雷公藤多甙对糖尿病肾病患者尿蛋白及血清sICAM-1的影响

目的观察雷公藤多甙对糖尿病肾病患者的尿蛋白和血清可溶性细胞间粘附因子-1（sICAM-1）表达的影响。方法将60例糖尿病肾病患者分为两组,对照组（30例）给以依那普利口服,治疗组（30例）给以雷公藤多甙口服。疗程为1个月,观察治疗前后尿蛋白定量和血清sICAM-1等指标的变化。结果对照组与治疗组尿蛋白定量均较治疗前下降,两组间比较无差异性;治疗组血清sICAM-1治疗后较治疗前降低,而对照组治疗前、后无明显变化。结论雷公藤多甙可以减少糖尿病肾病患者的尿蛋白,其机制可能与降低血清sICAM-1的表达有关。     

2型糖尿病肾病患者厄贝沙坦联合阿托伐他汀治疗后血尿转化生长因子β_1水平的变化

目的：对糖尿病早期肾病患者进行降糖及厄贝沙坦和阿托伐他汀治疗,检测血和尿转化生长因子β1（TTGF-β1）水平,比较厄贝沙坦、阿托伐他汀以及两药联合治疗对早期DN患者TTGF-β2的影响。方法：选取糖尿病早期肾病患者65例,随机分为厄贝沙坦组、阿托伐他汀组、厄贝沙坦联合阿托伐他汀治疗组,选取29名健康体检者作为正常对照。12周后采用放射免疫法检测24h尿白蛋白排泄率（UAER）,双抗体夹心酶联免疫吸附试验（ELISA法）检测血清和尿液TTGF-β1水平。结果：早期DN患者血和尿TTGF-β1水平显著高于健康志愿者（P〈0.01）。与治疗前基础值相比,两药均能减少UAER以及血和尿中TTGF-β1（P〈0.05）,以联合治疗更为明显。结论：早期DN患者血和尿TTGF-β1水平升高,厄贝沙坦、阿托伐他汀以及厄贝沙坦联合阿托伐他汀能有效降低TTGF-β1,血和尿TTGF-β1水平可以作为DN早期诊断和治疗效果评估的有效指标。     

白介素8，白介素10联检在2型糖尿病肾病患者中的临床意义

目的：探讨血清白细胞介素8、白细胞介素10水平的变化在糖尿病肾病发生、发展中的作用。方法：根据24h尿微量白蛋白排泄率对2型DN患者分组,观察血清IL-8、1L-10水平的改变。结果：糖尿病3组的IL-8、IL-10水平均明显高于正常对照组,随糖尿病肾病的严重程度增加而增加,且与及血肌酐呈正相关。结论：检测血清IL-8、IL-10水平的变化可以作为临床观察DN病情及判断DM预后的参考指标。     

A Novel Hypoxia-inducible Factor 1α Inhibitor KC7F2 Attenuates Oxygen-induced Retinal Neovascularization

PurposeKC7F2 is a novel molecule compound that can inhibit the translation of hypoxia-inducible factor 1α (HIF1α). It has been reported to exhibit potential antiangiogenic effect. We hypothesized that KC7F2 could inhibit oxygen-induced retinal neovascularization (RNV). The purpose of this study was to investigate this assumption.MethodsOxygen-induced retinopathy (OIR) models in C57BL/6J mice and Sprague-Dawley rats were used for in vivo study. After intraperitoneal injections of KC7F2, RNV was detected by immunofluorescence and hematoxylin and eosin staining. Retinal inflammation was explored by immunofluorescence. EdU incorporation assay, cell counting kit-8 assay, scratch test, transwell assay, and Matrigel assay were used to evaluate the effect of KC7F2 on the proliferation, migration and tube formation of human umbilical vein endothelial cells (HUVEC) induced by vascular endothelial growth factor (VEGF) in vitro. Protein expression was examined by Western blot.ResultsKC7F2 treatment (10 mg/kg/d) in OIR mice significantly attenuated pathological neovascularization and decreased the number of preretinal neovascular cell nuclei, without changing the avascular area, which showed the same trends in OIR rats. Consistently, after the KC7F2 intervention (10 µM), cell proliferation was inhibited in VEGF-induced HUVEC, which was in agreement with the trend observed in the retinas of OIR mice. Meanwhile, KC7F2 suppressed VEGF-induced HUVEC migration and tube formation, and decreased the density of leukocytes and microglia colocalizing neovascular areas in the retinas. Moreover, the HIF1α–VEGF pathway activated in retinas of OIR mice and hypoxia-induced HUVEC, was suppressed by KC7F2 treatment.ConclusionsThe current study revealed that KC7F2 was able to inhibit RNV effectively via HIF1α–VEGF pathway, suggesting that it might be an effective drug for RNV treatment.     

达格列净治疗糖尿病肾病患者的临床研究

目的 探讨对糖尿病肾病患者实施达格列净治疗的临床效果.方法 在2019年11月—2020年11月期间选取60例糖尿病肾病患者,将其按照随机数字表法分组,每组30例.对照组实施常规降糖药物治疗,研究组基于对照组治疗方案实施达格列净治疗,对比分析两组临床效果.结果 治疗后研究组空腹血糖、餐后2h血糖、糖化血红蛋白水平均低于...     

