2型糖尿病对雄性小鼠听觉功能及内耳Otoferlin、VGLUT3、Myosin Ⅶa蛋白表达的影响

目的 观察2型糖尿病对雄性小鼠听觉功能,静纤毛超微结构和耳畸蛋白(Otoferlin)、囊泡谷氨酸转运体3(vesicle glumate transporter 3,VGLUT3)、肌球蛋白Ⅶa(MyosinⅦa)蛋白表达的影响.方法 按体重将12只6周龄雄性C57BL/6J小鼠随机分为两组(对照组和糖尿病组,n=6).对照组小鼠食用饲料含铁量为(8.26±2.67) mg/kg,糖尿病组小鼠食用饲料含铁量为(8.39±1.03) g/kg.在实验开始前及实验第4、8、12、16周时测定小鼠血糖,实验第16周时测定葡萄糖耐量及胰岛素耐量,测定听觉诱发电位.分离左侧耳蜗基底膜,用免疫荧光法观察Otoferlin、VGLUT3与MyosinⅦa在内外毛细胞的定位与分布.分离右侧半数耳蜗用作western blot分析蛋白表达,另外半数耳蜗分离基底膜,用扫描电镜观察内毛细胞静纤毛形态.结果 实验第8、12、16周,糖尿病组小鼠血糖水平升高,与对照组比较差异有显著性意义(P＜0.05).糖尿病组小鼠糖耐量减弱,胰岛素抵抗指数升高,与对照组比较差异有显著性意义(P＜0.05).糖尿病组小鼠听力诱发电位阈值在刺激频率为2和3 kHz时升高,与对照组比较差异有显著性意义(P＜0.05).糖尿病组小鼠内毛细胞静纤毛排列正常,未见紊乱及数目减少;糖尿病组Otoferlin在内毛细胞底部表达减少,与对照组比较差异有显著性意义(P＜0.05).结论 2型糖尿病致雄性小鼠听觉功能损伤,可能与Otoferlin蛋白在耳蜗毛细胞中表达下调有关.     

格列苯脲辅助“双C”方案对高龄妊娠糖尿病患者血清FABP4、PAPP-A 表达的影响

目的 探讨格列苯脲辅助“双C”方案对高龄妊娠糖尿病（GDM）患者血清脂肪酸结合蛋白质4（FABP4）、妊娠相关血浆蛋白A（PAPP-A）表达的影响,为高龄GDM 的临床治疗提供参考。方法 选取2015 年1 月—2017 年12 月延安大学附属医院收治的120 例高龄GDM 患者作为研究对象,根据随机数字表法将患者分为研究组和对照组,每组60 例。对照组采用“双C”方案治疗,研究组在对照组基础上使用格列苯脲辅助治疗,比较两组患者治疗2 周后的血糖控制情况、新生儿及母体指标,并于治疗前后检测患者FABP4、PAPP-A 表达水平。结果 研究组治疗后的糖化血红蛋白（HbAlc）、空腹血浆葡萄糖（FPG）、餐后2 小时血糖（2 hPG）、血糖波动幅度、血糖达标时间及胰岛素平均用量低于对照组（P <0.05）,两组患者治疗前HbAlc、FPG、2 hPG、血糖波动幅度、血糖达标时间及胰岛素平均用量高于治疗后（P <0.05）。研究组妊娠期高血压、产程延长低于对照组（P <0.05）。研究组的早产儿少与对照组,高胆红素血症及总发生率低于对照组（P <0.05）。两组患者治疗后血清FABP4 水平较治疗前下降,PAPP-A 中位数倍数较治疗前增加（P <0.05）。研究组血清FABP4 较对照组低,血清PAPP-A 中位数倍数较对照组增加（P <0.05）。两组患者不良反应发生率比较,差异无统计学意义（P >0.05）。结论 格列本脲联合“双C”方案可有效改善GDM 患者血糖水平和妊娠结局,同时可以通过降低血清FABP4,升高PAPP-A 水平,改善胰岛素抵抗,该方案安全性高,值得临床推广应用。     

