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Objective To investigate the changes of visual acuity,fundus changes,and serum vitamin D concentration in diabetic retinopathy patients treated with metformin,and to evaluate its clinical efficacy.Methods Totally 80 cases (160 eyes) patients with background diabetic retinopathy were included in the study,and were divided into observation group (metformin + Pancreatic Kininogenase Enteric-coated Tablets) and control group (Pancreatic Kininogenase Enteric-coated Tablets) according to the different treatment methods used for 3 months.Fundus fluorescein angiography was used to evaluate the improvement of the fundus lesions.The serum levels of vitamin D were measured with electrochemiluminescence immunoassay (ECLIA).Results After 3 months of treatment,serum vitamin D concentration of the observation group increased,and the differences were statistically significant (P ＜ 0.05) when compared to before treatment.However,3 months after treatment,serum vitamin D levels of the control group increased slightly,but the difference was not statistically significant (P ＞ 0.05).The total effective rate of fundus improvement in the observation group and the control group was 70％ and 55％,respectively.There was significant difference between the two groups in the improvement of fundus (P ＜ O.05).Conclusions Metformin has an adjunctive effect on background diabetic retinopathy,and the increase of serum vitamin D may be one of the mechanisms of metformin in improving diabetic retinopathy.
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Objective To explore the role of transforming growth factor-β1/serum and glucocorticoid induced kinase 1 (TGF-β1/SGK1) signaling pathway in diabetic nephropathy (DN).Methods Totally 60 clean grade healthy male Sprague-Dawley (SD) rats were divided into normal control (Con group,n =20) and diabetic model group (diabetic group,n =40).Type 2 diabetic animal model was induced by intraperitoneal injection of streptozotocin (STZ,45 mg/kg) to SD rats.Half of rats in each group were sacrificed after implemented for 4 weeks and 8 weeks,respectively.Fasting glucose,serum urea and creatinine,as well as urine protein in 24 h were detected.Pathological changes of rats' kidney cortex tissue were examined by hematoxylin-eosin staining.The expression of SGK1 was detected by immunohistochemistry in renal tissue.The mRNA level of SGK1 was analyzed by real-time polymerase chain reaction (PCR).The protein expression of TGF-β1 and SGK1 were determined by Western blotting.Results Compared to the control group,the blood glucose of the diabetic group rats was significantly increased,kidney hypertrophy index,serum urea and creatinine,24 h urine volume and urinary microalbumin as well as kidney index were significantly higher (P ＜0.05).The mRNA expressed of SGK1,protein expression of TGF-β1 and SGK1 were also increased obviously in the renal cortex of diabetic rats (all P ＜ 0.05 vs Control).Conclusions TGF-β1/SGK1 signaling pathway is closely related to the TIF damage of kidney cortex in diabetic rats.
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OBJECTIVE:To observe the effects of insulin glargine in type 2 diabetes mellitus patients with poor glucose con-trol by rosiglitazone and metformin. METHODS:A total of 90 patients with type 2 diabetes mellitus with poor glucose control by rosiglitazone and metformin admitted to our hospital from Aug. 2013 to Dec. 2015 were divided into control group and observation group according to random number table,with 45 cases in each group. Control group was given Acarbose tablets 50 mg orally be-fore meal,tid,with maximal dose of 300 mg/d. Observation group was given Insulin glargine injection subcutaneously,qd,with initial dose of 0.15 u/kg,adjusted according to blood glucose monitoring,with maximal dose of 40 u/d. Both group were treated for 24 weeks. The levels of fasting blood glucose,2 h postprandial blood glucose,HbA1c,fasting C peptide and 2 h postprandial C peptide were compared between 2 groups before and after treatment. The time of blood glucose reaching target and the occur-rence of adverse events were recorded,and the incidence of adverse events was calculated. RESULTS:Before treatment,there was no statistical significance in above indexes between 2 groups(P>0.05). After treatment,The levels of fasting blood glucose and 2 h postprandial blood glucose in 2 groups were significantly lower than before treatment,and the levels of fasting C peptide,2 h postprandial C peptide and HbA1c were significantly higher than before treatment;except for fasting blood glucose,above indexes of observation group were significantly better than those of control group,with statistical significance (P<0.05). The time of blood glucose reaching target in observation group was significantly shorter than control group,the incidence of nocturnal hypogly-cemia,severe hypoglycemia,edema and gastrointestinal reactions and total adverse events in observation group were significantly lower than control group,with statistical significance(P<0.05). CONCLUSIONS:The application of insulin glargine in type 2 di-abetes mellitus patients with poor glucose control by rosiglitazone and metformin can effectively reduce the levels of blood glucose and HbA1c,and improve islet function with good safety.
