2012 Vol. 25, No. 1
Objective Evidence suggests that type 2 diabetes (T2DM) is associated with an increased risk of dementia and that glucose variability is an independent risk factor for diabetic complications.This study investigated the relationship between glucose excursion and cognitive function in aged T2DM patients.Methods A total of 248 aged T2DM patients wore a continuous glucose monitoring system (CGMS) for 3 days in order to evaluate glucose excursion,including mean amplitude of glycemic excursions (MAGE) and mean of daily difference (MODD).All subjects were evaluated with a number of accepted cognitive function tests,including the mini-mental status examination (MMSE).The relationship between MAGE and MODD and performance on these cognitive tests was assessed.Results The MAGE and MMSE score were negatively correlated,likewise with the correlation between MODD and MMSE.Liner multivariate regression analysis showed that MAGE and MODD were also negatively related to MMSE independent of age,sex,glycemic control,hypertension,smoking,or coronary heart disease history.Conclusion Glucose excursion is related to cognitive function in aged T2DM patients.Elevated glucose excursion decreased the MMSE score,which reflects general cognitive function.Thus,therapy aimed at controlling glucose excursion may be beneficial for maintaining cognitive function in aged T2DM patients.
Objective Type 2 diabetes has been recently recognized as an important risk factor for cognitive decline of patients with Alzheimer's disease (AD).But the roles of hyperinsulinemia (HI) and insulin resistance (IR) in the development of AD are still controversial.This study was designed to evaluate whether HI or IR influenced the cognitive functions of older cohort.Methods The cognitive functions of 328 consecutive elderly patients were evaluated with a battery of cognitive rating scales.Their fasting blood glucose (FBG) and fasting insulin (FINS) were analyzed and IR was calculated with modified-Homa.The cognitive scores in different groups and the correlation of cognitive functions with HI or IR were analyzed.Results In our study,there were 180 participants with HI and 148 without HI,and 192 with IR and 136 without IR.The participants with HI showed worse cognitive functions than those without HI in MMSE,MOCA,CDR,orientation,delayed memory,and attention/calculation domains.Similarly,the elderly with IR had lower cognitive scores than those without IR in MMSE,MOCA,CDR,GDS,orientation,delayed memory,and attention/calculation domains.The insulin levels and Homa IR had negative correlation with the scores of MMSE and delayed memory,not only in the model 1 adjusted for FBG and diabetes history,but also in the model 2 adjusted for all nine demographic characteristics.Conclusion HI and IR are important risk factors for cognitive decline of the elderly,especially for the dysfunctions in delayed memory domains.
Objective To evaluate the fetal cardiac function in gestational diabetes mellitus (GDM) pregnancies under different maternal glycemic controls.Methods Forty four GDM mothers received 78 fetal echocardiographic evaluations at three gestational periods (<28,28-34 and ≥34 weeks) and were divided into poorly-(DM1) and well-(DM2)controlled groups according to their glycemic control at examination.Seventy uncomplicated mothers were selected as controls.Parameters of fetal cardiac anatomy and function were measured and analyzed.Results GDM fetuses' cardiac ventricular walls were thicker than controls',and the differences between DM1 and DM2 were not significant except for end-diastolic left ventricular walls.In both GDM groups,the aortic flow velocities increased earlier than pulmonary artery and DM1 fetuses changed earlier than DM2 ones.GDM fetuses' left atrial shortening fraction was smaller than the controls' in the period of ≥34 weeks and negatively correlated with thicknesses of left ventricular walls and interventricular septum in DM1 fetuses (r=-0.438 and -0.506).The right ventricular diastolic function in DM1 and DM2 fetuses decreased after the period of 28-34 weeks and in the period of ≥34 weeks respectively.Tei index of both left and right ventricles increased in DM1 group after the period of <28 weeks and in DM2 group only in the period of ≥34 weeks,with no significant differences between DM1 and DM2 groups in this period.Conclusion Fetuses of GDM mothers showed cardiac function impairments.Good maternal glycemic control may delay the impairments,but cannot reduce the degree.Some cardiac changes in GDM fetuses were similar to those in pregestational diabetic pregnancies except for several parameters and their changing time.
