Diagnosis, treatment and genetic analysis of a case of familial aldosteronism type II with WFS1 gene mutation.

Primary aldosteronism (PA) is a disease characterized by hypertension and hypokalemia due to the excessive aldosterone secretion from the adrenal cortex, which leads to the retention of both water and sodium, and the inhibition of the renin-angiotensin system as well. Familial hyperaldosteronism type II (FH-II) is known as an autosomal dominant hereditary disease, which is a scarce cause of PA. In this report, we cllected the clinical data of a patient with repeated hypertension and hypokalemia of uncertain diagnosis since 2014. Nevertheless, we discovered by genetic sequencing in 2021 that the CLCN2 and WFS1 gene mutation of the patient, whose mother belongs to heterozygote genotype and father belongs to wild-type genotype. Combined with a series of endocrine function tests and imaging studies, the patient was finally certified her suffering from FH-II and WFS1 gene mutation. By summarizing and analyzing the characteristics and genetic test results of this case, we recommended gene sequencing for patients with PA whose etiology is difficult to be determined clinically. This case also provides new clinical data for subsequent genetic studies of the disease.

Activation of AMPK-dependent autophagy in the nucleus accumbens opposes cocaine-induced behaviors of mice.

Cocaine is a strong central nervous system stimulant, which can induce drug addiction. Previous studies have reported that cocaine-induced autophagy is involved in neuroinflammation and cell death. However, the role of autophagy in psychomotor sensitivity to cocaine has not been explored. Here, we reported that D1 receptor -CaMKII-AMPK-FoxO3a signaling pathway was involved in acute cocaine application-induced autophagy in the nucleus accumbens (NAc) both in vitro and in vivo. Furthermore, we found that knockdown of the ATG5 gene in the NAc augmented behavioral response to cocaine, and induction of autophagy in the NAc with rapamycin attenuated cocaine-induced behavioral response, which was coincident with the alterations of dendritic spine density in neurons of NAc. These results suggest that cocaine exposure leads to the induction of autophagy, which is a protective mechanism against behavioral response to cocaine of male mice.

[Characterization of oil/water partition coefficient of chishao terpene glucoside components based on contribution rate of representative components for myocardial ischemia].

The components of traditional Chinese medicine(TCMCs) are the basic unit of raw materials for Chinese medicines, and their physical and chemical properties directly affect the choice of dosage forms and the optimization of prescriptions. However, most of TCMCs are multi-component complex systems, and the characterization of their overall properties is still in the exploration stage. On the basis of biological activity, the representative components are determined, and then the individual characteristics are fitted with the weight coefficient of efficacy contribution rate, which may provide reference for characterizing the overall properties of TCMCs. In this study, with the pharmacological effects of isoproterenol(ISO)-induced myocardial ischemia in rats as the indicators, the pharmacodynamic contribution rates of three representative components of chishao terpene glucoside components(CSTGCs) were evaluated by the normalization weighting method. The contribution rates of paeoniflorin, paeoniflorin and benzoylpaeoniflorin were 54.87%, 32.46% and 12.67%, respectively. The oil-water partition coefficients of paeoniflorin, albiflorin, benzoylpaeoniflorin in water and buffer solutions with different pH values were measured, and the oil-water partition coefficients of CSTGCs were characterized by the weight of their pharmacodynamics contribution rate. The results showed that the apparent oil-water partition coefficient(log P) of CSTGCs in the phosphate buffer system such as n-octanol-water(pH 2.0, 2.5, 5.0, 5.8, 6.8) were 0.18-0.22, indicating that CSTGCs have common absorption and low permeability, providing basis for the preparation of CSTGCs.

Clemochinenosides C and D, two new macrocyclic glucosides from Clematis chinensis.

The EtOH extract of the roots and rhizomes of Clematis chinensis afforded two new macrocyclic glucosides clemochinenosides C (1) and D (2). Their structures were elucidated on the basis of spectroscopic means and hydrolysis products. These compounds were evaluated for inhibitory activity against lipopolysaccharides-induced TNF-α production in RAW 246.7 macrophages. Compounds 1 and 2 showed moderate inhibitory activity with IC50 values of 12.9 ± 2.3 and 18.4 ± 2.7 µM, respectively. In addition, a proliferation study was used to evaluate the anti-angiogenic effects of these compounds in vitro (VEGF-induced human umbilical vein endothelial cell proliferation). Compounds 1 and 2 displayed weak inhibitory effects with inhibition rates of 26.3 ± 1.8 and 19.2 ± 2.6% at 50 µM, respectively.

