Variation of serum monocyte chemoattractant protein-1 in patients with diabetes and metabolic syndrome

This study investigated the variation of serum monocyte chemoattractant protein-1(MCP-1) in patients with both diabetes mellitus(DM) and metabolic syndrome(MS).Based on the International Diabetes Federation(IDF) diagnostic criteria,93 patients enrolled in this study were divided into four groups:normal control(NC),simple DM,simple MS,and DM plus MS(DM-MS) groups.The main measures included height,weight,waist circumference(WC),hip circumference,blood pressure,fasting blood glucose,insulin resistance index(HOMA-IR),serum triglyceride(TG),HDL-ch,LDL-ch,and MCP-1.The results showed that the serum levels of MCP-1 in the DM-MS group were significantly increased as compared with those in the DM and MS groups(P<0.05),and the increase in the MCP-1 level in the DM group was much higher than in the MS group(P<0.05).The DM-MS group had the highest HOMA-IR levels,followed by MS,DM and NC groups(P<0.05).Correlation tests showed that the association of MCP-1 with age,HDL-ch,or LDL-ch was insignificant,whereas that of MCP-1 with body mass index(BMI),waist hip rate(WHR),WC,systolic blood pressure(SBP),diastolic blood pressure(DBP),TG,and HOMA-IR was significantly positive.It was concluded that circulating MCP-1 was substantially increased in patients with both DM and MS as compared with that in the patients with DM or MS alone,and the central obese state may contribute to a more vicious proinflammatory condition and insulin resistance in patients with diabetes.     

Protective effects of Modified Linggui Zhugan Decoction combined with short-term very low calorie diets on cardiovascular risk factors in obese patients with impaired glucose tolerance

OBJECTIVE:To observe the protective effects of modified Linggui Zhugan Decoction combined with short-term very low calorie diets(VLCDs) on cardiovascular risk factors in obese patients with impaired glucose tolerance(IGT).METHODS:Eighty-five obese patients with IGT of spleen hypofunction and dampness accumulation type were randomly divided into treated group(n=45)and control group(n=40).The treated group was given Linggui Zhugan Decoction combined short-term VLCDs.The control group was given basic weight-reduction treatment.The total course was 6 months.Changes of fasting plasma glucose(FPG),2-hour postprandial blood glucose(2hPG),glycosylated hemoglobin(HbA1c),fasting insulin(FINS),lipid metabolism,blood pressure,body mass index(BMI) and waist circumference(WC) were observed,and the outcomes were reviewed after the treatment.RESULTS:Compared with the control group,the levels of FPG,2hPG,HbA1c,FINS,HOMA-IR decreased significantly(P<0.05),and the indexes of total cholesterol(TC),triglyceride(TG),low-density lipoprotein(LDL),systolic blood pressure(SBP),diastolic blood pressure(DBP),BMI and WC were improved significantly(P<0.05) in the treated group.The transformation rate of normal glucose tolerance(NGT) was higher in treatment group than control group(P<0.01).No severe adverse reaction was found in the therapeutic course.CONCLUSION:The modified Linggui Zhugan Decoction combined with short-term VLCDs has good protective effects on cardiovascular risk factors as a treatment intervention for IGT with obesity,as it could improve glycometabolism,significantly decrease the levels of blood pressure,blood lipids,BMI,WC and effectively cut-off and reverse the development of diabetes mellitus.     

Preliminary study on relationship between tcm syndrome-type and insulin resistance in coronary heart disease

To observe the relationship between TCM Syndrome-type and insulin resistance (ISR) in coronary heart disease (CHD). Methods: Fifty patients were divided into 3 groups according to the Syndrome Differentiation-typing in TCM, the Heart blood stasis (HBS) Syndrome group, the Phlegm-Turbid stagnation (PTS) Syndrome group and both Qi-Yin Deficiency (QYD) Syndrome group. The fasting blood glucose (FBG), fasting blood insulin (Ins), insulin antibody (IAA), islet cell antibody (ICA), glutamic acid decarboxylase antibody (GAD-Ab) and related blood lipid parameters in patients were determined and insulin sensitive index (ISI) was calculated simultaneously. Then the above-mentioned data were compared with those determined in 20 healthy control subjects. Results: The levels of FBG and Ins in CHD group were higher than those in the healthy control group significantly (P＜0.05), but ISI level was obviously lower (P＜0.01). Moreover, the positive percentage of IAA (40%) was higher in CHD group than that in the control group (5%) significantly (P＜0.01). Comparison between the 3 TCM Syndrome-type groups and the control group showed that ISI level in HBS and PTS group was obviously lower than that in the control and the QYD (P＜0.05) respectively, and the IAA positive percentage in the former 2 groups (50%, 47.37%) was higher than that in the latter two (5%,P＜0.01 and 15.38%, P＜0.05) markedly. While Ins level increased only in the HBS group (P＜0.05). Besides, patients of HBS and PTS Syndrome were accompanied by lipid metabolic disturbance. Conclusion: ISR presents in part of CHD patients particularly in those with HBS and PTS Syndrome, which was partly due to the existence of serum IAA in patients.     