Objective To investigate a potential relationship between Solute carrier family 30 (zinc transporter)member 8 (SLC30A8) rs13266634 variant and efficacy of rosiglitazone or repaglinide in treating newly diagnosed Chinese type 2 diabetes patients.Methods A total of 209 diabetic patients without any antihyperglycemic history were recruited and treated with repaglinide or rosiglitazone randomly for 48 weeks (104 and 105 patients,respectively).Anthropometric measurements and clinical laboratory tests were carried out before and after the treatment.An non-synonymous variant rs13266634 was genotyped by matrix-assisted laser desorption ionization-time of flight mass spectroscopy.Results Ninety-one patients in repaglinide group and ninety-three patients in rosiglitazone group completed the study.A value of homeostasis model assessment of beta cell function (HOMA-B) and A value of fasting proinsulin levels were statistically significant between three genotype groups (P=0.0149and 0.0246,respectively) after rosiglitazone treatment.However,no genotype association was observed in the repaglinide or rosiglitazone group with other parameters.Conclusion The SLC30A8 variant was associated with the efficacy of insulin sensitizer monotherapy on insulin secretion in patients with newly diagnosed type 2 diabetes mellitus in Shanghai,China.
Objective To investigate the relationship of liver enzymes with hyperglycemia in a large population in Shanghai and identify the association between liver enzymes and insulin resistance.Methods A total of 3 756 participants were enrolled.Each participant underwent an oral glucose tolerance test and completed a questionnaire.Anthropometric indices were recorded and serum samples were collected for measurement.Results Liver enzymes concentrations were independently associated with i-IGT,IFG+IGT,and diabetes.With the increase of ALT and GGT concentrations,ORs for i-IGT,IFG+IGT,and diabetes increased gradually.By comparing patients in the highest quartile of GGT concentrations or ALT concentrations with those in the lowest quartile (Q1),ORs for i-IGT,IFG+IGT,or diabetes was significant after adjustment.Both ALT and GGT concentrations were linearly correlated with HOMA-IR and independently associated with HOMA-IR [ALT OR (95% CI):2.56 (1.51-4.34) P=0.00; GGT OR (95% CI):2.66 (1.S3-4.65) P=0.00].Conclusion Serum ALT and GGT concentrations were closely related to pre-diabetes and diabetes in the Shanghai population and positively associated with insulin resistance.
Objective The association of metabolic syndrome (MetS) with cardiovascular diseases (CVD) has not been adequately explored in middle-aged and elderly Chinese.This study aimed to investigate MetS' prevalence and its impact on the CVD incidence in this specific population group.Methods A data set of a community-based prospective cohort study was analyzed.A total of 2300 subjects aged 40-94 years were followed up for the CVD events.MetS defined according to the JCDCG criteria was assessed at baseline,and the middle-aged and elderly groups were classified by the WHO definition.Results As compared with the middle-aged group,the prevalence of MetS increased by 0.6 times (34.6% vs.21.3%) and the incidence density of CVD increased by 4.9 times in the elderly group (52.3/1000 person-year vs.8.9/1000 person-year).Furthermore,the multivariate Cox regression revealed that the risk to CVD incidence was independently related to increased waist circumference in the middle-aged group (HR=2.23,P<0.01) and to elevated blood glucose in the elderly group (HR=1.39,P<0.01).Conclusion MetS was highly prevalent in middle-aged and elderly Chinese.MetS significantly increased the risk to CVD incidence in the elderly.All individuals with metabolic disorders should receive active clinical care to reduce the incidence of CVD.
Objective To explore the Intervention effect of Rosiglitozone in ovarian fibrosis of PCOS rats.Methods 60 female SD rats were randomly divided into 3 groups:control group,model group and treatment group.The model and treatment groups were established by subcutaneous injection of DHEA,while the treatment group was given RGZ.The serum hormone values,pathohistology of ovarian structure of rats,ovarian ultrastructure and the expressions of TGF-β1 and CTGF were detected.Results The PCOS model was established successfully.The expression intensity of TGF-β1 and CTGF in Oocytes of the PCOS groups was 9.545±2.954 and 9.665±2.400,respectively and was significantly higher than that of the control group 6.636±2.264 and 7.036±2.133; after treatment with rosiglitazone,the expression was significantly decreased 6.980±2.421 and 6.642±2.721 as compared with that of the model group (P<0.05,P<0.001).The values in serum of the PCOS groups were 3.749±2.054 and 0.265±0.129,and 1.914±1.801 and 0.096±0.088 in the control group which had statistically significant difference (P<0.05,P<0.001).After treatment with rosiglitazone,the values were 2.3100±1.825 and 0.112±0.187 and were significantly different with those of the model group (P<0.05,P<0.001).Conclusion TGF-β1 and CTGF play an important role in the development of ovary fibrosis in PCOS.However,RGZ may postpone the development of fibrosis by decreasing the levels of TGF-β1 and CTGF.