Anticancer effects of Rosmarinic acid in OVCAR-3 ovarian cancer cells are mediated via induction of apoptosis, suppression of cell migration and modulation of lncRNA MALAT-1 expression.

PURPOSE: The main objective of the present research work was to study the anticancer properties of rosmarinic acid in OVCAR-3 human ovarian cancer cells and also to evaluate its effects on apoptosis induction, cancer cell migration and modulation of lncRNA MALAT-1 expression. METHODS: MTT assay was used to study the effects of the agent on OVCAR-3 cell viability, while inverted phase contrast microscopy and fluorescence microscopy were used to study the effects on cell morphology. Scanning electron microscopy (SEM) was used to study the effects of rosmarinic acid on cell surface morphology in OVCAR-3 cells. In vitro wound healing assay was used to study the effects on cell migration. RESULTS: Rosmarinic acid induced time-dependent and concentration- dependent cytotoxic effects in these malignant cells. The IC50 values at 48 and 72 hrs time intervals were found to be 34.6 and 25.1 µM respectively. Rosmarinic acidtreated cells revealed significant changes in cell morphology including cellular shrinkage and cell rounding. The cells also lost attachment with the plate surface. Doses of 10, 40 and 160 µM rosmarinic acid led to a substantial increase in bright blue fluorescence which is a signpost of chromatin condensation and DNA fragmentation. Rosmarinic acid treatment also led to a significant suppression of cell migration corresponding to 46.5% and 86.2 % cell migration inhibition at 40 and 160 µM doses, respectively. CONCLUSION: In conclusion, the current study showed that rosmarinic acid induced potent anticancer effects in OCVAR- 3 cancer cells by inducing apoptosis, inhibiting cell migration and modulating lncRNA Malat-1 expression.

Atomically Precise Bimetallic Au19Cu30 Nanocluster with an Icosidodecahedral Cu30 Shell and an Alkynyl-Cu Interface.

Bimetallic nanoclusters Au19Cu30 with chemical composition of [Au19Cu30(C≡CR)22(Ph3P)6Cl2](NO3)3 (where RC≡C is from 3-ethynylthiophene (H3C4S-3-C≡CH) or ethynylbenzene (PhC≡CH)) has been synthesized. Single X-ray structural analysis reveals that Au19Cu30 has a multishelled core structure of Au@Au12@Cu30@Au6, comprising a centered icosahedral Au13 (Au@Au12) surrounded by an icosidodecahedral Cu30 shell and an outmost shell of a chairlike hexagonal Au6. The alkynyl carbon is bound to the hollow sites on the Au19Cu30 nanocluster surface, which is a novel interfacial binding mode in alkynyl-protected alloy nanoclusters. The Cu30 icosidodecahedron is unprecedented and Au19Cu30 represents the first alkynyl-protected Au-Cu alloy nanocluster.

The Value of the Electrocardiogram for Evaluating Prognosis in Patients with Idiopathic Pulmonary Arterial Hypertension.

BACKGROUND: Association between electrocardiography (ECG) features and right ventricular anatomy and physiology has been established. This study is aimed to identify the value of 12-lead ECG in evaluating prognosis of patients with idiopathic pulmonary arterial hypertension (IPAH). METHOD: 194 patients with newly diagnosed IPAH were included in this study. Correlations between electrocardiography variables and hemodynamics were assessed. Univariate and multivariable cox regression analysis were performed to identify ECG variables for predicting all-cause mortality in IPAH. RESULTS: Partial correlation analysis showed that P wave amplitude in lead II correlated with the mean pulmonary arterial pressure (mPAP, r = 0.349, p ≤ 0.001) and cardiac index (CI, r = -0.224, p = 0.002); R wave amplitude in V1 correlated with mPAP (r = 0.359, p ≤ 0.001); S wave amplitude in V6 correlated with mPAP (r = 0.259, p = 0.030) and CI (r = -0.220, p = 0.003). P wave amplitude in lead II (HR 1.555, p = 0.033) and R wave amplitude in lead aVR (HR 5.058, p < 0.001) were the independent predictors of all-cause mortality. Kaplan-Meier survival curves showed patients with a p ≥ 0.25 mv in lead II, and R ≥ 0.4 mv in lead aVR had lower 3-year survival (55 vs. 91%, p < 0.001). CONCLUSION: Specific lead-12 ECG features could reflect right ventricular overload hemodynamics, and are useful to evaluate prognosis of patients with IPAH.