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Objective To investigate the effects of alpha lipoic acid on patients with diabetic retinopathy (DR),explore the possible mechanisms,and provide experimental evidence for the treatment of DR with lipoic acid.Methods Totally 75 DR patients were randomly divided into control group and treatment group.Patients in control group received the standard hypoglycemic treatment,antihypertensive therapy,and other comprehensive treatment.Patients from the treatment group were treated with alpha lipoic acid 600 mg + 250 ml 0.9％ sodium chloride injection additionally,avoiding light intravenous therapy,for a total of 4 weeks.Before and after treatment,fundus fluorescein angiography and visual inspection were detected in two groups.In addition,serum level of asymmetric dimethylarginine (ADMA) were detected with high performance liquid chromatography,serum lipid peroxidation product malondialdehyde (MDA) content and superoxide dismutase (SOD) activity were detected to reflect the in vivo oxidative stress before and after treatment in two groups.Results Compared to the control group,visual acuity was improved significantly (P ＜ 0.05),and total efficiency of ocular lesions-improved was increased significantly (84.21％ vs 40.54％,x2 =15.28,P ＜ 0.01).Serum levels of endogenous inhibitor of nitric oxide synthase ADMA [(0.32 ±0.13) μmol/L vs (0.51 ± 0.26) μmol/L,P ＜ 0.05] and MDA [(3.22 ± 0.90) nmol/L vs (5.13 ± 0.42) nmol/ml,P ＜ 0.05] were significantly decreased,while SOD levels [(72.68 ± 1.31) U/ml vs (53.16 ± 1.54) U/ml,P ＜0.05] were significantly increased in DR patients after alpha lipoic acid treatment.Conclusions Alpha lipoic acid had some therapeutic effects for DR patients,which mainly lied in the improvement of visual acuity and eye disease,might be related to the decrease of oxidative stress and serum level of endogenous nitric oxide synthase (NOS) inhibitor ADMA.
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Objective To investigate the stress distribution of the femur after cemented prosthetic replacement in aged patients with comminuted intertrochanteric fracture and to analyze the difference of stress distribution between cemented long and short stem prosthesises.Methods A volunteer's left femur image data was obtained by spiral CT tomography.Then,the three-dimensional model of the femur was reconstructed with Mimics and Unigraphics modeling softwares.Based on the above analysis,we established three-dimensional modles of comminuted intertrochanteric fracture,long stem and short stem prothesises,and mantle layer of cement.Finally,we established the three-dimensional finite element model of these materials with software ABAQUS6.5,and carried out finite element analysis to the model in biomechanics.Results The stress disrilbution of the femur after cemented long and short stem prosthetic replacement didn't change significantly.The stress distribution of short stem between cement and prothetic stem were in the correlative area of distal end of the prothesis,and the lateral peak value was 21.3 MPa which exceeds the fatigue strength of bone cement;However,that of long stem were in the middle of medial interface and in the distal end of bilateral interface.There was no significant stress concentration zone in the mantle layer of cement which was used to reconstruct calcar femorale.Conclusion The stress distribution of the femur didn't change significantly after treating comminuted intertrochanteric fracture of aged patients with cemented long and short stem prosthesises.The cemented long stem prosthesises may be more suitable to treat these patients for its lower loosening probability.