Objective To examine the relationship between overweight or obesity and the risk of the various hypertension hemodynamic subtypes in Yi farmers and migrants.Methods A cross-sectional study of 2 358 Yi farmers and 1 392 Yi migrants was carried out in the Liangshan Yi autonomous prefecture,Sichuan,China in 2007.Results The standardized prevalence of overweight in female Yi farmers (6.22%) was higher than in males (3.15%),whereas in Yi migrants 31.56% of males and 18.78% of females were overweight.The standardized prevalence of obesity was 0 and 0.61% in male and female Yi farmers,compared to 3.91% and 5.57% in male and female Yi migrants,respectively.For both genders the standardized prevalence of ISH,IDH,and SDH was higher in Yi migrants than Yi farmers.Overweight and obese Yi men and women had a higher risk for IDH and SDH (P<0.001) than non-overweight/obese individuals.However,an association of overweight or obesity with ISH was observed only in men.Conclusion Yi migrants have substantially higher proportion of overweight and obese individuals,as well as individuals affected by ISH,IDH,and SDH,than do Yi farmers.Overweight and obesity are significant risk factors for the development of hypertension in Yi people.
Objective Symptomatic predictors of influenza could assess risks and improve decisions about isolation and outpatient treatment.To develop such predictors,we undertook a prospective analysis of pandemic (H1N1) 2009 and seasonal influenza (H3N2) in patients attending fever clinics.Methods From 1 May 2009 to 1 January 2010,all adult patients admitted to fever clinics for suspected influenza,confirmed by real time RT-PCR,were enrolled.Predictors of influenza virus infection were selected with logistic regression models.Measures of sensitivity,specificity,positive and negative likelihood ratios (LRs) were calculated to identify the best predictors.Results The clinical features and routine blood test results of influenza (H1N1) 2009 and seasonal influenza were similar.The positive and negative LRs of current US CDC influenza-like illness (ILI) criteria were modest in predicting influenza infection.Our modified clinic predictors improved the ability of the positive and negative LRs to recognize pandemic (H1N1) 2009 and seasonal influenza.The revised criteria are:fever ≥38 ℃ accompanied by at least one of the following-cough,arthralgia or relative lymphopenia.Conclusion Patients with symptoms and signs that meet the new criteria are likely to have influenza and timely antiviral therapy may be appropriate.In addition,physicians should ascertain if influenza is circulating within the community or if there is a contact history of influenza and combine this information with the newly developed criteria to clinically diagnose influenza.
Objective To explore factors influencing the quality of life of people living with HIV/AIDS (PLHA) and receiving antiretroviral therapy (ART) in rural China.Methods In-depth interviews with 20 PLHA were conducted in March 1999.Participants were recruited from the USAID-funded Longitudinal Enhanced Evaluation of ART Project,which tracks a cohort of eligible PLHA receiving treatment at five collaborating treatment centers in Guangxi Autonomous Region,China.An interview guide (semi-structured with open-ended questions) was developed to provide a qualitative examination of the quality of life of PLHA.Results Participants identified that ART affects physical health,including the experience of pain,side effects,and opportunistic infections.ART imposes lifestyle constraints such as reduced mobility due to drug procurement,and social restrictions due to the daily drug regimen.Participants discussed the psychological burden of taking drugs,and the fear of accidental transmission to others,or having their disease status known by others,as well as optimistic feelings about their future due to ART.ART poses a significant drain on individual's economic resources due to related medical costs,and inability to seek seasonal migrant labor due to reduced mobility.Conclusion While China's national free ART program improved the physical health of those surveyed,their social and economic needs were left unaddressed.To improve life outcomes for PLHA,and by extension,the wider Chinese population,quality of life measures should be idcluded when evaluating the success of the ART program.
