胰岛素强化治疗在2型糖尿病骨折患者围手术期的应用

Objective To investigate the best way to control the blood sugar level during the perioperation of bone fracture patients with type 2 diabetes(T2DM).Methods Bone fracture patients with T2DM were randomly divided into three groups:continuous subcutaneous insulin infusion group(insulin aspart,group CSII,n=20),glargine treatment group(insulin aspart+insulin glargine,group GA,n=20),and NPH treatment(insulin aspart+rh-insulin,group NA,n=20).The levels of fasting plasma glucose(FPG)and the 2 hours postprandial glucose(2h PG),blood glucose fluctuation(BGF),insulin dosage(ID),good effective time(GET),incidence of hypoglycemia,dawn phenomenon and infection,average time of stitches removal(ATSR),average hospitalized length(AHL)of three groups were compared.Results FPG and 2hPG,ID in group CSII[(6.32±1.18)mmol/L,(7.72±1.53)mmol/L,(35.40±1.60)IU]and group GA [(6.25±0.88)mmol/L,(7.32±1.17)mmol/L,(36.20±0.80)IU]were significantly lower than those of group NA [(7.44±1.36)mmol/L,(8.52±0.76)mmol/L,(40.50±2.40)IU,all P<0.05],simulaneously,BGF,GET incidence of complications,ATSR,AHL of group CSII and GA were significantly lower than those of group NA(all P<0.05).There were not significant difference between group CSII and group GA.Compared with group CSII,group GA had less costs in-hospital and better practicability.Conclusion Both CSII and insulin glargine combined with insulin aspart can effectively,safely,rapidly and stablely control hyperglycemia.and might be the first choice to control blood sugar for bone fracture patients with T2DM in perioperation.     

戒烟与生活习惯病的预防

人类生活习惯、方式与行为对疾病、健康、寿命影响很大。吸烟、酗酒、饮食无度、好逸恶劳、起居无节等不良生活习惯、生活方式及行为是一种”自我危险”。众所周知 ,吸烟严重影响健康。公元前 ,印第安人以吸烟来作为对太阳崇拜会议仪式上的应用 ,而今 ,被世界卫生组织 (ＷＨＯ)     

口服降糖药与胰岛素联合应用

2型糖尿病是一种临床常见的内分泌代谢疾病,随着病程的逐步进展,可出现胰岛B细胞功能的减退及胰岛素抵抗的加重,继而导致多系统、多脏器的进行性损害。2型糖尿病的传统治疗模式,包括英国糖尿病前瞻性研究(UKPDS),即合理控制饮食、适当运动、口服降糖药等,当口服降糖药失效时,使用胰岛素治疗的阶梯模式。临床试验证明,这种传统治疗模式并不能阻止胰岛B细胞功能的减退。口服降糖药与胰岛素联合应用能有效控制血糖,缩短血糖达标时间,减少低血糖以及其他副作用的发生,并且可以节省胰岛素及口服降糖药的用量。合理的联合应用还可以显著地减轻…     

胰岛素强化治疗在2型糖尿病骨折患者围手术期的应用

Objective To investigate the best way to control the blood sugar level during the perioperation of bone fracture patients with type 2 diabetes(T2DM).Methods Bone fracture patients with T2DM were randomly divided into three groups:continuous subcutaneous insulin infusion group(insulin aspart,group CSII,n=20),glargine treatment group(insulin aspart+insulin glargine,group GA,n=20),and NPH treatment(insulin aspart+rh-insulin,group NA,n=20).The levels of fasting plasma glucose(FPG)and the 2 hours postprandial glucose(2h PG),blood glucose fluctuation(BGF),insulin dosage(ID),good effective time(GET),incidence of hypoglycemia,dawn phenomenon and infection,average time of stitches removal(ATSR),average hospitalized length(AHL)of three groups were compared.Results FPG and 2hPG,ID in group CSII[(6.32±1.18)mmol/L,(7.72±1.53)mmol/L,(35.40±1.60)IU]and group GA [(6.25±0.88)mmol/L,(7.32±1.17)mmol/L,(36.20±0.80)IU]were significantly lower than those of group NA [(7.44±1.36)mmol/L,(8.52±0.76)mmol/L,(40.50±2.40)IU,all P<0.05],simulaneously,BGF,GET incidence of complications,ATSR,AHL of group CSII and GA were significantly lower than those of group NA(all P<0.05).There were not significant difference between group CSII and group GA.Compared with group CSII,group GA had less costs in-hospital and better practicability.Conclusion Both CSII and insulin glargine combined with insulin aspart can effectively,safely,rapidly and stablely control hyperglycemia.and might be the first choice to control blood sugar for bone fracture patients with T2DM in perioperation.     

