糖尿病肥胖鼠胰岛β细胞3维高分辨影像研究

目的:研究患糖尿病肥胖鼠(ob/ob)体内胰岛β细胞的黄素蛋白(Fp)、还原型辅酶(NADH)和焦脱镁叶绿酸标记的2-脱氧葡萄糖(Pyro-2DG)的荧光强度分布特点。方法:使用低温成像器(Cyro-imager)检验胰腺胰岛β细胞的氧化还原特性,观察胰腺胰岛β细胞内Pyro-2DG的累加情况。结果:通过获得的胰腺组织的2维影像图,使用三维可视化(Amira)医学专用软件可构建出3维高分辨影像。结论:这项研究成果有助于评估胰腺组织光学研究的有效性。

宁夏城市社区中老年人群代谢综合征的流行特征

目的了解宁夏城市社区中老年人群代谢综合征(MS)的患病率及其组分的分布情况。方法采用典型抽样的流行病学调查方法进行问卷调查,并测定其身高、体重、血压、空腹血糖、血脂。结果城市社区中老年人群MS患病率为43.3%,其中男、女性患病率差异无显著性(χ2=0.04,P=0.844);回、汉族患病率差异无显著性(χ2=0.32,P=0.571)。男、女性MS的患病率不随着年龄的增长而升高(P=0.168,P=0.688)。不论是男性还是女性,MS组分的患病率都以高血压为著,空腹血糖升高次之。中老年女性血脂紊乱的患病率高于男性(P<0.05)。结论宁夏城市社区中老年人群MS患病率相对较高,应重视社区中老年人群MS的干预措施。

Clopidogrel resistance response in patients with coronary artery disease and metabolic syndrome： the role of hyperglycemia and obesity

Background Despite the proven benefits of clopidogrel combined aspirin therapy for coronary artery disease （CAD）, CAD patients with metabolic syndrome （MS） still tend to have coronary thrombotic events. We aimed to investigate the influence of metabolic risk factors on the efficacy of clopidogrel treatment in patients with CAD undergoing percutaneous coronary intervention （PCI）. Methods Cohorts of 168 MS and 168 non-MS subjects with CAD identified by coronary angiography （CAG） were enrolled in our study. MS was defined by modified Adult Treatment Panel Ⅲ criteria. All subjects had taken 100 mg aspirin and 75 mg clopidogrel daily for more than 1 month, and administered loading doses of 600 mg clopidogrel and 300 mg aspirin before PCI. Blood samples were taken 24 h after the loading doses of clopidogrel and aspirin. Platelet aggregation was measured using light transmittance aggregometry （LTA） and thrombelastography （TEG）. Clopidogrel resistance was defined as more than 50% adenosine diphosphate （ADP） induced platelet aggregation as measured by TEG. Re- sults Platelet aggregation inhibition rate by ADP was significantly lower in patients with MS as measured both by TEG （55% ＋ 31% vs. 68% ± 32%; P 〈 0.001） and LTA （29% ± 23% vs. 42% ± 29%; P 〈 0.001）. In the multivariate analysis, elderly [OR （95% CI）： 1.483 （1.047±.248）; P = 0.002], obesity [OR （95% CI）： 3.608 （1.241-10.488）; P = 0.018], high fasting plasma glucose level [OR （95% CI）： 2.717 （1.176±.277）; P = 0.019] and hyperuricemia [OR （95% CI）： 2.583 （1.095-6.094）; P = 0.030] were all statistically risk factors for clopido- grel resistance. CAD patients with diabetes and obesity were more likely to have clopidogrel resistance than the CAD patients without dia- betes and obesity [75% （61/81） vs. 43% （67/156）; P 〈 0.001]. Conclusions CAD patients with MS appeared to have poorer antiplatelet response to clopidogrel compared to those without MS. Obesity, diabetes and hyperuricemia were all significantly associated with clopido- grel resistance.

Clinical features and prognosis of obese breast cancer patients: a retrospective study

Objective:The aim of our study was to investigate the prognosis of obese breast cancer patients.Methods:This study was conducted on a total of 317 breast cancer patients who were histopathologically and clinically diagnosed at the General Hospital of Shenyang Military Region(China)from 2004 to 2006.Clinical data including height,weight,age at diagnosis,tumor size,lymph node status,menopausal status,family history of cancer and hormone receptor status were collected.Log-rank test was performed to compare the disease free survival(DFS)and overall survival(OS).Cox proportional hazards regression analysis was conducted to make multivariate analysis.The Chi square test was used to compare the clinical features among normal weight group,overweight group,and obese group.Results:Obesity was an independent prognostic factor for DFS(P=0.022)and OS(P=0.032)in breast cancer patients.In the stratified analysis based on the hormone receptor status,obesity was independently associated with OS in patients with negative ER/PR(P=0.002),but such association was not observed in patients with positive hormone receptors.Obesity was also associated with lymph node status(P=0.001)and smoking(P=0.009).Conclusion:Obesity is associated with poor DFS and OS in patients with breast cancer.Therefore,maintaining normal weight may benefit breast cancer patients.

