两组的脑梗塞发生率却相似。多因素逐步回归分析显示,脑梗塞发生的相关危险因素分别为PP、CHOL。结论Ⅱ型DM患者发生脑卒中的几率高于非DM所致ESRD患者,脑卒中发生的最危险因素为PP和CHOL,血液透析可能是导致Ⅱ型DM患者脑卒中几率增高的原因之一。     

A variant of the "DIDMOAD" syndrome: (Diabetes Insipidus, Diabetes Mellitus, Optic Atrophy and Deafness)

A 29-year-old female with diabetes insipidus, deafness, a visual disorder and an abnormal glucose tolerance test, who gave birth to a healthy baby is described. Her male sibling is probably also similarly affected. These patients may represent previously unreported variants of the "DIDMOAD" (Diabetes Insipidus, Diabetes Mellitus, Optic Atrophy and Deafness) syndrome. This is the first reported case of childbirth in an affected patient.     

2型糖尿病大鼠胰腺中Homer的表达及意义

目的 探讨Homer与胰岛素分泌及2型糖尿病发病机制的相关意义.方法 建立2型糖尿病大鼠模型,检测血糖和血胰岛素值.取胰腺组织,采用反转录PCR、免疫组化和免疫荧光方法检测Homer(Homer1c、Homer2、Homer3)和胰岛素的表达.结果 大鼠胰腺组织可见Homer表达,糖尿病大鼠胰腺组织胰岛素表达明显减少(P＜0.01),而Homer1c、Homer2和Homer3均表达增加(P＜0.05).结论 Homer基因在大鼠胰腺组织亦有表达,Homer1c、Homer2和Homer3可能对胰岛素分泌起负性调控作用.     

高脂饮食联合STZ建立2型糖尿病动物模型研究概况

高脂饮食联合链脲佐菌素(STZ)建立2型糖尿病动物模型是一种常见的造模方法,该动物模型具有较重要的研究价值。本文拟就该模型作一综述。     

Characteristics of Endocrine Pancreas in Chronic Pancreatitis,as Revealed by Simultaneous Immunocytochemical Demonstration of Hormone Production

Abstract

Cells producing insulin, glucagon, somatostatin, and pancreatic polypeptide (PP) were demonstrated by simultaneous immunocytochemical detection in human pancreatic sections of 3 patients with chronic pancreatitis (CP) and diabetes mellitus (DM), 2 patients with CP and normal glucose tolerance, and 2 patients with normal morphology (3 sections each). The triple and quadruple labeling protocol involved the sequential use of immunogold silver staining (IGSS), indirect immunoalkaline phosphatase (IAP), the indirect immunoperoxidase (IPO), and the peroxidase-antiperoxidase (PAP) methods. This approach proved useful for the recognition of some topo-morphological features of the endocrine pancreas at a glance in normal and CP tissues.

In the process of islet cell neoformation (ductoendocrine proliferation), the A cells seemed to occur first within the ducts and ductules, followed by the B and D cells. Additionally, in some islets of Langerhans damaged by intraislet peliosis in DM patients, the A cells were found to be very resistant, whereas the number B cells was seriously reduced. (The J Histotechnol 13:213, 1990)     

应用微信平台对初发中青年2型糖尿病患者进行 健康管理模式的研究

目的 探讨应用微信平台对初发中青年2型糖尿病患者进行健康管理的效果。方法 选取2016 年1月~2017年6月初发中青年2型糖尿病患者275例,给予空腹血糖、糖化血红蛋白、血脂等检查。随机分为对照组140例和观察组135例,对照组给与常规的健康管理模式,观察组应用微信平台健康管理模式,两组均随访6个月,比较两组患者干预6个月后空腹血糖、糖化血红蛋白、血脂及低血糖的发生率等的区别,用糖尿病自我管理行为量表对两组患者进行评分比较。结果 初始两组患者性别、年龄、空腹血糖、糖化血红蛋白,血脂水平对比,差异无统计学意义（P＞0.05）;两组患者随访6个月后,观察组空腹血糖、HbA1c,血脂水平均低于对照组（P＜0.05）,两组低血糖症的发生率,差异无统计学意义（P＞0.05）;观察组SDSCA评分大于对照组（P＜0.05）。结论 应用微信平台健康管理模式对初发中青年2型糖尿病患者进行健康管理可以取得较好的效果,能够有效降低空腹血糖和血脂水平,改善糖尿病患者自我管理行为。     

Bariatric Surgery Outcomes in Patients with Latent Autoimmune Diabetes of the Adult

