Clinical effects of hypoglycemic drugs in patients with type 2 diabetes mellitus and depression / 中国糖尿病杂志

Objective To explore the clinical effects of hypoglycemic drugs on depression degree in patients with type 2 diabetes mellitus(T2DM).Methods A total of 160 newly diagnosed T2DM patients or T2DM patients who have not used hypoglycemic drugs in the past 3 months with mild to moderate depressive episodes and visited our outpatient department were enrolled in this study from January to December 2022.All the participants HbA1c were ranged from 7%to 9%.They were randomly divided into four groups:Metformin treatment group(Met,n=40),Met combined with sulfonylurea treatment group(Met+SUs,n=40),Met combined with DPP-4i treatment group(Met+DPP-4i,n=40),and Met combined with GLP-1 receptor agonist treatment group(Met+GLP-1RA,n=40).All the patients were scored with the Hamilton Depression Rating Scale(HAMD)and the Hamilton Anxiety Rating Scale(HAMA)in each group.Results The Met+DPP-4i and Met+GLP-1RA groups showed the most significant decrease in HAMD and HAMA scores after treatment(P<0.05),while the proportion of moderate depression and significant anxiety in HAMD decreased(P<0.05).Pearson correlation analysis showed that?HAMD,?HAMA were positively correlated with ?HbA1c in the Met+GLP-1RA group(P<0.05).Conclusion The combination of Met with DPP-4i and GLP-1RA has the most significant effect on improving the degree of depression in patients with T2DM and depression.

Changes of glomerular filtration rate in type 2 diabetic patients with normal serum creatinine and serum cystatin C / 中国糖尿病杂志

Objective To investigate the changesof glomerular filtration rate(eGFR)in type 2 diabetic patients with normal serum creatinine(Scr)and serum cystatin C(Cys-C). Methods A total of 166 patients with type 2 diabetes mellitus admitted into our hospital from January 2014 to September 2015 were enrolled in this study and divided into three groups according to the level of Scr and Cys-C:T2DM patients with normal Scr and Cys-C (normal group,n =109),T2DM patients with normal Scr and high level of Cys-C (high Cys-C group,n=40),and T2DM patients with high levels of Scr and Cys-C (high Scr Cys-C group,n=17). Normal group were further divided into two subgroups according to the level of eGFR:eGFR≥90 ml/(min·1.73 m2 )subgroup and eGFR<90 ml/(min·1.73 m2 )subgroup.Clinical characteristics and laboratory datawere collected in all subjects. eGFR were measured by 99mTc-DTPA nephro-dynamic imaging. Results The average value of eGFR were significantly different in normal group(82.68±13.45)ml/(min·1.73 m2 ),high Cys-C group(67.93 ±14.01)ml/(min·1.73 m2 )and high Scr,Cys-C group (50.54±15.10)ml/(min·1.73 m2 ). In normal group,the proportion of patients with eGFR equal or greater than 90 ml/(min·1.73 m2 )was 26.6%,patients with eGFR ranged from 60 to 89 ml/(min·1.73 m2 )was 72.5%,patients with eGFR ranged from 30 to 59 ml/(min·1.73 m2 )was 0.9%. After follow-up for three months,in normal group,the proportion of patients with CKD stage1 was 4.6%,patients with CKD stage 2 was 34.9%,and patients with CKD stage 3 was 0.9%.Multivariate logistic regressionanalysis in normal group showed that female,older age,higher TC,lower LVEF were risk factors for eGFR decline (P <0.05). Conclusion In T2DM patients with normal Scr and Cys-C, 73.4% of them had mild to moderate eGFR decline,and 40.4%entered CKD stage in this study.eGFR should be evaluated especially in T2DM patients with risk factors including female,older age,higher TC and lower LVEF.

