低血糖生成指数饮食用于肥胖2型糖尿病效果观察

目的探讨低血糖生成指数（GI）饮食对肥胖2型糖尿病（T2DM）的治疗效果。方法将96例以餐后血糖升高为主的肥胖T2DM患者随机分为观察组40例和对照组56例,两组均予均衡饮食,观察组予低GI膳食模式;对照组采用食物交换份法制订饮食,干预时间为3个月。观察两组干预前后空腹血糖（FPG）、餐后2 h血糖（2hPG）、TC、TG、HDL-C、LDL-C、尿酸（UA）、空腹胰岛素（FINS）水平。结果观察组治疗后2hPG、LDL-C、FINS水平明显低于治疗前及对照组,UA水平明显低于治疗前,高于对照组,P均〈0.01。结论采取低GI膳食可有效地控制对以餐后血糖升高为主的肥胖T2DM患者,可有效控制餐后2 h血糖、血脂、尿酸水平,减轻胰岛素抵抗,有利于糖尿病病情控制。     

综合干预对2型糖尿病控制作用的研究

目的 应用低血糖指数膳食,联合糖尿病健康教育、饮食指导和自我监测,探讨其对改善2型糖尿病患者糖代谢的效果.方法 随机抽取体重指数(BMI)≥24 kg/m2的超重糖尿病患者150例,按2:1的比例分配至试验组和对照组,对照组的受试者仅接受包括运动和常规饮食指导的糖尿病健康教育.而试验组受试者除此以外还接受低血糖指数(glycemic index,GI)膳食指导,每天食用低GI的早餐替代食物(200 kcal),每周定期进行至少6次的自我m糖监测.试验周期为24周,分别于试验开始、第12周和第24周进行基线、中期和终期的问卷调查及相关指标检测.结果 基线时,试验组和对照组的能量、蛋白质、脂肪、碳水化合物和膳食GI均无明显差异(P＞0.05),通过糖尿病健康教育和饮食指导,试验组第12周和第24周,蛋白质、脂肪和膳食GI明显低于基线时(P＜0.01).试验组的BMI、腰嗣、臀围、收缩压、舒张压较试验前均有明显降低(P＜0.01),其中腰围、臀围、收缩压、舒张压试验组明显低于对照组(P＜0.05).与此同时,试验组和对照组第12周的宅腹血糖分别下降16.5%、10.6%,第24周时试验组下降10.4%,对照组反而上升2.8%(P＜0.01).两组在第12周时胰岛素抵抗指数分别下降24.2%、24.9%;第24周时试验组仍下降25.0%,对照组反而上升5.9%(P＜0.01),试验组第12周、24周的HbA1C也分别下降8.2%和11.1%.然而,对照组则分别上升0.7%和1.1%(P＜0.01).结论 2型糖尿病患者在综合干预措施后,空腹血糖和HbA1C水平明显改善,说明综合管理包括食用糖尿病专用的膳食替代食物(低GI食物)、糖尿病教育和定期的血糖监测在糖尿病治疗和控制中是有效的.     

食物交换份法联合食物血糖生成指数指导2型糖尿病病人饮食治疗的临床观察

目的采用自身对照观察初发2型糖尿病病人单纯给予食物交换份法进行饮食治疗及其联合食物血糖生成指数（GI）进行饮食治疗前后病人血糖及胰岛素抵抗指数等指标的变化，评价两种饮食治疗方法的疗效。方法选择初发2型糖尿病病人18例，首先接受单纯食物交换份法治疗3个月，之后接受食物交换份法联合GI治疗3个月，比较饮食治疗前后及两种方法治疗后病人体重指数（BMI）、空腹血糖（FPG）和空腹胰岛素（FINs）、糖化血红蛋白（HbA1c）及胰岛素抵抗指数（HOMA-IR）的变化。结果单纯食物交换份法治疗3个月后，病人BMI、FPG、HbA1c、FINS及HOMA-IR较饮食治疗前均明显降低（P〈0．001或P〈0.01）。联合GI治疗3个月后，病人BMI、FPG、HbA1c及HOMA-IR较联合GI治疗前明显降低（P〈0.001或P〈0.01）；FINS有下降趋势，但无统计学意义（P〉0.05）。结论饮食治疗能够改善初发2型糖尿病病人的血糖及胰岛素敏感性，食物交换份法是一种有效的治疗方法，食物交换份法联合GI进行饮食治疗优于单纯食物交换份法。     

结构化教育结合标准化饮食用于2型糖尿病患者健康管理中的效果

目的 探究结构化教育结合标准化饮食用于2型糖尿病患者健康管理的效果。方法 选取2021年1月—2023年4月盐城市第二人民医院收治的80例糖尿病患者为研究对象,按照双盲法采用1∶1分配的原则将患者分为观察组（40例）与对照组（40例）,对照组采用常规护理,观察组在此基础上采用结构化教育+标准化饮食。比较两组护理干预效果。结果 观察组血糖指标、自我效能评分均优于对照组,差异有统计学意义（P均<0.05）。结论 结构化教育、标准化饮食两种方法进行联合对2型尿病患者的干预效果较为显著,能够控制患者的血糖水平,提高其自我管理能力。     

