Role of arterial stiffness and endothelial dysfunction on lower limb performance in older adults with type 2 diabetes: A cross-sectional study

AimTo verify whether arterial stiffness and endothelial dysfunction influence lower limb muscle strength and gait speed in older adults with type 2 diabetes mellitus (T2DM).MethodsCross-sectional study including seventy-eight older adults with T2DM (aged 67 ± 6 years and 42 % male). Arterial stiffness was assessed using pulse wave velocity (PWV), while endothelial function was measured by flow-mediated dilation (FMD). Lower limb muscle strength and gait speed were assessed using the 30-second chair stand test (30s-CST) and 10-Meter Walk Test, respectively.ResultsBoth PWV (m/s) and FMD (%) were univariately associated with number of repetitions in 30s-CST and gait speed (P < 0.05). After control for age, sex and body mass index, PWV remained associated with repetitions in 30s-CST (95 % CI: ?0.494 to ?0.054; P = 0.015) and gait speed (95 % CI: ?0.039 to ?0.002; P = 0.031). After adjustments for control variables, T2DM duration and glycemic control, FMD was associated with repetitions in 30s-CST (95 % CI: 0.008 to 0.324; P = 0.039) and gait speed (95 % CI: 0.011 to 0.038; P = 0.001).ConclusionIn older adults with T2DM, both arterial stiffness and endothelial dysfunction are associated with decreased leg muscle strength and slower gait speed.     

Gender difference in association between diabetes mellitus and all-cause mortality in atrial fibrillation patients

ObjectiveThere may be gender difference in correlation of diabetes mellitus (DM) and cardiovascular events. We attempt to investigate whether there is gender-heterogeneity in one-year outcomes of atrial fibrillation (AF) patients with DM or not.MethodsPatients who were diagnosed with AF admitted to the emergency departments in the Chinese AF Multicenter Registry study were enrolled. Basic demographics information, initial Blood Pressure and heart rate, medical histories, and treatments of each patient were collected. Follow-up was carried out with a mean duration of one year. The primary endpoint was all-cause mortality and systemic embolism.ResultsA total of 2016 patients were selected from September 2008 and April 2011. All-cause mortality was significantly higher in male AF patients with DM than those without (21.8 % & 13.6 %, P = 0.014). Cox regression analysis showed that there was an interaction between gender and DM for one-year all-cause mortality (P = 0.049). DM was significantly associated with one-year all-cause mortality regardless of univariate analysis (HR = 1.436, 95%CI:1.079–1.911, P = 0.013) or multivariate analysis (HR = 1.418, 95%CI: 1.059–1.899, P = 0.019). For male patients with AF, DM was significantly associated with one-year all-cause mortality (P = 0.048), but not for female patients with AF (P = 0.362).ConclusionDM was independently associated with one-year all-cause mortality in the entire cohort of AF patients. This association was found mainly in male patients with AF, but not in female patients. DM management programs may need to reflect gender difference.     

“一带一路”倡议背景下与东盟国家的医学信息学人才交流探讨

阐述在“一带一路”倡议及大数据时代背景下医学信息学人才培养与交流的意义，从政策支持、医疗卫生及高等教育合作交流、高校学科建设等方面探讨广西与东盟国家医学信息学人才交流的可行性，分析目前医学信息学人才交流存在的障碍并提出相应对策。     

部分NANDA护理诊断缺陷分析及对策

NANDA护理诊断给中国护理带来了巨大进步,但在教学和临床应用时,有些护理诊断名称与医学名词相同而内涵不同,有些护理诊断缺乏定量判断而不够严谨,有些护理诊断概念不同但诊断依据和护理措施几乎类似,有些疾病的主要症状体征没有相应的护理诊断。改进护理诊断的对策:一是继续提升对护理诊断的认识,护理诊断很重要、很必要,更要不断发展;二是确立护理诊断的指导思想,起源于医学,为医学分支,症状护理较符合医学逻辑;三是提高护理诊断用语的准确性、公认性;四是在中国建立护理诊断认可程序,完善后编入护理教材,为世界护理事业发展再添中国色彩。     

