2型糖尿病患者日内血糖波动与动脉硬度的相关性研究

目的 研究2型糖尿病患者日内血糖波动与血管硬度的相关性。方法 选取2018年5月—2019年4月该院收治的75例2型糖尿病患者,根据baPWV值是否异常分为PWV正常组（baPWV<1 400cm/s,n=25）和PWV异常组（baPWV≥1 400cm/s,n=50）。采集两组一般信息、生化指标、糖化血红蛋白、baPWV、动态血糖监测数据,进行日内血糖波动与血管硬度的相关性分析。结果 PWV异常组的年龄、糖尿病病程、SBP、MBG、SD、MAGE值与PWV正常组比较,差异有统计学意义（P<0.05）;控制年龄、糖尿病病程、血压后行偏相关分析,结果可见baPWV与MAGE呈正相关(r=0.356,P=0.004),与MBG、SD无相关性（P>0.05）;baPWV与lnMAGE进行直线回归分析,回归方程：Y=1 275.27+254.93×X(r=0.434,R2=0.189,P<0.001)。结论 2型糖尿病患者的日内血糖波动与血管硬度呈正相关。     

多元化教学模式在超声诊断学网络直播教学中的应用

在利用网络对“5+3”一体化学生授课期间,对超声诊断学网络直播课程进行了教学改革实践。学生课前收看微课视频进行预习,网络直播课堂中,以以案例为基础的教学法(case-based learning,CBL)为主导,结合以授课为基础的教学法(lecture-based learning,LBL)、以问题为基础的教学法(problem-based learning,PBL)、演示法、归纳法等多模式教学方法进行超声诊断学线上授课。多种教学法的联合应用发挥了优势互补作用,使学生对授课内容有了更深入的理解,从而激发了他们学习的兴趣,调动了学习的积极性,培养了独立思考和解决问题的能力,提高了自主学习的能力,使超声诊断学网络教学取得了良好的效果,也为今后线上线下混合教学的发展奠定基础。     

李显筑教授从脾论治疑难杂证经验举隅

李显筑教授临床多年,精通中医经典,不仅学有渊源,而且立足创新,临床上博采众长,大胆探索,擅长内科,对妇科、儿科亦深有造诣。李师治学,治法有宗,师古不泥。以从脾论治疑难杂证而独树一帜,临证每收佳效。     

Association between Cardiac Changes and Stress,and the Effect of Peroxisome Proliferator-activated Receptor-γ on Stress-induced Myocardial Injury in Mice

This study was aimed to investigate the effect of stress induced by high-intensity exercises on the cardiovascular system. In the epidemiological investigation, 200 subjects(test group) engaged in special high-intensity exercises, and 97 who lived and worked in the same environment and conditions as those in the test group, but did not participate in the exercises served as controls. In the second part of the study, 50 mice were randomly divided into control group, exhaustive swimming group, white noise group, exhaustive swimming plus white noise group, and pioglitazone intervention group. The results showed that the plasma concentrations of the myocardial injury markers heart fatty acid-binding protein(H-FABP), C-reactive protein(CRP), β-endorphin(β-EP) and levels of psychological stress were significantly increased in test group as compared with control group; special high-intensity exercises resulted in a significant elevation of the incidence of cardiac arrhythmias. Animal experiments showed that the plasma levels of corticosterone(CORT) and troponin I(Tn I) were raised while the level of SOD was reduced in exhaustive swimming group, white noise group, and exhaustive swimming plus white noise group. The expression levels of PPARγ m RNA and protein were decreased in myocardial tissues in these groups as well. HE staining showed no remarkable change in myocardial tissues in all the groups. Treatment with pioglitazone significantly decreased the plasma levels of Tn I and CORT, while increased the level of SOD and the expression levels of PPARγ m RNA and protein. It was concluded that the high-intensity exercises may induce a heavy physical and psychological stress and predispose the subjects to accumulated fatigue and sleep deprivation; high-intensity exercises also increases the incidence of arrhythmias and myocardial injury. PPARγ may be involved in the physical and psychological changes induced by high-intensity exercises.     

