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Spontaneous remission of acromegaly or gigantism due to subclinical apoplexy of pituitary growth hormone adenoma

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Chinese Medical Journal 2011年第22期124卷 3820-3823页

作者： WANG Xian-ling DOU Jing-tao lu Zhao-hui ZHONG Wen-wen BA Jian-ming JIN Du lu ju-ming PAN Chang-yu MU Yi-ming Department of Endocrinology Chinese People＇s Liberation Army General Hospital Beijing 100853 China

Background Subclinical apoplexy of pituitary functional adenoma can cause spontaneous remission of hormone hypersecretion. The typical presence of pituitary growth hormone （GH） adenoma is gigantism and/or acromegaly. We investigated the clinical characteristics of patients with spontaneous partial remission of acromegaly or gigantism due to subclinical apoplexy of GH adenoma. Methods Six patients with spontaneous remission of acromegaly or gigantism were enrolled. The clinical characteristics, endocrinological evaluation and imageological characteristics were retrospectively analyzed. Results In these cases, the initial clinical presences were diabetes mellitus or hypogonadism. No abrupt headache, vomiting, visual function impairment, or conscious disturbance had ever been complained of. The base levels of GH and insulin growth factor-1 （IGF-1） were normal or higher, but nadir GH levels were all still 〉1 μg/L in 75 g oral glucose tolerance test. Magnetic resonance imaging detected enlarged sella, partial empty sella and compressed pituitary. The transsphenoidal surgery was performed in 2 cases, and the other patients were conservatively managed. All the patients were in clinical remission. Conclusions When the clinical presences, endocrine evaluation, biochemical examination and imageology indicate spontaneous remission of GH hypersecretion in patients with gigantism or acromegaly, the diagnosis of subclinical apoplexy of pituitary GH adenoma should be presumed. To these patients, conservative therapy may be appropriate.

关键词： growth hormone adenoma subclinical apoplexy of pituitary adenoma acromegaly

Correlation between 1,5-anhydroglucitol and glycemic excursions in type 2 diabetic patients

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Chinese Medical Journal 2011年第22期124卷 3641-3645页

作者： SUN Jie DOU Jing-tao WANG Xian-ling YANG Guo-qing lu Zhao-hui ZHENG Hua MA Fang-ling lu ju-ming MU Yi-ming Department of Endocrinology Chinese People＇s Liberation Army General Hospital Beijing 100853 China

Background The accurate and comprehensive assessment of glycemic control in patients with diabetes is important for optimizing glycemic management and for formulating personalized diabetic treatment schemes. This study aimed to analyze the correlation between 1,5-anhydroglucitol （1,5-AG） and glycemic excursions in type 2 diabetic patients. Methods Seventy-one outpatients with type 2 diabetes mellitus were randomly recruited from Chinese People＇s Liberation Army General Hospital. Using a continuous glucose monitoring system （CGMS）, these patients＇ blood glucose levels were monitored for three consecutive days to obtain mean blood glucose （MBG） data. Intraday glycemic excursions were evaluated using the mean amplitude of glycemic excursions （MAGE）, the largest amplitude of glycemic excursions （LAGE）, standard deviation of blood glucose （SDBG） and the M-value. Interday glycemic excursion was assessed by absolute mean of daily difference （MODD）. Postprandial glycemic fluctuations were evaluated using postprandial glucose excursions （PPGE） and postprandial incremental area under the curve （iAUC）. Fasting venous blood samples were collected to measure serum 1,5-AG, whole-blood hemoglobin Alc （HbAlc） and serum glycated albumin （GA）. Clinical markers of glycemia and parameters of glycemic excursions from CGMS were analyzed using the Pearson correlation coefficient and multivariate stepwise regression. Results Pearson correlation analysis revealed that 1,5-AG was significantly correlated with MAGE, SDBG, M-value, LAGE, PPGE and iAUC （r values were-0.509,-0.430,-0.530,-0.462,-0.416 and-0.435, respectively, P 〈0.01）, especially in moderately and well-controlled patients, based on defined HbAlc levels. Multivariate stepwise regression analysis revealed a negative correlation between 1,5-AG and the above parameters, but not HbAlc and GA. Finally, HbAlc and GA were positively correlated with MBG and fasting blood glucose （FBG）. Conclusions 1,5-AG was much better than HbAlc and GA

