妊娠期急性脂肪肝38例临床分析

目的 探讨妊娠期急性脂肪肝(AFLP)的临床特点.方法 对北京佑安医院2008年5月至2013年11月收治的38例AFLP患者的临床资料进行回顾性分析,包括临床特征、实验室检查和治疗、转归情况.结果 38例患者在发病前1～2周均出现不同程度乏力、不适症状,38例均有肝功能障碍,18例肝肾功能衰竭,死亡4例(10.5％),围产儿死亡3例(7.3％).结论 妊娠期急性脂肪肝起病急、病情凶险,应早期诊断治疗、及时终止妊娠,AFLP患者发生产后出血和多脏器功能不全的比例较高,应严密监测及调节凝血功能、肝肾功能,血浆置换治疗可有效降低母体病死率.     

高血压脑出血术后再出血的多因素分析

分析高血压脑出血术后再出血的可能原因,进行相应预防。回顾性分析124例高血压脑出血手术病例,用 Logis-tic 回归模型分析可能因素对术后再出血影响。术后再出血发生率为16.1%。单因素 Logistic 分析：手术时机、出血部位、有无凝血功能异常、术中止血彻底与否、术后血压波动等与术后再出血显著相关（P <0.05）;多元逐步 Logistic 分析：手术时机、术中止血彻底与否、术后血压波动等是术后再出血危险因素（P <0.05）。最佳的手术时机以及争取术中彻底确切止血和术后控制血压在合理范围对预防再出血有重要意义。     

采用赋能教育模式对糖尿病足患者护理的效果分析

目的 探讨采用赋能教育模式对Wagner0级糖尿病足患者护理后的效果.方法 选择Wagner0糖尿病足患者81例,分为对照组及观察组,分别有40例、41例.对照组采用常规方法护理,观察组采用赋能教育模式进行护理.对治疗后患者ABI、TBI、VPT、DMSES及DSQL评分、血糖控制情况进行检测.结果 对照组干预后ABI、TBI、VPT较干预前略有变化但差异无统计学意义(P＞0.05),观察组干预后ABI、TBI、VPT较干预前及对照组差异有统计学意义(P＜0.05).对照组干预后DMSES较干预前差异有统计学意义(P＜0.05),观察组干预后DMSES及DSQL评分较干预前及对照组差异有统计学意义(P＜0.05).观察组干预后FBG、HbAlc、每日测血糖次数较干预前差异有统计学意义(P＜0.05),每日测血糖次数较对照组干预后有增加(P＜0.05).结论 采用赋能教育可有效缓解Wagner0级糖尿病足进展,并改善患者的自我效能量、生存质量及自我管理水平.     

血清IGF-2及IGFBP-2与糖尿病肾病进展指标的相关性

目的 IGF-2及IGFBP-2与糖尿病肾病进展相关指标的相关性.方法 选择糖尿病患者126例,分为单纯糖尿病组(A组)、微量蛋白尿组(B组)、大量蛋白尿组(C组),分别有52例、41例、33例.对各组肾功能及尿蛋白、IGF-2、IGFBP-2水平进行测定.结果 B组Cys C、BUN、24h尿蛋白较A组差异有统计学意义(P＜0.05),C组Cys C、BUN、Cr、24 h尿蛋白较A、B组差异有统计学意义(P＜0.05).B组IGF-2、IGFBP-2较A组差异有统计学意义(P＜0.05),C组IGF-2、IGFBP-2较A、B组差异有统计学意义(P＜0.05).IGF-2与Cys C、24h尿蛋白呈正相关(P＜0.05),IGFBP-2与Cys C、BUN、24 h尿蛋白呈正相关(P＜0.05).结论 随着糖尿病肾病的进展,IGF-2及IGFBP-2水平与肾功能密切相关,是反映糖尿病肾病进展的重要因子.     

高血压脑出血个体化手术治疗方案的探讨

目的评价中小骨窗开颅术,去大骨瓣减压术及锥颅血肿抽吸治疗高血压脑出血的疗效。方法通过对37例去大骨瓣减压开颅和68例早期显微镜下斜切口中小骨窗开颅术以及42例锥颅血肿抽吸治疗高血压脑出血的观察比较各组死亡率。结果发现去大骨瓣组死亡9例,死亡率为24.3%,植物生存4例,中小骨窗组死亡11例,死亡率为16.4%。锥颅组死亡22例,死亡率为52.1%。中小骨窗组与去大骨瓣组在血肿清除程度、死亡率和早期预后等方面相差无显著差异,而与锥颅组差异明显。结论显微镜下超早期中小骨窗开颅手术能满足在直视下清除血肿的需要,又有手术时间短,创伤小,术中出血少等优点。是当前手术治疗高血压性脑出血的有效选择。     

Nerve function varies with hemoglobin A1c in controls and type 2 diabetes

Aims

To determine the cross-sectional threshold at which hemoglobin A1c (HbA1c) is associated with polyneuropathy in healthy controls, and the values associated with the most pronounced decline in nerve function in patients with diabetes.

Validation of data from electronic data warehouse in diabetic ketoacidosis: Caution is needed

Aims

This study validated enterprise data warehouse (EDW) data for a cohort of hospitalized patients with a primary diagnosis of diabetic ketoacidosis (DKA).

Bilirubin and its changes were negatively associated with diabetic kidney disease incidence and progression: A five-year's cohort study based on 5323 Chinese male diabetic patients

Aims

This study aimed to evaluate the association between baseline bilirubin (TBiL) and follow-up TBiL changes for diabetic kidney disease (DKD) incidence and progression based on a 5?years' cohort study.

Tetrahydroxy Stilbene Glucoside Alleviates High Glucose-Induced MPC5 Podocytes Injury Through Suppression of NLRP3 Inflammasome

Background

Tetrahydroxy stilbene glucoside (TSG) is an active ingredient of Heshouwu and is an antioxidant. The underlying mechanisms of the renoprotective effect of TSG in diabetic nephropathy have not been previously reported. In this study, we investigated the mechanisms of TSG in preventing podocytes injury in high glucose (HG) condition.

Erythromycin ameliorates renal injury via anti-inflammatory effects in experimental diabetic rats

Aims/hypothesis Recent studies have shown that the inflammatory process is involved in the pathogenesis of diabetic nephropathy. Fourteen-membered ring macrolides, including erythromycin, have anti-inflammatory, as well as antibacterial effects. The aim of this study was to investigate the renoprotective effects of erythromycin in streptozotocin (STZ)-induced diabetic rats.Methods STZ-induced diabetic rats were treated orally with erythromycin (5 mg/kg body weight) or vehicle every day for 8 weeks. To evaluate the effect of erythromycin treatment, we measured urinary albumin excretion, and examined the following in the kidney: histological changes, the expression of intercellular adhesion molecule-1 (ICAM-1), macrophage infiltration, and nuclear factor-kappa B (NF-B) activity.Results Erythromycin significantly reduced urinary albumin excretion without affecting blood glucose levels and blood pressure. Erythromycin also attenuated glomerular hypertrophy, mesangial expansion, macrophage infiltration and ICAM-1 expression in renal tissues. The expression of the gene encoding TGFB1 (also known as TGF-1), type IV collagen protein production and NF-B activity in renal tissues were increased in diabetic rats and reduced by erythromycin treatment.Conclusions/interpretation Erythromycin prevented renal injuries without changes of blood glucose levels and blood pressure in experimental diabetic rats. These results suggest that the renoprotective effects of erythromycin are based on its anti-inflammatory effect via suppression of NF-B activation. Modulation of microinflammation with erythromycin may provide a new approach for diabetic nephropathy.