The islet transplantation site can be divided into two categories: orthotopic islet transplantation and ectopic islet transplantation. Orthotopic islet transplantation refers to that the insulin secreted and released from the transplanted islet will be metabolized into the liver through the hepatic portal vein system, which does not change the original insulin metabolic pathway, including the portal vein of the liver, the greater omentum. The insulin secreted by the ectopic islet transplantation changes the original metabolic pathway of insulin. The ideal islet transplantation site generally has the following characteristics: high success rate transplantation, high long-term survival rate of graft, simple operation, less trauma, less complications, low risk, easy to repeat detection and so on. This article provides a review of the current research status of each islet transplantation site, in order to provide reference for future related research.
ObjectiveTo explore the morbidity rate and risk factors of proliferative diabetic retinopathy (PDR) in type 2 diabetes.MethodsThe clinical data of patients, with PDR in 2739 consecutive cases of type 2 diabetes diagnosed in this hospital from 1994 to 2001 were analyed retospectively. The diagnosis of diabetic retinopathy (DR) was confirmed by ophthalmoscopy and fundus fluorescein angiography (FFA). Blood pressure, fasting and postprandial blood sugar, glycosylated haemoglobin（HbA1c）, total serum cholesterol, triglyceride, creatinine, and albumin excretion rate were measured.ResultsThe morbidity rate of type 2 DR was 27.8%（761/2739）, and the morbidity rate of PDR was 4.2%（114/2 739） occupying 15% of the patients with DR. The duration, fasting blood sugar, glycosylated haemoglobin, blood pressure and albumin excretion rate were much higher than those in the control（P＜0.01, glycosylated haemoglobin P＜0.05）. The independent risk factors of PDR were duration of the disease （r=0.15, P＜0.01） and albumin excretion rate （r=0.08, P＜0.05）. The risk factors of PDR were albumin excretion rate and fasting blood sugar (r=0.13, P＜0.05) in patients with longer duration(≥5 years). The morbidity rate of PDR was 2.3%, 5.9% and 12.4% in patients with duration less than 5 years, 5 to 10 years and over 10 years groups, respectively. The morbidity of PDR of the patients in normal albuminuria, microalbuminuria and overt albuminuria group was 2.1%、5.3% and 18.8% respectively.ConclusionsType 2 diabetes accompanied with PDR is relative to the duration of the diabetes, albumin excretion rate, fasting blood sugar, blood pressure, and glycosylated haemoglobin, in which the duration of the disease, albuminuria and fasting blood sugar are the risk factors of occurance of PDR. (Chin J Ocul Fundus Dis, 2003,19:338-340)
ObjectiveTo discuss the effects of diabetes mellitus (DM) on gastrointestinal hormone changes before and after hepatocellular carcinoma (HCC) operation. MethodsThe clinical data of 143 patients with HCC treated in this hospital from April 2007 to Febuary 2010 were analyzed, which 43 patients with DM (DM group) and 100 patients without DM (NDM group). Gastrin (GAS) and motilin (MTL) levels were measured on day 3 before operation and on day 1, 2, and 7 after operation. Results① The blood MTL levels decreased and GAS levels increased on day 1, 2, and 7 after operation as compared with the levels before operation (all Plt;0.05). ② The blood MTL level and GAS level before operation in the DM group was higher than that in the NDM group (Plt;0.05), MTL level decreased while GAS level increased more significantly on day 1, 2, and 7 after operation (Plt;0.05). ③ The first anus exhausting time of patients with NDM was much earlier than that with DM (Plt;0.05). ④ The first anus exhausting time with DM over 10 years and fasting plasma glucose over 10 mmo1/L was obviously extended (Plt;0.05). ConclusionDM affectes GAS and MTL level changes after HCC operation, recovery of gastrointestinal function would be delayed if patients with long course of DM and poor control of plasma glucose.
Objective
To evaluate the change of blood sugar in diabetic patients after vitrectomy and analyze the relative reasons.
Methods
Nineteen diabetes II patients (20 eyes) who underwent vitrectomies received the tests of blood sugar preoperatively, and 1～2 hours, 1, 3, and 5 days postoperatively. Analysis of variance, apaired Studentrsquo;s t-test, and correlation analysis were used to analyze the change of postoperative blood sugar and correlation between postoperative blood sugar change and its relative factors.
Results
Postoperative blood sugar increased significantly compared with the preoperative one (Plt;0.05),reached the peak 1～2 hours postoperatively, and reached almost the preoperative level 5 days postoperatively (Pgt;0.05). There was a positive correlation between blood sugar increase and operation time, preoperative blood sugar level, and diabetic duration (Plt;0.05). Postoperative blood sugar was relative to potentiated anesthesia.
