| Modern medicine acknowledged Diabetes mellitus as a kind of condition about hyperglycemia, that linked insulin default or insulin resistance, or linked both of them. Among the uninfected diseases, mortality of the Diabetes mellitus is just behind Tumor and angio-cardiopathy. Without the insulinlike chemical therapy in clinic, there are more developments in nutriology, kinematics and medical fitness educations. With the development of the cytobiology and molecular biology, pathogenesis and therapy of diabetes have been improved, and some patients living normally with the diabetes milletus. However, the fundamental therapy in most of them is still undone. Even though serum glucose has been controlled in the better level, the patients couldn't escape from the microvascular complications, and the low life-quality or shortend life-span. So Diabetes mellitus has been one of the complex diseases that we are facing, and the severe public health problem that attracting great attention from all countries of the world. The vital movement and diseases couldn't be explained by single cell, or single gene, the homeostasis of organism should be emphasized.The essence of the neuro-endocrine-immune network is to keep the homeostasis and balance of organism by the three interdependent systems---nerve, endocrine and immune systems. The interaction between them is mediated by the nervous transmitters, hormones and cytokines. Any partion disbalance of the network must obviously impair other's function and lead to certain disorder. As a main disorder of the endocrine system, diabetes milletus not only gives effect on endocrine system, but also gives more effects to beworsen the functions of the immune system and nerve system.The Uighur traditional medicine has been thinking highly of the uniformity and integrality of the organism and the relationship to the nature, and it considers that various tissues and systems in the human body are inalienable in structure and function. The fluid theory in Uighur traditional medicine describes the following:body fluid is the basic matter during the vital life and physiological activity; it is produced and utilized continuously and provides the energy for the vital activity. The abnormal savda syndrome as the final pathological production of phlegmatic temperament, chol-hygroplasm, bloody-groplasm is related closely to the diabetes. It is similar to the essence of the Neuro-endocrine-immune network. The conception of the Neuro-endocrine-immune network offers the scientific evidence for Uighur traditional medicine, which has annotation to the pathogenesis and clinical manifestation of diabetes, and pose that different syndrome has distinct prevention and treatment.ObjectiveTo investigate the relationship between neuro-endocrine-immune (NEI) systems and type-2 diabetes millites (T2DM).To explore the changing mechanisms of NEI system in different fundus changing stages in type-2 diabetes millitesy. To further explore the changing mechanisms of NEI system in capillary complication in T2DM.To explore the changing mechanisms of NEI system of T2DM in different abnormal body fluid syndromes, from the point of traditional Uighur medicine (TUM).At the end, integrate modern Western Medicine and TUM on the T-2DM, with their constituent ratio, ages, courses and neuro-endocrine-immune (NEI) systems changing characters to find out the communication of the pathogenesis, prevention and treatment of T-2DM existed in the NEI network between the two different styled medicines.MethodsCertainly clinical diagnosed 174 patients with T-2DM, were enrolled into the study from September,2007. to February,2008. from the Endocrine department of the first affiliated Hospital, Xinjiang Medical University. Strict and impartial screened all above the T-2DM patients by diagnostic standard and exclude standard of diabetes with ADA criteria-2005 for the diagnosis of diabetes mellitus. And 33 normal volunteer people were served as control group after physical exam proved medical fitness.Flow cytometer technology was utilized to detect the serum level count of CD3+, CD4+and CD8+, and NK cell; Radio-immune technology was utilized to detect the serum level of cytokines including IL-1β(Interleukin-1β), IL-6,TNF-α(Tumor necrosis factor-a), and hormones including ACTH (adrenocorticotrophic hormone) and CORT (cortisol); Liquid Chromatography was utilized to detect the plazma level of DA (dopamine) and NE (norepinephrine), on every patient group and control group.TOPCON IMAGEnet 2000TM system was utilized to detect the flouressain fundus angiography of patients with T2DM."Diagnostic method of traditional Uighur medicine" was utilized to identify different abnormal hilit types of patients with T2DM.Statistical analysis:SPSS13.0 was used in the study. The data were expressed as means±standard deviation (SD). Significance levels of a comparison were determined buy using ANOVA. The difference between means were considered to be statistically significant