Background: Congenital malformations such as micropenis and cryptorchidism do not have immediate dramatic consequences. However, the diagnosis is often unknown at birth, and therefore late. In Ivory Coast, there are f...Background: Congenital malformations such as micropenis and cryptorchidism do not have immediate dramatic consequences. However, the diagnosis is often unknown at birth, and therefore late. In Ivory Coast, there are few studies on cryptorchidism and micropenis. We conducted this study to identify the epidemiological, clinical, etiological and therapeutic characteristics of the micropenis associated or not with cryptorchidism at Yopougon University Hospital. Methods: We conducted a retrospective descriptive study in the Department of Endocrinology-Diabetology of the Yopougon University Hospital carried out over 13 years from January 2005 to December 2018. All patients were included regardless of the presence of a micropenis associated or not with cryptorchidism in the clinical or paraclinical examination. Results: A total of 14 micropenis were reported associated in 6 cases with cryptorchidism. It was unilateral cryptorchidism in 4 patients or 66.66% of cases. The average age of affected patients was 21.32 years with extremes ranging from 10 months to 48 years. The reason for consultation was micropenis in 12 out of 14 cases or 85.75%. The associated signs apart from cryptorchidism were obesity in 42.86% of cases, gynecomastia in 35.71% of cases. The aetiology was dominated by idiopathic causes. Treatment with testosterone enanthate was more effective in pre-pubertal children than in adults. Conclusion: The diagnosis of micropenis associated or not with cryptorchidism is late because of the frustrations, taboos and psycho-social states that it causes. However, drug treatment is effective when treatment is started early.展开更多
BACKGROUND Diabetes foot is one of the most serious complications of diabetes and an important cause of death and disability,traditional treatment has poor efficacy and there is an urgent need to develop a practical t...BACKGROUND Diabetes foot is one of the most serious complications of diabetes and an important cause of death and disability,traditional treatment has poor efficacy and there is an urgent need to develop a practical treatment method.AIM To investigate whether Huangma Ding or autologous platelet-rich gel(APG)treatment would benefit diabetic lower extremity arterial disease(LEAD)patients with foot ulcers.METHODS A total of 155 diabetic LEAD patients with foot ulcers were enrolled and divided into three groups:Group A(62 patients;basal treatment),Group B(38 patients;basal treatment and APG),and Group C(55 patients;basal treatment and Huangma Ding).All patients underwent routine follow-up visits for six months.After follow-up,we calculated the changes in all variables from baseline and determined the differences between groups and the relationships between parameters.RESULTS The infection status of the three groups before treatment was the same.Procalcitonin(PCT)improved after APG and Huangma Ding treatment more than after traditional treatment and was significantly greater in Group C than in Group B.Logistic regression analysis revealed that PCT was positively correlated with total amputation,primary amputation,and minor amputation rates.The ankle-brachial pressure and the transcutaneous oxygen pressure in Groups B and C were greater than those in Group A.The major amputation rate,minor amputation rate,and total amputation times in Groups B and C were lower than those in Group A.CONCLUSION Our research indicated that diabetic foot ulcers(DFUs)lead to major amputation,minor amputation,and total amputation through local infection and poor microcirculation and macrocirculation.Huangma Ding and APG were effective attreating DFUs.The clinical efficacy of Huangma Ding was better than that of autologous platelet gel,which may be related to the better control of local infection by Huangma Ding.This finding suggested that in patients with DFUs combined with coinfection,controlling infection is as important as improving circulation.展开更多
Background: Type 2 diabetes mellitus (T2DM) is a metabolic disease, characterized by chronic hyperglycemia. This pathology is linked to various genes whose interaction with the environment promotes its development. Th...Background: Type 2 diabetes mellitus (T2DM) is a metabolic disease, characterized by chronic hyperglycemia. This pathology is linked to various genes whose interaction with the environment promotes its development. The aim of this work was to determine the relationship between the rs2241766 (T/G) polymorphism of the ADIPOQ gene with type 2 diabetes in the black population. Material and Methods: This work was a case-control study, involving type 2 diabetics subjects (n = 94) and controls (n = 82). The study took place from September 2022 to September 2023. Patients were recruited in the Endocrinology Department of the Libreville University Hospital Center. Analysis was performed in the Biochemistry laboratory of the University of Health Sciences in Libreville and at the Research Institute of Health Sciences of Bobodioulasso. Genomic DNA was extracted using the protocol Qiagen kit and the PCR-RFLP method was used to determine the rs2241766 (T/G) polymorphism of the ADIPOQ gene. Results: Only 2 genotypes were found in this population, the TT genotype and the GT genotype. The proportions were not different between the two groups (p = 0.1095) neither the distribution of G and T alleles (p = 0.1095). On the other hand, the HDL hypocholesterolemia was frequent in subjects with the GT genotype compared to TT heterozygous (51.1% vs 48.9%, p = 0.0280;OR = 0.55 [0.30 - 1.01]). Conclusion: There was no association between the rs2241766 (T/G) variant of the ADIPOQ gene and the occurrence of type 2 diabetes in this population. On the other hand, a relationship between HDL hypocholesterolemia and the GT genotype has been established.展开更多
Introduction: Diabetes mellitus, a metabolic disease, is now an important public health problem across the world. Our aim was to study the epidemiological, clinical, paraclinical, and evolutionary aspects of acute met...Introduction: Diabetes mellitus, a metabolic disease, is now an important public health problem across the world. Our aim was to study the epidemiological, clinical, paraclinical, and evolutionary aspects of acute metabolic complications (AMC) of diabetes in the endocrinology department of the Oueme-Plateau Provincial Teaching Hospital. Methods: This was a descriptive cross-sectional study with data collection based on the medical records of patients presenting with acute metabolic complications of diabetes in the endocrinology department of the Oueme-Plateau Provincial Teaching Hospital during the 3 years study period (from January 2020 to December 2022). Results: Over 788 patients hospitalized during the study period, 157 had an acute metabolic complication of diabetes, which is a hospital prevalence of 19.9%. Among these 157 cases, 140 were suitable for analysis and therefore constituted our study sample. The mean age of the patients was 49.9 ± 14.7 years, with 19 as minimum and 90 years as maximum. Most of them were women (52.4%). Hypertensive diabetics accounted for 54.9% of cases. Ketoacidosis was the most common complication (62.1%), followed by hyperosmolar hyperglycemic syndrome (23.6%) and hypoglycemia (14.3%). Infection (69.3%) and therapeutic noncompliance (22.9%) were the most common triggers. The average length period of their hospital stay was 7.1 ± 5.1 days, and the outcome was satisfactory in 87.9% of the cases. Unfortunately, there were 3.6% deaths during hospitalization. Conclusion: Acute metabolic complications of diabetes were dominated by ketoacidosis. Infection was the dominant factor in decompensation. Therapeutic education of diabetic patients as well as clinical and biological monitoring must be more stringent and rigorous.展开更多