Prognostic Value of Pulmonary Artery Compliance in Patients with Pulmonary Arterial Hypertension Associated with Adult Congenital Heart Disease.

In congenital heart disease (CHD), the presence of pulmonary arterial hypertension (PAH) is associated with a poor prognosis. In this study, we aim to investigate the role of pulmonary artery compliance (Cp) in predicting the mortality of PAH associated with adult congenital heart disease (APAH-CHD). One-hundred and seventy-five patients of APAH-CHD who underwent a comprehensive clinical evaluation were included in this study. All patients were followed up in a 6-month interval and the primary end point was all cause of death. The duration of mean follow-up was 67±26 months, of which there were twenty-three death. Cp had an inverse correlation with pulmonary artery resistance (PVR), regardless of the clinical phenotype (Eisenmenger syndrome, PAH with small defect and PAH after defect correction). Patients in the lowest Cp group (Cp ≤ 0.84 mL/mmHg) had advanced WHO function class, worse exercise tolerance, liver function, and status of oxygen saturation. In univariate cox regression analysis, Cp (HR = 1.359, P < 0.001), PVR (HR = 0.972, P = 0.001), pulmonary blood flow (HR = 1.092, P = 0.001), heart rate (HR = 1.038, P = 0.028) and 6-minute walking distance (HR = 1.003, P = 0.037) were predictors of survival. After adjustment by bivariate analysis, Cp was the independent predictor. Kaplan-Meier survival curves showed that patients with Cp < 1.04 mL/mmHg had worse prognosis. In conclusion, Cp possibly reflects disease severity and decreased Cp was associated with poor prognosis in patients with APAH-CHD.

Pulmonary Vascular Capacitance is Associated with Vasoreactivity and Long-Term Response to Calcium Channel Blockers in Idiopathic Pulmonary Arterial Hypertension.

PURPOSE: This study aimed to identify the relationship between pulmonary vascular capacitance (PVC) and vasoreactivity in patients with idiopathic pulmonary arterial hypertension (IPAH), and the value of PVC in predicting long-term response to CCB treatment. METHODS: Pulmonary vasodilator testing with inhaling iloprost was performed in 308 newly diagnosed IPAH patients. Acute vasodilator-responsive patients accepted CCBs treatment. Patients who benefit from long-term CCB were defined as those being in World Health Organization (WHO) functional class II or I after at least 1 year on CCB monotherapy. RESULTS: PVC had significant correlations with WHO function class, 6-min walk distance, mean pulmonary arterial pressure, and pulmonary vascular resistance (r = -0.363, p < 0.001; r = 0.333, p < 0.001; r = -0.514, p < 0.001; r = -0.739, p < 0.001). Thirty-five acute vasodilator-responsive IPAH patients (11.4 %) displayed less severe disease and a higher baseline PVC (1.5 ± 0.6 vs. 1.1 ± 0.7 ml/mmHg, p = 0.003). During acute vasodilator testing, PVC increased significantly by mean of 79 ± 48 % and reached to a higher absolute value of 2.6 ± 1.5 ml/mmHg compared with non-responsive patients (1.4 ± 1.5 ml/mmHg, p < 0.001). Furthermore, PVC increased more during acute vasodilator testing in the 24 patients who benefit from long-term CCB treatment (1.4 ± 1.3 vs. 0.5 ± 0.4 ml/mmHg, p = 0.004). The OR of increased PVC during vasodilator testing for predicting patients with long-term response to CCB was 1.24 (95 % CI 1.02-1.50, p = 0.031) as assessed by multivariable logistic regression analysis. CONCLUSIONS: PVC was higher in acute vasodilator-responsive IPAH patients and may be a predictor of long-term response to CCBs therapy.