实验性糖尿病小鼠心肌血管紧张素Ⅱ的变化及依那普利对其影响

目的探讨实验性糖尿病小鼠心肌超微的变化及依那普利对其影响。方法雄性昆明种小鼠40只，随机分为正常组、糖尿病组、盐酸二甲双胍治疗组、盐酸二甲双胍加依那普利治疗组。实验性糖尿病鼠用链脲佐菌素(STZ)诱发糖尿病，4周后观察血管紧张素Ⅱ的变化及依那普利对其影响。结果STZ诱导的糖尿病鼠早期心肌血管紧张素Ⅱ(AngⅡ)增多。盐酸二甲双胍治疗组AngⅡ明显降低，加用依那普利治疗纽的AngⅡ进一步降低。结论依那普利对STZ-DM鼠心肌具有良好的保护作用，其保护心功能作用部分是通过调节心肌肾素-血管紧张素系统(RAS)来实现的。     

胰岛素泵强化治疗对糖尿病酮症酸中毒疗效的影响

目的:探讨胰岛素泵强化治疗对血糖、血脂控制及其在延缓并发症方面的作用。方法:把糖尿病酮症酸中毒患者分成常规胰岛素多次注射组和胰岛素泵连续注射组,比较两种不同给药方法在血糖、血脂控制、平均治愈天数、胰岛素用量、低血糖发生率上的差异及对糖化血红蛋白、C-肽的影响。结果:胰岛素泵治疗可以有效地控制血糖、调节血脂、改善胰岛功能。结论:胰岛素泵强化治疗更有效地控制血糖,长期使用可以延缓并发症的发生,是一种行之有效的胰岛素强化治疗方式。     

高钙血症

高钙血症延边医学院附属医院内科裴海成，桂成淑大连医科大学附一院内科李昌臣概念机体内血清Ｃａ浓度大约在８．９～１０．１ｍｇ／ｄｌ（４．４５～５．０５ｍｍｏｌ／Ｌ）的狭窄范围内维持，其中４６％与白蛋白以结合型存在，４７．５％以离子型存在，起着维持细胞功能...     

肾综合征出血热少尿期病人血糖、血淀粉酶及血浆胰岛素含量的检测

应用全自动生化分析仪检测了３１例流行性出血热少尿期病人空腹血糖及血淀粉酶，并采用放射免疫分析法检测了血浆胰岛素含量．结果表明，此类病人的平均空腹血糖值为２．９４ｍｍｏｌ／Ｌ，明显低于正常值下限（３．８９ｍｍｏｌ／Ｌ）；血淀粉酶及胰岛素的平均含量分别为６３４．１６Ｕ和４６．３０ｍＵ／Ｌ，明显高于正常值上限（血淀粉酶为２２０Ｕ，血浆胰岛素为２２ｍＵ／Ｌ）．     

慢性乙型肝炎的疫苗治疗免疫学机制的探讨

通过对乙型肝炎疫苗治疗的13例患者的观察,分析乙型肝炎表面抗原特异细胞增殖反应及其抗原特异性T细胞分泌的细胞因子水平,以及观察疫苗治疗后的临床效果,探讨肝炎疫苗治疗慢性乙型肝炎的免疫学作用机制。血清HBVDNA水平在疫苗治疗结束后6个月显著地下降。疫苗治疗诱生6例抗原特异性CD4 T细胞的增殖反应(38 5 % ) ,同时分泌高水平的干扰素-γ和肿瘤坏死因子-α。血清HBVDNA水平在疫苗治疗结束6个月和18个月显著下降。表面抗原特异性CD4 T细胞可以间接地抑制HBV的复制,是由抗病毒细胞因子来介导