静松功结合有氧运动对糖尿病伴焦虑与抑郁情绪患者的影响

目的探讨静松功结合有氧运动对糖尿病伴焦虑与抑郁情绪患者的影响。方法将76例伴焦虑与抑郁情绪的2型糖尿病患者随机分为研究组40例和对照组36例,研究组患者采用有氧运动与医疗静松功相结合运动,对照组患者采用有氧运动。比较干预1、3、6个月后患者焦虑、抑郁状况及血糖各项指标。结果干预1、3、6个月后两组患者焦虑自评量表(self-rating anxiety scale,SAS)与抑郁自评量表(self-rating depression scale,SDS)得分、空腹血糖(fasting blood glucose,FBG)、餐后2h血糖(2hours postprandial bloodglucose,2hPBG)及糖化血红蛋白(glycosylated hemoglobin,GHB)均有明显改善,且研究组优于对照组,组间比较,差异具有统计意义(均P<0.05)。结论静松功结合有氧运动能更好地改善糖尿病患者焦虑与抑郁情绪,提高患者生活质量。     

抗阻运动训练配合药物治疗对2型糖尿病患者糖脂代谢指标的影响

目的探讨抗阻运动训练配合药物治疗对2型糖尿病患者糖脂代谢指标的影响。方法选择2018年2月至2019年2月某院收治的2型糖尿病患者92例,采用随机数表法分为两组,每组各46例。对照组接受常规抗糖尿病药物治疗,研究组在此基础上配合抗阻运动训练,持续观察16周。比较两组糖脂代谢指标及体脂改善情况。结果研究组训练16周后的空腹血糖、餐后2 h血糖、糖化血红蛋白(6.46±1.27)mmol/L、(10.88±1.74)mmol/L、(6.42±0.66)%均低于对照组的(7.12±1.36)mmol/L、(11.85±1.63)mmol/L、(6.75±0.62)%,差异有统计学意义(P<0.05);研究组训练16周后的总胆固醇、三酰甘油、低密度脂蛋白(4.06±1.55)mmol/L、(1.70±0.37)mmol/L、(1.69±0.44)mmol/L均低于对照组的(4.73±1.28)mmol/L、(1.89±0.35)mmol/L、(2.03±0.45)mmol/L,差异有统计学意义(P<0.05)。结论抗阻运动训练配合药物治疗对2型糖尿病效果显著,能够有效降低糖脂代谢指标水平,增强糖尿病控制效果。     

有氧运动对糖尿病小鼠血清白细胞介素6含量的影响

目的:观察有氧运动对糖尿病小鼠血清白细胞介素6含量的影响,为糖尿病运动疗法提供实验依据。方法:实验于2005-10/2006-04在成都体育学院运动医学实验室完成。①8周龄C57小鼠24只,用链脲佐菌采用腹腔注射法建立C57小鼠糖尿病模型,血糖浓度为16.7mmol/L的小鼠为造模成功,其中有2只造模失败。将剩余22只小鼠随机分为糖尿病有氧运动组与糖尿病模型组各11只。②糖尿病有氧运动组小鼠,第1,2天适应性游泳30min,以后每晚20:00开始运动,40min/次,1次/d,每周5d,连续运动4周。糖尿病模型组小鼠不进行有氧运动,每天自由饮食,保持清洁卫生。动态观察两组小鼠外观、体质量、血糖的变化。③第4周末在股动脉处取血1.5mL制备血清,用于测定血清白细胞介素6的含量。结果:纳入实验小鼠24只,其中2只造模失败。糖尿病有氧运动组溺水死亡1只,阳性对照组1只死于肺部感染。最终20只小鼠进入结果分析。①在第4周末糖尿病有氧运动组体质量明显高于糖尿病模型组[(16.6±0.39),(13.9±0.61)g,P<0.05],血糖水平明显低于糖尿病模型组[(22.84±1.85)mmol/L,(30.68±2.27)mmol/L,P<0.05]。②糖尿病有氧运动组有氧运动4周后血清白细胞介素6含量明显低于糖尿病模型组[(1.2420±0.7266)ng/L,(2.4075±0.7338)ng/L,P<0.05]。结论:有氧运动可改善糖尿病小鼠临床症状,其机制可能与有氧运动降低糖尿病小鼠血清白细胞介素6水平有关。     