Human MALAT-1 long non-coding RNA is overexpressed in cervical cancer metastasis and promotes cell proliferation, invasion and migration.

PURPOSE: Long non-coding RNAs (lncRNAs) have been shown to play a crucial role in the development as well as the prognosis of various human cancers, particularly in human metastasis associated lung adenocarcinoma transcript-1 (MALAT-1), which has been shown to be upregulated in some tumors. However, the role of MALAT-1 in cervical cancer (CC) is yet to be elucidated. This study aimed to establish a correlation between MALAT-1 and its role in CC progression and prognosis. METHODS: The expression of MALAT-1 was examined in tissue samples of 30 CC patients and was compared with the adjacent non-cancerous tissues. The relationship between MALAT-1 levels and clinicopathological parameters from the CC patients was analyzed. Cell migration and invasion assays were performed with quantification of the expression levels of MALAT-1 in 4 CC cell lines using RT-PCR. RESULTS: Our results demonstrate that MALAT-1 is upregulated in CC. We found higher expression of MALAT-1 in all the 4 CC cell lines, especially in SiHa and ME-180 CC cell lines. After analysis of the relationship between MALAT-1 levels and clinicopathological parameters from CC patients, a robust correlation could be obtained between MALAT-1 overexpression with lymph node metastasis, tumor differentiation and clinical stage. Furthermore, the ectopic expression of MALAT-1 increased cell proliferation and contributed directly to invasion and migration. CONCLUSION: Taken together, this study suggests an indispensible role played by MALAT-1 in CC progression, which may act as a potential prognostic indicator for CC and also could be a novel potential target for diagnosis of CC.

Analysis of the impact of platinum-based combination chemotherapy in small cell cervical carcinoma: a multicenter retrospective study in Chinese patients.

BACKGROUND: Small cell cervical carcinoma (SCCC) is a rare, aggressive tumor with a poor prognosis. However, information in relation to its treatment is scarce due to the limited numbers of patients. The aim of this study was to establish whether platinum-based combination chemotherapy may by beneficial in this patient population. METHODS: We carried out a multicenter, retrospective study comprising of 72 Chinese patients with SCCC. The patients were treated between 1995 and 2010 at Sun Yat-sen Memorial Hospital or the Cancer Center of Sun Yat-Sen University, and at the First Affiliated Hospital of Shantou University Medical College, China. RESULTS: Of the 72 patients, 46/72 (63.9%) had Federation of Gynecology and Obstetrics (FIGO) stage Ia-Ib2 and 26/72 (36.1%) had stage IIa-IV disease. Surgery was performed in 63/72 (87.5%) patients, 61/72 (84.7%) patients received chemoradiotherapy and 35/72 (48.6%) received radiotherapy. The 3-year overall survival (OS) and disease-free survival (DFS) rates were as follows: Ia (100%, 100%); Ib1 (62%, 57%); Ib2 (53%, 48%); IIa (36%, 23%); IIb (29%, 21%); IIIb (50%, 50%); and IV (0%, 0%), respectively. The estimated 3-year OS and DFS rates in patients who received platinum-based combination chemotherapy (etoposide + cisplatin [EP], or paclitaxel + cisplatin [TP]) as part of their adjuvant treatment were 64.8% and 63.0%, respectively, compared to 25.2% and 22.0% in those who did not (P = 0.0003; P = 0.0003). Univariate analysis showed that platinum-based combination chemotherapy was associated with improved survival compared to other chemotherapy techniques or no chemotherapy (OS: HR = 0.227; 95% CI, 0.099-0.524; P = 0.001; DFS: HR = 0.210; 95% CI, 0.087-0.506; P = 0.001). Multivariate analysis identified FIGO stage, lymphatic metastasis and platinum-based combination chemotherapy as independent prognostic factors for improved survival in patients with SCCC. CONCLUSIONS: Platinum-based combination chemotherapy (with EP or TP) can improve the 3-year survival outcomes in patients with SCCC. Therefore, it should be considered an important component in a future standardized treatment strategy for SCCC.

