Abstract:Diabeticnephropathy（DN）hasbecomeamajorproblemaffectinghumanhealth，andthepreventionandtreatmentofitsdevelopmentandprogressionhasattractedmoreandmoreattentionintheindustry.Inrecentyears，stemcelltransplantationhasshowngreatpotentialinthepreventionandtreatmentofDN，especiallymesenchymalstemcells（MSCs）transplantation.MoreandmorestudieshaveshownthatMSCsmainlyexertatherapeuticeffectinaparacrinemode，andaseriesofnanoscalevesicles（exosomes）releasedbyMSCsactasanimportantmediatorforintercellularcommunication.Theseexosomescantransferstemcellphenotypetorecipientcells，promotestemcellmaintenance，differentiation，self-renewal，andrepair，mediateinteractionsbetweenmatrixelements，andpro－motetissuerepairandregenerationofrecipientcells.Stemcellexosome-mediatedtreatmentofchronickidneydiseasehasbecomearesearchhotspotinrecentyears，andsomeachievementshavebeenmadeinthetreatmentofDN.Thisarticlereviewstherecentad－vancesinstemcellexosomesinthetreatmentofDNinChinaandforeigncountries.

Abstract:TheincidenceandmortalityofdiabetesinChinaareincreasingyearbyyear，andvascularcomplicationssecondarytodiabeteshaveprovedtobethemaincauseofdeathindiabeticpatients.Endothelialprogenitorcells（EPCs）canpromoteangiogenesisandrepairimpairedvessels，whileEPCsdepletionanddysfunctionleadtothedevelopmentofdiabeticangiopathy.ThisarticlereviewstheroleofEPCsintreatmentandpreventionofdiabetes-relatedcardiovasculardiseases.EPCsprovideanewapproachtothetreat－mentofdiabetes-inducedcardiovasculardiseases.Althoughpositiveeffectsweredocumentedbyanimalstudybothinvivoandvitro，clinicaltrialswithlargesamplearestillrequiredtoverifytheefficiencyandsafetyofEPCstransplantationtherapyinpatientswithdiabetes-inducedcardiovasculardiseases.Moderatealcoholconsumption，useofestrogenandstains，aswellasphysicalexerciseetc.canstimulateEPCstomobilize，proliferateandmigrate，theycanalsopromoteangiogenesis，whichisofgreatsignificanceforthetreatmentofdiabetesinducedcardiovasculardiseases.

Abstract:Diabeticfoot（DF）isoneofthemostcommonchroniccomplicationsofdiabetesanditssecondaryinfectionisthemajorcauseofnon-traumaticamputation，whichgreatlyaffectsthequalityoflifeofdiabeticpatientsandbringsseriouseconomicburdenstofamiliesandthesociety.Mesenchymalstemcell（MSCs）treatmentcaneffectivelypromoteangiogenesisandwoundhealingandisthusanewmethodforthetreatmentofDF.ThisarticlereviewstheresearchadvancesinMSCsinthetreatmentofDF，inordertoprovideatheoreticalbasisfortheclinicaltreatmentofDF.

Abstract:Aldosteroneproducingadenoma（APA）isthemostcommonsubtypeofsurgicalcurableunilateralprimaryaldosteronism.Discrepancyregardingtheoptimaloperationalstyleexistsbetweendomesticdoctors'opinionsandforeignpracticeguidelines.ThisreviewaimstomakeacommentonthemisunderstandingofsurgicalproceduresinthetreatmentofAPA.

Abstract:Asthenumberofpeoplewithdiabetesclimbs，theattentionondiabeticulcersisalsorising.Inrecentyears，thestudieshaveshownthatthestromalcellderivedfactor-1（SDF-1）axisinthemigrationoftransplantedangiogenesismobilizedbyvariedcy－tokineplaysanimportantroleinthehealingofdiabeticulcers，anditstargettreatmentprovidesanewwaytochroniculcerssuchasdiabeticfoot.ResearchesonSDF-1andangiogenesisindiabeticulcerwoundaremainlyreviewedinthisarticle.

Abstract:Objective：Toobservetheeffectofglucagon-likepeptide-1（GLP-1）ontheexpressionofPar-4/NF-κBandtheapoptosisofisletβcellsindiabeticmice.Methods：Experimentalmicewererandomlydividedintonormalcontrolgroup（Cgroup），Par-4knockoutgroup（CPgroup），diabetesgroup（Dgroup），diabetesandPar-4knockoutgroup（DPgroup），GLP-1+diabetesgroup（GDgroup），andGLP-1+diabetesandPar-4knockoutgroup（GDPgroup），with8miceineachgroup.Foreachgroup，theapoptosisrateofisletβcellswasdeterminedbyTUNELassay，theproteinexpressionlevelsofPar-4andNF-κBweredeterminedbyWesternblot，andinsulinsecretionwasmeasuredbyELISA.Results：TherewerenosignificantdifferencesbetweentheCPgroupandtheCgroupintheapoptosisrateofisletβcells（P=0.965），NF-κBexpression（P=0.754），andinsulinsecretion（P=0.797）.ComparedwiththeCgroupandCPgroup，theDgrouphadsignificantlyincreasedapoptosisrate（P=0.000）andexpressionofPar-4（P=0.000）andNF-κB（P=0.000），butsignificantlyreducedinsulinsecretion（P=0.000）.ComparedwiththeDgroup，theDPgroupandGDgrouphadsignifi－cantlydecreasedapoptosisrate（P=0.000，P=0.000）andexpressionofPar-4（P=0.000，P=0.000）andNF-?资B（P=0.000，P=0.002），butsignificantlyimprovedinsulinsecretion（P=0.000，P=0.026）.ComparedwiththeGDgroup，theGDPgrouphadsignificantlydecreasedapoptosisrate（P=0.000）andexpressionofPar-4（P=0.000）andNF-κB（P=0.015），butsignificantlyimprovedinsulinsecretion（P=0.026）.TherewerenosignificantdifferencesbetweentheDPgroupandtheGDPgroupintheapoptosisrateofisletβcells（P=0.930），theexpressionofPar-4（P=0.965）andNF-κB（P=0.875），andinsulinsecretion（P=0.797）.Conclusion：GLP-1improvestheapoptosisofisletβcellsandinsulinsecretionintype2diabetesbyinhibitingtheexpressionofPar-4/NF-κB.

