Objective To investigate adiponectin level in female patients with nonalcoholic fatty liver disease(NAFLD),and to explore the relationship between adiponectin and ?-cell function and insulin resistance.Methods The investigation used case control study.Nine patients with nonalcoholic fatty liver disease(NAFLD) and seven control subjects(C) were analyzed for ?-cell function and insulin resistance by hyperglycemic clamp.Serum adiponectin was assayed by ELISA.Subcutaneous adipose areas(SA),visceral adipose areas(VA),liver inphase(IP) and outphase(OP)were measured by MRI.Results The result showed the levels of fasting insulin(FINS),first phase insulin release(1Ph),glucose disposal rates(M),insulin sensitivity index(ISI),and adiponectin were significantly lower in NAFLD than those in C group(P0.05).Spearman correlation analysis showed adiponectin was positively associated with M(r=0.526,P=0.036),ISI(r=0.682,P=0.005),1Ph(r=0.676,P=0.003),liver OP(r=0.682,P=0.004) and OP/IP(r=0.594,P=0.015).Conclusion The result suggested that adiponectin level was decreased in female patients with NAFLD.Hypoadiponectinemia may be associated with insulin resistance and early beta-cell dysfunction in NAFLD.

Objective To investigate the adiponectin levels in non-obese first-degree relatives (FDR)of type 2 diabetic subjects and its relation to insulin sensitivity and the intima-media thickness of the common carotid artery (IMT) during 5-year follow-up. Methods Fifty-three FDR subjects and 37 control subjects who were free of type 2 diabetes were enrolled. Plasma adipenectin, lipid profile, blood glucose, fasting insulin, and blood pressure were determined at baseline and after 5-year follow-up. IMT and endothelial-dependent vasodilation (EDVD) were measured by high-resolution B-mode ultrasound imaging. Homeostasis model assessment was used to evaluate insulin resistance (HOMA-IR)and β-cell function (HOMA-β). 29 FDR subjects and 20 control subjects completed the follow-up. Results Comparing with the control, plasma adiponectin levels in non-obese FDR subjects were lower at baseline [(10.06±5.79)vs (14.43±7.91) mg/L, P< 0.05]. Plasma adiponectin were decreased 24.0% in non-obese FDR and 36.7% in control duning 5 year follow-up (both P<0.05). Adiponectin levels were negatively correlated with waist-to-hip ratio (r = -0. 397), fasting blood glucose (r = -0. 373), IMT (r = -0. 372), and HOMA-IR (r=-0. 40)in the non-obese FDR. After adjusting other relevant risk factors,adiponectin was associated with age, high-density lipoprotein-cholesterol, and IMT in multiple regression analyses in non-obese FDR group. In the control group, a similar analysis revealed that low-density lipoprotein-cholesterol and IMT explained 25% of the variability in the adiponectin concentration. Conclusion Plasma adiponectin levels were decreased after 5 years in both non-obese FDR and control subjects. Decreased adiponectin level may be related to IMT increment.

Objective:To investigate insulin resistance and the β-cell function in nondiabetic first degree relatives of type 2 diabetes mellitus(FDR) over 5 years follow-up. Methods:Thirty-two patients with non-diabetic first degree relatives of type 2 diabetes(FDR) and 18 healthy controls(NC)were assigned and measuerd body mass index(BMI), waist hip ratio(WHR), blood pressure, serum lipids, serum glucose and fasting insulin(FINS) at baseline. Homeostasis model assessment(HOMA) was applied to assess the status of insulin resistance and β-cell function. Five years later, all subjects were reexamined. Results:HOMA-IR was significantly elevated and HOMA-β was lower in FDR group compared with baseline. During 5 years follow-up, HOMA-IR was not significantly changed between two the groups, but HOMA-β was significantly lower in FDR group than in NC group. Multiple linear regression analysis showed that FBG, FINS,HDL-C were the major risk factors affecting insulin resistance in FDR and the major risk factors affecting β-cell function was FBG and FINS. Conclusion:The nonobese first degree relatives of type 2 diabetes mellitus had insulin resistance and impaired β-cell function at prediabetic stage, and by step, β-cell function may be significantly lower in the period of developing type 2 diabetes mellitus.

