α-硫辛酸辅助治疗对糖尿病周围神经病变患者糖代谢、周围神经传导速度和氧化应激的影响

目的:探讨α-硫辛酸辅助治疗对糖尿病周围神经病变患者糖代谢、周围神经传导速度和氧化应激的影响。方法:纳入糖尿病周围神经病变患者92例,按照收治单双号顺序分为观察组和对照组,每组各46例。两组均给予对症基础治疗,在此基础上,对照组给予口服胰激肽原酶肠溶片治疗,观察组给予α-硫辛酸注射液静脉滴注治疗,均治疗14d。观察两组治疗前后糖代谢指标:空腹血糖(FBG)、餐后2h血糖(2hPBG)和糖化血红蛋白(HbA1c),周围神经传导速度:正中神经、腓总神经的感觉神经传导速度(MCV)和运动神经传导速度(SCV),踝臂指数(ABI)和下肢动脉(股动脉、足背动脉、腘动脉)内径,氧化应激指标:超氧化物歧化酶(SOD)和丙二醛(MDA)。结果:两组治疗后FBG、2hPBG、HbA1c水平较本组治疗前均显著降低(P<0.05),但治疗后组间比较差异无统计学意义(P>0.05);两组正中神经和腓总神经MCV、SCV均较治疗前显著增加,且观察组治疗后正中神经和腓总神经MCV、SCV较对照组治疗后明显增高,差异均有显著性(P<0.05);治疗后,两组ABI和股动脉、足背动脉、腘动脉直径均显著增加,且观察组治疗后ABI和股动脉、足背动脉、腘动脉直径显著高于对照组治疗后,差异均有统计学意义(P<0.05);治疗后,观察组MDA显著降低,SOD明显增高,与治疗前和对照组治疗后对比差异均有显著性(P<0.05),对照组治疗前后MDA和SOD变化不明显,差异无统计学意义(P>0.05)。结论:α-硫辛酸辅助治疗可以显著改善糖尿病周围神经病变下肢血液供应,提高周围神经传导速度,降低氧化应激程度,其对糖代谢的影响仍需长疗程的观察。     

高压氧联合天麻素及甲钴胺治疗糖尿病周围神经病变的临床观察

目的观察高压氧联合天麻素及甲钴胺治疗糖尿病周围神经病变的临床效果。方法收集2型糖尿病周围神经病变患者72例,随机分为2组,每组36例。患者均予降糖药物口服或胰岛素皮下注射降血糖治疗,对照组给予天麻素6 ml静脉滴注及甲钴胺500μg静脉滴注,治疗组在对照组基础上加用高压氧(HBO)治疗,压力0.2MPa,吸氧30 min换吸空气5 min,反复2次,总吸氧时间60 min,1次/d。2组均治疗2周,比较治疗后的临床效果、感觉神经传导速度(SNCV)和运动神经传导速度(MNCV)。结果治疗组的临床治疗效果明显优于对照组(86.2%vs.63.9%),差异有统计学意义(P<0.05)。与治疗前比较,治疗组腓总神经、胫后神经的SNCV、MNCV及腓肠神经的SNCV均明显增快(P<0.01);对照组腓总神经MNCV明显增快(P<0.01),其他神经传导速度无明显变化(P>0.05)。治疗后2组间比较,治疗组腓总神经、胫后神经、腓肠神经的SNCV均较对照组增快(P<0.01),而MNCV差异无统计学意义(P>0.05)。结论高压氧联合天麻素及甲钴胺治疗糖尿病周围神经病变有较好的效果,值得临床应用。     

