激光联合牙周翻瓣术治疗重度牙周炎的疗效

目的 探究重度牙周炎应用激光联合牙周翻瓣术治疗的效果.方法 将2017年01月～2019年12月接收的120例重症牙周炎患者纳入研究,按抽签法分为A组60例,单纯采取牙周翻瓣术进行治疗;B组60例,在该手术基础上联合应用Er:YAG激光进行治疗,观察下述指标:术前(就诊时)、术后3个月患牙牙周探诊深度(probing ...     

曲安奈德联合复方氯已定含漱液治疗口腔扁平苔藓的临床疗效观察

目的探讨曲安奈德联合复方氯已定含漱液治疗口腔扁平苔藓的临床疗效。方法随机将我院就诊的108例口腔扁平苔藓患者依照治疗方法的不同分为两组,其中对照组54例,单纯采用复方氯已定含漱液治疗;治疗组54例,使用曲安奈德联合复方氯已定含漱液治疗。治疗3个月后观察两组的疗效。结果治疗组治疗3个月后显效及好转率为94.44%,对照组为38.88%。两组差异具有统计学意义(P<0.05)。结论曲安奈德联合复方氯已定含漱液治疗口腔扁平苔藓效果良好。     

氯吡格雷联合阿司匹林治疗老年心肌梗死合并糖尿病的疗效分析

目的探究氯吡格雷联合阿司匹林治疗老年心肌梗死合并糖尿病的临床疗效。方法选自收治的86例老年心肌梗死合并糖尿病患者,按照入院顺序单双号随机分为实验组与参照组,每组43例。参照组患者给予口服阿司匹林、降糖、溶栓等综合疗法,实验组患者在参照组患者的治疗基础上加用氯吡格雷进行治疗。观察两组患者的血糖改善情况、血管再通情况以及不良反应发生情况。结果实验组患者的血管再通率明显高于参照组,P<0.05;两组患者的血糖改善程度比较差异不显著,P>0.05;实验组患者的不良反应发生率低于参照组,P<0.05。结论应用氯吡格雷联合阿司匹林治疗老年心肌梗死合并糖尿病效果显著,且不良反应少,具有较高的临床价值。     

环磷酰胺联合赖诺普利氢氯噻嗪治疗2型糖尿病肾病临床效果观察

目的观察环磷酰胺联合赖诺普利氢氯噻嗪治疗2型糖尿病肾病的临床效果。方法选取三二〇一医院自2016年12月至2018年12月收治的80例2型糖尿病肾病患者为研究对象,将患者随机分入A、B两组,每组各40例。A组患者给予赖诺普利氢氯噻嗪,B组在A组基础上给予环磷酰胺。比较两组患者的临床治疗有效率及肾功能指标。结果 A组治疗有效率为80.0%(32/40),B组为95.0%(38/40),两组患者临床治疗有效率比较,差异有统计学意义(P<0.05)。治疗后,两组患者血肌酐、血尿素氮、尿白蛋白排泄率、尿微量白蛋白、尿白蛋白肌酐比值、24 h尿蛋白定量均明显低于治疗前,且B组低于A组,差异有统计学意义(P<0.05);肾小球滤过率明显高于治疗前,且B组高于A组,差异有统计学意义(P<0.05)。结论环磷酰胺联合赖诺普利氢氯噻嗪治疗2型糖尿病肾病临床效果良好,可明显改善患者肾功能。     

