Objective To observe the effect of diabetic retinopathy on endothelial progenitor cells (EPCs) from peripheral blood. Methods Sixty male Wistar rats were divided into control group and diabetes group. The rats in diabetes group were induced with streptozotocin (STZ) injection for diabetic retinopathy model. Flow cytometry was used to identify and count the number of EPCs from peripheral blood at 1 week, 1, 3 and 6 months after injection. All eyeballs were examined by hematoxylin and eosin (HE) staining, periodic acidSchiff's (PAS) staining of trypsin-digested retinal vessels flat preparation and transmission electron microscope. EPCs count, and the relationship between DR morphological changes and EPCs count were compared and analyzed. Results The quantity of EPCs from peripheral blood at 1 week, 1, 3 and 6 months after STZ injection were 25plusmn;7, 28plusmn;8, 39plusmn;7, 43plusmn;7 cells per 200 000 monocytes respectively, which decreased compared with the control group 45plusmn;4 cells per 200 000 monocytes (F=8.933，Plt;0.01). The quantity of EPCs was gradually increased at 1 week, 1, 3 and 6 months after STZ injection, accompanied with responsive pathological changes of retinal structure and vessels. The thickness of retina at 1 week and 1 month after injection were reduced slightly. The number of retinal ganglion cells reduced, with the time passing by. Endothelial cells were edema, mitochondrial was swollen, capillary basement membrane was thicken, lumen was significant stenosis, lumen occlusion and retinal artery aneurysm were observed at 6 months after STZ injection. Conclusion The number of EPCs increases gradually throughout the development of DR.
Objective To evaluate the change of blood sugar in diabetic patients after vitrectomy and analyze the relative reasons. Methods Nineteen diabetes II patients (20 eyes) who underwent vitrectomies received the tests of blood sugar preoperatively, and 1～2 hours, 1, 3, and 5 days postoperatively. Analysis of variance, apaired Studentrsquo;s t-test, and correlation analysis were used to analyze the change of postoperative blood sugar and correlation between postoperative blood sugar change and its relative factors. Results Postoperative blood sugar increased significantly compared with the preoperative one (Plt;0.05),reached the peak 1～2 hours postoperatively, and reached almost the preoperative level 5 days postoperatively (Pgt;0.05). There was a positive correlation between blood sugar increase and operation time, preoperative blood sugar level, and diabetic duration (Plt;0.05). Postoperative blood sugar was relative to potentiated anesthesia. Conclusion There is a regularity that blood sugar increases just postoperatively and reaches the preoperative level 5 days postoperatively. The relative factors to blood sugar change include preoperative blood sugar level, diabetic duration, operation time, and potentiated anesthesia. (Chin J Ocul Fundus Dis,2000,16:157-159)
ObjectiveTo observe and analyze the correlation between time within target glucose range (TIR) and hemoglobin A1c (HbA1c) and the risk of diabetic retinopathy (DR). MethodsA retrospective clinical study. From March 2020 to August 2021, 91 patients with type 2 diabetes mellitus (T2DM) who were hospitalized in Department of Endocrinology and Metabolic Diseases, Affiliated Hospital of Weifang Medical University, were included in the study. All patients underwent Oburg's no-dilatation ultra-wide-angle laser scan ophthalmoscopy, HbA1c and continuous glucose monitoring (CGM) examinations. According to the examination results and combined with the clinical diagnostic criteria of DR, the patients were divided into non-DR (NDR) group and DR group, with 50 and 41 cases respectively. The retrospective CGM system was used to monitor the subcutaneous interstitial fluid glucose for 7 to 14 consecutive days, and the TIR was calculated. Binary logistic regression was used to analyze the correlation between TIR, HbAlc and DR in patients with T2DM0. At the same time, a new indicator was generated, the predicted probability value (PRE_1), which was generated to represent the combined indicator of TIR and HbA1c in predicting the occurrence of DR. The receiver operating characteristic curve (ROC curve) was used to analyze the value of TIR, HbAlc and PRE_1 in predicting the occurrence of DR. ResultsThe TIR of patients in the NDR group and DR group were (81.58±15.51)% and (67.27±22.09)%, respectively, and HbA1c were (8.03±2.16)% and (9.01±2.01)%, respectively. The differences in TIR and HbA1c between the two groups of patients were statistically significant (t=3.501,－2.208; P=0.001, 0.030). The results of binary logistic regression analysis showed that TIR, HbA1c and DR were significantly correlated (odds ratio=0.960, 1.254; P=0.002, 0.036). ROC curve analysis results showed that the area under the ROC curve (AUC) of TIR, HbA1c and PRE_1 predicting the risk of DR were 0.704, 0.668, and 0.707, respectively [95% confidence interval (CI) 0.597-0.812, P=0.001; 95%CI 0.558-0.778, P=0.006; 95%CI 0.602-0.798, P=0.001]. There was no statistically significant difference between TIR, HbA1c and PRE_1 predicting the AUC of DR risk (P>0.05). The linear equation between HbAlc and TIR was HbAlc (%) = 11.37－0.04×TIR (%). ConclusionsTIR and HbA1c are both related to DR and can predict the risk of DR. The combined use of the two does not improve the predictive value of DR. There is a linear correlation between TIR and HbAlc.
