目的 探讨2型糖尿病(T2DM)患者血清网膜素1(Omentin-1)水平与骨代谢及氧化应激的关系.方法 选取120例T2DM患者,根据病情控制情况将其分为A组(病情控制良好)68例和B组(病情控制不良)52例.另选择同期健康体检者60例作为对照组.采集受试者清晨空腹静脉血,采用ELISA法检测Omentin-1以及骨代谢指标骨特异性碱性磷酸酶(BAP)、骨钙素(BGP)、抗酒石酸酸性磷酸酶(TrACP-5b),硫代巴比妥酸比色法测定血清丙二醛(MDA),羟胺法测定超氧化物歧化酶(SOD)水平.比较三组血清Omentin-1水平、骨代谢指标及氧化应激指标的差异,采用Pearson相关系数法分析T2DM患者血清Omentin-1水平与骨代谢指标及氧化应激指标的相关性.结果 A、B两组血清Omentin-1水平均低于对照组,且B组低于A组(P均<0.05).与对照组比较,A、B两组血清BAP、TrACP-5b水平升高,BGP水平降低(P均<0.05);与A组比较,B组血清BAP、TrACP-5b水平升高,BGP水平降低(P均<0.05).与对照组比较,A、B两组血清MDA水平升高,SOD水平降低(P均<0.05);与A组比较,B组血清MDA水平升高,SOD水平降低(P均<0.05).T2DM患者血清Omentin-1水平与BAP、TrACP-5b、MDA呈负相关(r分别为-0.508、-0.660、-0.625,P<0.05或<0.01),与BGP、SOD呈正相关(r分别为0.701、0.589,P<0.05或<0.01).结论 T2DM患者血清Omentin-1水平降低,血糖控制不佳者下降更显著;Omentin-1水平与骨代谢异常及氧化应激反应有关,可能在糖尿病进展及骨代谢异常中发挥作用.

Objective To investigate the expression of human epididymis secretory protein 4 (HE4) and osteopontin(OPN) in normal endometrium group,precancerous lesion group and endometrial cancer group,and to analyze the correlation between the two proteins as well as the effect on the prognosis of EC operation.Methods Immunohistochemical SP method was used to detect the expression of HE4 and OPN in normal group,precancerous lesion group and cancer group of Handan Central Hospital from January 2009 to June 2015,and the correlation of factors and overall survival time was evaluated by Kaplan-Meier method and Log-rank test.COX model was used for multivariate analysis.Results In normal group,precancerous lesion group and cancer group,the positive expression of HE4 protein gradually increased respectively 13.33％,32.00％,70.76％,and the positive expression of OPN protein also gradually increased respectively 10.00％,24.00％,63.74％,with statistically significant difference between the three groups (P ＜ 0.05).The positive expression rate of HE4 and OPN protein in surgery pathological stage,histological grade,myometrial invasion and lymph node metastasis group,and the differences were statistically significant (P ＜ 0.05).Spearman correlation analysis showed that the expression of HE4 protein was positively correlated with the expression of OPN protein in endometrial carcinoma (r =0.397,P ＜ 0.05).Kaplan-Meier analysis showed that the five factors of surgical pathologic staging,myometrial invasion,lymph node metastasis,HE4 positive status and OPN positive status were associated with prognosis (P ＜ 0.05),while the age,histological grade,histological type were not associated with prognosis (P ＞ 0.05).COX multivariate stepwise analysis showed that the significant factors influencing the prognosis were surgery pathological stage,histological grade,myometrial invasion,HE4 positive status and OPN positive status,but the histological grade was the least (P =0.049).Conclusion HE4 and OPN protein is highly expressed in the EC and both were positively correlated.The endometrial carcinoma patients with late surgery pathological stage,high histological grade,deep myometrial invasion,HE4 expression positive,OPN expression positive have poor prognosis.HE4 and OPN are expected to be an important marker for evaluating the prognosis of EC.

Objective:To investigate correlation of serum osteoprotegerin (OPG) and bone mineral density (BMD) in patients with type 2 diabetes mellitus.Methods:114 cases of T2DM patients in our hospital from January 2014 to January 2016 were selected,including 40 cases of normal bone group,35 cases of bone loss group and 39 cases of osteoporosis group,serum OPG and other biochemical parameters were detected.Results:Among the three groups,gender,age,lumbar spine BMD and hip BMD,lumbar T value,hip T value,course of disease and OPG difference had statistical significance (P ＜ 0.05),among which OPG in osteoporosis group was (6.81 ± l.17) pmol · L-1,was significantly higher than that in other groups (P ＜ 0.05);in the three groups serum OPG and lumbar,hip BMD were negatively correlated (P ＜ 0.05);multiple linear regression analysis showed that age,BMI and OPG were correlated with the BMD (P ＜ 0.05).Conclusion:In type 2 diabetic patients,serum OPG is negatively correlated with BMD,and OPG is significantly increased in the patients with osteoporosis.

Objective:To investigate the relationship between serum levels of bone protective factor (OPG) and oxidative stress in patients with type 2 diabetes mellitus (T2DM).Methods:January 2014 to December 2015,128 patients with T2DM in Handan Central Hospital were selected.According to the bone mineral density (BMD),they were divided into 45 cases of the normal bone mass group,42 cases of the bone mass reduction group and 41 cases of osteoporosis group,another 50 cases of healthy people were selected as the control group.Serum OPG,SOD,GSH,MDA,CAT,GSH-Px and AOPP wrer detected,and the relationship among the groups was analyzed.Results:SOD,GSH,GSH-Px in the normal bone mass group,osteopenia group and osteoporosis group were significantly higher than those in the control group (P ＜ 0.05).SOD,GSH-Px,CAT in the osteoporosis group were significantly lower than those of the osteopenia group and normal bone mass group (P ＜ 0.05).SOD and GSH in the osteoporosis group were significantly lower than those in the normal bone mass group (P ＜ 0.05).MDA,OPG,AOPP in the normal bone mass group,osteopenia group,osteoporosis group were significantly higher than those in the control group (P ＜ 0.05).OPG and AOPP in the osteoporosis group were significantly higher than those of osteopenia group,osteoporosis group (P ＜ 0.05).MDA in the osteoporosis group was significantly higher than that of normal bone mass group (P ＜ 0.05).Multiple stepwise regression analysis showed that OPG =-0.481 (SOD)-0.322 (GSH)+2.755 (MDA)-0.319 (GSH-Px)+ 1.672 (AOPP);OPG was negatively correlated with SOD,GSH,GSH-Px (P ＜ 0.05),and positively correlated with MDA,AOPP (P ＜ 0.05).Conclusion:OPG level in patients with T2DM is closely related to oxidative stress,oxidative stress may contribute to the development of diabetic osteoporosis.

A 45-years-old female patient with hyperthyroidism was given methimazole for treatment . Half a month after her medication she got obnubilation . The oral glucose tolerance test showed that 2 h later blood glucose was 10 . 97 mmol/L , the concentration of insulin and C-Peptide was 156 mIU/L and 15 . 4 ng/mL , 4 h later , blood glucose was 2 . 69 mmol/L , the concentration of insulin and C-Peptide was 156 mIU/L and 14 . 2ng/mL respectively . The female was diagnosed as a patient of insulin autoimmune syndrome ( IAS ) induced by methimazole . The symp-toms got relieved after an intravenous infusion of glucose was given . It is reminded that close attention should be paid on the occurrence of adverse drug reaction when using the drug , and hypoglycemia should be prevented .