Conclusion
There is a regularity that blood sugar increases just postoperatively and reaches the preoperative level 5 days postoperatively. The relative factors to blood sugar change include preoperative blood sugar level, diabetic duration, operation time, and potentiated anesthesia.
(Chin J Ocul Fundus Dis,2000,16:157-159)
Objective
To investigate the incidence and the correlative factors of diabetic retinopathy (DR) in patients with diabetes mellitus（DM）who lives in Beixinjing blocks, Shanghai.
Methods
Residents with DM were enrolled according to resident health archives. The data of disease history, visual acuity, eye disease and introcular pressure were collected by inquiry and examination. Photography of ocular fundus was used to confirm the diagnosis of DR.
Results
A total of 535 residents excepted the examination with the participating rate of 90.68%, in whom 146 (27.29%) were identified as with DR. The incidence of single and proliferative DR was 22.29% and 4.30%, respectively. Duration of DM was the independent risk factor of DR, while long duration of DM, accompanied with peripheral neuropathy and body mass index was the in-order independent factor of proliferative DR.
Conclusions
The incidence of DR is high in residents with DM. Monitoring DR progress in DM residents with risk factors is recommended.
(Chin J Ocul Fundus Dis, 2006, 22: 31-34)
ObjectiveTo explore the risk factors of diabetic retinopathy.
MethodsWe retrospectively analyzed the clinical data of 137 patients with diabetes mellitus (DM) from July 2012 to July 2015. According to the situation of retinopathy, the patients were divided into three groups. Forty-three patients without retinopathy were regarded as the control group, 46 non-proliferative retinopathy patients as the observation group, and 48 patients with proliferative retinopathy as the trial group. DM blood pressure, blood glucose, glycosylated hemoglobin, blood lipid, albumin creatinine ratio and other indicators were collected and analyzed, and multiple-factor non-conditional logistic regression analysis was carried out.
ResultsGlycosylated hemoglobin, total cholesterol, triglyceride, low density lipoproteincholesterol, high density lipoprotein cholesterol, body mass index, postprandial 2-hour blood glucose and fasting blood glucose were not significantly different among the three groups (P ＞ 0.05) , but the duration of diabetes, vascular endothelial growth factor and urinary albumin creatinine ratio were significantly different (P ＜ 0.05) . The diabetic duration, glycosylated hemoglobin, systolic blood pressure, urinary albumin creatinine ratio and vascular endothelial growth factor were independently associated with diabetic retinopathy (P ＜ 0.05) .
ConclusionThe prolonged disease course of diabetic patients, unstable status of blood glucose and blood pressure, and the increase of blood vessel growth factor and vascular endothelial growth factor can cause the development of diabetic retinopathy.
ObjectiveTo analyze and summarize the clinical characteristics, risk factors, pathogenic bacteria type, and drug tolerance of diabetes complicated with hospital-acquired pulmonary infection, in order to reduce the incidence of hospital-acquired pulmonary infection in patients with diabetes.
MethodsThe clinical data of diabetic patients with hospital-acquired pulmonary infection from 2011 to 2013 were taken for retrospective clinical analysis.
ResultsA total of 78 diabetic patients had hospital-acquired pulmonary infection among all the 572 hospitalized patients with diabetes. Age, complications of diabetes, chronic underlying disease, duration of hospital stay, glycated hemoglobin and invasive procedures were all correlated with the incidence of hospital-acquired infection (P<0.05). Through sputum culture and throat culture, 59 strains of pathogens were found, and they were mainly multidrug-resistant Gram-negative bacteria, accounting for 71.2%.
ConclusionThe rate of acquired pulmonary infection in diabetic patients is particularly high, and the pathogens are mostly Gram-negative and multidrug-resistant. Glycemic control, rational use of antimicrobial drugs, shorter hospital stay, effective prevention and treatment of diabetes complications and chronic underlying diseases, and aseptic techniques can be effective in preventing acquired pulmonary infection for diabetic patients.
Objective
To observe whether theograde axial flow of retinal ganglion cells (RGC) in diabetic rats at the early stage was damaged.
Methods
Diabetic model was induced by streptozotocin in 6 adult male Sprague-Dawley (SD)rats. Fluorogold (FG) was injected to the superior colliculi 4 weeks later.Streched preparation of retina was made 12 and 72 hours after the injection, and was stained after photographed by fluorescent microscope. The proportion of RGC with different sizes labeled by FG was calculated. Other 6 normal adult male SD rats were in the control group.