Salidroside protects PC12 cells from HO-induced apoptosis via suppressing NOX2-ROS-MAPKs signaling pathway / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the molecular mechanism by which salidroside protects PC12 cells from HO-induced apoptosis.</p><p><b>METHODS</b>PC12 cells cultured in DMEM supplemented with 10% horse serum and 5% fetal bovine serum were pretreated with different doses of salidroside for 2 h and then stimulated with HOfor different lengths of time. The expression levels of PARP and caspase 3 and the phosphorylation of p38, ERK and JNK were determined with Western blotting. The cell nuclear morphology was observed after DAPI staining. The production of ROS was detected using a ROS detection kit, and the levels of gp91and p47in the membrane and cytoplasm were detected by membrane-cytoplasm separation experiment; the binding between gp91and p47was assayed by coimmunoprecipitation experiment.</p><p><b>RESULTS</b>Salidroside dose-dependently suppressed cell apoptosis, lowered phosphorylation levels of p38, ERK and JNK, inhibited the production of ROS, reduced the binding between gp91and p47, and inhibited the activity of NOX2 in PC12 cells exposed to HO.</p><p><b>CONCLUSION</b>Salidroside protects PC12 cells from HO-induced apoptosis at least partly by suppressing NOX2-ROS-MAPKs signaling pathway.</p>

The relationship between ERK1/2 and p38 signaling pathway with the immune expression of diabetic based on MEBT/MEBO / 重庆医学

Objective To investigate the regulation on extracellular signal regulated kinase (ERK )1/2 and p38 signaling pathways and immune expression by moist exposed burn therapy/moist exposed burn ointment(MEBT/MEBO)in diabetic foot and their relationship ,to explore the repair mechanism of MEBT/MEBO on diabetic foot ulcers .Methods Totally 40 diabetic foot pa‐tients were treated by MEBT/MEBO ,to take wound tissue before and after treatment and detect the expression of ERK 1/2 ,p38 , MAPKK6 ,c‐myc ,Akt ,ATF2 ,IgA ,IgM ,IgG ,C3c and C4c by immunohistochemistry ,to investigate their relationship .Results Af‐ter treatment with MEBT/MEBO ,the area of foot wounds in 39 patients was reduced in different degree .Only one patient had no obvious change .14 patients(35 .00% ) were markedly effective ,25 patients(62 .50% ) and 1 patient(2 .50% ) were ineffective .Before andaftertreatment,allpositiveexpression,positiveimmunoreactivity(anyindex)andpositiveexpression(specificindex)ofsignal pathway molecules were statistically significant (P<0 .05) .While the positive rate of molecular expression in wound pathway in‐creased ,the positive expression rate of immune factor increased .Before treatment ,a small amount of immune factors were found in the wound tissue .After treatment ,the immune factors IgA ,IgM ,IgG ,C3c ,C4c were distributed widely and diffusely .Before treat‐ment ,the wound tissue showed a very small number of signal molecules .After treatment ,the signal pathway molecules MEBT/MEBO and p38 ,MAPKK6 ,c‐myc ,Akt ,ATF2 showed broad and diffuse distribution .Conclusion MEBT/MEBO may promote the expression of ERK1/2 and p38 signaling molecules and immune in diabetic foot ,p38 and ERK1/2 signaling pathway may promote the healing of diabetic foot wound by increasing the expression of immune .

Effect of sodium aescinate in inducing human breast cancer MCF-7 cells apoptosis by inhibiting AKT, ERK and upstream signal SRC activity / 中国中药杂志

To study the effect of sodium aescinate in inducing human breast cancer MCF-7 cells apoptosis and its possible mechanism. MTT assay was used to detect the inhibitory effect of sodium aescinate on the proliferation of MCF-7 cells. The morphological changes were observed under inverted microscope. DAPI nuclear staining was used to detect the changes in cell nucleus. Annexin V-FITC/PI flow cytometry was adopted to test the apoptosis rate. Changes in apoptosis-related proteins (PARP, cleaved caspase-8 and pro-caspase-3), cell survival-associated signal molecules (AKT and ERK) and their common upstream kinase SRC was detected by Western blotting. The result showed that after different concentrations of sodium aescinate were used to treat breast cancer MCF-7 cells, they inhibited the proliferation of MCF-7 cells in a dose-dependent manner, induced cell apoptosis (typical morphological changes in nucleus, significant increase in cell apoptosis rate). The expressions of cleaved PARP and caspase-8 increased, while the expression of pro-caspase-3 decreased, which further verified sodium aescinate's effect in inducing cell apoptosis. Sodium aescinate significantly inhibited the phosphorylation of cell survival-related signal molecules (AKT, ERK) and down-regulate the activation of their common up-stream kinase SRC. The findings indicated that sodium aescinate can block signals transiting to downstream molecules AKT, ERK, inhibit the proliferation of breast cancer cell MCF-7 cell apoptosis and induced cell apoptosis by suppressing the activation of SRC.

