Intensive insulin therapy in type 1 and type 2 diabetes

Intensive insulin regimens can produce substantial clinical benefits for patients with type 1 and type 2 diabetes, but they are associated with an increased incidence of hypoglycaemia. This article discusses such regimens and whether the risk of hypoglycaemia can be reduced by using the new basal insulin analogue, insulin glargine.     

幼年与成年斯蒂尔病的临床比较

目的　了解幼年与成人斯蒂尔病临床特点 ,提高诊治水平。方法　对 4 3例幼年型斯蒂尔病 (JOSD)与 5 2例成人斯蒂尔病 (AOSD)的临床资料进行回顾性分析。结果　发热、关节症状、皮疹、白细胞及血沉增高发生率高 ,是幼年型与成人型斯蒂尔病的主要临床表现 ,两组比较无显著性差异。JOSD组咽痛 37.2 %、肌痛 32 .6 %、脾肿大4 6 .5 % ;AOSD组咽痛 6 1 .5 %、肌痛 5 7.8%、脾肿大 70 .1 % ;AOSD组高于JOSD组 ,差异有显著性。结论　JOSD与AOSD临床表现各有特点 ,掌握其特点 ,有利于早期诊治     

Insulin detemir in the treatment of type 1 and type 2 diabetes

Insulin detemir is a soluble long-acting human insulin analogue at neutral pH with a unique mechanism of action. Following subcutaneous injection, insulin detemir binds to albumin via fatty acid chain, thereby providing slow absorption and a prolonged metabolic effect. Insulin detemir has a less variable pharmacokinetic profile than insulin suspension isophane or insulin ultralente. The use of insulin detemir can reduce the risk of hypoglycemia (especially nocturnal hypoglycemia) in type 1 and type 2 diabetic patients. However, overall glycemic control, as assessed by glycated hemoglobin, is only marginally and not significantly improved compared with usual insulin therapy. The weight gain commonly associated with insulin therapy is rather limited when insulin detemir is used. In our experience, this new insulin analogue is preferably administrated at bedtime but can be proposed twice a day (in the morning and either before the dinner or at bedtime). Detemir is a promising option for basal insulin therapy in type 1 or type 2 diabetic patients.     

Control charts: type of data plotted determines type of chart selected

Determining whether data are attribute or variable is a key first step. The size of samples and the timing of measurements also are important considerations. Be sure you know what you are measuring--and why.     

杓型和非杓型老年高血压与靶器官损害关系的探讨

目的　探讨杓型、非杓型和老年单纯收缩期高血压与靶器官损害的关系。方法　选择老年高血压病人 110例和非老年高血压病人 5 0例进行 2 4h动态血压监测 ,动态心电图 ,头颅CT或MRI,超声心动图测定室间隔厚度、左室舒张末直径并按Devereux校正公式计算左心室质量指数 (LVMI) ,2 4h微量白蛋白排泄量 (MAU)。结果　老年非杓型组和单纯收缩期高血压组的左室肥厚检出率明显高于杓型高血压组 (P <0 .0 0 1) ;老年非杓型组的复杂房性与室性心律失常例数和老年单纯收缩期高血压组复杂房性心律失常例数均明显高于老年杓型组和非老年杓型组 (P <0 .0 1) ;老年、非老年非杓型和老年单纯收缩期高血压组的脑卒中发生率均高于杓型组 (P <0 .0 0 1) ;非老年杓型组、老年杓型组和老年非杓型组的血肌酐、MAU虽然逐渐增高 ,但无统计学意义。结论　老年非杓型和单纯收缩期高血压多伴有左室肥厚、严重心律失常、脑卒中等靶器官损害     

Platelet monoamine oxidase activity in type 1 and type 2 alcoholism.

Earlier studies have identified at least two distinct subtypes of alcoholism. Type 2 is characterised by high heritability, early onset, frequent social complications and mixed misuse. With regard to temperament, the type 2 alcoholics score high in impulsiveness and sensation-seeking behaviour. Type 1 alcoholics have a later onset, lower degree of heritability and rarely there is misuse of illegal drugs. In the present study, 37 type 1 and 62 type 2 male alcoholics were compared with 36 male controls with regard to platelet monoamine oxidase (MAO) activity, which is a stable biological marker, inversely correlated to personality traits such as impulsiveness and sensation seeking. The platelet MAO activity was found to be lower in type 2 alcoholics when compared both with healthy controls and with type 1 alcoholics. Also, the type 1 alcoholics had lower platelet MAO activity than the controls. The result confirms a previous study and validates the subclassification of alcoholism according to the type 1 and 2 concept. This should be of value for future studies concerning etiology, epidemiology, treatment and prevention of alcoholism.     

未破裂型或流产型输卵管妊娠的超声诊断

目的:探讨未破裂型或流产型输卵管妊娠的超声图象特征及诊断价值。方法:对26例未破裂型或流产型输卵管妊娠患者的超声图象进行回顾性分析。结果:2003~2006年超声检出未破裂型或流产型输卵管妊娠26例,均经手术和保守治疗证实。结论:超声能直接显示孕囊在宫内或宫外,也能显示盆腔包块及液体的性质、特征,故应首选。     

Insulin glargine in the treatment of type 1 and type 2 diabetes

Insulin glargine is an analogue of human insulin that is modified to provide a consistent level of plasma insulin over a long duration. Pharmacokinetic and pharmacodynamic studies show that a single injection of insulin glargine leads to a smooth 24-hour time-action profile with no undesirable pronounced peaks of activity. In clinical trials, this profile has been associated with at least equivalent, if not better, glycemic control than other traditional basal insulins and a significantly lower rate of overall and nocturnal hypoglycemia. The convenience of a once-daily injection, a lack of need for resuspension (insulin glargine is a clear solution when injected), and lower rates of hypoglycemia should translate into improvements in patient treatment satisfaction. This review appraises the evidence for the view that insulin glargine represents an advance in basal insulin therapy for both type 1 and type 2 diabetes patients.     

普通湿式生化分析仪与干式生化分析仪的比较分析

生化分析是临床诊断常用的重要手段之一.目前,干化学式生化分析仪也已得到较为广泛的应用.干式与普通湿式生化分析仪的测试结果都可以满足临床检验的要求,但在测定原理、仪器结构、操作与保养等方面都有很大的不同,因此,这两种仪器也适用于不同的应用场合.