化浊祛毒健脾法治疗早期2型糖尿病对胰岛α/β细胞及氧化应激的影响

目的 通过观察化浊祛毒健脾法联合二甲双胍治疗早期2型糖尿病对胰岛α/β细胞及氧化应激的影响,进一步探究化浊祛毒法可能的降糖作用机制。方法 选取2020年1月—2021年6月163例早期2型糖尿病患者,随机分为两组,其中对照组81例,试验组82例。两组患者均予基础饮食及运动管理,合并有基础疾病分别给予相应治疗。对照组予二甲双胍,试验组予化浊祛毒健脾方联合二甲双胍治疗,观察疗程为48周。主要观察两组患者治疗前后临床疗效、血清胰高血糖素样肽-1(GLP-1)浓度、胰高血糖素（GC）浓度、空腹C肽（CP）水平、氧化应激指标超氧化物歧化酶（SOD）、空腹血糖（FPG）、餐后2 h血糖（2 h PBG）、糖化血红蛋白水平（HbAlc）指标变化。结果 治疗后,临床疗效方面,试验组总有效率为90.24%,高于对照组的74.07%,差异有统计学意义（P<0.05）;在糖代谢方面,试验组FPG、PBG、HbAlc水平明显低于对照组,差异有统计学意义（P<0.05）;试验组空腹C肽水平明显高于对照组,差异有统计学意义（P<0.05）;试验组GLP-1水平较对照组明显更高,差异有统计学意义（...     

胰高血糖素样肽-1类似物Exenatide的临床应用进展

胰高血糖素样肽-1（GLP-1）是由胰岛α细胞和肠黏膜L细胞分泌,具有促胰岛素分泌,抑制胰高血糖素分泌,延缓胃排空,降低体重等作用。而胰高血糖素样肽-1类似物（Exenatide,商品名Byetta）克服GLP-1T1/2短的缺点后,成功地在临床上应用了2年多,证明了作为磺脲类药物和二甲双胍等药物治疗不能达标的2型糖尿病患者的辅助用药,有助于改善患者长期空腹和餐后血糖及糖化血红蛋白的控制,还可减轻体重,给糖尿病治疗带来新契机。     

不同类型肥胖者血浆生长素、胰高血糖素样肽-1变化的研究

目的观察不同类型肥胖者生长素、胰高血糖素样肽-1水平的变化,探讨生长素、胰高血糖素样肽-1对肥胖者胃动力的影响。方法将肥胖者分为3组,即肥胖伴暴食症组、肥胖伴饮食正常组、肥胖伴消化不良（FD）组,采用酶联免疫法检测3组试验者及正常对照组餐前和餐后血浆生长素、胰高血糖素样肽-1水平。结果①肥胖组和对照组餐后生长素水平较餐前降低;无论是餐前还是餐后,肥胖组生长素水平均较对照组显著降低;肥胖伴暴食症组、肥胖伴饮食正常组、肥胖伴FD组3组之间Ghrelin水平无显著性差异。②对照组餐后GLP-1水平较餐前明显升高;肥胖组餐后GLP-1水平较餐前释放减少;无论是餐前还是餐后,肥胖组GLP-1水平均较对照组显著降低。结论胰高血糖素样肽-1在肥胖者胃动力紊乱中有一定的作用,生长素不是导致肥胖者胃动力异常的原因。     

葛根素联合二甲双胍对实验性高脂血症的降血脂效应

目的 探讨葛根素合用二甲双胍（P-M,2：1）对高脂血症大鼠和小鼠的降血脂作用.方法 高脂饲料喂养建立大鼠慢性高脂血症模型,分为正常组、高脂模型组、P-M合剂组（140mg/kg）、葛根素组（100mg/kg）、二甲双胍组（50mg/kg）,每组10只,灌胃给药21天,取血清测定TG、TC、HDL-C和LDL-C水平.尾静脉注射Triton WR-1339建立小鼠急性高脂血症模型,分为正常组、高脂模型组、P-M合剂组（200mg/kg）、葛根素组（140mg/kg）、二甲双胍组（70mg/kg）,每组10只,造模前3天开始灌胃给药,造模后24h取血清测定TG、TC、HDL-C和LDL-C水平.结果 P-M合剂能明显降低高脂血症大鼠血清TG、TC和LDL-C水平,与高脂模型组比较,差异均有统计学意义（P＜0.01）;葛根素组血清TC、LDL-C水平及二甲双胍组血清LDL-C水平与P-M合剂组比较,差异有统计学意义（P＜0.05）.与高脂血症小鼠模型组相比,P-M合剂组血清TG、TC、HDL-C和LDL-C水平均显著降低（P＜0.05或P＜0.01）;葛根素组血清HDL-C水平与P-M合剂组比较,差异有统计学意义（P＜0.05）.结论 葛根素合用二甲双胍有较好的降血脂作用.     