浅析套餐式饮食在糖尿病饮食护理中的应用

目的研究分析糖尿病患者接受套餐式饮食和单纯饮食控制的血糖情况,对套餐式饮食应用于糖尿病护理的效果进行探究。方法根据2015年1月—2017年1月该院接收的66例2型糖尿病患者来分析研究,将患者分成试验组和对照组,均有33例。对照组患者接受饮食控制,试验组患者接受个性化饮食套餐。每2个月对身高、体重进行测量,调整方案。在第2个月对患者的空腹喝餐后血糖水平进行检测。36个月时统计患者的血糖控制满意度。结果经过治疗,两组的空腹血糖指标均有所下降,治疗前后结果差异有统计学意义(P0.05),试验组患者空腹血糖和餐后2 h血糖比对照组低,结果差异有统计学意义(P0.05)。36个月后,试验组的满意度比对照组高(P0.05)。结论糖尿病患者的饮食使用套餐式饮食的效果比单纯饮食控制要更加优秀,临床中可以推广使用。     

个体化饮食教育对糖尿病患者的干预效应

目的 探讨个体化饮食教育的有效方法及干预效应。方法 对102例住院糖尿病患者采用自身对照方法，在接受个体化饮食治疗教育前后以自行设计的饮食相关知识评价问卷等评分、空腹血糖（FPG）、餐后2小时血糖（2hPG）。结果 饮食教育后患者饮食治疗的理论知识评分、对食物的重量、体积、容积等实物认识的评分以及评分优秀率均较教育前明显提高（P均〈0．01），通过教育、饮食、运动、药物等综合治疗，患者的FPG、2hPG明显降低（P〈0．01）。结论 对糖尿病患者实施个体化饮食教育干预是必要的、可行的和有效的。     

网格化管理对社区糖尿病患者依从性的影响

我中心自2009年起全面实施社区卫生服务网格化管理,选取辖区（孔浦街道）151例糖尿病患者作为试验组,（甬江街道）147例糖尿病患者作为对照组,试验组实施网格化管理,社区综合性干预。对照组沿用传统的松散型管理。一年后对每例糖尿病患者通过问卷调查评价其治疗依从性,监测空腹血糖（FBG）、餐后2小时血糖（2hPBG）、糖化血红蛋白（HbA-c）并进行评价。结果比较试验组和对照组糖尿病患者监测FBG、2hPBG、HbA1c、治疗依从性有显著差异。试验组血糖控制明显低于对照组。结论网格化管理有利于提高糖尿病患者的治疗依从性,有效地控制血糖,明显降低并发症,提高生活质量。     

血糖生成指数对社区糖尿病患者膳食和营养结构的影响

目的探讨在2型糖尿病（T2DM）患者中开展以食物血糖生成指数（GI）知识为基础的营养教育和膳食指导,对患者的膳食和营养结构的影响。方法随机选取T2DM患者126例,对照组和实验组各63例。对照组采取传统的食物交换份法教育为主,实验组以GI知识宣传教育作为主要教育方法。营养教育和膳食指导9个月,观察患者的低GI膳食结构、就餐GI值和营养摄入状况的变化。结果与对照组相比,实验组教育后低GI食物选择显著增加,全天总GI值降低,能量、碳水化合物（CHO）、钙、镁、锌、维生素B1、维生素C和膳食纤维摄入量增高,脂肪降低。结论在T2DM患者中进行基于GI知识的营养教育,可降低患者全天总GI值,有效地改善患者膳食和营养结构。     

研究标准化饮食护理在2型糖尿病肥胖患者中的应用

目的 分析标准化饮食护理在2型标准化饮食护理在2型糖尿病肥胖患者中的应用.方法 选择该院2019年1月—2020年1月100例诊治的2型糖尿病肥胖患者,将其分为试验组与对照组,每组50例,试验组采用标准化饮食护理,对照组采用常规护理,观察并对比两组患者的护理效果.结果 试验组患者的在空腹血糖及餐后2h的血糖均优于对照组...     

以问题为基础的教育对2型糖尿病患者相关指标控制的影响

将40例诊断为2型糖尿病患者随机分成试验组和对照组各20例，试验组接受以问题为基础的教育，对照组接受常规教育，观察干预前后6月两组患者空腹血糖（FPG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbA1c）、体重指数（BMI）、甘油三酯（Tg）、总胆固醇（Tc）。结果试验组在相关指标达标方面明显优于对照组（P〈0．05）。结论以问题为基础的教育可以明显提高2型糖尿病人患者相关指标的达标率，预防和延缓并发症的发生，提高了患者生活质量。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.