Bariatric surgery is a very effective treatment for obesity-associated type 2 diabetes. However, the benefits of bariatric surgery in patients with obesity and autoimmune diabetes, such as type 1 diabetes and latent autoimmune diabetes in adults (LADA), are controversial. We report 3 female patients with obesity and LADA who underwent laparoscopic Roux-en-Y gastric bypass >10 years ago. The patients were diagnosed with LADA both 1 and 9 years before (n = 2) or 11 years after the surgery (n = 1). Patients preoperative body mass index ranged from 36 to 47 kg/m² and improved to 23–37 kg/m² in the last follow-up visit, 10–15 years after surgery. Daily insulin dose also decreased from an average of 0.68 to 0.45 IU/kg in those patients treated with insulin before bariatric surgery. Only one patient developed diabetes-related target organ damage. This study shows that patients with LADA depict remarkable reduction of body weight and insulin requirements over long-term after bariatric surgery. So, LADA should not be considered a contraindication for bariatric surgery yet should only be recommended for patients with concomitant obesity with the primary aim of achieving sustained weight loss.     

Effect of Socio-Economic Status on the Prevalence of Diabetes

Purpose

As Korean society has become industrialized and westernized, the prevalence of diabetes has increased rapidly. Environmental factors, especially socio-economic status (SES), may account for the increased prevalence of diabetes. We evaluated the associations between the prevalence of diabetes and SES as reflected by household income and education level.

Materials and Methods

This study was based on data obtained from the fifth Korea National Health and Nutrition Examination Survey, conducted in 2010-2012. Diabetes referred to a fasting plasma glucose ≥126 mg/dL in the absence of known diabetes, previous diagnosis of diabetes made by a physician, and/or current use of oral hypoglycemic agents or insulin.

Results

Household income and education level were inversely associated with the prevalence of diabetes among individuals aged 30 years or older. These associations were more prominent in females aged 30-64 years. According to household income, the odds ratio (OR) [95% confidence interval (CI)] for the lowest quartile group versus the highest quartile group was 4.96 (2.87-8.58). According to education level, the OR (95% CI) for the lowest quartile group versus the highest quartile group was 8.02 (4.47-14.4).

Conclusion

Public policies for the prevention and management of diabetes should be targeted toward people of lower SES, especially middle-aged females.     

糖化血红蛋白联合糖化清蛋白测定在妊娠期糖尿病筛查中的应用价值

目的 探讨糖化血红蛋白(HbA1c)联合糖化清蛋白(GA)测定在妊娠期糖尿病筛查中的应用价值.方法 对2015年3月至2016年3月在荆州市中心医院产科做产前检查的GDM孕妇(GDM组)和健康妊娠孕妇(对照组),进行外周血HbA1c、GA检测并分析两组受试者上述指标的差异.结果 GDM组HbA1c、GA阳性检出率均高于对照组,差异具有显著统计学意义(均P＜0.01);且GDM组中HbA1c与GA呈显著性正相关(r=0.958,P＜0.01).结论 HbA1c联合GA检测有助于妊娠期糖尿病的临床诊断和治疗,具有较高的应用价值.     

生活事件在2型糖尿病发病中作用的追踪研究

目的 :探讨紧张性生活事件在糖尿病发生中的作用。方法 :以 139例糖耐量低减者与 12 1例糖耐量正常者为研究对象 ,平均年龄为 5 7.34± 9.18岁 ,体重指数为 2 3.92± 2 .83,进行为期四年 (3次 )的追踪调查研究。每次均进行口服葡萄糖耐量试验 ,测餐前、餐后血糖 ,进行生活事件测评。结果 :糖尿病发病者在追踪期间所经历的生活事件明显多于未发病者 ,且在某些类别事件上有显著性差异 (P <0 .0 5 ) ,如第二次追踪中的环境问题 ,第三次追踪中的家庭与婚姻问题 ,前两年半时间经历的工作与经济问题及生活事件总频数等 ;生活事件条目分析发现 ,在子女管教困难、家庭主要成员遭意外事故、本人生活习惯改变、本人工作中受批评等 9个项目均值发病者明显高于未发病者。结论 :紧张性生活事件在糖尿病的发生过程中具有重要作用     

Peripheral vascular stiffness,assessed with two-dimensional speckle tracking versus the degree of coronary artery calcification,evaluated by tomographic coronary artery calcification index

Introduction

Even in asymptomatic patients, the result of atherosclerosis progression is deterioration of the function and morphology of the artery wall. Two-dimensional speckle-tracking (2DST) is a sonographic technique that allows for precise evaluation of arterial wall compliance. Together with measurement of intima-media thickness (IMT), it can be applied for quick and non-invasive assessment of the progression of peripheral artery atherosclerosis.

