缬沙坦胶囊、厄贝沙坦片治疗糖尿病肾病患者106例临床观察

目的前瞻性观察缬沙坦与厄贝沙坦对糖尿病肾病患者微量尿白蛋白及血压的影响。方法前瞻性观察106例2型糖尿病肾病患者,按数字表法将患者随机分为A、B两组,均采用相应的基础降糖治疗后,A组(n=51)患者加用缬沙坦80 mg/d,B组患者(n=55)用厄贝沙坦150 mg/d,12周为1个疗程,每疗程观察微量白蛋白尿及血压,共3个疗程。结果①缬沙坦及厄贝沙坦对微量尿白蛋白经3个疗程治疗后,差异有统计学意义(Z=-6.490,P<0.001)。两种药物对于微量尿白蛋白治疗在各疗程终点比较差异无统计学意义(P>0.05)。②缬沙坦及厄贝沙坦对血压经3个疗程治疗后差异有统计学意义(P<0.05)。两种药物对于收缩压治疗在各疗程终点比较,差异有统计学意义(P<0.05)。结论两组药物均有减少糖尿病肾病患者微量蛋白尿及降压作用,而厄贝沙坦比缬沙坦在降低血压方面更有优势。     

新疆和田地区维吾尔族儿童糖尿病患病率调查

目的 调查新疆和田地区维吾尔族儿童糖尿病（diabetes mellitus,DM）患病率,以及DM患病的影响因素。 方法 采用整群随机抽样的方法抽取新疆和田地区5 308名在校中小学、幼儿园4~18岁儿童作为研究对象。调查方式包括问卷调查及身高、体重测量。对所有研究对象进行空腹指尖微量血糖检测,以调查DM和空腹血糖受损（impaired fasting glucose,IFG）的患病率。 结果 回收有效问卷5 184份,检出DM 14例（0.27%）,包括8例1型DM,2例2型DM,4例未分型DM;检出IFG 29例（0.56%）。男生和女生DM及IFG患病率的比较差异无统计学意义（P>0.05）。4~<10岁、10~<15岁和15~18岁组DM的患病率分别为0.18%、0.47%、0.07%,各年龄组比较差异无统计学意义（P=0.072）;以上3个年龄组IFG的患病率分别为0.18%、0.94%、0.42%,各年龄组间比较差异有统计学意义（P=0.007）。DM儿童DM家族史比例和超重/肥胖比例显著高于非DM儿童（P<0.05）,而DM儿童喜食粗粮比例显著低于非DM儿童（P<0.05）。 结论 新疆和田地区维吾尔族儿童DM和IFG的患病率较低;不同性别和年龄段儿童DM患病率无明显不同,但不同年龄段儿童IFG患病率不同。DM家族史、超重/肥胖、粗粮摄取不足可能与DM的发生有关。     

Ang-2、HSP90α在老年非小细胞肺癌患者血清中的表达及与TNM分期的相关性研究

目的分析血管生成素-2(Ang-2)、热休克蛋白-90α(HSP90α)与老年非小细胞肺癌患者血清中表达情况,及其与TNM分期的相关性。方法选取2015年1月至2016年6月间新疆医科大学附属中医医院收治的40例老年非小细胞肺癌患者及40例体检健康者作为研究对象。检测受试者血清中Ang-2、HSP90α水平,并分析其与患者TNM分期相关性。结果观察组患者血清中Ang-2及HSP90α水平均明显高于对照组,差异有统计学意义(P0.05);肿瘤TNMⅠ~Ⅱ期患者血清中Ang-2及HSP90α水平显著低于Ⅲ及Ⅳ期,差异有统计学意义(P0.05);TNMⅢ期患者血清中Ang-2及HSP90α水平显著低于Ⅳ期,差异存统计学意义(P0.05);TNM分期与患者血清中HSP90α水平呈正相关(r=0.425,P0.05),TNM分期与患者血清中Ang水平呈正相关(r=0.525,P0.05)。结论 Ang-2及HSP90α水平在老年非小细胞肺癌患者血清中呈显著高表达状态,且其表达水平与TNM分期呈正相关。     

Tapering duodenoplasty and gastrojejunostomy in the management of idiopathic megaduodenum in children

