去胰高血糖素样肽1受体激动剂成为2型糖尿病治疗新热点

1．传统2型糖尿病治疗观念面临严峻挑战 糖尿病（Diabetes mellitus,DM）是一组病因和发病机理尚未完全明确的内分泌-代谢综合征,其特点是慢性高血糖,伴随因胰岛素（Insulin）分泌及／或作用缺陷所引起的糖、脂肪和蛋白质代谢紊乱。糖尿病可分为4型：胰岛素依赖型糖尿病（1型糖尿病,IDDM）、非胰岛素依赖型糖尿病（2型糖尿病,NIDDM）、其他类型糖尿病、妊娠期糖尿病。主要分为1型和2型,后者占患者群体的90％以上。目前,     

代谢综合征与2型糖尿病慢性并发症的相关性分析

目的探讨分析代谢综合征与2型糖尿病慢性并发症的相关性。方法选取我院2012年1月至2012年12月间收治的240例2型糖尿病患者的临床资料,统计分析代谢综合征与2型糖尿病慢性并发症的发病率,根据是否合并代谢综合征,分析2型糖尿病慢性并发症的发病率。结果 240例2型糖尿病患者中,181例(75.42%)合并代谢综合征,男性患者68例(68%),女性113例(80.71%),P<0.05具有显著性差异,有统计学意义。合并代谢综合征的2型糖尿病患者的糖尿病肾病和大血管并发症的发病率明显高于不合并代谢综合征的2型糖尿病患者的发病率,P<0.05具有显著性差异,有统计学意义。结论代谢综合征与2型糖尿病慢性并发症存在相关性,合并代谢综合征的2型糖尿病患者的糖尿病肾病和大血管并发症的发病率较高。     

2型糖尿病合并消化性溃疡的临床分析

<正>糖尿病是常见的代谢性疾病,根据发病机制的不同可分为1型糖尿病和2型糖尿病,2型糖尿病的发病机制是胰岛素抵抗,通常患者体内胰岛素浓度较低,患者代谢系统发生紊乱,可以影响胃酸的分泌和胃黏膜的血液循环,进而导致消化性溃疡并发症的发生[1,2]。临床表现方面2型糖尿病合并消化性溃疡与单纯性消化性溃疡相似,都会出现胃痛、恶心、食欲下降等症状,缺乏一定的特异性[3]。正确认识和诊断2型     

2型糖尿病与骨质疏松相关性的临床观察

骨质疏松症是一种以低骨量和骨组织微结构破坏为特征，导致骨脆性增加和易于骨折的代谢性疾病。糖尿病是一种常见的全身代谢性疾病，常合并钙、镁、磷代谢紊乱。目前1型糖尿病患者较正常人骨质疏松发病率较高的结论较为肯定，而2型糖尿病是否促进骨质疏松目前尚无定论，选取2005-2007年在院糖尿病患者和门诊非糖尿病老年人，测定其骨密度（BMD）、     

糖尿病合并代谢综合征患者血浆脂联素变化及肾素血管紧张素系统对其影响

目的:观察2型糖尿病合并代谢综合征患者血浆内脂素、脂联素水平的变化及肾素血管紧张素系统对其影响.方法:选择合并代谢综合征的2型糖尿病患者44例,无代谢综合征等合并症的单纯2型糖尿病患者30例,30例为正常对照组,脂联素及血管紧张素Ⅱ的水平,观察奎那普利治疗后2型糖尿病合并代谢综合征患者血浆脂联素及血管紧张素Ⅱ的变化.结...     

