Effect of Yanggyuksanhwa-Tang on Non-Insulin-Dependent Diabetes Mellitus Unresponsive to Oral Hypoglycemic Agents:A Case Report

Diabetes mellitus is the fourth leading cause of death worldwide, following cancer, cerebrovascular disease, and heart disease. It is triggered by hyperglycemia and other metabolic disorders. Diabetes is a complex endocrine disease that causes chronic vascular complications such as diabetic nephropathy, retinopathy, and polyneuropathy.

Gene Expression of Adiponectin and Adiponectin Receptor 1 in Type 2 Diabetic Rats and the Relationship with the Parameters of Glucose and Lipid Metabolism

In order to confirm whether the mRNA levels of adiponectin in adipose tissue and mRNA levels of AdipoR1 in the skeletal muscles were correlated with the serum parameters of glucose and lipid metabolism and to clarify the regulation of adiponectin receptor gene expression in diabetic states, serum adiponectin, mRNA levels of adiponectin in adipose tissue and mRNA levels of AdipoR1 in the skeletal muscles were examined in type 2 diabetic rats. The model of type 2 diabetes was prepared by feeding high fat diet and injecting low dosage of streptozotocin (STZ). The diabetic rats were screened out by oral glucose tolerance test. One group of type 2 diabetic rats received rosiglitazone. The serum adiponectin concentration was detected by using ELISA and mRNA levels were examined by RT-PCR. The serum adiponectin levels and mRNA levels of adiponectin in adipose tissue of type 2 diabetic rats were significantly decreased as compared with the normal control rats (P<0.05, P<0.01 respectively). No siglificant changes were observed in the expression of adiponectin receptor 1 in the skeletal muscle of type 2 diabetic rats. The mRNA levels of adiponectin in adipose tissue were reversely correlated with serum insulin (r=-0.66, P<0.05), triglyceride (r=-0.58, P<0.05), cholesterol (r=-0.49, P<0.05), interleukin-6 (r=-0.49, P<0.05) and tumor necrosis factor (r=-0.43, P<0.05). The expression of adiponectin receptors was not altered in the skeletal muscle of Type 2 diabetic rats. The decreased serum adiponectin was caused by the decreased expression of adiponectin mRNA in adipose tissue rather than the adiponectin receptors in the skeletal muscle, which could be improved by rosiglitazone.

Pathology of diabetic myocardiac microangiopathy

Objective To investigate the cause of high cardiovascular lethality in patients with diabetics mellitus. Methods Sections from autopsied coronary arteries and myocardium of dead patients with non-insulin-dependent diabetics mellitus and 12 dead control subjects were used for histomorphometric studies. Results The coronary atherosclerotic lesion in diabetics patients was not different in severity fi＇om those in controls. Nor was there difference in number ofmyofibers or diameters of myoeardic fibers and capillaries.But the capillary density and the ratio of capillary number to myocardic fiber number in diabetics group were significeantly reduced compared with control group（P〈0.0 l）,and the capillary basement membrane in the former was significantly thicker than in the latter（P〈0.01）.Conclision The decrease in number of capillaries and the thickening of basement membrane enhance myocardiac vulnerability to further ischemia and hypoxia,which may undelie high lethality of myocardiopathy in diabetic patients.

Effects of Xianzhen Tablet（仙贞片）on Na^+-K^+-ATPase and Ca^(2+)-Mg^(2+)-ATPase in Erythrocytic Membranes and Viscosity of Whole Blood in Non-Insulin-Dependent Diabetes Patients with Qi-Yin Deficiency, Kidney Deficiency and Blood Stasis

Objective: To assess the effects of Xianzhen tablet (XZT) on Na+-K+ -ATPase and Ca2+ Mg2+-ATPase on erythrocytic membranes, viscosity of whole blood, plasma glucose and clinical manifestations.Methods: Seventy-two cases of non-insulin-dependent diabetes mellitus (NIDDM) patients with deficiency of both Qi and Yin, deficiency of the Kidney and blood stasis were selected, and the effects of treatment on Na+ K + -ATPase, Ca2+-Mg2+ -ATPase, whole blood viscosity, blood sugar and clinical Symptoms were observed.Results: In XZT group (test group), activities of Na+ -K+ -ATPase and Ca2+ -Mg2+ -ATPase rose significantly(P< 0. 01, P< 0. 05) after treatment. Viscosity of whole blood and clinical manifestations also improved obviously. The total effective rate in lowering plasma glucose was 77. 8 % with fasting blood glucose (FBG) and 69.4 % with 2 hours postprandial plasma blood glucose (2°PBG). In the control group, viscosity of whole blood andclinical manifestations had no significant improvement. Its total effective rate in lowering plasma glucose was41. 7% with FBG and 38. 9% with 2°PBG. Conclusions: XZT played a certain role in increasing activities ofNa+ -K + -ATPase and Ca2+-Mg2+ -ATPase, decreasing viscosity of whole blood and plasma glucose and improving clinical manifestations. Therefore, XZT was experimentally manifested as an effective drug in treating NIDDM patients with Qi-Yin deficiency, renal deficiency and blood stasis.