Low expression of long noncoding XLOC_010588 indicates a poor prognosis and promotes proliferation through upregulation of c-Myc in cervical cancer.

OBJECTIVE: The identification and investigation of cancer-associated long non-coding RNAs are important for understanding the molecular biology of cancer. The aim of the present study was to examine the expression pattern of lncRNA XLOC_010588 in cervical cancer and to evaluate its biological role and clinical significance in tumor progression. METHODS: We examined the expression of XLOC_010588 in 218 cervical cancer tissues and matched 218 adjacent normal tissues using real-time qRT-PCR. Over-expression and RNA interference approaches were used to investigate the biological functions of XLOC_010588. The effect of XLOC_010588 on proliferation was evaluated by MTT and BrdU assays. Western blot assays were used to investigate the molecular mechanism by which XLOC_010588 increases cervical cancer cell proliferation. RESULTS: The results showed that XLOC_010588 expression in cervical cancer was significantly downregulated. Decreased XLOC_010588 expression was correlated with FIGO stage, tumor size and SCC-Ag. Moreover, cervical cancer patients with XLOC_010588 lower expression have shown poorer prognosis. Multivariate Cox regression analyses showed that XLOC_010588 expression served as an independent predictor for overall survival. Ectopic expression of XLOC_010588 inhibited the proliferation of HeLa and SiHa cells. By contrast, knockdown of XLOC_010588 promoted the growth of HCC94 cells. Western blot assays confirmed that XLOC_010588 physically associates with c-Myc, consequently decreasing the expression of c-Myc. The expression of XLOC_010588 and c-Myc is strongly correlated in cervical cancer tissues. CONCLUSION: These results suggested that XLOC_010588 plays a pivotal role in cervical cancer cell proliferation via decreasing c-Myc expression and implicated the potential application of XLOC_010588 in cervical cancer therapy.

Overexpression of long noncoding RNA HOTAIR predicts a poor prognosis in patients with cervical cancer.

PURPOSE: The long noncoding RNA HOTAIR has been reported to be a good biomarker for poor prognosis in a variety of human cancers. However, whether HOTAIR could serve as novel biomarker to predict prognosis in cervical cancer or not is unknown. The aim of the present study was to examine the expression of HOTAIR in cervical cancers and to investigate the relationship between this lncRNA expression levels and existing clinicopathological factors and patient survival. METHODS: We examined the expression of HOTAIR in 218 cervical cancer tissues and matched 218 adjacent normal tissues using quantitative real-time RT-PCR and analyzed its correlation with the clinical parameters. RESULTS: The results showed that HOTAIR expression in cervical cancer tissues was significantly upregulated compared with the matched nontumorous tissues (P < 0.0001). Increased HOTAIR expression was significantly correlated with FIGO stage (P < 0.0001), lymph node metastasis (P < 0.0001), depth of cervical invasion (P < 0.0001), tumor size (P = 0.006) and age (P = 0.020), but not other clinical characteristics. Moreover, cervical cancer patients with HOTAIR higher expression have shown significantly poorer overall survival (P < 0.0001) and disease-free survival (P < 0.0001) than those with lower HOTAIR expression. Univariate (P < 0.0001, HR = 4.566, 95 % CI 2.122-9.825) and multivariate (P = 0.012, HR = 2.863, 95 % CI 1.263-76.490). Cox regression analyses showed that HOTAIR expression served as an independent predictor for overall survival. CONCLUSIONS: our data indicate that high expression of HOTAIR is involved in cervical cancer progression and could be a potential target for diagnosis and gene therapy.

[Correlation of sex hormones and parathyroid hormone with biochemical markers of bone turnover in aged men].