关键词： 1,5-anhydroglucitol type 2 diabetes mellitus glycemic excursions

LRP16 gene protects mouse insulinoma MIN6 cells against fatty acid-induced apoptosis through Akt/FoxO1 signaling

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Chinese Medical Journal 2012年第10期125卷 1695-1702页

作者： LI Xiao-jin GUO Qing-hua WANG Xuan XUE Bing SUN Lian-qing MENG Qu-tao lu ju-ming MU Yi-ming Department of Endocrinology Chinese People's Liberation Army General HospitalBeijing 100853China

Background Pancreatic β cells are susceptible to fatty acid-induced apoptosis. The 17β-estradiol （E2） protects pancreatic βcells from apoptosis, mediated by the estrogen receptor-a （ERa）. The mRNA level and promoter activity of leukemia-related protein （LRP） 16 were significantly increased by E2 in E R-a and LRP 16 was a co-activator of ER-a. The aim of the study was to assess the effects of LRP16 on fatty acid-induced apoptosis in MIN6 cells. Methods Cells with over-expressing LRP16 were obtained by lipidosome transfection. Insulin content and glucose-stimulated insulin secretion （GSIS） were examined by radioimmunoassay. Western blotting was applied to detect protein expression. Apoptosis was detected by terminal deoxynucleotidyl transferase dUTP nick end labeling （TUNEL） and flow cytometry. The forkhead boxO1 （FoxO1） subcellular localization was determined by immunocytochemical analysis. Results MIN6-LRP16 cells with overexpression of LRP16 were successfully established, and protein expression of LRP16 was 2.29-fold of that of control cells （MIN6-3.1, P 〈0.05）. Insulin content and GSIS in MIN6-LRP16 were substantially increased compared with those in control cells. When cells were stimulated with glucose, increased phosphorylation of extracellular signal-regulated kinase （ERK） 1/2 and serine-threonine kinase （Akt） were observed in MIN6-LRP16. When cells were under palmitate pressure, the TUNEL-positive rate in MIN6-LRP16 was （17.0±0.5）%, while it in MIN6-3.1 was （22.0±0.4）%. In palmitate-treated cells, attenuated Akt phosphorylation was observed, but the attenuation in Akt activity was partially restored in MIN6-LRP16 cells. Meanwhile, nuclear localization of FoxO1 in MIN6-LRP16 was apparently reduced compared with that in control cells. Conclusions LRP16 regulated insulin content and GSIS in MIN6 cells by ERK1/2 and Akt activated way. Meanwhile, LRP16 overexpression protected MIN6 cells from fatty acid-induced apoptosis by partially restoring Akt phosphorylation

关键词： leukemia-related protein 16, MIN6 cells, lipotoxicity Akt FoxO1

Management status of type 2 diabetes mellitus in tertiary hospitals in Beijing： gap between guideline and reality

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Chinese Medical Journal 2012年第23期125卷 4185-4189页

作者： LI ming-zi JI Li-nong MENG Zhao-lin GUO Xiao-hui YANG Jin-kui lu ju-ming luE Xiao-feng HONG Xu Department of Endocrinology and Metabolism Peking UniversityPeople's Hospital Beijing 100044 China Department of Endocrinology and Metabolism Xiamen UniversityZhongshan Hospital Xiamen Fujian 361004 China Department of Endocrinology and Metabolism Peking UniversityFirst Hospital Beijing 100034 China Department of Endocrinology and Metabolism Beijing TongrenHospital Capital Medial University Beijing 100730 China Department of Endocrinology and Metabolism Chinese People'sLiberation Army General Hospital Beijing 100853 China Department of Endocrinology and Metabolism Beijing MilitaryCommand General Hospital Beijing 100700 China Department of Endocrinology and Metabolism Beijing FriendshipHospital Capital Medial University Beijing 100050 China