First multicenter study for risk factors for hepatocellular carcinoma development in North Africa

AIM:To assess the role of the major risk factors for hepatocellular carcinoma(HCC) development in the western part of North Africa.METHODS:A multicenter case control study was conducted in Tunisia,Morocco and Algeria in collaboration with Pasteur Institutes in these countries.A total of 164 patients with HCC and 250 control subjects without hepatic diseases were included.Prevalences of HBsAg,anti-hepatitis C virus(HCV)and diabetes were assessed.HCV and HBV genotyping were performed for anti-HCV and HBsAg positive patients.RESULTS:The mean age of patients was 62±10 years old for a 1.5 M:F sex ratio.Sixty percent of HCC patients were positive for anti-HCV and 17.9% for HBsAg.Diabetes was detected in 18% of cases.Odd ratio(OR)and 95% confidence intervals(CI) were 32.0(15.8-65.0),7.2(3.2-16.1) and 8.0(3.1 -20.0)for anti-HCV,HBsAg and diabetes respectively.Multivariate analysis indicated that the three studied factors were independent.1b HCV genotype and D HBV genotype were predominant in HCC patients.HCV was the only risk factor significantly associated with an excess of cirrhosis(90% vs 68% for all other risk factors collectively,P=0.00168).Excessive alcohol consumption was reliably established for 19(17.6%) cases among the 108 HCC patients for whom data is available.CONCLUSION:HCV and HBV infections and diabetes are the main determinants of HCC development in North Africa.An active surveillance and secondary prevention programs for patients with chronic hepatitis and nutrition-associated metabolic liver diseases are the most important steps to reduce the risk of HCC in the region.Salah Berkane,Department of Gastroenterology BologhineUniversity Hospital,Bologhine 16090,Algiers。

β_3肾上腺能受体基因Trp64Arg变异与胰岛素抵抗的关系

目的 :观察中国人群β3 肾上腺能受体 (β3 AR)基因 Trp 64Arg的变异频率 ,以及此基因变异与肥胖、胰岛素抵抗及非胰岛素依赖性糖尿病 ( NIDDM)的关系。方法 :选取互相之间无任何亲缘关系的汉族NIDDM病人 1 32例 ,年龄 ( 55.41± 1 2 .3)岁。选取无亲缘关系的汉族非 NIDDM80人 ,年龄 ( 54.1 2± 1 3.6)岁。对上述对象查体 ,查血生化指标及空腹血清 C-肽 ( C- P)。用 PCR- RFLP方法检测β3 AR基因 Trp 64Arg变异。结果 :Arg 64纯合子发生 NIDDM的相对危险性是 1 .54。Arg 64纯合子的 NIDDM病人发病年龄较早( 37.33± 6.98岁 vs.45.69± 1 1 .0 1岁 ,P<0 .0 5)。Arg64纯合子与 Trp64纯合子相比 ,前者体重指数较大( 2 8.56± 2 .58vs.2 4 .72± 5.1 2 ,P<0 .0 5) ,血 TG水平较高 ( 2 .56± 1 .2 1 mmol/L vs.1 .71± 1 .31 mmol/L,P<0 .0 5) ,血 HDL- C水平较低 ( 1 .0 1± 0 .2 3mmol/L vs.1 .32± 0 .44mmol/L,P<0 .0 5) ,空腹血 C- P水平较高 ( 1 .0 5± 0 .34pmol/L vs.0 .77± 0 .2 3pmol/L,P<0 .0 5) ,动脉舒张压较高 ( 1 1 .30± 1 .75k Pa vs.1 0 .1 0± 1 .63k Pa,P<0 .0 5)。Trp64Arg杂合子也有以上倾向 ,但与 Trp64纯合子相比无显著性差异。结论 :β3 AR基因的 Trp64Arg变异与肥胖、胰岛素抵抗?