木丹颗粒联合胞磷胆碱钠胶囊治疗糖尿病周围神经病变疗效观察

目的观察木丹颗粒联合胞磷胆碱钠胶囊对糖尿病周围神经病变(DPN)的临床治疗效果。方法选择2014年5月至2015年4月于唐都医院神经内科及内分泌科就诊的DPN患者48例,将其分为木丹颗粒联合胞磷胆碱钠胶囊治疗的观察组25例和木丹颗粒联合甲钴胺片治疗的对照组23例,分别于治疗前、用药4、8周及治疗结束后4周对患者进行密歇根神经病变筛查(MNSI)、密歇根糖尿病神经病变记分(MDNS)评定;并于治疗前、治疗结束后4周进行神经电生理检查以明确神经传导速度改变情况。结果 2组患者治疗前MDNS、MNSI评分比较差异无统计学意义(P>0.05);用药4、8周后以及治疗结束后4周,2组患者的MDNS、MNSI评分均较治疗前显著下降(P<0.05);用药8周后及治疗结束后4周,观察组患者MDNS、MNSI评分均较对照组显著降低(P<0.05)。2组患者治疗前周围神经传导速度比较差异均无统计学意义(P>0.05),治疗结束后4周均较治疗前显著升高(P<0.05),其中观察组腓总神经、腓肠神经、胫神经感觉传导速度显著高于对照组(P<0.05)。结论木丹颗粒联合胞磷胆碱钠胶囊治疗DPN在促进神经细胞及髓鞘卵磷脂合成的同时可改善血液微循环障碍,从而达到缓解DPN症状,临床效果显著。     

生肌玉红膏联合西洛他唑对糖尿病足溃疡患者周围神经传导速度及氧化应激的影响

目的 探讨生肌玉红膏联合西洛他唑对糖尿病足溃疡患者周围神经传导速度及氧化应激的影响.方法 回顾性分析2018年6月至2020年6月本院收治的70例糖尿病足溃疡患者的临床资料,采用西洛他唑治疗的患者作为对照组(n=37),采用生肌玉红膏联合西洛他唑治疗的患者作为观察组(n=33).比较两组治疗前及治疗2周周围神经传导速度(尺神经、腓神经、胫神经)、氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)、晚期蛋白氧化产物(AOPP)]、生活质量[生活质量量表(SF-36)]评分及足部溃疡愈合时间.结果 治疗2周,两组尺神经、腓神经、胫神经的传导速度均快于治疗前,且观察组快于对照组,差异有统计学意义(P<0.05).治疗2周,两组SOD水平均高于治疗前,MDA、AOPP水平均低于治疗前,且观察组SOD水平高于对照组,MDA、AOPP水平均低于对照组,差异有统计学意义(P<0.05).观察组足部溃疡愈合时间短于对照组,差异有统计学意义(P<0.05).治疗2周,两组SF-36评分均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05).结论 生肌玉红膏联合西洛他唑治疗可加快糖尿病足溃疡患者周围神经传导速度,改善氧化应激指标,促进创口愈合,提高生活质量.     

高压氧联合α-硫辛酸治疗糖尿病周围神经病变效果

目的:观察高压氧联合α-硫辛酸治疗糖尿病周围神经病变的效果。方法:选取收治的糖尿病周围神经病变患者124例为研究对象,按照治疗方案分为观察组和对照组各62例。对照组采取常规治疗,观察组采取高压氧联合α-硫辛酸治疗。比较两组治疗效果、神经传导速度、血清指标以及氧化应激指标水平。结果:观察组治疗总有效率为95.16%(59/62),明显高于对照组的75.81%(47/62),差异有统计学意义(P<0.05);观察组尺神经、胫神经、正中神经的感觉神经传导速度和运动传导速度值均明显快于对照组,差异有统计学意义(P<0.05);观察组血清MDA、NO值均明显低于对照组,SOD、CAT、GSH-PX值均明显高于对照组,差异均有统计学意义(P<0.05);观察组各项血清学指标水平均明显优于对照组,差异有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:高压氧联合α-硫辛酸应用于糖尿病周围神经病变患者的治疗中有可靠的效果,能够帮助患者抑制病情进展,改善神经功能。     

黄芪桂枝五物汤加减治疗糖尿病周围神经病变的效果

目的探讨黄芪桂枝五物汤加减治疗糖尿病周围神经病变的效果。方法选取2018年1月至2019年1月河南省省立医院内分泌科收治的100例糖尿病周围神经病变患者,采用随机数表法分为对照组和观察组,每组50例。给予对照组常规降糖和神经营养治疗,观察组在对照组基础上加用黄芪桂枝五物汤加减治疗。比较两组血清谷胱甘肽过氧化物酶(GSH-Px)水平、神经传导速度[正中和腓总运动神经传导速度(MNCV)、正中和腓总感觉神经传导速度(SNCV)]及治疗效果。结果治疗后,两组GSH-Px水平均较治疗前升高,观察组GSH-Px水平高于对照组,差异有统计学意义(均P<0.05)。治疗后,两组MNCV、SNCV均较治疗前升高,观察组MNCV、SNCV均高于对照组,差异有统计学意义(均P<0.05)。观察组临床总有效率(92.0%)高于对照组(70.0%),差异有统计学意义(P<0.05)。结论采用黄芪桂枝五物汤加减治疗糖尿病周围神经病变,可提高患者血清GSH-Px水平,提高神经传导速度,临床效果较好。     