Abstract:Objective：ToinvestigatetheeffectofvaspinonhighglucoseandlipidinducedoxidativestressinINS-1cells.Methods：INS-1cellswereculturedanddividedintonormalcontrolgroup，highglucose（HG）+palmiticacid（PA）group，HG+PA+vaspin（80ng/mL）group，HG+PA+vaspin（160ng/mL）group，HG+PA+vaspin（320ng/mL）group，HG+PA+vaspin（640ng/mL）group.Colorimetryandenzyme-linkedimmunosorbentassaywereusedtomeasureoxidativestress-relatedindicators；meanwhile，DCFH-DAfluorescentprobestaining，glucose-stimulatedinsulinsecretiontest（3.3and16.7mmol/L），flowcytometry，andWesternblotwereusedtodeterminethelevelsofintracellularreactiveoxygenspecies（ROS），insulinsecretion，apoptosis，andproteinexpressionofnuclearfactorerythroid2-relatedfactor2（Nrf2），respectively.Results：ComparedwiththeHG+PAgroup，theHG+PA+vaspin（640ng/mL）grouphadasignificantlyincreasedinsulinsecretionlevelafterstimulationbybothlow-levelandhigh-levelglucose（bothP<0.05）aswellassignificantlyincreasedtotalantioxidantcapacityandlevelsofsuperoxidedismutaseandglutathioneperoxidase（allP<0.05），buthadsignificantlydecreasedlevelsofROS，malondialdehyde，and8-hydroxydeox-yguanosine（allP<0.05）.Withtheincreasingvaspinlevels，thevaspin-treatedgroupshadsignificantlyreducedapoptosisintheINS-1cellsafterinterventionbyhigh-levelglucoseandlipidscomparedwiththeHG+PAgroup，asrevealedbyflowcytometry（allP<0.05），andshowedanincreasingtrendinintracytoplasmicNrf2expressionasrevealedbyWesternblot，whiletheintranuclearNrf2expressionwassignificantlyhigheronlyintheHG+PA+vaspin（640ng/mL）groupcomparedwiththeHG+PAgroup（0.798±0.080vs.0.579±0.065，P=0.039）.Conclusion：VaspincansuppresshighglucoseandpalmiticacidinducedoxidativestressinjuryinINS-1cells，reduceapoptosis，andimproveinsulinsecretionlevelbyactivatingtheNrf2/AREsignalingpathway.

Abstract:Objective：Toinvestigatetheeffectoftheadipocytokinevaspinonthelevelofpalmiticacid（PA）-inducedautophagyinINS-1cells.Methods：INS-1cellsweredividedintogroupsandculturedasfollows：normalgroup：culturedinanordinarymediumfor24hours；PAgroup：culturedwith0.5mmol/LPAfor24hours；PA+vaspingroup：pre-culturedwith320ng/mlvaspinfor2hours，andthenco-culturedwith0.5mmol/LPAand320ng/mLvaspinfor24hours；PA+vaspin+rapamycingroup：pre-cul－turedwith50nmol/Lrapamycinfor2hours，andthenco-cul－turedwith0.5mmol/LPAand320ng/mLvaspinfor24hours；PA+vaspin+3-methyladenine（3-MA）group：pre-culturedwith1mmol/L3-MAfor2hours，andthenco-culturedwith0.5mmol/LPAand320ng/mLvaspinfor24hours.Theglucose-stimulatedinsulinsecretion（GSIS）test（withglucoselevelsof3.3and16.7mmol/L）wasperformedtodeterminetheinsulinlevelineachgroup；Westernblotwasusedtodeterminethelevelsofmammaliantargetofrapamycin（mTOR），p-mTOR，Beclin-1，LC3-I，LC3-II，andP62；mRFP-GFP-LC3andflowcytometrywereusedtodeterminetheautophagicflowandcellapoptosis，respectively.Results：Comparedwiththenormalgroup，thePAgrouphadsignificantlyreducedGSISlevelsintheINS-1cellsupernatant[（1.02±0.08）ng/mLvs.（0.54±0.06）ng/mL，P=0.000；（1.15±0.13）ng/mLvs.（0.71±0.05）ng/mL，P=0.000）]，whilethevaspin-treatedgrouphadsignificantlyincreasedGSISlevelsthanthePAgroup[（0.76±0.03）ng/mLvs.（0.54±0.06）ng/mL，P=0.001；（0.91±0.04）ng/mLvs.（0.71±0.05）ng/mL，P=0.011）].Comparedwiththenormalgroup，thePAgrouphadasignificantlyreducedp-mTOR-to-mTORratio（2.04±0.14vs.1.19±0.09，P=0.000），whilethevaspin-treatedgrouphadasignificantlyincreasedratiocomparedwiththePAgroup（1.51±0.05vs.1.19±0.09，P=0.005）.Comparedwiththenormalgroup，thePAgrouphadsignificantincreasesintheleveloftheautophagy-associatedproteinBeclin-1andtheratioofLC3-IItoLC3-I（0.65±0.04vs.0.81±0.07，P=0.005；1.16±0.11vs.2.35±0.25，P=0.000）andasignificantreductioninP62level（1.04±0.19vs.0.60±0.08，P=0.000）；thevaspin-treatedgrouphadsignificantdecreasesintheBeclin-1levelandtheLC3-Ⅱ-to-LC3-Ⅰratio（0.58±0.04vs.0.81±0.07，P=0.001；1.95±0.08vs.2.35±0.25，P=0.007）andasignificantincreaseinP62level（0.82±0.03vs.0.60±0.08，P=0.032）comparedwiththePAgroup.ThePAgrouphadasignificantlyhighernumberofautolysosomesthanthenormalgroup（8.33±1.53vs.0.33±0.58，P=0.000），whilethevaspin-treatedgrouphadasignificantlyreducednumberofautolysosomescom－paredwiththePAgroup（3.67±1.53vs.8.33±1.53，P=0.001）.Aftertreatmentfor24hours，thePAgrouphadasignificantlyincreasedapoptosisrateofINS-1cellscomparedwiththenormalgroup（22.15±2.05vs.7.91±0.50，P=0.000），whilethevaspin-treatedgrouphadasignificantlyreducedapoptosisratecomparedwiththePAgroup（13.23±1.97vs.22.15±2.05，P=0.000）.Conclusion：VaspincaninhibitPA-inducedexcessiveautophagyandapoptosisofINS-1cells，thusimprovingthesecretoryfunctionofisletβcells.