八段锦应用于糖尿病前期人群中的效果及对血糖血脂水平的影响分析

目的分析糖尿病前期人群应用八段锦干预后血糖、血脂水平变化。方法将某院103例糖尿病前期患者应用随机数字表分组,两组患者均给予健康教育、控制饮食干预,对照组51例增加健步走训练,观察组52例应用八段锦训练,对比两组患者训练后血糖水平、血脂水平、体质量指数、腰臀比及糖尿病前期转正率。结果随访6个月,观察组体质量指数(BMI)(23.22±0.49)kg/m~2、餐后2 h血糖(2 hPG)(7.01±1.70)mmol/L、腰臀比(WHR)(0.80±0.04)、空腹血糖(FPG)(5.02±0.68)mmol/L、总胆固醇(TC)(4.80±0.57)mmol/L、三酰甘油(TG)(1.91±0.50)mmol/L、低密度脂蛋白胆固醇(LDL-C)(2.80±0.32)mmol/L水平及糖尿病确诊率1.92%均低于对照组(24.99±0.59)kg/m~2、(7.88±1.65)mmol/L、(0.86±0.05)、(5.77±0.90)mmol/L、(5.10±0.83)mmol/L、(2.11±0.67)mmol/L、(3.05±0.71)mmol/L及5.88%,高密度脂蛋白胆固醇(HDL-C)(1.49±0.33)mmol/L水平及糖尿病前期转正率48.08%高于对照组(1.35±0.41)mmol/L及27.45%(P0.05)。结论在控制饮食、健康教育基础上,应用八段锦能够有效调节糖尿病前期患者血糖血脂水平,改善患者身体形态,提升糖尿病前期转正率。     

胰岛素联合二甲双胍短期强化治疗对2型糖尿病胰岛β细胞功能的影响

目的观察胰岛素加二甲双胍的强化治疗方案对胰岛β细胞功能的影响。方法20例2型糖尿病经饮食和运动调节、使用磺脲类降糖药仍不能有效控制血糖的患者改用胰岛素加二甲双胍治疗,疗程为1个月,分别在治疗前和疗程结束后测定了糖化血红蛋白A1c(HbA1c)、空腹血糖(FBG)与餐后2小时血糖(2 hBG),并同时作了胰岛素(Ins)、C肽(CP)释放试验;HbA1c采用比色法测定,血糖采用葡萄糖氧化酶法测定,胰岛素、C肽采用放免法检测,并按照HOMA稳态模型公式计算胰岛β细胞功能指数(Homaβ)和胰岛素抵抗指数(Homa IRI)。结果与治疗前相比,强化治疗后HbA1c、FBG与2 hBG均见下降[分别为(10.6±17.6)%vs(9.8±10.4)%,(17.4±3.8)mmol/Lvs(6.5±1.1)mmol/L,(23.0±4.0)mmol/Lvs(9.1±0.7)mmol/L,均P<0.001];胰岛素峰值和Homaβ均显著升高[分别为(24.1±10.2)mU/Lvs(66.9±17.6)mU/L,(2.62±0.46)vs(4.99±0.52),均P<0.001];而IRI则略有下降([(7.89±4.13)vs(6.50±2.44),P<0.05]。结论胰岛素联合二甲双胍治疗能明显增强胰岛β细胞的功能,可用于磺脲类降糖药治疗无效的2型糖尿病患者。     

妊娠糖尿病患者的PDCA运动效果研究

目的:探讨PDCA循环模式对妊娠糖尿病患者的影响。方法:选取2014年4月~2015年4月在我院接受治疗的妊娠糖尿病患者150例为研究对象,将其随机等分成观察组和对照组,对照组采取常规护理,观察组在此基础上实行PDCA循环护理模式(分计划、实施、检查、处理4个阶段),观察比较两组患者血糖控制情况、并发症情况、平均住院天数及医疗费用情况。结果:观察组干预后1周空腹血糖水平(5.51±0.78)mmol/L和干预后1个月空腹血糖水平(4.34±0.61)mmol/L明显低于对照组[(6.48±1.21)mmol/L,(5.21±0.93)mmol/L];观察组患者并发症情况明显低于对照组;观察组患者平均住院天数[6.34(2.02)]d和医疗费用(5285.63±2190.62元)明显低于对照组[8.78(2.53)]d,(7398.49±2783.74)元,两组比较结果具有统计学意义(P0.05)。结论:PDCA护理模式对妊娠糖尿病患者血糖水平的控制、并发症的避免有积极成效,且能有效减少患者住院天数,降低医疗费用,值得临床推广运用。     