Research progress in Smad1 and diabetic nephropathy / 中华内分泌代谢杂志

Diabetic nephropapthy (DN) is a common cause of end-stage renal disease.Early diagnosis and treatment are significant for delaying the development of DN.Smad proteins mediate transforming growth factor β superfamily intracellular signal transduction.Recent studies have found that Smad1 protein plays an important role in the process of renal fibrosis.Urine Smad1 emerges in the early stage of DN,which is expected to be a non-invasive indicator in early diagnosis of DN.

Treating Neer two- and three-part of proximal humeral fractures through anterolateral acromial approach and deltopectoral approach / 中国骨伤

<p><b>OBJECTIVE</b>To compare clinical results of treating Neer two- and three-part of proximal humeral fractures between anterolateral acromial approach and deltopectoral approach.</p><p><b>METHODS</b>From January 2009 to December 2012, 49 patients with Neer two- and three-part of proximal humeral fractures were treated with locked plate fixation. In anterolateral acromial approach group, there were 22 patients including 9 males and 13 females with an average of (63.2±7.6) years old, while 27 patients in deltopectoral approach including 12 males and 15 females with an average of (62.9±7.0) years old. Operative time, blood loss during operation, fracture healing time and complications were observed and compared, postoperative Constant-Murley scoring and VAS scoring were applied for evaluate function of shoulder joint and pain at 3 months, 1 and 2 years respectively.</p><p><b>RESULTS</b>All patients were followed up from 24 to 41 months with an average of 34.5 months. Operative time, blood loss, fracture healing time in anterolateral acromial approach group was (68.20±7.04) min, (151.30±20.57) ml, (10.88±4.90) weeks respectively, and better than that of in deltopectoral approach group which was (75.81±13.70) min, (242.10±37.25) ml and (13.60±2.45) weeks. Three months after operation, Constant-Murley scoring and VAS score in anterolateral acromial approach group was 88.32±5.45, 0.41±0.63 and better that of in deltopectoral approach group which was 63.53±8.31, 1.65±1.02. There was no significant differences between two groups in Constant-Murley scoring and VAS score at 1 and 2 years after operation. Each group has one case occurred loss of length humerus head height, and there was 1 case with subacromial impingement, 1 case with bolt loose and 2 cases with delayed union in deltopectoral approach. No axillary nerve injury, humeral head necrosis and breakage of internal fixation occurred both of two groups.</p><p><b>CONCLUSION</b>Both of anterolateral acromial approach and deltopectoral approach are effective in treating Neer two- and three-part of proximal humeral fractures, and can obtain excellent outcomes. Moreover, anterolateral acromial approach has advantage of less trauma, less blood loss, shorter operative time, rapid recovery of shoulder joint function and fracture.</p>

Trichostatin A promotes mouse bone marrow mesenchymal stem cells to differentiate into insulin-secreting cells / 中国病理生理杂志