Material and methods

Fifty-eight patients of mean age 61 years (SD 10.6) underwent cardiac computed tomography (CT) and subsequent ultrasonographic evaluation of the left common carotid artery. The calcium score was calculated according to the Agatston method and compared with IMT, circumferential strain variables assessed by 2DST, conventional arterial stiffness parameters (β-stiffness index and elastic modulus) and clinical data. Intra-observer and inter-observer agreement was evaluated.

Results

Strain variables and IMT differed significantly in patients with calcium score (CS) > 0 and CS = 0. Moreover, they correlated with CS, systolic blood pressure and age of patients. Conventional stiffness parameters were not able to identify the group of patients with calcifications present in the coronary arteries. For the 2DST technique, interclass and intraclass agreements were 84.83% and 94.42% respectively.

Conclusions

Circumferential strain variables assessed by 2DST and measurement of IMT can be used for evaluation of peripheral artery deterioration in patients until the 6^th decade of life. These parameters reflect the development of calcifications in coronary arteries and, more importantly, can be used for a more detailed estimation of the atherosclerosis risk in patients with CS = 0.     

L-Methionine prevents β-cell damage by modulating the expression of Arx,MafA and regulation of FOXO1 in type 1 diabetic rats

L-Methionine (L-Met) is an essential sulphur-containing amino acid having a vital role in various key cellular processes. Here we investigated the effect of L-Met on streptozotocin-induced β-cell damage model of diabetes mellitus in Sprague Dawley rats. At the end of study biochemical parameters, immunoblotting, qRT-PCR and ChIP-qPCR are performed. L-Met was administered orally (250 and 500 mg/kg/day) to diabetic animals for 8 weeks improved plasma glucose and insulin levels. Pancreas immunohistochemistry showed significant increase in insulin expression, decrease in glucagon and Bax expression. Interestingly, L-Met inhibited the expression of Arx; upregulated MafA and FOXO1 which play a critical role in the maintenance of β-cell identity. Our data also showed a decrease in H3K27me3 and an increase in H3K4me3 ("bivalent domain" alteration) in diabetic rats and these recovered by L-Met. Furthermore, the chromatin-immunoprecipitation assay showed a decreased enrichment of H3K27me3 on the promoter of the FOXO1 gene in diabetic rats and L-Met prevents this decrease. Our results showed the first evidence of the involvement of H3K27me3 in regulating the expression of the FOXO1 gene and the prevention of β-cell injury by L-Met treatment. In conclusion, we report the involvement of L-Met in the modulation of α-cell identity marker (Arx), β-cell identity marker (MafA) and regulation of FOXO1 by histone methylation marks for the first time. We are of the opinion that this employed as a novel therapeutic approach for mitigating diabetes-induced β-cell death.     

妊娠期糖尿病患者胰岛素抵抗与细胞内钙离子浓度变化的关系

为探讨妊娠期糖尿病患者胰岛素抵抗与细胞内钙代谢失常的关系,对32例妊娠糖尿病组及47名正常妊娠组,43名非妊娠组红细胞内Ca2 浓度和红细胞胰岛素受体酪氨酸激酶(TPK)活性进行测定.结果显示,妊娠期糖尿病患者红细胞内Ca2 浓度显著高于正常妊娠组和非妊娠组(P《0.01).相关性分析显示,妊娠期糖尿病患者红细胞内Ca2 浓度与空腹血糖(r=0.418)空腹胰岛素(r=0.367)显著正相关,与胰岛素受体TPK活性(r=-0.874)显著负相关,均有显著性差异(P《0.01).研究表明:妊娠期糖尿病患者红细胞内钙含量变化,可能是导致妊娠期糖尿病胰岛素抵抗的原因之一.     

