中老年糖耐量异常患者早期动脉硬化的危险因素分析

目的探讨中老年糖耐量异常（IGT）患者早期动脉粥样硬化（AS）的危险因素。方法选取本院收治的60例中老年IGT患者为研究对象,将其归入IGT组（A组）,同时选取60例自愿参与研究的健康人群归入NGT组（B组）,回顾性分析两组临床资料,对比两组的体重指数（BMI）、腰臀比（WHR）、空腹血糖（FPG）、餐后2h血糖（2hPG）、血清总胆固醇（TC）、高密度脂蛋白胆固醇（HDL—C）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL—C）、血清高敏C-反应蛋白（hs—CRP）、空腹胰岛素（FINS）、一氧化氮（NO）、胰岛素抵抗指数（HOMA—IR）、颈动脉内-中膜厚度（IMT）、肱动脉舒张内径变化率（D％）。结果A组的WHR与BMI均高于B组,差异有统计学意义（P〈0．05）;两组的血压比较差异无统计学意义（P〉0．05）;两组的FPG、TC及HDL_C比较差异无统计学意义（D．0．05）;两组的2hPG、TG、LDL-C、hs—CRP、FINS、NO、HOMA—IR、IMT、D％比较差异有统计学意义（P〈0．05）;AS与HOMA—IR、WHR呈正相关,与D％呈负相关（P〈0．05）;WHR、HOMA—IR为导致早期AS发生的危险因素,D％为早期AS的保护因素。结论胰岛素抵抗、肥胖为中老年IGT患者出现AS症状的危险因素,D％为保护因素。     

糖耐量减低伴微量白蛋白尿与胰岛素抵抗及颈动脉粥样硬化的关系探讨

目的研究糖耐量减低（IGT）患者微量白蛋白尿（MAU）与胰岛素抵抗及颈动脉粥样硬化的关系。方法应用病例对照研究方法,选择糖耐量正常组（NGT）和糖耐量减低组（IGT）各80例患者。测定尿白蛋白排泄率（UAE）、空腹血糖（FBG）、空腹胰岛素（FINS）、胰岛素抵抗指数（HOMA—JR）、颈动脉内膜-中层厚度（IMT）、阻力指数（RI）、搏动指数（P1）和超敏C反应蛋白（hs—CRP）等各项指标。结果糖耐量减低伴微量白蛋白尿（IGT—MAU）组HOMA．IR、IMT、RI、hs—CRP均显著高于糖耐量正常（NGT）组、糖耐量减低伴尿白蛋白正常（IGT—NAU）组（P〈0．05）,PI显著低于NGT组和IGT-NAU组（P〈0．05）。IGT—MAU组尿白蛋白排泄率与HOMA—IR及IMT均正相关。结论伴有微量白蛋白尿的糖耐量减低患者具有更严重的胰岛素抵抗,其颈动脉粥样硬化病变程度更严重。微量白蛋白尿可作为糖耐量减低患者胰岛素抵抗及颈动脉粥样硬化进展的临床监测指标。     

初发2型糖尿病患者糖化血红蛋白水平对胰岛素抵抗及胰岛功能的影响

目的探讨初发2型糖尿病（T2DM）患者糖化血红蛋白水平与胰岛功能的关系,为合理选择降糖药物和有效控制血糖提供理论依据。方法对新诊断的126例2型糖尿病患者（男76例,女50例）分别测量身高、体重、血脂、空腹血糖（FPG）、空腹胰岛素（FINS）、糖化血红蛋白（HbA1C）。按HbA1C水平分为A组（HbA1C〈7．0％）、B组（7．0％≤HbAIC〈9．0％）及C组（HbA1C≥9．0％）3组,并分别计算胰岛素抵抗指数（HOMA—IR）、胰岛B细胞功能（HOMA—B）及胰岛索敏感性指数（ISI）。结果3组平均年龄和体重指数差异无统计学意义（P〉0．05）;随着HbA1C的增加,TG依次递增,HDL—C则依次递减。C组的FPG明显高于其他两组（P〈0．05）。B组表现为HOMA—IR明显增高,ISI下降。C组HOMA—B较其他两组明显降低,差异有统计学意义（P〈0．05）。结论初发2型糖尿病患者随着糖化血红蛋白的增高胰岛素敏感性下降,B细胞分泌能力减弱。     