Abstract:Objective：ToinvestigatetherelationshipbetweenthemechanismofAMP-activated-protein-kinase（AMPK）-mediatedmyocardialmitochondrialautophagyandtuberoussclerosiscomplex-2（TSC2）indiabeticrats.Methods：ThirtyadultmaleSDratswererandomlydividedintocontrolgroup，modelgroup，andmodelgroup+AMPKagonistAICARgroup（AICARgroup）.Thediabeticratmodelwasestablishedbyintraperitonealinjectionofstreptozotocin.RatsintheAICARgroupweresubcutaneouslyinjectedwithAICARfor12weeks.Cardiacfunctionofallratswasmeasuredbyechocardiography，includingleftventricularend-diastolicvolume（LVEDV），leftventricularend-systolicvolume（LVESV），leftventricularejectionfraction（LVEF），heartrate（HR），peakvelocityofearlydiastolicflow（E），peakvelocityoflatediastolicflow（A），andE/A.ThemyocardialtissuewastakentodetectthebindinglevelsofAMPKandTSC2byimmunoprecipitationandtheexpressionlevelsofAMPK，TSC2，p-TSC2，LC3-Ⅱ，LC3-Ⅰ，Beclin-1andP62weredetectedbyWesternblot.Results：ThelevelsofLVEDV，LVEF，EandE/AinAICARgroupwerehigherthanthoseinthemodelgroup，butAwaslowerthanthatinthemodelgroup（P=0.004，P=0.001，P=0.000，P=0.011，P=0.027）.ThelevelsofAMPKandTSC2proteininAICARgroupwerehigherthanthoseinthemodelgroup（0.71±0.06vs.0.36±0.09，P=0.003；0.80±0.02vs.0.40±0.05，P=0.017）.ThebindinglevelofAICARgroupwashigherthanthatinthemodelgroup（0.49±0.09vs.0.23±0.03，P=0.002），andthelevelofp-TSC2proteininAICARgroupwashigherthanthatinthemodelgroup（1.48±0.07vs.0.92±0.07，P=0.029）.ThelevelsofLC3-Ⅱ/LC3-Ⅰ，Beclin-1andP62inAICARgroupwerehigherthanthoseinmodelgroup（P<0.05）.Conclusion：ThemechanismofAMPK-mediatedmyocardialmitochondrialautophagyindiabeticratsmayberelatedtoitsphos－phorylationtoTSC2.

Abstract:Objective：①ToinvestigatethemechanismofactionofactivevitaminD3throughregulatingtheNF-κBsignalingpathwayinrenalprotectionofratswithtype2diabeticnephropathy.②TodeterminetheoptimalconcentrationofvitaminDinthetreatmentofdiabeticnephropathy.Methods：SeventySprague-Dawleyratswererandomlydividedintonormalcontrolgroup（10rats）andDNmodelgroup（60rats），andtheDNmodelgroupwasfurhterdividedintopeanutoilgroup，irbesartangroup，low-dosevitaminDgroup，medium-dosevitaminDgroup，andhigh-dosevitaminDgroup，with10ratsineachgroup.Thenormalcontrolgroupwasfedwithroutinediet，whiletheratsinthemodelgroupweread－ministeredabove-mentioneddrugsbygavage.Theratswerethensacrificedandweighedafter6weeks.Andfastingbloodglucose（FBG）wasmeasuredafterbloodsampling，and24-hoururinewasalsocollectedtocalculateurinevolumeandquantify24-hoururineprotein.RenaltissuewasretainedandHEstainingwasusedtoobservethepathologicalchangesofrenaltissue.Meanwhile，real-timefluorescentquantitativePCRwasusedtodeterminetheexpressionofnuclearfactor-kappaB（NF-κB）mRNAanditsdownstreammonocytechemotacticprotein-1（MCP-1）mRNAinrenaltissue，andtheproteinexpressionofinflammatoryfactors，NF-κBandMCP-1，wasmeasuredbyWesternblot.Results：①ThelevelsofFBGand24-hoururineproteininthelow-dosevitaminDgroupweresignificantlylowerthanthoseinthepeanutoilgroup[18.20（16.25，21.25），32.24（26.09，37.68）vs.23.55（22.75，24.60），72.52（50.38，84.93），P<0.05].②Inthenormalcontrolgroup，HEstainingshowedthattheglomerularmorphologywasintact，themesangialareahadnoobvioushyperplasia，andthecapillarylumenandloopswerebothregularlyshaped；inthepeanutoilgroup，theglomerularvolumewasreduced，themesangialareasignificantlybroadened，theglomerularmesangialcellsproliferated，andcapillarywallbecamethickenedaswell.Theirbesartangroupshowedlesshyperplasiacomparedwiththepeanutoilgroup.Thehigh-，medium-，andlow-dosevitaminDgroupsallhadabroad－enedglomerularmesangialarea，butthelow-dosegroupexhibitedthelowestdegreeofbroadening.③ThemRNAlevelsofNF-κBandMCP-1inthelow-dosevitaminDgroupweresignificantlylowerthanthoseinthenormalcontrolgroupandthepeanutoilgroup（1.72±0.002，0.67±0.01vs.3.57±0.40，3.57±0.37，allP<0.05）.However，therewasnosignificantdifferencebetweentheirbesartangroupandthelow-dosevitaminDgroup.④TherewerenosignificantdifferencesbetweenthesegroupsregardingtheexpressionofNF-κBprotein.Thelow-dosevitaminDgrouphadasignificantreductionintheexpressionofMCP-1proteincomparedwiththepeanutoilgroupandthemedium-dosevitaminDgroup（0.47±0.17vs.0.90±0.30，1.22±0.18，0.93±0.43，allP<0.05）.Conclusion：①VitaminDcaneffectivelyalleviaterenalinjuryindiabeticnephropathybydown-regulationoftheNF-κBinflammatorysignalingpathway.②Asindicatedinthestudy，0.03μg/（kg·d）inthelow-dosevitaminDgroupistheoptimalconcentrationforre－nalprotectionindiabeticnephropathy.