With continuous population and economic growth in the 21st century,plastic pollution is a major global issue.However,the health concern of microplastics/nanoplastics(MPs/NPs)decomposed from plastic wastes has drawn pu...With continuous population and economic growth in the 21st century,plastic pollution is a major global issue.However,the health concern of microplastics/nanoplastics(MPs/NPs)decomposed from plastic wastes has drawn public attention only in the recent decade.This article summarizes recent works dedicated to understanding the impact of MPs/NPs on the liver-the largest digestive organ,which is one of the primary routes that MPs/NPs enter human bodies.The interrelated mechanisms including oxidative stress,hepatocyte energy re-distribution,cell death and autophagy,as well as immune responses and inflammation,were also featured.In addition,the disturbance of microbiome and gut-liver axis,and the association with clinical diseases such as metabolic dysfunction-associated fatty liver disease,steatohepatitis,liver fibrosis,and cirrhosis were briefly discussed.Finally,we discussed potential directions in regard to this trending topic,highlighted current challenges in research,and proposed possible solutions.展开更多
The aim of this study was to explore the associations of moderate-to-vigorous-intensity physical activity(MVPA)time and sedentary(SED)time with a history of cardiovascular disease(CVD)and multifactorial(i.e.,blood pre...The aim of this study was to explore the associations of moderate-to-vigorous-intensity physical activity(MVPA)time and sedentary(SED)time with a history of cardiovascular disease(CVD)and multifactorial(i.e.,blood pressure(BP),body mass index(BMI),low-density lipoprotein cholesterol(LDL-C),and glycated hemoglobin A1c(HbA1c))control status among type 2 diabetes mellitus(T2DM)patients in China.A cross-sectional analysis of 9152 people with type 2 diabetes from the Multifactorial Intervention on Type 2 Diabetes(MIDiab)study was performed.Patients were grouped according to their self-reported MVPA time(low,<150 min·week−1;moderate,150 to<450 min·week−1;high,≥450 min·week−1)and SED time(low,<4 h·d–1;moderate,4 to<8 h·d–1;high,≥8 h·d–1).Participants who self-reported a history of CVD were identified as having a CVD risk.Odds ratios(ORs)and 95%confidence intervals(CIs)of CVD risk and multifactorial control status associated with MVPA time and SED time were estimated using mixed-effect logistic regression models,adjusting for China’s geographical region characteristics.The participants had a mean±standard deviation(SD)age of(60.87±8.44)years,44.5%were women,and 25.1%had CVD.After adjustment for potential confounding factors,an inverse association between high MVPA time and CVD risk that was independent of SED time was found,whereas this association was not observed in the moderate-MVPA group.A higher MVPA time was more likely to have a positive effect on the control of BMI.Compared with the reference group(i.e.,those with MVPA time≥450 min·week−1 and SED time<4 h·d–1),CVD risk was higher in the low-MVPA group:The OR associated with an SED time<4 h·d–1 was 1.270(95%CI,1.040–1.553)and that associated with an SED time≥8 h·d–1 was 1.499(95%CI,1.149–1.955).We found that a high MVPA time(i.e.,≥450 min·week−1)was associated with lower odds of CVD risk regardless of SED time among patients with T2DM.展开更多
Osteocytes act within a hypoxic environment to control key steps in bone formation.FGF23,a critical phosphate-regulating hormone,is stimulated by low oxygen/iron in acute and chronic diseases,however the molecular mec...Osteocytes act within a hypoxic environment to control key steps in bone formation.FGF23,a critical phosphate-regulating hormone,is stimulated by low oxygen/iron in acute and chronic diseases,however the molecular mechanisms directing this process remain unclear.Our goal was to identify the osteocyte factors responsible for FGF23 production driven by changes in oxygen/iron utilization.Hypoxia-inducible factor-prolyl hydroxylase inhibitors(HIF-PHI)which stabilize HIF transcription factors,increased Fgf23 in normal mice,as well as in osteocyte-like cells;in mice with conditional osteocyte Fgf23 deletion,circulating i FGF23 was suppressed.An inducible MSC cell line(‘MPC2’)underwent FG-4592 treatment and ATACseq/RNAseq,and demonstrated that differentiated osteocytes significantly increased HIF genomic accessibility versus progenitor cells.Integrative genomics also revealed increased prolyl hydroxylase Egln1(Phd2)chromatin accessibility and expression,which was positively associated with osteocyte differentiation.In mice with chronic kidney disease(CKD),Phd1-3 enzymes were suppressed,consistent with FGF23 upregulation in this model.Conditional loss of Phd2 from osteocytes in vivo resulted in upregulated Fgf23,in line with our findings that the MPC2 cell line lacking Phd2(CRISPR Phd2-KO cells)constitutively activated Fgf23 that was abolished by HIF1αblockade.In vitro,Phd2-KO cells lost iron-mediated suppression of Fgf23 and this activity was not compensated for by Phd1 or-3.In sum,osteocytes become adapted to oxygen/iron sensing during differentiation and are directly sensitive to bioavailable iron.Further,Phd2 is a critical mediator of osteocyte FGF23 production,thus our collective studies may provide new therapeutic targets for skeletal diseases involving disturbed oxygen/iron sensing.展开更多
Background:This study will be aimed at investigating the effects of Baihu Renshen decoction(BHRS)on type 2 diabetes rats and on macromolecular enzyme 1(PINK1)/E3 ubiquitin protein ligase(Parkin)pathway.Methods:The exp...Background:This study will be aimed at investigating the effects of Baihu Renshen decoction(BHRS)on type 2 diabetes rats and on macromolecular enzyme 1(PINK1)/E3 ubiquitin protein ligase(Parkin)pathway.Methods:The experiment was divided into four groups:control group,model group,metformin group and BHRS low-dose group and high-dose group.Forty male rats were selected as samples and randomly assigned to at least one test group.Finally,there are 18 rats in each group.Except for the control group,the rats within the different teams got a high-fat diet associate in nursing an intraperitoneal injection of streptozotocin to make a type 2 diabetes mellitus(T2DM)rat model.The organic chemistry and inflammatory indexes of rats in every cluster were analyzed and compared once four weeks of intragastric administration of comparable reagents to review the therapeutic impact of BHRS on T2DM.In addition,we determined the pathological changes of ductal gland tissue of T2DM rats after treatment,and compared the expression of mitochondrial phagocytosis related proteins in ductal gland tissue of rats in each group.Results:FBG,LDL-C,TC,TG,MDA,IL-1,IL-6,TNF-,and mitophagy-related proteins COXIV,P62,VDAC1,and TOM20 were elevated in the model group compared to the control group,while HDL-C,SOD,GSH-Px,and mitophagy-related proteins PINK1,Parkin,and LC3II/I were decreased(P<0.05 or P<0.01).The expressions of FBG,TC,TG,LDL-C,MDA,IL-1,IL-6,TNF-,and mitophagy-related proteins COXIV,P62,VDAC1,and TOM20 were lowered in the BHRS group,while the expressions of HOMA-,HDL-C,SOD,GSH-Px,and mitophagy-related proteins PINK1,Parkin,and LC3II/I were(P<0.05 or P<0.01).After therapy with BHRS,hematoxylin-eosin staining showed that the intensity of pancreatic acinar staining increased,and islet cells became clear boundaries that were,regularly arranged,and with reduced vacuoles reduced.Conclusion:BHRS has a clear therapeutic effect on T2DM,which may be achieved by regulating mitochondrial autophagy through the PINK1/Parkin pathway.展开更多
Hypophosphataemia is defined as low level of phosphate in the blood (normal range 0.8 - 1.4 mmol/l), which can be drug-induced such as uniphyline. We present a case of elderly female patient with known chronic obstruc...Hypophosphataemia is defined as low level of phosphate in the blood (normal range 0.8 - 1.4 mmol/l), which can be drug-induced such as uniphyline. We present a case of elderly female patient with known chronic obstructive pulmonary disease, admitted with acute respiratory failure and low serum phosphate level, her clinical signs and serum phosphate level did not improve with conventional therapy and intravenous phosphate replacement, until her recently commenced uniphyline was discontinued. This highlights the importance of awareness amongst the clinicians about this rare but potential side effect of uniphyline. We suggest monitoring phosphate levels in patients admitted with acute respiratory failure especially those on extended bronchodilator therapy.展开更多