糖耐量减低与颈动脉硬化及超敏C反应蛋白相关性研究

目的 研究糖耐量减低（IGT）与颈动脉硬化及超敏C反应蛋白（hsC-RP）的关系。方法应用对照研究的方法,选择IGT组和健康体检（NGT）组各80例,收集空腹血糖（FPG）、口服葡萄糖耐量试验（OGTT）2h血糖（2hPG）、空腹胰岛素（FINS）、胰岛素抵抗指数（HOMA．IR）、颈动脉内膜．中层厚度（IMT）、hsC．RP、颈动脉粥样硬化斑块等指标。结果IGT组2hPG、HOMA-IR、IMT、hsC．RP、FINS均比NGT组增高,差异有统计学意义（P〈0．05）,IGT组颈动脉粥样硬化斑块检出率高于NGT组,差异有统计学意义（P〈0．05）。结论糖耐量减低阶段慢性亚临床炎症状态就已存在动脉粥样硬化。     

血糖水平与胰岛素抵抗及B细胞功能的关系

目的 探讨超生理浓度的血浆葡萄糖对胰岛素分泌功能及外周组织胰岛素敏感性的作用。方法正常糖耐量（NGT）20例为G1组；G2组为糖耐量减低（IGT）10例；2型糖尿病（T2DM）共71例，按空腹血浆血糖（FBG）值将2型糖尿病分为4组，G3组（FBG〈7．0mmol／L）13例；G4组（7.0≤FBG〈10，0mmol／L）23例；G5组（10．0≤FBG〈15．0mmol／L）18例；G6组（FBG≥15．0mmol／L）17例。采用HOMA—IR评价IR，HOMA—B、△I30／△G30分别评价基础状态下及糖负荷后的胰岛B细胞功能，组问进行统计学比较。结果按G1→G2→G3→G4→G5→G6组0h、0．5h、1h、2h、3h各时点血糖均逐渐升高。两两比较显示差异有显著性（P〈0．05）。各时点随血糖升高而胰岛素分泌有逐渐减少趋势，高峰延迟到2h，峰值逐渐下降，两两比较显示G5-G6组明显低于G1—G4组（P〈0．05）。各时点随血糖升高而C肽分泌逐渐减少趋势，高峰延迟到2h，峰值逐渐下降，两两比较显示G5-G6组明显低于G1-G4组（P〈0．05）。HOMA—IR各组间差异无显著性（P〉O．05），胰岛B细胞功能指数HOMA-β及早期胰岛素分泌功能指数△I30／△G30逐渐下降，两两比较显示各组间差异有显著性（P〈0．05）。结论 高浓度葡萄糖抑制胰岛分泌功能，血浆胰岛素浓度反而下降，HOMA—IR各组间差异无显著性，从IGT阶段开始，糖负荷后早期胰岛素分泌反应减低。从NGT—IGT—T2DM不同时期B细胞功能逐渐下降，糖尿病病人基础及糖负荷后胰岛B细胞功能明显受损。     

不同糖耐量老年人血清抵抗素水平及其与胰岛素抵抗相关性研究

目的探讨不同糖耐量（GT）状态下老年人血清抵抗素水平及其与胰岛素抵抗（IR）的关系。方法45例糖耐量正常者（NGT组）、43例初诊老年糖尿病患者（T2DM组）及43例糖耐量减低患者（IGT组）,常规测量体质量、身高,计算BMI,检测空腹血糖、血脂、胰岛素、抵抗素水平,用稳态模型计算胰岛素抵抗指数（HOMA—IR）。结果T2DM组、IGT组血清抵抗素水平[（4．59±2．06）ng／mL、（2．94±1．84）ng／mL]明显高于NGT组（2．08±1．32）ng／mL（F=6．23、4．58,P〈0．05或P〈0．01）,Spearman相关分析显示,在IGT组中,血清抵抗素与Fins显著性相关（r=0．278,P〈0．05）,在T2DM组血清抵抗素与IR显著性相关（r=0．311,P〈0．01）。结论随着糖耐量损害的加重,血清抵抗素水平逐渐升高,胰岛素抵抗程度加重,血清抵抗素在由糖耐量正常至糖耐量异常到糖尿病过程中,发挥了重要作用。     

