糖尿病调脂治疗的现状

糖尿病患者通常伴有特异性脂蛋白异常血症,心血管疾病(CVD)风险很高,所以迫切需要调脂治疗.本文从糖尿病患者脂蛋白异常的表现,分析糖尿病脂蛋白异常的致病作用,回顾他汀类药物用于糖尿病心血管疾病防治的循征依据,系统阐述糖尿病患者调脂治疗的必要性、治疗途径和目标.     

生活方式护理干预用于2型糖尿病患者的临床效果观察

目的 探讨生活方式护理干预用于2型糖尿病患者的临床效果,为糖尿病患者进行的更好护理提供参考.方法 120例2型糖尿病患者,随机分为观察组和对照组各60例.对照组患者给予常规护理,观察组患者给予生活方式护理干预,观察比较2组患者治疗后的日常自我护理能力、血糖控制情况和并发症发生率.结果 观察组日常自我护理能力和血糖控制情况明显优于对照组,且不良反应明显少于对照组,差异有统计学意义（P〈0.05）.结论 生活方式护理干预用于2型糖尿病患者具有良好的临床效果,而且安全可靠,值得在临床上推广应用.     

情景剧用于糖尿病患者健康教育中的效果研究

目的研究情景剧用于糖尿病患者健康教育中的临床效果,为临床治疗糖尿病提供参考。方法研究对象为2016年11月至2017年1月在我院内分泌科就诊的Ⅱ型糖尿病患者100例。本研究为自身对照研究。对糖尿病患者进行情景剧方式的健康教育,比较患者在情景剧的健康教育前和健康教育后对疾病自我管理能力、糖尿病相关知识的掌握程度以及糖化血红蛋白水平的变化。结果结果显示,情景剧用于糖尿病患者健康教育后患者的疾病自我管理能力、糖尿病相关知识的掌握情况较健康教育前明显改善,糖化血红蛋白水平也有明显的下降。结论情景剧用于糖尿病患者健康教育中使患者的疾病自我管理能力、糖尿病相关知识的掌握情况及糖化血红蛋白水平得到改善。即情景剧用于糖尿病患者健康教育中有利于患者遵医嘱改善疾病,是值得临床推广使用的。     

从糖尿病药物费用分析看糖尿病教育的重要性

糖尿病已成为当今严重威胁人类健康的疾病之一,随着糖尿病患者的增多,用于糖尿病方面的费用不断增长,给社会造成了巨大的经济负担,在糖尿病的研究过程中发现,对糖尿病患者进行教育.加强患者的自身管理.可以有效的减少糖尿病的治疗费用.现就我院1998年门、急诊处方进行分析,希望能对医疗机构减少糖尿病治疗的费用有所帮助.     

糖尿病周围神经病变筛查与诊断进展

糖尿病周围神经病变(DPN)是糖尿病慢性并发症之一,可导致糖尿病足、溃疡、感染和截肢的发生.研究显示,30％～ 50％的糖尿病患者合并有DPN[1].随着对DPN的日趋重视,一些新的诊断技术也不断涌现,本研究主要就DPN的筛查与诊断进展及治疗作一综述. 1 DPN的筛查及诊断 1.1 DPN的临床评分系统 1.1.1神经缺陷评分(NDS)系统 NDS系统用来评估神经病变的体征,是为一般神经病变设计,并非专门用于DPN.该方法主要根据双侧踝反射、大拇趾振动觉、温度觉、针刺觉评分,最高分为10分,能较好地预测糖尿病患者足溃疡及周围神经病变终点事件的发生情况.研究表明,评分≥6分者无症状足溃疡的发生风险增加[2],该评分可用于预测糖尿病患者足溃疡及周围神经病变终点事件的发生情况.     

那格列奈的药理特性与临床应用

糖尿病是一种以糖代谢紊乱为主要症状的内分泌系统疾病.1980年,世界卫生组织将糖尿病分为胰岛素依赖型糖尿病和非胰岛素依赖型糖尿病(Noninsulin-dependent diabetes mitus,NIDDM,又称2型糖尿病).目前,全球糖尿病患者超过1.2亿,其中90%为NIDDM.除胰岛素外,口服降血糖药也可用于NIDDM的治疗.在传统的口服药物中主要有磺酰脲类(如:甲苯磺丁脲)、双胍类(如:苯乙双胍)、α-葡萄糖苷酶抑制剂(如:阿卡波糖).随着对糖尿病发病机制与治疗的深入研究,目前已有不少新型的抗糖尿病药物用于临床,其中餐时血糖调节剂是20世纪90年代研究进展较快、最引人关注的药物之一.     

第3代口服降血糖药-阿卡波糖

第3代口服降血糖药-阿卡波糖,具有降低餐后高血糖和血浆胰岛素浓度的作用,可用于胰岛素依赖型或非胰岛素依赖型糖尿病.它的成功问世为上亿糖尿病患者带来了福音.本文参考已有文献对阿卡波糖做一评价,使广大糖尿病患者对此有一全面了解.     

参麦注射液治疗2型糖尿病体位性低血压疗效观察

糖尿病自主神经病变是糖尿病最常见的并发症之一,可广泛累及全身各系统,与糖尿病一些其他并发症密切相关.参麦注射液近年来临床广泛用于抗休克、抗心、脑、肝等重要脏器损伤,疗效可靠,屡有报道.我们试用其治疗2型糖尿病体性低血压39例患者,以探讨其疗效.     

认识新型口服降糖药

磺脲类和双胍类药物是10年前公认有效的口服降血糖药物,临床上主要用于经合理饮食及适当体力活动后空腹及餐后血糖仍不能满意控制的非胰岛素依赖型糖尿病(2型糖尿病)患者.     

文迪雅遭遇"心衰门"

对糖尿病患者而言,文遭雅这个名字应该不会陌生,因为它是目前用于治疗糖尿病最普遍的药物之一,国内仿制药品有"太罗"、"科能"、"爱能"、"圣敏"和"奥洛华"等.专家估计,至少有10%的口服降糖药的患者正在使用这种药物.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Trichinellosis in immigrants in Switzerland

We describe a case of trichinellosis diagnosed at the Division of Infectious Diseases, Hospital of Lugano, in January 2009. This case was associated with a cluster of cases and was traced to the consumption of contaminated meat after a wild boar hunt in Bosnia.