2型糖尿病合并非酒精性脂肪肝患者血清铁蛋白水平与氧化应激、胰岛素抵抗的关系

目的 探讨合并非酒精性脂肪肝(NAFLD)的2型糖尿病(T2DM)患者血清铁蛋白(SF)水平与氧化应激、胰岛素抵抗的关系.方法 对44例T2DM患者(A组,22例,无NAFLD;B组,22例,合并NAFLD)和健康体检者(C组,22例)检测了血总胆固醇(TC)、甘油三酯(TG)、空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、SF和丙二醛(MDA)水平,并采用稳态模型评估胰岛素抵抗指数(HOMA-IR).结果 A组和B组的SF、MDA水平高于C组(P＜0.01),B组SF、MDA水平显著高于A组(P＜0.01).SF水平与病程、体重指数、TC、TG、HbA1c、FPG、FINS、HOMA-IR、MDA水平呈正相关.结论 T2DM合并NAFLD患者体内铁超负荷;氧化应激、胰岛素抵抗可能参与了NAFLD的发生发展.     

罗格列酮联合二甲双胍治疗2型糖尿病的疗效和安全性研究

目的：观察罗格列酮（RGZ）联合二甲双胍（IⅥet）治疗2型糖尿病（％DM）的疗效和安全性。方法：将97例T2DM患者随机分为两组,A组采用RGZ联合Met治疗,B组采用格列齐特联合Met治疗,观察比较两组治疗前后FPG、2hPG、Fins、2h Ins、HbA1c、BMI、HOMA-IR等指标变化。结果：治疗后A组除BMI有升高外,其余各项指标均有改善,P均〈0.01;B组FPG、2hPG、HbA1c较治疗前下降,P〈0.05,而Fins、2h Ins、HOMA-IR、BMI无显著变化,P〉0.05。结论：RGZ联合Met治疗T2DM疗效确切,不但可以降糖,减轻胰岛素抵抗,还减少了空腹及餐后胰岛素分泌,减轻了β细胞负担,用药前严格排除禁忌证则安全可靠。     

2型糖尿病患者外周血内皮祖细胞与CD_(62)P改变的临床意义

目的探讨2型糖尿病(T2DM)外周血中内皮祖细胞(EPCs)与与CD62P的关系。方法采用流式细胞仪测定30例初诊T2DM患者包括10例血糖控制良好(HbA1c<7%)T2DM患者(A组)、10例血糖控制中等(HbA1c7~11%)T2DM患者(B组)、10例血糖控制较差(HbA1c>11%)T2DM患者(C组)及10例糖耐量正常的健康对照者的外周血中EPCs和CD62P的含量。结果 EPCs在T2DM组显著低于健康对照组(P<0.05);血小板CD62P表达阳性程度在2型糖尿病患者中显著高于对照组(P<0.01)。C组EPCs水平明显低于B组及A组,C组与B组有差异(P<0.05);C组与A组有差异(P<0.01);B组低于A组,但无统计学意义(P>0.05);C组CD62P的水平显著高于B组及A组(P<0.05,P<0.01),B组与A组相比,差异有统计学意义(P<0.05)。相关性显示EPCs与CD62P(r=-0.564,P<0.01)呈负相关;EPCs与空腹血糖(FPG)(r=-0.341,P<0.05)呈负相关;CD62P与FPG(r=0.443,P<0.01)呈正相关。结论人类空腹血清EPCs水平在T2DM患者中明显降低,而CD62P明显增高,二者间存在一定的相关性。     

硫氧还蛋白相互作用蛋白与2型糖尿病及胰岛素抵抗的相关性

目的 探讨硫氧还蛋白相互作用蛋白(TXNIP)与2型糖尿病(T2DM)及胰岛素抵抗的关系.方法 采用ELISA法检测T2DM组(A组,54例)及正常对照组(B组,30例)患者血清TXNIP水平,同时检测糖化血红蛋白(HbAlc)、空腹血糖(FPG)、胰岛素(FINS)及血脂.结果 A组血清TXNIP水平显著高于B组(P＜0.05).TXNIP与FPG、HbAlc、胰岛素抵抗指数(HOMA-IR)呈显著正相关(P＜0.01); HbAlc和HOMA-IR是TXNIP的独立影响因素.结论 TXNIP可能参与了T2DM及胰岛素抵抗的病理生理过程.     

2型糖尿病患者血清铁蛋白水平检测的临床意义

目的:探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清铁蛋白(serum ferritin,SF)检测的临床意义.方法:对49例T2DM患者以及30例健康体检者分别测定SF,按SF高低将T2DM患者分为正常SF组和高SF组,检测并比较两组患者空腹血糖(fasting plasma glucose,FPG)、餐后2h血糖(2h glucose,2hPG)、糖化血红蛋白(glycosylated hemoglobin,HbA1C)、空腹胰岛素(fasting insulin,FTNS)、胰岛素抵抗指数(insulin resistance index,HOMA-IR)、尿白蛋白(urinary albumin,UAAlb)、总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG).结果:糖尿病(DM)组与对照组相比,SF水平显著升高,高SF DM患者具有较高的FPG、2hPG、HbAIC、UA1b、HOMA-IR和FINS,差异具有显著性(P＜0.01),两组TC和TG无显著区别.结论:T2DM患者体内铁贮备增多,对判断DM病情及早期肾损害有重要的临床价值.     