妊娠期糖尿病患者血清分泌型卷曲相关蛋白5表达水平与胰岛素抵抗、糖脂代谢的相关性研究

目的 研究妊娠期糖尿病（GDM）患者血清分泌型卷曲相关蛋白5(SFRP-5)表达水平与胰岛素抵抗（IR）、糖脂代谢的相关性。方法 按照随机抽样法选择2017年5月至2019年10月菏泽市牡丹人民医院（菏泽市中心医院）妇产科85例GDM患者作为观察组,选择同期50例健康妊娠晚期孕妇作为对照组。检测两组孕妇空腹血糖（FBG）、糖化血红蛋白（HbAlc）、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、空腹胰岛素（FINS）等指标,计算稳态模型的胰岛素抵抗指标（HOMA-IR）,同时检测两组孕妇血清SFRP-5表达水平。比较两组IR、糖脂代谢相关指标及血清SFRP-5表达水平,分析GDM患者血清SFRP-5表达水平与IR、糖脂代谢相关指标的相关性及影响GDM的危险因素。结果 观察组TG、TC、LDL-C、FBG、FINS、HbA1c、HOMA-IR水平高于对照组,差异有统计学意义（P <0.05）,而HDL-C及血清SFRP-5表达水平低于对照组,差异有统计学意义（P <0.05）;血清SFRP-5、TG、TC、FBG及HO...     

妊娠期糖尿病患者血清apelin水平及其与胰岛素抵抗的关系

目的：探讨妊娠期糖尿病（GDM）患者血清（apelin）水平及其与胰岛素抵抗（IR）的关系。方法检测56例GDM患者和60例正常糖耐量孕妇（NGT组）的血清apelin、空腹血糖（ FPG）、空腹胰岛素（ FINS）和糖化血红蛋白（HbA1c）水平,计算胰岛素抵抗指数（HOMA-IR）。结果GDM组血清apelin明显高于NGT组（P〈0.01）。apelin与FPG、FINS、HbA1c 及HOMA-IR 均呈显著正相关（P〈0.01）。结论 GDM患者血清apelin明显增高且与IR密切相关。     

血清淀粉样蛋白A与不同糖耐量人群血管内皮功能的关系探讨

目的探讨不同糖耐量人群血清淀粉样蛋白A的水平,及与血管内皮功能的关系。方法59例患者根据OGIT试验分为3组：19例NGT、20例IGT和20例T2DM。分别检测血清淀粉样蛋白A、生化指标、肱动脉内皮依赖性舒张功能（FMD）和含服硝酸甘油后肱动脉内皮依赖性舒张功能（NID）。结果①SAA随着血糖的升高而升高,DM组的SAA较IGT组、NGT组明显升高（P〈0．01）,IGT组的SAA较NGT组升高（P〈0．05）。②FMD随着SAA的升高而下降,DM组的FMD较IGT组和NGT组明显降低（P〈0．01）,IGT组的FMD较NGT组降低（P〈0．05）。③Spearman相关分析显示SAA与FBG、HbA1c、TC均呈正相关（r值分别为0．63、0．48、0．59,P〈0．01）,与FMD呈显著负相关（r值为-0．62,P〈0．01）。结论SAA与血管内皮功能损害密切相关。     

2型糖尿病肾病患者糖化血红蛋白、尿微量白蛋白及生化指标关系的研究

目的：探讨研究2型糖尿病肾病患者肾功能、糖化血红蛋白、尿微量白蛋白与血脂代谢的关系。方法120例诊断患者依尿微量白蛋白排泄率分为正常白蛋白尿（ NAU）组、微量白蛋白尿（ MAU）组和临床蛋白尿（ CAU）组,依糖化血红蛋白水平分为A、B、C三组,另外选30例体检健康者作为对照组（ NC）。检测各种生化指标：空腹血糖（ FBG）、胆固醇（ TCH）、甘油三酯（TG）、血清素氮（BUN）、血清肌酐（Cr）、高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL-C）、糖化血红蛋白（HbA1C）、尿微量白蛋白（mAlb）。结果 T2DM组和NC组相比,FBG、TG、TC、LDL-C、HbA1C水平高于NC组（P＜0．01）,HDL-C低于对照组（P＜0．05）;CAU组、MAU组的FBG、TG、TC、LDL-C、HbA1C指标要明显的高于NAU组（P＜0．05）;CAU的FBG、TG、TC、LDL-C、HbA1C明显大于MAU组（P＜0．01）,CAU 组的HDL要低于MAU 组和NUA组（P＜0．05）,2型糖尿病肾病患者在FPG、HbA1C、TCH、TG、UAE和NC组相比较差异有统计学意义（P＜0．05）,BUN、Cr与NC组相对比,其差异无统计学意义（P＞0．05）。 T2DM患者各组之间FPG、HbA1C相互比较,差异有统计学意义（P＜0．05）;而各组间的TCH、TG、BUN、Cr相互比较无统计学意义（ P＞0．05）。结论2型糖尿病肾病患者的尿微量白蛋白增高程度与糖化血红蛋白的增高有关,而尿微量白蛋白是糖尿病早期肾脏损害的灵敏指标,联合检测 HbA1 C、mAlb以及各项血脂水平对糖尿病肾病的早期预防诊断及治疗有重要意义。     

