恶性肿瘤合并糖尿病的化疗期血糖水平控制分析

目的探讨恶性肿瘤合并糖尿病的化疗期血糖水平控制,为恶性肿瘤合并糖尿病的临床治疗积累经验。方法选取2016年8月—2017年12月期间该院收治的50例恶性肿瘤合并糖尿病患者,先积极控制血糖水平,根据患者肿瘤位置、临床分期等选择合适的化疗方案,对治疗方法及干预效果进行总结分析。结果50例恶性肿瘤合并糖尿病患者经合理进行化疗和血糖控制治疗,有48例(96.00%)患者顺利完成全部化疗方案,治疗后空腹血糖水平[(5.45±0.73)mmol/L]较治疗前[(11.37±1.59)mmol/L]明显下降,差异有统计学意义(P<0.05),顺利完成化疗,未出现低血糖、酮症酸中毒、感染等并发症。结论对恶性肿瘤合并糖尿病患者进行化疗的同时,需要合理控制血糖水平以保证化疗计划顺利完成,达到预期疗效。     

α-硫辛酸联合甲钴胺对2型糖尿病周围神经病变患者神经传导功能的影响

目的探讨2型糖尿病周围神经病变甲钴胺联合α-硫辛酸对患者神经传导功能的影响。方法回顾性选取2018年6月—2020年6月该院2型糖尿病周围神经病变患者100例,依据治疗方法分为甲钴胺联合α-硫辛酸治疗组(联合治疗组,n=50)、甲钴胺单独治疗组(单独治疗组,n=50)两组,统计分析两组患者的血糖水平、肢体疼痛程度、神经传导功能、临床疗效、不良反应发生情况。结果联合治疗组患者治疗后较治疗前的VAS评分降低幅度显著高于单独治疗组,差异有统计学意义(P<0.05),但两组患者治疗后较治疗前的空腹血糖、餐后2 h血糖水平降低幅度之间的差异无统计学意义(P>0.05)。联合治疗组患者治疗后较治疗前的胫神经MCV、尺神经、正中神经SCV升高幅度均显著高于单独治疗组,差异有统计学意义(P<0.05)。联合治疗组患者治疗的总有效率90.0%(45/50)显著高于单独治疗组62.0%(31/50),差异有统计学意义(χ²=10.746,P<0.05)。联合治疗组和单独治疗组患者的不良反应发生率6.0%(3/50)、4.0%(2/50)间的差异无统计学意义(χ²=0.000,P>0.05)。结论2型糖尿病周围神经病变甲钴胺联合α-硫辛酸治疗较甲钴胺单独治疗更能有效改善患者神经传导功能。     

糖化血红蛋白检测在2型糖尿病诊断中的应用效果

目的对2型糖尿病诊断中糖化血红蛋白检测的作用进行探究。方法于2019年4月—2020年3月选择该院收治的确诊为2型糖尿病的患者50例纳入研究,将其作为甲组。同时选择同一时期的健康人员50名作为乙组。对两组实施糖化血红蛋白检测,比较两组的糖化血红蛋白水平,从而分析在2型糖尿病诊断中糖化血红蛋白检测的价值。结果甲组的糖化血红蛋白水平(8.8±1.2)%、空腹血糖水平(10.6±1.3)mmol/L和餐后2 h血糖水平(15.3±5.5)mmol/L均明显高于乙组糖化血红蛋白水平(5.1±0.6)%、空腹血糖水平(4.8±0.4)mmol/L和餐后2 h血糖水平(6.6±1.3)mmol/L,差异有统计学意义(t=19.500、27.345、10.885,P<0.05)。结论在2型糖尿病的诊断中,应用糖化血红蛋白检测具有重要的参考价值,能够为临床诊断提供重要的参考依据。     

吡格列酮联合二甲双胍治疗2型糖尿病疗效探讨

目的探讨吡格列酮联合二甲双胍治疗2型糖尿病的疗效。方法在该院2019年4月—2020年3月收治的2型糖尿病患者中选取76例。按照入院编号分成两组:对照组38例,使用二甲双胍片治疗;试验组38例,联合使用吡格列酮片。观察两组的治疗效果和不良反应,比较治疗前后的血糖、血脂水平变化。结果相比于对照组,试验组患者的治疗总有效率更高(97.4%vs 79.0%),差异有统计学意义(P<0.05)。治疗后,两组患者的FPG、2 hPG、TC、TG、LDL-C水平均明显降低,其中试验组降低幅度更显著(P<0.05)。试验组不良反应发生率为13.2%,略高于对照组的7.9%,对比差异无统计学意义(P>0.05)。结论吡格列酮联合二甲双胍治疗2型糖尿病疗效优于单一用药,能进一步改善血糖和血脂水平。     

