胰岛素泵联合个性化饮食方案治疗妊娠期糖尿病对母婴结局的影响

目的探讨胰岛素泵联合个性化饮食方案治疗妊娠期糖尿病(GDM)对母婴结局的影响。方法收集该院2012年1月-2014年7月收治的GDM患者220例,随机分为试验组和对照组各110例。对所有患者进行常规治疗和护理,并使用胰岛素泵进行治疗,试验组患者在此基础上联合个性化饮食治疗,治疗后密切随访观察,比较2组患者血糖水平及不良分娩结局发生情况。结果治疗后试验组孕妇空腹血糖和餐后2h血糖水平控制更好,低于对照组,血糖控制时间短于对照组,酮症酸中毒和妊娠高血压综合征的发生率均低于对照组,试验组妊娠孕周长于对照组,胎盘早剥、巨大儿的发生率低于对照组,围生儿出生体质量低于对照组,差异均有统计学意义(P<0.05)。结论GDM患者在治疗时使用胰岛素泵联合个性化饮食的方法,可更有效地控制血糖,并减少不良结局的发生,具有良好的应用价值。     

饮食干预联合运动指导对妊娠期糖尿病患者血糖水平的影响

目的 分析饮食干预联合运动指导在妊娠期糖尿病孕妇中应用对血糖水平的影响。方法 选取本院产科在2021年1月至2022年8月收治的妊娠期糖尿病孕妇134例为研究对象,以随机数表法分为对照组和试验组,对照组给予健康宣教、自我调整饮食、运动和自我血糖监测等常规干预,试验组在此基础上定期来医院给予专业的饮食干预和运动指导,两组孕妇均随访到分娩,记录两组的血糖水平、母儿结局等。结果 干预后,试验组的空腹血糖、餐后2 h血糖和糖化血红蛋白水平均低于对照组（P <0.05）;试验组的科学饮食、适度运动比例明显高于对照组（P <0.05）;试验组的孕妇并发症发生率和新生儿并发症发生率均低于对照组（P <0.05）。结论 饮食干预和运动指导在妊娠期糖尿病患者中应用有利于促进血糖水平的控制,提高患者的遵医行为,改善母儿结局。     

胰岛素泵联合个性化饮食方案治疗妊娠糖尿病的疗效观察

目的：探讨胰岛素泵联合个性化饮食方案治疗妊娠并糖尿病的疗效。方法将220例妊娠并糖尿病患者随机分为研究组及对照组各110例。对照组给予胰岛素泵治疗,研究组给予胰岛素泵联合个性化饮食治疗方案。比较2组患者的血糖水平、血糖达标时间、胰岛素用量及妊娠结局等指标。结果2组患者治疗后的FBG、2hBG水平均低于治疗前,且研究组低于对照组,差异均有统计学意义（P＜0．05）。研究组血糖达标时间短于对照组,胰岛素用量均低于对照组,差异均有统计学意义（P＜0．05）。研究组孕产妇及围生儿病死率低于对照组,但差异无统计学意义（ P＞0．05）。结论胰岛素泵联合个性化饮食方案治疗妊娠糖尿病,可有效控制患者的血糖水平,缩短血糖达标时间,并减少了胰岛素的使用量,增加了母婴安全性,具有重要临床意义。     

药物联合饮食控制方案介导血清CRP、Mg2+及脂联素水平治疗妊娠期糖尿病对母婴结局的影响

目的探讨不同治疗方案介导血清C反应蛋白(CRP)、镁离子(Mg2+)及脂联素水平治疗妊娠期糖尿病对母婴结局的影响差异。方法收集2012年1月-2014年5月来我院就诊的妊娠期糖尿病孕妇224例,随机分为试验组和对照组各112例。2组患者均采取适宜的饮食控制和运动疗法,试验组于妊娠30周内行胰岛素皮下注射血糖控制治疗,对照组于妊娠30周后行胰岛素皮下注射血糖控制治疗。2组患者持续血糖控制治疗直至分娩,分别检测2组患者治疗后血清CRP、Mg2+及脂联素水平,观察2组母婴结局。结果治疗后2组患者血清CRP水平较治疗前下降,而Mg2+和脂联素水平升高,且试验组变化幅度大于对照组;试验组孕妇和新生儿并发症发生率均低于对照组,差异均有统计学意义(P<0.05)。结论早期胰岛素皮下注射治疗妊娠期糖尿病可显著降低CRP、升高Mg2+和脂联素水平,并改善母婴结局。     

妊娠期糖尿病孕妇控制血糖对母婴预后的影响

目的 探讨控制血糖对妊娠期糖尿病孕妇母婴并发症和预后的意义.方法 根据血糖控制情况将120例妊娠期糖尿病孕妇分成血糖控制理想组(A组,86例)与血糖控制不理想组(B组,34例),另外收集正常孕妇50例作为正常对照组,观察并比较母婴并发症和孕妇预后方面的差异.结果 A组中只有妊娠高血压发生率明显高于正常对照组孕妇(x2=5.920,P＜0.05),而B组中妊娠期高血压、羊水过多、巨大儿、早产及新生儿窒息的发生率均明显高于A组(均P＜0.05).结论 应当重视孕妇血糖的筛查,尤其对妊娠期糖尿病孕妇要进行早期诊断和早期治疗,理想控制血糖对减少母婴并发症和改善预后具有重要意义.     