OBJECTIVE: To investigate the correlation of serum sex hormones and parathyroid hormone (PTH) with the biochemical markers of bone turnover in aged men. METHODS: We collected the laboratory data of 465 men aged 60- 93 (73. 1 +/- 8. 3) years old, who came for routine physical examinations in our hospital. We obtained the levels of serum follicle- stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), testosterone (T), sex hormone binding globulin (SHBG), PTH, 25-hydroxy-vitamin D3 (25(OH) D3), and bone turnover markers C-terminal telopeptide of type I collagen (CTX), osteocalcin (OC) and amino-terminal propeptide of type I procollagen (PINP). We also determined free testosterone (FT) , bioactive testosterone (BT) , testosterone secretion index (TSI) and FT index (FTI), and analyzed the correlation of each index with the biochemical markers of bone turnover. RESULTS: The concentrations of serum FSH, LH, and SHBG increased, while the levels of FT, BT, TSI, FTI, PTH, CTX, OC and PINP decreased with age, especially in those over 80 years old (P <0.05). PTH was positively correlated with CTX, OC and PINP (r =0. 227, 0. 269 and 0. 162, P <0. 01), even after the adjustment for age, while SHBG negatively correlated with OC (r = -0. 100, P <0.05). The bone turnover markers increased with the elevation of the PTH quartiles, with significant differences between the first and the fourth quartile (P <0. 01). Multiple stepwise regression analysis showed that age was correlated inversely with CTX, OC and PINP ( beta = -0. 126, -0. 141 and -0. 122, P <0.05) , PTH positively with the three markers (beta = 0. 196, 0.279 and 0.189; P <0. 001), and SHBG negatively with OC ( beta = -0. 100, P <0.05) . CONCLUSION: Aging is the fundamental cause of reduced bone turnover in aged men. The levels serum PTH and SHBG are significantly associated with the biochemical markers of bone turnover.

The Beneficial Effects of Dietary Astragali Radix Are Related to the Regulation of Gut Microbiota and Its Metabolites.

Astragali Radix (AR) or its extract has been used as an herbal medicine and dietary supplement in China, Europe, and the United States. The gut microbiota could provide new insights for exploring dietary supplements' underlying mechanism on organisms. However, no reports have focused on the regulatory effect of AR on the gut microbiota as a dietary supplement. In this study, healthy ICR mice of either sex were divided into AR and control (CON) groups and given AR water extract (4.55 mg/kg·day-1) or saline by gavage for 14 days, respectively. Then 16S rRNA gene sequencing and ultra-high-performance liquid chromatography quadrupole time-of-flight tandem mass spectrometry-based fecal metabolomics were integrated to investigate the benefits of dietary AR. Weighted gene coexpression network analysis was also introduced to investigate the metabolites with highly synergistic changes. AR supplementation influenced the structure of intestinal microflora, especially enriching short-chain fatty acid-producing bacteria g_Coprobacillus, g_Prevotella, and g_Parabacteroides. AR also significantly altered the fecal metabolome, mainly related to amino acid metabolism, nucleotide metabolism, and bile acid (BA) metabolism. Moreover, the increased secondary BAs and BA-sulfates might closely relate to intestinal microflora. These findings provide valuable insights for future research of dietary AR as a functional food.

[Influencing factors of glycemic variability in elderly patients with type 2 diabetes].

OBJECTIVE: To explore the influencing factors of glycemic variability in elderly patients with type 2 diabetes. METHODS: A total of 337 elderly patients received continuous glucose monitoring (CGM) from January 2007 to January 2011. The evaluation variables of glycemic variability included standard deviation of blood glucose (SDBG), mean amplitude of glycemic excursion (MAGE), absolute means of daily differences (MODD) and postprandial glucose excursion (PPGE). The normal reference value of glycemic variability was defined according to the diagnostic criteria of Chinese Diabetes Society guideline. RESULTS: The difference of glycemic variability was compared by gender, age and diabetic duration. The values of SDBG, MAGE, MODD and PPGE in females were all higher than those in males (P < 0.05) and no difference existed between various age groups. The level of glycemic variability increased gradually with the extension of diabetic duration (P < 0.01). Logistic regression analysis showed that gender (MAGE: OR = 0.44, P = 0.023; SDBG: OR = 0.39, P = 0.023), diabetic duration (MAGE: OR = 1.58, P = 0.006; SDBG: OR = 2.42, P < 0.001) and HbA1c (MAGE: OR = 2.44, P < 0.001; SDBG: OR = 2.68, P < 0.001) were significant influencing factors of glycemic variability (MAGE/SDBG) in elderly patients with type 2 diabetes (P < 0.05), but not age, body mass index (BMI) or diabetic neuropathy. CONCLUSION: Gender, diabetic duration and HbA1c are significant influencing factors of glycemic variability while age, BMI or diabetic neuropathy has no association with glycemic variability in elderly patients with type 2 diabetes.