Increased circulating myostatin in patients with type 2 diabetes mellitus

The changes of plasma myostatin levels in patients with type 2 diabetes mellitus(T2D) and their clinical correlation were investigated.We recruited 43 T2D patients and 20 age-matched healthy subjects.Plasma myostatin,lipid and glucose,and serum insulin were determined.T2D patients showed significantly higher fasting plasma glucose(FPG),serum insulin and triglyceride levels,and lower high-density lipoprotein levels than normal control subjects(P<0.01).Mean plasma myostatin level in T2D patients and health controls was(66.5±17.8) and(46.2±13.8) ng/mL,respectively.An unpaired t test showed that the increase of myostatin in the T2D patients was significant(P<0.001).In both healthy control and T2D groups,the female subjects showed higher myostatin levels than the male subjects.In the T2D patients,plasma level of myostatin was negatively correlated with body mass index(BMI,r=-0.42,P<0.01) and FPG(r=-0.51,P<0.01),but positively correlated with insulin resistance index(HOMA-IR,r=0.48,P<0.01).Up-regulation of plasma myostatin in the T2D patients and its correlation with BMI,FPG and blood insulin sensitivity suggests that plasma myostatin may be implicated in the pathogenesis of T2D and thus presented as a therapeutic target for treating the disease.Furthermore,circulating myostatin levels may be used as a biomarker for the disease.     

Effects of Danqidihuang Granules on glucolipid metabolism in insulin-resistant rats

OBJECTIVE:To explore whether the insulin resistance(IR) model could be established through feeding Sprague-Dawley(SD) rats high-sugar and high-fat diets and to further observe the preventive and treatment effects of different doses of Danqidihuang Granules in rats.METHODS:Thirty-two SD rats were divided randomly into control group A(given regular feed),model group B(food high in sugar and fat),intervention group C(food high in sugar and fat as well as regular doses of Danqidihuang Granules),and intervention group D(food high in sugar and fat as well as double doses of Danqidihuang Granules).The interventions were for 8 weeks.Motion,change in color,body weight,and food intake,as well as plasma lipids(including low-density lipoprotein-cholesterol(LDL-C),high-density lipoprotein-cholesterol(HDL-C),total cholesterol(TC) and triglyceride(TG),fasting blood glucose(FBG),fasting insulin(FINs) levels,insulin sensitivity index(ISI),and insulin resistance index(HOMO-IR) were observed.RESULTS:At the end of the second week of the experiment,the appetite and activities of rats in groups B,C and D decreased significantly compared with group A.The fur of the rats in those three groups was curly.After the fourth week,the activities,food intake and color of rats in group B were worse than those in groups C and D,but there were no significant differences in weight(P>0.05).Compared with group A,LDL-C,TC,FBG and HOMO-IR in model group B were increased significantly(P<0.05),whereas the FINs and ISI increased obviously(P<0.05).The levels of LDL-C and TC in group D was decreased obviously compared with those in group C,and HOMO-IR in group D was less than that in group B(P<0.05).CONCLUSION:Danqidihuang Granules helped to prevent and improved the insulin resistance of rats.     

Effect of Compound Laser Acupuncture-Moxibustion on Blood Glucose, Fasting Insulin and Blood Lipids Levels in Type 2 Diabetic Rats

