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Perioperative intensive insulin therapy using artificial endocrine pancreas in patients undergoing pancreatectomy

World Journal of Gastroenterology 2009年第33期15卷 4111-4115页

作者： Hiromichi Maeda Takehiro Okabayashi Tomoaki Yatabe Koichi Yamashita Kazuhiro Hanazaki Department of Surgery Kochi Medical SchoolKochi University Department of Anesthesiology and Critical Care Medicine Kochi Medical SchoolKochi University

Perioperative glycemic control is important for reducing postoperative infectious complications. However, clinical trials have shown that efforts to maintain normoglycemia in intensive care unit patients result in deviation of glucose levels from the optimal range, and frequent attacks of hypoglycemia. Tight glycemic control is even more challenging in those undergoing pancreatic resection. Removal of lesions and surrounding normal pancreatic tissue often cause hormone deficiencies that lead to the destruction of glucose homeostasis, which is termed pancreatogenic diabetes. Pancreatogenic diabetes is characterized by the occurrence of hyperglycemia and iatrogenic severe hypoglycemia, which adversely effects patient recovery. Postoperatively, a variety of factors including surgical stress, inflammatory cytokines, sympathomimetic drug therapy, and aggressive nutritional support can also affect glycemic control. This review discusses the endocrine aspects of pancreatic resection and highlights postoperative glycemic control using a closed-loop system or artificial pancreas. In previous experiments, we have demonstrated the reliability of the artificial pancreas in dogs with total pancreatectomy, and its postoperative clinical use has been shown to be effectiveand safe, without the occurrence of hypoglycemic episodes, even in patients after total pancreatectomy. Considering the increasing requirement for tight perioperative glycemic control and the recognized risk of hypoglycemia, we propose the use of an artificial endocrine pancreas that is able to monitor continuously blood glucose concentrations with proven accuracy, and administer automatically substances to return blood glucose concentration to the optimal narrow range.

关键词： Blood glucose Diabetes mellitus hyperglycemia Pancreas Artificial Pancreatectomy

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The relationship between multiple clinicopathological features and nerve invasion in pancreatic cancer

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Hepatobiliary & Pancreatic Diseases International 2013年第5期12卷 546-551页

作者： Pao-Hsun Wang Ning Song Liu-Bin Shi Qun-Hua Zhang Zong-You Chen Department of General Surgery Huashan HospitalFudan University

BACKGROUND:Nerve invasion is a specific type of tumor expansion and characteristic manifestation of pancreatic cancer(PC),with an incidence rate ranging from 50% to 100%.It is an important prognostic factor for pancreatic cancer,and its early detection is helpful in the management of the *** study was undertaken to analyze retrospectively the relationship between neural invasion and multiple clinicopathological features and to provide evidences for clinicians in the management of neural invasion in patients with ***:Formalin-fixed paraffin-embeded specimens of PC taken from 215 patients were examined for the presence of neural invasion under a light *** was the relationship between neural invasion and multiple clinicopathological feature including preoperative fasting blood glucose level,amylase level,serum CA19-9 level,abdominal pain,lumbar and back pain,and the expressions of p53 and Ki67 in tumor ***:Preoperative fasting blood glucose level,serum CA19-9 level and p53 positive cells in cancer tissue were increased with the rise of pathological grade(Phyperglycemia may serve as an auxiliary treatment to curb neural invasion in PC.