ObjectiveTo investigate the relationship between glucose metabolism and endocannabinoid system (ECS) in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS).MethodsA total of 64 OSAHS patients (18 cases of mild OSAHS, 24 cases of moderate OSAHS, 22 cases of severe OSAHS) and 24 controls were included in the study. Body mass index, waist circumference, fasting blood lipids, fasting blood glucose, fasting blood insulin, homeostasis model of assessment for insulin resistance index (HOMA-IR), polysomnography and endogenous cannabinoid receptor 1 (CB1R) protein expression levels in peripheral blood mononuclear cells (PBMC) were measured in participants.ResultsThe incidence of diabetes and impaired fasting glucose (IFG) in the OSAHS group was significantly higher than that in the control group (28.12% vs. 8.33%). With the increase of apnea hypopnea index (AHI), HOMA-IR and the expression levels of CB1R protein increased gradually (HOMA-IR: 2.40±0.90, 2.34±0.59, 2.94±0.99, 3.46±0.77, respectively; CB1R protein: 0.04±0.01, 0.37±0.09, 0.40±0.07, 0.62±0.14, respectively). Correlation analysis showed that HOMA-IR, AHI and the expression of CB1R protein were significantly positively correlated with each other (P<0.05).ConclusionOSAHS patients are prone to insulin resistance, IFG and diabetes mellitus, which are closely related to the activation of ECS induced by OSAHS.
ObjectivesTo evaluate the quality of health information on diabetes in Chinese internet, so as to understand the current status of diabetes network health information, and provide reference for improving and enriching the three-level prevention of diabetes.MethodsThe three most common Chinese search engines: Baidu, Sogou and Haosou Search were searched with the keywords " diabetes” and " diabetes treatment”, using the health information evaluation tool DISCERN score to evaluate the quality of the information, and the integrity and accuracy of information content were evaluated with reference to the " Guidelines for the Prevention and Treatment of Type 2 Diabetes in China (2017 Edition)” issued by the Chinese Diabetes Society of Chinese Medical Association.ResultsA total of 300 links were accessed and included in 17 websites. The DISCERN review showed that only 1 item's average score exceeded 3 points. According to website content score, the excellent part accounted for 11.7%, the good part accounted for 35.2%, the fair part accounted for 47.1%, and the poor part accounted for 5.8%. 50% of websites contained error messages, and the subject of the most error-prone information was diagnosis and treatment. There was a positive correlation between the content score and the DSCERN score in the credibility score and the verbosity score (r=0.71, 0.73, P<0.001). The websites were evaluated by attributes, and the quality evaluation of diabetes-related information in some general-purpose websites was higher than that of diabetes specialist websites.ConclusionsThe quality of diabetes health information on Chinese websites is insufficient. It is necessary for China to establish a web-based information platform for diabetes. China has not yet formed a unified network health information evaluation standard in line with its national conditions. The key to solving the problem lies in the collaboration between professional health personnel and website developers.
