2型糖尿病患者血清肿瘤坏死因子和唾液酸联合检测的临床意义

目的　探讨血清 TNF和 SA含量在 2型糖尿病患者发生和发展中作用。方法　分别应用放免法和化学法测定 88例 2型糖尿病患者血清 TNF和 SA含量 ,并与 35名正常人作对照。结果　 2型糖尿病患者血清TNF、SA含量则显著地高于正常人组 (P<0 .0 1) ,且与胰岛素水平呈明显的正相关 (r=0 .6 82 5 ,0 .6 2 6 3,P<0 .0 1)。结论　测定 2型糖尿病患者血清中 TNF、SA含量的变化对其观察病情的变化具有重要的临床价值     

FTIR Characterization of the Secondary Structure of Insulin Encapsulated within Liposome

Aim:To determine the secondary structure of insulin encapsulated within liposome.Methods:The secondary structure of native insulin,mixture of insulin with liposome(sample I) and insulin encapsulated within liposome(sample Ⅱ) were determined by FTIR(Fourier Transform Infrared) spectroscopy.Results:The secondary structure of insulin encspsulated within liposome(Ⅱ） are similar with the secondary structure of native insulin.The difference existed in the amount of α-helices (from 36% of insulin to 31% of sample Ⅱ）and β-sheet(from 48% of insulin to 51% of sample Ⅱ).The content of α-helices and β-sheet of insulin in sample I was found to be very close to that of sample Ⅱ.The results revealed that the insulin encapsulated within liposome possibly spread on the surface of liposome,without inserting into the liposome membrane.Coclusion:The secondary structure of insulin encapsulated within liposome is similar with the native insulin.     

依那普利对2型糖尿病大鼠肠系膜血管内皮细胞的保护作用

目的　糖尿病血管病变的初始原因是血管内皮细胞损害。本研究观察依那普利对糖尿病大鼠肠系膜血管内皮细胞是否有保护作用。方法　大鼠用高脂饮食饲养 4周后 ,ip链佐霉素 30mg·kg- 1诱导 2型糖尿病 ,继续饲以高脂饮食 4周后 ,依那普利组给予依那普利 10mg·kg- 1·d- 1,ig ,连续 4周。采用大鼠离体肠系膜血管灌流技术 ,用去甲肾上腺素 1μmol·L- 1预收缩血管 ,再给予乙酰胆碱 (ACh) 1μmol·L- 1使血管舒张。观察ACh的舒张率来反映内皮细胞功能。结果　糖尿病大鼠肠系膜血管ACh舒张率为 (33±8) % ,较对照组 (79± 8) %明显降低 ,依那普利治疗组血管ACh舒张率为 (5 2± 6 ) % ,较糖尿病组明显改善。用皂素去内皮后 ,三个组肠系膜血管对ACh舒血管的反应性均明显降低 ,三组间无显著性差异。去内皮前后 ,三个组肠系膜血管对硝普钠舒张血管的反应性无显著变化。结论　依那普利对 2型糖尿病大鼠肠系膜血管内皮细胞具有保护作用。     

包裹在脂质体内部胰岛素的二级结构

目的以单纯胰岛素为对照，采用傅立叶红外光谱（Fourier transform infrared， FTIR）研究包裹在脂质体内部胰岛素二级结构的变化。方法分别对单纯胰岛素、胰岛素与空白脂质体混合物（样品I）及包裹胰岛素的脂质体（II）样品进行测定。结果样品I和样品II中胰岛素的FTIR谱图形状与单纯胰岛素相比基本一致，仅α-螺旋百分比略有下降（由36.09%分别下降到31.68%和31.45%），β-折叠百分比略有增加（由47.83%分别增加到53.29%和51.36%）。样品I和样品II中胰岛素的二级结构无明显差别（α-螺旋百分比为31.68%和31.45%，β-折叠百分比为53.29%和51.36%）。结论包裹在脂质体内部胰岛素的二级结构与单纯胰岛素相比无明显变化。     

荆豆凝集素修饰脂质体对小鼠口服吸收胰岛素的促进作用

目的研究荆豆凝集素(UEA1)修饰的胰岛素脂质体在小鼠胃肠道的吸收作用。方法采用碳二亚胺偶联法制备荆豆凝集素修饰的磷脂酰乙醇胺(PE)，将PE-UEA1参入胰岛素脂质体中制成凝集素修饰脂质体，并证实UEA1凝集活性不受影响。分别对正常小鼠及糖尿病模型小鼠灌胃给予350 u·kg^-1胰岛素的修饰脂质体溶液，用葡萄糖酶试剂盒测定小鼠血糖，并与同剂量普通胰岛素脂质体比较。结果对于正常小鼠，荆豆凝集素修饰脂质体在4 h使血糖降至初始水平的(84±15)%，8 h降至(78±11)%，12 h为(90±12)%。胰岛素普通脂质体几乎没有降糖作用，与生理盐水对照组相当。对于糖尿病模型小鼠，荆豆凝集素修饰脂质体在4 h使血糖降至初始水平的(73±7)%，8 h降至(74±9)%，12 h为(86±9)%。结论荆豆凝集素修饰的脂质体可能通过与M细胞表面特异性受体的结合促进大分子药物的胃肠吸收。     

开郁清胃颗粒对2型糖尿病胰岛素敏感性的影响

目的：通过临床观察初步探讨开郁清胃颗粒对2型糖尿病患者胰岛素敏感性的影响。方法：以二甲双胍为对照，观察60例2型糖尿病患者治疗前后体重及腰臀围、症状积分、血糖、胰岛素、胰岛素敏感指数、血脂、焦虑及抑郁积分等指标的变化。结果：开郁清胃颗粒对2型糖尿病患者的血糖、血脂紊乱有明显的改善作用，并能减轻体重，提高胰岛素敏感性，改善焦虑及抑郁状态。结论：开郁清胃颗粒增加2型糖尿病患者的胰岛素敏感性可能与改善血脂紊乱，改善焦虑、抑郁状态及减轻体重等有关。     

