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.

糖尿病并发感染891例临床分析

目的探讨糖尿病并发感染的相关因素。方法采用回顾性方法总结分析了1821例住院糖尿病患者中并发感染的891例的性别、年龄、病程、不同血糖水平以及有关并发症对感染发生的影响。结果随着年龄的增长、病程的延长及病情的恶化,其感染的发生率也随之升高。结论对糖尿病早期诊断。

原发性痛风及其伴发病临床分析

目的研究原发性痛风与伴发病 (冠心病、高血压病、高脂血症、糖尿病 )的关系。方法总结 1989年1月～ 1998年 3月间收治的 16 3例住院确诊为原发性痛风患者的临床资料。所有患者都常规检查血尿酸、2 4h尿尿酸、血胆固醇、甘油三脂、空腹血糖、餐后 2h血糖、心电图、X 全胸片及关节片等 ,并进行综合分析。采用 χ2 检验。结果 16 3例原发性痛风患者中 12 2例有伴发病 ,占 74.8% ,其中有 2种以上伴发病 80例占 5 6 .6 %。伴发冠心病 5 8例占 35 .6 % ,高血压病 87例占 5 3 .4% ,高脂血症 82例占 5 0 .3% ,糖尿病 37例占 2 2 .7%。痛风伴发病与年龄呈正相关 ,年龄越大 ,伴发病越多。结论作为嘌呤代谢紊乱的原发性痛风是冠心病、高血压病、高脂血症、糖尿病的恶化因素 ,对人类健康是一个潜在威胁 ,必须引起重视。

NIDDM尿转铁蛋白测定的临床意义

目的：了解转铁蛋白花早期糖尿病肾病中的临床意义。方法：采用免疫比浊法测定44例无明显血管合并症的NIDDM及266例健康人尿转铁蛋白排泄（UTFE）并与尿白蛋白排泄（UAE）进行比较。结果：无明显血管合并症的NIDDM病人UTFE增高的发生率明显高于UAE增高的发生率（57．1％与30．9％，u=3．76，P＜0．01）。UTFE与UAE呈明显正相关，UTFE与病程呈显著正相关，但与血糖及GHbA1c等水平无相关性。结论：以上结果提示UTFE可能是一个较UAE更敏感及更早反映NIDDM早期合并症的指标。

非胰岛素依赖型糖尿病患者家族史与诊断年龄的关系

目的：探讨糖尿病家族史对非胰岛素依赖型糖尿病（ＮＩＤＤＭ）诊断年龄的影响以及患有糖尿病的父母对子女ＮＩＤＤＭ发病影响的差别。方法：对１９９例有家族史及２７３例无家族史的ＮＩＤＤＭ患者诊断年龄、父母亲ＮＩＤＤＭ发病情况等临床特点进行统计学处理。结果：（１）有糖尿病家族史的ＮＩＤＤＭ患者诊断年龄明显早于无家族史者（４６．２岁ｖｓ５２．２岁，Ｐ＜０．０１）；（２）家族中母亲患糖尿病者多于父亲（３６．７％ｖｓ１９．１％，Ｐ＜０．０１）；（３）父母糖尿病史是ＮＩＤＤＭ的重要危险因素，它们的作用相互独立且相加；（４）各种遗传背景对ＮＩＤＤＭ发病的影响顺序为：母亲＞父亲＞二级亲属＞同胞。结论：（１）有遗传倾向的ＮＩＤＤＭ患者的诊断年龄提前；（２）母亲对ＮＩＤＤＭ遗传的影响大于父亲，父、母亲的作用相互独立。

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。

118例糖尿病患者的体感诱发电位研究

方法:对已确诊Ⅱ型(非胰岛素依赖型)糖尿病的118例患者进行了体感诱发电位(SEP)观察。结果:SEP正常28例(23.7%),异常90例(76.3%)。其异常发生率与年龄、病程、血糖控制情况有显著相关性。即年龄大、病程长及长期血糖控制差的患者SEP异常率高。结果还显示,有神经系统症状的患者SEP多为异常,而临床尚未出现神经系统症状者SEP也可出现异常改变。结论:该检查对糖尿病性神经病变的早期诊断有一定价值。