AIM:To investigate whether trichostatin A ( TSA) , a new revulsant ,can induce mouse mesenchy-mal stem cells to differentiate into insulin-secreting cells and to explore the appropriate concentration of TSA .METHODS:The mesenchymal stem cell line from C57BL/6 mice was cultured in vitro and divided into 5 groups before treated with dif-ferent concentrations of TSA , ( group A:DMSO;group B~E:treated with 25 nmol/L, 50 nmol/L, 100 nmol/L and 200 nmol/L of TSA, respectively).After exposed to different cultured media for 10 d during the 2 stages, the cells were detec-ted by the following methods:the insulin-secreting cells in each group were identified by dithizone staining and the results were calculated with immunohistochemical half quantitative analysis .The insulin secreted by insulin-secreting cells in each group was identified by immunofluorescence , and the mean fluorescence intensity of insulin was compared .The content of insulin in each group was quantified by ELISA .The appropriate concentration of TSA was determined according to the above results .RESULTS:TSA treatment for 10 d promoted the mouse bone marrow mesenchymal stem cells to differenti-ate into insulin-secreting cells which produced insulin .The immunohistochemistry and immunofluorescence imaging analysis of insulin-secreting cells showed that the insulin staining positive area , positive ratio , total density of insulin expression and mean fluorescence intensity of insulin in group B were significantly higher than those in the other TSA -treated groups .When the concentrations of TSA gradually increased , the content of insulin reduced accordingly .The content of insulin in group B was significantly higher than that in the other TSA-treated groups .CONCLUSION:TSA treatment for 10 d promotes bone marrow mesenchymal stem cells from C57BL/6 mice to differentiate into insulin-secreting cells and the appropriate concen-tration of TSA is 25 nmol/L.

The practice and effects of pre-job comprehensive training of medical postgraduates / 中华医学教育探索杂志

Objective To improve the teaching methods of graduate students, and provide the theoretical basis for other teaching hospitals to extend the preclinical training mode of clinical medicine professional degree students. Methods 90 clinical medical postgraduate students of Grade 2012 were divided into four groups according to their specialized field and 54 hours of pre-job clinical intensive training were conducted at the same time. The training included four modules lectured by teachers with physician-in-charge above title, such as communication between doctors and patients and medical history collection, physical examination, medical record writing as well as theory of knowl-edge. Before and after the implementation of intensive training, these four skills and knowledge of the students were tested and assessed by professional teachers. Relevant data were paired t test, ANOVA and non-parametric tests. Results The test results of patient-doctor communication and patient history collection, physical examination, complete medical records and theoretical examination results of each group after training were improved to be higher than before (P<0.05). And the effect of patient-doctor communication and patient history collection was the most significant. The doctor-patient communica-tion and history acquisition performance of different groups of graduate students had statistically sig-nificant difference (P=0.001). Conclusion Strengthening the preclinical comprehensive training for medical postgraduate can make the students master the basic clinical skills better and more effectively and the corresponding training methods are worthy of popularization to the other teaching hospitals.

Clinical features and COMP gene mutation in a family with a pseudoachondroplasia child / 中国当代儿科杂志

This study aimed to report the clinical characteristics and COMP gene mutation of a family with pseudoachondroplasia (PSACH), a relatively rare spinal and epiphyseal dysplasia that is inherited as an autosomal dominant trait. Clinical information on a 5-year-2-month-old PSACH child and his parents was collected and analyzed. Diagnosis was confirmed by PCR amplification and direct sequencing of all the 19 exons and their flanking sequences of COMP gene, and the mutation was further ascertained by cloning analysis of exon 10. The child presented with short and stubby fingers, bow leg, short limb dwarfism and metaphysic broadening in long bone as well as lumbar lordosis. A mutation c.1048_1116del (p.Asn350_Asp372del) in exon 10, inherited from his father who did not demonstrate any phenotypic feature of PSACH, was detected in the child. PSACH was diagnosed definitively by means of COMP mutation analysis, on the basis of the child's clinical and imaging features. The non-penetrance phenomenon of COMP mutation was described for the first time in PSACH.

Practice of intensive clinical skill training for non-mainland medical interns and its effect / 中华医学教育探索杂志

Objective To conduct intensive clinical skill training for non-mainland medicine interns and to explore the effects of training.Methods Twenty-six new clinical interns in the first affiliated hospital of Jinan university from June 2019 to June 2011 were enrolled and the 96 hours of intensive training was conducted.Results The scores of theoretical examination,puncture operation,physical examination and complete medical records of the 26 non-mainland interns were improved after training ( P ＜ 0.05 ) and were higher than those of mainland interns ( P ＜ 0.05 ).The enhancement in complete medical recording skills was the greatest and in puncture operation was the smallest among the four techniques.Conclusions The intensive training can effectively improve the clinical skills of nonmainland medical interns and the improvement of clinical skills in non-mainland interns is greater than that in mainland students.