检测了5年前后肥胖组32例和正常对照组19例脂肪素水平,并评价IMT、HOMA-IR和HOMA-β。结果5年后O组和NC组WHR、总胆固醇(TC)、甘油三酯(TG)和空腹血糖(FBG)水平高于5年前,脂联素水平均低于5年前(P<0.05)。5年后O组、BF、FBG和HOMA-IR水平高于NC组,HDL-C和脂联素水平低于NC组(P<0.05)。多元逐步回归分析显示,脂联素与BF呈正相关;与HOMA-IR呈负相关。结论随着年龄增长,肥胖和正常对照组的脂联素水平均逐渐降低,肥胖患者更明显;低脂联素血症与IR密切相关。

脂联素(Adiponectin,APN)是新近发现的一种脂肪细胞特异性分泌的激素蛋白,具有维持机体代谢平衡、增强胰岛素敏感性、抗炎和抗动脉粥样硬化作用[1].

Objective:To observe the effects of the application of external bile recycle combined with enteral nutrition for the treatment of malignant obstructive jaundice.Methods:The Chinical data of 60 cases with malignant obstructive jaundice treated in our hospital were analyzed retrospectively.All the cases were divided into bile recycle group(23 cases),simple external drainage group(18 cases)and enternal drainage group(19 eases).ALT.TB,serum albumin,prealbumin.ET.TNF-αand sIL- 2R were detected on the operation clay.the 6~(th)day and the 10~(th)day after operation respectively.Results:①The 3 groups inde- xes of ALT.TB.ET.TNF-αand sIL-2R fell down after operations.But the 6 days after operations these indexes in the bile re- cycle group were lower than other 2 groups.On the 10~(th)day after operations,these indexes in enternal drainage group were e- qual to those which in bile recycle group,and these indexes in simple external drainage group were higher than other 2 groups (P0.05).②The 3 groups indexes of serum albumin and prealbumin rise after operations.But the 6tb day after operations these indexes in the bile recycle group were higher than other 2 groups.On the 10~(th)day after operations these indexes in enter- nal drainage group were equal to those which in bile recycle group,these indexes in simple external drainage group were lower than other 2 groups(P0.05).③In the bile recycle group the complication occurrence,the time of hospitalization and cost were lower than other 2 groups(P0.05).Conclusion:Bile recycle can improve the nutritional condition of the patients suffer- ing from malignant obstructive jaundice more effectively and more quickly.It can also promote the restore of the hepatic function. alleviate inflammatory reaction,increase the immune activity,low down the occurrence of complication and the cost.External bile recy- cle combined with enteral nutrition has the significant clinical value which is simple,safe.effective and inexpensive.

梗阻性黄疸引起肝细胞的损伤,释放多种细胞因子及炎性介质致肠黏膜屏障损伤,肠道细菌移位产生肠源性内毒素血症,可导致肝肾等多脏器功能衰竭.乌司他丁(ulinastatin,UTI)有抑制多种水解酶活性,抑制细胞因子和炎性介质的释放,本研究探讨UTI在梗阻性黄疸大鼠模型中保护肠黏膜屏障功能的作用机制.

The plasma visfatin,endothelium-dependent artery dilation and intima-media thickness of common carotid arteries were measured in first-degree relatives of type 2 diabetes,obese patients and control subjects.Regional body fat were detected by MRI.The result suggested that plasma visfatin levels were significantly higher in obese subjects than those in non-obese subjects,and hypervisfatinemia is independently associated with fasting blood glucose.

Objective:To explore the relationship between serum adiponectin(APN)level and microalbuminuria with type 2 diabetes.Methods:Eighty six patients with type 2 diabetes and twenty control subjects(C)were analyzed for serum adiponectin by ELISA.Fasting blood glucose,serum lipids,insulin resistance index(HOMR-IR)and 24h urinary albumin were measured in all subjects.The patients with type 2 diabetes were separated into normalalbuminuria(NAU)and MAU group based on 24 h urinary albumin.Results:The result showed the serum APN level was significantly higher in group C than group that of MAU(P0.05).Spearman correlation analysis showed adiponectin was negatively associated with 24 h urinary albumin(r=-0.268,P=0.016)and FBG(r=-0.231,P=0.039).After the adjustment of FBG,the serum APN level was still higher in group C than that of group MAU(P0.05).Conclusion:The result suggests that the serum adiponectin level is decreased in type 2 diabetes with MAU.Hypoadiponectinemia may be associated with MAU.