Introduction: The curative management of primary hyperparathyroidism is based on surgery. We report the case of a patient presenting with elevated parathormone despite surgical removal of the parathyroid adenoma. Obse...Introduction: The curative management of primary hyperparathyroidism is based on surgery. We report the case of a patient presenting with elevated parathormone despite surgical removal of the parathyroid adenoma. Observation: A 48-year-old patient presented for more than 6 months with significant weight loss, polyuria with polydipsia and impaired renal function. The assessment carried out revealed hypercalcaemia at 155 mg/L with hypophastetaemia at 24 mg/L and an elevation of the parathyroid hormone at 218.9 pg/ml. Cervical ultrasound showed a mass at the expense of the lower left parathyroid gland. These results made it possible to conclude primary hyperparathyroidism by parathyroid adenoma which was supported surgically. The postoperative biological assessment revealed a normocalcemia at 85 mg/L associated with an increase in parathormone (PTH) at 271.9 pg/ml. In front of the normalization of calcemia in the subsequent controls and the amendment of all the signs, monitoring was carried out. 9 months after surgery, spontaneous normalization of PTH was observed at 38.4 pg/ml with normal serum calcium at 90 mg/l. Discussion: Primary hyperparathyroidism can be revealed by other manifestations. Post-operative follow-up is generally simple with normalization of PTH and serum calcium. However, there may persist an elevation of PTH with normal self-limiting calcemia.展开更多
BACKGROUND Transient hyperphosphatasemia(TH)is a condition characterized by elevated serum alkaline phosphatase(ALP)in the clinical setting with no evidence of bone or liver disease among children under the age of 5.T...BACKGROUND Transient hyperphosphatasemia(TH)is a condition characterized by elevated serum alkaline phosphatase(ALP)in the clinical setting with no evidence of bone or liver disease among children under the age of 5.Typically,it will resolve spontaneously in a few months in the majority of cases.TH has been found to be associated with viral infections.Two cases of TH associated with coronavirus disease 2019(COVID-19)infection in toddlers have been previously reported.CASE SUMMARY A previously healthy 2-year-old boy presented with fever and positive real-time polymerase chain reaction for COVID-19.Prior to his illness,the patient had been in close contact with his grandfather,who later developed COVID-19.The physical examination on admission was unremarkable.He remained asymptomatic throughout 7 d of hospitalization.On the 5th day of his illness,blood tests showed markedly elevated serum ALP(4178 U/L).Results from the simultaneous testing of the remaining liver profiles and metabolic bone panels were normal.Two months after discharge from the hospital,the patient continued to thrive well.The skeletal surveys revealed no significant abnormalities.The serum ALP declined into the normal range adjusted for his age.This evidence is consistent with the diagnosis of TH.CONCLUSION TH can occur in COVID-19-infected toddlers.Serial measurements of ALP levels have been shown to gradually decline into the normal range within a few months.Therefore,being aware of this transient abnormality will help clinicians to avoid additional unnecessary investigations.展开更多
Introduction: Surgical management of adrenal tumors has greatly improved over the past years, with laparoscopic adrenalectomy being the gold standard. However, Open adrenalectomy is indicated in large adrenal tumors, ...Introduction: Surgical management of adrenal tumors has greatly improved over the past years, with laparoscopic adrenalectomy being the gold standard. However, Open adrenalectomy is indicated in large adrenal tumors, malignant tumors and large phaeochromocytomas. We report surgical outcomes of 18 cases of functional adrenal tumors from 2007 to 2022. Methods: We conducted a retrospective cross-sectional and descriptive study in three tertiary hospitals in Yaounde, Cameroon. We reviewed files of patients who underwent adrenalectomy over a period of 15 years from July 2007 to July 2022. Clinical and diagnostic components of adrenal tumors, indications and surgical outcomes were analyzed. Results: A total of 18 patients were included in our study. The average age of patients was 38.33 years, with a female-to-male sex ratio of 2:1. Weight gain (72.2%) was the most represented clinical sign. The secretory nature of tumor and malignancy represented 55.5% and 33.3% of the operative indications and all 18 (100%) of the patients had open adrenalectomy. Vascular injury was the most common intraoperative complication with 5.63%, while acute adrenal insufficiency (16.7%) was the most common post-operative complication. The average tumor size was 6.22 cm and the mean duration of hospitalization was 11.61 days. Adenoma 7 (38.9%) and adrenocortical carcinoma 5 (27.8%) were the frequent histological types. One patient died two months post-surgery from anemia-related complications. Conclusion: The success of adrenal surgery is linked to multidisciplinary patient care and the experience of the surgeon. Conventional surgery still has indications with satisfactory short- and medium-term results in our context.展开更多
Pancreatic islet transplantation is a minimally invasive procedure aiming to reverse the effects of insulin deficiency in patients with type 1 diabetes(T1D)by transplanting pancreatic beta cells.Overall,pancreatic isl...Pancreatic islet transplantation is a minimally invasive procedure aiming to reverse the effects of insulin deficiency in patients with type 1 diabetes(T1D)by transplanting pancreatic beta cells.Overall,pancreatic islet transplantation has improved to a great extent,and cellular replacement will likely become the mainstay treatment.We review pancreatic islet transplantation as a treatment for T1D and the immunological challenges faced.Published data demonstrated that the time for islet cell transfusion varied between 2 and 10 h.Approximately 54%of the patients gained insulin independence at the end of the first year,while only 20%remained insulin-free at the end of the second year.Eventually,most transplanted patients return to using some form of exogenous insulin within a few years after the transplantation,which imposed the need to improve immunological factors before transplantation.We also discuss the immunosuppressive regimens,apoptotic donor lymphocytes,anti-TIM-1 antibodies,mixed chimerism-based tolerance induction,induction of antigen-specific tolerance utilizing ethylene carbodiimide-fixed splenocytes,pretransplant infusions of donor apoptotic cells,B cell depletion,preconditioning of isolated islets,inducing local immunotolerance,cell encapsulation and immunoisolation,using of biomaterials,immunomodulatory cells,etc.展开更多
With lifestyle changes,the incidence of type 2 diabetes(T2DM)and obesity has significantly increased,becoming major chronic diseases that seriously threaten the health of China’s residents.Both domestic and internati...With lifestyle changes,the incidence of type 2 diabetes(T2DM)and obesity has significantly increased,becoming major chronic diseases that seriously threaten the health of China’s residents.Both domestic and international guidelines and consensus exist regarding the diagnosis and management of this disease.In recent years,T2DM treatment has focused more on new tactics that lean towards a patient-centered comprehensive management approach,replacing the traditional glucose-centered approach.Additionally,an increasing amount of evidence in medicine suggests that the reversal of diabetes is possible.However,there is currently no expert consensus on the clinical management of T2DM combined with obesity reversal treatment.Therefore,experts and scholars in China with extensive experience in T2DM combined with obesity reversal treatment have been invited to develop this consensus.The content includes early identification and diagnosis of T2DM combined with obesity,definition and mechanisms of diabetes reversal,disease assessment and grading,staging of diabetes and goals of reversal,the 2+N reversal strategy,inpatient system treatment combined with comprehensive outpatient management(including weight control,precise nutrition,scientific exercise,glucose-lowering medication,psychological intervention,rehabilitation therapy,and remote follow-up through online platforms),and evaluation of post-reversal efficacy.The aim is to further improve the level of T2DM combined with obesity reversal diagnosis,treatment,and management in China,and to implement the Healthy China strategy.展开更多