PurposeThe purpose of this study is to present the management of idiopathic megaduodenum in children.MethodsA retrospective analysis of 4 cases of megaduodenum admitted from 2005 to 2011 was performed evaluating clinical features, radiologic data, treatment, pathologic findings, and prognosis. The corresponding literature was reviewed.ResultsThe diagnosis of nonobstructive megaduodenum was confirmed by upper gastrointestinal contrast study, ultrasonography, and exploratory laparotomy. Treatment consisted of either tapering duodenoplasty with pylorus division and closure of the proximal stump plus Roux-en-Y gastrojejunostomy or tapering duodenoplasty with closure of the proximal stump and end-to-side gastrojejunostomy. On pathologic evaluation, neural and vascular structures appeared normal in all sections. All symptoms, including diarrhea, bloating, vomiting, and nausea, had resolved on follow-up, and all patients experienced rapid weight gain after their operation.ConclusionsIdiopathic megaduodenum without organic obstruction is a rare clinical condition. Massive dilatation confined to the duodenum was shown by upper gastrointestinal contrast studies and ultrasonography and can also be identified on antenatal ultrasonography. In children with megaduodenum, satisfactory results can be obtained by tapering duodenoplasty with proximal stump closure and gastrojejunostomy with either Roux-en-Y or end-to-side anastomosis.     

Association between celiac disease and vitiligo: A review of the literature

Celiac disease (CD) is an autoimmune intestinal disease caused by the intake of gluten-containing cereals and their products by individuals with genetic susceptibility genes. Vitiligo is a commonly acquired depigmentation of the skin; its clinical manifestation are skin patches caused by localized or generalized melanin deficiency. Both diseases have similar global incidence rates (approximately 1%) and are associated to similar diseases, including autoimmune bullous disease, inflammatory bowel disease, autoimmune thyroiditis, autoimmune gastritis, and type 1 diabetes. The relationship between CD and vitiligo has been reported in several studies, but their conclusions are inconsistent. Further, it has also been reported that a gluten-free diet (GFD) can improve the symptoms of immune-related skin diseases such as vitiligo. In this mini-review, we summarize and review the literature on the relationship between CD and vitiligo, assess the therapeutic significance of GFD for patients with vitiligo, and explore their possible physiopathology. We are hopeful that the information summarized here will assist physicians who treat patients with CD or vitiligo, thereby improving the prognosis.     

经腹腔镜Nissen与Toupet胃底折叠术治疗GERD前瞻性随机对照研究的Meta分析

目的系统评价腹腔镜Nissen胃底折叠术(LNF)与腹腔镜Toupet胃底折叠术(LTF)治疗胃食管反流疾病(gastroesophageal reflux disease,GERD)的价值和意义。 方法计算机检索Cochrane图书馆(2015年第二期);PubMed(1978～2016);Embase(1966.1～2016.5);CMB(1978.1～2016.5);VIP(1989.1～2016.5);CNKI(1989.1～2016.5);OVID(2006～2016.5)。查阅文章后所附的参考文献及手工检索相关杂志及会议论文集中未发表的文献。 结果纳入10个随机对照试验,共1 468例患者,试验组(LNF)769例,对照组(LTF)701例。结果显示LNF与LTF治疗GERD的疗效,手术时间差异无统计学意义(P＝0.09);术后6个月和1年吞咽困难、胃灼热、腹胀、胸痛发生率差异无统计学意义(P>0.05)。术后DeMeester评分差异有统计学意义(P＝0.007);术后6个月和2年食管反流发生率差异无统计学意义(P＝0.77)。 结论现有有限证据表明如果把握好手术适应症,运用LNF较LTF治疗GERD并不缩短手术时间,术后6个月、1年吞咽困难、胃灼热、腹胀、胸痛发生率和2年食管反流病的复发率无明显差异。术后DeMeester评分LNF组明显低于LTF组,但反流症状无明显差异。     

Color change of airborne particle–abraded acrylic resin surfaces: A palatography method

Statement of problem

A palatogram aids prosthodontists and speech pathologists in evaluating the precise prosthetic treatment needed and the effectiveness of such treatment to improve speech intelligibility. Powder is commonly used to visualize tongue-palate contact, where wetted areas of powder in the oral cavity reveal such contact during palatography. However, discomfort and the risk of aspiration are among the shortcomings of this method, and an improved method is needed.