牛磺酸治疗对冠心病合并2型糖尿病伴高脂血症患者血脂和内皮功能的影响

目的探讨牛磺酸治疗对冠心病合并2型糖尿病伴高脂血症患者血脂水平和内皮功能的影响。方法选取2018年1月至2020年2月我院收治的稳定性冠心病合并2型糖尿病伴高脂血症患者120例,随机分为对照组和观察组,每组60例。对照组患者给予常规治疗,观察组患者加用小剂量牛磺酸治疗,疗程6周。比较两组患者治疗前后的三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、一氧化氮(NO)和内皮素-1水平以及治疗过程中的不良反应发生情况。结果治疗前,两组患者的三酰甘油、总胆固醇、高密度脂蛋白胆固醇及低密度脂蛋白胆固醇水平比较,差异无统计学意义(P>0.05);治疗6周后,观察组患者的三酰甘油、总胆固醇、低密度脂蛋白胆固醇水平显著低于对照组,高密度脂蛋白胆固醇水平显著高于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者的NO、内皮素-1水平比较,差异无统计学意义(P>0.05);治疗6周后,观察组患者的NO水平显著高于对照组,内皮素-1水平显著低于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者的不良反应发生率比较差异无统计学意义(P>0.05)。结论在常规治疗的基础上,加服小剂量牛磺酸治疗可有效改善冠心病合并2型糖尿病伴高脂血症患者的血脂水平及内皮功能,对减缓疾病进展具有积极的意义。     

Influence of Lateral Movement on Level Behavior of Adhesion Force Measured Repeatedly by an Atomic Force Microscope (AFM) Colloid Probe in Dry Conditions

An atomic force microscope (AFM) was operated to repeatedly measure the adhesion forces between a polystyrene colloid probe and a gold film, with and without lateral movement in dry conditions. Experimental results show that the adhesion force shows a level behavior without lateral movement and with a small scan distance: the data points are grouped into several levels, and the adhesion force jumps between different levels frequently. This was attributed to the fact that when the cantilever pulls off the sample, the contact area of the sample is not exactly the same between successive contacts and jumps randomly from one to another. Both lateral velocity and material wear have little influence on level behavior. However, with a medium scan distance, level behavior is observed only for some measurements, and adhesion forces are randomly distributed for the other measurements. With a large scan distance, adhesion forces are randomly distributed for all measurements. This was attributed to the fact that the cantilever pulls off the sample in many different contact areas on the scanning path for large distances. These results may help understand the influence of lateral movement and imply the contribution of asperities to adhesion force.     

Lipid Droplets Accumulation during Hepatitis C Virus Infection in Cell-Culture Varies among Genotype 1–3 Strains and Does Not Correlate with Virus Replication

Liver steatosis is a common complication of chronic hepatitis C virus (HCV) infection, which can result in accelerated liver fibrosis development, especially in patients infected with genotype 3a. The precise mechanisms of HCV-induced liver steatosis remain unclear, but it is often posited that increased intracellular lipid accumulation is the underlying cause of steatosis. To study experimentally how HCV infection in human liver derived cells by different genotypes and subtypes might affect lipid accumulation, we performed detailed cytofluorimetric and microscopy analyses of intracellular lipid droplets (LDs) in relation to the viral Core and to cell endoplasmic reticulum proteins. Following culture infection with HCV genotype 1a, 2a, 2b, 2c, and 3a strains, we found variable levels of intracellular LDs accumulation, associated to the infecting strain rather than to the specific genotype. Although two genotype 3a strains showed high levels of lipid accumulation, as previously observed, some strains of other genotypes displayed a similar phenotype. Moreover, the analyses of LDs size, number, and shape indicated that the apparent increase in lipid accumulation is due to an increase in the overall number rather than in the size of droplets. Finally, differences in total lipid content across genotypes did not correlate to differences in Core distribution nor Core levels. In conclusion, our study provides a quantitative in-depth analysis of the effect of HCV infection on LDs accumulation in cell-culture.     

