老年2型糖尿病患者周围神经病变的临床分析

一、对象和方法　　1.对象:我院2 0 0 1～2 0 0 2年住院的老年2型糖尿病患者135例,根据肌电图检查有周围神经病变83例为DPN组,其中男4 3例,女4 0例,年龄6 0～75岁,平均(6 8 6±6 6 )岁,病程(10 3±6 5 )年,体质指数(2 3 9±3 5 9)kg/m2 ;无周围神经病变的5 2例为无神经病变组,其中男2 8例,女2 4例,年龄6 0～76岁,平均(6 8 4±6 7)岁,病程(9 0±5 9)年,体质指数(2 4 9±3 9)kg/m2 ;两组年龄、性别、病程及体质指数差异均无显著性。2型糖尿病的诊断符合1996年美国糖尿病协会推荐的标准。糖尿病视网病变,根据中华医学会眼科分会1985年…     

痰热清治疗急性下呼吸感染37例疗效观察

1 资料与方法 我科自2005年1月～2005年6月治疗下呼吸道感染患者74例,按入院顺序随机分为两组:治疗组37例,男28例,女9例,年龄25～68岁,平均(48.5±6.8)岁;对照组37例,男29例,女8例,年龄26～67岁,平均(47.8±6.7)岁.     

血浆纤维蛋白原α-颗粒膜蛋白与2型糖尿病患者视网膜病变的关系

本文通过观察糖尿病视网膜病变患者血浆纤维蛋白原(Fg)及α 颗粒膜蛋白 (GMP 14 0 )质量浓度的变化 ,以探讨二者在糖尿病视网膜病变中的变化及临床意义。1　对象与方法1.1　对象　本组 4 6例为 2 0 0 0 - 0 1～ 0 6在我院内分泌科住院的糖尿病患者。其中糖尿病无视网膜病变组 :2 4例(男 13例 ,女 11例 ) ,年龄 36～ 75岁 ,平均 5 6 2岁。糖尿病视网膜病变组 :2 2例 (男 9例 ,女 13例 ) ,年龄 33～ 72岁 ,平均 5 4 2岁。正常对照组 :同期体检健康成人 2 2名 (男14名 ,女 8名 ) ,年龄 38～ 6 0岁 ,平均 4 9 6岁。糖尿病诊断按 1997年WHO…     

阿糖腺苷治疗HBV无症状携带者54例

1 一般资料 112例患者随机分为甲(治疗组)、乙(对照组)两组。甲组男34例,女22例,年龄20～54岁,平均35.7±8.36岁。乙组男40例,女16例,年龄19～47岁,平均33±8.65岁。全部病例符合下列标准:①血清HBsAg和HBV-DNA携带半年以上;②无临床症状。肝功能情况:甲组有4例患者ALT轻度升高,乙组患者ALT基本正常。     

糖尿病患者的血小板表面糖蛋白

我们测定了21例糖尿病微血管病变患者、27例糖尿病无并发症患者的血小板表面糖蛋白,以探讨血小板表面糖蛋白与糖尿病血小板功能改变及微血管病变的关系。 一、对象:糖尿病并微血管病变患者21例(男9例,女12例),年龄42～82岁,平均58.2±12.0岁,病程1个月～17年,血糖7.98±3.04mmol/L(±s);21     

冠心病患者血浆cAMP、cGMP水平变化及临床意义

不稳定性心绞痛(UAP)和急性心肌梗死(AMI)是冠心病的严重类型,而冠状动脉栓形成是UAP、AMI的重要诱因.我们对不同类型冠心病患者血浆cAMP、cGMP浓度进行了检测,以探讨其在冠心病发病中的作用. 资料与方法:观察对象为1999年10月至2001年1月我院收治的冠心病患者,均符合国际心脏病学会及WHO1979年制定的诊断标准.其中稳定性心绞痛(SAP)组28例,男16例、女12例,年龄31～77岁、平均54± 12.7岁.UAP组48例,男27例、女21例,年龄30～82岁、平均56±15 .4岁.AMI组23例,男15例、女8例,年龄36～78岁、平均58±13.3岁 .对照组为26例健康人,无心绞痛病史,心电图、Holter超声心动图正常,男1 5例、女11例,年龄34～72岁、平均年龄52±12.4岁.     

糖尿病并发糖尿病足的康复

糖尿病是一种可累及全身任何组织和器官的内分泌一代谢疾病。而糖尿病足又是令病人,尤其老年病人痛苦的一种慢性并发症。我院在1995年6月～1998年8月共收治糖尿病足患者13例,报告如下。1　一般资料1.1　对象13例糖尿病足患者均系本院住院患者,符合1995年糖尿病及糖尿病足诊断标准。其中2型糖尿病足10例,男6例,女4例;年龄51～92岁,平均71.5±20.5岁;糖尿病病程6个月～19年,平均9.75±9.25年。1型糖尿病足3例,男2例,女1例;年龄29～36岁,平均31.5±4.5岁;糖尿病病程2～9年,平均4.5±2.5年。1.2　诊断依据(1)有糖尿病史;(2)年龄较大(但1型糖尿病…     

肺心病患者心钠素的测定分析

对慢阻肺、肺心病患者26例进行ANP、肾素(PRA)、血管紧张素(ANGⅡ)及醛固酮(ALD)系统测定,分析和观察其变化。 资料和方法 1.对象 健康对照组10例,男女各5例。年龄45～65岁,平均54±1.23岁,慢阻肺15初,男10例,女5例,年龄47～70岁,平均60.1±2.34岁,肺心病11例,男11例,年龄60～78岁,平均63.31±12.21岁。均符合1977年全国肺心病诊断标准。     

溶栓前肝素抗凝治疗对急性心肌梗死面积的影响

1　资料和方法86例急性心肌梗死 (ＡＭＩ)患者随机分为两组 :治疗组 48例 ,男 36例 ,女 12例 ,年龄 2 6～ 70岁 ,平均 (5 1.7± 8.8)岁 ;对照组 38例 ,男 30例 ,女 8例 ,年龄 33～ 6 9岁 ,平均 (5 4.8±9.4)岁。治疗组首先静脉推注肝素 6 2 5 0Ｕ ,继之尿激酶(ＵＫ) 10 0～ 15     

老年性退行性心瓣膜病的超声心动图诊断

近年来 ,由于临床上彩色多普勒超声心动图的应用普及 ,老年性退行性心瓣膜病的诊断率越来越高。但有时经胸超声心动图 (TTE)诊断缺乏特异性 ,易引起误诊或漏诊 ,而经食管超声心动图 (TEE)可明确诊断 ,并可明确诊断其他主动脉病变。1　材料与方法1 1　研究对象　 2 0 0 0 2 0 0 3年 6月心内科门诊及住院患者 2 5 9例 ,排除风湿性心脏病 ,心肌病后 ,经TTE及TEE确诊为老年退行性心瓣膜病共 175例 ,其中男 111例 ,女 64例 ;年龄 4188岁 ,平均 (68 48± 9 96)岁。其他主动脉病变 84例 ,其中男 5 0例 ,女 3 4例 ,年龄 14 82岁 ,平均年龄 (4 4…     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Serological survey of HIV and syphilis in pregnant women in Madagascar

Objectives Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow‐up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy. Methods Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow‐up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays. Results Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum. Conclusions Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.