Background Diabetes has become one of the most common chronic diseases and the third leading cause of death in China. Many programs have been initiated at national and local levels to address the illness. However, the effect of these programs in daily outpatient clinics is still unclear. The objective of this study was to investigate the management status of type 2 diabetes mellitus （T2DM） and factors associated with it in diabetes clinics of tertiary hospitals in Beijing. Methods A cross-sectional survey was conducted in six tertiary hospitals in Beijing. Control criteria were defined based on 2007 China guideline for type 2 diabetes （CGT2D）. Results A sample of 1151 patients, age （60.8±9.2） years, and with a median disease duration of 7.3 years was included. The hemoglobin Alc （HbAlc） mean level was （7.15±1.50）%, the percentage of patients achieving the targets for HbAlc was 37.8%, blood pressure 65.6%, triglyceride （TG） 48.8%, high-density lipoprotein （HDL） 59.2%, low-density lipoprotein （LDL） 34.0%, and total cholesterol （TC） 42.0%. The factors independently associated with glycemic control were diabetes duration （odds ratio （OR） = 0.95; 95% confidence interval （CI）： 0.919-0.982, P 〈0.01）, body mass index （BMI）（OR=0.914, 95% CI： 0.854-0.979, P=0.01） and smoking （OR=0.391, 95% Ch 0.197-0.778, P〈0.01）. The factors independently associated with blood pressure control were BMI （OR=0.915, 95% Ch 0.872-0.960, P 〈0.01） and male gender （OR=0.624, 95% CI： 0.457-0.852, P 〈0.01）. The factor independently associated with LDL control was education level （OR=1.429, 95% Ch 1.078-1.896, P=0.013）. Conclusions The management status of T2DM patients in tertiary hospitals in Beijing has improved remarkably. However, there is still room for further improvement to reach the guideline target. Long diabetes duration, high BMI, smoking, male gender and low education level were independently associated with poor metabolic control.

关键词： type 2 diabetes management status, tertiary hospitals

Experimental study on neuroendocrinological and immunological characteristics of the military-trained artillerymen

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Chinese Medical Journal 2012年第7期125卷 1292-1296页

作者： LI Xin HUANG Wen-XU lu ju-ming YANG Guang MA Fang-ling LAN Ya-ting MENG jun-hua DOU Jing-tao Department of Endocrinology Chinese People’s Liberation Army General HospitalBeijing 100853China

Background Over one million soldiers were treated for battle- or training-fatigue during World War I1. Of all ground combat troops, 37% were discharged for psychiatric reasons due to fatigue. The neuroendocrinological and immunological systems played important roles in the work-related fatigue of military personnel. The aim of this study was to investigate the characteristics of fatigue associated with military operations, and we observed changes in the regulatory functions of the neuroendocrinological and immunological systems that may provide theoretical support for improving the combat effectiveness of armies. Methods A total of 240 soldiers from the Field Artillery regiment were selected as subjects. Researchers and subjects received training before participating in the study. Data of the subjects＇ medical histories, physical examinations, scores on a fatigue assessment scale, and assessments of pituitary-adrenal hormones （adrenal cortical hormone （ACTH）, cortical hormone （F）, and 24-hour urine-free cortisol （UFC））, pituitary-gonadal hormones （luteinizing hormone （LH）, follicle-stimulating hormone （FSH）, testosterone, estradiol （E2）, and prolactin （PRL））, pituitary-thyroid hormones （thyroid-stimulating hormone （TSH）, thyroxine （TT4）, triiodothyronine （TT3）, free thyroxine （FT4）, and free triiodothyronine （FT3））, and cellular immune parameters （CD3~, CD4~, CD8~, CD4~/CD8＋, B, and NK cells） were investigated before and after large-scale and high-intensity field exercises. Data were statistically analyzed with Student＇s t test using SPSS software （version 13.0）, and P values 〈0.05 were deemed to be significant. Results After the high-intensity military training, the scores on the fatigue scale reflected significant increases of feeling of unpleasantness among soldiers. Additionally, the symptom checklist showed notable increases in somatization scores and significant decreases in psychoticism scores. After intensive military work, levels of plasma ACTH, F, and UFC

