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.

不同糖代谢人群一相胰岛素分泌状况研究

目的:探讨正常糖耐量(NGT)、空腹血糖受损(IFG)、糖耐量受损(IGT)及新诊断2型糖尿病(T2DM)患者第一时相胰岛素分泌水平差异。方法:NGT11例,IFG10例、IGT19例,新诊断T2DM54例。采用静脉葡萄糖耐量试验(IVGTT)测定第一时相胰岛素分泌水平、血糖、血脂,计算Homa-β、Homa-IR和胰岛素敏感指数(ISI)。结果:10min时4组间胰岛素分泌水平差异无显著性;1、2、4、6、10min时NGT、IFG、IGT各组和T2DM组差异具有显著性;2、4、6min时NGT和IGT组也有显著性差异。2T2DM组0min时血糖水平明显高于另三组,4组血糖高峰均出现于1min,NGT组10min内血糖下降迅速,T2DM组血糖水平下降最迟缓。3Homa-βNGT、IFG、IGT组分别和T2DM组差异具有显著性,4组间Homa-IR和ISI差异无显著性。4HDL水平依葡萄糖代谢的恶化而逐渐降低。结论:NGT、IGT及新诊断T2DM一相胰岛素分泌依次递减,存在明显差异。IVGTT各组胰岛素峰值不随血糖峰值迁移,分泌模式一致,血糖峰值出现于1min,而胰岛素峰值出现于2min。

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。