Abstract:Objective：Toobservetheeffectofliraglutideontheexpressionofperoxisomeproliferator-activatedreceptors（PPARs）inthebraintissueofdiabeticratsaftercerebralischemicinjury，andtofurtherinvestigatetheeffectofliraglutideoncerebralischemicinjurywithdiabetesmellitusandthepossiblemechanism.Methods：Forty-eightadultmaleSprague-Dawleyratswererandomlydividedintofourgroups：sham-operatedgroup（Shamgroup），diabetescerebralischemiagroup（DCIgroup），liraglutide-pretreatmentDCIgroup（Lirgroup），andinsulin-pretreatmentDCIgroup（Insgroup），with12ratsineachgroup.Diabeteswasinducedbyintraperi－tonealinjectionofstreptozotocin，andamodelofpermanentmiddlecerebralarteryocclusion（MCAO）wasestablishedinthediabeticrats.TheratsintheLirgroupandInsgroupwereintraperitoneallyinjectedwithliraglutide（100μg/kg，q12h）andinsulin（2U/kg，q12h），respectively，7daysbeforeMCAO，whiletheothertwogroupswereinjectedwithanequalvolumeofnormalsalineduringthesameperiodoftime.Neurologicaldeficitscoresweredeterminedat24hoursafterMCAO.Thentheratsweredecapitated，andtheirbraintissuesweretakenouttomeasuretheinfarctareabyTTCstaining.WesternblottingwasusedtomeasuretheexpressionofPPARα，PPARβ，PPARγ，nuclearfactor-kappaBp65（NF-κBp65），andtumornecrosisfactor-α（TNF-α）intheischemicarea.Results：TheLirgroupandInsgroupshowedsignificantreductionsinbloodglucoseafterinjectionofliraglutideorin－sulin（P=0.000，P=0.000）.TheShamgroupshowednoneuro－logicaldeficit；comparedwiththeDCIgroup，theInsgrouphadnosignificantchangeinneurologicaldeficitscore，buttheLirgroupshowedasignificantreductioninneurologicaldeficitscore（P=0.00８）.TTCstainingshowedthatnoinfractwasobservedintheShamgroup；comparedwiththeDCIgroup，theInsgrouphadnosignificantchangeininfarctvolume，buttheLirgroupshowedasignificantreductionininfarctvolume（P=0.033）.WesternblotshowedsignificantdifferencesintheexpressionlevelsofPPARα，PPARβ，PPARγ，NF-κBp65，andTNF-αbetweentheShamgroup，theDCIgroup，theInsgroup，andtheLirgroup（F=15.826，P=0.000；F=21.988，P=0.000；F=21.132，P=0.000；F=21.023，P=0.000；F=63.607，P=0.000）；comparedwiththeDCIgroup，theInsgrouphadnosignificantchangesintheexpressionoftheaboveproteins，buttheLirgroupshowedsignificantincreasesintheexpressionofPPARα，PPARβ，andPPARγ（P=0.000，P=0.000，P=0.000）andsignificantreductionsintheexpressionofNF-κBp65andTNF-α（P=0.000，P=0.000）.Conclusion：Liraglutidehasacertainprotectiveeffectagainstfocalcerebralischemicinjuryindiabeticrats，possiblybyup-regulatingtheexpressionofPPARα，PPARβ，andPPARγanddown-regulatingtheexpressionofNF-κBp65andTNF-α.

Abstract:Objective：Toinvestigatetheeffectsofexercisecombinedwithdietcontrolonglucosemetabolism，developmentofinsulinresistance，andbloodlipidmetabolisminratswithtype2diabetes.Methods：Atotalof35Wistarratswereincludedinthisstudy.TenWistarratswererandomlyselectedasnormalcontrolgroup，andtheremaining25ratswereusedtoestablishatype2diabetesmodel.Atotalof20modelratswererandomlydividedintomodelcontrolgroupandintervention（exercisecombinedwithdietcontrol）group.Theratsinthenormalcontrolgroupwerefreetomoveandgivenstandardfeed.Theratsinthemodelcontrolgroupwerefreetomoveandgivenhigh-fatandhigh-sugardiet.Swimmingtrainingandstandardfeedweregiventotheratsintheinterventiongroup.Theinterventionperiodinthethreegroupswas8weeks.Bodyweightanddailyfoodintakeoftheratsinthethreegroupsweremeasuredbeforeexperiment，aftermodelingandbeforeintervention，andafter4and8weeksofintervention.Beforeinterventionandafter8weeksofintervention，thelevelsoffastingbloodglucose（FBG），fastinginsulin（FINS），triglyceride（TG），cholesterol（TC），andlow-densitylipoproteincholesterol（LDL-C）weremeasured，andglucosetolerancetest（GTT）andinsulintolerancetest（ITT）wereperformedtoassessinsulinresistance.Afterexercise，thepancreatictissuewastakentodeterminetheactivitiesofglucoseki－nase（GK）andadenosinetriphosphatase（ATPase）；themRNAexpressionofinsulinreceptorsubstrate-1（IRS-1），phosphoinositide3-kinase（PI3K），proteinkinaseB（PKB），andmammaliantargetofrapamycin（mTOR）inthepancreatictissuewasdeterminedbyreal-timepolymerasechainreaction；theproteinexpressionofIRS-1，phosphorylatedIRS-1（p-IRS-1），PI3K，PKB，phosphorylatedPKB（p-PKB），mTOR，andphosphorylatedmTOR（p-mTOR）inthepancreatictissuewasdeterminedbyWesternblot.Results：①After4and8weeksofintervention，theinterventiongrouphadasignificantlyhigherbodyweightthanthemodelcontrolgroup（P<0.05），andtherewasasignificantdifferenceindailyfoodintakebetweenthetwogroups（P<0.05）.②After8weeksofintervention，theinterventiongrouphadsignificantlylowerlevelsofFBGandFINS，homeostasismodelassessmentofinsulinresistance，areaunderthereceiveroperatingcharacteristiccurve（AUC）GTT，andAUCITTthanthemodelcontrolgroup（P<0.05）.③After8weeksofinterven－tion，theinterventiongrouphadsignificantlylowerlevelsofTG，TC，andLDL-Cthanthemodelcontrolgroup（P<0.05）.④After8weeksofintervention，theinterventiongrouphadsignificantlyhigherGKandATPaseactivitiesinthepancreatictissuecomparedwiththemodelcontrolgroup（P<0.05）.⑤After8weeksofintervention，theinterventiongrouphadsignificantlyhighermRNAexpressionofIRS-1，PI3K，andPKBinthepancreatictissueandsignificantlylowermRNAexpressionofmTORinthepancreatictissuecomparedwiththemodelcontrolgroup（P<0.05）.⑥After8weeksofintervention，theinterventiongrouphadsignificantlyhigherproteinexpressionofIRS-1，p-IRS-1，PI3K，PKB，andp-PKBinthepancreatictissueandsignificantlylowerproteinexpressionofmTORandp-mTORcomparedwiththemodelcontrolgroup（P<0.05）.Conclusion：Exercisecombinedwithdietcontrolcancontrolthebloodglucoselevelofratswithtype2diabetes，alleviateinsulinresistanceanddyslipidemia，increasetheactivitiesofGKandATPaseinthepancreatictissue，andregulatetheIRS/PI3K-Aktsignalingpathway.

