2型糖尿病患者并发肌少症影响因素分析

目的:探讨2型糖尿病患者发生肌少症的影响因素,为肌少症的防治提供参考依据。方法:选取2016年1月至2019年1月我院2型糖尿病肌少症患者30例为观察组,随机抽取同期30例2型糖尿病非肌少症住院患者为对照组,分析2型糖尿病患者发生肌少症的影响因素。结果:单因素方差分析结果表明,年龄、糖尿病病程、糖尿病肾病、运动、25羟基维生素D(25-OH-D)以及体重指数(BMI)与2型糖尿病患者发生肌少症相关(P<0.05),对该6项关联因素再进行条件logistic回归分析,统计结果显示,年龄、糖尿病病程、糖尿病肾病是2型糖尿病患者发生肌少症独立危险因素(P<0.05),运动、25-OH-D是2型糖尿病患者发生肌少症的保护因素(P<0.05)。结论:2型糖尿病患者发生肌少症的危险因素包括年龄(高龄)、糖尿病病程和肾脏病变;运动和25-OH-D是其保护因素。     

2型糖尿病患者并发周围血管病变的危险因素及与血清C肽水平的关系

目的:探讨2型糖尿病患者并发周围血管病变(DPVD)的危险因素及与血清C肽水平的关系。方法:收集2018年1月-2019年9月在本院住院的112例2型糖尿病患者的临床资料。按照血管彩超结果,将其分为病例组(合并DPVD)64例和对照组(未合并DPVD)48例。比较两组患者的临床资料,分析2型糖尿病患者并发DPVD的独立危险因素。结果:两组饮酒史、DBP、BUN、Cr比较,差异均无统计学意义(P0.05);两组的糖尿病病程、吸烟史、SBP、TC、TG、HDL、LDL-C、FBG、HbA1c、FCP、PBG、PCP比较,差异均有统计学意义(P0.05)。多因素logistic回归分析结果显示:糖尿病病程、TC、FBG、HbA1c是2型糖尿病患者并发DPVD的危险因素(P0.05);FCP是2型糖尿病患者并发DPVD的保护因素(P0.05)。结论:糖尿病病程长、胆固醇升高、血糖升高、HbA1c升高是2型糖尿病患者并发周围血管病变的独立危险因素;FCP对糖尿病患者周围血管病变具有保护作用。     

2型糖尿病合并脑梗塞老年患者的病变特点及危险因素分析

目的:针对2型糖尿病合并脑梗塞老年患者的病变特点进行案例分析,并对可能的相关危险因素进行梳理.方法:选取医院神经内科接诊并治疗的20例2型糖尿病合并脑梗塞老年患者作为观察组,探究2型糖尿病合并脑梗塞老年患者的病变特点和相关危险因素.HTH结果:2型糖尿病合并脑梗塞老年患者的病变类型多为腔隙性、再发性、出血性和混合性,其中观察组对比对照组1的发病率差异P<0.05,具有显著差异.结论:2型糖尿病合并脑梗塞老年患者的常见病变类型包括腔隙性、再发性、出血性和混合性,2型糖尿病合并脑梗塞老年患者面临的主要危险因素为甘油三酯和高血脂指数等.     

2型糖尿病合并非酒精性脂肪肝的临床特点及危险因素分析

目的探讨2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)的临床特点及其相关危险因素。方法随机抽取我院已建立健康档案的糖尿病患者200例,根据是否合并非酒精性脂肪肝分为两组,比较T2DM合并NAFLD(A组,n=114)与T2DM不合并NAFLD(B组,n=86)患者之间的临床特征,探讨影响NAFLD的危险因素。结果两组患者体重指数(BMI)、腰围(WC)、舒张压(DBP)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、血尿酸(UA)、血清丙氨酸转氨酶(ALT)、空腹血糖(FBG)水平比较差异有统计学意义(P<0.01或P<0.05);A组代谢综合征、肥胖症、脂代谢紊乱、冠心病、高血压病的发生率明显高于B组(P<0.01或P<0.05)。Logistic回归分析显示BMI、TG、UA对糖尿病合并NAFLD的发生有显著影响(均P<0.01)。结论 2型糖尿病合并NAFLD易发生于肥胖、血脂紊乱、胰岛素抵抗人群,2型糖尿病患者的BMI、TG、UA升高是并发非酒精性脂肪性肝病的危险因素。     

2型糖尿病患者合并糖尿病肾病的临床特征及相关危险因素分析

目的:分析2型糖尿病患者合并糖尿病肾病(DN)的临床特征及相关危险因素。方法:选取2017年1月-2019年10月在本院住院的2型糖尿病合并DN患者62例为病例组,选取同期未合并DN的2型糖尿病患者62例为对照组。比较两组患者的临床资料,对2型糖尿病患者合并DN的危险因素进行单因素及多因素logistic回归分析。结果:两组性别、年龄、SBP、DBP、TG、FBG、合并视网膜病变方面比较,差异均无统计学意义(P0.05);两组糖尿病病程、BMI、TC、LDL、HDL、HbA1c、FCP、BUN、Cr、UA、hs-CRP、HOMA-IR、合并周围血管病变、周围神经病变方面比较,差异均有统计学意义(P0.05)。多因素logistic回归分析结果显示:BMI、HbA1c、UA和HOMA-IR均是2型糖尿病患者合并DN的独立危险因素(P0.05)。结论:BMI、HbA1c、UA和HOMA-IR均是2型糖尿病患者合并DN的独立危险因素。加强对危险因素监测,积极采取预防措施,有利于降低DN的发病率。     

