老年人糖耐量减低的中西医病机浅探

探讨老年人糖耐量减低中西医病机,以便为中西医防治老年人糖耐量减低提供理论参考和治疗依据,降低老年糖尿病的发病率;针对老年人糖耐量减低的发病机制,以中医理论为指导并与西医的微观认识相结合来分析老年人糖耐量减低的病机特点;老年人糖耐量减低的中医病理本质为"脾肾亏虚为其本,痰瘀互结为其标",西医以胰岛素抵抗、β细胞功能缺陷为其主要发病机制;老年人糖耐量减低可以从中医虚实、标本方面分析,结合西医临床用药为其治疗另辟蹊径。     

益肾活血胶囊治疗糖耐量异常的临床研究

目的观察益肾活血胶囊治疗糖耐量异常的临床疗效和安全性。方法采用随机平行对照的临床试验。选取60例既符合糖耐量异常,又符合中医气虚血瘀证辨证标准的患者随机分为两组：治疗组30例和阳性对照组30例。治疗组：在饮食运动干预的基础上口服益肾活血胶囊0.5g/粒,一次4粒,一日3次;对照组：在饮食运动干预的基础上口服盐酸二甲双胍肠溶片0.25g/片,一次1片,一日3次;两组均以6周为一个疗程。治疗前后分别检测：糖耐量试验（Oral Glucose Tolerance Test,OGTT）,总胆固醇（Total Cholesterol,TC）、甘油三酯（Triglyceride,TG）、高密度脂蛋白胆固醇（High Density Lipoprotein Cholesterol,HDL-C）、低密度脂蛋白胆固醇（Low Density Lipoprotein Cholesterol,LDL-C）、体重指数（Body Mass Index,BMI）。结果治疗组服用益肾活血胶囊后能明显改善患者的临床症状与体征,与对照组相比差异性显著（P〈0.05）,同时患者OGTT中空腹血糖（FPG）、餐后2h血糖（2hPG）、TC、TG、LDL-C、BMI较治疗前明显下降,与治疗前相比差异有显著性（P〈0.05）。结论益肾活血胶囊可以用于干预糖耐量异常,并且降低糖尿病患病率;新型的中药制剂在治疗慢性病患者时,提高了患者的依从性。     

Muscle recovery after repair of short and long peripheral nerve gaps using fibrin conduits

Several lines of experimental evidence support an association between facial processing and social cognition, but no direct link between cortical markers of facial processing and complex cognitive processes has been reported until now. In the current study, we tested the hypothesis that cortical electrophysiological markers for the processing of facial emotion are associated with individual differences in executive and social cognition skills. We tested for correlations between the amplitude of event-related potentials (N170) in a dual valence task and participants’ scores on three neuropsychological assessments (general neuropsychology, executive functioning, and social cognition). N170 was modulated by the stimulus type (face versus word) and the valence of faces (positive versus negative). The neural source of N170 was estimated to be the fusiform gyrus. Robust correlations were found between neuropsychological markers and measures of facial processing. Social cognition skills (as measured by three tests: the Reading the Mind in the Eyes test, the Faux Pas test, and the Iowa Gambling Task) correlated with cortical measures of emotional discrimination. Executive functioning ability also correlated with the cortical discrimination of complex emotional stimuli. Our findings suggest that the cortical processing of facial emotional expression is associated with social cognition skills.     

Effect of rosiglitazone/ramipril on preclinical vasculopathy in newly diagnosed,untreated diabetes and IGT patients: 1-year randomised,double-blind,placebo-controlled study

Objective To investigate whether pharmacological interventions with rosiglitazone/ramipril can reverse preclinical vasculopathy in newly diagnosed untreated patients with type 2 diabetes (T2DM) and impaired glucose tolerance (IGT). Methods In this randomised, double-blind, placebo-controlled study, 33 T2DM and 33 IGT patients were randomised to 4 mg rosiglitazone or 5 mg ramipril or placebo for 1 year. The subjects were newly diagnosed, untreated, normotensive, nonobese, nonsmoker, and nonhyperlipidaemic. Haemodynamic variables were measured at three treatment phases and pulse wave velocity (PWV) and augmentation index (AI) were measured throughout the treatment period. Results Rosiglitazone showed a significant reduction in PWV (p=0.039) and AI (p=0.031) and ramipril demonstrated a significant reduction of AI (p=0.025) in IGT in comparison to placebo on the 12th month of treatment. No significant difference was observed in PWV and AI in T2DM with rosiglitazone/ramipril in comparison to placebo during overall treatment period. Conclusions Rosiglitazone significantly reversed preclinical vasculopathy in IGT as evident by significant decrease in PWV and AI after 1 year of treatment. Ramipril also reduced large artery stiffness as shown by significant decrease of AI after 1 year of treatment in IGT. Further trials are needed for a longer period of time, maybe with higher doses, to show whether rosiglitazone/ramipril can reverse preclinical vasculopathy in T2DM.     

Parental diabetes, pubertal stage, and extreme obesity are the main risk factors for prediabetes in children and adolescents: a simple risk score to identify children at risk for prediabetes

Objectives:  The current worldwide increase of prediabetes defined as impaired fasting glucose or impaired glucose tolerance and type 2 diabetes mellitus (T2DM) coincides the increase of obesity. However, it is unclear that which children have an increased risk and should be screened for prediabetes.
Methods:  We studied 437 overweight children and adolescents to identify risk factors for prediabetes. A risk score for prediabetes was calculated using logistic regression. This score was examined in a second, independent cohort of 567 overweight children and adolescents. History of T2DM in parents and grandparents, degree of overweight, age, pubertal stage, birth weight, hypertension, dyslipidemia, acanthosis nigricans, and abdominal obesity were considered as potential risk factors.
Results:  The frequency of prediabetes was 6% in sample 1 and 17% in sample 2. The strongest association was observed for history of parental diabetes with an adjusted odds ratio (aOR) of 9.5 [95% confidence interval (CI) 2.5–36.4] in sample 1 and 6.3 (95% CI 3.7–10.7) in sample 2, followed by pubertal stage with an aOR of 5.5 (95% CI 0.7–45.4) in sample 1 and 6.2 (95% CI 2.4–15.6) in sample 2, and by extreme obesity with an aOR of 5.0 (95% CI 1.7–15.3) in sample 1 and 3.3 (95% CI 2.0–5.4) in sample 2.
Conclusions:  The main risk factors for prediabetes were parental diabetes, pubertal stage, and extreme obesity. Screening for prediabetes seems meaningful in subjects with either a parental history of diabetes or a combination of extreme obesity and pubertal stage and detected nearly 90% of the overweight children and adolescents with prediabetes.