Study on the Clinical and Endocrine Characteristics of Poly- cystic Ovary Syndrome with Different Ovarian Morphology

Objective To evaluate the differences of the clinical manifestation and endocrine situation in patients with different ovarian morphology of polycystic ovary syndrome(PCOS).Methods A total of 234 PCOS patients were enrolled according to the ovary morphology and divided into three groups: 112 patients with B-polycystic ovary morphology(both two ovaries were PCOM, B-PCOM), 50 with U-PCOM(only one ovary was PCOM) and 72 with N-PCOM(none was PCOM). There were 39 infertile women without PCOS as control group. Data were analyzed by using SPSS 15.0 software.Results There was no statistical difference in body mass index(BMI) among the three groups of PCOS. The endometrial thickness increased in patients with B-PCOM and decreased with N-PCOM. The levels of testosterone, androstenedione and luteinizing hormone increased in PCOS groups, especially in N-PCOM patients. HOMA-IR increased, HOMA-β, disposition index(DI) and △I60/△G60 decreased in patients with NPCOM compared with in B-PCOM and U-PCOM groups. Higher level of total cholesterol(TC) and lower level of high-density lipoprotein(HDL)-C existed in PCOS patients,especially in N-PCOM. There were positive correlations between oligo-anovulation,endometrial thickness, LH/FSH ratio, fasting insulin(FINS), the area under curve of glucose(AUCGLU) and PCOM, while there was a negative correlation between HOMAIR and PCOM.Conclusion There are relationships among hyperandrogenism, hyperinsulinemia,insulin resistance(IR) and ovary morphology in PCOS patients. PCOS patients without PCOM have more serious IR and hyperandrogenism.     

复方贞术调脂方对HepG2细胞胰岛素抵抗的作用及机制研究

目的 观察复方贞术调脂方（FTZ）对胰岛素抵抗（IR） HepG2细胞的作用,为开拓FTZ的治疗范围,阐明FTZ调节糖脂代谢的机制提供实验依据.方法 用高浓度胰岛素诱导HepG2细胞使其产生胰岛素抵抗,用高、中、低3个剂量的FTZ干预后,葡萄糖氧化酶法检测HepG2细胞培养液上清液中葡萄糖的含量,实时荧光定量PCR检测HepG2细胞胰岛素信号PI-3Kp85 mRNA的表达,Western blot检测HepG2细胞胰岛素信号转导蛋白IRS1表达.结果 模型细胞培养基上清液中葡萄糖含量高于正常细胞（P＜0.05）.给予FTZ（1、25、100μg/mL）后,HepG2细胞培养基上清液中葡萄糖含量均低于模型细胞葡萄糖含量（P＜0.05）.胰岛素抵抗细胞与正常细胞相比PI-3Kp85 mRNA和IRS1的蛋白表达显著降低（P＜0.05）.给予FTZ干预后,与胰岛素抵抗细胞相比PI-3Kp85 mRNA和IRS1的蛋白表达显著增加（P＜0.05）.结论 FTZ可改善胰岛素抵抗HepG2细胞对葡萄糖的摄取.其改善胰岛素抵抗的作用机制之一可能是通过上调胰岛素信号PI-3Kp85 mRNA和IRSl蛋白质在胰岛素抵抗HepG2细胞的表达.     

电针对非酒精性脂肪性肝炎大鼠胰岛素抵抗指数水平的影响简

目的 采用电针刺激大鼠腧穴,观察其对高脂饮食所致的非酒精性脂肪肝（NASH）大鼠胰岛抵抗指数（HO-MA-IR）水平的影响.方法 40只SD大鼠随机分为正常对照组、模型组、电针组和西药组,每组10只,在16周后隔夜空腹,以2％戊巴比妥钠（45mg/kg体重）麻醉,经下腔静脉采血,分离血清.采用放射免疫分析法测定空腹血清胰岛素（FINS）,计算HOMA-IR.结果 空腹血糖（FBG）正常组与其他各组比较,差异无统计学意义（P＞0.05）;胰岛素抵抗指数水平模型组比正常组显著增高（P＜0.01）;模型组比电针组增高（P＜0.05）;电针组较之西药组有下降趋势,但二者比较无明显差异（P＞0.05）.结论 电针可能通过改善NASH大鼠HOMA-IR而发挥治疗NASH的作用.     

Treatment Patterns,HealthCare Resource Utilization and Costs in Patients with Bipolar Disorder,Newly Treated with Extended Release or Immediate Release Quetiapine Fumarate using US Healthcare Administrative Claims Data

Background

Differences in treatment patterns, health care resource use, and costs are expected among patients newly treated with quetiapine extended release (XR) or quetiapine immediate release (IR).

Objective

To compare treatment patterns, health care resource use, and costs in patients with bipolar disorder newly treated with quetiapine XR or quetiapine IR.

Methods

This was an observational, retrospective cohort study that used HealthCore Integrated Research Database–identified patients (age range, 18-64 years) with an International Classification of Disease, Ninth Revision diagnosis of bipolar disorder and ≥1 pharmacy claim for quetiapine XR or quetiapine IR between October 2, 2008, and July 31, 2010. Outcomes were as follows: patient characteristics at the index date (first claim for quetiapine XR or quetiapine IR); 12-month preindex clinical characteristics, health care resource use, and costs; and 12-month postindex treatment patterns, health care resource use, and costs, assessed using generalized linear models (adjusted for index date and preindex patient demographic characteristics, clinical characteristics, health care resource use, and costs).