Serum levels and sputum levels of cefmenoxime in respiratory tract infections

In 11 patients with respiratory tract infections, the concentrations of cefmenoxime (CMX) in serum and sputum after 1 hour intravenous administration of 2 g of CMX were investigated. The peak serum level of CMX was 102.2 +/- 11.4 micrograms/ml after 1 hour drip infusion, then declined and was 3.51 +/- 0.55 micrograms/ml after 5 hours. Sputum level of CMX was lower than serum level but it was able to cover enough for MIC of Haemophilus influenzae, Klebsiella pneumoniae, Escherichia coli, Streptococcus pneumoniae and the peak sputum level of CMX was 0.77 +/- 0.17 micrograms/g after from 2 hours to 4 hours. Among the 11 patients with respiratory tract infections, 2 patients showed excellent, 6 patients good, 3 patients poor results (isolated organisms of sputum were normal flora) and no side effects observed.     

Below background levels of blood lead impact cytokine levels in male and female mice

A number of studies have documented that Pb exerts immunotoxic effects on T lymphocytes. In studies designed to explore this general response over a broad dose range, female Swiss mice were administered six different diets containing Pb acetate 1 day after mating. During lactation, the mothers received the same feed given during pregnancy, and the same diets were administered to the offspring for 9 months after weaning. At the end of exposure, blood Pb level in the offspring was determined, and possible changes in two type 1 cytokines (IL-2, INF-gamma) and one type 2 cytokine (IL-4) in the serum were measured. At higher dietary Pb levels (40 and 400 ppm), a significant increase in IL-4 production was associated with a profound decrease in INF-gamma and IL-2 production. At the lowest Pb diet level (0.02 ppm), which resulted in a blood lead level of (0.8 microg/dL), which is below background (2-3 microg/dL) values in humans, increases in INF-gamma and IL-2 production along with a significant decrease in IL-4 production were observed. The findings provide evidence of a reversal of lead-induced cytokine skewing depending on the blood lead concentration. As blood lead concentration increases, there is a notable skewing toward Th2, while the pattern is reversed favoring Th1 development at lower blood lead values. The present findings are also notable since they indicate the potential for dietary Pb to have significant biological effects below normal background concentrations.     

脑出血患者血浆和脑脊液中亮氨酸脑啡肽含量及纳络酮的影响

目的:探讨脑出血患者血浆和脑脊液中亮氨酸脑啡肽(L-ENK)的含量变化以及纳络酮对其影响。方法:将60例脑出血(ICH)患者随机分为对照组(n=30)和纳络酮组(n=30)。对照组采用常规治疗,纳络酮组在常规治疗基础上加用纳络酮3.0mg/d静脉滴注,两组均治疗14d。采用放射免疫分析法(RIA),检测60例脑出血患者血浆和脑脊液中L-ENK在发病第1天、3天、7天、10天和14天的含量变化,并设立正常对照组,观察纳络酮对L-ENK的影响,并观察不同部位出血时L-ENK的变化。结果:1不同部位出血患者之间血浆和脑脊液中L-ENK含量的差别不大,无显著性差异(P>0.05);2脑出血患者血浆和脑脊液中L-ENK含量在发病第7天达高峰,第14天基本接近正常,治疗结束后两组比较有显著性差异(P<0.05或P<0.01);结论:1L-ENK参与了脑出血的病理生理过程;2纳络酮能拮抗L-ENK所引起的中枢神经系统损伤,具有脑保护作用。     

Correlation of thiothixene serum levels and age

Two experiments are reported in which acute single test dose levels of thiothixene (Navane) were correlated with age. In the first study 20 mg oral doses were given to 28 male subjects and serum levels were drawn 2 h later. Mean age was 30 and correlation of serum level with age was 0.43, P<0.02. In a second older group with a mean age of 41, 10 mg oral doses were given to 25 subjects. A correlation with age of 0.41, P<0.05 was obtained with age. In prior work such acute levels have been found to correlate with steady-state serum levels and with clinical response to the medication. Few side-effects were seen in these populations and no correlations were obtained between serum levels and any side-effects.     