Objective:To investigate the effat of on UTI of intestinal mucosa of rats with obstructive jaundice.Methods:Fifty- six SD rats were randomized into the Sham group,OJ group and UTI group.After the establishment of the model,the rats were injected 1 ml/10 000U UTI,one time for every day.After 3d,6d and 9d the rats of Group UTI3,UTI6 and UTI9 were killed separately,The Sham group and OJ group were killed by injecteng saline at the same time.Then the symptooms were watched,the blood was collected from inferior vena cava to detect the content of ET,TNF-α,WBC,the transloeation rate of hac- teria,ALT and SB.The specimen of liver and small intestine were collected to make the pathological analysis.Results:Com- pared with OJ group,the contents of WBC,ALT,SB,ET,TNF-α,the translocation rate of bacteria,ascites,wound infection, hemorrhage,cholestasis,necrosis of liver cells,the edema,erosion,atrophy and infiltration of inflammatory cell of intestinal mucosa of UTI group were all notabaly lowered down.Conclusion:UTI can protect the liver,inhibit the inflammatory reaction, lower down the translocation rate of bacteria and protect the defence function of intestinal mucosa when treating the rat model of Obstructive jaundice.

D-乳酸是细菌代谢、裂解的产物,血中D-乳酸的蓄积可能反映全身感染或某些胃肠道疾病时肠黏膜通透性的增高.文献报道认为,D-乳酸可作为新的血浆标志物应用于急性肠黏膜损害的早期诊断,并有将D-乳酸用于评价肠道屏障功能方面的报道[1-2].

Purpose To study beta-cell function and insulin sensitivity in abdominal visceral obesity. Methods Fifty-two abdominal visceral obesity patients,47 control subjects and 102 type 2 diabetes mellitus(T2DM) were selected to study.Nine visceral obesity subjects,3 novisceral obesity patients,9 control subjects and 7 T2DM were analyzed for beta-cell function and insulin sensitivity by hyperglycemic clamp and regional body fat was measured by MRI. Results The result showed that the levels of first phase insulin release(FPIR),glucose disposal rates(GDR) and insulin sensitivity index(ISI) were significantly elevated and fasting insulin(FINS).HOMA-IR and proinsulin were remarkably decreased in control group compared with visceral obesity group and T2DM group(P0.05).As compared with T2DM group,the levels of waist hip ratio(WHR),HOMA-β,fasting blood glucose(FBG),visceral adipose area(VA),subcutaneous adipose area(SA),FPIR,second phase insulin release(SPIR) and maximum insulin release(INS-ax) were increased and FBG decreased in visceral obesity group.Multiple stepwise regression analysis showed FBG was the independent negatively correlated to FPIR,WHR negatively correlated with ISI(P0.05). Conclusions The study confirmed that insulin resistance is uniformly present in subjects with visceral obesity who may be had early beta-cell dysfunction.

OBJECTIVETo investigate the relationship between adiponectin and beta-cell function in abdominal visceral obesity women.METHODSNine abdominal visceral obesity women (VO), 9 normal subjects (C) and 7 patients with type 2 diabetes mellitus (T2DM) were enrolled in the study. Beta-cell function and insulin sensitivity were determined by hyperglycemic clamp, fasting serum adiponectin was assayed by ELISA and regional body fat was measured by MRI.RESULTThe levels of first phase insulin release (FPIR), glucose disposal rates (GDR), insulin sensitivity index (ISI) and adiponectin were significantly elevated in control group compared with VO group and T2DM group. As compared with T2DM group, the levels of adiponectin, FPIR, second phase insulin release (SPIR) and maximum insulin release (INS(max)) increased significantly in VO group. Multiple stepwise regression analysis showed that age, FPIR and GDR were positively correlated to adiponectin (B=0.145, 0.194, 0.277 respectively, all P<0.05), while waist-hip ratio was negatively correlated with adiponectin (B=-7.424, P<0.05).CONCLUSIONThe visceral obesity women have lower adiponectin levels, and hyperadiponectinemia may be the link with insulin secretion.

Objective To describe the current HBV incidence and epidemiology among children born by women suffering from hepatitis B.Methods Newborns were injected hepatitis B vaccine,and one month and six months later were injected hepatitis B Vaccine repeatly.Six years later fresh serum samples of the children were analyzed by ELISA.Results The HBsAg rate among children not received hepatitis B vaccine was 90%(9/10),the HBsAb rate was 10%(1/10).And the HBsAg rate among children received hepatitis B vaccine was 5%(1/20),while the HBsAb rate was 80%(16/20).Conclusion The HBsAg rate is lower among children received hepatitis B vaccine than those not received hepatitis B vaccine .

[目的] 了解上海市闵行地区乙肝表面抗原流行情况.[方法] ELISA法测定14750不同年龄段体检人群乙肝表面抗原.[结果] 小于18岁乙肝表面抗原感染率2.26%(242/10698),大于18岁乙肝表面抗原3.43%(139/4052),合计2.58%(381/14750).[结论] 18岁人群乙肝表面抗原感染率比18岁以下感染率高,男性感染率较女性高.