Objective:To investigate the relationship between carotid atherosclerosis(CAS)and subclinical left ventricular(LV)dysfunction in type 2 diabetes mellitus patients with preserved LV ejection fraction(LVEF).Methods:A total of 120 patients with type 2 diabetes mellitus who had LVEF≥50% were selected in the Department of Endocrinology, the First Affiliated Hospital of Air Force Medical University from June 2021 to October 2021. The global longitudinal strain(GLS)was obtained by two-dimensional speckle tracking echocardiography(STE)to assess subclinical LV systolic function. The mitral ratio of peak early to late diastolic filling velocity(E/A), and mitral velocity to early diastolic velocity of the mitral annulus(E/E′)ratio were obtained by pulsed tissue Doppler echocardiography to assess LV diastolic function. Acrroding to bilateral carotid ultrasound examination, the subjects were divided into normal carotid arteries group( n=46) and CAS group( n=74). Demographics and biochemical parameters were compared between two groups. Binary logistic regression and Pearson correlation analysis were used to evaluate the relationship between CAS and subclinical LV dysfunction. Results:The CAS group had a higher proportion of men, older age, and a longer duration of diabetes than the normal carotid arteries group(all P<0.05). There was no difference in LVEF and GLS between the two groups [normal carotid arteries group vs CAS group, LVEF: (60.72±4.73)% vs(60.07±4.28)%; GLS: (18.24±3.72)% vs(17.81±3.47)%, respectively; both P>0.05]. However, compared with normal carotid arteries group, E/A ratio was decreased and E/E′ ratio was significantly increased in CAS group(both P<0.01). Pearson correlation analysis showed that GLS was not correlated with carotid plaque thickness and carotid intima-media thickness(CIMT; both P>0.05). By contrast, E/E′ ratio was positively correlated with carotid plaque thickness and CIMT(both P<0.05). Binary logistic regression analysis showed that GLS and E/E′ ratio were not associated with CAS( both P>0.05). However, decreased E/A ratio was significantly associated with the existence of CAS( OR=0.09, 95% CI 0.01-0.67, P=0.018). Conclusions:In type 2 diabetes mellitus patients without overt heart failure and with preserved LVEF, the occurrence of CAS is not associated with subclinical LV systolic impairment assessed by GLS, but is significantly associated with LV diastolic dysfunction, and is independent of traditional cardiovascular risk factors.

Diabetic nephropathy is a microvascular complication of diabetes mellitus, threatening the health of millions of people. Herein, we explored a blood glucose independent function of coptisine on diabetic nephropathy. A diabetic rat model was established by intraperitoneal administration of streptozotocin (65 mg/kg). Coptisine treatment (50 mg/kg/day) retarded body weight loss and reduced blood glucose. On the other hand, coptisine treatment also decreased kidney weight and the levels of urinary albumin, serum creatinine, and blood urea nitrogen, indicating an improvement of renal function. Treatment with coptisine also mitigated renal fibrosis, with alleviative collagen deposition. Likewise, in vitro study showed that coptisine treatment decreased apoptosis and fibrosis markers in HK-2 cells treated with high glucose. Furthermore, after coptisine treatment, the activation of NOD-like receptor pyrin domain containing protein 3 (NRLP3) inflammasome was repressed, with decreased levels of NLRP3, cleaved caspase-1, interleukin (IL)-1 beta, and IL-18, indicating that the repression of NRLP3 inflammasome contributed to the effect of coptisine on diabetic nephropathy. In conclusion, this study revealed that coptisine mitigates diabetic nephropathy via repressing the NRLP3 inflammasome. It is indicated that coptisine may have the potential to be used in the diabetic nephropathy treatment.