Objective To establish and evaluate a real-time PCR assay to detect Mycoplasma pneumoniae (M.pneumoniae) in clinical specimens.Methods By analysing the whole p1 gene sequence of 60 M.pneumoniae clinical isolates in Beijing of China,an optimized real-time PCR assay (MpP1) using p1 gene conserved region was designed.The specificity and sensitivity of this assay were evaluated and compared with other two reported assays (RepMp1 and Mp181) using 40 positive and 100 negative clinical specimens.Results The detection limit of the new assay was 8.1 fg (about 1~3CFU) M.pneumoniae DNA.The sensitivity of Mpp1,RepMp1,and Mp181 assays appeared to be 100%,100%,and 85%,respectively.Conclusion MpP1 assay is suitable for the detection of M.pneumoniae in Chinese clinical specimens.
Objective To evaluate four candidate variable number tandem repeat (VNTR) loci for genotyping Mycobacterium tuberculosis complex strains.Methods Genomic sequences for two M.tuberculosis strains (CCDC5079 and CCDC5180) were generated,and using published sequence data,four candidate VNTR loci were identified.The VNTRs were used to genotype 225 Chinese clinical M.tuberculosis complex strains.The discriminatory power of the VNTRs was evaluated using BioNumerics 5.0 software. Results The Hunter-Gaston Index (HGI) for BJ1,BJ2,BJ3,and BJ4 loci was 0.634,0.917,0.697,and 0.910,respectively.Combining all four loci gave an HGI value of 0.995,thus confirming that the genotyping had good discriminatory power.The HGI values for BJ1,BJ2,B J3,and BJ4,obtained from Beijing family strain genotyping,were 0.447,0.878,0.315,and 0.850,respectively.Combining all four loci produced an HGI value of 0.988 for genotyping the Beijing family strains.We observed unique patterns for M.bovis and M.africanum strains from the four loci.Conclusion We have shown that the four VNTR loci can be successfully used for genotyping M.tuberculosis complex strains.Notably,these new loci may provide additional information about Chinese M.tuberculosis isolates than that currently afforded by established VNTR loci typing.
Objective Nucleostemin (NS) is a GTP-conjugated protein located in the nucleoli of stem cells and some cancer cells,and maintains cell self-renewal.We aimed to evaluate NS as a potential target for lung carcinoma gene therapy by investigating NS gene expression and its effect on A549 cell proliferation.Methods NS mRNA and protein expression in A549,HepG2,SMMC-7721,HeLa,and U251 cells was analyzed by RT-PCR and western blotting following transfection of NS siRNAs and negative control siRNA (NC).The effect on cell proliferation was also analyzed by MTT assays.Results NS mRNA and protein were both expressed in A549 cells and four other tumor cell lines; the relative expression levels were similar in all five cell lines.The three pairs of NS siRNA,either transfected alone or cotransfected into A549 cells,could effectively inhibit the expression of NS mRNA and protein.Moreover,the interference ratio showed an obvious concentration-dependent relationship.NS siRNA treatment resulted in significant inhibition of A549 cell proliferation by 35.7%.Conclusion NS gene was not only highly expressed but also played an important role in A549 cell proliferation.Thus,targeting of NS may be a promising novel strategy for the treatment of lung carcinoma.
Objective To prepare monoclonal antibodies against a newly discovered and conserved linear epitope of Rabies virus nucleoprotein and to use them in a rabies diagnostic test.Methods Synthetic peptide containing the epitope was used as immunogen to prepare hybridoma cell lines by classical hybridoma technology.Anti-peptide monoclonal antibodies produced in ascites of inoculated Balb/c mice were labeled with fluorescein isothiocyanate (FITC) after purification and used in fluorescent antibody test (FAT). Results Two positive hybridoma cell lines,RVNP-mAb1-CL and RVNP-mAb2-CL,were obtained.RVNPmAb1-CL produced a higher concentration of monoclonal antibody RVNP-mAb1 in Balb/c ascites.FITC-labeled RVNP-mAb1 showed correct results on certain Rabies virus-positive canine brain tissue samples and cells of a small subclone of baby hamster kidney 21 cell line (BSR).Conclusion FITC-labeled RVNP-mAb1 has potential application for laboratory diagnosis of rabies.
