Bone Metabolism Discrepancy in Type 2 Diabetes Mellitus Patients With and Without Non-Alcoholic Fatty Liver Disease

To explore the distribution of several bone metabolic indicators in type 2 diabetes patients (T2DM) with and without non-alcoholic fatty liver disease (NAFLD) and to preliminarily evaluate the relationship of bone metabolism with NAFLD in patients with T2DM. The hospitalized patients with T2DM were divided into the group of T2DM complicated with NAFLD and the group of T2DM alone according to the results of ultrasonic diagnosis. The general information and laboratory test data such as bone metabolism indexes of these patients were collected and the differences of the indexes between the 2 groups were compared. Furthermore, the independent influencing factors of NAFLD in patients with T2DM were analyzed. A total of 186 patients were included in the study. Compared with patients with T2DM only, patients with T2DM combined with NAFLD were characterized with younger age (p < 0.001), higher BMI (p = 0.016), ALT (p = 0.001), TG (p = 0.005), HOMA-IR (p = 0.005), and lower HDL-C (p = 0.031). Significant discrepancy of age (OR 1.052, p = 0.001), ALT (OR 0.964, p = 0.047), HOMA-IR (OR 0.801, p = 0.005), and T-PINP (OR 1.022, p = 0.008) was found using multivariate logistic regression model. Significant discrepancy of T-PINP was found in T2DM patients with and without NAFLD. Further studies are needed to explore whether T-PINP could be used as a predictor of fatty liver disease, osteoporosis, and other related complications in patients with T2DM.     

滤膜法与涂抹法检测血液透析相关用水微生物的效果

目的 探讨滤膜法和涂抹法检测血液透析相关用水微生物的效果,为选择合适的检测方法提供依据。方法 回顾性收集某三级甲等综合性医院2018年1-12月同时采用滤膜法和涂抹法检测血液透析相关用水微生物的结果,对比分析滤膜法和涂抹法检测细菌检出率、单位菌落数、超干预值检出率和微生物合格率。结果 共收集274份血液透析相关用水微生物检测结果,其中透析液131份,反渗水39份,B浓缩液（下简称B液）14份,置换液34份,其他透析用水56份。滤膜法细菌检出率均高于涂抹法,其中透析液、反渗水、置换液、其他透析用水标本使用两种方法的细菌检出率比较,差异有统计学意义（均P<0.05）。透析液、B液、其他透析用水标本单位菌落数滤膜法数值上低于涂抹法,但仅其他透析用水标本使用两种方法检测结果单位菌落数差异有统计学意义（t=-3.011,P=0.004）。超干预值检出率其他透析用水滤膜法低于涂抹法,差异有统计学意义（χ²=6.596,P=0.010）。置换液、反渗水标本微生物合格率滤膜法数值上低于涂抹法,但仅置换液标本微生物合格率差异有统计学意义（χ²=18.987,P<0.001）。结论 滤膜法检出细菌的能力高于涂抹法,但其在血液透析相关用水微生物检测中存在一定局限性,除用于置换液比较适合外,应用在其余血液透析相关用水微生物的检测效果并不优于涂抹法。     

完善医疗设备管理降低使用成本

本文从医疗设备的早期故障期、偶然故障期和耗损故障期三个阶段,阐述设备使用不同时期的针对性维修及管理方法,提出技术支持的必要性,用实例说明完善医疗设备管理是降低使用成本的有效途径。     

LC-MS-based plasma metabolomics reveals metabolic variations in ovariectomy-induced osteoporosis in female Wistar rats

Osteoporosis with a reduction in bone mineral density has become one of the most common metabolic bone diseases. Postmenopausal women are a high-risk group that suffers from osteoporosis when the production of estrogen in their body rapidly declines. Early prediction and diagnosis of osteoporosis will be conducive to having a greater chance to control the deterioration in condition of osteoporosis patients; however, there are still no effective measures in practice. In this study, we aimed at exploring metabolic variations in postmenopausal osteoporosis using ovariectomized female rats as an animal model. The research was performed using liquid chromatography/mass spectrometry (LC/MS) combined with multivariate statistical analysis for plasma metabolome analysis. The results reveal that metabolic variations of ovariectomized-induced osteoporosis involve 18 differentially expressed metabolites and 13 related metabolism pathways such as valine, leucine and isoleucine biosynthesis as well as arachidonic acid and glycerophospholipid metabolism. Notably, the ingenuity pathway analysis platform for further understanding the relationship between metabolic alteration and osteoporosis shows that the change in the levels of metabolites mainly lead to the abnormal state of cellular compromise, cell signaling, inflammation, molecular transport and lipid metabolism. Metabolomics, as a novel way to characterize resolute endogenous small metabolites in organisms, describes the variation in the early stages of metabolic alteration for offering valuable information on pathogenic mechanisms.

Osteoporosis with a reduction in bone mineral density has become one of the most common metabolic bone diseases.     

新的心电图诊断标准RLⅠ＋SV4和SD＋SV4对高血压合并左心室肥厚的诊断价值

目的]观察新的心电图诊断标准RLⅠ＋SV4、SD＋SV4是否适用于高血压合并左心室肥厚(LVH)的诊断,研究13项心电图诊断标准以及新标准与常用标准联合应用对于高血压合并LVH的临床价值。[方法]以超声心动图测定的左心室质量指数(LVMI)为标准,选取原发性高血压或者有高血压治疗史的住院患者280例,其中高血压合并LVH患者94例(LVH组),左心室正常患者186例(左心室正常组)。同步记录12导联心电图。绘制各种心电图诊断标准的受试者工作特征曲线(ROC),比较ROC的曲线下面积(AUC)。计算各种诊断标准的灵敏度和特异度。分析RLⅠ＋SV4、SD＋SV4及其联合目前公认的心电图诊断LVH标准对高血压患者合并LVH的诊断价值。[结果]单个心电图导联中,RLⅠ即Ⅰ导联的R波是较好预测LVH的因子之一(AUC＝0.63,P＜0.01)。两个导联振幅相加诊断LVH的研究中,RLⅠ＋SV4标准(AUC＝0.64,P＜0.01)的灵敏度为50%,特异度为71%;配对卡方检验显示RLⅠ＋SV4诊断LVH与金标准(LVMI判定LVH)之间无明显统计学差异。SD＋SV4标准(AUC＝0.59,P＜0.05)的灵敏度为31%,特异度为87%,其中SD波为12导联中拥有最大振幅的S波。RLⅠ＋SV4联合Sokolow-Lyon电压标准能够提高诊断高血压合并LVH的灵敏度,其灵敏度为59%,特异度为60%。[结论]RLⅠ＋SV4标准具有较高的AUC,适合高血压患者合并LVH的初步筛查;RLⅠ＋SV4联合Sokolow-Lyon电压标准能够提高诊断的灵敏度。SD＋SV4标准临床适用性没有RLⅠ＋SV4标准高。