Classical regression equations of spirometric parameters are not applicable for diagnosing spirometric abnormalities in adipotic adults

The prevalence of overweighing and obese adults (defined as "adipotic" adults),has markedly increased over the world. A remarkable increase in the adipotic population urgently needs developing the regression equations for predicting spirometric parameters (SPs), which are specifically applicable to adipotic adults.Unfortunately, however, the reliable equations suitable for adipotic adults have not been reported to date. Recently, Yamaguchi et al have proposed the quantitative method to estimate the effects of adiposity on deciding the SPs incorporating with age-specific contributions of various explanatory,independent variables such as age (A), standing height (H), body weight (BW),and fat fraction of body mass(F). Extending the method proposed by Yamaguchi et al, we attempted to elaborate the novel regression equations applicable for diagnosing the spirometric abnormality in adipotic adults. For accomplishing this purpose, never-smoking, adipotic adults with body mass index (BMI) over 25 kg/m^2 and no respiratory illness were recruited from the general population in Japan (n = 3696, including men: 1890 and women: 1806). Introducing the four explanatory variables of A, H, BW, and F, gender-specific and age-dependent regression equations that allowed for prescribing the SPs in adipotic adults were constructed. Comparing the results obtained for non-adipotic adults (i.e., those with normal BMI), the negative or positive impact of height on SPs was preserved in adipotic adults, as well. However, the negative impact of age on SPs was blunted in adipotic men and the positive effect of BW on SPs was impeded in adipotic men and women. The fat fraction of body mass-elicited negative impact on SPs vanished in adipotic women. These results indicate that the regression equations of SPs for adipotic adults differ significantly from those for nonadipotic adults, leading to the conclusion that the regression equations for nonadipotic adults should not be used while judging the spirometric abnormalities in adipotic adults.

Study of the patency of different peritoneal drains used prophylactically in bariatric surgery

AIM:To compare the performance of different types of abdominal drains used in bariatric surgery.METHODS:A vertical banded Roux-en-Y gastric bypass was performed in 33 morbidly obese patients.Drainage of the peritoneal cavity was performed in each case using three different types of drain selected in a randomized manner:a latex tubular drain,a Watterman tubulolaminar drain,and a silicone channeled drain.Drain permeability,contamination of the drained fluid,ease of handling,and patient discomfort were evaluated postoperatively over a period of 7 d.RESULTS:The patients with the silicone channeled drain had larger volumes of drainage compared to patients with tubular and tubulolaminar drains between the third and seventh postoperative days.In addition,a lower incidence of discomfort and of contamination with bacteria of a more pathogenic profile was observed in the patients with the silicone channeled drain.CONCLUSION:The silicone channeled drain was more comfortable and had less chance of occlusion,which is important in the detection of delayed dehiscence.

Red blood cell level is increased in obese but not in non-obese patients with coronary heart disease

Objective To examine the changes of red blood cell levels in the obese and non-obese patients with coronary heart disease （CHD） and its clinical significance. Methods 230 cases of coronary heart disease were selected and divided into the obese group and the non- obese group. Obesity and non-obesity were defined based on the body mass index （BMI if 28.0kg/m2）, or waist-hip ratio （men〉 0.9, women〉 0.85）. In addition, 130 healthy subjects were recruited as controls. The pathological status of coronary lesions was quantita- tively analyzed according to the Coronary Vascular Image Segmentation Evaluation Criteria （American Heart Association 1984） and the Gensini scoring system. Results of the changes of both the hemoglobin levels and the red blood cell count in the obese group, the non- obese group with CHD and the control group were compared. Besides, Multivariant Logistic Regression Analysis was applied to assess the correlation between the red blood cells and the coronary artery disease. Results The red blood cell count and the level of hemoglobin in the obese group with CHD was higher than that in the non-obese group with CHD [（4.35 ± 0,55） and （4.13 ± 0.56） 10^9/L; （136.71± 15.87） and （129.96 ±16.23） g/L, P 〈 0.05 in both]; the proportion of acute coronary syndrome in the obese group with CHD was higher in the obese group with CI-/D than that in the non-obese group with CHD （P〈0.05）; Multivariant logistic regression analysis also showed that the red blood cell count was positively correlated with obesity with CHD.Conclusion The red blood cell count and the level of hemoglobin in the obese group were higher than those in the non-obese group; the increase of red blood cell count and hemoglobin level is one of the independent risk factors for the obese patients with CHD.