Introduction: The distribution of arteriopathy of the lower limbs (ALL) is not familiar in the city of Porto-Novo. The aim of this study was to determine the prevalence and associated factors of ALL in diabetic patien...Introduction: The distribution of arteriopathy of the lower limbs (ALL) is not familiar in the city of Porto-Novo. The aim of this study was to determine the prevalence and associated factors of ALL in diabetic patients in treatment at the Oueme-Plateau Provincial Teaching Hospital. Methods: This was a cross-sectional, descriptive, and analytical study from July 12 to October 10, 2021, at the Oueme-Plateau Provincial Teaching Hospital in Porto-Novo. ALL was screened by performing systolic pressure index (SPI) in all diabetic patients aged at least 18 years, seen in consultation or hospitalization during the study period and who had given their consent. Results: The study registered 165 diabetics and 98.2% of them were type 2. Subjects aged between 55 and 65 years were the most represented (33.9%), with an average age of 59.4 years. Women were in the majority (61.2%), with a sex ratio of 0.6. High blood pressure was associated with diabetes in 61.2% of patients. The prevalence of ALL was 48.5% (80 patients). Obliterative arteriopathy of the lower limbs (OALL) was observed in 70 patients (42.4%), mediacalcosis in 8 patients (4.8%), and mixed arteriopathy in 2 patients (1.2%). In 88.5% of patients, the pathology was symptomless. Factors significantly associated with ALL included advanced age (p = 0.01), the age of the glycemic imbalance (p = 0.03), lack of regular physical activity (p = 0.001) and dyslipidemia (p = 0.008). Conclusion: Pelvic limb arteriopathy is usual among diabetics at Oueme-Plateau Provincial Teaching Hospital. The use of SPI, which enables diagnosis, requires simple, low-cost means, and should be encouraged.展开更多
Diabetic foot ulcers are the consequence of multiple factors including peripheral neuropathy,decreased blood supply,high plantar pressures,etc.,and pose a significant risk for morbidity,limb loss and mortality.The cri...Diabetic foot ulcers are the consequence of multiple factors including peripheral neuropathy,decreased blood supply,high plantar pressures,etc.,and pose a significant risk for morbidity,limb loss and mortality.The critical aspects of the wound healing mechanism and host physiological status in patients with diabetes necessitate the selection of an appropriate treatment strategy based on the complexity and type of wound.In addition to systemic antibiotics and surgical intervention,wound care is considered to be an important component of diabetic foot ulcer management.This article will focus on the use of different wound care materials in diabetic foot.From a clinical perspective,it is important to decide on the wound care material depending on the type and grade of the ulcer.This article will also provide clinicians with a simple approach to the choice of wound care materials in diabetic foot ulcer.展开更多
Type 2 diabetes (T2D) is a disorder characterized by chronic inflated blood glucose levels (hyperglycemia), at first due to insulin resistance and unregulated insulin secretion but with tendency towards global spreadi...Type 2 diabetes (T2D) is a disorder characterized by chronic inflated blood glucose levels (hyperglycemia), at first due to insulin resistance and unregulated insulin secretion but with tendency towards global spreading. The gut microbiota is recognized to have an influence on T2D, although surveys have not formed a clear overview to date. Because of the interactions between gut microbiota and host homeostasis, intestinal bacteria are believed to play a large role in various diseases, including metabolic syndrome, obesity and associated disease. In this review, we highlight the animal and human studies which have elucidated the roles of metformin,α-glucosidase inhibitors, glucagon-like peptide-1 agonists, peroxisome proliferator-activated receptors γ agonists, inhibitors of dipeptidyl peptidase-4, sodium/glucose cotransporter inhibitors, and other less studied medications on gut microbiota. This review is dedicated to one of the most widespread diseases, T2D, and the currently used antidiabetic drugs and most promising new findings. In general, the gut microbiota has been shown to have an influence on host metabolism, food consumption, satiety, glucose homoeostasis, and weight gain. Altered intestinal microbiota composition has been noticed in cardiovascular diseases, colon cancer, rheumatoid arthritis, T2D, and obesity. Therefore, the main effect of antidiabetic drugs is on the microbiome composition, basically increasing the short-chain fatty acids-producing bacteria, responsible for losing weight and suppressing inflammation.展开更多
Objective: Metaplastic meningioma is a rare subtype of benign meningiomas, classified as WHO grade I with well prognosis. Here we presented our experiences on 15 cases of metaplastic meningioma, to investigate the cli...Objective: Metaplastic meningioma is a rare subtype of benign meningiomas, classified as WHO grade I with well prognosis. Here we presented our experiences on 15 cases of metaplastic meningioma, to investigate the clinicopathological features, therapies and prognosis of these cases. Methods: 15 patients underwent surgical treatment for intracranial metaplastic meningioma between 2001 and 2010 at Neurosurgery Department of Huashan Hospital, Shanghai, China. The clinical data, radiological manifestation, treatment strategy, pathological findings and prognosis of all patients were analyzed retrospectively. Results: Among the 15 cases (10 males and 5 females), the age ranged from 22 to 74 years old (the mean age was 50.67-year old). The clinical manifestations include headache, dizziness, seizure attack, vision decrease, and weakness of bilateral lower limbs. All the patients received surgical treatment, combined with radiotherapy in some cases. In the follow-up period, recurrence occurred in 2 cases, of which 1 patient died of other system complications. Conclusions: Metaplastic meningiomas are characterized by focal or widespread mesenchymal differentiation with formation of bone, cartilage, fat, and xanthomatous tissue elements. Surgical removal is the optimal therapy, and the overall prognosis is well. But recurrence may occur in some cases, thus radiotherapy is necessary for such kind of patients.展开更多
Objective:To study the effect of sitagliptin on adipocytokines expression in diabetic rats and its molecular mechanism.Methods:Male SD rats were chosen and randomly divided into NC group,T2DM group,SP group and SP+LY ...Objective:To study the effect of sitagliptin on adipocytokines expression in diabetic rats and its molecular mechanism.Methods:Male SD rats were chosen and randomly divided into NC group,T2DM group,SP group and SP+LY group.NC group received conventional breeding,T2DM group,SP group and SP+LY group received intraperitoneal injection of streptozotocin after 12 weeks of high-fat diet to establish diabetes animal model,SP group received sitagliptin intervention and SP+LY group received sitagliptin combined with PI3 K inhibitor LY294002 intervention.6 weeks after the intervention,serum was collected to determine the levels of biochemical indexes and adipocytokines,and visceral adipose tissue was collected to determine expression levels of adipocytokines.Results:Serum TC,TG,LDL-C,FBG,FINS,Leptin and Chemerin levels as well as HOMA-IR of T2DM group were higher than those of NC group,and HDL-C,Adiponectin and Omentin-1 levels were significantly lower than those of NC group; serum TC,TG,LDL-C,FBG,FINS,Leptin and Chemerin levels as well as HOMA-IR of SP group were lower than those of T2DM group,and HDL-C,Adiponectin and Omentin-1 levels were significantly higher than those of T2DM group; Leptin and Chemerin levels in serum and visceral adipose tissue of SP+LY group were higher than those of SP group while Adiponectin and Omentin-1 levels were significantly lower than those of SP group.Conclusion:Sitagliptin can regulate the expression of adipocytokines in adipose tissue of diabetic rats through PI3K-AKT pathway.展开更多