种植体支抗联合闭合式牵引在颌骨内埋伏牙、阻生牙患者中的应用效果及对治疗后康复、口腔健康的影响

目的 探讨种植体支抗联合闭合式牵引在颌骨内埋伏牙、阻生牙患者中的应用效果及对治疗后康复、口腔健康的影响。方法 选取2019年1月—2022年5月收治的颌骨内埋伏牙、阻生牙90例,根据治疗方法不同将其分为观察组和对照组2组各45例。观察组采取种植体支抗联合闭合式牵引治疗,对照组采取闭合式开窗术加传统固定治疗。比较2组治疗后临床效果、康复情况,治疗前和治疗后4个月龈沟液细胞因子、口腔健康微生态环境、咀嚼功能,以及治疗后4个月内不良反应发生情况。结果 治疗后,观察组总有效率95.56%(43/45)高于对照组80.00%(36/45),疼痛程度低于对照组(P<0.05)。治疗后4个月,2组龈沟液丝氨酸蛋白酶抑制剂、基质金属蛋白酶-3、白细胞介素-1β和牙周袋探诊深度、牙龈指数、龈沟出血指数、菌斑指数、牙齿松动度均较治疗前升高,且观察组低于对照组(P<0.01)。治疗后4个月,2组咀嚼效率、咬合力均高于治疗前,咀嚼疼痛评分低于治疗前,且观察组咀嚼效率、咬合力高于对照组,咀嚼疼痛评分低于对照组(P<0.01)。治疗后4个月内,2组不良反应发生率比较差异无统计学意义(P>0...     

糖尿病足诊断箱在糖尿病患者中应用分析

糖尿病足是导致糖尿病患者致残的严重慢性并发症之一。早期对糖尿病患者下肢血管病变筛查以给以早期的预防治疗是防治糖尿病足的最佳方法。我院于2007年引进由美国享特立公司生产的糖尿病足筛查诊断箱,对入院所有糖尿病人进行下肢血管病变筛查,据踝肱指数评价下肢血管病变严重程     

心理护理在糖尿病伴焦虑症患者的治疗中的应用

目的:观察糖尿病伴抑郁、焦虑,给予治疗的和心理护理的疗效。方法对108例伴有抑郁或焦虑症状的糖尿病患者治疗前后的比较。结果治疗组和对照组均有显著的差异(P<0.01)。结论对糖尿病伴有抑郁、焦虑症状的患者,有其情绪变化的规律,针对性地采取相应的护理措施,加强健康宣教,做好心理护理,有利于糖尿病的治疗。     

治疗性义齿在重度牙槽嵴吸收患者全口义齿修复中疗效评价

目的 探讨治疗性义齿在重度牙槽嵴吸收患者全口义齿修复中的疗效。方法 选取上海市虹口区牙病防治所自2017年3月至2021年8月收治的28例行全口义齿修复的患者为研究对象。记录并比较应用旧义齿、治疗性义齿修复后1、3个月的咀嚼效率、咬合力、咬合平衡性。评价应用旧义齿、治疗性义齿修复后3个月的患者满意度。结果 治疗性义齿修复后3个月的吸光度值、咬合力均高于应用旧义齿、治疗性义齿修复后1个月,差异均有统计学意义(P<0.05)。治疗性义齿修复后1、3个月的咬合平衡性均优于应用旧义齿,差异均有统计学意义(P<0.05)。治疗性义齿修复后3个月的美观效果、咀嚼功能、语言功能、固位功能、舒适程度均优于应用旧义齿,差异均有统计学意义(P<0.05)。结论 治疗性义齿可改善全口义齿的固位及稳定性,提高患者咀嚼效率及满意度。     

腺苷负荷超声心动图在糖尿病患者中筛查无症状心肌缺血的应用

冠心病是糖尿病的重要并发症,发病往往缺乏典型临床表现,多以支血管病变为主,心电图缺乏典型表现.我们在腺苷负荷超声心动图试验中发现糖尿病患者阳性检出率较高,且与冠脉造影吻合程度很高,提示可将其作为糖尿病患者筛查冠心病的检查手段.     