Reverse Swiss Roll technique for diabetic vitreous membranes

Background:Diabetic membranes are always a challenge for a surgeon because of sticky nature and chances of iatrogenic break while removing.Purpose:To demonstrate a safe reverse swiss roll technique to dissect diabetic vitreous membranes.Synposis:Approaches and techniques for membrane dissection are segmentation, delamination and en-bloc dissection using various types of instruments and illumination. With vitreous cutte, picks and scissors, surgical steps are traditionallu performed by using classic lift and shave technique. After identifying the plane, tissue is lifted and then cut, which puts the retina at risk of break because of traction and active suction. Such a threat can be reduced by placing the cutter above the membrane thereby having the membrane itseld acting as a protective cushion to the retina. Port here, unlike lift and shave technique, doesn’t face the edge of membrane but is exactly 180 degree opposite and membrane curls into port because of suction. Also, hemostasis is maintained by continuous aspiration and cutting as the instrument is moved side to side, retracting from the edge.Highlights:Reverse swiss roll technique is safer compared to lift and shave because of the safety cushion of the membrane between the port and the retina. There is inherently less chances of retinal break because the active suction from the port is directed away from the retina. The technique also minimises traction and localised pull on the atrophic macula.Video link: https://youtu.be/WNnSsP69ZLw     

倍频Nd:YAG激光光凝对不同分期糖尿病视网膜病变患者视力康复的影响

目的:探讨倍频Nd:YAG激光光凝对不同分期糖尿病视网膜病变患者视力康复的影响。方法:根据DRPSG(diabetic retinopathy photocoagulation study group)制定的治疗技术规定,对219例368眼分别为增殖前期糖尿病视网膜病变(PPDR)和增殖期糖尿病视网膜病变(PDR)用倍频Nd:YAG激光行全视网膜光凝治疗,术后3,6,12mo后复查眼底荧光血管造影。结果:PPDR患者视力提高和不变者占77.6%,PDR患者视力提高和不变者占83.4%,而高危PDR患者视力提高和不变者占65.2%。结论:倍频Nd:YAG激光治疗DR是安全有效的,选择合适的时机和合理的激光参数对不同分期DR行全视网膜光凝是确保DR患者视力康复的关键。     

糖尿病视网膜病变相关因素的因子分析

目的:探讨糖尿病视网膜病变(DR)与全身因素的关系.方法:对2 731例糖尿病患者的临床资料进行回顾性分析.所有患者均参加了糖尿病并发症筛查,同时接受了眼科、内科和实验室检查.DR的诊断系根据散瞳眼底镜检查、眼底照相及荧光血管造影检查确定.采用因子分析及Logistic回归模型分析DR与全身因素的关系.结果:通过主成分因子分析方法在原始观察指标基础上提取8个公共因子,分别代表血压、血糖、胰岛素、血脂、病程、体重指数(BMI)、肌酐和尿白蛋白排泄率(UAE)等因素.Logistic回归分析表明DR与病程(OR=1.788,P＜0.001)、血糖(OR1.246,P＜0.001)、血压(OR=1.223,P＜0.01)、肌酐(OR=1.136,P=0.008)、UAE(OR=1.147,P=0.002)和BMI(OR=0.861,P=0.002)等因素独立相关,增生性糖尿病视网膜病变(PDR)与病程(OR=1.747,P＜0.001)、血压(OR=1.557,P=0.001)、UAE(OR=1.255,P＜0.001)和BMI(OR=0.576,P＜0.001)等因素独立相关.单变量分析显示除BMI外所有相关因素因子得分均随着DR程度的增加而增加.非增生性糖尿病视网膜病变(NPDR)相关因素因子得分从高到低依次为病程、血糖、血压、肌酐、UAE和BMI(绝对值),PDR相关因素因子得分依次为病程、UAE、BMI(绝对值)、血压和血糖.结论:DR的发生与严重程度与全身因素的变化密切相关.重视对DR相关因素的监测与评价有助于DR的预防及治疗.     

Comparison of Initial Presentation of Pediatric Diabetes Before and During the Coronavirus Disease 2019 Pandemic Era

BackgroundHospital visitation has become challenging during the coronavirus disease 2019 pandemic because of quarantine measures and fear of infection. Consequently, newly diagnosed patients may present with more severe diseases during the pandemic. The present study analyzed the differences in the initial clinical presentations of newly diagnosed patients with type 1 diabetes (T1D) and type 2 diabetes (T2D), comparing pre-pandemic and pandemic periods.MethodsNewly diagnosed patients with T1D or T2D and aged < 18 years during 2018–2020 were included in the study. Data were collected retrospectively from four academic centers in Gyeonggi-do, South Korea. Initial clinical data were compared between the pre-pandemic (2018–2019) and pandemic (2020) periods.ResultsIn the pre-pandemic and pandemic periods, 99 patients (41 T1D and 58 T2D patients) and 84 patients (51 T1D and 33 T2D patients) were identified, respectively. During the pandemic, the proportion of diabetic ketoacidosis (DKA) cases increased compared to the pre-pandemic period (21.2% during 2018–2019 vs. 38.1% in 2020; P = 0.012). In the pre-pandemic and pandemic periods, initial pH was 7.32 ± 0.14 and 7.27 ± 0.15, respectively (P = 0.040), and HbA1c values were 11.18 ± 2.46% and 12.42 ± 2.87%, respectively (P = 0.002). During the pandemic, there was an increased risk of DKA in patients with T1D (odds ratio, 2.42; 95% confidence interval, 1.04–5.62; P = 0.040).ConclusionDuring the pandemic, the proportion of DKA in newly diagnosed patients with T1D increased and clinical parameters showed a deteriorating pattern. Increased awareness of pediatric diabetes, especially DKA, could facilitate visit to the hospital for an early diagnosis; thus, reducing the number of DKA cases during the pandemic era.