2型糖尿病合并脂肪肝的危险因素分析

目的分析2型糖尿病发生脂肪肝的危险因素。方法130例2型糖尿病病人,分为糖尿病合并脂肪肝(DFL)组与糖尿病非合并脂肪肝(NDFL)组。结果DFL有关的危险因素包括体重、体质指数、腰臀比值、血压、空腹胰岛素、餐后2 h胰岛素、胆固醇、甘油三酯、载脂蛋白B、胰岛素抵抗指数(HOMA-IR),其中最主要的两个危险因素是体质指数、甘油三酯。结论影响DFL的因素很多,主要危险因素是甘油三酯和体质量指数,脂肪肝可能是糖尿病前的一个阶段。     

2型糖尿病合并非酒精性脂肪肝临床相关因素分析

目的探讨2型糖尿病合并非酒精性脂肪肝患者与血糖、血脂、体质指数（BMI）、胰岛素抵抗之间的关系。方法216例2型糖尿病患者进行肝脏B超，空腹血糖、血脂，体质指数，空腹胰岛素的检测。结果诊断2型糖尿病合并非酒精性脂肪肝患者118例，发病率54．63％；与未合并脂肪肝组比较，体质指数、甘油三酯、胰岛素抵抗指数差异具有统计学意义（P〈0．01），2组的血糖、糖化血红蛋白、低密度脂蛋白胆固醇比较亦有统计学意义（P〈0．05）；而总胆固醇、年龄、病程等比较差异无统计学意义。结论脂肪肝在2型糖尿病患者中有较高的发病率，肥胖、胰岛素抵抗、高甘油三酯血症为其重要危险因素，在临床中应予积极防治。     

2型糖尿病合并非酒精性脂肪肝的临床研究

【目的]探讨影响2型糖尿病（T2DM）合并非酒精性脂肪肝的危险因素。【方法】分析T2DM伴有非酒精性脂肪肝组26例,T2DM不伴脂肪肝组31例多项指标。【结果】T2DM病伴有脂肪肝组体重指数、腰围、腰臀比、体脂百分比、甘油三酯、胰岛素敏感指数较T2DM不伴有脂肪肝组显著增高（P〈0．05）。【结论】T2DM患者合并非酒精性脂肪肝的独立危险因素是肥胖、高甘油三酯血症和胰岛素抵抗。     

2型糖尿病合并脂肪肝的危险因素分析

目的：分析2型糖尿病发生脂肪肝的危险因素。方法：136例2型糖尿病病人，分为糖尿病合并脂肪肝(DFL)组与糖尿病非合并脂肪肝(NDFL)组，分别测定血脂、空腹血糖、血清转氨酶、计算体重指数。结果：DFL组患者体重指数、甘油三酯，胆固醇明显升高，与NDFL组相比差异有显著意义，两组患者的年龄、性别、血糖、载脂蛋白、高密度脂蛋白、低密度脂蛋白与血清转氨酶相比无显著意义。结论：影响DFL的因素很多，主要危险因素是甘油三酯和体重指数，脂肪肝可能是糖尿病前的一个阶段。     

新诊断2型糖尿病合并非酒精性脂肪肝临床分析

目的 探讨2型糖尿病(T2DM)合并非酒精性脂肪肝与胰岛素抵抗之间的关系.方法 对32例新诊断2型糖尿病合并非酒精性脂肪肝患者和28例新诊断2型糖尿病不合并非酒精性脂肪肝患者的血糖、体重指数(BMI)、空腹及餐后2 h胰岛素、C肽、脂代谢指标、胰岛素敏感指数(ISI)、胰岛素抵抗指数(HOMA-IR)等进行比较分析.结果 合并脂肪肝组的体重指数、腰围、甘油三酯、胰岛素抵抗指数均明显高于非脂肪肝组(P＜0.05).结论 T2DM合并脂肪肝患者存在明显的胰岛素抵抗、高胰岛素血症、脂代谢紊乱和超重,应加强综合管理.     

2型糖尿病患者的高尿酸血症与胰岛素抵抗的相关性研究

目的 探讨2型糖尿病患者的高尿酸血症与胰岛素抵抗的关系。方法 对131例2型糖尿病患者分为高尿酸组和对照组，测定血糖、胰岛素、胆固醇(Tch)、甘油三酯（TG)、高密度脂蛋白(HDL)水平。计算胰岛素抵抗指数，分析其相关性。结果 高尿酸组空腹血糖、空腹胰岛素、HOMA-IR、TG明显高于对照组，HDL明显低于对照组。结论 高尿酸血症与胰岛素抵抗密切相关，可能参与胰岛素抵抗的发生发展。     

机关单位体检人群高尿酸血症的患病现状及影响因素分析

目的分析机关单位体检人群的高尿酸血症发生率及影响因素。方法对2 876例体检者的资料进行回顾性分析,对体检者的年龄、性别、吸烟史、脂肪肝病史、体质指数、血生化检验部分指标以及糖化血红蛋白等进行单因素分析,选择有统计学意义的因素进行二元Logistic回归分析。结果 2 876例机关单位体检人群中检出684例高尿酸血症,检出率23.78%。Logistic回归分析显示,年龄>35岁、男性、有脂肪肝病史、高体质指数、高甘油三酯、高总胆固醇及高低密度脂蛋白胆固醇是机关单位人群体检发生高尿酸血症的危险因素,各危险因素作用由大到小为总胆固醇、低密度脂蛋白胆固醇、甘油三酯、脂肪肝病史、体质指数、年龄、性别。结论机关单位体检人群高尿酸血症的发生率较高,男性高于女性,且年龄>35岁、肥胖、高血脂均能增加高尿酸血症的发生风险。     