GLP-1受体激动剂治疗2型糖尿病临床观察

目的观察GLP-1受体激动剂治疗2型糖尿病的临床疗效及不良反应。方法选择血糖控制不达标的2型糖尿病患者6例,在原降糖治疗方案的基础上加用GLP-1受体激动剂,疗程8周。治疗前后测量身高（Ht）、体质量（Wt）、空腹血糖（FBG）、早餐后2h血糖（2hPBG）及糖化血红蛋白（HbA1c）。治疗过程中根据微量血糖监测水平调整口服降糖药物用量并记录不良反应情况。结果所有患者加用GLP-1受体激动剂后,体质量、糖化血红蛋白、血糖较治疗前下降,早餐后2h血糖较治疗前明显降低,差异有统计学意义。3例患者治疗早期有恶心症状,可耐受,无低血糖记录。结论GLP-1受体激动剂对2型糖尿病患者有降糖作用,降餐后血糖作用明显,消化道不良反应轻,低血糖发生率低。     

Effect of treatment on the concentration of lipoproteins and the postheparin-lipolytic activity in the plasma of noninsulin-dependent diabetics

Summary To study the effect of treatment on plasma lipid and lipoprotein concentration and on postheparin-lipolytic activity (PHLA) in plasma, 26 noninsulin-dependent diabetics were investigated who were treated with maximally effective doses of glibenclamide. The patients were randomly divided into two groups: In group I, glibenclamide was replaced by a long-acting insulin preparation given once daily at variable doses until satisfactory metabolic control was achieved. In group II, glibenclamide was replaced by placebo. At weeks 0, 1, 3, 7, and 12 after change of treatment, the following parameters were determined: Blood glucose, plasma concentrations of cholesterol, triglycerides, phospholipids, HDL cholesterol, very-low-density lipoproteins, intermediate-density lipoporteins, low density lipoproteins, high-density lipoproteins₂ (HDL₂), HDL₃, and PHLA. At week 0, no statistically significant differences existed between group I and group II with respect to all parameters mentioned above. The replacement of glibenclamide by insulin resulted in a continous decrease of blood glucose (p<0.01) with a concomitant increase in HDL₂ (p<0.01) and in PHLA (p<0.01) during the period of investigation. In contrast, replacement of glibenclamide by placebo exerted no significant influence on all determined parameters during 12 weeks. These data suggest that in noninsulin-dependent diabetics, who are inadequately controlled by sulfonylureas, an adequate insulin substitution is necessary to correct, apart from glucose metabolism, the impaired lipoprotein metabolism of diabetes mellitus. Sulfonylureas per se seem not to decrease the HDL₂ fraction nor the PHLA.     

葛根在治疗糖尿病和戒酒中的应用

葛根（Pueraria lobata）是中国传统上最重要的药用植物之一。根据《伤寒论》（外感热病论）记载,传统上可用于解热、眼睛酸痛、口干及与高血压相关的头痛和颈部僵直等症状。20世纪70年代的研究表明,从葛根中提取的异黄酮是愈风宁心片主要的生物活性成分,可用于治疗中风后的患者。本文回顾了葛根在治疗糖尿病和戒酒方面的最新应用。由于葛根毒性较低,是用于开发治疗人类疾病的植物药的良好机遇。     

Does obesity cause type 2 diabetes mellitus (T2DM)? Or is it the opposite?

Obesity is believed to be a promoter of type 2 diabetes mellitus (T2DM). Reports indicate that severe obesity in childhood and adolescence increases the risk of T2DM in youth and young adults. T2DM, which is commonly asymptomatic, frequently is not recognized until random blood glucose is measured. Screening blood glucose levels measured in obese individuals are more effective for identifying undiagnosed persons, than screening the general population and therefore introduces a selection bias for discovery. The following commentary will indicate why these observations do not indicate that obesity is the cause of T2DM. Also, it will be shown that the insulin resistance of T2DM occurs primarily in the muscles of lean individuals predisposed to diabetes before they become obese. This insulin resistance is not secondary to, but instead, is the cause of the excessive fat accumulation associated with T2DM. Moreover, this early muscle insulin resistance is the etiology of the hyperlipidemia and excess fat accumulation characteristic of T2DM.     