Efficacy of periimplant mechanical debridement with and without adjunct antimicrobial photodynamic therapy in patients with type 2 diabetes mellitus

ObjectiveThere are no studies that have assessed the efficacy of mechanical debridement (MD) with and without adjunct antimicrobial photodynamic therapy (aPDT) in the treatment of periimplant inflammation in patients with type 2 diabetes mellitus (T2DM). The aim of the present 12-month follow-up study was to assess the efficacy of MD with and without adjunct aPDT in the treatment of periimplant inflammation in patients with T2DM.MethodsSixty-seven patients with diagnosed periimplant inflammation and T2DM were included. Treatment-wise, the patients were divided into 2 groups: (a) test-group (n = 34): patients receivedMD+ aPDT; and (b) control group (n = 33): patients received MD only. Periimplant bleeding on probing (BOP), probing depth (PD) ≥4 mm and mesial and distal marginal bone loss (MBL) were measured at baseline and after 6 and 12 months of therapy in both groups. The Kruskal-Wallis test was used to compare the periimplant BOP, PD, MBL and HbA1c levels in both groups. P-values less than 0.05 were considered statistically significant.ResultsMean preoperative hemoglobin A1c (HbA1c) for patients in the control group and test group were 8.5% and 8.8%, respectively. In the control group, there was no significant difference in HbA1c levels at all follow-up durations. Among patients in test group, there was a significant decrease (P < 0.05) in HbA1c levels at 6 and 12 months of follow-up. Both PD and BOP were significantly lower in the test group compared to the control group at all follow-up durations. At 6 and 12 months of follow-up, there was no significant difference in MBL in both groups.ConclusionIn patients with T2DM, MD with adjunct aPDT is more effective in the treatment of periimplant inflammation compared with MD alone.     

糖尿病和非糖尿病胸痛患者64层螺旋CT冠状动脉斑块特点的对照研究

目的利用64层螺旋cT冠状动脉造影研究糖尿病和非糖尿病胸痛患者冠状动脉斑块的特点。方法收集120例胸痛患者（糖尿病组60例,非糖尿病组60例）64层螺旋cT冠状动脉造影成像资料,观察2N患者冠状动脉斑块的分布特点与类型,并进行对照研究。并将糖尿病组60例患者根据病程将其分成3组（〈5年,5-10年,〉10年）,并对各组冠状动脉狭窄及斑块性质进行评价。结果本组120例患者共计1800段血管进行分析,其中糖尿病组存在斑块297段,而非糖尿病组存在斑块119段（χ2=99．057,P〈0．01）,糖尿病组单支病变的比例明显少于非糖尿病组,糖尿病组2支及以上的病变发生率明显高于非糖尿病组（P〈0．01）。受累血管段分布中,以左冠前降支受累差异有统计学意义（χ2=5．626,P〈0．05）,而左冠主干、回旋支及右侧冠状动脉均无明显差异。在斑块类型分布中,糖尿病组以软斑块和混合斑块为主（P〈0．05）。60例糖尿病患者中,〈5年组斑块发生率14．2％（64／450）,病变以软斑块为主,管腔以轻度狭窄为主;5～10年组斑块发生率为46．7％（112／240）,病变以混合性斑块为主,管腔呈现中度狭窄为主;〉10年组斑块发生率57．6％（121／210）,病变以混合斑块和钙化斑块为主,管腔多呈中．重度狭窄。结论64层螺旋CT冠状动脉造影能够比较准确地反映糖尿病和非糖尿病胸痛患者的粥样斑块之间的差异,同时能够准确识别斑块分布和特征,进行危险评估,指导临床选择合适的治疗方案。     

糖尿病患者的经颅多普勒变化

目的:应用经颅多普勒检查糖尿病患者颅内血管状况,以了解糖尿病与血液动力学变化的关系。方法:采用德国EME公司2020型经颅多普勒检查仪。对55例糖尿病患者及60例健康对照组进行了经颅多普勒检查,观察大脑中动脉、大脑前动脉、大脑后动脉,椎、基底动脉的血流速度,搏动指数及血流频谱进行检测。结果:55例糖尿病患者中血流速度异常占81.82%,其中血管痉挛8例,血管硬化30例,血管狭窄7例,正常10例。两组搏动指数值比较,糖尿病组搏动指数值显著高于健康对照组。结论:经颅多普勒超声检查可以较明确反映糖尿病脑血管病变的部位、范围和性质。     

Ultrasound characterization of the seminal vesicles in infertile patients with type 2 diabetes mellitus