非肥胖2型糖尿病胰岛素抵抗与非酒精性脂肪肝相关性分析

目的 探讨非肥胖2型糖尿病(T2DM)合并非酒精性脂肪肝与胰岛素抵抗之间的关系.方法 对49例非肥胖T2DM合并非酒精性脂肪肝与43例无合并患者的体重指数(BMI)、血糖、血脂、胰岛素、胰岛素抵抗指数等进行比较分析.结果 合并组空腹血糖、甘油三酯、空腹胰岛素、胰岛素抵抗指数均高于无合并组(P＜0.05,P＜0.01),Logistic回归分析显示胰岛素抵抗指数与非酒精性脂肪肝星独立相关(P＜0.01).结论 非肥胖T2DM合并非酒精性脂肪肝与胰岛素抵抗密切相关.     

2型糖尿病合并脂肪肝相关因素分析

目的：探讨2型糖尿病（2-DM）合并脂肪肝的临床相关因素.方法：回顽性分析56例2-DM合并脂肪肝患者及同期61例2-DM无脂肪肝患者的临床资料.结果：（1）脂肪肝组甘油三酯（TG）明显高于无脂肪肝组（P〈0.01）,而高密度脂蛋白（HDL）则明显降低（P〈0.05）;（2）脂肪肝组胰岛素作用指数（IAI）明显低于无脂肪肝组（P〈0.01）,而体重指数（BMI）则明显升高（P〈0.01）.结论：脂质代谢紊乱、胰岛素抵抗及肥胖与脂肪肝的形成密切相关,高甘油三酯血症、高胰岛素血症及肥胖是脂肪肝形成的高危因素.     

2型糖尿病合并高尿酸血症的相关影响因素分析

目的分析2型糖尿病合并高尿酸血症的相关影响因素。方法选择我院2016年6月～2017年12月收治的102例2型糖尿病患者,根据患者血清尿酸水平将其分为观察组54例和对照组48例,观察组血尿酸水平升高,对照组血尿酸水平正常。对比两组患者临床资料,探究影响2型糖尿病合并高尿酸血症的相关因素。结果两组患者的性别、年龄、糖尿病病程等一般资料比较,差异均无统计学意义(P0.05);观察组患者体质量指数、胰岛素抵抗指数高于对照组,TG、TC、LDL-C等血脂水平及SBP、DBP等血压水平均显著高于对照组,差异有统计学意义(P0.05);经Logistic回归分析,体质量指数、胰岛素抵抗指数、血脂及血压水平均与高尿酸血症之间存在相关性。结论 2型糖尿病合并高尿酸血症与胰岛素抵抗、血脂异常和高血压水平呈正相关,临床可通过监测2型糖尿病患者上述指标防范高尿酸血症的发生。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Clinical Trial Updates and Hotline Sessions presented at the European Society of Cardiology Congress 2007

This article provides information and commentaries on trials which were presented at the Hotline and Clinical Trial Update Sessions at the European Society of Cardiology Congress 2007 in Vienna. The key presentations were performed by leading experts in the field with relevant positions in the trials or registries. It is important to note that unpublished reports should be considered as preliminary data, as the analysis may change in the final publications. The comprehensive summaries have been generated from the oral presentation and the webcasts of the European Society of Cardiology and should provide the readers with the most comprehensive information of relevant publications.     

Balance and Boundaries in Grief Counseling: An Intervention Framework for Volunteer Training

Volunteers or paraprofessional counselors are commonly used to provide supportive care to the bereaved. These counselors generally are trained in basic listening skills, providing a generic, nonspecific approach to intervention that remains to be proven effective. The present paper outlines a framework that provides paraprofessionals with a broader model for intervention with the bereaved. Attention to boundaries as a helper and balance in the grief recovery are central to the model. Interventions are described that provide the paraprofessional counselor with more options for tailoring their counseling strategy to the individual. These include techniques that are presumed to be more specific to the enhancement of grief recovery.     

A new method for the simultaneous analysis of unmodified and modified urinary nucleosides and nucleobases by high performance liquid chromatography

Details are given of a new, rapid and simple pre-fractionation method and an isocratic high performance liquid chromatography system suitable for parallel analysis of nucleosides and nucleobases from urine and other biological fluids. The quantitative recovery and excellent reproducibility of the method is demonstrated by analysis of representative standard RNA catabolites. The advantage of this new method for application to biological samples is discussed.     

Adsorption of Charged Non-albumin Bound Drugs by Amorphous Silica

We investigated the in vitro drug adsorption of PQ 10150 sodium silicate gel (AIS, Santa Clara, CA) with particle size of 230 um and surface area of 400 nr/g. We observed 99% to 88% adsorption of gentamicin; a mean 91 % of disopyramide; a mean 89% of quinidine at low concentration, falling to 75% at higher concentration. Insulin was 88% adsorbed at low concentrations but less so (65%) at higher concentrations. We observed a mean 83 % adsorption of procainamide, a mean 84% of N-acetyl procainamide, 74% oflidocaine, 73% of amitriptyline; and 44% of desipramine. We found an average 14% reduction of total digoxin concentration when serum containing digoxin (2 to 33 ng/mL) was exposed to sodium silicate, while the reduction in free digoxin concentration was 16%. Five percent ethosuximide was also removed. The adsorption of theophylline, phenobarbital, acetaminophen, phenytoin, ethylene glycol, methotrexate, salicylate, thiocyanate and diazepam was minimal and not significant. We conclude that significant amounts of charged, non-albumin bound drugs can be removed by PQ 10150 sodium silicate gel.