芍药苷脂质液晶纳米粒制备及体外释放研究

目的制备芍药苷脂质液晶纳米粒(Pae-LLCN),并考察其体外释药特性。方法以包封率为指标,采用自发乳化-超声法制备Pae-LLCN,用正交试验设计对Pae-LLCN的处方进行优化,用透析法测定Pae-LLCN在24 h内的累积释放量并绘制释药曲线,采用透射电镜、纳米粒度仪对其形态和粒径进行考察。结果 Pae-LLCN最佳处方为泊洛沙姆407(F127)与甘油单油酸酯(GMO)质量比为1∶10、芍药苷投料量为40 mg、磷酸盐缓冲液(PBS)的用量为20 m L,药物的平均包封率达到73.72%,载药量为14.81%,粒径(170±16)nm,体外24 h累积释放量为72.68%。结论 Pae-LLCN制备合理可行,稳定性好,有良好的缓释作用。     

BOLD-MRI评价2型糖尿病患者降血糖治疗前后肾组织氧合状况

目的 采用BOLD-MRI评价糖尿病患者降血糖治疗前后肾组织氧合水平改变情况及其与血糖水平的相关性。方法 对23例2型糖尿病患者（糖尿病组）于降血糖治疗前后及23名健康志愿者（对照组）行肾脏BOLD-MRI,测量肾脏皮、髓质R2^*值,并进行统计学分析。结果 糖尿病组降血糖前、降血糖后及对照组肾皮质的R2^*值均低于肾髓质（P均<0.001）。糖尿病组降血糖前肾髓质R2^*值高于降血糖后和对照组（P均=0.001）,降血糖后肾髓质R2^*值与对照组差异无统计学意义（P=0.941）。糖尿病组降血糖前、降血糖后、对照组间肾皮质R2^*值差异无统计学意义（P=0.572）。糖尿病组肾髓质R2^*值与血糖值呈正相关（r=0.365,P=0.002）,而肾皮质R2^*值与血糖值无明显相关性（r=-0.014,P=0.908）。结论 降血糖治疗可以改善肾髓质的氧合状况;BOLD-MRI可用于评价糖尿病患者降血糖治疗前后肾组织氧含量的变化。     

Responsiveness and Predictive Validity of the Participation Measure–3 Domains, 4 Dimensions in Survivors of Stroke

ObjectivesTo examine the responsiveness and predictive validity of the Participation Measure–3 Domains, 4 Dimensions (PM-3D4D) in people receiving outpatient rehabilitation following stroke.DesignProspective cohort observational study.SettingOutpatient rehabilitation settings.ParticipantsVolunteer patients (N=269) with stroke (mean age ± SD [y], 55.36±12.46; 70.26% male).InterventionsNot applicable.Main Outcome MeasuresThe PM-3D4D was designed to measure 3 domains (Productivity, Social, and Community) and 4 dimensions (Diversity, Frequency, Desire for change, and Difficulty) of participation in individuals with rehabilitation needs. All participants completed the PM-3D4D, the Participation Assessment with Recombined Tools-Objective (PART-O), the Participation Measure for Post-Acute Care (PM-PAC), and the EuroQol-5-Dimension (EQ-5D) at the baseline assessment and again following 3 months of outpatient rehabilitation.ResultsSignificant mean changes in scores were observed for most of the PM-3D4D subscales, with the largest score change observed in the Difficulty subscale (standardized response mean=0.57～0.88). The minimal detectable change and meaningful clinically important differences were calculated for each subscale. The Frequency and Difficulty dimensions of the PM-3D4D demonstrated significantly greater responsiveness than the PART-O and PM-PAC, respectively. The baseline PM-3D4D scores, except for Desire for change subscales, were significantly correlated with the PART-O, PM-PAC, and EQ-5D scores after 3 months of rehabilitation.ConclusionsThis study provides evidence supporting the responsiveness and predictive validity of the PM-3D4D in survivors of stroke. Among all subscales of the PM-3D4D, the Difficulty dimensional scale demonstrated the greatest responsiveness. The Desire for change dimension of the PM-3D4D showed less responsiveness, and we recommend that it be used as a goal-setting tool rather than an outcome measure. The PM-3D4D can potentially be used to predict participation outcomes and the health-related quality of life following rehabilitation interventions.