关键词： pancreatic cancer neural invasion hyperglycemia referred pain

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Role of TRPM2 ion channel,an oxidative stress sensor,in hyperglycemiainduced pro-inflammaotry IL-1β in human monocytes

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中国药理学与毒理学杂志 2015年第S1期29卷 74-74页

作者： Hui-ling TSENG Chi-teng VONG Pui-man HOI State Key Laboratory of Quality Research in Chinese Medicine Institute of Chinese Medical SciencesUniversity of Macao

OBJECTIVE To investigate the role of transient receptor potential melastatin 2(TRPM2),a calcium-permeable non-selective cation channel which acts as an oxidative stress sensor,in mediating the production of pro-inflammatory IL-1βin high glucose *** Human pro-monocytic leukemia cell U937 was purchased from ATCC and cultured in RPMI 1640(Life Technologies).Prior to high glucose(HG)stimulation,U937 cells were cultured in medium with glucose 5.5mmol·L-1 for 48 *** cells were then incubated in high glucose concentration(30mmol·L-1)or mannitol(30mmol·L-1)for 48 *** protein expression of TRPM2 and the production of human IL-1β were evaluated by ***2 inhibitors(DPQ and AMP)and TRPM2 siRNAs were employed to further investigate the role of TRPM2 in HG-induced IL-1β *** The TRPM2 protein expression was significantly up-regulated by 2-folds in U937 cells after the treatment of high glucose(30mmol·L-1 for 48h)(P<0.01).The production of IL-1β in U937 was also significantly increased by HG treatment and was time-and dose-dependent(10,20 or 30mmol·L-1 glucose for 24,48 or 72h)(P<0.01).The HG-induced IL-1β production in U937 could be abolished by using TRPM2 inhibitors DPQ(100μmol·L-1 for 45min)and AMP(100μmol·L-1 for 45 min)as well as by the transfection of TRPM2siRNAs(60nmol·L-1).CONCLUSION High glucose condition(such as in diabetes)might mediate pro-inflammatory environments via the modulation of TRPM2 channels on immune cells.

关键词： TRPM2 monocyte hyperglycemia pro-inflammatory

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Impact of preoperative carbohydrate loading on gastric volume in patients with type 2 diabetes

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World Journal of Clinical Cases 2022年第18期10卷 6082-6090页

作者： Xin-Qiang Lin Yu-Ren Chen Xiao Chen Yu-Ping Cai Jian-Xin Lin De-Ming Xu Xiao-Chun Zheng Department of Anesthesiology Affiliated Hospital of Putian CollegePutian Maternity and Child Care HospitalPutian 351100Fujian ProvinceChina Department of Anesthesiology Affiliated Hospital of Putian CollegePutian 351100Fujian ProvinceChina Department of Anesthesiology Shenli Clinical Medical College of Fujian Medical UniversityFujian Provincial HospitalFuzhou 350001Fujian ProvinceChina

BACKGROUND Enhanced recovery after surgery advocates that consuming carbohydrates two hours before anesthesia is beneficial to the patient’s *** with diabetes are prone to delayed gastric *** guidelines for preoperative carbohydrate consumption in patients with diabetes remain controversial due to concerns about the risk of regurgitation,aspiration and *** gastric volume(GV)assessment and blood glucose monitoring can comprehensively evaluate the safety and feasibility of preoperative carbohydrate intake in type 2 diabetes(T2 D)*** To evaluate the impact of preoperative carbohydrate loading on GV before anesthesia induction in T2 D *** Patients with T2 D receiving surgery under general anesthesia from December 2019 to December 2020 were included.A total of 78 patients were randomly allocated to 4 groups receiving 0,100,200,or 300 m L of carbohydrate loading 2 h before anesthesia *** volume per unit weight(GV/W),Perlas grade,changes in blood glucose level,and risk of reflux and aspiration were evaluated before anesthesia *** No significant difference was found in GV/W among the groups before anesthesia induction(P>0.05).The number of patients with Perlas grade II and GV/W>1.5 m L/kg did not differ among the groups(P>0.05).Blood glucose level increased by>2 mmol/L in patients receiving 300 m L carbohydrate drink,which was significantly higher than that in groups 1 and 2(P<0.05).CONCLUSION Preoperative carbohydrate loading<300 m L 2 h before induction of anesthesia in patients with T2 D did not affect GV or increase the risk of reflux and *** glucose levels did not change significantly with preoperative carbohydrate loading of<200 m ***,300 m L carbohydrate loading may increase blood glucose levels in patients with T2 D before induction of anesthesia.

