黄连体外改善胰岛素抵抗活性与HPLC指纹图谱的相关性研究

目的：探索黄连体外改善胰岛素抵抗活性与HPLC指纹图谱的相关性。方法：采用RP—HPLC法建立不同产地的黄连样品的指纹图谱，采用主成分分析法进行化学模式识别研究，并采用体外测定药物改善脂肪细胞胰岛素抵抗生物活性，对化学信息和生物效应进行灰色关联分析和多元相关分析，以探索两者的相关性。结果：不同产地黄连药材化学成分含量及生物效应的有一定的差异。HPLC指纹图谱各共有峰中色谱峰10、6、3、7和巴马汀与改善胰岛素抵抗活性相关性较强。结论：基本明确了化学指纹图谱与改善胰岛素抵抗生物效应的相关性，有利于黄连改善胰岛素抵抗活性成分的筛选。     

Uncooked rice of relatively low gelatinization degree resulted in lower metabolic glucose and insulin responses compared with cooked rice in female college students

Cooking processes that gelatinize granules or disrupt structure might increase the glucose and insulin responses because a disruption of the structure of starch by gelatinization increases its availability for digestion and absorption in the small intestine. We hypothesized that the uncooked form of rice, which has a relatively low degree of gelatinization even though in powder form, would result in lower metabolic glucose and insulin responses compared with cooked rice (CR). To assess the effects of the gelatinization of rice on metabolic response of glucose and insulin, we investigated the glucose and insulin responses to 3 rice meals of different gelatinization degree in female college students (n = 12): CR (76.9% gelatinized), uncooked rice powder (UP; 3.5% gelatinized), and uncooked freeze-dried rice powder (UFP; 5.4% gelatinized). Uncooked rice powders (UP and UFP) induced lower glucose and insulin responses compared with CR. The relatively low gelatinization degree of UPs resulted in low metabolic responses in terms of the glycemic index (CR: 72.4% vs UP: 49.7%, UFP: 59.8%) and insulin index (CR: 94.8% vs UP: 74.4%, UFP: 68.0%). In summary, UPs that were less gelatinized than CR induced low postprandial glucose and insulin responses.     

Increased glucose excursion in cystic fibrosis and its association with a worse clinical status

BACKGROUND: Abnormal glucose tolerance is a frequent co-morbidity in cystic fibrosis patients (CF), and is associated with a worse prognosis. The objectives are to investigate (a) the relative contribution of insulinopenia and insulin resistance (IR) for glucose tolerance and (b) the association between various glucose parameters and CF clinical status. METHODS: Oral glucose tolerance tests were performed in 114 consecutive CF patients not known to be diabetic as well as 14 controls similar for age and BMI. RESULTS: Abnormal glucose tolerance was found in 40% of patients with CF: 28% had impaired glucose tolerance (IGT) and 12% had new cystic fibrosis related diabetes (CFRD). Compared to control subjects, all CF patients were characterized by an increased glucose excursion (AUC). While reduced early insulin release characterised CF, IGT and CFRD patients also present IR thus both mechanisms significantly contribute to glucose tolerance abnormalities. Increased glucose AUC and reduced early insulin release but not glucose tolerance categories were associated with a reduced pulmonary function (FEV(1)). CONCLUSION: In CF, early insulin secretion defect but also IR contribute to glucose intolerance. Early in the course of the disease, increased glucose AUC and reduced early insulin secretion are more closely associated with a worse clinical status than conventional glucose tolerance categories.     

含胰岛素的全营养混合液对患者血糖的影响

目的:观察全营养混合液中加入胰岛素进行肠外营养对患者血糖水平的影响。方法:将进行肠外营养的患者随机分成两组,治疗组50例次,在全营养混合液中加入胰岛素进行肠外营养。对照组50例次,全营养混合液中不加入胰岛素。观察营养液输注前10min、输注后1h及10h两组各时段血糖值。结果:营养液输注前10min,治疗组血糖值为(5.41±1.07)mmol/L,对照组血糖值为(5.84±1.21)mmol/L,差异无显著性意义(μ=1.88,P>0.05)。营养液输注1h后,治疗组血糖值为(6.79±1.42)mmol/L,对照组血糖值为(7.84±1.65)mmol/L,差异有显著性意义(μ=3.41,P<0.01)。营养液输注10h后,治疗组血糖值为(6.68±1.05)mmol/L,对照组血糖值为(8.01±1.34)mmol/L,差异有显著性意义(μ=5.52,P<0.01)。结论:将胰岛素直接加入全营养混合液中输注,能有效地控制患者的血糖水平。     

二甲双胍在多囊卵巢综合征的作用

生殖及代谢异常是多囊卵巢综合征(PCOS)的特征性表现。已证实高胰岛素血症及胰岛素抵抗,导致血中雄激素水平过高,是PCOS的重要发病机制。二甲双胍(metformin)称为胰岛素增敏剂,用于治疗PCOS后,可减轻高雄激素血症,使月经周期规律,改善卵巢对诱导排卵的反应,提高妊娠率,降低早孕流产率,且能减低发展为II型糖尿病及心血管疾病的危险性。本文就国外近年有关metformin运用于PCOS的进展作一综述。     