Abstract:Objective：Toinvestigatethepossiblemechanismofinsulin-likegrowthfactor1receptor（IGF-1R）inhibitorinhibitingrenalfibrosisinmicewithdiabeticnephropathy.Methods：Ninety8-week-oldC57/BL6maleratswereequallyandrandomlydividedintofivegroups：groupA（diabeticnephropathygroup），groupB（IGF-1Rgroup），groupC（angiotensin-converting-enzymeinhibitorgroup），groupD（insulingroup），andcontrolgroup.GroupsA-Dwereintraperitoneallyinjectedwith100mg/kgstreptozotocintoestablishadiabetesmodel，whichwasconfirmedwith48hrandombloodglucose（≥16.7mmol/L）andurineglucose（+~4+）.After8weeksofmodeling，groupAwasgivennormalsalinebygavage，groupBwasgiven30mg/kgIGF-1Rinhibitorbygavageonceevery48h，groupCwasgiven30mg/kgangiotensin-converting-enzymeinhibitoronceevery48h，andgroupDwasinjectedsubcutaneouslywith1-2U/kginsulin.Theurinecreatinine，bloodglucose，and24-hourproteinexcretionineachgroupwereroutinelytested.Attheageof16weeks，themiceineachgroupwereanesthetizedandsacrificed.Therenaltissuesampleswerecollectedandroutinelyparaffin-embeddedforhistopathologicalexamination.Results：Thebloodglucoseinthecontrolgroupwasnormal.ThebloodglucoselevelsingroupsA-Cwerehigherthan16.7mmol/L，andthatingroupDwaslowerthan16.7mmol/L.Therewasasignificantdifferenceinbloodglucosebetweenthegroups（P<0.05）.Theurinarypro－teinexcretionrateingroupAwassignificantlyhigherthanthatinthecontrolgroup（P<0.05）；theurinaryproteinexcretionratesingroupBandDweresignificantlylowerthanthatingroupA（P<0.05）.Theurinaryprotein/creatinineratioingroupAwassignificantlyhigherthanthatinthecontrolgroup（P<0.05）；comparedwithgroupA，groupsBandDhadasignificantlylowerurineprotein/creatinineratio（bothP<0.05）.InsituhybridizationassayshowedthattheexpressionofSnail1andIGF-1intherenaltissuewasup-regulatedinmicewithdiabeticnephropathy.Comparedwiththecontrolgroup，groupAhadnosignificantchangeinthemRNAexpressionofIGF-1（P>0.05），buthadsignificantlylowermRNAexpressionofSnail1（P<0.05）；nosignificantchangesinthemRNAexpressionofSnail1andIGF-1intherenaltissuewereobservedingroupsCandD（P>0.05）.Immunohistochemicalstainingresultsshowedthatcomparedwiththecontrolgroup，groupAhadsignifi－cantlyhigherproteinexpressionofSnail1andIGF-1intherenaltissue（P<0.05）；groupBhadnosignificantchangeintheproteinexpressionofIGF-1（P>0.05），buthadsignificantlylowerproteinexpressionofSnail1（P<0.05）.NosignificantchangesintheproteinexpressionofSnail1andIGF-1wereobservedingroupsCandDcomparedwithgroupA（P>0.05）.Conclusion：InhibitingIGF-1RorsilencingIGF-1caninhibitrenaltubularepithelial-mesenchymaltransitionandrelieverenalfibrosis.

Abstract:Objective：Toinvestigatethedisorderofglucoseandlipidmetabolisminducedbyolanzapineinratsanditsinfluencingmechanism.Methods：Accordingtotherandomdigitstablemethod，40healthyadultmaleratsweredividedintothecontrolgroupandtheobservationgroup，with20ratsineachgroup.Ratsinthecontrolgroupwerereceivednormalfood，whileintheobservationgroupwerefedwitholanzapine（1.2mg/kg）onthebasisofnormalfoodforcontinuousfourweeks.Afterfourweeks，indicatorchangesofbodyweight，glycemiaandlipidemiawerecompared.Additionally，pancreaticglycometabolismkeykinaseofglucokinase（GCK）andglucosetransporter-2（GLUT-2），andlipocyteskeykinaseofperoxisomeproliferatoractivatedreceptor-γ（PPARγ）andfattyacidsynthase（FAS）weremeasured.Results：Afterfourweeks，theweightofratsintheobservationgroupwas23%higherthanthatinthecontrolgroup，andtheweightofratsintheobservationgroupwassignificantlyhigherthanthatinthecontrolgroupfromthesecondweek（P<0.05）；fastingglucose，totalcholesterol，triglycerideandlowdensitylipoprotein（LDL）ofratsintheobservationgroupweresignificantlyhigherthanthoseinthecontrolgroup（P<0.05），butthehighdensitylipoprotein（HDL）ofratsintheobservationgroupwaslowerthanthatinthecontrolgroup（P<0.05）.ThemRNAexpressionlevelsofGCKandGLUT-2intheobservationgroupweresignificantlylowerthanthoseinthecontrolgroup（P<0.05），whilethemRNAexpressionlevelsofPPARγandFASgenesweresignifi－cantlyhigherthanthoseinthecontrolgroup（P<0.05）.Conclusion：Olanzapinecaninducethedisorderofglucoseandlipidmetabolisminrats，anditsmechanismmayberelatedtothedownregulatingkeyglycometabolicgenesofGCKandGLUT-2，andtheupregulatinglipocytesdifferentiationkeygenesofPPARγandFAS.

Abstract:Objective：Toexploretheeffectofmetformininterventiononserumirisinlevelsinpatientswithnewlydiagnosedtype2diabetesmellitus（T2DM）anditsroleindelayingatherosclerosis（AS）.Methods：Onehundredandtwentypatientswithnewlydiag－nosedT2DMwererandomlydividedintotwogroups，namelylow-dosegroupandhigh-dosegroup，with60casesineachgroup.Boththelow-dosegroup（250mg，tid）andthehigh-dosegroup（500mg，tid）weretreatedwithmetforminfor6months.Ｃarotidin－tima-mediathickness（CIMT）wasmeasuredbyultrasound.Thelevelsofmatrixmetalloprotein9（MMP9）andotherbiochemi－calindexessuchasfastfoodglucose（FBG），triacylglycerol（TAG）andbodymassindex（BMI）werecomparedbeforeandaftertreatment.Results：Beforetreatment，therewasnosignifi－cantdifferenceinbaselinedatabetweenthetwogroups（P>0.05）.Aftertreatment，thelow-dosegrouphadasignificantlyincreasedlevelofserumirisin（215.17±89.96vs.356.66±102.32，P<0.05），whilethehigh-dosegroupshowedasignificantimprovementinCIMT（1.43±0.89vs.1.10±1.21，P<0.05）inadditiontoasignificantincreaseinserumIrisinlevel（238.17±67.96vs.389.43±93.43，P<0.05）.Meanwhile，thereweresignificantreductionsinthelevelsofMMP-9andoxidativestressinbothgroups（P<0.05）.Comparedwiththelow-dosegroup，thehigh-dosegrouphadsignificantlygreaterreductionsinMMP9andmalondialdehydeandasignificantlygreaterincreaseinserumIrisin（P<0.05）.Correlationanalysisshowedthatafter6months，ΔCIMTinthehighdosegroupwasnegativelycorrelatedwithserumΔirisin，andpositivelycorrelatedwithΔBMI，ΔFBG，ΔTGandchangeofoxidativestresslevel.ΔMMP9wasnegativelycorrelatedwithserumΔirisinandpositivelycorrelat－edwithΔFPGandchangeinoxidativestresslevel.ΔIrisinwasnegativelycorrelatedwiththechangeinoxidativestresslevel.Fur－thermore，multivariatelinearstepwiseregressionanalysiswasperformedwithΔCIMTandΔMMP9inthehigh-dosegroupasdepen－dentvariables，andotherrelatedfactorsasindependentvariables.TheresultsshowedthatΔirisinandchangeinoxidativestresslevelwereindependentinfluencingfactorsforΔCIMTandΔMMP9.Conclusion：Metformincandelaytheprogressionofcarotidatheroscle－rosisinpatientsnewlydiagnosedwithT2DM，partlyduetotheelevatedirisinlevelandimprovedoxidativestress.