关键词： Type 2 diabetes Preoperative Carbohydrate loading Gastric volume Ultrasound assessment hyperglycemia

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β-Islet cell regeneration potential of Mirabilis jalapa in hyperglycemic rats

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Asian Pacific Journal of Tropical Biomedicine 2022年第8期12卷 351-356页

作者： Masud Eneji Sadiq Chibuzo Egwuenu Rabiu Saidu Umar Wasagu Usman Zayyanu Umar Bello Usman Department of Biochemistry and Molecular Biology Usmanu Danfodiyo UniversitySokotoNigeria Department of Physiology Usmanu Danfodiyo UniversitySokotoNigeria Department of Morbid Anatomy and Forensic Medicine Usmanu Danfodiyo UniversitySokotoNigeria

Objective:To investigate the role of Mirabilis jalapa root extracts in restoration of glucose homeostasis in alloxan-induced hyperglycemic Wistar albino ***:Experimental hyperglycemic rats were treated daily with 200 and 400 mg/kg of Mirabilis jalapa extracts after initial fasting for 6 ***-hour postprandial glucose and changes in body weight were monitored during *** 14 d,the rats were sacrificed and blood was collected for biochemical assessment of serum glucose and insulin levels,lipid profile,and oxidative stress *** examinations of harvested pancreas were also carried ***:Mirabilis jalapa root extracts at 200 and 400 mg/kg increased the body weight of hyperglycemic *** glucose levels of the extract-treated hyperglycemic groups progressively declined during treatment compared with the untreated hyperglycemic control group(P<0.05).The lipid profile indices of the untreated negative control group were significantly elevated(P<0.05),which were reversed by treatment with Mirabilis jalapa *** remarkable increases in antioxidant enzyme activities and a significant decrease in malondialdehyde levels were observed in the hyperglycemic group treated with Mirabilis jalapa *** jalapa extracts also significantly increased serum insulin levels(P<0.05).In addition,histopathological examinations of the pancreas revealed a significant cell population within the islet nests of the extract-treated hyperglycemic ***:Mirabilis jalapa extract can restore glucose homeostasis and show hypoglycemic and hypolipidemic effects in hyperglycemic *** studies are needed to verify the active components of the plant and the underlying mechanism of action in the future.

关键词： Mirabilis jalapa Glucose toxicity Diabetes mellitus hyperglycemia β-Islet cell Antioxidant Rat

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Comparison of anterior segment parameters of the eye between type 2 diabetic with and without diabetic retinopathy and non-diabetic

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International Journal of Ophthalmology(English edition) 2023年第4期16卷 571-578页

作者： Foroozan Narooie-Noori Amir Asharlous Ali Mirzajani Ebrahim Jafarzadehpur Mehdi Behnia Mehdi Khabazkhoob Rehabilitation Research Center Department of OptometrySchool of Rehabilitation SciencesIran University of Medical SciencesTehran ***Iran Noor Research Center for Ophthalmic Epidemiology Noor Eye HospitalTehran ***Iran Department of Basic Sciences School of Nursing and MidwiferyShahid Beheshti University of Medical SciencesTehran ***Iran