糖尿病足治疗方法的研究进展

糖尿病足是糖尿病常见的一种并发症。近年来,糖尿病足的治疗越来越受到人们的重视。糖尿病足患者往往伴有多系统疾病,因此本病的治疗不能依靠单一的学科进行单一的治疗,而是需要多个学科协同的综合治疗。本文就糖尿病足的治疗进展进行综述,以期为临床上治疗本病提供参考依据。

血糖控制对2型糖尿病患者胰岛β细胞功能及胰岛素敏感性的影响

目的 观察 2型糖尿病血糖控制前后胰岛β细胞功能及胰岛素敏感性变化。 方法 2型糖尿病血糖控制未达标者 ,检查 β细胞功能及胰岛素敏感性。以胰岛素耐量试验 (ITT)中KITT表示胰岛素抵抗程度 ;以标准馒头餐试验中 30min内C肽曲线下面积 (AUCCP30 )及 1 2 0min内C肽曲线下面积(AUCCP1 2 0 )分别反映葡萄糖刺激的胰岛素分泌第一时相变化及总量 ;以精氨酸刺激试验中急性C肽反应(ACRARG)反映非葡萄糖刺激的胰岛素分泌功能。然后控制血糖 ,随访督导 3个月以上 ,复查空腹血糖、餐后血糖、HbA1c并重复上述检测。结果 30例进入研究 ,2 0例完成。研究结束时 ,随血糖控制改善 ,β细胞功能指标AUCCP30 、AUCCP1 2 0 、ACRARG均升高 ,血清空腹胰岛素原 (PI)及与C肽比例下降 ,胰岛素抵抗程度减轻 ,差异均有显著性。结论 血糖控制可改善胰岛 β细胞葡萄糖刺激的及非葡萄糖刺激的胰岛素分泌功能 ,减少PI分泌绝对及相对数量。

尿TGF-β_1、层粘连蛋白、Ⅳ型胶原与2型糖尿病肾病的关系

在 18 2例 2型糖尿病患者测定尿液转化生长因子β1(TGF β1)、层粘连蛋白 (LN)和Ⅳ型胶原排泄量 ,糖尿病患者的尿液TGF β1、LN和Ⅳ型胶原排泄量增加 ,并与糖尿病肾病 (DN)的严重程度有较好的相关性。尿TGF β1可能为早期DN的指标、尿LN。

磷酸烯醇式丙酮酸羧激酶基因多态性与2型糖尿病的相关性研究

目的 研究华东地区汉族人群中磷酸烯醇式丙酮酸羧激酶 (PCK1)基因的单核苷酸多态性(SNP)与 2型糖尿病的相关性。方法 采用直接测序法对PCK1基因作SNP筛查 ,并按病例 对照研究选用直接测序法对改变氨基酸编码的cSNP作进一步的基因分型。结果 共检出 11个SNPs ,其中出现在启动子区 3个 (P/-10 99G→A ,P/-969G→A ,P/-2 3 4G→C) ,内含子区 2个 (I3 /3 79A→T ,I5/85C→G) ,外显子区 6个SNP(E2 /69C→T ,E4/47C→T ,E4/56C→T ,E4/83C→T ,E4/14 4G→C ,E7/179G→A) ,而改变氨基酸编码的cSNP只有E4/14 4G→C ,即Leu184Val。进一步基因分型后显示 ,2型糖尿病组中GG :10 6,GC :77,CC :8,而正常对照组中GG :13 0 ,GC :58,CC :3 ,这两组间的基因型频率差异有显著性 (P <0 .0 5) ,而且两组间等位基因频率差异也有显著性 (P <0 .0 1)。结论 PCK1基因的Leu184Val多态性与华东地区汉族人群

肥胖与非肥胖2型糖尿病患者外周血T淋巴细胞亚群研究

以免疫荧光双标记单克隆抗体及流式细胞仪检测外周血淋巴细胞亚群 ,在非肥胖 2型糖尿病患者外周血CD+ 3CD+ 8阳性细胞数显著低于肥胖 2型糖尿病患者和健康对照组 ,而CD4 /CD8比值增高。在非肥胖 2型糖尿病患者可能存在明显的细胞免疫功能异常。

磺脲类药物受体1基因多态性与2型糖尿病相关性

目的 探讨中国南方人群 2型糖尿病 (DM)的发生与磺脲类药物受体 1(SUR1)基因多态性的关系。方法 抽提正常人 51名及 2型DM患者 10 5例外周血白细胞基因组DNA ,PCR扩增SUR1基因4个多态性位点的区域 ,用限制性酶切片段长度多态性分析其基因型 ,并用测序证实不同酶切图形基因型的准确性。结果 SUR1基因 16号外显子 -3t→c的多态性在 2型DM和正常人群之间差异无显著性。研究人群未发现SUR1基因 18号外显子 (ACC→ACT ,T761T)和 3 1号外显子 (R12 73R ,AGA→AGG)的多态性变化。SUR1基因 3 3号外显子 13 70位 (TCC→GCC ,S13 70A)的多态性变化 ,在 2型DM和正常人群之间差异有显著性 (P <0 .0 5)。结论 SUR1基因可能是中国南方