血清同型半胱氨酸水平检测在2型糖尿病诊治中的价值

目的探讨动态检测血清同型半胱氨酸（homocysteic acid,HCA）水平在2型糖尿病患者中的诊治价值。方法前瞻性地调查102例2型糖尿病患者血清HCA、空腹血糖（fasting blood glucose,FBG）、空腹胰岛素（fasting insulin,FINS）以及C肽水平,计算了胰岛素抵抗指数HOMA-IR以及胰岛β细胞分泌指数HOMA-β,并分析了HCA和FBG、FINS、C肽、HOMA-IR以及HOMA-β的相关性。结果2型糖尿病患者血清HCA水平明显高于正常对照组（P〈0.05）,血清HCA水平与FINS、HOMA-IR以及HOMA-β呈明显负相关,与FBG以及空腹C肽无明显相关。结论胰岛素缺乏和胰岛素抵抗可能是2型糖尿病患者血清HCA水平升高的重要相关因素,检测血清HCA水平对评估疾病程度、了解病情进展和转归以及指导临床治疗均有一定的临床价值。     

深圳地区人群2型糖尿病相关基因多态性的研究

目的研究分析深圳地区2型糖尿病（DM）相关基因浆细胞膜糖蛋白（PC-1）基因K121Q多态性，探讨其于2型DM的关系。方法选择214例2型DM患者和295例非DM对照人群作病例对照研究。聚合酶链反应-限制性酶切片段长度多态性（PCR-RFLP）检测PC-1基因K121Q多态性。并分析其与2型DM的相关性。结果PC-1基因PCR扩增片段大小为240bp，与预期的扩增片段大小相符。扩增片段经限制性内切酶AvaⅡ酶切后，产生Q与K两个等位基因，出现2种基因型条带，分别为KK型和QK型。509例研究对象中，KK基因型者433例，所占比例最高，为85．07％；KQ基因型者次之，有76例，占14．93％；未见QQ基因型。K等位基因频率为92．53％，Q等位基因频率为7．47％。各组基因型频率及等位基因频率比较，差异均有统计学意义（P〈0．05）。以是否患2型糖尿病为因变量，PC．1基因K121Q基因型为自变量，进行Logistic回归分析。单因素分析结果表明，与KK基因型者相比，KQ基因型与2型DM存在显著相关性，其P=0．034，OR=1．84，OR95％CI为（1．05-3．24）。结论PC-1基因K121Q多态性与2型糖尿病存在相关性，KQ基因型可能是2型糖尿病的危险因素之一。     

The length of the large intestine in children determined by computed tomography scan

Little information is available on the length of the normal large intestine and its component parts in children. This information would be useful for procedures such as colonoscopy. The aim of this study was to investigate the length of the large intestine and its component parts in New Zealand children. Archival deidentified pediatric supine abdominopelvic computed tomography (CT) scans were retrospectively analyzed. After exclusion criteria, a total of 112 scans (57 males and 55 females) were included in the study and divided into three age groups: 0–2 years (n = 33), 4–6 years (n = 40), and 9–11 years of age (n = 39). The length of the large bowel increased from a mean of 52 cm in children aged <2 years to 73 cm at 4–6 years and 95 cm at 9–11 years. In all age groups, the transverse colon was the longest segment, contributing ～30% of the total length of the large bowel. In comparison to total large bowel length, the mean proportional length of the rectum (9–12%), sigmoid colon (23–27%), descending colon (19–22%), transverse colon (27–32%), and ascending colon (14–17%) varied little between the three age groups. There were no significant differences between males and females in all age groups. The cecum was located in the right upper quadrant in 27% of children aged 0–2 years but in the right lower quadrant in all 9–11 year olds. These data provide useful information on the length of the large intestine and its component parts in living children, which are particularly relevant to pediatric colonoscopy and surgery. Clin. Anat. 30:887–893, 2017. © 2017 Wiley Periodicals, Inc.     

Diabetes mellitus and congestive heart failure: the prevalence of congestive heart failure in patients with and without diabetes in Poland

IntroductionDiabetes mellitus is a systemic disease and has a negative effect on the cardiovascular system. This paper aimed to present a retrospective analysis of morbidity associated with heart failure in subgroups of patients with and without diabetes in Poland in 2012.Material and methodsData from the National Health Fund were used for the study. In general, 656,937 patients with heart failure, including 281,538 males and 375,354 females, were studied. In this population, additionally, 201,043 patients with heart failure (main diagnosis) and diabetes were studied, including 82,117 males and 118,926 females.ResultsThe mean index of morbidity associated with heart failure in the whole subpopulation of diabetes patients was 9.03%; 8.42% for males and 9.50% for females. Morbidity associated with heart failure in the population of patients diagnosed with diabetes in Poland in 2012 was seven times higher compared to morbidity associated with heart failure in non-diabetes patients. Morbidity associated with heart failure in females was significantly higher compared to morbidity in males in the whole population, in both the subpopulations of patients with and without diabetes.ConclusionsDiabetes mellitus significantly increases risk of heart failure in both women and men. The risk is significantly high after the age of 60 years and higher in females.