中药泡洗治疗糖尿病足90例疗效分析

目的为了观察中药泡洗对糖尿病足的疗效。方法对90例糖尿病足患者用中药（方剂组成：桃仁、红花、桂枝、没药、乳香、花椒、川芎等各10g）水煎制后分为2袋各300ml配合足浴仪泡洗，2次，d，30min／次，10d为1疗程。结果全组90例患者显效66例，有效24例，总有效率100％。结论中药泡洗治疗糖尿病足疗效确切。     

Significance of various systemic and ocular parameters in the long-term prognosis after diabetic vitrectomy

The presence or absence of retinal detachment, especially detachment of the macula, was the most critical parameter predicting visual outcome, and long duration of detachment worsened the prognosis (P=0.0084). In contrast, the time interval from vitreous haemorrhage to surgery did not associate with the long-term visual outcome. Pre-operative visual acuity of counting fingers 1 m or better was associated with favourable visual outcome (P=0.0032). Other pre- or per-operative parameters (e.g. aphakia, iris rubeosis, extent of photocoagulation, retinal breaks) did not associate with visual prognosis significantly.Significant association between general parameters and visual outcome was found only in the group of traction retinal detachment where loss of vision was related to shorter duration of diabetes (P=0.0213), and shorter duration of background retinopathy (P=0.0300), and proliferative retinopathy (P=0.0072).     

3,6-(二甲氨基)-二苯骈碘杂六环葡萄糖酸盐对AGEP引起的大鼠主动脉平滑肌细胞增殖及牛主动脉内皮细胞内皮素和一氧化氮改变的影响

目的 :观察 3 ,6 (二甲氨基 ) 二苯骈碘杂六环葡萄糖酸盐对AGEP引起的大鼠主动脉平滑肌细胞增殖及牛主动脉内皮细胞内皮素和一氧化氮改变的影响。方法 :采用牛血清白蛋白 (BSA)与不同浓度葡萄糖 (0 ,2 0 ,5 0 ,80mmol·L-1)体外孵育制备糖基化终产物 (AGEP) ,应用 [3 H] TdR掺入法和MTT比色法观察I-93对重度糖化的AGEP诱导的大鼠主动脉平滑肌细胞 (ASMC)增殖的影响 ;应用放射免疫技术及Greiss法观察I -93对AGEP引起的牛主动脉内皮细胞 (BAEC)释放内皮素 1(ET 1)和一氧化氮 (NO)的影响。结果 :I-93 10 -7～ 10 -5mol·L-1能明显抑制AGEP引起的ASMC增殖 ,其 [3 H] TdR掺入量和MTT比色法的最大抑制率分别为79 .4%和 44 .2 %。随AGEP糖浓度的增加 (2 0～ 80mmol·L-1) ,BAEC培养液中ET 1含量亦逐渐上升 [(4 93± 63 )～ (779± 10 5 )ng·L-1] ,I -93 10 -7～ 10 -5mol·L-1能明显抑制重度糖化的AGEP促进ET 1释放的作用 ;I -93对AGEP灭活NO的作用有剂量依赖性抑制效应。结论 :I -93有抑制ASMC增殖的作用 ;对AGEP诱导的BAEC释放ET 1和NO间平衡失调有调节作用 ,在防治阻塞性血管疾病方面I -93具有潜在的应用价值     

Amputation in elderly and high-risk vascular patients

Fifty-eight patients underwent lower limb amputation for arterial disease over a 30-month period. Mean age of the patients was 72 years. Cardiopulmonary and metabolic risk factors were present in the majority of the patients. Postoperative one-year and three-year mortality rates were 24, 40, and 76%, respectively. Contralateral amputation was required in one-third of the patients after a mean period of eight months. Only younger and healthier patients returned to a meaningful social life after appropriate prosthetic fitting. In view of the high mortality and morbidity rates, above-knee amputation seems a better choice than below-knee amputation in these elderly and high-risk patients.     

大黄对实验性糖尿病大鼠肾脏肥大及高滤过作用的影响

肾脏肥大和高滤过是糖尿病肾病出现最早的病理生理特征。本研究利用中药大黄抑制糖尿病的肾脏肥大,试图达到控制其高滤过现象。实验结果表明,大黄能明显地抑制糖尿病肾脏肥大及其组织中蛋白质、DNA含量的增加;大黄治疗组的菊粉清除率明显低于非治疗组;此外,大黄还能使糖尿病血清甘油三酯、胆固醇水平降低。结论:大黄可以通过影响糖尿病肾病肾脏肥大,降低高滤过和纠正血脂代谢紊乱,治疗实验性糖尿病肾病动物模型。     

The bipartite tarsal navicular bone: Radiographic and computed tomography findings

Two cases of bipartite tarsal navicular bone are presented. The radiographic and computed tomography (CT) findings of this anatomical variant are described. Correct recognition of this entity is important, both because it may be the cause of symptoms perse, and because it may be misdiagnosed as a fracture. When plain films are not diagnostic, CT scanning is helpful in distinguishing between a fracture and this variant.     