Background. The purpose of this research was to assess the relationship between the severity of diabetic retinopathy (DR) and indexes of left ventricle (LV) structure and function in type 2 diabetes mellitus (T2DM). Methods. Retrospective analysis of 790 patients with T2DM and preserved LV ejection fraction. Retinopathy stages were classified as no DR, early nonproliferative DR, moderate to severe nonproliferative DR, or proliferative DR. The electrocardiogram was used to assess myocardial conduction function. Echocardiography was used to evaluate myocardial structure and function. Results. Patients were divided into three groups based on the DR status: no DR group (NDR, n = 475 ), nonproliferative DR group (NPDR, n = 247 ), and proliferative DR group (PDR, n = 68 ). LV interventricular septal thickness (IVST) increased significantly with more severe retinopathy (NDR: 10.00 ± 1.09 ; NPDR: 10.42 ± 1.21 ; and PDR: 10.66 ± 1.58 ; P < 0.001). Multivariate logistic regression analysis showed that the significant correlation of IVST persisted between subjects with no retinopathy and proliferative DR (odds ratio = 1.35 , P = 0.026 ). Indices of myocardial conduction function were assessed by electrocardiogram differences among groups of retinopathy (all P < 0.001 ). In multiple-adjusted linear regression analyses, the increasing degree of retinopathy was closely correlated with heart rate ( β = 1.593 , P = 0.027 ), PR interval ( β = 4.666 , P = 0.001 ), and QTc interval ( β = 8.807 , P = 0.005 ). Conclusion. The proliferative DR was independently associated with worse cardiac structure and function by echocardiography. Furthermore, the severity of retinopathy significantly correlated with abnormalities of the electrocardiogram in patients with T2DM.

Objectives: The impacts of diabetic peripheral neuropathy (DPN) on clinical manifestations of left ventricular (LV) function in patients suffering from type 2 diabetes mellitus (T2DM) and the preserved LV ejection fraction (LVEF) lack a full evaluation. This study was carried out to investigate the correlation of peripheral neuropathy with subclinical LV systolic dysfunction, accompanied by the exploration of the relevant clinical features of peripheral neuropathy in these patients. Methods: A retrospective analysis was conducted depending on the data of 101 consecutive inpatients with T2DM and preserved LVEF (all ??? 50 %), without coronary artery disease and other histories of heart disease. All subjects received both a nerve conduction assessment and a speckle-tracking echocardiography examination. Global longitudinal strain (GLS) was conducted to assess the subclinical LV systolic function. Results: Forty-six (46 %) patients were diagnosed as DPN according to electrophysiological examination and clinical assessment. A significant difference was revealed in GLS between patients with and without DPN (16.5 ?? 2.8 vs. 19.3 ?? 3.4, p < 0.001). Multiple logistic regression analysis indicated GLS as one of the independent determinative factors for DPN (odds ratio, 0.68; P < 0.001). In addition, motor-sensory nerve conduction exhibited a significant positive correlation with GLS, which may not be revealed between the types of peripheral nerve damage. Conclusions: Despite the preserved LVEF, the subclinical LV myocardial dysfunction may have occurred in T2DM patients with DPN. Peripheral nerve conduction was significantly correlated with GLS. An early assessment of nerve conduction may exert a dual warning significance for the progression of subclinical LV dysfunction in asymptomatic patients with T2DM.

BackgroundWe aimed to examine the association between glycated hemoglobin (HbA1c), microvascular complications, and subclinical left ventricular (LV) systolic dysfunction, and to determine the strength of the correlation in asymptomatic patients with type 2 diabetes mellitus (T2DM). MethodsGlobal longitudinal strain (GLS) was employed to assess the subclinical LV function of 152 enrolled T2DM patients with preserved LV ejection fraction, with the cutoff for subclinical LV systolic dysfunction predefined as GLS < 18%. ResultsAccording to univariate analysis, the reduced GLS exhibited association with the clinical features including HbA1c, triglyceride, systolic blood pressure, fasting glucose, heart rate, diabetic retinopathy, and urinary albumin creatinine ratio (UACR) (all p < .05). After the factors of gender, age, and related clinical covariables adjusted, multiple logistic regression analysis revealed the HbA1c (odds ratio [OR] 1.66; 95% confidence interval [CI] 1.30-2.13; p < .001), UACR (OR 2.48; 95% CI 1.12-5.47; p = .025) and triglyceride (OR 1.84; 95% CI 1.12-3.03; p = .017) as the independent risk factors for the reduced GLS. Receiver operating characteristic curve showed a predictive value of the HbA1c for the subclinical LV systolic dysfunction (area under curve: 0.74; p < .001). ConclusionsIn asymptomatic T2DM patients, subclinical LV systolic dysfunction was associated with HbA1c, diabetic complications, and triglyceride. More prominently, HbA1c may exert a prognostic significance for the progression of myocardial damage.