Abstract:Objective：Toinvestigatetherelationshipbetweentype2innatelymphoidcells（ILC2s）andmetabolicsyndrome（MS）inhemodialysispatientswithdiabeticnephropathy（DN）.Methods：Atotalof105hemodialysispatientsinourhospitalwereenrolledinthisstudy，including40DNpatients（hemodialysis+DNgroup）and65patientswithnon-diabeticnephropathy（hemodialysis+NDNgroup）.Theclinicaldatawerecollected.Anthropometricparameters，bloodglucose，andbloodlipidsweremeasured.And35patientswithtype2diabetesalone（diabetesgroup）and30outpatientsreceivingphysicalexamination（healthycontrolgroup）wereselectedascontrol.ThemRNAexpressionlevelsofILC2srelatedfactorsinperipheralbloodmononuclearcellsweredeterminedbyquantitativereal-timePCR.ILC2s%wasmeasuredbyflowcytometry.TheproteinexpressionlevelsofILC2srelatedcytokines（interleukin[IL]-5andIL-13）inplasmaweremeasuredbyenzyme-linkedimmunosorbentassay.Results：Thehemodialysis+DNgrouphadasignificant－lyhigherincidencerateofMScomparedwiththehealthycon－trolgroup，thediabetesgroup，andthehemodialysis+NDNgroup（87.5%vs.0%，57.10%，and50.80%，?字2=53.084，P=0.000）.Com－paredwiththehealthycontrolgroup，thehemodialysis+DNgrouphadsignificantlyhighermRNAexpressionlevelsofILC2schar－acteristictranscriptionfactorROR-alpha，membranereceptorT1/ST2，IL-17B，IL-5，andIL-13（P=0.000，P=0.000，P=0.000，P=0.000，P=0.004）andhadsignificantlyhigherproteinexpressionlev－elsofIL-5andIL-13（P=0.012，P=0.076）.Theflowcytometryresultsshowedthatthehemodialysis+DNgrouphadasignificantlyhigherILC2s%thantheotherthreegroups（F=185.287，P=0.000）.LogisticregressionanalysisshowedthatwiththeincreasingILC2sactivity，thehemodialysis+DNgrouphadahigherprobabilityofMSthantheotherthreegroups.CorrelationanalysisindicatedthatILC2swaspositivelycorrelatedwithwaistcircumferenceandtriglyceridelevelinhemodialysispatientswithDN（r=0.356，P=0.024；r=0.462，P=0.003）.Conclusion：HemodialysispatientswithDNhaveahigherprevalenceofMS.ILC2sappearstobethedominantactivationstateinhemodialysispatientswithDN.ILC2srelatedfactorsmaybeinvolvedintheformationofMSinhemodialysispatientswithDNthroughtheeffectsonabdominalobesityandlipidmetabolism.

Abstract:Objective：Toinvestigatetheriskfactorsfordiabeticfootamputationintheelderly，aswellasthepredictivevalueofhomocysteine（Hcy）foramputation.Methods：Theretrospectivestudyincluded134eligibleelderlypatientswithdiabeticfoot，whowerehospitalizedintheDepartmentofEndocrinology，JinzhouCentralHospital，fromDecember2012toFebruary2018.Accordingtothelimbstatus，thepatientsweredividedintoamputationgroup（AMPgroup）andnon-amputationgroup（NAMPgroup）.Theinter-groupdatawereanalyzedwithttest，Mann-Whitneytest，andchi-squaretest；theriskfactorsforamputationinelderlypatientswithdiabeticfootwereanalyzedwithmultivariateregression.Thereceiveroperatingcharacteristic（ROC）curvewasusedtodeterminethepredictivevalueofHcyforamputationintheelderlypatientswithdiabeticfoot.Results：Inthe134elderlypatientswithdiabeticfoot，90werenon-amputated，and44wereamputated；theamputationratewas32.83%.ThemeanlengthofhospitalstayintheAMPgroupwassignificantlylongerthanthatintheNAMPgroup（P<0.01）.Theserumalbuminlevelandankle-brachialindexintheAMPgroupweresignificantlylowerthanthoseintheNAMPgroup（P<0.01）.TheHcylevelandwhitebloodcell（WBC）countintheAMPgroupweresignificantlyhigherthanthoseintheNAMPgroup（P<0.01）.MultivariatelogisticregressionanalysisshowedthatHcy（OR=1.168，95%CI＝1.096-1.244）andWBC（OR=1.186，95%CI＝1.039-1.354）wereindependentriskfactorsforamputationinelderlypatientswithdiabeticfoot.TheareaundertheROCcurverepresentingthepredictivevalueofHcyfordiabeticfootamputationintheelderlywas0.812（95%CI＝0.731-0.893，P<0.01）.Attheoptimalcut-offvalueof22.5?滋mol/L，Hcyhadasensitivityof63.60%，aspecificityof90.00%，anaccuracyof81.34%，apositivepredictivevalueof75.67%，andanegativepredictivevalueof83.50%inpre－dictingamputation.TheamputationrateofpatientswithHcylevelshigherthanthecut-offvaluewas75.67%，whichwas2.30timestheoverallamputationrate.Conclusion：HighHcyisanindependentriskfactorfordiabeticfootamputationintheelderly.WhenHcylevelishigherthan22.5?滋mol/L，ithashighspecificity，positivepredictivevalue，andnegativepredictivevalueinpredictingdiabeticfootamputationintheelderly，withahighoverallcoincidencerate.

Abstract:Objective：Tocomparetheresultsofthebackpropagation（BP）neuralnetworkmodel，BPneuralnetworkmodeltrainedwithgeneticalgorithm（GA-BP），andCoxproportionalhazardsmodelinthepredictionofamputationandsurvivalprognosisofdiabeticfoot（DF）patients，andtochoosetheoptimalpredictionmodel.Methods：Hospitalizationdataof273patientswithDFwerecollectedwhowereadmittedtoTheFirstAffiliatedHospitalofChongqingMedicalUniversityfromJanuary2014toJanuary2016.ThesepatientswerealsofollowedupbytelephoneuntilDecember2016.Thenthreemodelswereestablished，namelytheBPneuralnetworkmodel，BPneuralnetworkmodeltrainedwithgeneticalgorithm，andCoxproportionalhazardsmodel.Theareaunderthereceiveroperatingcharacteristiccurve，sensitivity，andspecificitywereusedtojudgetheperformanceofthethreemodelsinthepredictionofamputationandsurvivalprognosisofDFpatients.Results：Whentheoutcomeswereamputationanddeath，theBPneuralnetworkmodel（amputa－tion：χ2=7.692，P=0.005；death：χ2=12.071，P=0.000）andBPneuralnetworkmodeltrainedwithgeneticalgorithm（amputation：χ2=10.083，P=0.001；death：χ2=12.071，P=0.000）werebetterthantheCoxproportionalhazardsmodel.However，therewasnosignificantdifferencebetweentheBPneuralnetworkmodelandtheBPneuralnetworkmodeltrainedwithgeneticalgorithm（amputation：χ2=0.200，P=1.000；death：χ2=0.000，P=1.000）.Conclusion：BoththeBPneuralnetworkmodelandtheBPneuralnetworkmodeltrainedwithgeneticalgorithmcanbeappliedtotheanalysisofsurvivalandprognosisofchronicdiseasessuchasDF.