左卡尼汀联合血液透析治疗尿毒症性周围神经病变的临床疗效分析

目的:研究左卡尼汀与血液透析联合用于尿毒症性周围神经病变的效果。方法:在2013年12月~2016年12月收治的尿毒症性周围神经病变患者中选出92例作为研究对象,随机将患者分成对照组和观察组。对照组患者给予常规血液透析疗法,观察组患者在对照组的基础上加用左卡尼汀治疗,对比两组患者的感觉神经传导速度、临床症状评分等指标值。结果:治疗2个月时,观察组患者的正中神经、胫神经、腓总神经传导速度比对照组快,且血清β_2-MG浓度低于对照组,差异有统计学意义(P<0.05);观察组患者治疗2个月时的感觉障碍、麻木感以及肢端疼痛的评分低于对照组,差异有统计学意义P<0.05。结论:对尿毒症性周围神经病变患者应用左卡尼汀联合血液透析治疗有助于改善肾功能,缓解临床症状,促进患者感觉神经功能的恢复,值得推广应用。     

温络通外用联合甲钴胺治疗紫杉醇所致周围神经毒性的疗效观察

目的:评价温络通外用联合甲钴胺治疗紫杉醇所致周围神经毒性(PN)的临床疗效。方法:采用随机对照研究,纳入紫杉醇所致PN患者,对照组予甲钴胺口服方式治疗,治疗组在对照组治疗的基础上,加用温络通外用治疗,疗程均为2周。观察患者临床症状、体征、神经传导速度和生活质量等指标的变化。结果:治疗组(30例)临床总有效率为83.3%,高于对照组(29例)的58.62%,差异有统计学意义(P<0.05)。治疗组胫神经感觉和运动神经传导速度,有效率均高于对照组,差异均有统计学意义(均P<0.05)。治疗组、对照组生活质量评分较治疗前均升高,差异均有统计学意义(P<0.01);治疗后治疗组生活质量评分优于对照组,差异有统计学意义(P<0.05)。结论:温络通外用联合甲钴胺治疗方法可有效改善紫杉醇所致PN患者症状、体征,改善神经传导,并能够提高其生活质量。     

硫辛酸联合血栓通治疗糖尿病周围神经病变37例

目的:观察硫辛酸联合血栓通治疗糖尿病周围神经病变的疗效。方法:72例糖尿病周围神经病变患者,随机分为治疗组37例,给予硫辛酸联合血栓通治疗;对照组35例,仅给予硫辛酸治疗,连续治疗2周。观察2组患者神经症状和神经传导速度的变化。结果:治疗组糖尿病周围神经病变有效率明显高于对照组(97.29%,68.57%)(P<0.05)。治疗组治疗后正中神经和腓总神经的传导速度均较治疗前有所改善(P<0.05),且治疗组治疗后神经传导速度好转明显高于对照组(P<0.05)。结论:硫辛酸联合血栓通能够有效的治疗糖尿病周围神经病变。     

依帕司他治疗2型糖尿病周围神经病变的效果观察

目的观察依帕司他治疗2型糖尿病并发周围神经病变的临床效果。方法选择河南省宏力医院2014年1月至2015年1月收治的2型糖尿病并发周围神经病变60例,随机分为观察组和对照组,每组30例。对照组仅服用甲钴胺胶囊,观察组服用依帕司他与甲钴胺胶囊,观察治疗前后神经病变症状、体征及神经传导速度的变化。结果观察组患者总有效率显著高于对照组,差异具有统计学意义(P<0.05)。两组治疗前神经传导速度比较,差异无统计学意义(P>0.05);治疗后,两组神经传导速度优于治疗前,且观察组优于对照组,差异具有统计学意义(P<0.05)。结论依帕司他治疗糖尿病周围神经病变安全、有效。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

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.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.