糖尿病人头发糖基化的测定及其临床意义

作者对人头发糖基化(GHair)比色法测定进行了研究,测定了35名正常人和40例糖尿病人的G-Hair,同时对21例NIDDM患者GHair与测定日、1月前、2月前的糖化血红蛋白(GHb)、空腹及餐后2小时血糖平均值进行了相关分析。结果显示糖尿病患者GHair显著高于正常人,并与同时取血测定的GHb呈正相关,与2月前的空腹及餐后2小时血糖平均值也呈正相关。     

不同方法测定的糖化血红蛋白与口服葡萄糖耐量之间的关系

本文总结了80例受试者空腹、餐后2小时血糖与两种方法测定的糖化血红蛋白(HbAlc)之间的关系,其中糖尿病50例,排除糖尿病及糖耐量低减者30例。结果表明:糖尿病人空腹血糖、餐后2小时血糖和两种方法测定的HbAlc均非常显著高于非糖尿病者。全部受检者空腹及餐后2小时血糖与两种方法测定的HbAlc均呈显正相关。     

血糖的检测与血糖升高的原因

血糖的检测指标有两个,即空腹血糖和餐后2小时血糖。正常人血糖浓度相对稳定,餐后血糖可暂时升高,但应不超过10mmol／L（180mg／dl）。正常空腹血糖为3．9～6．1mmol／L（70-110mg／d1）,正常餐后2小时血糖为7．8mmol／L（140mg／d1）以下。空腹血糖大于7．0mmol／L或餐后血糖大于11．1mmol／L即达到诊断糖尿病的标准。     

阻塞性睡眠呼吸暂停低通气综合征与2型糖尿病相关性研究

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与2型糖尿病的关系。方法分别检测OS-AHS及正常人各50例的空腹血糖、餐后2小时血糖、空腹胰岛素及餐后2小时胰岛素水平,并监测OSAHS患者睡眠呼吸暂停低通气指数(AHI)、夜间平均血氧饱和度水平、鼾声。结果 OSAHS组空腹及餐后2小时的血糖与胰岛素水平均显著高于对照组。Logistic回归分析提示,OSAHS组患者AHI与空腹血糖水平具有相关性(r=0.467)、AHI与餐后2小时血糖水平具有相关性(r=0.462)、平均血氧饱和度与空腹血糖水平具有相关性(r=0.512)、平均血氧饱和度与餐后2小时血糖水平具有相关性(r=0.561)。结论 OSAHS可引起糖代谢异常,从而诱发和(或)促进2型糖尿病的发生、发展。OSAHS的治疗应作为对2型糖尿病患者的一项常规辅助治疗。     

胰岛素泵强化治疗早期糖尿病肾病的疗效观察

目的探讨胰岛素泵强化治疗早期糖尿病肾病(DN)的疗效观察。方法选取我院2013年7月至2015年7月48例早期DN患者,随机分为两组,治疗组与对照组,治疗组给予胰岛素强化治疗,对照组应用口服降糖药治疗。结果胰岛素强化治疗组治疗后尿白蛋白排泄率(UAER)、空腹血糖、餐后两小时血糖、糖化血红蛋白(GHb A1 c)显著下降,空腹C肽及餐后2小时C肽显著升高,与治疗前及对照组比较均有统计学意义(P0.05),其中逆转为正常蛋白尿5例;对照组上述指标治疗前、后比较无统计学意义(P0.05),进展为临床期糖尿病1例。结论应用胰岛素泵强化治疗控制血糖水平,可能会改善糖尿病预后,延缓糖尿病肾病进展。     