文摘Background: Congenital malformations such as micropenis and cryptorchidism do not have immediate dramatic consequences. However, the diagnosis is often unknown at birth, and therefore late. In Ivory Coast, there are few studies on cryptorchidism and micropenis. We conducted this study to identify the epidemiological, clinical, etiological and therapeutic characteristics of the micropenis associated or not with cryptorchidism at Yopougon University Hospital. Methods: We conducted a retrospective descriptive study in the Department of Endocrinology-Diabetology of the Yopougon University Hospital carried out over 13 years from January 2005 to December 2018. All patients were included regardless of the presence of a micropenis associated or not with cryptorchidism in the clinical or paraclinical examination. Results: A total of 14 micropenis were reported associated in 6 cases with cryptorchidism. It was unilateral cryptorchidism in 4 patients or 66.66% of cases. The average age of affected patients was 21.32 years with extremes ranging from 10 months to 48 years. The reason for consultation was micropenis in 12 out of 14 cases or 85.75%. The associated signs apart from cryptorchidism were obesity in 42.86% of cases, gynecomastia in 35.71% of cases. The aetiology was dominated by idiopathic causes. Treatment with testosterone enanthate was more effective in pre-pubertal children than in adults. Conclusion: The diagnosis of micropenis associated or not with cryptorchidism is late because of the frustrations, taboos and psycho-social states that it causes. However, drug treatment is effective when treatment is started early.
基金Supported by the Chongqing Science and Technology Bureau and Health Commission of Chinese Medicine Technology Innovation and Application Development Project,No.2020ZY013540General Project of Chongqing Natural Science Foundation,No.CSTB2023NSCQMSX0246 and No.CSTB2022NSCQ-MSX1271Science and Health Joint Project of Dazu District Science and Technology Bureau,No.DZKJ2022JSYJ1001.
文摘BACKGROUND Diabetes foot is one of the most serious complications of diabetes and an important cause of death and disability,traditional treatment has poor efficacy and there is an urgent need to develop a practical treatment method.AIM To investigate whether Huangma Ding or autologous platelet-rich gel(APG)treatment would benefit diabetic lower extremity arterial disease(LEAD)patients with foot ulcers.METHODS A total of 155 diabetic LEAD patients with foot ulcers were enrolled and divided into three groups:Group A(62 patients;basal treatment),Group B(38 patients;basal treatment and APG),and Group C(55 patients;basal treatment and Huangma Ding).All patients underwent routine follow-up visits for six months.After follow-up,we calculated the changes in all variables from baseline and determined the differences between groups and the relationships between parameters.RESULTS The infection status of the three groups before treatment was the same.Procalcitonin(PCT)improved after APG and Huangma Ding treatment more than after traditional treatment and was significantly greater in Group C than in Group B.Logistic regression analysis revealed that PCT was positively correlated with total amputation,primary amputation,and minor amputation rates.The ankle-brachial pressure and the transcutaneous oxygen pressure in Groups B and C were greater than those in Group A.The major amputation rate,minor amputation rate,and total amputation times in Groups B and C were lower than those in Group A.CONCLUSION Our research indicated that diabetic foot ulcers(DFUs)lead to major amputation,minor amputation,and total amputation through local infection and poor microcirculation and macrocirculation.Huangma Ding and APG were effective attreating DFUs.The clinical efficacy of Huangma Ding was better than that of autologous platelet gel,which may be related to the better control of local infection by Huangma Ding.This finding suggested that in patients with DFUs combined with coinfection,controlling infection is as important as improving circulation.
文摘Background: Type 2 diabetes mellitus (T2DM) is a metabolic disease, characterized by chronic hyperglycemia. This pathology is linked to various genes whose interaction with the environment promotes its development. The aim of this work was to determine the relationship between the rs2241766 (T/G) polymorphism of the ADIPOQ gene with type 2 diabetes in the black population. Material and Methods: This work was a case-control study, involving type 2 diabetics subjects (n = 94) and controls (n = 82). The study took place from September 2022 to September 2023. Patients were recruited in the Endocrinology Department of the Libreville University Hospital Center. Analysis was performed in the Biochemistry laboratory of the University of Health Sciences in Libreville and at the Research Institute of Health Sciences of Bobodioulasso. Genomic DNA was extracted using the protocol Qiagen kit and the PCR-RFLP method was used to determine the rs2241766 (T/G) polymorphism of the ADIPOQ gene. Results: Only 2 genotypes were found in this population, the TT genotype and the GT genotype. The proportions were not different between the two groups (p = 0.1095) neither the distribution of G and T alleles (p = 0.1095). On the other hand, the HDL hypocholesterolemia was frequent in subjects with the GT genotype compared to TT heterozygous (51.1% vs 48.9%, p = 0.0280;OR = 0.55 [0.30 - 1.01]). Conclusion: There was no association between the rs2241766 (T/G) variant of the ADIPOQ gene and the occurrence of type 2 diabetes in this population. On the other hand, a relationship between HDL hypocholesterolemia and the GT genotype has been established.
文摘Introduction: Diabetes mellitus, a metabolic disease, is now an important public health problem across the world. Our aim was to study the epidemiological, clinical, paraclinical, and evolutionary aspects of acute metabolic complications (AMC) of diabetes in the endocrinology department of the Oueme-Plateau Provincial Teaching Hospital. Methods: This was a descriptive cross-sectional study with data collection based on the medical records of patients presenting with acute metabolic complications of diabetes in the endocrinology department of the Oueme-Plateau Provincial Teaching Hospital during the 3 years study period (from January 2020 to December 2022). Results: Over 788 patients hospitalized during the study period, 157 had an acute metabolic complication of diabetes, which is a hospital prevalence of 19.9%. Among these 157 cases, 140 were suitable for analysis and therefore constituted our study sample. The mean age of the patients was 49.9 ± 14.7 years, with 19 as minimum and 90 years as maximum. Most of them were women (52.4%). Hypertensive diabetics accounted for 54.9% of cases. Ketoacidosis was the most common complication (62.1%), followed by hyperosmolar hyperglycemic syndrome (23.6%) and hypoglycemia (14.3%). Infection (69.3%) and therapeutic noncompliance (22.9%) were the most common triggers. The average length period of their hospital stay was 7.1 ± 5.1 days, and the outcome was satisfactory in 87.9% of the cases. Unfortunately, there were 3.6% deaths during hospitalization. Conclusion: Acute metabolic complications of diabetes were dominated by ketoacidosis. Infection was the dominant factor in decompensation. Therapeutic education of diabetic patients as well as clinical and biological monitoring must be more stringent and rigorous.