Abstract:Objective：Toinvestigatetheclinicalcharacteristicsofpatientswithdiabeticfootulcers（DFUs）indifferentstatusofrenalfunction，andtoexploretheassociationbetweenrenalfunctionandprognosis.Methods：Atotalof409patientswithDFUswereretro－spectivelyanalyzed.Accordingtoestimatedglomerularfiltrationrate（eGFR），thepatientsweredividedintothreegroups：normalrenalfunctiongroup，mildrenaldysfunctiongroup，andmoderatetosevererenaldysfunctiongroup.Theclinicalcharacteristics，socio-eco－nomicstatus，self-management，andprognosiswerecomparedbetweenthethreegroups.Aregressionanalysiswasusedtoinvestigatetheassociationbetweenrenalfunctionandprognosisofpatients.Results：Comparedwiththenormalrenalfunctiongroup，therenaldysfunctiongroupshadolderageofpatients，longerdurationofdiabetes，betterself-management，moremicroangiopathyandmacroan－giopathy，andlowerlevelsofhaemoglobinandserumalbumin.Moreover，thepatientswithmoderatetosevererenaldysfunctionhadasignificantlyhigherproportionofindividualswtihadverseoutcomes（43.7%vs.26.8%，χ2=8.567，P=0.003）andasignificantlyhighermortalityrate（26.1%vs.8.3%，χ2=16.587，P=0.001）.UnivariateanalysisshowedasignificantassociationbetweeneGFRandadverseoutcomes（OR=1.462，95%CI=1.132-1.874，P=0.004）.FurtherregressionanalysisconductedindifferentagegroupsshowedthatthedeclineineGFRwasassociatedwithpooreroutcomesofDFUsinelderlypatients（OR=1.614，95%CI=1.021-2.571，P=0.040），butnotinyoungandmiddle-agedpatients.Conclusion：PatientswithDFUshavelongerulcerhealingtimeandhighmortalityratewiththedeteriorationofrenalfunction，especiallyinelderlypatients.

Abstract:Objective：ToinvestigatetheMRIfindingsofperianalinfectionindiabeticpatients.Methods：AretrospectiveanalysiswasperformedontheMRIfilmsof300diabeticpatientswithperianaldiscomfortswhounderwentMRIexaminationoftheanusandrec－tuminourhospitalfromSeptember2009toDecember2017；thefollowingwereanalyzedandrecordedbytworadiologistsexperi－encedintheMRIdiagnosisofpelvicdiseases：perianalinflammation，perianalabscess，glutealfatpadinflammation，glandularanalfistula（fistulatypeandmainfistulalocation，maininternalfistulalocation，branchfistulanumber，externalfistulastatus，distancebe－tweentheexternalapertureandtheverticallineoftheanus），sinus，dynamiccontrast-enhancedsignalchange，non-glandularanalfistula.Results：Abnormalsignalchangesinthepelvicfloorwerefoundin241ofthe300cases，includinganalcanalinflammation，thickeningofmucousmembraneintheanalcanal，vasculardilation，hemorrhoidswithinfection，perianalabscess，perinealcellulitisorabscess，glutealcellulitisorabscess，glandularanalfistula（Parkstype），non-glandularanalfistula，orco-existenceoftheabovemani－festations；amongthese，therewere212casesofperianalvascu－lardilation，hemorrhoids，andanalcanalinflammation，157cas－esofglutealfatpadinflammation，132casesofperianorectalspaceabscess（including8casesofabscessinvolvingsuperiorlythespacebelowandaroundtherectalmucosa，17casesofab－scesslocalizedwithintheposteriordeepspacebetweentheposterioranalsphincters，26casesofabscessspreadingtoperi－analareasalongtheposteriordeepspaceoftheanalcanal，27casesofabscessspreadinganterioinferiorlytotheperineumafterperfo－ratingtheexternalsphincter，22casesofabscessspreadingposterioinferiorlytotheglutealfatpadafterperforatingtheexternalsphincter，23casesofabscessspreadingalongtheinter-sphincterspacetotheglutealcleftduetofailuretoperforatethesphincters，and9casesofabscesswidelyspreadingalongtheabovetwoorthreepaths）；moreover，therewere144casesofanalfistula，ofwhich，98weresimplefistula（including41casesofinter-sphincterfistula，22casesoftrans-sphincterfistula，16casesofextra-sphinc－terfistula，10casesofsuperior-sphincterfistula，and9casesofParkstypeundefined），and46werecomplexfistula（including25casesofinter-sphincterfistulawithtrans-sphincterfistula，11casesofsuperior-sphincterfistulawithinter-sphincterfistula，3casesofsuperior-sphincterfistulawithtrans-sphincterfistula，and7casesoffistulaundefined）.Therewere89mainfistulas（41casesspreadingwithinthesphincters，22casesspreadingtotheischioanalfossaafterperforatingtheanalcanalandexternalsphincter，16casesspreadingsuperiorlywithintheinter-sphincterspaceafterperforatingtheanalcanal，andthenintotheischioanalfossafollow－ingperforatingtheexternalsphincter，and10casesspreadingabovethesphincter），and138branchfistulas（32branchesextendingtothespacearoundorbelowtherectalmucosa，64branchesextendingtotheinter-sphincterspace，and42branchesextendingtotheposteriordeepspaceoftheanalcanal）.Themorphologicalfeatureswereasfollows：markedearlyenhancementforthefistulaandinternalfistulaorificeafterdynamicenhancement，slighthyperintensityofabscessonDWI，markedenhancementforabscesswithperipheralinfections，mostlydelayedenhancementforthefistulawall，anddelayedenhancementforthefibrousinternalfistulaorifice.Conclusion：Perianalinfectionisverycommonindiabeticpatients.MRIprovidesaccuratediagnosisforperianallesionsindiabeticpatients.

