2型糖尿病患者胃排空影响因素及西沙必利治疗观察

 [目的]探讨2型糖尿病患者胃排空影响因素、单光子发射计算机断层摄影（SPECT）显影技术和B超在糖尿病性胃轻瘫诊断中的应用及西沙必利治疗效果.[方法]①对120例2型糖尿病进行临床分析.②120例2型糖尿病随机分为两组：A组应用核素^99mTc-SC标记固体试餐,SPECT显像技术检测胃半排空时间（T1/2）;B组予B超检测T1/2.两组均检测空腹血糖（FBG）和糖基化血红蛋白（HbA1c）.③胃T1/2延迟者予西沙必利30 mg,/d,疗程均为1个月,复查胃T1/2.[结果]①糖尿病性胃轻瘫的发生与年龄、病程、空腹血糖、糖基化血红蛋白、神经病变及微血管病变呈正相关（P＜0.01）;②A组60例患者中24例（40.0%）胃T1/2延迟;B组：60例患者中22例（36.7%）.两种检查方法的检出率差异无统计学意义（P＞0.05）;③西沙必利治疗A组有效率为91.7%,B组为90.9%.[结论]糖尿病性胃轻瘫与年龄、病程、高血糖、神经病变及微血管病变相关;SPECT显像技术与B超检出率相似,但不排除与病例数少有关.患者对这两种检查方法耐受性好,但SPECT显像技术费用高,不利于广泛开展,而B超价廉,易于临床使用.西沙必利是有力的促进胃动力的药物,对糖尿病性胃轻瘫有一定的改善胃排空的疗效.     

胃排空与糖尿病胃瘫

采用~(99)mTc标记植酸钠固、液体实验餐,通过SPECT显像,检测了34例糖尿病患者固、液体胃未排空时间及2h残留率。结果:①有胃瘫综合征的A组与无胃瘫综合征的B组固、液体胃排空(t 1/2)及2h残留率相似(P>0.05),两组与正常对照组均呈显著性差异(P<0.01);②有内脏自主神经病变的B_1组与无内脏自主神经病变的B_2组固、液体胃排空(t 1/2)及2h残留率无显著性差异(P>0.05)。结果表明临床上无胃瘫综合征的糖尿病患者其胃排空功能也是受损的,糖尿病胃瘫的发生受多种因素的共同参与和调节。     

红霉素治疗糖尿病胃轻瘫的临床研究

19例糖尿病胄轻瘫患者口服红霉素125mg，2次/d．服药前后行症状计分及B超测定胃排空动能。结果显示：上消化不良症状及胃排空功能均显著改善（P＜0．01）。提示：红霉素是治疗糖尿病胃轻瘫的有效药物。     

CCK、Cx43、GLP-1对2型糖尿病胃轻瘫患者胃排空的预测价值及其相关性分析

目的 探讨胆囊收缩素（cholecystokinin,CCK）、间隙连接蛋白43（connexin 43,Cx43）、胰高血糖素样肽1(glucagon-like peptide-1,GLP-1)对2型糖尿病胃轻瘫患者胃排空的预测价值及其相关性。 方法 选择2型糖尿病胃功能异常患者127例,其中功能性消化不良49例设为消化不良组,糖尿病胃轻瘫患者78例设为胃轻瘫组,另选择同期体检的胃功能正常的健康者50例设为对照组,所有受试对象均进行胃半排空时间测定。酶联免疫吸附法检测CCK、Cx43、GLP-1水平,放射性核素法检测固体胃排空功能。分析CCK、Cx43、GLP-1对2型糖尿病胃轻瘫患者胃排空的预测价值,并分析CCK、Cx43、GLP-1的相关性。 结果 消化不良组和胃轻瘫组CCK、Cx43水平低于对照组,GLP-1水平高于对照组,胃半排空时间长于对照组;胃轻瘫组CCK、Cx43水平低于消化不良组,GLP-1水平高于消化不良组,胃半排空时间长于消化不良组（P＜0.05）。CCK、Cx43、GLP-1联合检测对2型糖尿病胃轻瘫患者胃排空的预测价值较高。CCK、Cx43呈正相关（r=0.482;P＜0.001）;CCK、GLP-1呈负相关（r=-0.356;P＜0.001）;Cx43、GLP-1呈负相关（r=-0.619;P＜0.001）。 结论 CCK、Cx43、GLP-1在2型糖尿病胃轻瘫疾病中异常表达,对预测2型糖尿病胃轻瘫患者有一定的价值。     

