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Risk factors of proliferative diabetic retinopathy in type 2 diabetes

ObjectiveTo explore the morbidity rate and risk factors of proliferative diabetic retinopathy (PDR) in type 2 diabetes.MethodsThe clinical data of patients, with PDR in 2739 consecutive cases of type 2 diabetes diagnosed in this hospital from 1994 to 2001 were analyed retospectively. The diagnosis of diabetic retinopathy (DR) was confirmed by ophthalmoscopy and fundus fluorescein angiography (FFA). Blood pressure, fasting and postprandial blood sugar, glycosylated haemoglobin（HbA1c）, total serum cholesterol, triglyceride, creatinine, and albumin excretion rate were measured.ResultsThe morbidity rate of type 2 DR was 27.8%（761/2739）, and the morbidity rate of PDR was 4.2%（114/2 739） occupying 15% of the patients with DR. The duration, fasting blood sugar, glycosylated haemoglobin, blood pressure and albumin excretion rate were much higher than those in the control（P＜0.01, glycosylated haemoglobin P＜0.05）. The independent risk factors of PDR were duration of the disease （r=0.15, P＜0.01） and albumin excretion rate （r=0.08, P＜0.05）. The risk factors of PDR were albumin excretion rate and fasting blood sugar (r=0.13, P＜0.05) in patients with longer duration(≥5 years). The morbidity rate of PDR was 2.3%, 5.9% and 12.4% in patients with duration less than 5 years, 5 to 10 years and over 10 years groups, respectively. The morbidity of PDR of the patients in normal albuminuria, microalbuminuria and overt albuminuria group was 2.1%、5.3% and 18.8% respectively.ConclusionsType 2 diabetes accompanied with PDR is relative to the duration of the diabetes, albumin excretion rate, fasting blood sugar, blood pressure, and glycosylated haemoglobin, in which the duration of the disease, albuminuria and fasting blood sugar are the risk factors of occurance of PDR. (Chin J Ocul Fundus Dis, 2003,19:338-340)

Location Diagnosis and Treatment of Insulinoma (Report of 38 Cases)

目的　正确评价胰岛素瘤的各种定位诊断方法和各种手术治疗方法。 方法　回顾性分析吉林大学第一医院普外科与吉林省肿瘤医院普外科1985年6月至2005年6月期间诊治的38例胰岛素瘤的临床资料，系统评价术前超声、术中超声、术前CT及术前增强CT定位诊断方法。结果　术前超声、术前CT、术前增强CT及术中超声检查其确诊率分别为47.4%、51.5%、85.7%及100%。行肿瘤局部摘除术21例，单纯远端胰腺切除术14例，远端胰腺切除术联合脾摘除3例。结论　胰岛素瘤的术前定位诊断较困难，术前超声与术前CT在术前定位诊断方面差异无统计学意义，术前增强CT能够明显提高胰岛素瘤的术前诊断率，术中超声是胰岛素瘤最有效的定位诊断方法。行肿瘤摘除术是治疗良性胰岛素瘤的最佳方式，能够降低术后并发症发生率。多发性胰岛素瘤或恶性胰岛素瘤应行胰腺次全切除术以避免复发，必要时可联合脾脏摘除。

The in Vitro Study of A14125IInsulin Combining with Receptor on Rat H22 Hepatocarcinoma Cell Membrane

Objective To investigate the insulin receptor expression and binding characteristics of H22 rat hepatic cancer cell membrane with 125Iinsulin and the possibility of using insulin as a carrier for the receptor mediated targeted therapy. MethodsInsulin was radiolabelled using ChT method, isolated and purified by polyacrylamide gel electrophoresis, the labelled 125Iinsulin was measured by specific activity selfreplacement and over dose receptor combination experiment. The rat H22 hepatocarcinoma cells, normal rat hepatic cells were made, continuing the value Kd and Bmax of 125Iinsulin binding with insulin receptor on rat H22 hepatocarcinoma and normal hepatic cells membrane were evaluated in vitro, the competed binding curve was pictured. The binding Kd and Bmax value of 125Iinsulin receptor were evaluated with t test and receptor binding curve was tested with Scatchard method. ResultsThe Bmax value of rat H22 hepatocarcinoma cell receptor ［(5.6±1.1) pmol/106 cell］ was higher than that of normal hepatic cell ［(3.2±0.8) pmol/106 cell］ significantly (P＜0.05). The Kd value of H22 cell ［high and lowaffinity vs (1.8±0.6) nmol/L and (32.0±10.7) nmol/L］ and normal hepatic cell ［high and low affinity vs (2.1±0.9) nmol/L and (37.0±12.3) nmol/L］ were not significant respectively. In this experiment, it was specific when 125Iinsulin combined with receptor on H22 hepatocarcinoma cell and rat normal hepatic cell membrane. Conclusion This experiment showed that the receptor expresses much more significantly on H22 hepatocarcinoma cell membrane than that on normal rat hepatic cell membrane, 125Iinsulin combining with receptor on H22 hepatocarcinoma cell and rat hepatic cell membrane is highly specific. We may use insulin as an anticancer carrier to mediate insulin combined with receptor on hepatocarcinoma cell membrane in the target treatment of hepatic cancer.

THE EXPRESSION OF IGF 1 AND ITS RECEPTOR IN CULTURED TENDON CELL

In order to study the expression change of insulin-like growth factor-1 (IGF-1) and its receptor genes in different generations of tendon cell in culture, Dig-labeled synthesized oligonucleotide probes were used to detect the mRNA expression in primary, 6th and 13th generation of tendon cell. The results showed that IGF-1 receptor mRNA was expressed in all of the 3 above generation tendon cells. IGF-1 mRNA was expressed only in primary and 6th generation cells. Tendon cell of 13th generation did not express IGF-1 mRNA. It might suggest that the absence of IGF-1 mRNA expression be one of the causes which led to the decrease of reproductive ability of 13th generation tendon cell.