[Different prevalence of impaired glucose tolerance between hyperinsulinemic and normoinsulinemic subjects].

OBJECTIVE: To study the impact of different insulin levels on the conversion from impaired glucose tolerance (IGT) to type 2 diabetes mellitus (T2DM), through analysis of different glycometabolism condition among quinquagenarian population. METHODS: Subjects enrolled were Beijing habitants who received annual physical examination [including oral glucose tolerance test (OGTT)] in the Chinese PLA General Hospital from 2005 - 2007. According to the OGTT results, the subjects were divided into three groups, including normal glucose tolerance-non-hyperinsulinemia group (NGT-NHIns), IGT-hyperinsulinemia group (IGT-HIns) and IGT-non-hyperinsulinemia group (IGT-NHINS). The prognosis between the year 2009 and 2010 of the three groups was observed. Hyperinsulinemia was diagnosed with fasting serum insulin ≥ 15 mU/L and/or 2-hour serum insulin ≥ 80 mU/L after glucose loading. RESULTS: The rate of case number of conversion to T2DM in IGT-NHIns group (42/133) was higher than that in IGT-HIns group (24/154) or NGT-NHIns group (12/126). The HOMA insulin resistance index (HOMA-IR) of individuals with IGT-NHIns was lower than that of IGT-HIns [0.96 (0.40, 3.53) vs 2.04 (0.59, 23.20), P < 0.05], while whole body insulin sensitivity index (WBISI) was higher than that of IGT-HIns [7.48 (3.20, 31.35) vs 3.28 (0.86, 7.67), P < 0.05]. Modified ß-cell function index (MBCI) and insulin secretion index (ISI) in IGT-NHIns was poorer than that of IGT-HIns respectively [2.57 (0.58, 10.98) vs 5.17 (1.04, 65.09); 7.66 (0.99, 28.40) vs 17.56 (4.18, 96.46), all P values < 0.01]. CONCLUSIONS: The risk of IGT-NHIns progressing into T2DM is higher than that of IGT-HIns. For the prevention of T2DM, individuals with IGT-NHIns should be paid more attention than keeping an eye on IGT-HIns patients. Early control of risk factors could protect ß cell function and prevent the progression to T2DM.

[Different establishing conditions of hyperinsulinemic-euglycemic clamp technique among different groups].

OBJECTIVE: To compare the different establishing conditions of hyperinsulinemic-euglycemic clamp technique among the groups of normal glucose tolerance (NGT), hyperinsulinemia with normal glucose (HINS) and impaired glucose tolerance (IGT). METHODS: The hyperinsulinemic-euglycemic clamp technique was applied to the study of methodology in 10 NGT, 11 HINS and 10 IGT subjects. Different establishing conditions were compared through variance analysis (ANOVA) among three groups. And the influencing factors resulting in these differences were analyzed through stepwise regression analysis. RESULTS: The serum insulin concentration of three groups were acutely raised and maintained at above 100 mU/L. During the steady stage, the blood glucose level remained stable and all coefficient variations were under 5%. The secretion of endogenous insulin and hepatic glucose production were completely inhibited during the test. Under these steady-state hyperinsulinemic-euglycemic conditions, the glucose infusion rate (M value) was equal to glucose disposal rate by all tissues in body, M value of three groups were as follows: (11.6 ± 1.7), (6.1 ± 1.9) and (6.0 ± 1.5) mg×kg(-1)×min(-1). During clamping, the peak and steady-state serum insulin concentrations of IGT and HINS groups were significantly higher than those of NGT group. Although the peak and steady-state serum insulin concentration of HINS group were higher than those of IGT group, the differences had no statistical significance (P = 0.34, 0.11). The independent influencing factor of peak serum insulin concentration was waist-to-hip ratio (WHR) while the independent influencing factors of steady-state serum insulin concentration included insulin metabolic clearance rate (MCR) and body mass index (BMI). The peak and steady-state serum insulin concentrations were not the independent influencing factors of M value. CONCLUSION: During the establishment of hyperinsulinemic-euglycemic clamp technique, the differences in peak and steady-state serum insulin concentrations existed among NGT, HINS and IGT groups. But the differences do not influence the use of M value in the evaluation of insulin resistance.