Results
Twelve hours after injection with FG, there was no difference of the total number of RGC in experimental and control group, but the ratio of small RGC was lower in experimental group than that in the control group; 72 hours after injection with FG, The number of RGC, especially the small RGC, decreased obviously in experimental group compared with the control group.
Conclusion
The speed of the retrograde axial flow of RGC in diabetic rats at the early stage is affected, and the small RGC are damageable.
(Chin J Ocul Fundus Dis, 2006, 22: 4-6)
Objective To determine the clinical efficacy of probucol in patients with diabetic macular edema (DME) and elevated serum lipids after focal/grid laser photocoagulation. Methods A prospective randomized controlled study included 48 type 2 diabetic patients with DME and dyslipidemia which were randomly divided into three groups. For patients with bilateral disease only the more severe eye was included. All patients were subjected to strict metabolic and blood pressure control during enrollment. All cases received macular laser photocoagulation. Besides, sixteen patients in group A were treated with probucol, 16 members in group B with atorvastatin and 16 members in group C were not treated with any lipid-lowering therapy for about three months. The outcome measurements were status of macular edema and hard exudates, visual acuity, foveal thickness, serum lipids and urine 8-hydroxydeoxyguanosine (8-OHdG) during the three months. Results The study included 20 men and 28 women with noninsulin dependent diabetes mellitus who could achieve good metabolic and blood pressure control within three months of inclusion in the study. Thirteen of 16 patients in group A, twelve of 16 patients in group B and five of 16 patients in group C showed reduction in hard exudates. Regression of macular edema was seen in twelve patients in group A, 11 in group B and eight in group C (χ2=2.368,P＞0.05). The difference of foveal thickness in group A, B and C was statistically significant (t=4.929, 4.669; P=0.000). Nine patients in group A, eight in group B and six in group C showed improving of visual acuity (χ2=1.169,P＞0.05). Three months after treatment, triglycerides (TG) (t=7.954, 6.832; P＜0.05), total cholesterol (TC) (t=6.643, 5.368; P＜0.05) and low-density lipoprotein cholesterol (LDLC) (t=3.279, 3.835; P＜0.05) decreased in group A and group B but not in group C, and high-density lipoprotein cholesterol showed no significant difference in the three groups. 8-OHdG decreased gradually during the first and third month in group A and group B but not in group C. In the first month post treatment, 8-OHdG showed no difference between group A and group B. In the third month, the 8-OHdG was lower in group A than group B, and the difference was statistically significant (t=2.947,P＜0.05). ConclusionsIn type 2 diabetes patients with DME and dyslipidemia, oral probucol can reduce the severity of hard exudates and macular edema, improve the visual acuity, and inhibit the levels of TG, TC, LDLC and 5-OHdG. The effect of probucol was similar to atorvastatin. Probucol could be an adjunct treatment of those patients.
Objective To investigate the effect of constitutively active Akt1 gene on rat engrafted islets in apoptosis and revascularization, and to explore potential method of gene therapy in the islet transplantation. Methods Rat islet which was transfected constitutively actived Akt1 gene via adenovirus vector using MOI=500. Thirty-six streptozotocin induced diabetic Wistar rats were divided into 3 groups complete randomly: Adv-CA-Akt1 group, Adv-LacZ group and simple transplantation group. Blood glucose and insulin were determined after operation. TUNEL was used to detect the apoptotic islet cells. HE and immunohistochemical staining of insulin were used to evaluate the histology of the islet grafts. The microvessel density (MVD) was determined by CD31 immunohistochemical staining. Results The fasting glucose level in Adv-CA-Akt1 group restored to normal 2 days after transplantation. However, in Adv-LacZ group and simple transplantation group, it reduced but still kept being hyperglycemia. And the serum insulin level was higher than other two groups ( P ＜ 0.05). Compared to simple transplantation group and Adv-LacZ group, apoptotic rate decreased 25% in Adv-CA-Akt1 group, a large number of islet grafts were seen under the capsule of the kidney, which were positively stained by insulin antibody. In the other two groups, the islet groups mass were lighter, and few positively stained by insulin antibody. MVD showed lighter positive endothelial cells stained by CD31 antibody in the other two groups than Adv-CA-Akt1 group ( P ＜ 0.05). Conclusion Constitutively activate Akt1 gene can prolong graft survival during early posttransplant period, and can accelerate the revascularization of islet grafts effectively.
