DPP-4抑制剂调节血糖的作用机制及临床疗效

传统降糖药物的局限2型糖尿病的主要发病机制是由于遗传和生活方式等因素导致的胰岛素抵抗和胰岛B细胞功能衰竭.胰岛素抵抗主要是在骨骼肌、肝脏和脂肪细胞胰岛素作用受损[1].胰岛B细胞功能衰竭在2型糖尿病的发生发展过程中起着重要作用,与健康的葡萄糖耐量正常人相比,新诊断的2型糖尿病患者B细胞功能下降了75％～80％[1,2].糖尿病诊断以后,胰岛B细胞功能会进行性下降[3].     

2型糖尿病一级亲属脂联素水平与胰岛素抵抗的相关性研究

2型糖尿病(T2DM)患者的家族成员发生糖尿病(DM)和糖耐量减低(IGT)的机会远高于非糖尿病患者的家族成员,其中一级亲属更是糖尿病家系中的高危人群[1].本研究探讨2型糖尿病患者正常糖耐量一级亲属胰岛素抵抗(IR)和B细胞功能,以及脂联素水平在2型糖尿病发病中的作用.     

α-硫辛酸对2型糖尿病患者血清sICAM-1和尿白蛋白排泄的影响

α-硫辛酸(α-lipoic acid,ALA)是一种类维生素物质,存在于线粒体,能通过清除活性氧和自由基减轻氧化应激水平,是唯一兼具脂溶性和水溶性的万能抗氧化剂,现已用于临床治疗氧化应激、糖尿病及其相关并发症等有关疾病[1-2].但其对于糖尿病肾脏抗炎保护作用目前研究尚少.本实验通过观察ALA治疗前后2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清可溶性细胞间黏附分子-1(soluble intercellular adhesion molecule-1,sICAM-1)水平和尿白蛋白排泄的变化,探讨ALA对T2DM患者血清sICAM-1水平的影响及其肾脏保护机制.     

核转录因子κB与脑缺血再灌注损伤

脑缺血再灌注损伤(CIRI)是由兴奋性(氨基酸)中毒、氧化应激、细胞内钙超载、炎症反应和细胞凋亡(AP)等多种因素参与的病理过程[1].以往对CIRI机制的研究主要集中在氧化应激、兴奋性(氨基酸)中毒、细胞内钙超载等方面,近年来随着分子生物学的发展,发现CIRI与炎症反应和细胞凋亡也有着密切的关系.     

8-异前列腺素F2α与糖尿病肾病的相关性

糖尿病肾病是2型糖尿病的重要并发症.在糖尿病肾损伤的机制中,氧化应激损伤发挥着重要作用[2].8-异前列腺素F2α(8-iso-PGF2α)的产生机制及过程与过氧化损伤极为密切,是近年来学者们研究和评估过氧化损伤的热点.本研究检测不同程度2型糖尿病肾病患者血清8-iso-PGF2α水平,探讨其与糖尿病肾病的相关性.     

氧化应激和糖尿病肾病的研究进展

糖尿病肾病(DN)是糖尿病最常见而严重的慢性并发症,已成为导致终末期肾功能衰竭而进行透析治疗的重要原因,全世界范围内需要透析治疗的新病例中有35%～40%是由糖尿病肾病引起[1].目前DN的发病机制尚未完全明了,已知的主要影响机制有:高血糖引发的四大经典途径、血流动力学障碍及多种细胞因子、生长因子和趋化炎症反应物质的产生[2].近几年氧化应激(oxidative stress,OS)学说备受国内外学者的关注, 本文就氧化应激的产生途径、对糖尿病肾组织的影响及抗氧化治疗进展等作一综述.     

胰岛素治疗初诊2型糖尿病疗效观察

对于初诊2型糖尿病,以往的观点是当最佳的口服药物治疗方案和生活干预后,糖化血红蛋白(HbAlC)仍然>7.5%时,才使用胰岛素治疗[1].近年来,越来越多的研究表明积极应用胰岛素泵持续输注胰岛素强化治疗初诊2型糖尿病.能够使患者的胰岛B细胞功能得到保护[2～4].我院对2007年5月～2008年12月收治的初诊2型糖尿病32例患者采用胰岛素多次注射强化治疗法,已取得了良好的近期及远期疗效.现报道如下.     