Results

In total, 3049 patients with bipolar disorder were analyzed (651 in the quetiapine XR group and 2398 in the quetiapine IR group). Of patients initiating treatment with quetiapine XR, 8.8% had no change in or discontinuation of their index therapy compared with 5.7% of patients treated with quetiapine IR (adjusted odds ratio, 1.44; 95% confidence interval, 1.03-2.00; P = 0.0317). The average daily dose (adjusted mean) of quetiapine XR was higher than quetiapine IR (225 vs 175 mg/d, P < 0.0001). An average daily dose of 300 to 800 mg was reached sooner (15.6 vs 30.8 days, P = 0.0049) and in more patients (44.2% vs 27.2%, P < 0.0001) who were taking quetiapine XR compared with patients taking quetiapine IR. No differences in total health care costs were found between the cohorts; however, patients taking quetiapine XR were less likely to be hospitalized for mental health–related reasons (12.1% vs 18.3%, P = 0.0022) and incurred lower mental health–related costs (US $6686 vs US $7577, P = 0.0063) compared with patients taking quetiapine IR.

Conclusions

Treatment patterns and dosing differ in patients with bipolar disorder treated with quetiapine XR compared with those treated with quetiapine IR. Mental health–related hospitalizations and costs may be reduced in the 12 months after patients initiating treatment with quetiapine XR compared with initiating treatment with quetiapine IR.     

胰岛素抵抗及信号转导在胎儿生长受限中的意义

胎儿生长受限上是胎儿对宫内不良环境的反应,造成胎儿代谢的适应性改变使多种内分泌系统重整,胰岛素抵抗现象是其中重要的改变环节之一,直接决定成年后多种代谢性疾病的发生.胎儿生长受限演变为胰岛素抵抗的病理过程及分子机制尚不明确,胎儿生长受限与胰岛素代谢指标和敏感性改变密切相关,同时存在促分裂原活化蛋白激酶信号转导机制中AKT1,2,3、ERK1/2、SAPK/JNK1/2及p38促分裂原活化蛋白激酶信号转导通路参与,通过探讨胎儿生长受限发生胰岛素抵抗的潜在机制,以期为早期诊断和相应临床干预、降低成年后代谢性疾病提供理论依据.     

胰岛素自身抗体与原发性高血压的关系

目的：探讨胰岛素自身抗体（IAA）含量与原发性高血压（EHT）的关系，揭示胰岛素抵抗（IR）与EHT的发生机制。方法：在北票市600名60岁以下的小学教师中筛选出EHT58人（排除继发性高血压、原发性肾脏疾患和糖尿病）作为观察组；从该人群中随机抽取血压正常、无肝肾疾患及糖尿病者33人作为对照组。用定量方法检测IAA含量，经χ^2检验、非条件Logistic分析揭示IAA与EHT的关系。结果：EHT组IAA水平比例明显高于对照组，EHT组分别为10．34％，44．83％，对照组分别为33．33％，48．49％，18．18，经χ^2检验有显著性差异（P＜0．05）；在不同因素下，在因素水平较代组均有显著性差异（P＜0．05），且因素的不同水平下IAA与EHT间存在剂量－反应关系；经非条件Logistic分析，最终进入模型的有家族史、胰岛素（IN）、IAA。结论：结果提示IAA与EHT的发生有联系，多因素分析提示IAA可能是EHT的危险因素；IAA与HT妥生联系与年龄、总胆固醇（CHO）、血糖（GLU）、IN有关。     

中药白花前胡有效成分Pd－Ia的提取与分离

用甲醇提取白花前胡根茎，提取液经乙醚和水萃取，将其醚提部分经硅胶柱层析，用石油醚与丙酮梯度洗脱，可分离得到有效成分Ｐｄ－Ｉａ，并经理化常数和波谱数据鉴定。     

Interaction between the insulin receptor and Grb14: a dynamic study in living cells using BRET

Grb14 is a molecular adaptor that binds to the activated insulin receptor (IR) and negatively regulates insulin signaling. We have studied the dynamics of interaction of the IR with Grb14, in real time, in living HEK cells, using bioluminescence resonance energy transfer (BRET). Insulin rapidly and dose-dependently stimulated this interaction. Removing insulin from the incubation medium only resulted in a modest decrease in BRET signal, indicating that the interaction between the IR and Grb14 can remain long after insulin stimulus has disappeared. BRET saturation experiments indicated that insulin markedly increases the affinity between IR and Grb14, resulting in recruitment of the adaptor to the activated IR. In addition, using both BRET and co-immunoprecipitation experiments, we demonstrated that insulin induced the dimerization of Grb14, most likely as a result of simultaneous binding of two Grb14 molecules on the activated IR. We also investigated the relationships between IR, Grb14 and the protein tyrosine phosphatase PTP1B. We observed that insulin-induced BRET between the IR and PTP1B was markedly reduced by Grb14, suggesting that Grb14 regulated this interaction in living cells. Using site-specific antibodies against phosphorylated tyrosines of the insulin receptor, we showed that Grb14 protected the three tyrosines of the kinase loop from dephosphorylation by PTP1B, while favouring dephosphorylation of tyrosine 972. This resulted in decreased IRS-1 binding to the IR and decreased activation of the ERK pathway. Our work suggests that Grb14 may regulate signalling through the insulin receptor by controlling its tyrosine-dephosphorylation in a site-specific manner.