Objective To study the advances in microcirculation after islets of Langerhans transplantation (ILT). Methods The literature in the recent years on the study of the relationship between ILT and microcirculation was reviewed. Results The process of angiogenesis and revascularization of the islet grafts was in progress within 1 week after transplantation, and was completed within 10-14 days after transplantation, exhibiting a microangioarchitecture similar to pancreatic islets in situ. The sequence of vascular intraislet cellular perfusion was from β cells outward to α-and δ-cell cortex, with the majority of α cells perfused before the majority of δ cells. Freely transplanted islet grafts were revascularized from the hostderived microvascular bed. The interstitial pressure in the islet transplants was markedly lower than the capillary pressure. There were clearly differences in microcirculation between syngeneic and xenogeneic islet grafts. The phenomena of microcirculation failure were observed in xenografts. The influential factors of microcirculation after ILT were ①culture temperature of isolated islets, ②cultured time and cryopreserved method of islets, ③blood glucose, ④immunosuppressive agents, ⑤angiogenesis factors. Conclusion Microvascularization of freely islet grafts is one of the essential requirements for successful engraftment, guaranteeing sufficient nutritional blood supply to the tissue and establishing blood drainage for adequate liberation of the endocrine hormones. Through the studies of the microcirculation after ILT, it is helpful to recognize the mechanism of the survival of islet grafts.
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)
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。
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.
Objective To explore the ability of insulin-like growth factor-Ⅰ (IGF-Ⅰ) and hyaluracan acid in prompting chondrogenesis of engineering cartilage tissue.Methods Human articular chondrocytes were isolatedand cultured in DMEM plus 10% fetal bovine serum. They were divided into three groups：hyaluracan acid+chondrocytes + IGF-Ⅰ group(IGF-Ⅰ group), hyaluracan acid+chondrocytes group(cell group), hyaluracan acid group(control group). The ability of chondrogenesis was investigated by HE and toluidine blue staining, human collagen Ⅱ immunohistochemistry and reverse transcription polymerase chain reaction (RT-PCR).Results Both cell group and IGF-Ⅰ group could develop into cartilage tissue in the sixth week while control group could not. The number of cartilage lacuna in IGF-Ⅰ group were more than that in cell group. Human collagen Ⅱ immunohistochemistry showed that there were ber positive cell in IGF-Ⅰ group than in cell group, collagen Ⅱ mRNA expression was more higher and collagen Ⅰ mRNA expression was lower in IGF-Ⅰ group than in cell group. Conclusion Insulin growth factorⅠ can prompt chondrogenesis of engineering cartilage tissue and ameliorate the quality of engineering cartilage tissue in vitro.
Objective To detect the difference of the light sensitivity in the central visual field between normal people and type Ⅱ diabetic patients without diabetic retinopathy, and evaluate the effect of perimetric examination in early diagnosis of diabetic retinopathy. Methods The light sensitivity at the 80 locations in the central field was measured by Dicon field analyzer (model TKS-4000) in 76 normal eyes of 44 normal volunteers aged from 45 to 72 years and 75 eyes of 40 type Ⅱ diabetic patients without retinopathy aged from 46 to 71 years. Results For the diabetic patients without diabetic retinopathy, the light sensitivity of locations decreased by 4-8 dB,and there were some decreased light sensitivity areas. The mean light sensitivity of three zones of the central field had significant reduction in the diabetic patients as compared with the control group(Plt;0.001). Conclusion The retinal neurosensory function of diabetic patients is damaged in some degrees before diabetic retinopathy occured, and no relationship is found between the decrease of retinal light sensitivity and localized blood-retinal barrier leakage. It is suggested that examination of central field with computerized perimetry has certain clinical significance in early diagnosis of diabetic retinopathy. (Chin J Ocul Fundus Dis, 2002, 18: 218-220)
【Abstract】 Objective To explore good methods for isolation and purification of rat islets. Methods The isletswere isolated from male SD rat pancreata by a collagenase perfusion method and purified by a modified method: added 4 kinds of Euro-Ficoll of different densities (F1: D=1.132, F2: D=1.108, F4: D=1.069, F5: D=1.023), discontinuous density gradient centrifuge the tube at 2 000 r/min for 20 minutes at 4℃ , then the islets between F1 and F2 were collected. The purity of islets was assessed by dithizone staining with islets counted and scored for size. Islets viabil ity was assessed by fluorescin diacetate / propidium iodide. The function of purified islets was judged by the test of insul in release and islets transplantation. Results After an improved method for optimized isolation and purification, (920±122) IEQ purified islets were obtained from one rat. Both the purity and viabil ity of islets were over 90%. The amount of insul in secretion was (18.25±0.32) mU/L and (36.70±3.57) mU/Lat 2.2 mmol/ L and 22.2 mmol/L concentration of glucose respectively, there was significant difference between the two phases(P lt; 0.05). The insul in release index was 2.01±0.15. Under 1 000 IEQ islets transplantation, the normal glucose level could beremained in diabetic rats. Conclusion High purity and high viabil ity islet cells can be got through improved collagenase perfusion and centrifugation on gradients method.