Male patients with type 2 diabetes mellitus (DM) may experience infertility because the disease affects negatively many aspects of reproduction, including seminal vesicle (SV) function. The aim of this study was to evaluate the ultrasound characteristics of the SVs of infertile patients with DM because no such data are available in these patients. To accomplish this, 25 infertile patients with type 2 DM and no other known causes of sperm parameter abnormalities were selected. Two different control groups were also enrolled: healthy men with idiopathic infertility (n = 25) and infertile patients with male accessory gland infections (MAGI) (n = 25), a well-studied clinical model of SV inflammation. Patients and controls underwent prostate-vesicular transrectal ultrasonography after 1 day of sexual abstinence before and 1 h after ejaculation. The following SV ultrasound parameters were recorded: (1) body antero-posterior diameter (ADP); (2) fundus APD; (3) parietal thickness of the right and left SVs; (4) number of polycyclic areas within both SVs; (5) fundus/body ratio; (6) difference of the parietal thickness between the right and the left SV; and (7) pre- and post-ejaculatory APD difference. Patients with DM had a significantly (p < 0.05) higher F/B ratio compared to controls and patients with MAGI. Only patients with MAGI had a significantly (p < 0.05) higher number of polycyclic areas. Controls and MAGI patients have a similar pre- and post-ejaculatory difference of the body SV APD, whereas this difference was significantly (p < 0.05) lower in patients with DM. In conclusion, this study showed that infertile patients with DM have peculiar SV ultrasound features suggestive of functional atony.     

肝癌肝动脉栓塞化疗术后糖尿病的发生与治疗

糖尿病是肝癌患者接受肝动脉化疗栓塞（transcatheter arterial chemoembolization,TACE）治疗后并不罕见的并发症,但目前临床对此尚不够重视,对其发病的原理、临床表现、治疗及预后缺乏深入的研究。本研究收集我院放射科介入病房自2001年2月至2005年5月期间肝癌在以TACE为主的综合治疗过程中发生的糖尿病病例27例,就肝癌TACE后糖尿病发生的发病率、临床表现、诊断和治疗以及发病原因进行了探讨和研究。     

Chest radiological finding of COVID-19 in patients with and without diabetes mellitus: Differences in imaging finding

The pandemic of novel coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Diabetes mellitus is a risk factor for developing severe illness and a leading cause of death in patients with COVID-19. Diabetes can precipitate hyperglycaemic emergencies and cause prolonged hospital admissions. Insulin resistance is thought to cause endothelial dysfunction, alveolar capillary micro-angiopathy and interstitial lung fibrosis through pro-inflammatory pathways. Autopsy studies have also demonstrated the presence of microvascular thrombi in affected sections of lung, which may be associated with diabetes. Chest imaging using x-ray (CXR) and computed tomography (CT) of chest is used to diagnose, assess disease progression and severity in COVID-19. This article reviews current literature regarding chest imaging findings in patients with diabetes affected by COVID-19. A literature search was performed on PubMed. Patients with diabetes infected with SARS-CoV-2 are likely to have more severe infective changes on CXR and CT chest imaging. Severity of airspace consolidation on CXR is associated with higher mortality, particularly in the presence of co-morbidities such as ischaemic heart disease. Poorly controlled diabetes is associated with more severe acute lung injury on CT. However, no association has been identified between poorly-controlled diabetes and the incidence of pulmonary thromboembolism in patients with COVID-19.     