组织相容性复合物DQ基因与胰岛素依赖型糖尿病易感相关性剂量效应规律的研究

为研究中国北方汉族人中组织相容性复合物ＤＱ（ＨＬＡ－ＤＱ）基因与胰岛素依赖型糖尿病（ＩＤＤＭ）遗传易感性相关的剂量效应规律，采用聚合酶链反应和序列特异性寡核苷酸探针杂交技术，对５４例胰岛素依赖型糖尿病患儿和４０例正常成年供血员ＨＬＡ－ＤＱ基因进行了研究。结果：携带４个易感性基因的个体只见于患者，携带３个易感性基因的个体在患者中为３３．３％，正常对照中为１０％；携带２个或１个易感性或保护性基因的个体在正常对照中频率较患者为高，但差异无显著意义；携带３个保护性基因的个体只见于正常对照。提示：ＩＤＤＭ易感性基因具有部分隐性遗传的特点且具有累加效应。个体中１个或２个易感性基因的存在不能对ＩＤＤＭ构成显著的易感性，３个或３个以上易感性基因的存在方可对ＩＤＤＭ构成显著易感性。ＤＱ保护性基因具有部分显性遗传的特点并且也具有累加效应。携带１个或２个保护性基因的个体患ＩＤＤＭ的机会将大大减少，而携带３个保护性基因的个体则可以不发生ＩＤＤＭ。     

Postprandial glycaemia after regular and lispro insulin in children and adolescents with diabetes

We compared the postprandial blood glucose (BG)-levels following preprandial regular insulin or lispro insulin before and after eating in adolescents with diabetes. Lispro is a rapidly absorbed insulin analogue. Lispro insulin injected immediately before breakfast reduced the postprandial BG-rise significantly compared to the 20 min preprandially administered regular insulin (P<0.01). Postprandial lispro injection resulted in similar BG values as the standard treatment with regular insulin 20 min preprandially. Conclusion Lispro insulin injected immediately before the meal leads to lower postprandial BG levels and seems to be an option for teenagers who use multiple preprandial insulin injections. Postprandial lispro administration could be a benefit in certain situations since it resulted in similar BG values to preprandial regular insulin. Received: 13 March 1997 / Accepted: 26 May 1997     

Oocyte quality in polycystic ovaries revisited: Identification of a particular subgroup of women

Purpose: Our purpose was to assess the endocrine status of women with polycystic ovaries (PCO) undergoing IVF, and to compare oocyte quality with endocrine markers of the syndrome, in an attempt to define a subpopulation with poor quality oocytes. Methods: This was a retrospective study. Patients were first endocrinologically analyzed: serum levels of androgens (T, androstenedione, DHEAS), FSH, and LH as well as glucose and insulin after an oral glucose tolerance test (OGTT) were recorded and are expressed as absolute values and area under the curve (AUC). Subsequently, they were followed over a 2-year period in which patients underwent several attempts of IVF as well as serving as oocyte donors. Patients were divided into three groups: group I (n=4) was women who displayed embryos unable to implant in 15 IVF cycles and 10 ovum donation cycles in which they served as donors; group II (n=16) was PCO patients in whom IVF (n=38) and/or oocyte donation cycles (n=42) resulted in pregnancies; and group III (n=13) was IVF patients with normal appearance of the ovaries by ultrasound. The endocrine status was compared with the IVF results. Results: There was no difference among groups in the endocrinological parameters tested, except for the OGTT which identified women in group I as having higher serum glucose and insulin levels than patients in groups II and III. Similarly, the OGTT showed higher serum glucose values in group II compared to group III. Women in group I were also obese. Patients in group III were older than PCO patients and needed more gonadotropins to reach an ovarian response which resulted in a reduced number of oocytes retrieved. Fertilization was also impaired in group I, in which no pregnancy was recorded. Conclusions: This study shows that there is a particular subgroup of PCO patients with lower fertilization rates and embryos unable to implant. These patients are obese and nonhyperandrogenic and show derangements of insulin secretion.     

Advanced glycosylation end products, protein kinase C and renal alterations in diabetic rats

Objective To study the relationship between advanced glycosylation end products (AGE) an d protein kinase C (PKC), and their effects on renal alteration in diabetic rats .
Methods Insulin or aminoguanidine was administered to diabetic rats. Blood glucose, hem oglobin A_1C (HbA_1C), glomerular tissue extracts AGE (GTE-AGE), PKC, glomerular basement membrane thickness (GBMT) and urine protein/creatinine ( Pr/Cr) ratio in diabetic rats were measured and analysed.
Results Levels of blood glucose, HbA_1C and AGE, PKC activity, the Pr/Cr ratio an d GBMT were all significantly increased (P values all less than 0.01) in di abetic rats. Insulin could decrease the formation of HbA_1C and AGE, and improve PKC activity. Aminoguanidine had no influence on PKC activity (P >0.05) although it decreased the formation of AGE. Both drugs could delay t he increase of urine Pr/Cr ratio and GBMT (P<0.05 or P<0.01).
Conclusions Chronic hyperglycemia may lead to an increase of PKC activity. HbA_1Cand AGE may not directly contribute to alterations of PKC activity, but the increa se of PKC activity could promote the action of AGE on GBM thickening. It is imp ortant t o inhibit the formation of AGE and reduce the PKC activity so as to prevent or d elay the development of diabetic nephropathy.