Comparing the effectiveness of continuous subcutaneous insulin infusion with multiple daily insulin injection for patients with type 1 diabetes mellitus evaluated by retrospective continuous glucose monitoring: A real-world data analysis.

Objective: Regarding the effects and practical application of insulin pumps on patients with type 1 diabetes mellitus (T1DM), the real-world evidence is limited especially concerning the incidence of hypoglycemia. This study aimed to compare the efficacy of continuous subcutaneous insulin infusion (CSII) therapy with multiple daily injection (MDI) therapy on glycemic metrics evaluated by retrospective continuous glucose monitoring (CGM) in Chinese patients with T1DM. Methods: In total, 362 T1DM Chinese patients from the outpatient department of the Second Xiangya Hospital, Central South University, who underwent intensive insulin therapy and used a retrospective CGM system were included in this retrospective cross-sectional study. Comprehensive analysis of clinical and biological features and retrospective CGM derived-metrics was performed on the 362 enrolled T1DM patients who underwent CSII (n = 61) or MDI (n = 301) therapy (defined as 4 or more insulin injections per day). Results: Our findings demonstrated that patients who underwent CSII therapy, compared with those who received MDI therapy, had lower levels of hemoglobin A1c (HbA1c) and fasting blood glucose; moreover, CSII therapy was associated with better glycemic outcomes in terms of increasing time in range (TIR), decreasing time above range (TAR), and achieving CGM-associated targets of TIR ≥70% and TAR <25%. However, patients who underwent CSII therapy did not experience decreasing time below range (TBR), achieving CGM-associated targets of TBR <4%, and reduction of the risk of hypoglycemia as evidenced by comparing TBR and low blood glucose index (LBGI) between the two treatment regimens. The parameters of glycemic variability, such as standard deviation of glucose (SD), mean amplitude glycemic excursion (MAGE), and large amplitude glycemic excursion (LAGE) in T1DM patients who underwent CSII therapy outperformed. Conclusion: Our results provided further evidence that CSII therapy is safe and effective for management of Chinese T1DM patients, which was confirmed by a lower HbA1c level and better CGM-derived metrics but no demonstration of improvment in the risk of hypoglycemia. To achieve more satisfactory glycemic outcomes through the utilization of CSII therapy for Chinese T1DM patients, a strong physician-patient relationship is essential.

Protective effect of ACTH4-10 on adriamycin-induced podocyte injury / 中华肾脏病杂志

Objective To observe the influence of adrenocorticotropic hormone (ACTH4-10) in the changes of podocyte proliferation,apoptosis and expression of nephrin and podocin on adriamycin (ADR)-induced podocyte injury and investigate the protective effect of ACTH4-10.Methods All podocytes were randomly divided into following groups:normal control,ADR-induced group and ACTH4-10 intervention group (low,middle and high concentration).Normal control group was not treated,ADR-induced group was induced to set the model of podocyte injury by ADR (1 μmol/L) for 24 hours and ACTH4-10 intervention groups were intervened by 1 μg/L,10 μg/L and 100 μg/L ACTH4-10 for 1 hours respectively,prior to setting the model of podocyte injury.Cell counting kit (CCK-8) was used to detect the multiplication of podocytes and TUNEL apoptosis detection kit was used to detect podocyte apoptosis.Real-time PCR and Western blotting were used to examine the expression of nephrin and podocin.Results Compared with control group,podocyte proliferation and expression of nephrin and podocin was decreased significantly in ADR-induced group (P ＜ 0.05),meanwhile podocyte apoptosis was increased obviously (38.14％ vs 5.12％).Compared with ADR-induced group,podocyte proliferation and expression of nephrin and podocin was increased generally with concentration of ACTH4-10.Although podocyte apoptosis rates (20.45％,17.39％,11.02％) were increased in ACTH4-10 intervention group (low,middle and high concentration) while comparing with normal control group,podocyte apoptosis decreased obviously while comparing with ADR-induced group.Conclusions ACTH4-10 can stabilize the expression of nephrin and podocin on slid diaphragm,and has the protective effect on podocyte injury induced by ADR,while the effect depends on the concentration of ACTH4-10.

The application of super-selective external carotid artery embolization in head and neck diseases / 介入放射学杂志

Objective To study the application of super-selective external carotid artery embolization in head and neck diseases. Methods DSA and super-selective external carotid artery embolization were carried out in 41 cases of head and neck diseases including 12 cases of epistaxis,7 nasopharyngeal fibroangioma,1 traumatic arterial bleeding,14 vascular malformation,and 7 malignancies. Results No recurrence of nose bleeding after embolization of epistaxis was seen within 6 - 12-month follow up. The operative bleeding was reduced significantly by preoperative embolization in nasopharyngeal fibroangioma. No recurrence of bleeding was achieved after embolization of traumatic artery. Among the cases of vascular malformation,3 were proven to be significantly effcient,6 effcient,and 5 inefficent in the 6 - 12-month follow up. Among the 7 malignant cases,3 survived more than 2 years. Conclusion Super-selective external carotid artery embolization is safe and effective in the treatment of head and neck diseases. (J Intervent Radiol,2006,15: 330-332)