Objective Both the 2,6 linkage and its topology on target cells are critical for the recognition by human influenza virus.The binding preference of avian flu virus H5N1 HA to the 2,3-linked sialylated glycans is considered the major factor limiting its efficient infection and transmission in humans.To monitor potential adaptation of H5N1 virus in human population,the surveillance of receptor-binding specificity was undertaken in China.Methods The binding specificity of 32 human H5N1 virus strains isolated from 2003 to 2009 was tested by 2,3-specific sialidase-treated chicken red blood cell (CRBC) agglutination assay and a solid-phase direct binding assay with synthetic sialylglycopolymers.Results Dual binding preference to 2,3 and 2,6-glycans were found in two strains:A/Guangdong/1/06 (A/GD/1/06) and A/Guangxi/1/08 (A/GX/1/08).Though minor effect of short-2,6-binding was detected in A/GX/1/08 at a low virus titer,both showed high affinity to the oligosaccharide at a high load.Notably both are of the long-2,6-recognition,with the same topology as that of human H1N1 and H3N2 viruses.Conclusion The findings suggest that human H5N1 virus in China likely acquired the potential human-adaptation ability.Further research and surveillance on receptor-binding specificity of H5N1 viruses are required.
Objective To investigate oxidative DNA damage in pharmacy technicians preparing antineoplastic drugs at the PIVAS (Pharmacy Intravenous Admixture Service) in two Chinese hospitals.Methods Urinary 8-OHdG served as a biomarker.5-Fluorouracil (5-FU) concentrations in air,masks and gloves were determined.The spill exposure of each PIVAS technician to antineoplastic drugs was investigated.Eighty subjects were divided into exposed group Ⅰ,Ⅱ,and control group Ⅰ,Ⅱ.Results 5-FU concentration ratios for gloves and masks in exposed group Ⅰ were significantly higher than those in exposed group Ⅱ (P<0.05 or P<0.01).The average urinary 8-OHdG concentrations in exposed group Ⅰ,control group Ⅰ,exposed group Ⅱ,and control group Ⅱ were 14.69±0.93,10.68±1.07,10.57±0.55,and 11.96±0.73 ng/mg Cr,respectively.Urinary 8-OHdG concentration in exposed group Ⅰ was significantly higher than that in control group Ⅰ or that in exposed group Ⅱ (P<0.01).There was a significant correlation between urinary 8-OHdG concentrations and spill frequencies per technician (P<0.01).Conclusion There was detectable oxidative DNA damage in PIVAS technicians exposed to antineoplastic drugs.This oxidative DNA damage may be associated with their spill exposure experience and contamination of their personal protective equipment.
Objective Left ventricular remodeling (LVR) following myocardial infarction (MI) is a key pathophysiological process in which MI develops into heart failure.The exact mechanism of LVR remains unclear.We performed differential proteomic analysis on the myocardia of rats with LVR after MI,to explore the mechanism of ventricular remodeling after MI.Methods In the LVR group (n=12),after the anterior descending coronary artery was ligated,the rats were fed for four weeks before the LVR models were established.Rats in the sham-operated group (n=11) underwent thread-drawing without ligation.The hemodynamic parameters,pathological findings,and proteomics were compared between the two groups.Results In the LVR group,the left ventricular end-diastolic pressure increased,the maximal left ventricular pressure increase/decrease ratio decreased significantly,and the left ventricular systolic pressure decreased.H-E staining and Masson staining of cardiac muscle tissues of the LVR group showed myocytolysis,disarray,and collagen proliferation.Twenty-one differentially expressed proteins were detected by proteomic analysis.We validated two proteins using western blot analysis.The differentially expressed proteins could be divided into six categories:energy metabolism-related proteins,cytoskeletal proteins,protein synthesis-related proteins,channel proteins,anti-oxidationrelated proteins,and immune-related proteins.Conclusion These differentially expressed proteins might play key roles in LVR following MI.