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)
摘要:目的:了解糖尿病患者胰島素泵強化治療的護理特點并觀察其療效。方法:對158例糖尿病胰島素泵治療的患者進行心理、技術等綜合護理。結果:158例患者用胰島素泵強化治療后血糖控制良好,生活質量明顯提高。結論:胰島素泵在強化治療糖尿病方面提供了前所未有的安全、可靠、方便及靈活性,是強化治療的最佳手段。綜合護理是胰島素泵強化治療的保障。Abstract: Objective: To understand the insulin pump treatment of diabetes care characteristics and observe the effect. Methods: 158 patients with diabetes insulin pump therapy in patients with psychological, technology and other comprehensive care. Results: 158 patients were treated with insulin pump therapy a good blood sugar control and quality of life improved markedly. Conclusion: The diabetic insulin pump in intensive therapy has provided an unprecedented security, reliability, convenience and flexibility, is to strengthen the best means of treatment. Integrated care is the protection of insulin pump therapy.
ObjectiveTo summarize the research progress of correlation between pancreatic cancer and diabetes mellitus.MethodsRecent studies on the association between pancreatic cancer and diabetes mellitus were extensively reviewed, and relevant research results on the association between pancreatic cancer and diabetes mellitus were reviewed.ResultsPancreatic cancer had a particular association with diabetes. Patients with pancreatic cancer may develop new diabetes or worsen existing diabetes mellitus. About 50% of patients with pancreatic cancer had diabetes mellitus before diagnosis, suggesting a “dual causal relationship” between pancreatic cancer and diabetes mellitus. Long-term type 2 diabetes mellitus (T2DM) was one of the high risk factors for the occurrence and development of pancreatic cancer. T2DM may also increase the risk of pancreatic cancer due to hyperinsulinemia, adipokine, and other factors. Pancreatic cancer was one of the cause of diabetes mellitus at the same time, but its mechanism was not yet known, also needed to get a lot of information to understand the impact of long-term diabetes mellitus on the development of pancreatic cancer, as well as the reason of pancreatic cancer related to diabetes mellitus mechanism.ConclusionThe clear relationship between pancreatic cancer and diabetes mellitus has not been proved, and further research is needed to clarify the relationship between them.
Objective To explore the correlation between blood glucose and self-management behaviors in patients with type 2 diabetic mellitus before initial basal insulin therapy. Methods A convenient sample of 200 patients with type 2 diabetic mellitus who were hospitalized in a tertiary hospital from February to August 2016 were enrolled in the study on a voluntary basis. Patients’ demographic information, fast blood glucose, glycosylated hemoglobin, and scores of diabetes self-care activities were gathered through questionnaires. Results A total of 193 valid questionnaires were recovered. Before starting basal insulin therapy, the mean blood glucose and the mean glycosylated hemoglobin of the 193 patients were (12.22±3.95) mmol/L and (10.01±2.38)%, respectively, with 12 patients (6.22%) meeting the goal of fasting blood glucose ≤7 mmol/L and 18 patients (9.33%) meeting the goal of glycosylated hemoglobin <7%, respectively. The total score of self-care activities was 26.76±14.77, in which 3 patients (1.55%) performed well. Spearman analysis demonstrated that the total score of self-care activities was negatively correlated with fast blood glucose ( r=–0.401, P<0.001) and glycosylated hemoglobin (r=–0.227, P=0.028). Conclusions The blood glucose levels and self-management behaviors in diabetic patients at the beginning of initial basal insulin therapy are not optimistic. Enhanced management of type 2 diabetic patients with initial basal insulin therapy is the prerequisite to promote diabetes self-care activities.
Objective To study the interferencing and anti-tumor effects of lentiviral vector of siRNA targeting IGF1R and EGFR gene of the liver cancer cell. Methods The complementary DNA containing both sense and antisense Oligo DNA of the targeting sequence was designed, synthesized and connected to the pLVTHM vector, named pLVTHM-IGF1R, into whom the EGFR-siRNA expression frame containing H1 promotor synthesized by RT-PCR was cloned to generate pLVTHM-IGF1R-EGFR-siRNA. The 293T cells were cotransfected by 3 plasmids of pLVTHM-IGF1R-EGFR-siRNA, psPAX2 and pMD2G to enclose LVTHM-IGF1R-EGFR-siRNA, which was amplified in large amount and purified by caesium chloride density gradient centrifugation for measurement of virus titer. SMMC7721 cells infected by LVTHM-IGF1R-EGFR-siRNA were infection group, the untreated SMMC7721 cells and blank vector plasmid LVTHM were two control groups (SMMC7721 cell group and blank vector group). The effect of LVTHM-IGF1R-EGFR-siRNA on IGF1R and EGFR expressions of SMMC7721 cells were detected by RT-PCR and Western blot. The antitumor potential of LVTHM-IGF1R-EGFR-siRNA to SMMC7721 cells was evaluated by Cell Counting Kit-8 assay for cell growth and TUNEL for apoptosis respectively. Results LVTHM-IGF1R-EGFR-siRNA was constructed successfully. Functional pfu titers of LVTHM-IGF1R-EGFR-siRNA was 4.58×109 pfu/ml. Protein and mRNA expression of IGF1R and EGFR of infection group were less than those of blank vector group and SMMC7721 cell group （P＜0.05）, LVTHM-IGF1R-EGFR-siRNA was more effective to inhibit the proliferation and promote apoptosis of SMMC7721 cells （P＜0.05）. Conclusion LVTHM-IGF1R-EGFR-siRNA expressing IGF1R-EGFR-siRNA can inhibit the expression of IGF1R and EGFR, and may be used for further investigation of gene therapy of liver cancer.