AIM:To compare anterior segment parameters between two groups of type 2 diabetic with and without diabetic retinopathy(DR)and non-diabetic elderly subjects based on hemoglobin A1c(Hb A1c)levels and status of ***:This study was conducted on 997 residents aged 60y or over in Tehran,*** group had Hb A1c level≥6.4%with no other systemic *** non-diabetic participants had normal eye findings and no systemic diseases.K1,K2,mean K,Q-value,anterior,central,posterior,and total corneal densitometric findings,anterior chamber volume(ACV),anterior chamber depth(ACD),corneal volume(CV),and pachymetry were measured by Pentacam ***:A total of 678 non-diabetic(39%male)and 319 diabetic(35%male)subjects with mean age of 66.31±5.23 and 67.22±4.96y were examined,*** statistically significant difference was found in anterior segment parameters between non-diabetic and diabetic groups(all P>0.05).However,middle,posterior,and total corneal densitometric values were statistically different between two groups af ter controlling the ef fects of confounders(P=0.014,0.007,and 0.042,respectively).Corneal densitometric values in all layers,ACD,and ACV were different between diabetic subjects with and without DR(all P<0.05).In the diabetic group,only corneal densitometric values had a negative relationship with fasting blood sugar(P<0.001).ACD and ACV had a negative correlation with Hb A1c levels(all P<0.05,r=-0.129 and-0.146,respectively).However,the relationships were not observed after controlling the confounders(P=0.938,0.466,respectively).CONCLUSION:Considering the higher densitometric values of the cornea and lower ACD and ACV in diabetic subjects with DR,it is suggested that the examiners should perform comprehensive retinal examinations when faced with such conditions.

关键词： anterior segment diabetes hyperglycemia retinopathy cornea

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Development and validation of a risk assessment model for prediabetes in China national diabetes survey

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World Journal of Clinical Cases 2022年第32期10卷 11789-11803页

作者： Li-Ping Yu Fen Dong Yong-Ze Li Wen-Ying Yang Si-Nan Wu Zhong-Yan Shan Wei-Ping Teng Bo Zhang Department of Endocrinology China-Japan Friendship HospitalBeijing 100029China Institute of Clinical Medical Sciences China-Japan Friendship HospitalBeijing 100029China Department of Endocrinology and Metabolism First Hospital of China Medical UniversityShenyang 110001Liaoning ProvinceChina

BACKGROUND Prediabetes risk assessment models derived from large sample sizes are *** To establish a robust assessment model for prediabetes and to validate the model in different *** The China National Diabetes and Metabolic Disorders Study(CNDMDS)collected information from 47325 participants aged at least 20 years across China from 2007 to *** Thyroid Disorders,Iodine Status and Diabetes Epidemiological Survey(TIDE)study collected data from 66108 participants aged at least 18 years across China from 2015 to 2017.A logistic model with stepwise selection was performed to identify significant risk factors for prediabetes and was internally validated by bootstrapping in the *** validations were performed in diverse populations,including populations of Hispanic(Mexican American,other Hispanic)and non-Hispanic(White,Black and Asian)participants in the National Health and Nutrition Examination Survey(NHANES)in the United States and 66108 participants in the TIDE study in China.C statistics and calibration plots were adopted to evaluate the model’s discrimination and calibration *** A set of easily measured indicators(age,education,family history of diabetes,waist circumference,body mass index,and systolic blood pressure)were selected as significant risk factors.A risk assessment model was established for prediabetes with a C statistic of 0.6998(95%CI:0.6933 to 0.7063)and a calibration slope of *** externally validated in the NHANES and TIDE studies,the model showed increased C statistics in Mexican American,other Hispanic,Non-Hispanic Black,Asian and Chinese populations but a slightly decreased C statistic in non-Hispanic White *** the risk assessment model to the TIDE population,we obtained a C statistic of 0.7308(95%CI:0.7260 to 0.7357)and a calibration slope of 1.1137.A risk score was derived to assess *** with scores≥7 points were at high risk of prediabetes,with a se

关键词： hyperglycemia Prediabetes Risk assessment model Risk scores

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Antihyperglycemic and antioxidant effects of Solanum xanthocarpum leaves(field grown & in vitro raised) extracts on alloxan induced diabetic rats

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Asian Pacific Journal of Tropical Medicine 2011年第10期4卷 778-785页