文摘With continuous population and economic growth in the 21st century,plastic pollution is a major global issue.However,the health concern of microplastics/nanoplastics(MPs/NPs)decomposed from plastic wastes has drawn public attention only in the recent decade.This article summarizes recent works dedicated to understanding the impact of MPs/NPs on the liver-the largest digestive organ,which is one of the primary routes that MPs/NPs enter human bodies.The interrelated mechanisms including oxidative stress,hepatocyte energy re-distribution,cell death and autophagy,as well as immune responses and inflammation,were also featured.In addition,the disturbance of microbiome and gut-liver axis,and the association with clinical diseases such as metabolic dysfunction-associated fatty liver disease,steatohepatitis,liver fibrosis,and cirrhosis were briefly discussed.Finally,we discussed potential directions in regard to this trending topic,highlighted current challenges in research,and proposed possible solutions.
基金supported by the National Key Research and Development Program of China(2017YFC1309800)the“Outstanding University Driven by Talents”Program and Academic Promotion Program of Shandong First Medical University(2019LJ007)the Key Research and Development Program of Shandong Province(2017CXGC1214).
文摘The aim of this study was to explore the associations of moderate-to-vigorous-intensity physical activity(MVPA)time and sedentary(SED)time with a history of cardiovascular disease(CVD)and multifactorial(i.e.,blood pressure(BP),body mass index(BMI),low-density lipoprotein cholesterol(LDL-C),and glycated hemoglobin A1c(HbA1c))control status among type 2 diabetes mellitus(T2DM)patients in China.A cross-sectional analysis of 9152 people with type 2 diabetes from the Multifactorial Intervention on Type 2 Diabetes(MIDiab)study was performed.Patients were grouped according to their self-reported MVPA time(low,<150 min·week−1;moderate,150 to<450 min·week−1;high,≥450 min·week−1)and SED time(low,<4 h·d–1;moderate,4 to<8 h·d–1;high,≥8 h·d–1).Participants who self-reported a history of CVD were identified as having a CVD risk.Odds ratios(ORs)and 95%confidence intervals(CIs)of CVD risk and multifactorial control status associated with MVPA time and SED time were estimated using mixed-effect logistic regression models,adjusting for China’s geographical region characteristics.The participants had a mean±standard deviation(SD)age of(60.87±8.44)years,44.5%were women,and 25.1%had CVD.After adjustment for potential confounding factors,an inverse association between high MVPA time and CVD risk that was independent of SED time was found,whereas this association was not observed in the moderate-MVPA group.A higher MVPA time was more likely to have a positive effect on the control of BMI.Compared with the reference group(i.e.,those with MVPA time≥450 min·week−1 and SED time<4 h·d–1),CVD risk was higher in the low-MVPA group:The OR associated with an SED time<4 h·d–1 was 1.270(95%CI,1.040–1.553)and that associated with an SED time≥8 h·d–1 was 1.499(95%CI,1.149–1.955).We found that a high MVPA time(i.e.,≥450 min·week−1)was associated with lower odds of CVD risk regardless of SED time among patients with T2DM.
基金NIH grants F31-DK122679 and T32-HL007910(MLN)a postdoctoral research grant from the Research Foundation–Flanders(FWO/12H5917N)(SS)+6 种基金R01-AR074473(WRT)R21-AR059278,R01-DK112958,and R01-HL145528(KEW)The David Weaver Professorship(KEW)The Indiana University Melvin and Bren Simon Comprehensive Cancer Center FCRF is funded in part by NIHNational Cancer Institute(NCI)grant P30 CA082709National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK)grant U54DK106846supported in part by NIH instrumentation grant 1S10D012270。
文摘Osteocytes act within a hypoxic environment to control key steps in bone formation.FGF23,a critical phosphate-regulating hormone,is stimulated by low oxygen/iron in acute and chronic diseases,however the molecular mechanisms directing this process remain unclear.Our goal was to identify the osteocyte factors responsible for FGF23 production driven by changes in oxygen/iron utilization.Hypoxia-inducible factor-prolyl hydroxylase inhibitors(HIF-PHI)which stabilize HIF transcription factors,increased Fgf23 in normal mice,as well as in osteocyte-like cells;in mice with conditional osteocyte Fgf23 deletion,circulating i FGF23 was suppressed.An inducible MSC cell line(‘MPC2’)underwent FG-4592 treatment and ATACseq/RNAseq,and demonstrated that differentiated osteocytes significantly increased HIF genomic accessibility versus progenitor cells.Integrative genomics also revealed increased prolyl hydroxylase Egln1(Phd2)chromatin accessibility and expression,which was positively associated with osteocyte differentiation.In mice with chronic kidney disease(CKD),Phd1-3 enzymes were suppressed,consistent with FGF23 upregulation in this model.Conditional loss of Phd2 from osteocytes in vivo resulted in upregulated Fgf23,in line with our findings that the MPC2 cell line lacking Phd2(CRISPR Phd2-KO cells)constitutively activated Fgf23 that was abolished by HIF1αblockade.In vitro,Phd2-KO cells lost iron-mediated suppression of Fgf23 and this activity was not compensated for by Phd1 or-3.In sum,osteocytes become adapted to oxygen/iron sensing during differentiation and are directly sensitive to bioavailable iron.Further,Phd2 is a critical mediator of osteocyte FGF23 production,thus our collective studies may provide new therapeutic targets for skeletal diseases involving disturbed oxygen/iron sensing.
基金the Construction Project of Workshop of Prestigious Chinese Physician Xiu-Hai Su(2022-75).
文摘Background:This study will be aimed at investigating the effects of Baihu Renshen decoction(BHRS)on type 2 diabetes rats and on macromolecular enzyme 1(PINK1)/E3 ubiquitin protein ligase(Parkin)pathway.Methods:The experiment was divided into four groups:control group,model group,metformin group and BHRS low-dose group and high-dose group.Forty male rats were selected as samples and randomly assigned to at least one test group.Finally,there are 18 rats in each group.Except for the control group,the rats within the different teams got a high-fat diet associate in nursing an intraperitoneal injection of streptozotocin to make a type 2 diabetes mellitus(T2DM)rat model.The organic chemistry and inflammatory indexes of rats in every cluster were analyzed and compared once four weeks of intragastric administration of comparable reagents to review the therapeutic impact of BHRS on T2DM.In addition,we determined the pathological changes of ductal gland tissue of T2DM rats after treatment,and compared the expression of mitochondrial phagocytosis related proteins in ductal gland tissue of rats in each group.Results:FBG,LDL-C,TC,TG,MDA,IL-1,IL-6,TNF-,and mitophagy-related proteins COXIV,P62,VDAC1,and TOM20 were elevated in the model group compared to the control group,while HDL-C,SOD,GSH-Px,and mitophagy-related proteins PINK1,Parkin,and LC3II/I were decreased(P<0.05 or P<0.01).The expressions of FBG,TC,TG,LDL-C,MDA,IL-1,IL-6,TNF-,and mitophagy-related proteins COXIV,P62,VDAC1,and TOM20 were lowered in the BHRS group,while the expressions of HOMA-,HDL-C,SOD,GSH-Px,and mitophagy-related proteins PINK1,Parkin,and LC3II/I were(P<0.05 or P<0.01).After therapy with BHRS,hematoxylin-eosin staining showed that the intensity of pancreatic acinar staining increased,and islet cells became clear boundaries that were,regularly arranged,and with reduced vacuoles reduced.Conclusion:BHRS has a clear therapeutic effect on T2DM,which may be achieved by regulating mitochondrial autophagy through the PINK1/Parkin pathway.
