GDM患者脂肪组织中HMGB1表达与产后糖代谢异常的关系

目的研究脂肪组织中高迁移率族蛋白B1(HMGB1)表达增加与妊娠期糖尿病(GDM)患者胰岛素抵抗程度及产后糖代谢异常的关系。方法选择2016年10月至2019年3月期间在海安市中医院诊断为GDM并接受剖宫产的126例患者作为GDM组,选择同期在该院接受剖宫产的健康孕妇150例作为对照组,检测剖宫产当天孕妇血清HMGB1、空腹胰岛素(FINS)的含量及脂肪组织中HMBG1、胰岛素受体底物(IRS)-1、IRS-2的表达水平,计算胰岛素抵抗指数(HOMA-IR)。随访产后1年内糖代谢异常的发生情况并绘制K-M曲线。结果GDM组患者脂肪组织中HMGB1的表达水平、血清HMGB1含量及FINS、HOMA-IR水平明显高于对照组(t值分别为14.496、16.503、19.068、13.446,P<0.05),脂肪组织中IRS-1、IRS-2的表达水平明显低于对照组(t值分别为11.616、10.596,P<0.05);GDM组患者脂肪组织中HMGB-1的表达水平与血清HMGB1、FINS的含量及HOMA-IR的水平呈正相关(r值分别为0.405、0.358、0.405,P<0.05),与脂肪组织中IRS-1、IRS-2的表达水平呈负相关(r值分别为-0.278、0.255,P<0.05);经K-M曲线分析,与GDM组中脂肪组织HMGB1低表达患者比较,HMGB1高表达患者产后1年糖代谢异常累积发生率明显升高(χ^(2)=3.933,P<0.05)。结论GDM患者脂肪组织中HMGB1表达增加与胰岛素抵抗的加重、产后糖代谢异常的发生有关。     

Zur Topographie des oberen Bicepssehnenabschnittes

Zusammenfassung Die polarisationsoptische and histologische Untersuchung des oberen Bicepssehnenabschnittes an 26 Schultern bestätigt, daß die Sehne ihren Ursprung nicht nur, wie allgemein angenommen, am Tuberculum supraglenoidale hat, sondern außerdem -förmig im Labrum glenoidale. Dieser Befund kann phylogenetisch erklärt werden. Im weiteren Verlauf der Sehne können neue Befunde im Bereich des Sulcus bicipitalis erhoben werden. Hier ist regelmäßig ein Mesotenonium nachweisbar, das durch einen bindegewebigen Ausläufer an Sulcusdach oder -grund befestigt ist. Darüberhinaus wird gezeigt, daß das Sulcusdach nicht als Ligament (Ligamentum transversum humeri) anzusprechen ist, es handelt sich vielmehr um Ausläufer der Kollagenfasern von Subscapularis- bzw. Kapselansatz am Tuberculum minus.

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Topography of the upper biceps tendon

Summary 26 shoulders are studied by polariscopic and histologic examination. It can be confirmed that the origin of the long biceps tendon is not only at the supraglenoid tubercle, but also -shaped in the glenoid labrum. This finding can be explained by phylogenetic means. Further details are found during the course of the tendon through the bicipital groove. A mesotenonium is seen regularly. This is fixed either to the roof or the ground of the sulcus by a band of connective tissue. It is shown also, that the roof of the groove is not a ligament (ligamentum transversum. humeri) but consists of collagen fibers continuing from the subscapularis and capsular attachment at the lesser tubercle.

     

甘油三酯增高者畸变产物耳声发射的初步观察

目的：观察甘油三酯增高者变畸变产物耳声发射（ＤＰＯＡＥ）的振幅和潜伏期的变化情况。方法：采用ＩＬＯ－Ｖ５耳动态分析仪检测３０例（５５耳）甘油三酯增高者和１８例（３６耳）正常人的ＤＰＯＡＥ的振幅和潜伏期。结果：本组病例虽无纯音听阈异常,但ＤＰＯＡＥ振幅明显下降,而潜伏振幅值和明显。结论：甘油三酯增高者耳蜗功能可能有早期的损害,ＤＰＯＡＥ的反应幅值和潜伏期在产生机制和影响因素方面有所差异。     