胰岛素泵在糖尿病治疗中的临床疗效分析

目的 分析糖尿病治疗中胰岛素泵的临床效果。方法 选取2020年6月—2021年9月在该院实施治疗的糖尿病患者137例,以胰岛素用药方式不同予以分组,69例予以胰岛素泵治疗的患者归入治疗组,68例予以胰岛素皮下注射的患者归入对照组,对比治疗效果。结果 两组患者治疗前血糖水平对比,差异无统计学意义(P>0.05);治疗后,与对照组睡前(8.25±2.35)mmol/L、餐后2 h血糖(8.25±1.65)mmol/L、空腹血糖(6.75±1.18)mmol/L比较,治疗组睡前血糖(6.55±1.35)mmol/L、餐后2 h血糖(7.18±0.95)mmol/L、空腹血糖(5.40±0.48)mmol/L均明显降低,差异有统计学意义(t=5.201、4.660、8.794,P<0.001)。治疗前血管内皮功能对比,差异无统计学意义(P>0.05);治疗后,与对照组NMD(17.10±1.65)%、FMD(5.05±0.68)%比较,治疗组NMD(21.10±2.25)%、FMD(7.35±0.75)%均明显较高,差异有统计学意义(t=11.852、18.796,P<...     

有氧运动对2型糖尿病前期患者糖脂代谢的影响

目的观察不同方式有氧运动(如跳绳、慢跑)对2型糖尿病前期患者糖脂代谢的影响。方法采用随机数字表法将36例2型糖尿病前期患者分为跳绳实验组、慢跑实验组及对照组,每组12例。3组患者均进行严格的饮食控制(未给予药物治疗),跳绳实验组、慢跑实验组则同时辅以跳绳运动或慢跑运动,每天运动1次,每次持续40 min,每周运动7 d。于入选时及干预3个月后分别对3组患者空腹血糖、餐后2 h血糖、糖化血红蛋白(HbA1c)、体质量指数(BMI)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)及低密度脂蛋白(LDL)等进行检测。结果跳绳实验组和慢跑实验组餐后2 h血糖、TC、TG、HDL、LDL均较治疗前及对照组明显改善(P0.05);并且跳绳实验组HDL、LDL含量[分别为(1.3±0.3)mmol/L、(2.0±0.5)mmol/L]亦显著优于慢跑实验组相应水平[分别为(1.1±0.6)mmol/L、(3.7±0.7)mmol/L],组间差异均具有统计学意义(P0.05)。结论跳绳运动、慢跑运动均能有效改善2型糖尿病前期患者血糖、血脂水平,并且以跳绳运动对患者血脂代谢的改善作用较显著。     

瑞格列奈治疗2型糖尿病疗效观察

目的探讨瑞格列奈治疗2型糖尿病的疗效。方法对136例2型糖尿病患者服用瑞格列奈0.5~4 mg,3次/d,用药12周观察疗效。结果治疗前空腹血糖(9.02±1.33)mmol/L,治疗后空腹血糖(6.30±1.13)mmol/L,治疗前餐后2 h血糖(15.89±2.32)mmol/L,治疗后餐后2 h血糖(10.23±1.05)mmol/L。结论瑞格列奈治疗2型糖尿病疗效确切,且能重塑人体胰岛素分泌的生理模式。     

甘精胰岛素联合瑞格列奈治疗2型糖尿病临床疗效评价

选取诊断为2型糖尿病并进行治疗的患者100例,按照随机对照原则,将其分为使用甘精胰岛素同瑞格列奈联合治疗的治疗组50例,使用预混胰岛素治疗的对照组50例。对两组的疗效进行统计分析。治疗组空腹血糖(6.21±0.52)mmol/L,餐后2h血糖(8.35±1.54)mmol/L,糖化血红蛋白(6.11±0.75)%。对照组空腹血糖(6.67±0.58)mmol/L,餐后2h血糖(10.48±2.71)mmol/L,糖化血红蛋白(7.19±0.67)%。两组对比,差异具有统计学意义(P<0.05)。治疗组有效率为90%(45/50),对照组为80%(40/50)。两组对比,差异具有统计学意义(P<0.05)。对于2型糖尿病使用甘精胰岛素同瑞格列奈联合的方法进行治疗,效果显著且安全性高,值得大力推广应用。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Clinical Pharmacokinetics of Morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.