糖尿病患者教育对血糖控制的影响

目的评估糖尿病患者教育对血糖控制的影响。方法将525例2型糖尿病患者按是否接受糖尿病教育分为教育组（246例）和非教育组（279例）,分析糖尿病教育对空腹血糖、餐后2h血糖控制的影响。结果教育组血糖控制理想占（50%）,明显优于非教育组（19.71%）。结论加强糖尿病教育可提高糖尿病患者对糖尿病治疗的依从性,使糖尿病患者达到理想的血糖控制,增强患者战胜疾病的信心,从而改善患者的生活质量。     

初诊2型糖尿病胰岛素强化治疗对血糖、游离脂肪酸及血脂变化的对比研究

目的观察初诊2型糖尿病患者，应用连续胰岛素皮下输注（CSII）及多次胰岛索皮下注射（MDI）强化治疗2周对血糖、游离脂肪酸（FFA）、血脂变化的对比研究。方法选择初诊2型糖尿病88例随机分为CSII组44例及MDI组44例。分别在治疗前和胰岛素强化治疗2周结束后，同时测定空腹血糖、游离脂肪酸及血脂。结果CSII组和MDI组治疗前后游离脂肪酸、血清胆固醇（Tc）、甘油三酯（TG）、低密度脂蛋白（HDL—C）、载脂蛋白B（ApoB）均明显下降（P〈0．05），高密度脂蛋白胆固醇（HDL—C）及载脂蛋白A（ApoA）均上升。结论短期强化治疗可改善2型糖尿病的血糖、游离脂肪酸及脂质代谢。     

Central corneal thickness and corneal endothelial cell changes caused by contact lens use in diabetic patients

Purpose

To analyze the effects of soft contact lenses on central corneal thickness and morphologic characteristics of the corneal endothelium in diabetic patients.

Materials and Methods

Ultrasound pachymetry and noncontact specular microscopy were performed on 26 diabetic patients who regularly use soft contact lenses (group 1), 27 diabetic patients who do not use soft contact lenses (group 2) and 30 normal subjects (group 3). We compared the values in each group using the Mann-Whitney test.

Results

The central cornea was found to be thicker in diabetic patients, both those who use and do not use contact lenses, than in the normal control group. The central corneal thickness was significantly higher in group 1 (564.73 ± 35.41 µm) and group 2 (555.76 ± 45.96 µm) than in the control group (534.05 ± 27.02 µm), but there was no statistically significant difference between groups 1 and 2. Endothelial cell density was significantly different between the groups, and was smallest in the group of diabetic patients using contact lenses. The coefficient of variation of cell size was significantly higher and the percentage of hexagonal cells was significantly lower in contact lens using diabetic patients than in non-contact lens using diabetic patients and in the control group.

Conclusion

Central corneal thickness and endothelial cell density is more affected by diabetes mellitus, and corneal endothelial cell morphology is more affected by contact lens use, when compared with normal subjects.     

Effects of Rifaximin Administration on the Intestinal Microbiota in Patients with Ulcerative Colitis

Abstract

The effect of rifaximin on the intestinal bacterial population was studied in a clinical trial. Twelve patients with ulcerative colitis were administered rifaximin 1800 mg/day in 3 treatment periods of 10 days, each followed by 25 days of wash-out. Fecal samples were collected at the beginning and at the end of each treatment period to perform microbiological examinations. Titer variations of enterococci, coliforms, lactobacilli, bifidobacteria, Bacteroides spp., and Clostridium perfringens as well as their susceptibility to rifaximin during the different phases of the study were evaluated. The presence of Candida spp. was also monitored. After each wash-out period, concentrations of the intestinal microbial groups tested returned to initial values, showing that the administration of high doses of rifaximin does not significantly modify the colonic microbiota. Rifaximin-resistant isolates were also found, particularly in bacteria belonging to Bifidobacterium genus, included as probiotics in several fermented foods and in pharmaceutical preparations.