GLP-1对2型糖尿病患者心肌及血管舒张功能的影响

目的探讨胰高血糖素样肽-1(GLP-1)对2型糖尿病患者心肌及血管舒张功能的影响。方法选取96例2型糖尿病患者为研究对象,应用随机数字表法分成观察组(n=48)和对照组(n=48),其中观察组采用二甲双胍+GLP-1方案,对照组采用二甲双胍+胰岛素方案。比较治疗前后血脂指标[甘油三酯(TG)、总胆固醇(TC)]、心功能指标[左心室舒张末期内径(LVEDD)、左室射血分数(LVEF)]及肱动脉血管舒张率。结果治疗后,两组受试者TG、TC水平均较治疗前显著降低,且观察组优于对照组(P<0.05);两组LVEF水平及肱动脉血管舒张率较治疗前显著提高,且观察组优于对照组(P<0.05);两组LVEDD水平同治疗前比较,差异无统计学意义(P>0.05)。结论 GLP-1对2型糖尿病患者心血管系统具有一定保护作用,对预后恢复有利。     

石斛合剂调控老年糖尿病大鼠GLP-1的研究

[目的] 观察石斛合剂(DC)对老年糖尿病大鼠胰高血糖素样多肽-1(GLP-1)的影响,探讨石斛合剂治疗衰老糖尿病大鼠的作用机制。[方法] 老年Wistar雌性大鼠分为正常对照组、模型组、DC低剂量组、DC高剂量组、二甲双胍对照组,检测0.5、2.5 h血清GLP-1,免疫组化法检测小肠GLP-1.[结果] DC低剂量组0.5、2.5 h GLP-1的差值低于模型组(P<0.05),DC高剂量组差值显着高于模型组(P <0.01),小肠未发现GLP-1.[结论] 低剂量DC可能具有减缓GLP-1代谢的作用,高剂量DC可能具有促进0.5 h GLP-1分泌的作用。     

回药甘松丸子对糖尿病治疗作用的实验研究

目的 对〈回回药方〉记载的经典方剂甘松丸子进行降血糖作用的初步研究,为该方的临床应用提供科学依据.方法 50只正常小鼠、50只正常大鼠平均分成5组,采用葡萄糖转化酶法测定正常小鼠血糖,放射性免疫法测定正常大鼠胰岛素及胰高血糖素.结果 回药甘松丸子高中低剂量组均能降低正常小鼠血糖和胰高血糖素（P＜0.05）,对胰岛素无显著影响.结论 经典回药方剂甘松丸子对糖尿病有一定的治疗作用.     

开郁清胃颗粒对链脲佐菌素糖尿病大鼠胰腺组织Fas系统表达的影响

目的 观察开郁清胃颗粒对链脲佐菌素所致糖尿病大鼠胰腺组织Fas抗原和Fas配体的影响.方法 实验Wistar大鼠分成4组:正常组(生理盐水3 mL/只);模型组(生理盐水3 mL/只);中药治疗组(开郁清胃颗粒36 g/kg);二甲双胍治疗组(二甲双胍0.5 s/kg).各组分别给药1个月后,测定各组大鼠血糖、胰岛素和胰高血糖素水平,应用免疫组化方法观察胰腺Fas抗原和Fag配体的表达.结果 与正常组比:模型组、中药组和二甲双胍组的血糖和胰高血糖素水平均较正常组明显升高(P<0.05),三组间无明显差异(P>0.05);模型组的Fas抗原的表达增强,Fas配体呈微弱表达.治疗4周后,中药组和二甲双胍均可使血糖下降,减弱Fas抗原的表达,增强Fas配体的表达,且中药组减弱Fas抗原的表达更为明显.中药组和二甲双胍组对胰岛素和胰高血糖素含量均无明显影响(P>0.05).结论 开郁清胃颗粒可对胰腺组织起到保护作用.     

糖尿病患者胰高血糖素水平变化及其临床意义

观察了糖尿病患者空腹及馒头餐后血浆胰高血糖素水平的变化。结果表明，胰岛素依赖型糖尿病（ＩＤＤＭ）及非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者空腹胰高血糖素水平均显著高于正常人。ＮＩＤＤＭ患者馒头餐后胰高血糖素水平显著升高，且于各时相均显著高于正常人，胰岛素／胰高血糖素比值的升高幅度则显著低于正常人。提示，糖尿病患者存在胰岛Ａ细胞功能障碍。     

妊娠期糖尿病患者血清胰高血糖素样肽-1的临床分析

目的:探讨妊娠期糖尿病患者血清胰高血糖素样肽-1(GLP-1)的水平与其临床应用。方法:抽选妊娠期糖尿病患者70例为观察组,以同期体检的妊娠期糖耐量正常者70例为对照组,两组患者均给予血清胰高血糖素样肽-1检查。结果:观察组患者血糖、胰岛素抗性均高于对照组,差异无统计学意义(P<0.05)。观察组患者血清胰高血糖素样肽-1水平指标相较对照组差异有统计学意义(P<0.05)。使用逐步回归法分析GLP-1相关因素可见GLP-1与患者孕期体重、HOMA-IR呈负相关(P<0.05)。结论:妊娠期糖尿病患者与正常患者相比其GLP-1水平显著下降,与患者疾病发生有密切关系。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.