声门型喉癌T_3病变喉部分切除术后疗效评价

目的　探讨喉部分切除术对声门型喉癌T3 病变的可行性及修复材料的选择。方法　对 1986年 1月～ 1994年 1月 78例行喉部分切除术的声门型喉癌T3 病变患者的术式及修复方法进行了回顾性分析。结果　患者 3年、5年生存率分别为 88 5 %、75 6 % ,局部复发率 15 4%。应用了梨状窝粘膜 甲状软骨板外侧软骨膜、会厌软骨瓣及带状肌双肌双蒂瓣 3种方法修复创面 ,均获得了较好的喉功能恢复。结论　喉部分切除术是根治声门型喉癌T3 病变合理、有效的方式 ,但不能完全替代全喉切除术 ,应根据切除范围选择合理的修复方式。     

子宫内膜异位症癌抗原(CA125)检测及其临床意义

目的：探讨子宫内膜异位症与ＣＡ１２５有无相关性、提高临床子宫内膜异位症诊断雍诊断最佳途径。方法：用放射免疫测定法（ＲＩＡ）检测７９例子宫内膜异位症、７０例子宫肌瘤、６４例子宫颈癌、８０名正常育龄女性为对照。结果：子宫内膜异位症、子宫肌瘤、子宫颈癌、正常对照组阳性率分别是７９．７５％、８．５７％、１７．１９％、０．００％。前者显著高于后三者（Ｐ〈０．０１）。结论：ＣＡ１２５检测为临床诊断子宫内膜异位     

人流术中应用异丙酚与复合应用氯胺酮的比较

本实验旨在探讨微量氯胺酮与异丙酚联合应用的效果,以期获得更安全、更适合门诊手术的麻醉方式。　　作者简介:郭晓丽(1963-),女,河南省新乡市人,硕士研究生,主治医师,讲师,主要从事麻醉镇痛方面的研究,发表论文5篇。电话:(023)68757347　　收稿日期:20000508;修回日期:200010201　资料与方法　　研究对象:60例停经8～12周的早期妊娠妇女,年龄17～43岁,体重40～77ｋｇ,ＡＳＡⅠ～Ⅱ级,术前禁食6ｈ,禁饮4ｈ。麻醉前20ｍｉｎ肌注阿托品0.5ｍｇ。随机分为两组,异丙酚+氯胺酮组(ＰＫ组,ｎ=30例);异丙酚组(Ｐ组,ｎ=30例麻醉方法:ＰＫ组:异丙酚1～…     

Extracellular site of action of phenylalkylamines on L-type calcium current in rat ventricular myocytes

The effects of the phenylalkylamines verapamil, gallopamil, and devapamil on L-type calcium currents (I_Ca) were studied in ventricular myocytes from rat hearts using the whole-cell patch-clamp technique. In particular, the question was addressed, whether the pharmacological binding sites for these drugs were located at the inner and/or at the outer surface of the cell membrane. Therefore, tertiary verapamil, gallopamil, and devapamil and their corresponding quaternary derivatives were applied either from the outside or the inside of the cell membrane. Extracellular application of verapamil, gallopamil and devapamil (each at 3 M) reduced Ica to 16.1 ±8.6%, 11 ± 8.9 %, and 9.3 ± 6 % of control, respectively. Intracellular application of the same substances, via the patch pipette filled with 30 M of either verapamil, gallopamil, or devapamil, failed to depress I_Ca. The quaternary derivatives of the phenylalkylamines (30 M) were ineffective both when applied extracellularly or intracellularly. It is suggested that phenylalkylamines block I_Ca in ventricular myocytes by acting on a binding site of the calcium channel molecule located at the outer surface of the cell membrane.     

Wegener's granulomatosis with unusual cavernous sinus and sella turcica extension

Intracerebral extension of Wegener's granulomatosis (WG) is rare. We present a patient with oculomotor and trochlear nerve palsy with histologically proved WG. An MR examination revealed granulomatous tissue in nasal cavity, paranasal sinuses with meningeal infiltration, and uncommon penetration into cavernous sinus and sella turcica. The MR images before and during pharmacological therapy are presented. Received: 14 July 1998; Revision received: 12 October 1998; Accepted: 13 January 1999