if P<0.05.ResultsNEI network related indexes shows that, a significant decrease of serum CD4+, CD8+ lymphocytes and NK cells count and CD4+/CD8+ ratio increased was found in T-2DM groups compared to the control group (P<0.01); the serum level of IL-1β,IL-6 and TNF-αincreased in T-2DM compared to the control group (P<0.01); It was discovered that the serum level of ACTH and CORT decreased significantly in T-2DM compared to the control group (P<0.01); it was discovered that the plasma level of DA and NE increased in T-2DM group compared to the control group (P<0.01).By diagnostic standard and exclude standard of diabetes with ADA criteria-2005, and detecting by flourescein fundus angiography,174 T2DM patients divided into three groups:non-diabetic retinopathy group (contains 98 patients), non-proliferating retinopathy group (56 patients), and proliferating retinopathy group (20 patients). Mean age of non-diabetic retinopathy group significantly smaller than non-proliferating retinopathy group and proliferating retinopathy group (P<0.05), mean course of non-diabetic retinopathy group significantly shorter than non-proliferating retinopathy group and proliferating retinopathy group (P<0.01), but both of the above index have no difference between non-proliferating retinopathy group and proliferating retinopathy group (P>0.05).Comparing between different fundus groups, serum CD4+lymphocyte count in proliferating retinopathy group smaller than non-diabetic retinopathy group (P<0.05); the serum level of ACTH and CORT decreased significantly in proliferating retinopathy group smaller than non-diabetic retinopathy group (P<0.05).By diagnostic standard of "Diagnostic method of traditional Uighur medicine",174 T2DM patients divided into four groups:abnormal savda group 79 patients (45.40%), abnormal khan group 39pateints (22.41%), abnormal belghem group 35 patients (20.12%), abnormal sepra group 21 patients (12.07%).Comparing between Uighur medicine different abnormal hilit groups, a significant decrease of serum CD4+ cells count was found in abnormal khan group than abnormal savda group (P<0.01), a significant decrease of serum NK cells count was found in abnormal savda than abnormal khan and abnormal belghem group (P<0.01); the serum level of IL-1βincreased in abnormal savda group than other three groups (P<0.05).Comparing between abnormal savda and non-abnormal savda groups, a significant decrease of serum CD4+ and NK cells count was found in abnormal savda group than non-abnormal savda group (P<0.01), the serum level of IL-1βand IL-6 increased in abnormal savda group than non-abnormal savda group (P<0.01), the plasma level of NE increased in abnormal savda group than non-abnormal savda group (P<0.05).The mean age is high, and mean course is long in all of the proliferating retinopathy group and abnormal savda group type-2 diabetes millets. On diagnosing,40% of proliferating retinopathy group belongs to abnormal savda diabetes. Between the proliferating retinopathy group and abnormal savda group type-2 diabetes millets, lymphocytes, cytokines, hormones and mono-peptides have the same changing outputs.ConclusionThe nerval-endocrino-immuno network is imbalanced in the patients with type-2 diabetes milletus. The cellular immunity be weakend, humoral immunity strengthent;endocrine function weakend and the sympathic nerve system activated in type-2 diabetes milletus NEI nerwork.Among the different fundus group of T2DM, the proliferating retinopathy group has the highest mean age and longest course, and has the heaviest retinal capillary complication. So, the age and course may be the risk factor for T2DM in retinal capillary complication.It is may be the characteristic signal of type-2 diabetes milletus, that cellular immunity weakened and endocrine secretion decreasing, would lead to capillary endothelium proliferating and accelerate newvasculirezation on retina.Abnormal savda syndrome is the mean syndrome in type-2 diabetes milletes, according to the constituent ratio between the different abnormal hilit group in. Uighur medicine. Comparing with other Uighur abnormal hilit group type-2 diabetes, abnormal savda group has the most ambalanced immune system (cellular immune depressed, and cytokines activated), and its sympathetic nerve activated mostly.Both of proliferating retinopathy T2DM and abnormal savda T2DM, may be the same heavier stage of T2DM, so mean age high, mean course long and pathogenetic condition severe almost in the same degree;and their immune system ambalanced, endocrine function depressed and sympathetic nerve activated in same condition.We conclude that, when there appears abnormal savda syndrome in type-2 diabetes milletus, and accompany with depressed cellular immune function and decreasing endocrine secretion, we could decide that there would be appear diabetic microvascular complication, and decide to "treat before desease". The research field be continued.
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