Abstract Background We aimed to examine the association between glycated hemoglobin (HbA1c), microvascular complications, and subclinical left ventricular (LV) systolic dysfunction, and to determine the strength of the correlation in asymptomatic patients with type 2 diabetes mellitus (T2DM). Methods Global longitudinal strain (GLS) was employed to assess the subclinical LV function of 152 enrolled T2DM patients with preserved LV ejection fraction, with the cutoff for subclinical LV systolic dysfunction predefined as GLS < 18%. Results According to univariate analysis, the reduced GLS exhibited association with the clinical features including HbA1c, triglyceride, systolic blood pressure, fasting glucose, heart rate, diabetic retinopathy, and urinary albumin creatinine ratio (UACR) (all p < .05). After the factors of gender, age, and related clinical covariables adjusted, multiple logistic regression analysis revealed the HbA1c (odds ratio [OR] 1.66; 95% confidence interval [CI] 1.30–2.13; p < .001), UACR (OR 2.48; 95% CI 1.12–5.47; p = .025) and triglyceride (OR 1.84; 95% CI 1.12–3.03; p = .017) as the independent risk factors for the reduced GLS. Receiver operating characteristic curve showed a predictive value of the HbA1c for the subclinical LV systolic dysfunction (area under curve: 0.74; p < .001). Conclusions In asymptomatic T2DM patients, subclinical LV systolic dysfunction was associated with HbA1c, diabetic complications, and triglyceride. More prominently, HbA1c may exert a prognostic significance for the progression of myocardial damage.

Background The triglyceride glucose (TyG) index has been considered a new biomarker for the diagnosis of angiocardiopathy and insulin resistance. However, the association of the TyG index with subclinical left ventricular (LV) systolic dysfunction still lacks comprehensive exploration. This study was carried out to examine this relationship in patients with type 2 diabetes mellitus (T2DM). Methods A total of 150 T2DM patients with preserved LV ejection fraction (LVEF ≥ 50%) from June 2021 to December 2021 were included in this study. The subclinical LV function was evaluated through global longitudinal strain (GLS), with the predefined GLS < 18% as the cutoff for subclinical LV systolic dysfunction. The TyG index calculation was obtained according to ln (fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2), which was then stratified into quartiles (TyG index—Q). Results Analyses of clinical characteristics in the four TyG indexes-Q (Q1 (TyG index ≤ 8.89) n = 38, Q2 (8.89 < TyG index ≤ 9.44) n = 37, Q3 (9.44 < TyG index ≤ 9.83) n = 38, and Q4 (TyG index > 9.83) n = 37) were conducted. A negative correlation of the TyG index with GLS ( r = -0.307, P < 0.001) was revealed according to correlation analysis. After gender and age were adjusted in multimodel logistic regression analysis, the higher TyG index (OR 6.86; 95% CI 2.44 to 19.30; P < 0.001, Q4 vs Q1) showed a significant association with GLS < 18%, which was still maintained after further adjustment for related clinical confounding factors (OR 5.23, 95% CI 1.12 to 24.51, p = 0.036, Q4 vs Q1). Receiver operator characteristic analysis indicated a diagnostic capacity of the TyG index for GLS < 18% (area under curve: 0.678; P < 0.001). Conclusions A higher TyG index had a significant association with subclinical LV systolic dysfunction in T2DM patients with preserved ejection fraction, and the TyG index may have the potential to exert predictive value for myocardial damage.