行为问题儿童的生活质量及其影响因素调查

目的:探讨行为问题儿童的生活质量及影响因素.方法:采用Conners量表和儿少主观生活质量问卷调查2087例少年儿童的行为问题和生活质量,然后将问题儿童与正常儿童的结果做比较.结果:行为问题儿童的生活质量明显低于正常儿童,相关分析显示儿少主观生活质量问卷与Conners量表父母问卷和教师评定量表的部分因子存在不同程度的相关.逐步回归显示儿童的学业、行为问题、家庭经济、父亲性格、年龄、父母对不良行为的处理方式、独生共7个变量影响着儿童的生活质量.结论:行为问题儿童生活质量下降,需要得到学校、家庭、同伴、社会等多方面的关怀帮助.     

小梁切除术联合应用丝裂霉素C及巩膜瓣可拆除缝线治疗青光眼的效果观察

目的：探讨小梁切除术联合应用丝裂霉素C（MMC）及巩膜瓣可拆除缝线对青光眼的治疗效果。方法：对43例60眼各类青光眼随机分为A组20例30眼和B组23例30眼,A组采用小梁切除术联合应用MMC及巩膜瓣可拆除缝线,B组行传统小梁切除术。结果：术后随访7－25个月。手术成功率A组（93．3％）明显高于B组（60％,P＜0．01）;功能性滤过泡A组（93．3％）亦明显高于B组（53％,P＜0．01）;浅前房A组（3．3％）则低于B组（26％,P＜0．05）;低眼压等并发症两组对比无显著性差异。结论：小梁切除术联合应用MMC及巩膜瓣可拆除缝线在提高成功率的同时减少了并发症的发生,为一种安全可靠的青光眼滤过性手术。     

蛤蚧皮质加厚区的形态解剖及三维重建

目的明确蛤蚧皮质加厚区的位置、核团的形态及与比邻结构的关系,为研究皮质加厚区的功能提供依据。方法对蛤蚧脑行冷冻冠状连续切片(厚60μm),Nissl染色,对每张含有皮质加厚区的切片进行摄片和测量,选取其中1套用于三维重建,重组软件为3D MAX。结果1.皮质加厚区位于端脑吻侧端,前背侧室嵴外侧,外侧皮层内侧和背侧皮层腹侧。皮质加厚区的吻尾长(912.67±110.96)μm(n=10),体积(0.1430±0.0414)μm3(n=10)。2.皮质加厚区从吻侧端到尾侧端大约可分为前段、中段、后段和末段。后段的背腹径最长,可分为背侧部和腹侧部,两部分的细胞分界清晰。结论皮质加厚区为一吻尾径长于内外径的狭长片状结构,背侧缘较腹侧缘平滑;加厚区的尾侧端比吻侧端大,且尾端的后段分离成背侧和腹侧两个细胞群。     

D二聚体与脑血管病关系的研究

目的　探讨D二聚体(DDimer,DD)与脑血管病的关系。方法　采用ELISA法,分别采取观察对象空腹静脉血2ml,脑血管病患者为发病后1周内采血,定量检测急性脑血管病及高血压、脑动脉硬化患者血浆DD含量。结果　短暂性脑缺血发作(TIA)、脑梗塞及蛛网膜下腔出血(SAH)与正常对照组相比有显著性差异(P<005),高血压、脑动脉硬化及脑出血与正常对照组相比无显著性差异(P>005),SAH血浆DD含量与各组相比有显著性差异(P>005),SAH血浆DD含量与各组相比有显著性差异(P<005),其他各组两两比较无显著性差异(P>005)。结论　测定DD对急性脑血管病的诊断有价值,对其鉴别诊断无参考意义。     

岗松油的气相色谱指纹图谱研究

目的建立岗松油化学成分指纹图谱的研究方法,以鉴别岗松油的质量。方法采用气相色谱法测定,对不同产地和采收期的岗松油的指纹图谱进行研究。结果建立了岗松油指纹图谱,确定12个色谱峰为共有峰。结论不同产地和采收期岗松油的指纹图谱稳定性好,相似性高,具有特征性和唯一性,利用岗松油指纹图谱可以对岗松油的质量进行控制。