Objective To assess the efficacy and safety of rosiglitazone in treating type 2 diabetes mellitus (T2DM) with essential hypertension (HBP). Methods Such databases as The Cochrane Library (Issue 4, 2009), PubMed (1970 to May 2010), CBM (1978 to May 2010), CNKI (1996 to May 2010), WanFang Database (1999 to May 2010), VIP (1996 to May 2010), and Google Scholar were searched on computer, and the relevant journals such as Chinese Journal of Diabetes Mellitus were also hand researched to investigate references and collect randomized controlled trials (RCTs) about rosiglitazone (experimental group) compared with non-rosiglitazone (control group) in treating T2DM with HBP. The data were extracted according to the inclusion and exclusion criteria by two reviewers independently, the quality of the included studies was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions Version 5.0, and meta-analysis was conducted by using RevMan 5.0 software. Results Among 10 RCTs involving 738 patients, one was in English from Greece, while nine were in Chinese. The average score quality of the included studies was in C level. The results of meta-analyses showed that the experimental group was more effective than the control group in lowering blood pressure levels (SBP: WMD= –17.83 mmHg, 95%CI –27.63 to –8.02; DBP: WMD=–7.81 mmHg, 95%CI –10.18 to –5.44), blood glucose levels (FBG: WMD= –1.66 mmol/L, 95%CI –3.08 to –0.23; PBG: WMD= –2.38 mmol/L, 95%CI – 4.12 to –0.64), triglyceride (TG) levels (WMD= –0.29 mmol/L, 95%CI –0.43 to –0.14), low-density lipoprotein cholesterol (LDL-C) levels (WMD= –0.76 mmol/L, 95%CI –1.02 to –0.50), insulin levels (FINS: WMD= –7.06 mU/L, 95%CI –9.47 to –4.65; PINS: WMD= –98.86 mU/L, 95%CI –116.38 to –81.34), glycosylated hemoglobin (HbA1c) levels (WMD=–0.75%, 95%CI –1.07 to –0.42), and insulin resistance index (HOMA-IR) (WMD= –1.61, 95%CI –2.18 to –1.05); the experimental group was more effective than the control group in increaseing the high-density lipoprotein cholesterol levels (HDL-C) (WMD=0.21 mmol/L, 95%CI 0.12 to 0.30), and insulin sensitivity index (ISI) (WMD=1.64, 95%CI 1.48 to 1.80); the therapeutic effect for hypertension was greater in the experimental group than in the control group (OR=9.35, 95%CI 4.76 to 18.35); there were no significant differences in cholesterol levels (TC) (WMD= –0.22 mmol/L, 95%CI –0.55 to 0.10), body mass index (BMI) (WMD= –0.26 kg/m2, 95%CI –0.86 to 0.33), heart rates (HR) (WMD=0.50 bpm, 95%CI –4.98 to 5.98), and urine albumin excretion (UAE) (WMD= –16.00mg/24h, 95%CI –37.90 to 5.90); additionally, there were also no significant differences in adverse reactions between the two groups, such as edema (OR=3.01, 95%CI 0.62 to 14.54), gastro-intestinal discomfort (OR=1.19, 95%CI 0.63 to 2.24), headache and fatigue (OR=9.79, 95%CI 0.51 to 186.95), and anemia (OR=2.38, 95%CI 0.09 to 59.90). Conclusion To treating patients suffering from T2DM with HBP, the rosiglitazone is much effective than the control group in lowering blood pressure, blood glucose and lipid, reducing insulin resistance and improving β-cell function.
ObjectiveTo explore the influence factors of gallstone. MethodsClinical data of 511 patients who were admitted to our hospital from Apr. 2015 to Apr. 2016 were retrospectively analyzed. ResultsOf 511 patients, there were 274 patients with gallstone (gallstone group) and 237 patients without gallstone (control group). Univariate analysis results showed that, no significant difference of age, gender, and diabetes was found between gallstone group and control group (P > 0.050), but the levels of serum total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL-C), and fasting blood glucose (FBG) were significantly higher in patients of gallstone group (P < 0.050), but the level of serum high density lipoprotein (HDL-C) was significantly lower in patients of gallstone group (P=0.001). Logistic regression results showed that four factors including diabetes〔OR=4.491; 95% CI is (2.021, 9.976); P < 0.001〕, the serum TC〔OR=2.548; 95% CI is (1.944, 3.338); P < 0.001〕, HDL-C〔OR=0.115; 95% CI is (0.056, 0.237); P < 0.001〕, and FBG〔OR=1.277; 95% CI is (1.086, 1.502); P=0.003〕 entered the final regression model after controlling confounding factors. The results showed that patients who combined with diabetes, high levels of serum TC and FBG, and low level of serum HDL-C, had higher ratio of galls-tone. ConclusionDiabetes, high-level of serum TC and FBG, low-level of serum HDL-C were risk factors of gallstone.