格列美脲联合甘精胰岛素治疗初诊2型糖尿病疗效观察

目的:探讨格列美脲联合甘精胰岛素或中性鱼精蛋白锌胰岛素强化治疗对糖化血红蛋白(HbA1c)＞9%的初诊2型糖尿病(T2DM)患者的疗效.方法:将58 例新诊断的T2DM患者随机分为甘精胰岛素治疗组(IG组)和鱼精蛋白锌胰岛素治疗组(NPH组),予睡前皮下注射胰岛素联合口服格列美脲治疗12周,对其在治疗前后血糖控制情况及胰岛β细胞功能进行自身及组间比较.结果:治疗后两组空腹血糖(FPG)、餐后2 h血糖(2 hPG)、HbA1c、胰岛素抵抗指数(HOMA-IR)均显著下降(P＜0.001);空腹C肽(FC-P)、餐后2 h C肽(2 h C-P)、胰岛素分泌指数(HOMA-islet)均显著升高(P＜0.001).组间比较IG组低血糖事件少于NPH组(P＜0.05).结论:格列美脲联用甘精胰岛素或中性鱼精蛋白锌胰岛素对HbA1c＞9%的初诊T2DM患者的疗效佳,但甘精胰岛素更能减少低血糖事件的发生.     

门冬胰岛素联合地特胰岛素对2型糖尿病强化治疗的疗效评价

目的 比较门冬胰岛素联合地特胰岛素与单纯使用门冬胰岛素对新诊断2型糖尿病（T2DM）患者治疗的安全性和有效性.方法 选取2010年9月-2013年5月在我院就诊的新诊断的T2DM 患者100例,随机分两组,A组联合使用门冬胰岛素和地特胰岛素强化治疗,B组单纯使用门冬胰岛素,比较两组治疗前后的静脉空腹血糖（FPG）、FPG达标率、糖化血红蛋白（HbA1c）、HbA1c达标率、静脉餐后2h血糖（2hPG）、2 hPG达标率、低血糖发生率情况.结果 强化治疗后两组FPG、HbA1c、2hPG均下降,A组较B组相关指标下降明显,且A组的FPG达标率增高,差异有统计学意义（P＜0.05）;A组低血糖发生率较B组低.结论 在控制T2DM患者的血糖方面,采用门冬胰岛素联合地特胰岛素的强化治疗方案更为安全有效.     

西格列汀治疗老年2型糖尿病的临床观察

目的观察西格列汀(SITA)治疗2型糖尿病(T2DM)的临床疗效。方法将79例T2DM患者随机分为2组,A组39例单纯采用胰岛素治疗,B组40例采用SITA治疗,观察两组餐后2 h血糖(2hPG)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、体重指数(BMI)及胰岛素分泌指数(HOMA-B)的变化。结果治疗8周后,B组2hPG、FPG、HbA1c、胰岛素用量及BMI均低于A组(P<0.05),HOMA-B高于A组(P<0.05)。结论SITA治疗T2DM可有效控制血糖,减少胰岛素用量,改善胰岛β细胞功能。     

超重T2DM患者血清Hcy、APN、LP、FFA的水平变化及其意义

目的 探讨超重型2型糖尿病(T2DM)患者血清同型半胱氨酸(Hcy)、脂联素(APN)、瘦素(LP)及游离脂肪酸(FFA)的变化及其意义.方法 选取2015年10月至2016年5月本院确诊的80 例T2DM患者,其中超重T2DM患者47例(A组)、非超重T2DM患者33例(B组)、单纯性超重患者30例(C组)、健康人群30例(D组),检测各组的血清Hcy、APN、LP、FFA及相关血糖、血脂指标并进行统计分析.结果 各组间血清Hcy、FFA、HOMA-IR比较,呈A组>B组>C组>D组,差异均具有统计学意义(P<0.05);各组间血清APN比较,呈A组相似文献   

踝肱指数（ABI）对糖尿病下肢动脉病变的筛查及其临床应用

目的：探讨踝肱指数（ABI）对糖尿病下肢动脉病变的筛查的意义及其临床应用。方法：取ABI阳性者68例入院治疗患者,随机分为A、B两组,A组为单纯降糖、降血脂治疗,B组除降糖、降血脂外加用丁咯地尔治疗,治疗3个月后再次复查ABI,观察两组治疗前后ABI、血压、空腹血糖（FPG）、餐后2h血糖（2hPG）、总胆固醇（TC）、甘油三脂（TG）变化。结果：1538例糖尿病患者ABI测定阳性者为394例,阳性率为25.6%,ABI阳性患者经下肢动脉彩超证实符合率达100%,ABI阳性者距诊断糖尿病病史1月至20年,ABI阳性患者病史超过5年者阳性率高达80%。治疗前患者年龄、病程、BMI、SBP、FPG、2hPG、TG、TC、ABI差异均无统计学意义,经治疗后A组患者FPG、TG明显下降（P＜0.05）,SBP、ABI无明显变化。B组患者治疗后较治疗前FPG、TG明显下降（P＜0.05）,SBP无明显变化,ABI明显改善（P＜0.05）。结论：ABI与下肢血管彩超对比相关性好,踝肱指数测量仪既可在诊室中使用,也适用于大规模人群的筛查;应用盐酸丁咯地尔后,临床症状及相关指标均显著优于对照组,ABI明显升高。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.