Relation between Diabetes and Pedopathy of Type II Diabetes and Insulin Resistance

摘要:目的:探讨2型糖尿病合并糖尿病足患者与胰岛素抵抗的关系。方法:205例2型糖尿病患伴糖尿病足患者作为观察组,无足部病变的糖尿病患者作为对照组,观察其体重指数、空腹血糖、胰岛素、血脂等指标,两组间进行比较并相关性分析、多元回归分析。胰岛素抵抗指数(HOMAIR)=FPG×FIns/22.5。结果:糖尿病足患者的HOMAIR显著高于无糖尿病的患者(Plt;0.05)。多元回归分析显示糖尿病病程、LDL及BMI是影响2型糖尿病足患者胰岛素抵抗的主要危险因素。结论:糖尿病足患者存在着更严重的胰岛素抵抗。Abstract: Objective: To discuss the relationship between diabetes and pedopathy of type II diabetes and insulin resistance. Methods:The diabetes type II patients were divided into group A (combined with pedopathy) and group B (without pedopathy). The blood glucose and insulin of empty stomach, BMI,Alc and lipid were detected. The insulin resistance index (HOMAIR) was calculated and compared between two groups. Results:The HOMAIR was higher in group A than that in group B (Plt;0.05).The duration of disease,LDL and BMI was positive related with diabetes pedopathy. Conclusion:The insulin resistance was more worse in pedopathy of Type II diabetes.

Advances in Research of MicroRNA in The Pathogenesis of Type 2 Diabetes

Objective　To summarize the relationship of diabetes and its complications with microRNA. Methods　Domestic and international researches were collected by searching to summarize the role of microRNA in diabetes and its complications. Results　MicroRNA could affect the secretion of insulin and interfer metabolism of gulcose in fat cells， muscle cells， and liver cells， which resulting in insulin resistance. At the same time， the microRNA also played an role in damage of vascular endothelial cells and myocardial cell in diabetes. Conclusion　MicroRNA acts an important role in the process of diabetes and its complications.

妊娠期糖尿病胰岛素治疗特点及对母婴结局的影响

摘要： 目的：研究妊娠期糖尿病（GDM）胰岛素治疗特点及对母婴结局的影响。方法：回顾性总结我院住院分娩的妊娠期糖尿病患者胰岛素治疗特点，并与饮食治疗（对照组）对比，分析胰岛素治疗（研究组）对母婴结局的影响。结果：胰岛素使用率23.29%，随孕周增加逐渐增加（Plt;0.05），使用剂量及方法个体差异较大。两组孕妇年龄、分娩孕周、新生儿体重差异无显著性（Pgt;0.05）。研究组孕妇酮症、胎膜早破发生率较对照组减少(Plt;0.05）；妊高症、胎儿窘迫、羊水过多、剖宫产、巨大儿、低体重儿、新生儿窘迫、早产儿发生率差异无显著性（Pgt;0.05）。结论：胰岛素使用应遵循个体化原则，及时正确加用胰岛素可有效控制血糖、改善母婴预后。

Long-acting Insulin Analogues Similar to Regular Forms

Experimental study on injection completion rate and performance for needle-free insulin injection

As a relatively novel technique for drug delivery, the needle-free injection technique is characterized by transporting the drug liquid to the designated subcutaneous position through a high-speed micro-jet. Although this technique has been applied in many fields, the research on its drug dispersion mechanism and injection performance is insufficient. The presented study aims to identify critical parameters during the injection process and describe their influence on the injection effect. The injection completion rate and performance of a needle-free injector under various operating conditions were compared based on mouse experiments. The results show that the nozzle diameter imposes a more significant influence on jet characteristics than other injection parameters. Moreover, the injection completion rate increases with the nozzle diameter. The nozzle diameters of 0.14 mm and 0.25 mm correspond to injection completion rates of 89.7% and 95.8%, respectively. Furthermore, by analyzing the rate of blood glucose change in the tested mice, it is found that insulin administration through the needle-free injection can achieve a drug effect duration longer than 120 min, which is better than that obtained using conventional needle-syringe technique. In summary, the obtained conclusions can provide an important reference for the optimal design and extending application of the air-powered needle-free injector.

Insulin-Like Growth Factor-1 Receptor Overexpression in Pretreatment Biopsies Predicts Response of Rectal Cancer to Preoperative Radiotherapy

ObjectiveTo evaluate the possible role of the expression of insulin-like growth factor-1 receptor (IGF-1R) in determining rectal cancer radiosensitivity. MethodsThe paired preradiation biopsy specimens and postoperative specimens were obtained from 87 patients with rectal cancer in the department of digestive tumor surgery, Jiangsu Province Hospital of Traditional Chinese Medicine, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from January 2009 to December 2010. The IGF-1R expression was examined by immunohistochemistry (IHC) and reverse transcription-polymerase chain reaction (RT-PCR). The tumor radiosensitivity was defined according to Rectal Cancer Regression Grade, then the relation between the IGF-1R expression and tumor radiosensitivity was evaluated. ResultsCompared with the preradiation biopsy specimens, IGF-1R expression significantly increased in the paired postoperative specimens of the residual cancer cells (Plt;0.001). The IHC result demonstrated IGF-1R overexpression was significantly associated with a poor response to radiotherapy (rs=0.401, Plt;0.001); RT-PCR detection of IGF-1R expression on preradiation biopsy specimens also showed that IGF-1R mRNA negative patients had a higher radiation sensitivity (rs=0.497, Plt;0.001). ConclusionDetection of IGF-1R expression may predict radiosensitivity of preoperative irradiation for rectal cancer.