Addition of glomerular lesion severity improves the value of anemia status for the prediction of renal outcomes in Chinese patients with type 2 diabetes

We aimed to determine the utility of biopsy data and anemia for the prediction of renal outcomes in Chinese patients with type 2 diabetes. In total, 441 Chinese patients with type 2 diabetes and biopsy-confirmed diabetic nephropathy (DN) were enrolled in a retrospective study. Their renal pathology was assessed using the Renal Pathology Society system. Cox proportional hazards models were used to estimate hazard ratios (HRs) for end-stage renal disease (ESRD), and immunofluorescence staining was used to assess the expression of hypoxia-inducible factor (HIF)-α in patients’ kidneys. We found that glomerular pathology classification was an independent pathological predictor of low hemoglobin concentration, according to linear and logistic regression analyses. Each 1 g/dL decrease in baseline hemoglobin concentration was associated with a 42% higher risk of an adverse renal outcome, after adjustment for clinical and pathologic covariates. In patients with severe glomerular lesions, the risk of progression to ESRD was significantly higher if mild or moderate/severe anemia was present, but in patients with mild glomerular lesions, the risk was only significantly higher in those with moderate or severe anemia than in the absence of anemia. Harrell’s C Concordance was improved, but the Akaike information criterion was worsened by adding the glomerular pathology classification to the use of anemia status and clinical data. Immunofluorescence staining revealed that renal HIF-1α and HIF-2α expression was significantly higher in classes II–IV than class I. Thus, the addition of glomerular pathology classification increases the value of anemia status for the prediction of the progression to ESRD.     

rhPDGF对糖尿病鼠全层皮肤缺损创面微血管形成的影响和意义

目的:观察外源性重组人血小板源性生长因子(rhPDGF)对全层皮肤缺损的糖尿病鼠创面愈合过程中微血管形成的影响及促创面愈合的作用。方法:利用大鼠全层皮肤缺损创面愈合模型,将26只非糖尿病鼠52个创面分为3组:①A组为糖尿病大鼠创伤自然愈合组;②B组为接受rhPDGF治疗的糖尿病大鼠创伤愈合组;③C组为赋性剂组。于伤后3 d、7 d和14 d采取创面皮肤标本,用组织病理HE和血管Ⅷ因子抗体免疫组织化学染色技术检测创面肉芽再生与再血管化情况进行观察,同时观察创面的愈合情况。结果:全层皮肤缺损糖尿病鼠创面肉芽组织中微血管的形成数量少,采用赋性剂对照组与糖尿病鼠自然愈合组无显著差别。但外源性使用rhPDGF后,肉芽组织的形成量明显增多,内含的微小血管数量显著增加,愈合能力明显增强。结论:糖尿病大鼠微血管形成障碍可能是其创面愈合延迟的重要因素。而应用外源性的PDGF有助于微血管的形成,可以改善糖尿病鼠的创面愈合能力。     

针刺配合济生肾气丸治疗阴阳两虚糖尿病肾病的临床观察

目的 观察针刺配合济生肾气丸治疗阴阳两虚糖尿病肾病(DKD)的临床疗效.方法 将88例阴阳两虚DKD患者按照随机分组原则分为观察组和对照组,每组44例.对照组予以西医常规治疗,观察组在西医常规治疗基础上加用针刺配合济生肾气丸,两组均连续治疗12周.观察两组患者治疗前后中医证候评分及单一症状评分、糖代谢指标[空腹血糖(F...     

Pseudoaneurysm after an ultrasound-guided breast core needle biopsy in a lactating woman

This is a case report of a lactating woman in her twenties diagnosed with a breast pseudoaneurysm following a 14-gauge ultrasound-guided core needle biopsy detected by a Color Doppler exam, and treated with surgery. Further discussion concerning the patient’s symptoms, useful imaging modalities, and treatment options are included. Knowledge on this complication is crucial for the correct diagnosis and best management and treatment.     