Objective: To investigate the effect of compound laser acupuncture-moxibustion on blood glucose, fasting insulin and blood lipids levels in type 2 diabetes mellitus(T2DM) rats. Methods: Forty male Wistar rats were randomly divided into 4 groups, including the normal group, model control group, laser group and sham laser group(n=10 per group). The rats in the normal group were fed with a standard diet. Rats in other groups were fed with a high-sugar and high-fat diet for 4 weeks, then intraperitoneally injected with 1% streptozotocin to induce T2 DM model. The laser group was irradiated by 10.6 μm and 650 nm compound laser on bilateral Pishu(BL 20), Shenshu(BL 23) and Sanyinjiao(SP 6) for 5 min, 6 times a week for 5 weeks. The sham laser group received the same treatment as the laser group, but without laser output. The model control group and normal group were not treated. Blood glucose levels were measured before and after 1, 2, 3, 4 and 5 weeks of treatment. The serum levels of fasting insulin, total cholesterol(TC), triglyceride(TG), low-density lipoprotein(LDL), and high-density lipoprotein(HDL) were analyzed after the last treatment. Results: The blood glucose levels in the model control group increased during the 5 weeks of treatment compared with the normal group(P0.05), while those in the laser group were significantly lower than the model control group after weekly treatment(P0.01 or P0.05). After 1, 2 and 3 weeks of treatment, the blood glucose levels in the laser group decreased obviously compared with the sham laser group(P0.01 or P0.05). Compared with the normal group, the levels of fasting insulin, TC and LDL in the model control group notably increased(P0.01 or P0.05), while their levels in the laser group were significantly lower than the model control group after 5 weeks of treatment(P0.05 or P0.01). However, no statistically significant differences were observed in TG or HDL levels among the 4 groups(P0.05). Conclusion: The compound laser acupuncture-moxibustion of 10.6 μm and 650 nm had positive effects on the regulation of hyperglycemia and insulin resistance in T2 DM rats, which may be a potential treatment for T2 DM, and also provide an alternative to the traditional acupuncture and moxibustion therapy.     

Effect of ARB on Expression of CD68 and MCP-1 in Adipose Tissue of Rats on Long-term High Fat Diet

In adipose tissue of rats on long-term high fat diet, the inflammatory changes the roles of angiotensin receptor blocker （ARB） in pimelitis and insulin resistance （IR） were observed. LR rat model was established by feeding high calorie and high fat diet. The change in insulin sensitivity was detected by euglycemic-hyperinsulinemic clamp technique 8 weeks after intervention by valsartan. The expression levels of CD68 and MCP-1 mRNA and proteins in adipose tissue were examined by RT-PCR and immunohistochemistry respectively. The parameters of blood glucose, insulin and blood lipid were analyzed. The results showed that in high fat diet group intra-abdominal obesity developed the content of visceral fat and the number of inflammatory cells in local adipose tissue were significantly increased （P〈0.01）, the levels of serum triglyceride, free fatty acids and fasting serum insulin were markedly increased, the insulin sensitivity was significantly lowered （P〈0.01）, and the expression of CD68 and MCP-1 was significantly increased as compared with control group （P〈0.01）. In ARB interventional group, the content of visceral fat, the number of inflammatory cells and the ex- pression of CD68 and MCP-1 in local adipose tissue were significantly reduced （all P〈0.01）, but the insulin sensitivity was significantly enhanced （P〈0.01） as compared with high fat diet group. There were pimelitis and IR in rats with obesity induced by long-term high calorie and high fat diet. The ARB can significantly inhibit the infiltration of macrophages and the expression of MCP-1 in adipose tissue, thereby attenuating the inflammation and improving LR in rats.     

Effect of Tang No.1 granule (糖1号方) in treating patients with impaired glucose tolerance

Objective： To observe the therapeutic effect of Tang No.1 granule （糖1号方, T1G） in treating patients with impaired glucose tolerance （IGT）. Methods： One hundred and forty patients with IGT and with Pi （脾）-Wei （胃） dampness-heat syndrome type were assigned randomly according to their visiting sequence into two equal groups. The control group received only general knowledge about IGT, but to the treated group, based on current knowledge available, T1G was given additionally for 6 months. Changes in related laboratory indexes, including fasting plasma glucose and insulin （FPG and FINS）, plasma glucose 2 h after meal （2hPG）, glycosylated hemoglobin （HbAlc）, serum triglyceride （TG）, low density lipoprotein cholesterol （LDL） and insulin resistance index （HOMA-IR）, were observed. Results： The levels of FPG, 2hPG, HbAlc, FINS, TG and HOMA-IR were significantly decreased after treatment in the treated group, showing a significant difference compared to the control group （P〈0.01）. Among them, HbAlc decreased from 7.08±1.41% to 6.56±1.29% in the treated group, while in the control group, it decreased from 7.02±1.37% to 6.93±1.31%. The level of LDL was also reduced in the treated group after treatment （P〈0.05）. In the treated group, 13 out of 68 patients （19.12%） had their glucose tolerance reversed to normal, while in the control group, only 2/64 （3.1%） got it reverse; a comparison between the two groups in terms of reversion rate showed a significant difference （P〈0.01）. No severe adverse reaction was found in the therapeutic course. Conclusions： T1G has good clinical effect as a treatment intervention for IGT, as it could improve glycometabolism, significantly depress the levels of post-prandial blood sugar and blood lipids, alleviate clinical symptoms of patients, and effectively cut-off and reverse the yielding and development of diabetes mellitus.     