APPLICATION OF ACUPUNCTURE AND MOXIBUSTION FOR KEEPING SHAPE

On the basis of TCM diferentiation, the authors have treated 359 adult female cases of non-obesity with undesirable body shape by combined application of body acupuncture and moxibustion and auricular acupuncture, and achieved quite good remoulding and orthopedic results, suggesting that acupuncture and moxibustion can very effectively regulate the somatotypic indexes of body weight, circumference of the chest, loin, hip and thigh, the ratio of the loin to hip, sebum thickness, obesity degree, body mass index and body fat percentage of the cases in the overweight group and orthopedic groups 1,2. It is therefore concluded that acupuncture and moxibustion is a good therapy for obtaining a graceful body shape.

Cross-Sectional Study of the Prevalence of Obesity Among Adults in Constantine

In Algeria, as in all countries in the developing world, obesity has become more and more common in adults, suggesting a worsening of risk factors for cardiovascular disease and diabetes for these generations. This study aims to assess the prevalence of obesity by anthropometry in adults in the city of Constantine over the year 2010-2011, and to explore its relationship with certain determining factors. A cross-sectional study with cluster sampling and stratification on sex allowed us to estimate the frequency of all categories of BMI. For this purpose, 320 adults living in Constantine were interviewed. In 2011, the prevalence of obesity was 35.84%. Women are more affected by obesity than men （40.83% vs. 22.08%）. The prevalence of abdominal obesity, according to IDF, was 81.0% for women vs. 56.2% for men; according to NCEP ATP III, it was 64.3% in women vs. 35.9% in men. Obesity is more common in families of low socioeconomic status. Similarly, level of education and obesity are inversely correlated. People who have a sedentary lifestyle are more likely to be obese than those who are physically active. Obesity is a serious condition that results in significant health care costs. There is a need to undertake epidemiological surveillance in childhood. Urgent preventive actions are required. Promotion of a healthy balanced diet and physical exercise is a priority in the prevention of obesity.

Effects of electroacupuncture and Chinese kidney-nourishing medicine on polycystic ovary syndrome in obese patients

OBJECTIVE： To explore the effect of electroacu- puncture and Chinese kidney-nourishing medicine on insulin （INS）, adiponectin （APN）, leptin （LEP）, and glucolipid metabolism of obese patients with polycystic ovary syndrome （PCOS）. METHODS： Sixty-seven obese PCOS patients were randomly divided into two groups. Thirty-three pa- tients in the acupuncture-medicine group were treated three times a week with electroacupunc- ture at the Tianshu （ST 25）, Zhongwan （CV ] 2）, Qi- hai （CV 6）, Sanyinjiao （SP 6）, Geshu （BL 17）, and Cil-iao （BL 32） acupoints. They drug, Tiankui capsule, for 3 treatment. Point-taking and also took the Chinese months as a course of treatment in the elec- troacupuncture group of 34 patients was the same as those in the acupuncture-medicine group. We observed and compared the changes in the obesi- ty-related indexes of body weight （BW）, body mass index （BMI）, and waist-hip ratio （WHR）, as well as fasting plasma glucose （FPG）, fasting insulin （FINS）, APN, and LER RESULTS： BW, BMI, WHR, and FINS decreased and insulin sensitivity index （ISI） and APN were higher in the acupuncture-medicine group than in the electroacupuncture group （P〈0.01）. There was no obvious difference in LEP between the two groups （P〉0.05）. CONCLUSION： Acupuncture combined with medi- cine is better than just electroacupuncture for obese PCOS patients by improving obesity-related indexes, insulin sensitivity, and APN level. This indi- cates that acupuncture-medicine therapy is worth clinical popularization.

Adapter proteins regulate insulin resistance and lipid metabolism in obesity

Insulin resistance and dysregulated lipid meta- bolism are major causes of type 2 diabetes. Insulin and inflam- matory signal pathways play key roles in insulin resistance and fat accumulation. Specifically, adapter proteins transduce sig- nals from insulin or cytokine receptors to the downstream pathways and may contribute to insulin resistance and disor- dered lipid metabolism in obesity and type 2 diabetes. Here, the recent advances in understanding the roles of adapter proteins in insulin resistance and lipid homeostasis are discussed.