Adipose tissue is considered to be an endocrine organ, and adipocyte size correlates with insulin resistance and metabolic parameters in obesity. There is little data on the effects of angiopoietin-1 in adipose tissue and kidney in streptozotocin (STZ)-induced diabetes. In this study, we investigated the protective effect of COMP-angiopoietin-1 (COMP-Ang1), a potent variant of angiopoietin-1, on vascular endothelial cells in epididymal adipose tissue and its regulatory effect on other metabolic parameters, such as lipid droplet diameter, macrophage infiltration, and renal inflammation in STZ-treated mice. Our data showed that COMP-Ang1 increased the density of platelet endothelial cell adhesion molecule-1 (PECAM-1)-1-positive vascular endothelial cells in adipose tissue, which were significantly decreased by treatment with STZ. COMP-Ang1 ameliorated the STZ–induced decrease in lipid droplet diameter and increase in macrophage infiltration in adipose tissue. Serum free fatty acid and triglyceride levels were decreased after administration of COMP-Ang1. There was a beneficial effect on serum insulin levels after treatment with COMP-Ang1 in STZ-induced diabetic mice. Fasting blood glucose levels in COMP-Ang1-treated mice were significantly lower than those of LacZ-treated mice. Cotreatment with COMP-Ang1 and STZ also had similar effects on the above parameters. Administration of soluble Tie2, an inhibitor of angiopoietin-1, reversed the effects of COMP-Ang1. COMP-Ang1 was found to ameliorate the up-regulation of proinflammatory molecules and F4/80-positive macrophage infiltration in the kidneys of STZ-treated mice. COMP-Ang1 increased the phosphorylation of Akt in epididymal adipose tissue and kidneys of STZ-induced diabetic mice. These data indicate that COMP-Ang1 regulates lipogenic effects in adipose tissue and renal inflammation in STZ-induced diabetic mice.

Due to the increased prevalence of papillary thyroid carcinoma (PTC), difficult cases and unexpected events have become more common during long-term follow-up. Herein we reported four cases that exhibited poor progress during long-term follow-up. All the cases were diagnosed with PTC and treated with total thyroidectomy before several years, and the patients had been newly diagnosed with recurrent and metastatic PTC. These four cases included recurred PTC with invasion of large blood vessels, a concomitant second malignancy, malignant transformation, and refractoriness to treatment. Physicians should closely monitor patients to promptly address unforeseen circumstances during PTC follow-up, including PTC recurrence and metastasis. Furthermore, we suggest that the development of a management protocol for refractory or terminal PTC is also warranted.

Aims and objectives:To validate a hypothetical path model estimating the health status of patients with insulin-treated type 2 diabetes and to verify the mediating effects of diabetes management self-efficacy, diabetes self-management behaviour and haemoglobin A1c using a multi-mediation model. Background: Diabetes knowledge, personal and social motivations, diabetes management self-efficacy and health behaviours may be interrelated and may directly or indirectly affect the objective and subjective health outcomes of patients with type 2 diabetes mellitus receiving insulin treatments. Design: Model testing correlational design. Methods: The participants were 193 outpatients with insulin-treated type 2 diabetes. Data were collected between July and November 2019. The collected data were analysed using SPSS version 25.0 ® and AMOS 23.0. This study is based on STROBE guidelines.Results: The model's fit indices were adequate. Diabetes-related knowledge, psychological insulin resistance, family support for diabetes management, diabetes self-care activities and haemoglobin A1c had significant direct effects on subjective health status. Diabetes management self-efficacy had significant indirect effects on subjective health status via diabetes self-care activities and haemoglobin A1c, and mediated the path through which diabetes knowledge, psychological insulin resistance and family support for diabetes management indirectly affect subjective health status. These variables explained 55.0% of the total variance of subjective health status. Conclusion:Diabetes knowledge, psychological insulin resistance, diabetes management family support, diabetes management self-efficacy and diabetes self-care activities were found to be related to the subjective and objective health status. Relevance to clinical practice:The findings can help health professionals improve diabetes self-care activities and haemoglobin A1c, which will influence subjective health status in patients with type 2 diabetes mellitus, receiving insulin treatments.

No abstract