血浆内皮素和非酯化脂肪酸改变与糖尿病视网膜病变的关系

目的：为探讨血浆内皮素（ＥＴ）和非酯化脂肪酸（ＮＥＦＡ）水平与糖尿病视网膜病变（ＤＲ）Ｒ 关系。方法：分组分析了５６例伴和不伴ＤＲ的２型糖尿病（ＤＭ）人血浆ＥＴ和ＮＥＥＡ水平,并与正常人进行了比较。结果：２型ＤＭ病人血浆ＥＴ水平明显高于正常人,伴有ＤＲ组病人又明显高于无ＤＲ的病人。     

慢心律联合丹参治疗糖尿病周围神经病变的疗效观察

目的 :为糖尿病周围神经病变探讨有效的治疗方法。方法 :选择 65例糖尿病周围神经病变患者 ,随机分为两组 ,一组为慢心律治疗组 ,另一组为慢心律联合丹参注射液治疗组 ,以临床表现改善客观指标及运动传导速度 (MCV)、感觉传导速度 (SCV)测定做为判定标准。结果 :两组经治疗 4wk后 ,慢心律组总有效率为76 7% ,慢心律联合丹参注射液组总有效率为 94 3 %。两组肌电图显示神经传导异常率均下降 ,而以慢心律联合丹参注射液组作用较强 (P <0 0 5 )。结论 :慢心律联合丹参注射液治疗糖尿病周围神经病变更有效     

Novel imaging techniques for diabetic macular edema

Retinal edema should be defined as any increase of water of the retinal tissue resulting in an increase in its volume. It may be of cytotoxic or vasogenic origin. Development of vasogenic macular edema is dependent on a series of factors such as blood pressure, blood-retinal barrier permeability, retinal cell damage, retinal tissue osmotic pressure and retinal tissue compliance. Objective measurements of retinal thickness are now possible using the Retinal Thickness Analyser. Localised measurements of blood-retinal barrier permeability may also be obtained using the Retinal Leakage Analyser, a modified confocal scanning laser fluorometer, while obtaining simultaneously angiographic images of the choroid and retina. These new imaging techniques show that cytotoxic and vasogenic retinal edema may occur independently in the early stages of diabetic retinopathy. These findings offer new perpectives for designing novel therapeutic strategies. This revised version was published online in July 2006 with corrections to the Cover Date.     

Diabetic maculopathy induced by vitreo-macular traction: evaluation by optical coherence tomography (OCT)

Aim: To evaluate the role and efficacy of optical coherence tomography (OCT) in the evaluation of diabetic maculopathy induced by vitreo-retinal traction. Methods: 12 patients affected by diabetic maculopathy induced by vitreo-retinal traction were examined using biomicroscopy with a three-mirror contact lens, fluorescein angiography (FA) and OCT scanning in order to identify the presence of a vitreomacular traction. Results: OCT revealed two patterns of maculopathy which were characterised by a thickening of the superior profile of the OCT tomogram or by the disappearance and inversion of the physiologic foveal depression respectively. Conclusions: OCT may be useful in the characterisation and monitoring of diabetic maculopathy induced by vitreo-retinal traction. This revised version was published online in July 2006 with corrections to the Cover Date.     

糖尿病性视网膜病变的血液流变学改变

目的探讨糖尿病视网膜病变患者的血液流变学变化。方法对２６例糖尿病视网膜病变（ＤＲ）患者、３２例糖尿病眼底正常者（ＮＤＲ）和３１例正常人（对照组）进行血液流变学测定。结果ＤＲ组的全血粘度、血浆粘度、血沉均高于ＮＤＲ组。结论血液粘度的升高与ＤＲ的发生有关。     

Interactions between essential fatty acid,prostanoid, polyol pathway and nitric oxide mechanisms in the neurovascular deficit of diabetic rats