Objective:To investigate the association between glycated hemoglobin A 1c (HbA 1c) and subclinical left ventricular (LV) systolic function in patients with type 2 diabetes mellitus (T2DM). Methods:T2DM patients who consecutively admitted to the Department of Endocrinology, First Affiliated Hospital of Air Force Medical University, Shaanxi Province from June to December 2021 were selected. The age, heart rate, systolic blood pressure, fasting plasma glucose (FPG), HbA 1c, triglyceride (TG) and urinary albumin to creatinine ratio (UACR), LV global longitudinal strain (GLS) were collected. According to the GLS results, patients were divided into three groups: T1 (GLS≤16.6%), T2 (16.6%19.4%). One-way analysis of variance, Fisher exact test or chi-square test, and Kruskal-Wallis H test were used to compare the differences in clinical characteristics and metabolic indexes among groups. Pearson correlation analysis was used to evaluate the correlation between HbA 1c and GLS, and multiple linear regression analysis was used to analyze the influencing factors of LV subclinical myocardial systolic dysfunction in patients with T2DM. Results:A total of 152 patients were included. There were 51 cases in T1 group, 51 cases in T2 group, and 50 cases in T3 group. HbA 1c level decreased with increasing GLS group [(10.01±2.39)% vs. (8.69±1.77)% vs. (7.78±1.38)%, P<0.001]. Pearson correlation analysis showed that HbA 1c was negatively correlated with GLS ( r=-0.48, P<0.001). The results of univariate linear regression analysis showed that HbA 1c, age, heart rate, systolic blood pressure, FPG, TG and UACR were significantly correlated with GLS (all P<0.05). Multivariate analysis showed that HbA 1c was independently associated with GLS ( β=-0.613, P<0.001). In addition, the results showed that logUACR was an independent and major risk factor for reduced GLS ( β=-1.010, P=0.024). Conclusions:HbA 1c was negatively associated with the progression of LV subclinical systolic function in patients with T2DM. High UACR level was the main influencing factor of LV longitudinal dysfunction.

抑郁症是以显著而持久性的心境低落为主要临床特征的一种心理障碍性疾病.抑郁症发病率较高,预计2020年将成为第二大疾病,但抑郁症受多方面因素的影响,迄今病因仍不明了.脑源性神经生长因子(brain-derived neurotrophic factor,BDNF)与阿尔茨海默病[1]、精神分裂症[2]、帕金森病[3]等多种精神性疾病有关.近年来,抑郁症中 BDNF 的相关研究已成为热门话题,本文对抑郁症中 BDNF的相关研究综述如下.

江西的高校,虽然命运多磨难,却无论寒暑,自有坚毅品格,犹如盛产的丹橘.历代江西校友,并非等闲之辈.江西的教育,自近代以来,遭遇了多少艰难险阻,都已成了历史的脚注.如今,南昌大学办学百年,它虽不如桃李名门,却如丹橘亦有荫凉.南昌大学最早的办学史,始于医学院.

夏季天气炎热,是中暑的高发期.在高温、高湿的气温环境下,很容易导致人体的"核心体温"上升.所谓"核心体温",就是我们内部脏器工作的温度,是我们机体细胞赖以生存的环境.如果这个温度高于一个正常范围,常规来说是40摄氏度,就会产生有可能危及生命的疾病.当然,中暑有轻度有重度,严重的中暑就包含死亡率很高的热射病.那么,我们的机体自身是否有应对这种以中枢神经系统和心血管系统为主的疾病的功能呢?其实,在我们进行必要的医学处理的同时,我们的身体自身也具有细胞水平的抵御中暑的机能.