妊娠合并真性红细胞增多症的诊治进展

真性红细胞增多症（PV）是一种以获得性克隆性红细胞异常增多为主的慢性骨髓增殖性肿瘤。临床表现主要为外周血血细胞比容增加、血液黏稠度增高,常伴有白细胞和血小板计数增多,可出现血栓和出血等并发症。妊娠合并PV较少见,但会增加母儿并发症及不良结局,包括子痫前期、肺栓塞、胎儿生长受限、胎儿宫内死亡及孕产妇死亡。对PV孕妇应加强...     

基于生物信息学筛选的结肠癌细胞焦亡相关基因的分析及预后模型的构建

目的探讨应用生物信息学筛选的结肠癌细胞焦亡相关基因特点, 对基于差异表达的细胞焦亡相关基因构建的结肠癌预后模型予以验证。方法从癌症基因组图谱(TCGA)数据库下载结肠癌患者RNA测序的基因数据和临床数据。通过检索文献确定52个与细胞焦亡相关基因, 将其与TCGA数据库中获得的结肠癌和正常结肠组织的RNA测序基因数据集进行对比, 获取差异表达的临床样本细胞焦亡基因, 应用STRING网站和R软件分析这些基因蛋白质互作网络。依据TCGA数据库临床样本中细胞焦亡基因的差异表达情况, 将TCGA数据库中结肠癌患者分为焦亡组和未焦亡组, 根据基因表达量, 以P<0.05筛选两组间差异表达明显的基因;基于这些差异表达基因, 采用LASSO Cox回归构建细胞焦亡相关的结肠癌预后模型。按照模型计算的风险评分的中位值将从TCGA数据库中收集的患者分为高风险(≥中位值)和低风险(<中位值)两组, 通过Kaplan-Meier生存函数分析两组总生存, 采用R软件的timeROC程序包分析应用风险评分预测TCGA数据库结肠癌患者生存不同时间的效能。采用多因素Cox回归分析临床病理因素及模型风险评...     

小小『感冒』摊上『大病』

病例纪实 22岁的小张在安徽老家镇上打工,可是一次小小的“感冒”却让他“摊上了大事儿”. 随着救护车的鸣笛声,年轻的患者小张从安徽紧急转到省城医院的急诊科.当他被抬下救护车的时候,已是呼吸急促,病情危重.几天前,小张感觉不适,还有点发烧,以为是着凉感冒了.到了下午,妈妈不放心,带着小张到卫生所去挂了水.可是第二天醒来,小张仍然感觉浑身无力,又继续躺了两天.     

甲氨蝶呤与米非司酮联合治疗异位妊娠的疗效观察及护理

目的：对使用药物甲氨蝶呤与米非司酮联合治疗异位妊娠的临床护理方法进行探究。方法对2013年4月到2014年4月来我院就诊的30例采用甲氨蝶呤与米非司酮治疗患者的临床护理措施。结果对采用甲氨蝶呤与米非司酮联合治疗异位妊娠的患者给予有效地、全方面的综合护理，患者疾病均被成功治愈且顺利出院。结论在药物治疗期间可根据患者的实际情况，给予患者可行的、全方位的综合护理干预，能够促进患者早日康复，增强患者疾病治愈率，在临床疾病治疗中具有十分重要的意义。     

食疗抗感冒

感冒俗称"伤风",是最常见的外感疾病,四季都可发生,尤以冬末初春为多。临床上以恶寒、发热、周身酸楚、头痛、鼻塞、流涕、咳嗽等为主要表现。虽然现代医学有不少预防和治疗感冒的药物,但效果并不尽如人意,有些还存在着某些副作用。而调整好合理的饮食结构,巧用某些食物