关键词： training fatigue military operations endocrine hormones immune indices job inventory

INHIBITORY EFFECTS OF ATROPINE ON GROWTH HORMONE RELEASE IN NORMAL SUBJECTS AND ACROMEGALY

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中华医学杂志(英文版) 1989年第1期102卷 47-47页

作者： Zhang Jian lu ju-ming Huang Zhao-jian Department of Endocrinology Chinese PLA General Hospital Beijing

Growth hormone (GH) secretion is mediated by hypothalamic factors, mainly growth hormone releasing factor (GRF) and somatostatin (SS). The hypothalamic hormones, under direct neurotransmitter control, stimulate GH secretion through different central mechanisms. Atropine, an anticholinergic agent, can cross the blood-brain barrier and inhibit GH secretion stimulated by exercise and sleep in normal persons. In order to study the inhibiting effect of atropine on GH release and whether glucose can be replaced by stropine, normal persons and acromegaly patients were observed during exercise, after stropine, and 100 g glucose loading. The results confirmed that GH secretion increases after exercise and that this GH elevation can be inhibited by stropine in normal subjects. But in acromegaly patients high basal GH levels can not be inhibited by 100 g glucose loading or 0.6 mg atropine during the active phase of the disease. Blood sugar levels remained unchanged during the atropine test. It is suggested that the atropine test can be used as a GH inhibitory test in acromegaly patients with overt diabetes.

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Effects of a Multivitamin/multimineral Supplement on Young Males with Physical Overtraining: A Placebo-controlled, Randomized, Double-blinded Cross-over Trial

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Biomedical and Environmental Sciences 2013年第7期26卷 599-604页

作者： LI Xin HUANG Wen Xu lu ju ming YANG Guang MA Fang Ling LAN Ya Ting MENG jun Hua DOU Jing Tao Department of Endocrinology Chinese PLA General Hospital

Objective To investigate the effects of vitamin-mineral supplement on young males with physica overtraining. Methods Two hundred and forty male Chinese field artillery personnel who undertook large scale and endurance military training and were on ordinary Chinese diet were randomized to receive a multivitamin/multimineral supplement or a placebo for 1 week. After a 1-week wash-out period, a cross-over with 1 week course of a placebo or multivitamin/multimineral supplement was conducted. Blood and urine samples were analyzed for adrenal, gonadal and thyroid hormones. In addition, cellular immune parameters （CD3＋, CD3＋CD4＋, CD3＋CD8＋, CD4/CD8, CD3-CD56＋, CD3-CD19＋） were examined and psychological tests were performed before and after the training program and nutrition intervention. Results After a large scale and endurance military training, the participants showed significantly increased thyroid function, decreased adrenal cortex, testosterone and immunological function, and significantly increased somatization, anger and tension. Compared to placebo, multivitamin/ multimineral intervention showed significant effects on functional recovery of the pituitary - adrenal axis, pituitary-gonadal axis, pituitary- thyroid axis and immune system as well as psychological parameters. Conclusion High-intensity military operations have significant impacts on the psychology, physical ability and neuroendocrine-immune system in young males. Appropriate supplementation of multivitamin/multimineral can facilitate the recovery of the psychology, physical ability and neuroendocrine-immune system in young males who take ordinary Chinese diet.