糖尿病患者甘油三酯/高密度脂蛋白胆固醇比值水平与胰岛素抵抗的关系

目的探讨血清甘油三酯/高密度脂蛋白胆固醇(TG/HDL-C)比值水平与胰岛素抵抗的关系。方法对146例2型糖尿病患者测定空腹胰岛素(FINS)、空腹血糖(FBG),TG,HDL-C,低密度脂蛋白胆固醇(LDL-C)水平,计算TG/HDL-C比值,并按TG/HDL-C和FBG水平分组,比较组间差异与胰岛素抵抗指数(HOMA-IR)的关系。结果糖尿病组TG/HDL-C比值水平(2.531±3.741)显著高于正常对照组(0.898±0.487),差异有显著性(t=4.279,P<0.001)。TG/HDL-C比值增高组HOMA-IR(3.291±2.004)明显高于TG/HDL-C比值正常组(2.403±1.789),差异有显著性(t=2.796,P<0.01)。血糖水平>10 mmol/L组HOMA-IR(3.575±2.216)明显大于血糖水平≤10mmol/L组(2.384±1.584),差异有显著性(t=3.760,P<0.001)。结论糖尿病患者TG/HDL-C比值水平与胰岛素抵抗存在着密切的相关性。     

耐药对肺结核病治疗效果的影响

目的 评价耐药对地区肺结核病治疗效果的影响.方法 对上海地区2004年2月-9月新登记敏感及耐药肺结核病人1年治疗转归进行分析和比较.结果 在全市各区（县）结核病定点医院新登记1 597例肺结核病病人中,805例培养阳性,其中731例经菌型鉴定为结核分枝杆菌的病人纳入分析.731例病人的总耐药率为18.7%,耐多药率为6.7%.敏感组治疗成功率达到93.0%,非MDR的耐药病人治疗成功率达到85%以上,MDR组治疗成功率为71.4%.经x2检验,差别有统计学意义（x2=83.996 8,P＜0.01）.在68例治疗不成功的病人中,耐药病人占38.2%;而在30例治疗失败的病人中,耐药病人占60%.复治敏感病人的治疗成功率（92.0%）与初治敏感病人（93.1%）相当,但是复治耐药病人的治疗成功率远低于初治耐药病人.结论 （1）上海地区肺结核病病人治疗管理效果良好;（2）耐药是肺结核病治疗失败的重要因素,应加强和改进对耐药结核病的治疗措施;（3）耐药和敏感病人治疗效果存在较大差异,应分别评价.     

烧伤病人耐甲氧西林金黄色葡萄球菌及其肠毒素的检测和耐药性分析

目的:评价乳胶结合实验,检测重症监护病房(ICU)耐甲氧西林金黄色葡萄球菌(MRSA)及其肠毒素(SE),并进行耐药性分析。方法:收集260株金黄色葡萄球菌临床分离株,通过药敏试验将其分为耐甲氧西林金黄色葡萄球菌和甲氧西林敏感金黄色葡萄球菌(MSSA),用反向间接血凝试验(RPHA)检测金黄色葡萄球菌肠毒素。结果:MRSA产肠毒素为134株,MSSA产肠毒素为38株,MRSA产肠毒素率为100％,MSSA产肠毒素率为30％。结论:重症监护病房应重视MRSA的检测和金黄色葡萄球菌肠毒素的检测,合理使用广谱抗菌药物。     

Nutritional-inflammation status and resistance to erythropoietin therapy in haemodialysis patients.

BACKGROUND: Chronic kidney disease patients who are resistant to erythropoietin (EPO) treatment may suffer from malnutrition and/or inflammation. METHODS: In a cross-sectional study of haemodialysis patients, we investigated the relationship between the natural logarithm of the weekly EPO dose normalized for post-dialysis body weight and outcome measures of nutrition and/or inflammation [BMI, albumin and C reactive protein (CRP)] by means of multiple linear regression analysis. On the basis of the decile distribution of weekly EPO doses, we also evaluated four groups of patients: untreated, hyper-responders, normo-responders and hypo-responders. RESULTS: Six hundred and seventy-seven adult haemodialysis patients were recruited from five Italian centres. BMI and albumin were lower in the hypo-responders than in the other groups (21.3+/-3.8 vs 24.4+/-4.7 kg/m(2), P<0.001; and 3.8+/-0.6 vs 4.1+/-0.4 g/dl, P<0.001), whereas the median CRP level was higher (1.9 vs 0.8 mg/dl, P = 0.004). The median weekly EPO dose ranged from 30 IU/kg/week in the hyper-responsive group to 263 IU/kg/week in the hypo-responsive group. Transferrin saturation linearly decreased from the hyper- to hypo-responsive group (37+/-15 to 25+/-10%, P = 0.003), without any differences in transferrin levels. Ferritin levels were lower in the hypo-responsive than in the other patients (median 318 vs 445 ng/ml, P = 0.01). At multiple linear regression analysis, haemoglobin, BMI, albumin, CRP and serum iron levels were independently associated with the natural logarithm of the weekly EPO dose (R(2) = 0.22). CONCLUSIONS: Our findings support a clear association between EPO responsiveness and nutritional and inflammation variables in haemodialysis patients; iron deficiency is still a major cause of hypo-responsiveness.