ATP Synthase β-subunit Abnormality in Pancreas Islets of Rats with Polycystic Ovary Syndrome and Type 2 Diabetes Mellitus

This study investigated the abnormal expression of ATP synthase β-subunit（ATPsyn-β） in pancreas islets of rat model of polycystic ovary syndrome（PCOS） with type 2 diabetes mellitus（T2DM）,and the secretion function changes after up-regulation of ATP5 b.Sixty female SD rats were divided into three groups randomly and equally.The rat model of PCOS with T2 DM was established by free access to the high-carbohydrate/high-fat diet,subcutaneous injections of DHEA,and a single injection of streptozotocin.The pancreas was removed for the detection of the ATPsyn-β expression by immunohistochemical staining,Western blotting and reverse transcription-PCR（RT-PCR）.The pancreas islets of the rats were cultured,isolated with collagenase Ⅴ and purified by gradient centrifugation,and the insulin secretion after treatment with different glucose concentrations was tested.Lentivirus ATP5 b was successfully constructed with the vector of GV208 and transfected into the pancreas islets for the over-expression of ATPsyn-β.The insulin secretion and intracellular ATP content were determined after transfection of the PCOS-T2 DM pancreas islets with Lenti-ATP5 b.The results showed that the expression of ATPsyn-β protein and m RNA was significantly decreased in the pancreas of PCOS-T2 DM rats.The ATP content in the pancreas islets was greatly increased and the insulin secretion was improved after the up-regulation of ATPsyn-β in the pancreas islets transfected with lenti-ATP5 b.These results indicated that for PCOS,the ATPsyn-β might be one of the key factors for the attack of T2 DM.

Alternative therapeutic strategies in diabetes management

Diabetes is a heterogeneous metabolic disease characterized by elevated blood glucose levels resulting from the destruction or malfunction of pancreaticβcells,insulin resistance in peripheral tissues,or both,and results in a non-sufficient production of insulin.To adjust blood glucose levels,diabetic patients need exogenous insulin administration together with medical nutrition therapy and physical activity.With the aim of improving insulin availability in diabetic patients as well as ameliorating diabetes comorbidities,different strategies have been investigated.The first approaches included enhancing endogenousβcell activity or transplanting new islets.The protocol for this kind of intervention has recently been optimized,leading to standardized procedures.It is indicated for diabetic patients with severe hypoglycemia,complicated by impaired hypoglycemia awareness or exacerbated glycemic lability.Transplantation has been associated with improvement in all comorbidities associated with diabetes,quality of life,and survival.However,different trials are ongoing to further improve the beneficial effects of transplantation.Furthermore,to overcome some limitations associated with the availability of islets/pancreas,alternative therapeutic strategies are under evaluation,such as the use of mesenchymal stem cells(MSCs)or induced pluripotent stem cells for transplantation.The cotransplantation of MSCs with islets has been successful,thus providing protection against proinflammatory cytokines and hypoxia through different mechanisms,including exosome release.The use of induced pluripotent stem cells is recent and requires further investigation.The advantages of MSC implantation have also included the improvement of diabetes-related comorbidities,such as wound healing.Despite the number of advantages of the direct injection of MSCs,new strategies involving biomaterials and scaffolds have been developed to improve the efficacy of mesenchymal cell delivery with promising results.In conclusion,this paper offered an overview of new alternative strategies for diabetes management while highlighting some limitations that will need to be overcome by future approaches.

胰岛细胞瘤的CT和MRI表现

目的:探讨胰岛细胞瘤的CT和MRI表现。方法:对9例手术证实的胰岛细胞瘤的CT和MRI表现进行回顾性分析,其中功能性胰岛细胞瘤7例,无功能性胰岛细胞瘤2例。结果:9例胰岛细胞瘤均富血供,边界清楚,与周围胰腺分界清楚,无血管、胰管侵犯。功能性胰岛细胞瘤多较小,无功能性胰岛细胞瘤较大。结论:胰岛细胞瘤有典型的CT和MRI表现,CT和MR增强扫描能准确诊断胰岛细胞瘤。

饥饿状态下大鼠胰岛α细胞免疫细胞化学及形态计量研究

应用免疫细胞化学方法对饥饿５ｄ大鼠和正常大鼠胰鸟α细胞进行显示，并用显微分光光度计和体视学技术对２组动物α细胞内胰高糖素的反应强度和α细胞在胰岛内所占数量和体积进行计量分析。结果表明：与正常对照组相比，饥饿大鼠胰岛α细胞内胰高糖素含量明显下降，但α细胞在胰岛内的相对数量和体积并无明显变化。提示：饥饿可导致胰高糖素释放，但由于大鼠胰岛α细胞在胰岛内并未出现相应数量和体积增加的代偿性改变，因此推测在持续性饥饿过程中α细胞对血糖不起主要调节作用。

Current surgical management of pancreatic endocrine tumor liver metastases

BACKGROUND: The management of metastatic disease in pancreatic endocrine tumors (PETs) demands a multidisciplinary approach and the cooperation of several medical specialties. The role of surgery is critical, even when a radical excision cannot always be achieved. DATA SOURCES: A PubMed search of relevant articles published up to February 2011 was performed to identify current information about PET liver metastases regarding diagnosis and management, with an emphasis on surgery. RESULTS: The early diagnosis of metastases and their accurate localization, most commonly in the liver, is very important. Surgical options include radical excision, and palliative excision to relieve symptoms in case of failure of medical treatment. The goal of the radical excision is to remove the primary tumor bulk and all liver metastases at the same time, but unfortunately it is not feasible in most cases. Palliative excisions include aggressive tumor debulking surgeries in well-differentiated carcinomas, trying to remove at least 90% of the tumor mass, combined with other additional destructive techniques such as hepatic artery embolization or chemoembolization to treat metastases or chemoembolization to relieve symptoms in cases of rapidly growing tumors. The combination of chemoembolization and systemic chemotherapy results in better response and survival rates. Other local destructive techniques include ethanol injection, cryotherapy and radiofrequency ablation. CONCLUSION: It seems that the current management of PETs can achieve important improvements, even in advanced cases.