Summary Impaired -6 essential fatty acid metabolism and exaggerated polyol pathway flux contribute to the neurovascular abnormalities in streptozotocin-diabetic rats. The potential interactions between these mechanisms were examined by comparing the effects of threshold doses of aldose reductase inhibitors and evening primrose oil, alone and in combination, on neurovascular deficits. In addition, highdose aldose reductase inhibitor and evening primrose oil treatment effects were challenged by co-treatment with the cyclo-oxygenase inhibitor, flurbiprofen, or the nitric oxide synthase inhibitor, N^G-nitro-l-arginine. Eight weeks of diabetes caused an 18.9% reduction in sciatic motor conduction velocity (p<0.001). This was only modestly ameliorated by a 0.1% dietary supplement of evening primrose oil or the aldose reductase inhibitors ZD5522 (0.25 mg · kg^–1 · day^–1) and WAY121509 (0.2 mg · kg^–1· day^–1) for the final 2 weeks. However, joint treatment with primrose oil and ZD5522 or WAY121509 caused marked 71.5 and 82.4% corrections, respectively, of the conduction deficit. Sciatic nutritive blood flow was 43.1% reduced by diabetes (p<0.001) and this was corrected by 67.8% with joint ZD5522 and primrose oil treatment (p<0.001). High-dose WAY121509 (10 mg · kg^–1 · day^–1) and primrose oil (10% dietary supplement) prevented sciatic conduction velocity and nutritive blood flow deficits in 1-month diabetic rats (p<0.001). However, these effects were abolished by flurbiprofen (5 mg · kg^–1 · day^–1) and N^G-nitro-l-arginine (10 mg · kg^–1 · day^–1) co-treatment (p<0.001). Thus, the data provide evidence for synergistic interactions between polyol pathway/nitric oxide and essential fatty acid/cyclo-oxygenase systems in the control of neurovascular function in diabetic rats, from which a potential therapeutic advantage could be derived.Abbreviations ARI Aldose reductase inhibitor - EPO evening primrose oil - NCV nerve conduction velocity - NO nitric oxide - NOLA N^G-nitro-l-arginine     

Current therapy of retrolental fibroplasia. Retinopathy of prematurity

Retrolental fibroplasia, frequently referred to now as the "retinopathy of prematurity," has shown an increased incidence in recent years. This is apparently due to advances in neonatal care, which have resulted in a four- to five-fold improvement in the survival of the extremely low birthweight infants and it is these infants who are at the highest risk of developing retrolental fibroplasia. The use of large supplements of vitamin E, a known antioxidant, is discussed along with other forms of therapy.     

Diabetic foods and the diabetic diet: A British Diabetic Association Discussion Paper

The role of special ‘Diabetic’ foods in the diabetic diet is considered and the following conclusions are drawn.

• 1 Most diabetic foods provide slightly, but not substantially, less energy than comparable non-diabetic products.
• 2 Many diabetic foods have a higher fat content than their non-diabetic equivalents. This is contrary to the requirements of the 1984 Food Labelling Regulations.
• 3 Many diabetic products have a relatively high content of protein.
• 4 In percentage terms, the greatest difference between diabetic and non-diabetic foods remains that of carbohydrate content, particularly carbohydrate other than fructose or sorbitol. On a per portion basis (for instance per teaspoon of jam) the difference is relatively small and likely to be of minimal practical significance.
• 5 Diabetic foods cost between 1.5 and 4 times as much as their non-diabetic equivalents.
• 6 Some ordinary reduced-sugar/low-calorie products are preferable to diabetic products in terms of fat and energy content and cost.
• 7 The promotion and widespread availability of diabetic foods tend to delude patients into believing that these products are advantageous, or even necessary. Their existence also undermines current dietary teaching by implying that diabetics cannot eat normal foods.
• 8 Diabetic foods offer no significant physiological or psychological benefits to diabetic patients and can even be counterproductive to good diabetic control. There is no longer a need for special diabetic foods in the modern dietary management of diabetes.

     

肾虚型糖尿病肾病与Ⅰ型血管紧张素Ⅱ受体基因多态性相关性研究

目的:探讨Ⅰ型血管紧张素Ⅱ受体(AGT1R)基因多态性与肾虚型糖尿病肾病的关系。方法:将240例2型糖尿病分为糠尿病肾病(DN)组和非DN组,进一步分为肾阳虚证、肾阴虚证及非肾虚证,用PCR-RFLP方法检测AGT1R基因型。结果:2组肾阳虚、肾阴虚型AGT1R-A1166C的AC型频率和C等位基因的携带率明显高于非肾虚型,非DN组非肾虚型AC型占3.4%,而DN组肾阳虚型为8.4%、肾阴虚型为10.8%(均P<0.05);非DN组非肾虚型C等位基因占1.7%,而DN组肾阳虚型为4.2%、肾阴虚型为5.4%(均P<0.05);但肾阳虚型与肾阴虚型间差异无显著性意义(P>0.05)。结论:A1166-C多态与肾虚型DN的发生显著相关,提示AGT1R基因的不同基因型与等位基因可能是DN患者肾虚证的物质基础。