Effect of detoxification, removing stasis and nourishing yin method on corticosteroid-induced hyperlipidemia in patients with systemic lupus rythematosus

Objective:To observe the effect of TCM therapy for detoxification,removing stasis,and nourishing yin on corticosteroid-induced hyperlipemia in patients with systemic lupus erythematosus (SLE),and to investigate its mechanism.Methods:One hundred and seventy patients with SLE were randomly assigned to the integrative medicine group (IM group) and the Western medicine group (WM group),85 in each group.Also,30 healthy subjects selected from blood donors were enrolled in the normal control (NC) group.All patients were treated mainly with prednisone, while those in the IM group were given TCM therapy additionally,and the therapeutic course for both groups was 6 successive months.The changes of serum total cholesterol (TC),triglyceride (TG),high density lipoprotein cholesterol (HDL-G),low density lipoprotein cholesterol (LDL-C),very low density lipoprotein cholesterol (VLDL-C) and apolipoprotein A (ApoA) were determined and observed.A 2-year follow-up study was carried out in 16 patients of the WM group and 25 of the IM group.Results:Before treatment,no significant difference had been found among the three groups in the serum levels of lipids and lipoproteins.After the 6-month treatment,as compared with the WM group,the IM group showed lower levels of TC,TG,LDL-C,and VLDL-C (P<0.05 or P<0.01) and higher levels of HDL-C and ApoA (P<0.05).A similar effect was also shown by the follow-up study in the IM group (P<0.05 or P<0.01). Conclusion:TCM therapy for detoxification,removing stasis,and nourishing yin can effectively regulate the levels of serum lipids and lipoproteins in preventing and treating SLE patients with corticosteroid- induced hyperlipemia.     

子宫内膜异位症伴不孕患者行腹腔镜联合药物治疗效果观察

目的观察子宫内膜异位症伴不孕患者行腹腔镜联合药物治疗的临床疗效。方法选择2009年6月至2011年6月厦门长庚医院收治的Ⅲ^Ⅳ期盆腔子宫内膜异位症伴不孕患者84例,按照不同的治疗方法分为观察组和对照组,各42例,两组患者均采用腹腔镜手术治疗,观察组患者在腹腔镜治疗的基础上加用药物(醋酸戈舍瑞林缓释植入剂)治疗。比较两组患者治疗后的妊娠率、CA125水平。结果治疗后观察组患者的治疗术后妊娠率为47.62%,对照组为16.67%,两组比较观察组的妊娠率显著高于对照组(P<0.05);两组患者治疗后的CA125水平均发生显著改善,且观察组改善情况优于对照组(P<0.01);治疗后观察组患者的不良反应发生率低于对照组(2.38%vs19.05%),两组比较差异有统计学意义(P<0.05)。结论采用腹腔镜手术合并药物治疗ⅢⅣ期盆腔子宫内膜异位症伴不孕患者84例,按照不同的治疗方法分为观察组和对照组,各42例,两组患者均采用腹腔镜手术治疗,观察组患者在腹腔镜治疗的基础上加用药物(醋酸戈舍瑞林缓释植入剂)治疗。比较两组患者治疗后的妊娠率、CA125水平。结果治疗后观察组患者的治疗术后妊娠率为47.62%,对照组为16.67%,两组比较观察组的妊娠率显著高于对照组(P<0.05);两组患者治疗后的CA125水平均发生显著改善,且观察组改善情况优于对照组(P<0.01);治疗后观察组患者的不良反应发生率低于对照组(2.38%vs19.05%),两组比较差异有统计学意义(P<0.05)。结论采用腹腔镜手术合并药物治疗Ⅲ^Ⅳ期盆腔子宫内膜异位症能够有效提高妊娠率,降低CA125水平,是治疗子宫内膜异位症伴不孕的有效方法,水平得临床广泛推广。     

丙硫咪唑治疗囊虫病82例疗效观察

１３年来我们用丙硫咪唑治疗囊虫病８２例，其中Ａ组（皮肌型）总有效率１００％，Ｂ组（脑囊虫病）总有效率９０％，ＡＢ两组治疗前后有非常显著性差异（Ｐ＜０．０１）。采用小剂量，长疗程的服药方法，既能杀死虫体而反应轻，表明丙硫咪唑是治疗囊虫病疗效好毒性低口服方便的药物。     