Efficacy and vitreous levels of topical NSAIDs

Introduction: Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly prescribed medications and are routinely used for their analgesic, antipyretic, and anti-inflammatory properties. Because of their potent cyclooxygenase-inhibitory activity, they can inhibit pro-inflammatory prostaglandin synthesis, leading to complex inflammatory cascades. NSAIDs have been broadly used systemically for many decades and have recently become commercially available in the form of topical ophthalmic formulations. NSAIDs are weak acids with pK_a values mostly between 3.5 and 4.5 and are poorly water-soluble. New, aqueous ophthalmic solutions of NSAIDs that afford better tissue penetration have recently been developed. In ophthalmological practice, topical NSAIDs are mostly used to stabilize pupillary dilation during intraocular surgery, manage postoperative pain and inflammation, and treat pseudophakic cystoid macular edema.

Areas covered: This review focuses on the vitreous penetration of topical NSAIDs and their potential clinical applications in the treatment of retinal diseases.

Expert opinion: A growing body of evidence suggests that NSAIDs may be beneficial in the treatment of age-related macular degeneration, diabetic retinopathy, and ocular tumors. Recent studies from our group and other authors have shown that the vitreous levels of NSAID exceed the median inhibitory concentration, which can significantly decrease vitreous PGE₂ levels.     

Impairment of memory and plasma flunitrazepam levels

 The 5-HT_2A/2C receptor antagonist, ritanserin, was reported to retard the acquisition of conditioned responses (CRs) during classical conditioning of the rabbit’s nictitating membrane (NM) response. The present study compared the effects of ritanserin on acquisition of CRs to a tone conditioned stimulus (CS) with that of the 5-HT_2A/2C receptor antagonist, LY-53,857 and the 5-HT_2A selective antagonist, MDL-11,939. All three drugs were injected at equimolar doses of 0.067, 0.67 and 6.7 μmol/kg, SC, 1 h before behavioral testing. Ritanserin and MDL-11,939 retarded CR acquisition to a tone CS, while LY-53,857 had no effect. Control experiments demonstrated that ritanserin (1 μmol/kg), MDL-11,939 (1 μmol/kg) and LY-53,857 (2 μmol/kg) had no effect on baseline responding or non-associative responding to the CS. However, both ritanserin and MDL-11,939 impaired the performance of the unconditioned NM reflex, as measured by a decrease in UR amplitudes on US alone trials, while LY-53,857 had no effect. In previously trained animals, ritanserin robustly impaired the performance of CRs, as measured by a reduced ability of the CS to elicit CRs, while the effects of LY-53,857 and MDL-11,939 were marginal. The retardation of associative learning produced by ritanserin and MDL-11,939 may have been due, at least in part, to their impairment of the NM reflex arc. Since MDL-11,939 is a highly selective 5-HT_2A antagonist, the retardation of learning and impairment of UR amplitudes produced by MDL-11,939 and ritanserin may have been due to blockade of the 5-HT_2A receptor. The ability of ritanserin and MDL-11,939 to produce effects on learning and performance that were opposite to that of 5-HT_2A/2C agonists suggests that they may be acting as inverse agonists at that receptor. These results stress the importance of the serotonergic system for optimal associative learning and motor function. Received: 22 May 1997 / Final version: 3 December 1997     

Pharmacokinetics and blood levels of polychlorinated biphenyls

Despite the enormous number of reports on polychlorinated biphenyl (PCB) toxicology, both the causal interpretation of epidemiological studies and the risk assessment of human exposures have been hampered by the lack of information on the pharmacokinetics of various PCB isomers and congeners. Thus, the assessment of exposure by means of measuring either total PCBs or individual congeners in the blood has so far been unsatisfactory. For example, the concentration and the pattern of congeners in the blood did not correlate with that at site(s) of action. In fact, the same levels of blood PCBs correlated with either toxic effects or no effects (both in clinical and epidemiological studies). In addition, when toxicity caused by PCBs was observed, the severity of the signs did not correlate with blood levels.Reasons for such a qualified failure are manifold and include different ways of reporting blood measurements, the different toxicological characteristics of each PCB, and different timing of sampling the blood, etc. Therefore, only limited conclusions can be drawn concerning what blood PCB measurements mean.     

Brain area nicotine levels in male and female rats with different levels of spontaneous activity

The present investigation was designed to study brain area nicotine distribution in an attempt to determine why, in previous research, rats of different activity levels were differentially affected by this drug, at least insofar as it's effects on behavior and 5-hydroxytryptamine turnover were concerned. Brain area nicotine levels were evaluated in male and female rats grouped according to different levels of activity; drug levels were studied 15 and 30 min following the s.c. administration of 400 μg/kg of nicotine. The results obtained indicated that there were few significant differences between experimental groups, but whether high or low active rats were analyzed, brain area nicotine levels were higher in the female rat. However, these differences also appeared to be related to other factors such as whether each rat received single or 5 nicotine doses, or the time studied after nicotine administration.