2型糖尿病患者骨密度与血清C肽水平的相关性研究

目的 研究2型糖尿病患者骨密度及骨代谢指标与血清C肽水平的关系.方法 收集我院就诊的2型糖尿病患者127例,对照组为105例非糖尿病正常人群.双能X线骨密度仪测定腰椎(L2～4)及左股骨颈骨密度;ELISA法检测骨钙素(BGP)及1型胶原胶联蛋白羧基肽(CTX-I);放射免疫法检测空腹及餐后2 hC肽水平.结果两组间年龄差异无统计学意义(P>0.05).2型糖尿病组腰椎、左侧股骨颈BMD、空腹及餐后C肽水平均低于对照组(P<0.05),在骨代谢指标方面,2型糖尿病组CTX-1水平高于对照组,BGP水平低于对照组(P<0.05).2型糖尿病患者腰椎、股骨颈骨密度、血清BGP水平与空腹及餐后2 hC肽水平均呈正相关(P<0.05),CTX-1水平与空腹及餐后2 hC肽呈负相关(P<0.05).结论 2型糖尿病患者骨密度及骨代谢水平与空腹及餐后2 hC肽水平密切相关.     

2型糖尿病及合并代谢综合征危险因素患者尿8-异前列腺素F2α水平分析

目的观察2型糖尿病及合并代谢综合征危险因素患者中氧化应激指标尿8-异前列腺素F2α水平。方法选择60例2型糖尿病患者,根据是否有合并代谢综合征危险因素分为单纯2型糖尿病组22例和合并代谢综合征危险因素组38例,同时选取健康查体者作为正常对照组30例。用ELISA法检测3组尿8-异前列腺素F2α水平。结果与正常对照组相比,单纯2型糖尿病组及2型糖尿病合并代谢综合征危险因素组尿8-异前列腺素F2α水平显著升高,差异有统计学意义(P<0.01);与单纯2型糖尿病组相比,2型糖尿病合并代谢综合征危险因素组尿8-异前列腺素F2α水平明显提高,差异有统计学意义(P<0.05)。结论单纯2型糖尿病患者存在着氧化应激,2型糖尿病合并代谢综合征危险因素患者氧化应激水平增高,提示临床上使用抗氧化药物可预防其综合征的发生。     

品管圈活动在提高糖尿病患者生酮饮食知晓率的效果

糖尿病是一种以慢性高血糖为主要特点的代谢性疾病,可分为1型和2型.大量研究表明,遗传、环境和饮食因素的共同作用是引发糖尿病的主要原因[1].糖尿病患者由于胰岛素分泌和功能的紊乱,常导致碳水化合物、蛋白质、脂肪等与能量代谢相关的代谢物质的调节紊乱,并由此引发多器官的功能障碍[2].随着研究的深入,糖尿病的治疗方法越来越多...     

2型糖尿病患者与非2型糖尿病人群代谢综合征与ABI的相关性研究

目的：在2型糖尿病患者与非2型糖尿病人群中,明确代谢综合征(MetS)与踝臂指数(ABI)的相关性。方法356例患者,其中代谢综合征184例,无代谢综合征172例。计算各代谢综合征包含因素个数和各代谢综合征及糖尿病(DM)分组的ABI值。多元线性回归模型分析非糖尿病及糖尿病人群中,代谢综合征与ABI的相关性。结果随着代谢综合征包含因素个数的增加, ABI值呈现出下降的趋势(P=0.009);代谢综合征及糖尿病均为(-)的人群ABI最高,代谢综合征及糖尿病均为(+)的人群ABI最低,各分组的ABI值比较差异具有统计学意义(P=0.019)。在非糖尿病人群中,在经过年龄、性别、低密度脂蛋白及吸烟的校正后,代谢综合征并不与ABI显著相关(P=0.328)。在糖尿病人群中,在校正上述影响因素后,代谢综合征与ABI显著相关(P=0.011)。结论在糖尿病患者中,代谢综合征与ABI存在相关性,但在非2型糖尿病患者中,这种相关性并未存在。     

儿童1型糖尿病20例临床分析

通过分析20例儿童1型糖尿病患者的临床资料,探讨儿童1型糖尿病的诊断、治疗方法。糖尿病是由于胰岛素缺乏所造成的糖、脂肪、蛋白质代谢紊乱症,其治疗是综合性的,包括胰岛素治疗、饮食管理和身体的锻炼,增强身体的适应能力,还应加强精神心理的治疗。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Pharmacological treatment of COVID-19: an opinion paper

The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.