A technical approach to endothelial dysfunction by atomic force microscope / 生物医学工程学杂志

Endothelial cells (ECs) with a variety of functions are vulnerable to attack by various risk factors. These risk factors of vascular pathology lead to endothelial dysfunction (ED). However, the present methods of evaluating ED have their limitations. Atomic force microscope (AFM), which can offer the information on the surface images and the mechanical properties of the single cell at nanometer scale, will become a new technical approach to ED evaluation. This review focuses on the recent progress in the application of AFM to assess ED.

Analysis and strategy on the early complications of lumbar disc herniation with Coflex system / 中国骨伤

<p><b>OBJECTIVE</b>To explore the short-term effectiveness and the cause of the early complications of lumbar disc herniation with Coflex system in order to provide evidence for the prevention.</p><p><b>METHODS</b>From November 2007 to August 2008, 37 patients (20 males and 17 females) were treated with Coflex system. The age was from 33 to 70 years with an average of 52 years and the history was from 6 to 50 months with an average of 16.5 years. Complications were observed and the short-term effectiveness was evaluated by scores of JOA and ODI before and after operation.</p><p><b>RESULTS</b>All patients were followed up from 1 to 2 years with an average 20 months. The JOA score increased from 9.09 +/- 1.10 preoperatively to 25.40 +/- 1.20 in the last follow-up. ODI decreased from 24.70 +/- 4.80 preoperatively to 4.80 +/- 1.00 in the last follow-up. The VAS score decreased from 7.86 +/- 0.80 preoperatively to 3.20 +/- 0.50 in the last follow-up. The symptoms remarkably improved. Complications occurred in 4 pa-tients (10.8%), among them, persistent low back pain was in 1 case and conservative treatment did not work; opposite lower limb pain was in 1 case at the 3rd week after operation and symptomatic treatment was effective; displacement of Coflex was in 1 case and Coflex breakage happened in 1 case at the 6th month after operation, but both did not have related clinical symptom.</p><p><b>CONCLUSION</b>Coflex can obtain good clinical outcomes in treating lumbar disc herniation, but it has special complications. The indications and manipulations should be chosen properly.</p>

Analysis of the factors related to glomerular filtration rate in type 2 diabetes without albuminuria / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze the risk factors affecting the glomerular filtration rate (GFR) in type 2 diabetic patients without albuminuria.</p><p><b>METHODS</b>A total of 131 type 2 diabetic patients with normal urinary albumin excretion rate (UAER) were divided into normal GFR group and decreased GFR group. The factors relevant to GFR were analyzed by multiple factors regression.</p><p><b>RESULTS</b>Age, course of diabetes, systolic blood pressure, prevalence of hypertension, the level of serum creatinine (SCr), blood urea nitrogen (BUN) and uric acid (UA) were significantly higher in decreased GFR group than in normal GFR group. Multivariate regression showed that SCr, age, systolic blood pressure, and UA were negatively correlated to GFR.</p><p><b>CONCLUSION</b>Reduced GFR occurs in some type 2 diabetic patients without albuminuria. SCr, age, systolic blood pressure and UA are the major factors related to decreased GFR. The degree of early renal damage in diabetic patients can be better evaluated by combining GFR and UAER.</p>

The inflammation response of sVCAM-1 in patients with coronary artery disease and diabetes mellitus / 中国糖尿病杂志

The study of isolated coronay heart disease (iCHD) (n=17) and CHD+T2DM (n=17) showed that the serum level of vascular cell adhesion molecule-1 (VCAM-1) and CHD scores increased in CHD+T2DM group than in iCHD grup, and was positively correlated with CHD scores in CHD population (all P<0.01).

