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101.
E.Y.F. Wan E.Y.T. Yu C.S.C. Fung W.Y. Chin D.Y.T. Fong A.K.C. Chan C.L.K. Lam 《Diabetes & metabolism》2018,44(5):415-423
Aim
The current trend on diabetes management advocates replacing the paradigm from a uniform to an individualized patient-centered haemoglobin A1c (HbA1c) target, but there is no consensus on the optimal HbA1c level. The study aimed at examining the association between HbA1c and the risk of cardiovascular diseases (CVD) for diabetic patients with different characteristics, in order to identify patient-centered treatment targets.Methods
A retrospective cohort study was conducted on 115,782 Chinese adult primary care patients with type 2 diabetes mellitus (DM) but no known CVD history, who were prescribed antidiabetic medications in 2010–2011. The cumulative mean HbA1c over a median follow-up period of 5.8 years was used to evaluate the relationship between HbA1c and CVD incidence using Cox analysis. Subgroup analyses were conducted by stratifying different baseline characteristics including gender, age, smoking status, diabetes duration, body mass index, Charlson's comorbidity index and DM treatment modalities.Results
For patients with a DM duration of < 2years, an exponential relationship between HbA1c and risk of CVD was identified, suggesting that there was no threshold HbA1c level for CVD risk. For other diabetic patients, an HbA1c level of 6.8–7.2% was associated with a minimum risk for CVD and a J-shaped curvilinear association between HbA1c. The risk of CVD increased in patients with HbA1c < 6.5% or ≥ 7.5%.Conclusion
Among Chinese primary care patients at the early (< 2years) disease stage, lower HbA1c targets (< 6.5%) may be warranted to prevent CVD events whilst for all others, excessively lower HbA1c levels may not necessarily better and can potentially be harmful. 相似文献102.
103.
B.M. Mishriky D.M. Cummings J.R. Powell K.A. Sewell R.J. Tanenberg 《Diabetes & metabolism》2019,45(2):102-109
Aims
Our aim was to compare once-weekly semaglutide to incretin-based therapies – defined as either dipeptidyl peptidase-4 inhibitors (DPP-4i) or other glucagon-like peptide-1 receptor agonist (GLP-1RA) – in patients with type 2 diabetes.Methods
We searched for randomized trials comparing once-weekly semaglutide to other incretin-based therapies in patients with type 2 diabetes. We pooled trials that compared semaglutide to other GLP-1RA together, and those comparing semaglutide to DPP-4i together. The primary outcome was the change in haemoglobin A1c over time.Results
Five trials met our inclusion criteria. There was a significantly greater reduction in haemoglobin A1c favouring semaglutide when compared to other GLP-1RA or DPP-4i [MD (95% CI)?=??0.38% (?0.62, ?0.15) and ?1.14% (?1.53, ?0.75) respectively]. There was a significantly greater weight loss favouring semaglutide when compared to other GLP-1RA or DPP-4i [MD (95% CI)?=??2.50?kg (?3.91, ?1.09) and ?3.19?kg (?3.66, ?2.72) respectively]. The proportion of patients achieving glycaemic goals and goal weight loss was greater in semaglutide-treated patients when compared to either other GLP-1RA or DPP-4i. However, semaglutide-treated patients had a significantly higher incidence of gastrointestinal side effects.Conclusions
While both once-weekly semaglutide and other incretin-based therapies can reduce haemoglobin A1c, semaglutide causes a more potent haemoglobin A1c reduction and greater weight loss when compared to other incretin-based therapies. However, this potent effect of semaglutide was associated with a higher incidence of gastrointestinal side effects. Additional studies are needed to determine whether this marked reduction in both haemoglobin A1c and body weight may translate into improved cardiovascular outcomes. 相似文献104.
目的 为大鼠迷走神经移位膈神经重建高位颈髓损伤大鼠的膈肌功能提供显微解剖学依据。 方法 10只健康雌性SD大鼠在10倍手术显微镜下解剖双侧膈神经、迷走神经及其分支。用数显卡尺测量迷走神经与膈神经在“膈神经主干起始平面”、“锁骨上平面”、“入膈肌平面”的相对距离,用读数显微镜测量各平面迷走神经和膈神经的直径。 结果 在颈部,迷走神经直径为（0.3284±0.0247）mm,膈神经直径为（0.2267±0.0164）mm,二者的相对距离很接近,无论是在“膈神经主干起始平面”还是“锁骨上平面”,平均都不超过2.5 mm;在“入膈肌平面”平面,迷走神经直径为（0.2912±0.0326）mm,膈神经直径为（0.2794±0.0282）mm,二者的相对距离较颈部远,左侧为（8.71±0.804）mm,右侧为（6.203±0.952） mm。 结论 (1)在颈部,迷走神经与膈神经的直径相差不大,相对距离很接近,二者可直接无张力缝合。(2)在入膈肌平面,迷走神经与膈神经的直径大致相同,相对距离稍远,但将膈神经和迷走神经向上游离一段距离后仍可实现二者的直接无张力缝合。 相似文献
105.