西沙必利与吗叮啉治疗新生儿胃轻瘫的比较

目的：比较西沙必利和吗叮啉治疗新生儿胃轻瘫的疗效。方法：新生儿胃轻瘫78例随机分为2组各39例，分别经胃管注入西沙必利和吗叮啉各1mg/Kg，每日2次，3天1疗程。结果：西沙必利组临床有效率97%，吗叮啉组为69％（P＜0．05）。结论：西沙必利治疗新生儿胃轻瘫临床效果优于吗叮啉，是治疗新生儿胄轻瘫的首选药。     

血浆GLP-1水平对糖尿病胃轻瘫病人固体胃排空影响

目的 探讨糖尿病胃轻瘫(DGP)病人血浆胰高糖素样肽=1(GLP-1)水平对固体胃排空的影响.方法 应用放射性核素法对55例2型糖尿病病人及15例正常人(NC组)进行固体胃半排空时间(T1/2)测定.根据T1/2结果将糖尿病病人分为胃排空时间正常的DM组和胃排空延迟的DGP组.采用酶联免疫吸附法检测各组空腹及餐后30、...     

西沙必利与吗叮啉治疗新生儿胃轻瘫的疗效比较

目的比较西沙必利和吗叮啉治疗新生儿胃轻瘫的疗效.方法新生儿胃轻瘫78例随机分为2组各39例,分别经胃管注入西沙必利和吗叮林各0.1 mg/kg,每日2次,3天1疗程.结果西沙必利组临床有效率为97%,吗叮啉组为69%(P＜0.05).结论西沙必利治疗新生儿胃轻瘫临床疗效优于吗叮啉,是治疗新生儿胃轻瘫的首选药.     

自制胃健口服液治疗糖尿病性胃轻瘫的临床观察

目的：观察自制胃健口服液对糖尿病性胃轻瘫的疗效，探讨其作用机理。方法：将58例患者随机分为治疗组（30例）和西沙比利对照组（28例），观察两组对糖尿病性胃轻瘫症状的改善，以及检查对胃排空、空腹血糖的影响。结果：治疗组对改善症状及加速胃排空方面疗效明显优于对照组（P＜0．05）。对空腹血糖的影响有差异，但不显著。结论：自制中药胃健口服液对治疗糖尿病性胃轻瘫疗效好、作用持久、无副作用。     

西沙必利治疗糖尿病胃轻瘫疗效观察

糖尿病是影响人民健康和生命的常见病,植物神经损害为其主要并发症,表现之一为胃轻瘫综合征(简称胃轻瘫),是一种以胃排空延缓为特征的临床症候群。主要与糖尿病造成胃肠道神经损害及胃肠运动不协调有关。西沙必利是一种新型全胃肠道促动力药,通过选择性地作用于胃肠肌丛乙酰胆碱受体,从而促进胃肠动力。笔者以单盲平行对照方法应用西沙必利与安慰剂治疗糖尿病胃轻瘫患者69例,观察其临床疗效。1　资料和方法1.1　一般资料　60例糖尿病伴顽固的胃排空延缓表现而经胃镜等检查排除原发和其它继发胃肠道疾病,确诊为糖尿病胃轻瘫。随机分为二组。…     

西沙必利治疗糖尿病性胃轻瘫47例临床分析

目的:观察西沙必利治疗糖尿病性胃轻瘫的疗效观察。方法:糖尿病性胃轻瘫患者给予西沙必利(治疗组)和胃复安(对照组)对照治疗。结果:用西沙必利治疗糖尿病胃轻瘫治疗组总有效率100.00%,钡餐X线检查总有效率99.61%;对照组用胃复安治疗糖尿病胃轻瘫总有效率66.70%,钡餐X线检查总有效率66.70%。结论:西沙必利治疗糖尿病胃轻瘫比胃复安更有效,而且副作用轻,是一种治疗糖尿病胃轻瘫的理想药物。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.