胎儿胰腺形态及B细胞的免疫组织化学观察

取20例坐高85mm～240mm的胎儿胰腺,按头、体、尾分别取材。组织学观察显示胰腺实质被结缔组织分割成叶或小叶,腺泡分化逐渐清晰,但基底部嗜碱性不明显,提示其外分泌功能还很弱。少量聚集的内分泌细胞与外分泌部细胞无明显界限。仅见较大量聚集成团的内分必细胞外有结缔组织包绕,易与外分泌部区别。免疫组织化学染色显示胰岛内B细胞,各小叶间、叶间B细胞数目差别显著,而同一胰腺的头、体、尾部B细胞数目无明显差异。提示:本研究对临床进行胎儿胰岛移植提供了形态学依据。

清脂康胰联针穴位注射治疗2型糖尿病的疗效观察

目的探讨清脂康胰联针穴位注射治疗2型糖尿病的疗效。方法经知情同意,将120例门诊2型糖尿病患者分为穴位组和对照组,穴位组90例用清脂康胰联针(复方丹参注射液、盐酸川芎嗪注射液、板兰根注射液、穿心莲注射液、舒血宁注射液、脉络宁注射液)穴位注射。对照组30例不使用清脂康胰联针穴位注射。2组患者均给予血脂康胶囊、益肝灵片、维生素E、二甲双胍片等药物治疗。结果穴位组治愈84例,有效4例,无效2例;对照组治愈5例,有效6例,无效19例。穴位组治愈率93.3%,总有效率97.8%,明显优于对照组(治愈率16.2%,总有效率36.25%)(P<0.01)。2组患者经过4个月治疗后,穴位组体质量指数(BMI)、白细胞计数(WC)、收缩压、舒张压、糖化血红蛋白(HbAlc)、胰岛素抵抗指数(HOMA-IR)、中心性肥胖、血脂、血压、脂肪肝治疗后与治疗前及与对照组治疗后比较,差异均有统计学意义(P<0.01)。2组总胆固醇(TC)、三酰甘油(TG)治疗后与治疗前比较,差异均有显著性(P<0.01)。穴位组各时间点口服葡萄糖耐量试验(OGTT)血糖值治疗后与治疗前及与对照组治疗后比较,差异均有统计学意义(P<0.01)。穴位组OGTT 0 min胰岛素值治疗后与治疗前比较有下降,差异有统计学意义(P<0.05)。穴位组30 min胰岛素值治疗后与治疗前及对照组治疗后比较有显著上升,差异均有统计学意义(P<0.01)。穴位组60、120 min胰岛素值治疗后与治疗前及对照组治疗后比较有下降,差异均有显著性(P<0.01)。穴位组ΔI30/ΔG30、B细胞功能指数(HOMAB)治疗后与治疗前及对照组治疗后比较差异显著(P<0.01)。穴位组B细胞功能指数(MBCI)治疗后与治疗前比较差异显著(P<0.05)。结论采用清脂康胰联针穴位注射治疗初诊2型糖尿病的疗效,明显优于单用祛脂降糖等药物的疗效。

胰血管活性肠肽瘤1例报告并国内文献复习

目的探讨胰血管活性肠肽瘤(VIPoma)诊断和治疗方法。方法报告中国医科大学附属第一医院2010年2月收治1例VIPoma的临床资料,并检索国内1993年1月至2009年12月间文献报道的24例。对25例VIPoma临床表现、实验室检查、影像学检查、手术方式及随访资料进行分析。结果有记载的24例中22例有周期性发作的水样泻;22例检测血清钾,21例有低钾血症。13例血浆血管活性肠肽(vasoactive intestinal peptide,VIP)测定均高于正常。行B超检查15例中13例发现病变,10例病变于胰腺内。行CT检查22例中18例胰腺内发现病变,其中7例发现肝脏转移性病灶。25例中24例行手术治疗,行胰体尾切除术13例中11例术前有水样泻,术后7例水样泻消失,1例好转,另3例无记载。行肿瘤摘除术3例中1例术后水样泻消失,1例明显好转。1例胰头部VIPoma并发肝转移,行扩大的胰十二指肠切除术后水样泻消失。行胰体尾切除术13例,获得远期随访8例,随访3个月至3.5年,1例术后3个月大出血死亡,1例术后3.5年复发、肝转移,另6例无复发。结论 VIPoma诊断依赖于典型的临床症状和血浆VIP测定;B超及CT是胰腺VIPoma定位诊断的可靠方法。手术切除为胰腺VIPoma有效治疗手段,即使是姑息性切除亦可改善病人生活质量,延长存活时间。