Abstract:Objective：Toexploretherelationshipbetweensaltintakeandobesity.Methods：Twohundredandtwenty-sixhealthypeopleaged18-55yearsfromcommunitiesinChengduwereenrolledinthisstudyfromSeptember2017toJuly2018，including92malesand134non-pregnantfemales.24-hoururineandserumsampleswerecollectedfromhealthypeople，andgeneralinformationwasobtainedthroughquestionnairesurvey.Saltintakeinthepopulationwasestimatedbymeasuring24-hoururinesodiumexcretion.Accordingtothequantityofsaltintake，thepopulationwasdividedintolow-saltintakegroup（<12g/d）andhigh-saltintakegroup（≥12g/d）.Overweightandobesityweredefinedbybodymassindex（BMI）andabdominalcircumference.Thesubjectstasteddiffer－entconcentrationsofsodiumchloridesolutioninalow-to-highorderinthefastingstate，andpointedouttheminimumsodiumchlo－rideconcentration，thusdeterminingthesalttastethreshold.Results：Obesitywascloselyrelatedtohigh-saltintake，whileBMIwasinapositivecorrelationwithsaltintake（P<0.001，r=0.223）.Caseswithoverweightandobesityhadalowersalttastesensitivity，andtheirsaltintakewassignificantlyhigherthanthatofpeoplewithnormalbodyweight[（13.50±0.37）gvs.（15.34±0.47）g，P=0.002]，especiallyinabdominalobesitypatients.Theproportionofobesepeoplewassignificantlyhigherinthepopulationwithhighsaltin－takethaninthepopulationwithlowsaltintake（78.64%vs.31.25%，P=0.016）.Conclusion：Obesityiscloselyrelatedtohighsaltin－take.Overweightandobesepatientshaveincreasedsaltintakeandreducedsalttastesensitivity.Highsaltintakeleadstoanincreaseintheprevalenceofoverweightandobesity.

Abstract:Objective：Toevaluatethebloodglucosechangesinhospitalizedpatientswithdiabetesbybigdataanalysisofpatientsus－inginformationtechnologyaccordingtotheepidemiologyofdiabetesandthecurrentstatusofprevention，treatment，andmanagementofdiabetesintheregion，tounderstandtheweaklinksofmonitoringhospitalizedpatients'bloodglucose，andtoguideclinicalbloodglucosemanagement.Methods：Basedonamulticenterinformationizedbloodglucosemanagementplatform，fromSeptember2016toJanuary2018，thebedsidebloodglucosedataof10608hospitalizedpatientswithdiabeteswerecollectedfromtheYongchuanHospi－talofChongqingMedicalUniversity，TheSecondAffiliatedHospitalofChongqingMedicalUniversity，andtheChongqingThreeGorgesCentralHospital.Thepopulationmodel，patientmodel，andpatient-daymodelwereusedtoanalyzethebloodglucoseconstituentratioofinpatientswithdiabetes：proportionsofpatientswithhyperglycemia，hypoglycemia，andidealbloodglucoselevel.Results：Atotalof253738point-of-caretestingbloodglucosemonitoringdatawerecollected.Thepopulationmodelanalysisshowedthattheprevalenceofhyperglycemiareached38.3%，andtheindividualswithanidealbloodglucoselevelonlyaccountedfor20.5%.Thepatientmodelanalysisshowedthat13.2%ofthepatientshadhypoglycemiaduringhospitalization；patientswithseverehypoglycemiaaccountedfor1.2%；patientswithseverehypogl-ycemiaaccountedfor9.4%ofpatientswithhypoglycemia.Thepatient-daymodelanalysisshowedthatthepatientswithanidealbloodglucoselevelaccountedfor49.6%；theincidenceofhyperglycemiawas60.2%；theincidenceofseverehyperglycemiawas18.8%.Conclusion：Theproportionofhospitalizeddiabetespatientswithanidealbloodglucoselevelislow，andthepro－portionofthosewithhyperglycemiaishigh.Afteraperiodofhospitalization，theincidenceofhyperglycemiaisdecreasing，butthetra－ditionalendocrinologypassiveconsultationmodecausesthatsomehyperglycemiaeventsarenotmanagedintime.Hypoglycemiaeventsoccurinalltimeperiods，andsomepatientshaveseverehypoglycemiaevents.Thehigh-riskperiodsofhypoglycemiaarebeforelunchandfasting.Thefrequencyofbloodglucosemonitoringbeforedinnerislow.

Abstract:Objective：Toreportanewmutationintheinsulinreceptor（INSR）geneinapatientwithsevereinsulinresistanceandre－viewrelatedliterature.Methods：Theclinicaldata，laboratorytestresults，imagingexaminationresults，andINSRgenemutationdataofa9-year-oldobesemalepatientwithsevereinsulinresistanceandacanthosisnigricanswerecollected，andthetypesofINSRgenemutationreportedbydomesticscholarssince1991wereretrospectivelyanalyzed.Results：Thelaboratorytestresultsofthepatientwithacanthosisnigricansindicatedsevereinsulinresistance.Moleculardiagnosisfoundc.1088_1090del，aheterozygousnucleotidemutation，inboththeprobandandhisfather.Thismutationwasanewtypeofmutationandmightbeassociatedwithsevereinsulinresistanceofthepatient.Conclusion：Geneticanalysiscanhelptoconfirmetiologyinchildrenwithsevereinsulinresistance.

Abstract:Objective：ToexploretheefficacyandsafetyofliposomalamphotericinBcombinedwithposaconazoleinthetreatmentofdiabetesmellituswithpulmonarymucormycosisinchildren.Methods：AretrospectiveanalysiswasperformedonthetreatmentofachildwithdiabetesmellitusandpulmonarymucormycosisbyliposomalamphotericinBcombinedwithposaconazole，andtherelevantliteraturewasreviewed.Results：Sputumboltocclusionandgranulomatoushyperplasiawerefoundinthesegmentalbronchioftheleftupperlobe，andmucoraleswerefoundinbronchoalveolarlavagefluid，soadiagnosisofpulmonarymucormycosiswasmade.Afterin－travenousadministrationofliposomalamphotericinBfor1week，achestCTre-examinationrevealedcavity-likechangesintheleftupperlung，andoralposaconazolewasadded.At3weeksofadministrationofliposomalamphotericinB，thepatientdevelopedsinusbradycardiawithprematureventricularbeats，whichimprovedafterdiscontinuationofliposomalamphotericinB.Themedicationwaschangedtosequentialadministrationofposaconazoleuptothe12thweek，andthecavitiesintheleftupperlungdisappearedwithoutanyadversereactionobserved.Conclusions：Diabetesmellituswithpulmonarymucormycosisinchildrenarerareanddifficulttotreat.TheregimenofliposomalamphotericinBcombinedwithposaconazoleprovidessomereferencefortheclinicaldiagnosisandtreatmentofthecondition.