摘要:目的:了解甘精胰岛素联合二甲双胍治疗对口服降糖药血糖控制不理想的2型糖尿病患者的疗效和安全性。方法:对30例口服降糖药血糖控制不理想的2型糖尿病患者给与甘精胰岛素联合二甲双胍治疗,共12周。治疗前后测身高、体重、空腹血糖(FPG)、餐后2小时血糖(PPG)以及糖化血红蛋白(HbA1c)水平。了解治疗期间低血糖发生情况。结果:治疗后的FPG、PPG以及HbA1c水平明显下降,分别下降了303mmol/L、510mmol/L和198%,差异有统计学意义(Plt;005)。治疗后5330%的患者HbA1c水平lt;70%。治疗前HbA1c水平≥70%lt;90%的患者,治疗后706%的患者HbA1c水平lt;70%,治疗前HbA1c水平≥90%的患者,治疗后307%的患者HbA1c水平lt;70%,两者的HbA1c达标率有明显差异(Plt;005)。治疗前后体重及BMI无明显差异(Pgt;005)。30例患者中仅发生两次轻微低血糖。结论:甘精胰岛素联合二甲双胍治疗对口服降糖药治疗血糖控制不理想的2型糖尿病患者是安全有效的,尤其是对HbA1c水平lt;90%的患者,血糖控制更好,达标率更高。
ObjectiveTo investigate whether transplantation of islet cells combined with bone marrow mesenchymal stem cell (BMSCs) of the pancreatic subcapsular promoting revascularization of pancreatic islets in rats, so as to reduce the loss of islet cells after transplantation and improve the success rate of islet cell transplantation. MethodsThe model of diabetic rat was established. The BMSCs and islet cells were cultured and identified, then the simple islet cells, simple BMSCs, and combination of islet cells and BMSCs were injected into the pancreatic subcapsular of the islet cell group, BMSCs group, and combination group, respectively. In addition, the same amount of normal saline was injected into the same site as the control group. There were 10 rats in each group. The changes of blood glucose and serum insulin in different time point were detected in each group. The mRNA expressions of angiogenesis factors such as hypoxia inducible factor-1α (HIF-1α), stromal cell derived factor 1α (SDF1α), vascular endothelial growth factor (VEGF), and basic fibroblast growth factor 2 (FGF2) were determined by real-time quantitative PCR. Results① The blood glucose levels of the islet cell group and combination group were lower than those of the control group and the BMSCs group within 15 d after surgery (P<0.05) and decreased to the normal level, which of the combination group could still maintain the normal level until on day 29 (P<0.05), but which of the islet cell group began to increase on day 15 after surgery and was similar to that in the BMSCs group (P>0.05). ② Compared with the control group and the BMSCs group, the insulin levels were higher in the islet cell group and combination group on day 1, 3, 7, 15, and 29 after surgery (P<0.05), especially in the combination group. ③ The expression levels of HIF-1α, SDF1α, VEGF, and FGF2 mRNAs in the combination group were higher than those the other three groups, and the differences were statistically significant (P<0.05). ConclusionsIslet cell transplantation of pancreatic subcapsular could decrease blood glucose level in diabetic rats. Hypoglycemic effect of single islet cell transplantation gradually weakens on day 15 d after surgery. After BMSCs combined with islet cells transplantation, the glycemic effect of rat is stable for a longer time. Expressions of angiogenesis factors of BMSCs combined with islet cells transplantation rat are high, which combined with pathological sections suggests that BMSCs could promote vascular recanalization of islet transplantation.