非胰岛素依赖型糖尿病患者骨密度变化的探讨

目的 研究非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者的骨密度变化,以了解ＮＩＤＤＭ患者是否易合并骨质疏松及其特点。方法 采用双能Ｘ线骨密度仪（简称为ＤＸＡ）,４８例ＮＩＤＤＭ患者及３５例３０￣３５岁正常人腰椎正侧位、髋部及全身骨密度。病例选择是根据１９８５年世界卫生组织（ＷＨＯ）糖尿病专家委员会提出的诊断和分型标准,结果均经统计学处理分析。结果 ４８例ＮＩＤＤＭ患者的骨密度都有不同程度下降,按ＳＨＯ推     

彩超对老年性糖尿病颈动脉粥样硬化的诊断价值

目的 探讨彩超在评价老年糖尿病患者中颈动脉粥样硬化发生情况的价值。方法 彩超检查61例老年糖尿病患者的颈动脉直径，测量内径及内一中膜厚度（IMT），测量有关血流参数，观察有无斑块，判断斑块性质，并将检查结果与61例老年健康对照组进行比较。结果 糖尿病组61例中的54例（88．52％）有不同程度的颈动脉粥样硬化，其中不稳定斑块29例（47．54％），对照组61例中颈动脉粥样硬化11例（18．33％），其中，不稳定斑块3例（4．91％），两组比较，差异显著（P〈0．01）。结论 糖尿病患者的颈动脉粥样硬化发生率远高于正常人群，应用彩色多普勒超声评价老年糖尿病患者的颈动脉粥样硬化发生情况及选择治疗方案，具有重要的临床意义。     

糖尿病患者骨科围手术期若干问题探讨

目的 总结糖尿病患者围手术期的处理经验。方法 对我科1989-2000年89例37-82岁糖尿病住院患者进行回顾性分析，血糖控制在11mmol/L以下，根据个体情况，使用胰岛素及抗生素。合并2种以上疾病者62例，78例应用连续硬膜外麻醉，5例局部麻醉，6例全身麻醉。截肢、截趾、关节离断45例，钢板螺丝钉固定21例，清创术29例，清创术后截肢5例。结果 糖尿病住院患者择期手术89例，死亡2例，其中术前死亡1例，术中、术后未发生严重并发症。结论 控制血糖和抗感染是围手术期处理的关键因素，可使患者安全度过围手术期。     

Prevalence and predictors of an abnormal stress myocardial perfusion study in asymptomatic patients with type 2 diabetes mellitus

Purpose  The purpose of this study was to evaluate the prevalence of an abnormal stress myocardial perfusion study in a cohort of truly asymptomatic patients with type 2 diabetes mellitus using myocardial perfusion imaging by means of single photon emission computed tomography (SPECT). Secondly, we determined which clinical characteristics may predict an abnormal stress myocardial perfusion study in this population. Methods  A total of 120 asymptomatic patients (mean age 53±10 years) with type 2 diabetes mellitus and one or more risk factors for coronary artery disease were prospectively recruited from an outpatient diabetes clinic. All patients underwent myocardial perfusion imaging by means of adenosine ^99mTc sestamibi SPECT. Images were evaluated for the presence of perfusion abnormalities as well as other nonperfusion abnormalities that may indicate extensive ischaemia, including left ventricular dysfunction (defined as a left ventricular ejection fraction <45%), transient ischaemic dilatation and adenosine-induced ST segment depression. Multivariable analysis was performed using a backward selection strategy to identify potential predictors for an abnormal stress myocardial perfusion study. Finally, all patients were followed up for 12 months to determine the occurrence of cardiovascular events: (1) cardiac death, (2) nonfatal myocardial infarction, (3) unstable angina requiring hospitalization, (4) revascularization, or (5) stroke. Results  Of the 120 patients, 40 (33%) had an abnormal stress study, including myocardial perfusion abnormalities in 30 patients (25%). In 10 patients (8%), indicators of extensive (possibly balanced ischaemia) were observed in the absence of abnormal perfusion. The multivariable analysis identified current smoking, duration of diabetes and the cholesterol/high-density lipoprotein (HDL) ratio as independent predictors of an abnormal stress study. During a follow-up period of 12 months six patients (5%) had a cardiovascular event. Conclusion  The current study revealed a high prevalence of abnormal stress myocardial perfusion studies in patients with type 2 diabetes mellitus despite the absence of symptoms. In contrast to earlier studies, current smoking, duration of diabetes and the cholesterol/HDL ratio were identified as independent predictors of an abnormal study.