文摘Hypophosphataemia is defined as low level of phosphate in the blood (normal range 0.8 - 1.4 mmol/l), which can be drug-induced such as uniphyline. We present a case of elderly female patient with known chronic obstructive pulmonary disease, admitted with acute respiratory failure and low serum phosphate level, her clinical signs and serum phosphate level did not improve with conventional therapy and intravenous phosphate replacement, until her recently commenced uniphyline was discontinued. This highlights the importance of awareness amongst the clinicians about this rare but potential side effect of uniphyline. We suggest monitoring phosphate levels in patients admitted with acute respiratory failure especially those on extended bronchodilator therapy.
文摘Introduction: The curative management of primary hyperparathyroidism is based on surgery. We report the case of a patient presenting with elevated parathormone despite surgical removal of the parathyroid adenoma. Observation: A 48-year-old patient presented for more than 6 months with significant weight loss, polyuria with polydipsia and impaired renal function. The assessment carried out revealed hypercalcaemia at 155 mg/L with hypophastetaemia at 24 mg/L and an elevation of the parathyroid hormone at 218.9 pg/ml. Cervical ultrasound showed a mass at the expense of the lower left parathyroid gland. These results made it possible to conclude primary hyperparathyroidism by parathyroid adenoma which was supported surgically. The postoperative biological assessment revealed a normocalcemia at 85 mg/L associated with an increase in parathormone (PTH) at 271.9 pg/ml. In front of the normalization of calcemia in the subsequent controls and the amendment of all the signs, monitoring was carried out. 9 months after surgery, spontaneous normalization of PTH was observed at 38.4 pg/ml with normal serum calcium at 90 mg/l. Discussion: Primary hyperparathyroidism can be revealed by other manifestations. Post-operative follow-up is generally simple with normalization of PTH and serum calcium. However, there may persist an elevation of PTH with normal self-limiting calcemia.
文摘BACKGROUND Transient hyperphosphatasemia(TH)is a condition characterized by elevated serum alkaline phosphatase(ALP)in the clinical setting with no evidence of bone or liver disease among children under the age of 5.Typically,it will resolve spontaneously in a few months in the majority of cases.TH has been found to be associated with viral infections.Two cases of TH associated with coronavirus disease 2019(COVID-19)infection in toddlers have been previously reported.CASE SUMMARY A previously healthy 2-year-old boy presented with fever and positive real-time polymerase chain reaction for COVID-19.Prior to his illness,the patient had been in close contact with his grandfather,who later developed COVID-19.The physical examination on admission was unremarkable.He remained asymptomatic throughout 7 d of hospitalization.On the 5th day of his illness,blood tests showed markedly elevated serum ALP(4178 U/L).Results from the simultaneous testing of the remaining liver profiles and metabolic bone panels were normal.Two months after discharge from the hospital,the patient continued to thrive well.The skeletal surveys revealed no significant abnormalities.The serum ALP declined into the normal range adjusted for his age.This evidence is consistent with the diagnosis of TH.CONCLUSION TH can occur in COVID-19-infected toddlers.Serial measurements of ALP levels have been shown to gradually decline into the normal range within a few months.Therefore,being aware of this transient abnormality will help clinicians to avoid additional unnecessary investigations.
文摘Introduction: Surgical management of adrenal tumors has greatly improved over the past years, with laparoscopic adrenalectomy being the gold standard. However, Open adrenalectomy is indicated in large adrenal tumors, malignant tumors and large phaeochromocytomas. We report surgical outcomes of 18 cases of functional adrenal tumors from 2007 to 2022. Methods: We conducted a retrospective cross-sectional and descriptive study in three tertiary hospitals in Yaounde, Cameroon. We reviewed files of patients who underwent adrenalectomy over a period of 15 years from July 2007 to July 2022. Clinical and diagnostic components of adrenal tumors, indications and surgical outcomes were analyzed. Results: A total of 18 patients were included in our study. The average age of patients was 38.33 years, with a female-to-male sex ratio of 2:1. Weight gain (72.2%) was the most represented clinical sign. The secretory nature of tumor and malignancy represented 55.5% and 33.3% of the operative indications and all 18 (100%) of the patients had open adrenalectomy. Vascular injury was the most common intraoperative complication with 5.63%, while acute adrenal insufficiency (16.7%) was the most common post-operative complication. The average tumor size was 6.22 cm and the mean duration of hospitalization was 11.61 days. Adenoma 7 (38.9%) and adrenocortical carcinoma 5 (27.8%) were the frequent histological types. One patient died two months post-surgery from anemia-related complications. Conclusion: The success of adrenal surgery is linked to multidisciplinary patient care and the experience of the surgeon. Conventional surgery still has indications with satisfactory short- and medium-term results in our context.
基金Supported by European Union-NextGenerationEU,through The National Recovery and Resilience Plan of the Republic of Bulgaria,No.BG-RRP-2.004-0008-C01.
文摘Pancreatic islet transplantation is a minimally invasive procedure aiming to reverse the effects of insulin deficiency in patients with type 1 diabetes(T1D)by transplanting pancreatic beta cells.Overall,pancreatic islet transplantation has improved to a great extent,and cellular replacement will likely become the mainstay treatment.We review pancreatic islet transplantation as a treatment for T1D and the immunological challenges faced.Published data demonstrated that the time for islet cell transfusion varied between 2 and 10 h.Approximately 54%of the patients gained insulin independence at the end of the first year,while only 20%remained insulin-free at the end of the second year.Eventually,most transplanted patients return to using some form of exogenous insulin within a few years after the transplantation,which imposed the need to improve immunological factors before transplantation.We also discuss the immunosuppressive regimens,apoptotic donor lymphocytes,anti-TIM-1 antibodies,mixed chimerism-based tolerance induction,induction of antigen-specific tolerance utilizing ethylene carbodiimide-fixed splenocytes,pretransplant infusions of donor apoptotic cells,B cell depletion,preconditioning of isolated islets,inducing local immunotolerance,cell encapsulation and immunoisolation,using of biomaterials,immunomodulatory cells,etc.
文摘With lifestyle changes,the incidence of type 2 diabetes(T2DM)and obesity has significantly increased,becoming major chronic diseases that seriously threaten the health of China’s residents.Both domestic and international guidelines and consensus exist regarding the diagnosis and management of this disease.In recent years,T2DM treatment has focused more on new tactics that lean towards a patient-centered comprehensive management approach,replacing the traditional glucose-centered approach.Additionally,an increasing amount of evidence in medicine suggests that the reversal of diabetes is possible.However,there is currently no expert consensus on the clinical management of T2DM combined with obesity reversal treatment.Therefore,experts and scholars in China with extensive experience in T2DM combined with obesity reversal treatment have been invited to develop this consensus.The content includes early identification and diagnosis of T2DM combined with obesity,definition and mechanisms of diabetes reversal,disease assessment and grading,staging of diabetes and goals of reversal,the 2+N reversal strategy,inpatient system treatment combined with comprehensive outpatient management(including weight control,precise nutrition,scientific exercise,glucose-lowering medication,psychological intervention,rehabilitation therapy,and remote follow-up through online platforms),and evaluation of post-reversal efficacy.The aim is to further improve the level of T2DM combined with obesity reversal diagnosis,treatment,and management in China,and to implement the Healthy China strategy.