过氧亚硝基阴离子在糖尿病及其并发症中的作用

据世界卫生组织统计,2002年全球约有1.7亿糖尿病患者,预计到2030年患糖尿病的人数将增加1倍[1].在糖尿病患者中2型糖尿病约占90%,以胰岛素抵抗为特点,并与肥胖和脂质代谢紊乱有关.1型糖尿病人占5%～10%,主要发生于儿童和青年人,以分泌胰岛素的胰腺β细胞损伤导致胰岛素分泌不足为特点.高血糖是这两种类型糖尿病最显著的特征.持续的高血糖刺激可引起氧化应激和硝化应激,导致过量一氧化氮(NO)和超氧阴离子产生,两者通过非酶促化学反应可形成细胞毒性更强的过氧亚硝基阴离子(ONOO-).     

肝内异种胰岛细胞移植治疗1型糖尿病的护理体会

糖尿病(DM)是由多种原因引起的胰岛B细胞功能减退或衰竭,导致胰岛素分泌绝对或相对不足.其中1型糖尿病患者终身需要依赖胰岛素治疗,给患者生活及工作带来痛苦与不便.进行胰岛细胞移植是治疗糖尿病的有效方法[1].我科于2005年成功进行了2例猪胰岛细胞移植,通过对患者治疗护理及院外随访,患者胰岛素用量较移植前明显减少,未再发生酮症酸中毒,现将护理体会报告如下.     

肝内异种胰岛细胞移植治疗1型糖尿病的护理体会

糖尿病(DM)是由多种原因引起的胰岛B细胞功能减退或衰竭,导致胰岛素分泌绝对或相对不足.其中1型糖尿病患者终身需要依赖胰岛素治疗,给患者生活及工作带来痛苦与不便.进行胰岛细胞移植是治疗糖尿病的有效方法[1].我科于2005年成功进行了2例猪胰岛细胞移植,通过对患者治疗护理及院外随访,患者胰岛素用量较移植前明显减少,未再发生酮症酸中毒,现将护理体会报告如下.     

Degraded and undegraded carrageenans and experimental gastric and duodenal ulceration

The prevention of histamine-induced gastric and duodenal ulceration in the guinea-pig has been examined using a series of undegraded and degraded carrageenans. Undegraded carrageenans were active at lower doses than degraded carrageenans. The high viscosity of the undegraded carrageenans in solution prevented their use in larger doses. Degradation of carrageenan without serious loss of sulphate, gives a product which allows the dose to be increased to an extent that its effect more than offsets the slight loss in activity caused by the degradation. No single feature of carrageenan structure can be related to anti-ulcer activity although degradation, and hence reduction of molecular size, generally reduces activity. Sulphate contents over 30% have little apparent effect on activity; κ-carrageenans were not consistently different in anti-ulcer activity from Λ-carrageenans. This contrasts with the antipeptic activity of carrageenans where κ-carrageenans are less active than their Λ-counter-parts. As with antipeptic activity, the degree of anti-ulcer activity is probably determined by a combination of structural features which includes molecular size and polyanionic properties.     

Affective and Anxiety Disorders and Alcohol and Drug Dependence:

Depression and anxiety frequently coexist in patients with substance use disorders. This clinically-oriented article examiens the relationship between these conditions and emphasizes data showing that substances of abuse can cause signs and symptoms of both depression and anxiety. These substance-related syndromes appear to have a different course and prognosis than uncomplicated, independent anxiety and major depressive disorders, and clinicians should consider the role of alcohol and other drugs in all patients presenting with these complaints. The authors will also outline an approach for diagnosing and managing patients with the combination of a substance use and depressive or anxiety disorder.     

Alcohol and Substance Use and Abuse in Women and Children

No abstract available for this article.     

Glucosidase and fucosidase inhibitors and Advances in nucleosides and nucleotides.

The American Chemical Society Symposium "Glucosidase and fucosidase inhibitors" took place on 1 April 1998 and was organized by Professors Zbigniew J Witczak (UConn, School of Pharmacy, CT, USA), Kuniaki Tatsuta (Waseda University, Tokyo, Japan) and Waldemar Priebe, MD (Anderson Cancer Center, University of Texas, USA). Professor Witczak provided introductory remarks including the status of existing glucosidase inhibitors, and chaired the morning session, which consisted of six lectures. The symposium was well received, and was particularly attractive for those interested in networking, as attendance was about sixty. In addition, some participants and attendees presented posters on the subject during the regular poster session organized by the Division of Carbohydrate Chemistry.