维生素D对妊娠期糖尿病孕妇的血糖控制及胰岛功能的影响分析

目的探讨维生素D对妊娠期糖尿病孕妇的血糖控制及胰岛功能的影响。方法选取2018年3月至2019年3月来我院产检的妊娠期糖尿病(GDM)孕妇100例,分为实验组和对照组,两组孕妇均给予饮食运动指导、健康教育等常规治疗措施干预,对照组每日三餐前皮下注射门冬胰岛素;实验组在对照组的基础上,给予维生素D滴剂口服,比较两组的临床治疗效果、胰岛功能的变化及母婴结局。结果与对照组相比,实验组FPG、2h PG、Hb A1c水平均明显下降;HOMA-β、IAI明显提高,HOMA-IR明显下降。实验组母婴并发症发病率13例,占12%,对照组并发症13例,占26%。结论维生素D联合门冬胰岛素治疗妊娠期糖尿病,可改善孕妇胰岛素抵抗状态,能较好的控制血糖及防止低血糖的发生,减少母婴并发症,值得临床应用研究。     

胰岛素泵联合个性化饮食护理用于妊娠糖尿病患者治疗的效果观察

目的观察胰岛素泵联合个性化饮食护理用于妊娠糖尿病患者的治疗效果。方法选取2018年2月-2019年1月江西省妇幼保健院收治的妊娠糖尿病患者102例,采用随机数字表法分为观察组和对照组,各51例。2组患者均接受胰岛素泵治疗,在此基础上对照组予常规饮食指导,观察组则采取个性化饮食方案。比较2组患者干预前后血糖相关指标(空腹血糖、餐后2 h血糖、糖化血红蛋白)水平变化、血糖达标时间、胰岛素用量、剖宫产率、并发症发生率及新生儿不良结局发生情况。结果干预后2组空腹血糖、餐后2 h血糖与糖化血红蛋白水平均有所降低,其中观察组干预后上述指标较对照组更低(P<0.01);观察组患者血糖达标时间以及胰岛素用量均少于对照组(P<0.01);观察组剖宫产率与并发症总发生率分别为49.02%和3.92%,低于对照组的78.43%和17.65%(P<0.01或P<0.05);观察组新生儿不良结局总发生率为1.96%,低于对照组的15.69%(χ²=4.387,P=0.036)。结论胰岛素泵联合个性化饮食护理治疗妊娠糖尿病临床效果理想,患者血糖恢复迅速,胰岛素用量更少,更降低了患者剖宫产率、并发症发生率与不良妊娠结局发生风险,值得临床推广应用。     

规范化生活管理对妊娠期糖尿病孕妇血糖水平及妊娠结局的影响分析

目的 观察规范化生活管理对妊娠期糖尿病孕妇血糖水平及妊娠结局的影响。方法 选取2017年1月～2018年11月在我院产科收治的妊娠期糖尿病孕妇300例,随机分为对照组150例和研究组150例。对照组采用常规护理及治疗方案,研究组在对照组基础上辅以规范化生活管理,针对性干预血糖方法护理及治疗妊娠期糖尿病孕妇,并比较两组孕妇血糖控制水平及母婴妊娠结局的影响。结果 研究组患者的空腹血糖、餐后2h血糖、夜间血糖均低于对照组,尿酮指标优于对照组。研究组孕妇妊娠不良结局发生率明显少于对照组孕妇,研究组新生儿并发症发生情况明显少于对照组,组间数据比较差异有统计学意义(P 0.05)。结论 对妊娠期糖尿病孕妇,临床应用规落化生活管理,科学、专业、针对性的控制血糖,不仅可以有效控制血糖水平,还可以减少孕妇妊娠不良结局发生率及新生儿并发症发生率,保障新生儿健康发育,对妊娠期糖尿病孕妇妊娠结局有积极重要的作用。     

妊娠期糖尿病孕妇门诊定期血糖监测的指导

目的探讨妊娠期糖尿病孕妇门诊定期血糖监测的指导方法和措施。方法将60例妊娠期糖尿病孕妇随机分成对照组与观察组各30例,对照组未进行定期门诊血糖监测,观察组给予定期门诊血糖监测来控制血糖,观察两组孕妇分娩期及新生儿并发症的发生率。结果 60例妊娠期糖尿病孕妇在门诊检查期间根据孕期时间护理规律完成门诊产前检查,接受血糖监测,血糖值控制至孕末期(7.8~8.0mmol/L),未使用胰岛素治疗。与对照组比较,观察组发生妊娠期高血压、胎膜早破、早产、胎儿窘迫、巨大儿、剖宫产的发生率明显低于对照组,两组发生率差异有统计学意义(P<0.05)。结论通过定期门诊监测指导,使产妇更好的恢复健康,降低母婴并发症的发生。     

维生素D联用胰岛素对妊娠期糖尿病孕妇血糖代谢、炎症因子及母婴结局的影响

目的 探讨对妊娠期糖尿病孕妇在胰岛素治疗基础上联用维生素D干预对改善血糖代谢、炎症因子水平以及母婴结局的影响。方法 选择我院2019年1月至2020年6月收治妊娠期糖尿病孕妇90例为研究对象,按照随机数字表法分为常规胰岛素治疗对照组(n=45)与联合使用维生素D治疗试验组(n=45),治疗1个月后评价治疗前后血糖代谢指标(空腹血糖、糖化血红蛋白)与炎症因子[C反应蛋白(CRP)与肿瘤坏死因子(TNF)-α]水平,并比较两组母婴结局。结果 治疗两组空腹血糖、糖化血红蛋白水平均明显降低,试验组水平低于对照组,差异均有统计学意义(P 0.05)。两组治疗后CRP、TNF-α水平均明显降低,试验组水平低于对照组,差异均有统计学意义(P 0.05)。试验组不良母婴结局中母亲发生率、新生儿发生率分别为15.56%、2.22%,均低于对照组,差异有统计学意义(P 0.05)。结论 对妊娠期糖尿病孕妇采用维生素D联合胰岛素治疗效果理想,有利于改善患者血糖代谢,可减轻机体炎症反应,有利于改善母婴结局。     

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.     

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.     

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.