在中枢神经系统中,神经调节素1(NRG1)可激活其ErbB受体,影响神经元的发育和迁移,突触的形成、成熟以及突触可塑性.许多研究表明,NRG1与ErbB4基因为精神疾病的易感基因.最早与精神分裂症关联,随后与双向情感障碍、焦虑、抑郁的联系也被逐渐发现.该文通过对NRG1/ErbB4信号通路在中枢神经系统的作用及其与多种精神疾病相关性的研究进行综述,以期为相关精神疾病带来更多的研究思路.

急性大量失血是危及紧急灾难或战地前沿危重伤员生命的最主要的问题,随着临床用血量的急剧增加,临床大量需要极大地促进了血液代用品的研究与开发,现有研究表明纳米淀粉微球有助于扩充血容量、维持血液循环,稳定心血管功能和保护重要器官作用.因此本文主要对现在失血性休克复苏机制研究进展进行综述,为抗失血性休克复苏提供一些新的研究思路.

The relationship between normal thyroid function and type 2 diabetes mellitus (T2DM) has been a particular focus for concern. The present study determined the relationship between thyroid hormone levels and the prevalence of diabetic retinopathy (DR) in T2DM patients. A cross-sectional study (n = 633) was performed in Xi'an, Shaanxi Province, China. Subjects were evaluated for anthropometric measurements, thyroid function, and diabetic retinopathy. Logistic regression models were used to assess the relationships between thyroid hormones and DR. Of 633 patients, 243 (38.4%) patients suffered from DR. The prevalence of DR showed a significantly decreasing trend across the quartiles based on free triiodothyronine (FT3) (FT3 quartile 1 group [FT3-Q1] <4.35 pmol/L, FT3 quartile 2 group [FT3-Q2] 4.35-4.70 pmol/L, FT3 quartile 3 group [FT3-Q3] 4.70-5.08 pmol/L, and FT3 quartile 4 group [FT3-Q4] ≥5.08 pmol/L) (56.7%, 42.5%, 33.1%, 23.8%, P < 0.001). In comparison with all participants categorized in FT3-Q1, the multivariable adjusted odds ratios (95% confidence interval) of DR in FT3-Q2, FT3-Q3, and FT3-Q4 were 0.587 (0.340-1.012), 0.458 (0.258-0.813), and 0.368 (0.201-0.673), (P = 0.055, P = 0.008, P = 0.001), respectively. FT3 levels within the normal range are negatively associated with DR in euthyroid patients with type 2 diabetes. Further studies should be aimed at clarifying the relationship between thyroid hormones and T2DM.

20世纪60年代到90年代,是丝状病毒马尔堡病毒和它的近亲埃博拉病毒在人类社会初次大流行时间,也是《血疫》记录的年代.现代医学第一次直面流行的高致死率的病毒,病毒性出血热的恐怖画面,即使用文字表述,也让人触目惊心.面对死亡疾病的恐惧和对病痛的共情,给人们蒙上了一层阴翳:每一次人类史上的大规模传染病,都是一场血泪史,一次人们内心无助绝望的历程,一段公共社会的心理与记忆上的伤痕.普遍的大众心理学不断证明,心理上的创伤弥漫并不会因英雄的无所畏惧而消退.五味杂陈的记忆中,少不了伤痕记忆.