关键词： Overtraining Vitamins Intervention Randomized Diet supplement

Glycated albumin may be a choice, but not an alternative marker of glycated hemoglobin for glycemic control assessment in diabetic patients undergoing maintenance hemodialysis

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Chinese Medical Journal 2013年第17期126卷 3295-3300页

作者： CHEN Fengskun SUN Xue-feng ZHANG Dong CUI Shao-yuan CHEN Xiang-mei WEI Ri-bao lu ju-ming LI Ji-jun LIU Wen-hu ZHANG Dong-liang ZHANG Zhi-min Department of Nephrology First Affiliated Hospital of People's Liberation Army General Hospital Beijing 100048 China Institute of Nephrology People's Liberation Army General Hospital Beijing 100853 China Department of Endocrinology People's Liberation Army General Hospital Beijing 100853 China Department of Nephrology Affiliated Beijing Friendship Hospital of Capital Medical University Beijing 100050 China Department of Nephrology People's Liberation Army the 309th Hospital Beijing 100091 China

Background It has been suggested that glycated hemoglobin （HbAlc） underestimate the actual glycemic control levels in maintenance hemodialysis （MHD） patients, because of anemia and the using of erythropoietin （EPO）; it was recommended that glycated albumin （GA） should be an alternative marker. Therefore, the assessment performances of glycemic control were compared between GA and HbAlc in this research by referring to mean plasma glucose （MPG） in diabetes mellitus （DM） patients undergoing MHD or not. Methods MPG was calculated according to the data registered at enrollment and follow-up 2 months later and corresponding HbAlc, albumin （ALB）, GA, etc. were measured in 280 cases. A case-control study for comparing GA and HbAlc was done among the groups of MHD patients with DM （n=88） and without DM （NDM; n=90）, and non-MHD ones with DM （n=102） using MPG for an actual glycemic control standard. Results In these 3 groups, only for DM patients＇（whether undergoing MHD or not）, GA and HbAlc correlated with MPG significantly （P 〈0.01）. Through linear regression analysis, it could be found that the regression curves of GA almost coincided in MHD and non-MHD patients with DM, because the intercepts （2.418 vs. 2.329） and slopes （0.053 vs. 0.057） were very close to each other. On the contrary, regression curves of HbAlc did not coincide in the two groups, because variance of the slopes （0.036 vs. 0.052） were relatively large. Through comparing receiver operating characteristic （ROC） areas under the curve （AUC）, it could be understood that the assessment performances of GA and HbAlc in MHD patients were lower than those in non-MHD ones, and assessment performance of HbAlc in MHD patients was better than GA （P 〈0.05）. In addition, the effects of Hb and EPO dose on HbAlc, or that of ALB on GA were unobvious in our study. Conclusions Actual glycemic control level in MHD patients with DM may be underestimated by HbAlc, and it could be avoided by GA; however, glycemic evaluating perfo

关键词： maintenance hemodialysis diabetes mellitus glycated albumin glycated hemoglobin

Numerical analysis on the factors affecting post-peak characteristics of coal under uniaxial compression

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International Journal of Coal Science & Technology 2024年第1期11卷 42-60页

作者： Zhiguo lu Wenjun ju Fuqiang Gao Taotao Du CCTEG Coal Mining Research Institute BeijingChina State Key Laboratory of Coal Intelligent Mining and Strata Control(China Coal Research Institute) BeijingChina

The post-peak characteristics of coal serve as a direct reflection of its failure process and are essential parameters for evaluating brittleness and bursting *** the significant factors that influence post-peak characteristics can offer valuable insights for the prevention of coal *** this study,the Synthetic Rock Mass method is employed to establish a numerical model,and the factors affecting coal post-peak characteristics are analyzed from four perspectives:coal matrix mechanical parameters,structural weak surface properties,height-to-width ratio,and loading *** research identifies four significant influencing factors:deformation modulus,density of discrete fracture networks,height-to-width ratio,and loading *** response and sensitivity of post-peak characteristics to single-factor and multi-factor interactions are *** result suggested that feasible prevention and control measures for coal bursts can be formulated through four approaches:weakening the mechanical properties of coal pillars,increasing the number of structural weak surfaces in coal pillars,reducing the width of coal pillars,and optimizing mining and excavation *** efficacy of measures aimed at weakening the mechanical properties of coal is successfully demonstrated through a case study on coal burst prevention using large-diameter borehole drilling.

关键词： Post-peak behavior Synthetic rock mass Coal bursts Coal burst prevention