空腹血糖、餐后2h血糖、糖化血红蛋白测定对诊断糖尿病的临床价值分析

目的:探讨分析检测空腹血糖、餐后2h血糖、糖化血红蛋白对诊断糖尿病的临床诊断疗效。方法:随机选取2015年4月-2016年4月经我院诊治的152例糖尿病患者作为A组,以同一时期在我院进行检查的152例健康人员作为B组,分别记录检测受试者的空腹情况下和餐后2小时情况下血糖以及糖化血红蛋白测定;并比较。通过糖尿病患者与健康人群之间的差异证明检测患者空腹情况下和餐后2小时情况下血糖以及糖化血红蛋白的意义。结果:A组监测空腹情况下和餐后2小时情况下血糖以及糖化血红蛋白明显高于B组,P均0.05,均具有统计学意义。结论:通过检测糖尿病患者的空腹情况下和餐后2小时情况下血糖以及糖化血红蛋白与正常人群有明显差异,因此检测空腹情况下和餐后2小时情况下血糖以及糖化血红蛋白对糖尿病疾病具有诊断意义。     

怎样控制餐后高血糖

一般来说，人的餐后血糖比空腹血糖要高一些，但不能高出太多。正常人餐后2小时血糖低于7．8毫摩尔／升，如果糖尿病患者的餐后2小时血糖经常高于11．1毫摩尔／升，将会出现许多并发症，如眼底视网膜病变、肾脏病变、心脑血管病变、四肢麻木等。因此，糖尿病患者不仅要控制好空腹血糖，     

糖尿病患者糖化血红蛋白与空腹血糖、餐后1小时血糖和餐后2小时血糖检测的相关性分析

目的探讨糖尿病患者糖化血红蛋白与空腹血糖、餐后1小时血糖和餐后2小时血糖检测结果的相关性。方法选择25例糖尿病患者为观察对象,分别检测糖化血红蛋白、空腹血糖、餐后1小时血糖和餐后2小时血糖,并进行比较以及相关性分析。结果糖化血红蛋白与空腹血糖检测结果无明显相关(P0.05);糖化血红蛋白与餐后1小时血糖检测结果有明显正相关(P0.05);糖化血红蛋白与餐后2小时血糖检测结果有明显正相关(P0.05)。结论糖尿病患者糖化血红蛋白与餐后血糖有明显的相关性,且糖化血红蛋白与餐后2小时血糖的相关性明显优于餐后1小时血糖。     

益气活血轻身汤治疗2型糖尿病脂代谢紊乱临床观察

目的:观察益气活血轻身汤对2型糖尿病脂代谢紊乱患者中医临床疗效及体重、BMI、空腹血糖、餐后2小时血糖、HbA1c及血脂指标的影响。方法:将60例患者随机分为治疗组与对照组,均予糖尿病饮食、运动及西药降血糖治疗,对照组加服辛伐他汀,治疗组加服益气活血轻身汤;两组疗程均为60d。比较两组中医临床疗效及体重、BMI、空腹血糖、餐后2小时血糖、HbA1c及血脂指标的变化。结果:治疗组总有效率高于对照组(P<0.05),其空腹血糖、餐后2小时血糖、HbA1c及血脂指标改善亦优于对照组(P<0.01)。结论:益气活血轻身汤能明显改善2型糖尿病脂代谢紊乱患者中医临床症状及体重、BMI、空腹血糖、餐后2小时血糖、HbA1c及血脂代谢。     

Graves病患者糖耐量、糖化血红蛋白及胰岛素的变化

目的：探讨Graves病患糖代谢状况及糖化血红蛋白，胰岛素变化的临床意义。方法：对86例Graves病患作口服葡萄糖耐量试验（OGTT）、胰岛素释放试验，糖化血红蛋白（GHb)及甲状腺激素水平测定，并与正常人且及2型糖尿病组进行比较。结果：Graves病患合并糖代谢异常占55．8％，GHb异常率占54．6％，其中糖耐量减低占34．9％，呈糖尿病样占20．9％，糖尿病样餐后胰岛素明显升高，经抗甲亢6个月至1年，甲状腺激素恢复正常后，糖耐蛳减低组93．3％的患血糖恢复正常，83．3％患的GHb恢复正常，糖尿病样组28％的患血糖恢复正常，餐后胰岛素仅16．7％恢复正常。结论：Graves病患应常规作OGTT，GHb检查，并定期随访，部分患可进一步查糖负荷后胰岛素及谷氨酸脱羧酶抗体（GAD－Ab）。     

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.