作者： K Poongothai P Ponmurugan K Syed Zameer Ahmed B Senthil Kumar SA Sheriff Research and Development Centre Bharathiar UniversityCoimbatore-646041Tamil NaduIndia Department of Biotechnology K.S.Rangasamy College of TechnologyK.S.R.KalvinagarThiruchengode-637215Tamil NaduIndia Department of Biotechnology K.S.Ranga.samy College of TechnologyK.S.R.KalvinagarThiruchengode-637215Tamil NaduIndia Department of Biochemistry C.Abdul Hakeem CollegeMelvisharam-632509Tamil NaduIndia Department of Zoology Thiruvalluvar UniversitySerkaduVelloreTamil NaduIndia Department of Biochemistry College of Applied Medical SciencesShaqra UniversityShaqra-11961.Kingdom of Saudi Arabia

Objective:To investigate antidiabetic efficacy of the extract of field grown and in vitro raised leaves of Solanum xanthocarpum(***) against alloxan induced diabetic rats. Methods:The antidiabetic activity of the crude methanol extracts of the field grown and in vitro raised leaves of *** at different concentrations(100-200 mg/kg bw) was tested against alloxan induced diabetic *** antidiabetic efficacy was validated through various biochemical parameters and the antioxidant effect was also *** phytochemical analyses of field grown *** and in vitro rasied *** leaves were done by estimating their chlorophyll,carotenoids,total sugar,protein,amino acid and minerals contents. Results:The results revealed that the methanol extracts of both the leaves(field grown and in vitro raised) of *** was efficient anti hyperglycemic agents at a concentration of 200 mg/kg bw and posses potent antioxidant ***,the extracts of in vitro rasied *** raised leaves exhibit higher efficacy than the field grown leaves in all tested *** composition and mineral analysis of *** revealed higher concentration of contents in in vitro rasied *** than field grown ***. Conclusions:From the results it can be concluded that the leaves extracts of *** can be a potential candidate in treating the hyperglycemic conditions and suits to be an agent to reduce oxidative stress.

关键词： Solanum Xanthocarpum Alloxan Field grown In vitro Oxidative stress Antioxidant hyperglycemia Hypolipidemic

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γ-aminobutyric acid B2 receptor:A potential therapeutic target for cholangiocarcinoma in patients with diabetes mellitus

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World Journal of Gastroenterology 2023年第28期29卷 4416-4432页

作者： Charupong Saengboonmee Supannika Sorin Sakkarn Sangkhamanon Surang Chomphoo Somsiri Indramanee Wunchana Seubwai Kanyarat Thithuan Ching-Feng Chiu Seiji Okada Marie-Claude Gingras Sopit Wongkham Department of Biochemistry Faculty of MedicineKhon Kaen UniversityKhon Kaen 40002Thailand Center for Translational Medicine Faculty of MedicineKhon Kaen UniversityKhon Kaen 40002Thailand Cholangiocarcinoma Research Institute Khon Kaen UniversityKhon Kaen 40002Thailand Department of Pathology Faculty of MedicineKhon Kaen UniversityKhon Kaen 40002Thailand Department of Anatomy Faculty of MedicineKhon Kaen UniversityKhon Kaen 40002Thailand Department of Forensic Medicine Faculty of MedicineKhon Kaen UniversityKhon Kaen 40002Thailand Graduate Institute of Metabolism and Obesity Sciences Taipei Medical UniversityTaipei 11031Taiwan Division of Hematopoiesis Joint Research Center for Human Retrovirus InfectionKumamoto UniversityKumamoto 860-0811Japan Human Genome Sequencing Center Department of Human and Molecular GeneticsBaylor College of MedicineHoustonTX 77030United States Michael E.DeBakey Department of Surgery Baylor College of MedicineHoustonTX 77030United States