文摘Introduction: The distribution of arteriopathy of the lower limbs (ALL) is not familiar in the city of Porto-Novo. The aim of this study was to determine the prevalence and associated factors of ALL in diabetic patients in treatment at the Oueme-Plateau Provincial Teaching Hospital. Methods: This was a cross-sectional, descriptive, and analytical study from July 12 to October 10, 2021, at the Oueme-Plateau Provincial Teaching Hospital in Porto-Novo. ALL was screened by performing systolic pressure index (SPI) in all diabetic patients aged at least 18 years, seen in consultation or hospitalization during the study period and who had given their consent. Results: The study registered 165 diabetics and 98.2% of them were type 2. Subjects aged between 55 and 65 years were the most represented (33.9%), with an average age of 59.4 years. Women were in the majority (61.2%), with a sex ratio of 0.6. High blood pressure was associated with diabetes in 61.2% of patients. The prevalence of ALL was 48.5% (80 patients). Obliterative arteriopathy of the lower limbs (OALL) was observed in 70 patients (42.4%), mediacalcosis in 8 patients (4.8%), and mixed arteriopathy in 2 patients (1.2%). In 88.5% of patients, the pathology was symptomless. Factors significantly associated with ALL included advanced age (p = 0.01), the age of the glycemic imbalance (p = 0.03), lack of regular physical activity (p = 0.001) and dyslipidemia (p = 0.008). Conclusion: Pelvic limb arteriopathy is usual among diabetics at Oueme-Plateau Provincial Teaching Hospital. The use of SPI, which enables diagnosis, requires simple, low-cost means, and should be encouraged.
文摘Diabetic foot ulcers are the consequence of multiple factors including peripheral neuropathy,decreased blood supply,high plantar pressures,etc.,and pose a significant risk for morbidity,limb loss and mortality.The critical aspects of the wound healing mechanism and host physiological status in patients with diabetes necessitate the selection of an appropriate treatment strategy based on the complexity and type of wound.In addition to systemic antibiotics and surgical intervention,wound care is considered to be an important component of diabetic foot ulcer management.This article will focus on the use of different wound care materials in diabetic foot.From a clinical perspective,it is important to decide on the wound care material depending on the type and grade of the ulcer.This article will also provide clinicians with a simple approach to the choice of wound care materials in diabetic foot ulcer.
文摘Type 2 diabetes (T2D) is a disorder characterized by chronic inflated blood glucose levels (hyperglycemia), at first due to insulin resistance and unregulated insulin secretion but with tendency towards global spreading. The gut microbiota is recognized to have an influence on T2D, although surveys have not formed a clear overview to date. Because of the interactions between gut microbiota and host homeostasis, intestinal bacteria are believed to play a large role in various diseases, including metabolic syndrome, obesity and associated disease. In this review, we highlight the animal and human studies which have elucidated the roles of metformin,α-glucosidase inhibitors, glucagon-like peptide-1 agonists, peroxisome proliferator-activated receptors γ agonists, inhibitors of dipeptidyl peptidase-4, sodium/glucose cotransporter inhibitors, and other less studied medications on gut microbiota. This review is dedicated to one of the most widespread diseases, T2D, and the currently used antidiabetic drugs and most promising new findings. In general, the gut microbiota has been shown to have an influence on host metabolism, food consumption, satiety, glucose homoeostasis, and weight gain. Altered intestinal microbiota composition has been noticed in cardiovascular diseases, colon cancer, rheumatoid arthritis, T2D, and obesity. Therefore, the main effect of antidiabetic drugs is on the microbiome composition, basically increasing the short-chain fatty acids-producing bacteria, responsible for losing weight and suppressing inflammation.
基金supported by National Natural Science Foundation of China(81200936,30872675,30901549)Shanghai Committee of Science and Technology (12JC1401800)2011 Shanghai Medical College Young Scientist Fund of Fudan University(11L-24)
文摘Objective: Metaplastic meningioma is a rare subtype of benign meningiomas, classified as WHO grade I with well prognosis. Here we presented our experiences on 15 cases of metaplastic meningioma, to investigate the clinicopathological features, therapies and prognosis of these cases. Methods: 15 patients underwent surgical treatment for intracranial metaplastic meningioma between 2001 and 2010 at Neurosurgery Department of Huashan Hospital, Shanghai, China. The clinical data, radiological manifestation, treatment strategy, pathological findings and prognosis of all patients were analyzed retrospectively. Results: Among the 15 cases (10 males and 5 females), the age ranged from 22 to 74 years old (the mean age was 50.67-year old). The clinical manifestations include headache, dizziness, seizure attack, vision decrease, and weakness of bilateral lower limbs. All the patients received surgical treatment, combined with radiotherapy in some cases. In the follow-up period, recurrence occurred in 2 cases, of which 1 patient died of other system complications. Conclusions: Metaplastic meningiomas are characterized by focal or widespread mesenchymal differentiation with formation of bone, cartilage, fat, and xanthomatous tissue elements. Surgical removal is the optimal therapy, and the overall prognosis is well. But recurrence may occur in some cases, thus radiotherapy is necessary for such kind of patients.
基金supported by General Medical Science and Technology Plan Project of Zhejiang Province in 2016.(Grant No.:2016KYB214)
文摘Objective:To study the effect of sitagliptin on adipocytokines expression in diabetic rats and its molecular mechanism.Methods:Male SD rats were chosen and randomly divided into NC group,T2DM group,SP group and SP+LY group.NC group received conventional breeding,T2DM group,SP group and SP+LY group received intraperitoneal injection of streptozotocin after 12 weeks of high-fat diet to establish diabetes animal model,SP group received sitagliptin intervention and SP+LY group received sitagliptin combined with PI3 K inhibitor LY294002 intervention.6 weeks after the intervention,serum was collected to determine the levels of biochemical indexes and adipocytokines,and visceral adipose tissue was collected to determine expression levels of adipocytokines.Results:Serum TC,TG,LDL-C,FBG,FINS,Leptin and Chemerin levels as well as HOMA-IR of T2DM group were higher than those of NC group,and HDL-C,Adiponectin and Omentin-1 levels were significantly lower than those of NC group; serum TC,TG,LDL-C,FBG,FINS,Leptin and Chemerin levels as well as HOMA-IR of SP group were lower than those of T2DM group,and HDL-C,Adiponectin and Omentin-1 levels were significantly higher than those of T2DM group; Leptin and Chemerin levels in serum and visceral adipose tissue of SP+LY group were higher than those of SP group while Adiponectin and Omentin-1 levels were significantly lower than those of SP group.Conclusion:Sitagliptin can regulate the expression of adipocytokines in adipose tissue of diabetic rats through PI3K-AKT pathway.