Effect of morphological abnormalities on blood retinal barrier permeability in diabetic retinopathy

The morphological base for the impaired function of the blood retinal barrier was studied in 50 eyes of 10 insulin dependent and 21 non-insulin dependent patients with various levels of diabetic retinopathy. The permeability of the blood retinal barrier (P_BRB) was determined by vitreous fluorophotometry with correction for autofluorescence, lenstransmission and non-protein bound plasma fluorescein concentration. Morphological abnormalities of diabetic retinopathy assessed by fundus photography and fluorescein angiography were individually scored on a decimal scale and related to the P_BRB by multiple regression analysis. The P_brb was not correlated to morphological abnormalities of non-proliferative retinopathy [(1) microaneurysms, (2) hard exudates, (3) soft exudates, (4) intraretinal hemorrhages, (5) fluorescein leakage, and (6) capillary closure, p > 0.3]. The P_BRB was correlated to morphological abnormalities of (pre)proliferative retinopathy [(1) intraretinal microvascular abnormalities (S_irma) and (2) new vessels (S_neo): p_brb = A – B.S_IRMA – C.S_neo with P_BRB in nm/sec, A = 1.5 ± 0.5, B = 0.9 ± 0.2 and C = 1.7 ± 0.4, R² = 0.65, p < 0.0001]. It can be concluded that the increased blood retinal barrier permeability in diabetic patients is mainly due to (pre)proliferative abnormalities and not to non-proliferative abnormalities.     

血管内皮生长因子在糖尿病大鼠视网膜中的表达

目的 :利用糖尿病大鼠动物模型 ,通过大鼠视网膜中血管内皮生长因子 ( vascular en-dothelial growth factor,VEGF)的表达情况 ,探讨 VEGF在糖尿病视网膜病变 ( diabetic retinopa-thy,DR)发展过程中作用机理。方法 :复制链脲佐菌素 ( streptozocin,STZ)糖尿病大鼠动物模型 ,取不同组、不同时期大鼠视网膜 ,利用免疫组织化学及原位杂交方法 ,检测 VEGF蛋白质及 m RNA的表达情况。结果 :1正常对照组 ( M)、血糖恢复组及糖尿病 1个月组 ( M1)大鼠视网膜均无 VEGF蛋白质及 m RNA的阳性表达 ;2糖尿病 3个月组 ( M3 )未见 VEGF m RNA表达 ,而在内核层及节细胞层有 VEGF蛋白表达阳性 ( 34%) ,此表达与胶质纤维酸性蛋白 ( GFAP)染色阳性细胞相同 ;3糖尿病 5个月组 ( M5) VEGF m RNA表达阳性率为 67%,表达位于视网膜各层 ,内界膜中的表达与 GFAP免疫组化阳性分布相同 ,VEGF蛋白质表达强阳性 ( 89%) ,主要位于内核层、节细胞层的细胞及血管上。结论 :VEGF在 STZ大鼠视网膜中的表达与病程相关 ,而且 VEGF的产生存在着自分泌和旁分泌多种途径     

葛根素联用甲钴胺治疗糖尿病周围神经病变32例

目的 观察葛根素联用甲钴胺治疗糖尿病周围神经病变(DPN)的疗效。方法 将诊断明确的64例DPN患者随机分为治疗组和对照组各32例,两组均给予糖尿病饮食和降糖治疗,治疗组给予葛根素联用甲钴胺治疗,对照组单给予葛根素治疗。10天为一疗程,共治疗两疗程,对两组疗效进行比较。结果 治疗组总有效率和神经传导速度改善均好于对照组(P<0.01),且无明显副作用。结论 葛根素联用甲钴铵治疗DPN比单用葛根素疗效好,值得临床推广应用。     

应用局部皮瓣治疗仰趾畸形

目的:探讨烧、创伤后,足背瘢痕挛缩所致仰趾畸形的治疗。方法:术中将足背瘢痕切除,彻底松解挛缩,将弓弦状伸肌腱切除部分或切断,切除部分挛缩的跖趾关节背侧关节囊,使关节复位,克氏针外固定,在拇指内侧或小趾侧,以跖趾关节处为蒂设计逆行皮瓣,转移覆盖外露的跖趾关节,供区及瘢痕切除后创面行全厚或断层皮片修复。结果:本组7例,均采用逆行皮瓣修复,畸形完全纠正,无继发畸形。结论:应用拇指及小趾侧方逆行皮瓣转移,治疗仰趾畸形可达到满意效果。