目的观察化合物SD118-2对人HepG2细胞增殖、凋亡及细胞周期的影响。方法取对数生长期人HepG2细胞,分为对照组和给药组。给药组分别给予7 mg/L SD118-2处理12、24和48 h,对照组给予相同浓度DMSO。用MTT法检测细胞增殖率,DAPI荧光染色法观察SD118-2处理后细胞形态,流式细胞仪AnnexinⅤ-FITC/PI双标法检测细胞凋亡率及周期阻滞,用流式细胞仪JC-1染色法检测线粒体膜电位(ΔΨm),Western blot检测凋亡相关蛋白BCL-2、BAX、PARP和C-PARP表达。结果 SD118-2呈时间依赖性抑制人HepG2细胞生长、降低线粒体膜电位、诱导细胞凋亡、阻滞细胞G2期;抗凋亡蛋白BCL-2表达呈时间依赖性减少,促凋亡蛋白BAX、C-PARP表达呈时间依赖性增加;SD118-2对正常肝脏细胞增殖几乎无影响。结论化合物SD118-2具有诱导人HepG2细胞凋亡的作用,并能使细胞周期进程发生变化。 相似文献
106.
目的探讨构建一种SD大鼠脊髓钳夹损伤模型,用于脊髓损伤（spinal cord injury,SCI）的研究。方法将36只成年雄性SD大鼠随机分成A、B、C三组,每组12只。脊髓损伤组（A组）：用动脉瘤夹钳夹大鼠第10胸椎对应脊髓。假手术组（B组）：只打开椎板,暴露脊髓,不造成SCI。正常对照组（C组）：正常大鼠,不做任何处理。通过行为学观察（BBB评分）、HE染色和神经电生理检测进行判断。结果HE染色结果：A组可见脊髓正常组织被破坏,损伤区可见血管破裂出血,有大片坏死灶,周围神经细胞肿胀变性,内有炎症细胞浸润。B、C两组基本一致,组织结构正常。BBB评分：B组术后1周功能恢复接近正常,评分20分。A组术后第2周开始恢复,到第3周基本停止,最终BBB评分低于6分,两组比较有明显差异（P〈0．05）。神经电生理（SEP）检测：A组可以明显看到SEP的波峰趋于水平,且潜伏期无限延长,与B组相差显著（P〈0．05）。A组内动物BBB评分、SEP无显著性差异（P〉0．05）。结论通过动脉瘤夹钳夹SD大鼠T10脊髓,能够建立良好的脊髓损伤动物模型。 相似文献
107.
108.
目的探讨家蝇蛆粉对大鼠的致畸性,以评价其安全性。方法家蝇蛆粉按比例定量添加到普通饲料原料中混匀,干燥,做成高、中、低剂量家蝇蛆粉饲料。将性成熟的98只SD大鼠按雌雄2∶1的比例同笼交配。取64只孕鼠平均分为4组:家蝇蛆粉饲料低剂量组;家蝇蛆粉饲料中剂量组;家蝇蛆粉饲料高剂量组;普通饲料对照组。于受孕后称量体质量增长情况。最后脱颈椎处死孕鼠,称子宫质量,并进行胎鼠检查。结果家蝇蛆粉饲料高、中、低剂量组与对照组相比,雌鼠体质量增长、子宫质量比较差异无统计学意义,无吸收胎、早死胎、晚死胎;各组间雄性与雌性胎鼠数比较差异均无统计学意义;各组间雄性与雌性胎鼠的外观、体质量、体长比较差异均无统计学意义。各组间胎鼠骨骼和胎鼠内脏比较差异均无统计学意义。结论家蝇蛆粉对SD大鼠未见致畸性。 相似文献
109.
Baowei Zhang Wenhui Peng Hailing Li Yuyan Lu Jianhui Zhuang Ke Wang Yang Su Yawei Xu 《Clinical biochemistry》2013
Objective
Previous studies suggested that decreased serum vaspin levels were associated with coronary artery disease (CAD). The present study aimed to investigate the association between plasma vaspin levels and different states of CAD.Design and methods
A total of 162 patients with coronary angiography (CAG) proved that CAD was enrolled. Additional 103 patients complained with “chest discomfort” with negative CAG, and 60 normal subjects were enrolled in this study. The levels of plasma vaspin, adiponectin, clinical parameters, lipid profile and C reactive protein (CRP) were measured.Results
The levels of plasma vaspin were significantly lower in the CAD group (0.47 ± 0.63 μg/L) than those in the healthy group and CAG (−) group (all p < 0.001). In CAD group, the pos hoc analysis showed that serum vaspin concentration in acute myocardial infarction group (0.21 ± 0.19 μg/L) was significantly lower than that in the unstable angina pectoris group (0.40 ± 0.37 μg/L) (p = 0.012), and serum vaspin concentration in unstable angina pectoris was significantly lower than that in stable angina pectoris group (0.92 ± 0.94 μg/L) (p = 0.013). The plasma vaspin concentration was also negatively correlated with the severity of CAD (1-vessel: 0.86 ± 0.90 μg/L; 2-vessel: 0.36 ± 0.39 μg/L; 3-vessel: 0.21 ± 0.16 μg/L). The plasma vaspin concentration in CAG (−) group with “chest discomfort” (1.93 ± 2.57 μg/L) was similar to the healthy control group (2.18 ± 3.49 μg/L).Conclusions
The plasma vaspin concentration correlated to the severity of CAD. Furthermore, plasma vaspin has a value of avoiding patients without CAD from unnecessary CAG. 相似文献110.
躯体形式障碍是精神科常见的一种神经症,该病具有较高的发病率和很强的专科特点。绝大多数患者到综合医院就诊,但临床识别率和有效治疗率很低,给患者造成极大的经济和心理负担。本文对不同药物治疗躯体形式障碍的疗效及常见不良反应进行了综述,旨在为临床用药提供依据。 相似文献