Diagnosing early scar pregnancy in the lower uterine segment after cesarean section by intracavitary ultrasound.

BACKGROUND: Early scar pregnancy (CSP) in the lower uterine segment after cesarean section is a type of ectopic pregnancy that can cause major complications if left untreated. Transabdominal ultrasound is a common procedure but is influenced by external factors. Thus, intracavitary ultrasound may have better diagnostic efficiency for CSP. AIM: To assess the value of intracavitary ultrasound for diagnosing CSP in the lower uterine segment after cesarean section. METHODS: Patients diagnosed with CSP in our hospital from October 2019 to April 2021 were recruited. Transabdominal and intracavitary ultrasound examinations were performed to compare the diagnostic differences for CSP and its types. RESULTS: Sixty-three patients were diagnosed during the study period. The diagnostic accuracy for CSP was higher in intracavitary ultrasound (96.83%) than in transabdominal ultrasound (84.13%) (P < 0.05). The missed diagnosis and misdiagnosis rates did not differ among the ultrasound types (intra: 0.00% and 3.17%; trans: 4.76% and 11.11%, respectively; P > 0.05). For the diagnostic rates for the CSP types, the rates for gestational sac (100.00% vs 90.48%), heterogeneous mass (93.75% vs 75.00%), and part of the uterine cavity (80.00% vs 60.00%) were higher in intracavitary ultrasound than in transabdominal ultrasound, but the difference was not statistically significant (P > 0.05). For gestational sac CSP patients, intracavitary ultrasound showed that the gestational sac was located in the lower uterine segment scar with abundant peripheral blood flow; the distance between the gestational sac and the serosal layer was 2.42 ± 0.50 cm. Intracavitary ultrasound for heterogeneous mass CSP patients indicated that the mass mainly occurred in the lower anterior uterine wall, protruding into the bladder, and was surrounded by abundant internal and peripheral blood flow; the distance between the mass and serosal layer was 1.79 ± 0.30 cm. For CSP type partly located in the uterine cavity, the gestational sac was partly located in the lower uterine cavity and partly in the scar with abundant internal and peripheral blood flow; the distance between the gestational sac and the serosal layer was 2.29 ± 0.28 cm. CONCLUSION: Intracavitary ultrasound had a higher diagnostic accuracy and application value for diagnosing CSP than transabdominal ultrasound, with reduced risk of missed diagnoses and misdiagnosis, thereby preventing delayed treatment.

[The correlation between hyperinsulinemia and pulse wave velocity].

OBJECTIVE: To study the correlation between hyperinsulinemia (HIns) and arteriosclerosis in one community in Beijing. METHODS: Subjects who received arteriosclerosis screening in physical examination annually were studied. All subjects were received 75g oral glucose tolerance test (OGTT) to evaluate glucose metabolic level, and brachial-ankle pulse wave velocity (baPWV) examination to evaluate arteriosclerosis. The correlation between hyperinsulinemia and pulse wave velocity was analyzed. RESULTS: Among all the 1046 subjects under investigation, baPWV of subjects with HIns was higher than subjects with normoinsulinemic (NIns) in different glucose metabolism status [normal glucose tolerance, (1381.2 ± 280.8) cm/s vs (1280.3 ± 218.7) cm/s; imparied glucose regulation, (1557.5 ± 319.3) cm/s vs (1474.7 ± 305.1) cm/s; diabetes, (1764.3 ± 476.6) cm/s vs (1664.2 ± 374.6) cm/s], especially in subjects with normal glucose tolerance (P < 0.01). The prevalence of cardiovascular risk factors in subjects with HIns was much higher than subjects with NIns (P < 0.01). Multiple logistic regression analysis showed that hyperinsulinemia was the risk factor of arteriosclerosis, and the OR (95%CI) of subjects with HIns was 1.91 (1.169 - 3.105, P < 0.01) as compared to the subjects with NIns. CONCLUSION: The subjects with HIns suffered from much more metabolic risk factors than NIns. Hyperinsulinemia that closely correlated with baPWV was a risk factor of arteriosclerosis.