A number of studies have reported that diabetic retinopathy (DR) is the major cause of blindness. Berberine (BBR) is a bioactive constituent that displays effects on blood glucose; however, the mechanism underlying the role of BBR during the development of DR is not completely understood. In the present study, a rat model of DR was successfully established. The eye tissues were removed and subsequently assessed by hematoxylin and eosin staining and the TUNEL assay. The catalase, malondialdehyde, reactive oxygen species, glutathione and superoxide dismutase contents of the eye tissues were measured. Müller cells were chosen for further in vitro experiments. Cell apoptosis was examined by Annexin V‑FITC apoptosis detection and Hoechst staining, and the mitochondrial membrane potential was assessed by JC‑1 mitochondrial membrane potential detection. BBR decreased ganglion cell layer, cell apoptosis, reduced diabetic‑induced oxidative stress and deactivated the NF‑κB signaling pathway in the rat model of DR. High glucose enhanced oxidative stress and induced mitochondria‑dependent cell apoptosis in Müller cells by activating the NF‑κB signaling pathway. BBR reversed the high glucose‑induced effects by decreasing the phosphorylation of IκB, inhibiting NF‑κB nuclear translocation and deactivating the NF‑κB signaling pathway. The results suggested that BBR protected against DR by inhibiting oxidative stress and cell apoptosis via deactivation of the NF‑κB signaling pathway; therefore, suggesting that BBR may serve as a promising therapeutic agent for DR.

你可曾对街头巷尾自称“包治百病”的假药恨之入骨?你可曾幻想过小说里“灵丹妙药”的奇妙功效?你可曾认为“保健养生”的只有传统中草药?你应该听说过现代医药中阿司匹林具有“多重功效”.而如今,又有一种药物得到了这个桂冠,它就是二甲双胍——长期以来的糖尿病一线药,拥有多功能的新“神药”.

目的:探讨小檗碱在棕榈酸(palmic acid, PA)诱导的胰岛β细胞发生凋亡时PTEN及AMPK的变化及其作用机制.方法:采用1.0 mmol/L PA诱导胰岛βTC6细胞损伤模型,然后给予小檗碱干预.采用流式细胞术检测βTC6细胞凋亡率,RT-qPCR法及免疫荧光法检测在PA及小檗碱作用下信号转导通路分子PTEN及AMPK表达的变化.结果:PA抑制βTC6细胞的生长并诱导其凋亡,小檗碱可缓解PA引起的βTC6的凋亡,对氧化应激具有保护作用;伴随着凋亡的发生,AMPK的表达显著降低,而PTEN的表达显著升高,表明细胞氧化损伤严重时抑制了AMPK的表达及转录,而PTEN在βTC6细胞的凋亡中具有促进作用;小檗碱治疗后,AMPK的表达增多,而PTEN的表达下降,暗示着小檗碱通过激活AMPK并抑制PTEN的表达来增强βTC6细胞的抗氧化能力.结论:小檗碱对PA引起的细胞凋亡有保护作用,同时小檗碱可能通过调节AMPK及PTEN的表达来发挥抗氧化作用.

The present study has been designed and carried out to evaluate the potential of coptisine on diabetic nephropathy. Diabetes was induced in SD rats through one single intraperitoneal injection of streptozotocin (65 mg/kg) method, and then diabetic rats were orally administered with 25 mg/kg/day coptisine or 50 mg/kg/day coptisine for 8 weeks. Severe impairment of renal function in rats with diabetes was observed as indicated by increased urine protein excretion, kidney hypertrophy index, serum creatinine level, and blood urea nitrogen level. Oxidative stress damage was observed as indicated by increased levels of reactive oxygen species, malondialdehyde, and decreased levels of glutathione, superoxide dismutase, and catalase. However, these alterations in kidneys of rats with diabetes were alleviated by administration of coptisine. Furthermore, the expression levels of nuclear factor-erythroid 2-related factor 2 (Nrf2) and its targeted antioxidative genes heme oxygenase 1 and NADPH quinone oxidoreductase 1 in the diabetic kidneys were significantly increased after coptisine treatment. These results suggested that coptisine ameliorated oxidative renal injury in diabetic rats, and the possible mechanisms for the renoprotective effects of coptisine may be related to activation of the Nrf2 signaling pathway.

军事医院"军民不分"是有历史渊源的.长久以来,经过一轮又一轮改革和调整,军事医院长期保持着以医疗、科研、教学为主的纲领.以1983年解放军总后卫生部整顿军队医院为例,大部分精力还是脱离实战的"后勤"导向,这一导向一直持续到本世纪初.