2型糖尿病肾病的危险因素分析

目的: 探讨2型糖尿病肾病发生的危险因素.方法: 根据24 h尿微量白蛋白(UAlb)定量检测结果,将120例2型糖尿病患者分为2型糖尿病(DM)组60例和2型糖尿病并发糖尿病肾病(DN)组60例,观察2组患者的年龄、病程、收缩压(SBP)、舒张压(DBP)、体质量指数、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、三酰甘油(TC)、总胆固醇(TG)等指标的差异,并采用多因素非条件logistic回归分析DN与各因素的相关性.结果: DN组患者的病程较DM组长(P< 0.01),年龄、SBP、DBP和FPG均高于DM组(P< 0.05～P< 0.01);logistic回归分析显示:病程、SBP、DBP、HbA1c、TG和TC均为DN发生的独立危险因素(P< 0.01).结论: 年龄、病程、高血糖、高血压及脂代谢紊乱是2型糖尿病肾病发生的危险因素.     

2型糖尿病患者并发糖尿病肾病的危险因素及Nomogram风险预测模型构建

目的：探讨2型糖尿病患者并发糖尿病肾病（DN）的危险因素,并构建Nomogram风险预测模型。方法：选取2020年5月至2022年12月首都医科大学附属北京友谊医院收治的2型糖尿病患者200例作为研究对象,根据是否并发DN,分为合并DN组（n=76）和未合并DN组（n=124）,收集所有患者一般资料和血生化指标,采用多因素logistic回归分析法分析2型糖尿病患者并发DN的影响因素;采用R语言软件4.0“rms”包构建Nomogram风险预测模型。结果：合并DN组患者2型糖尿病病程≥10年占比、合并高血压占比明显高于未合并DN组（P<0.05）。合并DN组患者总胆固醇（TC）、低密度脂蛋白胆固醇（LDLC）、高敏C反应蛋白（hs-CRP）、糖化血红蛋白（HbAlc）、尿白蛋白排泄率（UAER）、肌酐（Cr）、血尿素氮（BUN）、胱抑素C(Cys C)水平明显高于未合并DN组（P<0.05）,合并DN组患者高密度脂蛋白胆固醇（HDL-C）、血清C肽（FCP）、肾小球滤过率（e GFR）水平明显低于未合并DN组（P<0.05）。多因素logistic回归分析结果显示,2...     

2型糖尿病远端对称性多发性神经病变的临床特点及相关因素分析

目的 探讨2型糖尿病并发远端对称性多发性神经病变（DSPN）的患病情况、临床特点及相关危险因素。方法 选取2016年1~6月北京积水潭医院门诊或病房明确诊断2型糖尿病并自愿参加糖尿病神经病变筛查的患者160例,根据是否合并DSPN分为DSPN组和非DSPN组,比较两组的临床特点、糖尿病肾病及糖尿病相关合并症的发生情况,采用Logistic回归分析探讨DSPN的危险因素。结果 在160例2型糖尿病患者中,共筛查出合并DSPN患者98例,DSPN发生率达61.3%。DSPN组患者的年龄、糖尿病病程和吸烟率高于非DSPN组,且差异均有统计学意义（P<0.05）;DSPN组较非DSPN组糖尿病肾病发生率和心脑血管疾病发生率高,且差异有统计学意义（P<0.05）;多因素Logistic回归分析结果显示年龄、糖尿病病程、HbA1c、是否吸烟、是否合并糖尿病肾病以及是否合并心血管疾病与2型糖尿病并发DSPN有关。结论 2型糖尿病患者DSPN发生率高,年龄大、糖尿病病程长、吸烟、糖尿病肾病以及合并心血管疾病是2型糖尿病并发DSPN的危险因素。     

2型糖尿病患者Ⅲ～Ⅴ期糖尿病肾病危险因素临床分析

目的:探讨2型糖尿病(DM2)患者糖尿病肾病(DN)Ⅲ～Ⅴ期的危险因素。方法:对221例DM2病患者分组进行回顾性流行病学危险因素调查分析。结果:DN组和非DN组性别、体重指数差异无统计学意义(P>0.05),但年龄、病程、血压、糖化血红蛋白、空腹血糖差异均有统计学意义(P<0.05)。结论:DN的危险因素与血压、血糖控制、年龄、病程有关。     

惠州地区2型糖尿病住院患者非酒精性脂肪肝患病情况的调查

目的:调查惠州地区2型糖尿病住院患者合并非酒精性脂肪肝(NAFLD)的患病率及危险因素。方法:选取2018年7月-2019年6月于惠州市第一人民医院及惠州市中心人民医院内分泌科住院的2型糖尿病患者1 070例。按是否合并NAFLD分为病例组(n=579)与对照组(n=491)。比较两组临床特征,分析2型糖尿病合并NAFLD的危险因素。结果:2型糖尿病合并NAFLD患病率为54.11%(579/1 070)。两组年龄、性别、体重指数(BMI)、糖化血红蛋白、尿酸及甘油三酯比较,差异均有统计学意义(P0.05)。BMI、甘油三酯及尿酸为2型糖尿病合并NAFLD的危险因素(P0.05)。结论:惠州地区2型糖尿病患者合并NAFLD患病率达54.11%,女性发生率较高;BMI、甘油三酯及尿酸是2型糖尿病患者合并NAFLD的危险因素。     

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.