摘要:目的:探討2型糖尿病合并糖尿病足患者與胰島素抵抗的關系。方法:205例2型糖尿病患伴糖尿病足患者作為觀察組,無足部病變的糖尿病患者作為對照組,觀察其體重指數、空腹血糖、胰島素、血脂等指標,兩組間進行比較并相關性分析、多元回歸分析。胰島素抵抗指數(HOMAIR)=FPG×FIns/22.5。結果:糖尿病足患者的HOMAIR顯著高于無糖尿病的患者(Plt;0.05)。多元回歸分析顯示糖尿病病程、LDL及BMI是影響2型糖尿病足患者胰島素抵抗的主要危險因素。結論:糖尿病足患者存在著更嚴重的胰島素抵抗。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 (HOMAIR) was calculated and compared between two groups. Results:The HOMAIR was higher in group A than that in group B (Plt;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.
Purpose To investigate the status of proliferation and activation of vascular endothelial cells in preretinal neovascular membranes from patients with insulin dependent diabetetes mellitus(IDDM)by means of immunohistochemical techniques. Methods Status of vascular endothelial cells in 18 preretinal neovascular membranes from 18 patients with IDDM was studied by double-immunofluorescence technique and the alkaline phosphataes-anti-alkaline phosphatase(APAAP)technique and compared the findings with the main clinical features of the patients. Results Of 18 vascularized membranes,16(88.9%)contained proliferating endothelial cells (positive for proliferating vascular endothelial cell marker EN 7/44) and 14 (77.8%) were positive for endothelial cell activation marker anti-VCAM-1;furthermore,by using a double staining technique,we found that in 14 of the 16 cases(87.5%) the proliferating vascular endothelial cells were activated (expressing VCAM-1). Conclusion The proliferation and activation of the vascular endothelial cells of the newly formed vessels in preretinal neovascular membranes suggests the significance of the vascular endothelial cells in the pathophysiology and the progress of proliferative diabetic retinopathy. (Chin J Ocul Fundus Dis,1998,14:141-143)
Objective Through studying a diabetic patient accompanied with pancreatic cancer by means of evidence-based clinical practice, to find out the relationship between diabetes mellitus and cancer and whether the long-acting insulin glargine increases the risk of cancer or not, which is regarded as a disputable hot issue at present. Methods Such databases as The Cochrane Library (Issue 3, 2010), OVID-EBM Reviews (1991 to Sept. 2010), MEDLINE (1950 to Sept. 2010) and CNKI (2000 to Sept. 2010) were retrieved to collect high quality clinical evidence, and the best therapy was formulated in accordance with the willingness of patients themselves. Results Eight randomized controlled trials (RCTs), four meta-analyses and one RCT meta-analysis were included. The evidence indicated that: a) Diabetes mellitus was kind of related to the occurrence of malignancies; b) There was no evidence at present showing the relationship between long-acting insulin glargine and cancer; c) Strictly controlling of blood sugar did not increase the risk of tumorigenesis, but hyperglycemia causing cancer was proofless; and d) Whether the diabetic patient with cancer should stop taking long-acting insulin glargine or not should require suggestions from specialists rather than patients themselves. Conclusion No evidence at present shows that tumorigenesis is related to diabetes mellitus, long-acting insulin glargine and strict controlling of blood sugar. It is necessary to require more evidence to decide whether the therapy should be adjusted or not for the diabetic patient with cancer who is in the process of glargine therapy.
ObjectiveTo explore the efficacy and safety of basal insulin plus oral antidiabetic drugs (OADs) treatment switched from premixed insulin therapy in type 2 diabetes patients. MethodsPatients with type 2 diabetes with glycosylated hemoglobin (A1C) lower than 10%, taking stable dose of premixed insulin twice daily for at least 12 weeks, and treated between February 2010 and August 2011 were identified from our outpatient service, and their treatment was switched to glargine plus OADs. After 24 weeks of treatment, we analyzed the changes of the patients' weight, fasting and postprandial blood glucose (FBG and PBG), A1C, hypoglycemic events and insulin dose. ResultsA total of 36 patients were followed up and received glargine plus OADs. After glargine treatment, the patients' weight[(63.77±10.34) vs. (62.31±9.98)kg, P=0.002] and total insulin dose[(23.56±6.15) vs. (10.28±4.04)kg, P=0.000] were declined obviously. The A1C level had further declined in the group of premixed insulin therapy with A1C approaching or reaching 7% from start to end point (6.70±0.81)% vs.(6.34±0.55)kg, P=0.007], and the insulin dose was (0.16±0.06) U/(kg·d). However, no significant difference of the incidence of hypoglycemic events was discovered compared with non-standard group (33.33% vs. 55.56%, P=0.267). Compared with premixed insulin group, glargine group usually had 1 or 2 kinds of OADs, and the most widely used drug was glucophage (17/36). ConclusionIn type 2 diabetes patients whose A1C level approaches or reaches 7%, switching premixed insulin therapy to glargine plus OADs is associated with significant improvement in glycemic control, as well as sound safety and other benefits.
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)