针药结合治疗糖尿病胃轻瘫研究进展

糖尿病胃轻瘫(DGP)是糖尿病患者中发病率较高的慢性胃肠道并发症,其发病原因及机制十分复杂,目前临床尚无针对性的治疗方案,其治疗一直为临床所重视。目前研究表明,针药结合较单纯用药及单纯针灸具有明显优势,但大多属于临床小样本观察,机制尚不明确。     

高龄患者常见护理并发症的预防及护理

随着我国人口结构的老龄化,老龄患者逐渐增多,对长期卫生服务及护理的需求也相应增加。为此,需要更新、更专业、更全面的护理措施得以完善。结合老年人的生理特点,对老年患者常见护理并发症的预防及护理进行综述,旨在延长老龄患者的寿命,提高老龄患者的生存质量。     

肾小管上皮细胞表型转化与糖尿病肾病

肾小管病变及肾间质纤维化在糖尿病肾病中的重要作用逐渐被认识,其中肾小管上皮细胞向间充质细胞转化(EMT)可能是其发挥作用的关键环节,与肾间质纤维化的程度相平行。在糖尿病肾病中引发EMT的因素主要有高血糖、晚期糖基化终末产物、蛋白尿、血管紧张素Ⅱ、结缔组织生长因子等。     

Ⅰ型Na+/H+交换器在LPS引起的大鼠肺微血管内皮细胞损伤中的作用

目的探索Ⅰ型Na /H 交换器(NHE1)在脂多糖(LPS)引起的大鼠肺微血管内皮细胞(PMVECs)损伤中的作用。方法培养大鼠PMVECs。MTT比色试验检测细胞活力;比色法测试上清液中乳酸脱氢酶(LDH)活力和丙二醛(MDA)浓度;BECEF-AM荧光探针染色细胞,激光共聚焦显微镜下观察细胞内酸碱度,检测NHE1的活性;PT-PCR技术检测NHE1的mRNA表达。结果LPS不仅使细胞活力降低35%(P<0.05),使上清液中LDH和MDA分别升高3倍和2.5倍(P<0.05),而且使NHE1的活性增强,mRNA表达增多(P<0.05)。但是NHE1的抑制剂———环己阿米洛利(HMA)能显著抑制LPS引起的这些变化(P<0.05)。结论NHE1的活性增强和表达增多是LPS引起大鼠PMVECs损伤的重要机制。     

P38 MAPK激活在高血糖致大鼠微血管通透性增高过程中的作用

目的研究P38 MAPK信号传导通路在糖尿病大鼠微血管内皮细胞通透性增高中的作用机制。方法SD雄性大鼠,腹腔注射链脲佐菌素(STZ 55 mg/kg)制备糖尿病模型。分正常组、糖尿病组、溶剂对照组、MKK6b(A)组和MKK6b(E)组。溶剂组:给予相同容量的柠檬酸缓冲液;MKK6b(A)组:在糖尿病模型基础上,实验前24 h尾静脉注射MKK6b(A)2.5 mL/kg;MKK6b(E)组:在实验前24 h给正常大鼠尾静脉注射MKK6b(E)2.5 mL/kg。用荧光强度检测微血管通透性;用荧光染色法观察微血管内皮细胞骨架蛋白的形态。结果糖尿病大鼠的微血管通透性明显高于正常组;注射MKK6b(E)可以增高大鼠微血管的通透性,而注射MKK6b(A)后微静脉的高通透性则被抑制。结论P38 MAPK信号转导系统参与介导了糖尿病微血管通透性增高的反应过程。     

Effect of Yinqi Ointment on Wound Morphology and Growth Factor in Treating Diabetic Foot Ulcer

Objective: To investigate the effect of Yinqi ointment on wound morphology and growth factor in treating diabetic foot ulcer(DFU).Methods: From December 2016 to December 2017, 92 cases of DFU with deficiency of both Qi and Yin syndrome were randomly divided into treatment group and control group(44 cases in each group). The treatment group was treated with Yinqi ointment, while the control group was treated with mupirocin ointment. After 4 weeks of treatment, the ulcer healing effect, ulcer area, granulation tissue, epithelial tissue coverage,pain score, and dynamic analysis of vascular endothelial growth factor(VEGF), epidermis growth factor(EGF), and basic fibroblast growth factor(bFGF) in local granulation tissue were statistically analyzed before and after treatment in both groups. Results: The total effective rate was 88.37% in the treatment group and 74.42% in the control group. The wound reduction rate, epithelial tissue coverage rate, granulation tissue growth rate, and local pain relief rate in the treatment group were significantly superior to those in the control group(P 0.05). Through the local granulation detection, the treatment group and the control group have increased VEGF, EGF, and bFGF, but the treatment group increased the role of growth factor than the control group. Conclusion: Yinqi ointment can promote the healing of DFU, and its mechanism may be related to the increase of the content of growth factor in granulation tissue.