BACKGROUND The association between diabetes mellitus(DM)and the increased risk and progression of cholangiocarcinoma(CCA)has been reported with unclear underlying *** studies showed thatγ-aminobutyric acid(GABA)B2 receptor(GABBR2)was upregulated in CCA cells cultured in high glucose(HG)*** of GABA receptors in CCA progression have also been studied,but their association with DM and hyperglycemia in CCA remains *** To investigate the effects of hyperglycemia on GABBR2 expression and the potential use of GABBR2 as a CCA therapeutic *** CCA cells,KKU-055 and KKU-213A,were cultured in Dulbecco Modified Eagle’s Medium supplemented with 5.6 mmol/L(normal glucose,NG)or 25 mmol/L(HG)glucose and assigned as NG and HG cells,***2 expression in NG and HG cells was investigated using real-time quantitative polymerase chain reaction and western *** and localization of GABBR2 in CCA cells were determined using ***2 expression in tumor tissues from CCA patients with and without DM was studied using immunohistochemistry,and the correlations of GABBR2 with the clinicopathological characteristics of patients were analyzed using univariate *** of baclofen,a GABA-B receptor agonist,on CCA cell proliferation and clonogenicity were tested using the MTT and clonogenic ***-kinases arrays were used to screen the affected signaling pathways after baclofen treatment,and the candidate signaling molecules were validated using the public transcriptomic data and western *** GABBR2 expression in CCA cells was induced by HG in a dose-and time-dependent *** tissues from patients with DM and hyperglycemia also showed a significantly higher GABBR2 expression compared with tumor tissues from those with euglycemia(P<0.01).High GABBR2 expression was significantly associated with a poorer non-papillary histological subtype but with smaller sizes of CCA tumors(P<0.0

关键词： Baclofen Cholangiocarcinoma Diabetes mellitus Drug repurposing hyperglycemia Gamma-aminobutyric acid

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Trends of nanotechnology in type 2 diabetes mellitus treatment

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Asian Journal of Pharmaceutical Sciences 2021年第1期16卷 62-76页

作者： Yannis V.Simos Konstantinos Spyrou Michaela Patila Niki Karouta Haralambos Stamatis Dimitrios Gournis Evangelia Dounousi Dimitrios Peschos Department of Physiology Faculty of MedicineSchool of Health SciencesUniversity of IoanninaIoannina 45110Greece Department of Materials Science and Engineering University of IoanninaIoannina 45110Greece Biotechnology Laboratory Department of Biological Applications and TechnologiesUniversity of IoanninaIoannina 45110Greece Department of Nephrology Faculty of MedicineSchool of Health SciencesUniversity of IoanninaIoannina 45110Greece Nanomedicine and Nanobiotechnology Research Group University of IoanninaIoannina 45110Greece

There are several therapeutic approaches in type 2 diabetes mellitus(T2DM).When diet and exercise fail to control hyperglycemia,patients are forced to start therapy with antidiabetic ***,these drugs present several drawbacks that can affect the course of *** major disadvantages of current oral modalities for the treatment of T2DM are mainly depicted in the low bioavailability and the immediate release of the drug,generating the need for an increase in frequency of *** conjugation with the manifestation of adverse side effects,patient compliance to therapy is *** the past few years nanotechnology has found fertile ground in the development of novel delivery modalities that can potentially enhance anti-diabetic regimes *** efforts have been targeted towards two main vital steps:(a)to protect the drug by encapsulating it into a nano-carrier system and(b)efficiently release the drug in a gradual as well as controllable ***,only a limited number of studies published in the literature used in vivo techniques in order to support *** we discuss the current disadvantages of modern T2DMmarketed drugs,and the nanotechnology advances supported by in vivo in mouse/rat models of glucose *** generation of drug nanocarriers may increase bioavailability,prolong release and therefore reduce dosing and thus,improve patient *** novel approach might substantially improve quality of life for *** ofmetal nanoformulations as indirect hypoglycemic agents is also discussed.

关键词： Type 2 diabetes mellitus Nanotechnology hyperglycemia Controlled release In vivo

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