推拿配合膏摩治疗小儿原发性遗尿症

用推拿配合膏摩，辨症加减治疗小儿原发症遗尿症52例，其治愈率为81％，有效率为19％，总有效率为100％．     

用Excel轻松处理学生的学期考试成绩

长期以来，教务处汇总处理学生学期考试成绩的工作相当繁重。在没有计算机的年代，每学期末，各学科成绩上报到教务处后，所有成绩的处理都是手工操作。近年来，计算机也只是代替了很少部分的人力，成绩的录入、校对、计算、统计汇总，以及各班班主任对学生成绩进行评定等，基本上还是手工操作，花费了大量的时间和精力，出错的几率还非常高，工作效率很低，严重影响了此项工作的顺利完成。     

腹腔镜联合胆道镜治疗胆总管结石的临床体会

目的 探讨腹腔镜联合纤维胆道镜治疗胆总管结石的可行性及临床应用价值. 方法 2000年～2007年我院对110例在术前通过B超或内镜超声确诊的胆总管结石患者行腹腔镜联合纤维胆道镜胆总管切开取石术,并与同期100例开腹手术者比较. 结果 2组手术均获成功,腹腔镜组胆总管Ⅰ期缝合46例,置T管引流64例.开腹组均置T管引流.2组比较, 手术时间、术中出血量、住院日差异有统计学意义;术后并发症发生率(胆瘘、出血),腹腔或切口感染率、残石率差异无统计学意义. 结论 腹腔镜联合纤维胆道镜是治疗胆总管结石安全、有效的方法 , 同样可起到创伤小、痛苦轻、恢复快、住院时间缩短等微创效果, 如能在取净结石的情况下行胆总管Ⅰ期缝合, 微创效果尤为明显.     

重视医疗投诉对医院医疗质量的促进作用

文章论述了医疗投诉的概念、形成原因和表现形式,分析了医疗投诉能发现医院工作中的问题和患者潜在的需求,是一项重要资源.医院必须畅通投诉渠道,建立和完善投诉体系及机制,充分重视医疗投诉对医院医疗质量的促进作用.     

Phaeochromocytoma with myocarditis managed with alpha-methyl-p-tyrosine.

A case of bilateral phaeochromocytoma with catecholamine-induced myocarditis is described. The two operations needed allowed comparison of the use of alpha-methyl-p-tyrosine alone and in conjunction with adrenergic blocks in the management of the patient. The combination of both drugs was particularly successful in the relief of symptoms and reduction of catecholamine metabolism as monitored by 4-hydroxy-3-methoxymandelic acid (HMMA) excretion. As myocarditis is a potentially fatal complication, further investigation of the combined use of alpha-methyl-p-tyrosine and adrenergic blocking drugs is suggested in the pre-operative management of patients with phaeochromocytoma.     

止痛药物与抗抑郁药物联合治疗伴有抑郁状态的癌痛临床研究

目的:研究不同类型的抗抑郁剂作为辅助性干预伴有抑郁状态的癌痛患者治疗效果及生活质量提高情况。方法:采用QOL(肿瘤患者生活质量评分)、SDS(抑郁自评量表),HRSD(汉密顿抑郁量表)、NRS(疼痛数字分级法),将100例患者随机分组,全部患者在不受干扰、继续常规应用止痛药物芬太尼透皮贴剂的同时进行抗抑郁药物辅助性干预治疗。A组:抗抑郁药物选择盐酸文拉法莘,B组:选择三环类抗抑郁药物阿米替林,分别于服药当日及服药后4周进行相关各项指标的评定比较。观察辅助性抗抑郁药物对伴有抑郁状态的癌痛患者抑郁情绪及生活质量提高情况;观察联合用药对疼痛程度、强度的影响及抗抑郁药物的毒副反映情况。结果:A组患者抑郁情绪及生活质量有明显改善,治疗前后比较差异有统计学意义(P<0.05),B组治疗前后差异无统计学意义(P>0.05),同时NRS在两组患者中均有明显下降(P<0.05)。A组患者在用药期间未见明显的不良反应,B组患者出现口干、多语、嗜睡、视物模糊、体位性低血压等不良反应。结论:在伴有抑郁状态的癌痛患者治疗中常规应用止痛药物同时加用抗抑郁药物非常有必要。阿米替林副反应较大不宣作为推广和首选,盐酸文拉法莘抗抑郁效果好,毒副反应小,使用安全,尤其适合体弱的晚期伴有抑郁情绪的癌痛患者。