A Study on the Relationship between the Three Kinds of Urinary Proteins and Serum Magnesium in Diabetic Patients / 中国医师杂志

Objective To explore the relationship between the three kinds of urinary proteins and serum magnesium(Mg 2+ ) in diabetic patients. Methods The levels of three kinds of urinary proteins and serum Mg 2+ concentration were measured using Arsenzo-III method and RIA respectively in 246 patients with type 2 diabetes. Results Serum Mg 2+ concentration was associated with the levels of urinary ? 2-microglobulin(? 2-MG), immunoglobulin(IgG) and albumin(Alb), as well as the patients age(P

Diabetic autonomic neuropathy is a risk factor of cerebrovascular disease / 中华内分泌代谢杂志

Objective To study the relationship between the diabetic autonomic neuropathy (DAN) and the cerebrovascular disease. Methods The heart rate variability (HRV) was measured in 77cases of type 2 diabetes 〔49 men, 28 women, age (63.1?11.4)years〕. Forty-one cases suffered from DAN (group A), 36 cases without DAN (group B) according to the results of HRV. All the cases received the examination with transcranial Doppler ultrasonography (TCD). Results Compared with group B, the abnormality detected with TCD was higher in group A, cerebrovascular compliance was commonly decreased and cerebrovascular stenosis was also extensively observed. Conclusion DAN seems to be one of the risk fcators in inducing cerebrovascular disease.

Protective effects of losartan on diabetic glomerulopathy in STZ-induced diabetic rats / 中华肾脏病杂志

Objndve To evaluate the protective effects of specific antagonists of angiotensin II receptor losartan on the kidneys of diabetic rats and study their mechanisms. Methods Changes of urinary albumin, ?2-m excretion, creatinine clearance(Ccr), NO, ET level of plasma, urine and renal tissue, serum and urinary TGF-?1 concentration and mean glomerular volume were measured. Results Losartan could correct elevated urinary albumin, ?2-m excretion, Ccr and mean glomerular volume. Urinary and renal tissue NO, ET concentration decreased after diabetic rats received losartan. Large doses of losartan also reduced urinary TGF-?1 level. Conclusion Losartan can protect the kidney of diabetic rats and the decrease of NO, ET, TGF-?1 concentration in renal tissue may be a mechanism for this action.

Therapeutic effects of losartan and astragalus membranaceus on diabetic nephropathy / 中国病理生理杂志

AIM: To observe the protective effects of losartan and astragalus membranace on the kidney of diabetic rats, and to study their possible mechanisms. METHODS: The diabetic rats were induced by a single intraperitoneal injection of streptozotocin. At the end of 12th week,changes in urinary albumin excretion, urinary ? 2-MG excretion, Ccr,NO,ET-1 levels in blood, urinary and renal tissue were observed. Serum and urinary TGF-? 1 concentration,average volume of glomeruler,average thickness of glomerular basement membrane were also measured. RESULTS: In the treated diabetic rats, urinary albumin excretion, urinary ? 2-MG excretion, Ccr, urinary and renal tissue NO, urinary TGF-? 1, average volume of glomeruler, average thickness of glomerular basement membrane decreased obviously as compared with diabetic untreated rats. These effects were enhanced when losartan was combined with astragalus membranace. CONCLUSION: Losartan or astragalus membranace reversed the injury of renal structure and function in STZ-induced diabetic rats. The protective effects were enhanced when losartan was combined with astragalus membranace. The decrease in NO,ET,TGF-? 1 concentration in renal tissue may be one of mechanisms for this action.

Impaired glucose tolerance,angiopathy and advanced glycation end products / 中国病理生理杂志

The definition of impaired glucose tolerance (IGT) was first introduced by the National Diabetes Data Group at 1979. Recently the morbidity rate of IGT is soaring. About 10%-15% of patients with IGT will progress to type 2 diabetes mellitus (T2DM) which is approximately more than 100 times comparing with normal glucose tolerance people. Angiopathy can be detected in 40% patients with newly diagnosed IGT. Advanced glycation end products (AGEs) are closely related to angiopathy. Meanwhile there is some connection between IGT and AGEs. In this review, the relationship between IGT, agiopathy and AGEs is discussed.