ObjectiveTo systematically review the efficacy of amlodipine versus valsartan in the treatment of diabetes mellitus combined with hypertension and renal impairment. MethodsAll relevant randomized controlled trials (RCTs) were retrieved in WanFang Data, CNKI, VIP, CBM, The Cochrane Library (Issue 10, 2013), PubMed, EMbase and Ovid up to October 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of included studies. Then meta-analysis was performed using RevMan 5.2. ResultsNine RCTs were finally included involving 794 cases. The results of meta-analysis showed that amlodipine was better than valsartan in improving 24-hour proteinuria (basic level < 1 000 mg:WMD=-10.24, 95%CI-18.52 to-1.95, P=0.02; basic level > 1 000 mg:WMD=-575.69, 95%CI-781.02 to-370.36, P < 0.000 01). However, there was no significant difference between two groups in lowing urine albumin excretion rates (UAER), serum creatinine (Scr), systolic blood pressure (SBP), diastolic blood pressure (DBP), and incidences of adverse events (UAER:WMD=-11.29, 95%CI-27.93 to 5.36, P=0.18; Scr:WMD=1.05, 95%CI-3.89 to 5.99, P=0.68; SBP:WMD=0.52, 95%CI-0.83 to 1.87, P=0.45; DBP:WMD=-0.40, 95%CI-1.41 to 0.62, P=0.44; ADR:WMD=1.00, 95%CI 0.3 to 3.34, P=1.00). ConclusionCurrent evidence shows that, compared with valsartan, amlodipine has the same efficacy in treatment of diabetes mellitus combined with hypertension and renal impairment, and it is even better in improving 24-hour proteinuria.
Objective To investigate the medical charge of in-patients with diabetes and its influencing factors for effective hospital costs controlling. Methods The inpatients with diabetes (the first diagnosis was diabetes; the first three ICD-10 codes of which were between E10 to E14) in Fifth Peoples' Hospital of Chengdu during January to September of 2014 were analyzed for their hospital costs with descriptive statistical method, ANOVA and multiple linear regression method. Statistical analysis was conducted by using SPSS 18.0 software. Results A total of 1 389 cases of diabetes were included. The median of total medical costs and daily costs were 4 554.45 yuan and 446.46 yuan, respectively. The differences of total medical costs and daily costs between diabetes patients with different amount of complications were statistically significant (P<0.001). The factors including age, the way of the medical expense, the number of complications, with acute complications, CCI score and the hospital-stay length were proved to be significantly correlated to total medical costs of diabetes inpatients (P<0.05). Conclusion Age, the way of the medical expense, the number of complications, with acute complications, CCI score and the hospital-stay length are influence factors of medical costs of diabetes inpatients.
Objective To observe the relationship between retinal microglial activations and ganglion cell (RGC) damages in early-stage diabetic rats. Methods A total of 20 SpragueDawley（SD）rats were randomly divided into 4 groups (each with 5 rats): 1 month control group, 1 month diabetes group, 3 month control group, 3 month diabetes group. Diabetes was induced by intraperitoneal injection of streptozotocin (STZ). The RGCs of all rats were retrograde labeled by carbocyanine dye DiI injected at the superior colliculi.Microglial cells and RGCs in retinal flat-mounts and sections were stained immunohistochemically and recorded under confocal microscope.Results The diabetic microglial cells were amoeboid and ovoid with fewer processes on retinal flat mounts. The density of microglial cells which phagocytosed DiI particles in the RGC layer significantly increased in the 3month diabetes group（P＜0.01）. The density of microglial cells in the RGC layer significantly increased in the 1- and 3- month diabetes group（P＜0.05）. However there were more microglial cells in the RGC layer in the 3- month diabetes group than the 1-month diabetes group（P＜0.0001）. Significant correlation was found between the amount of microglial cells and that of RGCs in the early-stage of diabetes. Conclusions Microglial cell activation has close relationship with the RGC damages in early-stage diabetic rats.