Clinical features of different stage subacute combined degeneration of the spinal cord

Subacute combined degeneration (SCD), caused by vitamin B12 disorders, leads to severe degeneration of the spinal cord. Thus, it is significant to make timely diagnosis and treatment options of SCD. The objectives were to summarize clinical features of different sate SCD. Clinical data of 42 SCD patients of spinal cord were retrospectively analyzed, which were classified into early stage, middle stage and late stage SCD. Among the patients, 9 were classified into early stage, 22 into middle stage, and 11 into late stage SCD. Total cholesterol and hemoglobin levels were relatively higher in late stage SCD. In contrast, mean corpusular volume (MCV) level was higher in early stage SCD. There were typical abnormalities only in 8 patients on magnetic resonance imaging (MRI), and a dynamia was a common neurological abnormality in all patients. Importantly, the differences in abnormal findings in anti-nuclear antibodies (ANA) testing, visual acuity and fundus testing were statistically significant in different stage SCD (P < .05). There were correlation between most variances with SCD stage. Strikingly, there existed close relationship between enhanced levels of blood glucose (r = −0.289, P = .066), glycated hemoglobin (GHB) (r = −0.288, P = .068) and homocysteine (r = −0.563, P = .000), abnormal visual findings (r = 0.309, P = .049) and megaloblastic anemia (r = −0.295, P = .061) with different SCD stage, among which abnormal visual findings were closely associated with middle stage SCD. Moreover, levels of total cholesterol, blood glucose, homocysteine and abnormal finding of visual acuity were significant in diagnosis and clinical staging of SCD (P < .05). Although MRI scanning and serum vitamin B12 level were widely used for SCD diagnosis, neurological examination and homocysteine level may be more potentially valuable indexes for SCD diagnosis and staging.     

不同剂量低分子肝素钠对急性DVT大鼠血管形态学影响的研究

目的:观察不同剂量低分子肝素钠对急性DVT大鼠在不同时期治疗后血管形态学的变化。方法:将72只SD大鼠制备模型后,随机按血栓形成后1、3、7、14d分期,每期18只,分为Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期。然后每期再根据低分子肝素钠剂量分为:低分子肝素钠小剂量组(700U/kg、一次/24h,n=6)、低分子肝素钠大剂量组(700U/kg、二次/24h,n=6)、模型组(0U/kg,n=6)。低分子肝素钠大、小剂量组均由大鼠腹壁皮下注射,连续7日。实验结束后获取病变段血管,观察内皮细胞数量变化,胶原阳性染色面积百分比变化,并与同期模型组进行比较。结果:模型组在Ⅱ期、Ⅲ期分别死亡一只,低分子肝素钠治疗大剂量组Ⅰ期、Ⅲ期、Ⅳ期内死亡4只。在Ⅰ期低分子肝素钠大、小剂量组内皮细胞数量与模型组相比均有统计学差异(P<0.05),组间亦有差异.低分子肝素钠大、小剂量组胶原阳性染色面积百分比与模型组相比均有统计学差异(P<0.05),组间相比无差异;在Ⅱ期,低分子肝素钠大、小剂量组内皮细胞数量与模型组相比均有统计学差异(P<0.05),组间无差异;在Ⅲ期、Ⅳ期低分子肝素钠大、小剂量组内皮细胞数量与模型组相比无统计学差异(P>0.05);在Ⅱ期、Ⅲ期低分子肝素钠大、小剂量组胶原阳性染色面积百分比与模型组相比仍有统计学差异(P<0.05),组间亦有差异;在Ⅳ期低分子肝素钠大、小剂量组胶原阳性染色面积百分比与模型组相比无统计学差异(P>0.05)。结论:血栓形成3d内,大、小剂量低分子肝素钠对内皮细胞均有保护作用,以大剂量效果较好。血栓形成7d内,大、小剂量低分子肝素钠对对胶原增生均有抑制作用,随着时间的延长,以大剂量低分子肝素钠抑制作用最强。