糖尿病乳腺病的研究进展

糖尿病乳腺病（DMP）是一种少见的影响妇女健康的疾病,通常见于长期进行胰岛素治疗的糖尿病患者。通过对肿瘤坏死因子及穿孔素的观察表明,细胞介导的细胞毒性作用在DMP的发病中起重要作用。DMP可能还与糖尿病的其他并发症如糖尿病视网膜病变及神经病变并存。针吸活检病理检查、高频超声检查、CT及动态增强MR1是必要的检查手段。但是DMP的病因学尚不清楚,其诊断需要临床、影像学和病理的结合。     

实验性糖尿病大鼠肺组织晚期糖基化终末产物、肺表面活性物质蛋白质A免疫组织化学分析

Objective To approach the changes of advanced glycosylated end products (AGEs),surfactant proteins A (SP-A) in the lung of experimental diabetic rats and their relationship. Methods 48 male SD rats were divided into diabetes mellitus (DM) group and control group, each group with 24 rats.The DM rat model was made by injecting streptozocin (60mg/kg) into caudal vein. The rats were killed and the lung was individually taken out at the end of 4, 12 and 20 weeks after the models were established. The changes of AGEs, SP-A in rats lung were observed with immunohistochemical assay and the images were analyzed( black is minimum of gray, white is maximum of gray ). Results We observed a great quantity of AGEs positive cells in the alveolar epithelial cells, bronchial mucosal epithelium, angio-endothelial cell and smooth muscle cells of the DM rats. The average gray (AG) was inferior to that of the controls(4weeks 93.92 ± 7.92 vs 104. 75 ± 8. 20; 12 weeks 76. 25 ± 6. 76 vs 93.50 ± 7.56; 20 weeks 47.63 ± 7.96 vs 142. 38 ± 19. 76; P ＜0. 05) and decreased with the DM course. In the 4 weeks DM rats, there were a few SP-A positive cells in the type Ⅱ alveolar epithelial cells, Clara cells and alveolar macrophage cells. In the 12 and 20 weeks DM rats, there were a great many CTGF and TGF-β1 positive cells. The AG was inferior to that of the controls( 12 weeks 75.63 ± 6. 70 vs 110. 50 ± 13.20;20 weeks 47.38 ± 4. 84 vs 97. 25 ± 9. 87; P ＜ 0. 01 ). Conclusion With the progress of diabetes, DM rats' pulmonary alveolar type Ⅱ cells injury appeared, that might be related with the deposition of AGEs.     

实验性糖尿病大鼠肺组织晚期糖基化终末产物、肺表面活性物质蛋白质A免疫组织化学分析

目的 探讨实验性糖尿病（diabetes mellitus,DM）大鼠肺组织晚期糖基化终末产物（advanced glycosylated endproducts,AGEs）、肺表面活性物质蛋白质A（surfactant proteins A,SP-A）的变化.方法 48只SD雄性大鼠随机分为DM组和对照组,每组24只.链脲佐菌素（streptozotocin,STZ）60mg/kg尾静脉注射制造DM模型.分别于造模成功后4、12、20周末杀检.免疫组织化学方法 观察肺组织AGEs、SP-A的变化,并进行图像分析（灰度值以0为黑,最大值为白）.结果 （1）AGEs：DM大鼠肺泡上皮细胞、支气管黏膜上皮细胞、血管内皮细胞及平滑肌细胞可见大量AGEs阳性细胞,平均灰度值低于对照组（4周93.92±7.92 vs 104.75±8.20;12周76.25±6.76 vs 93.50±7.56;20周47.63±7.96 vs 142.38±19.76;P均＜0.05）,随着DM病程的增加逐渐降低.（2）SP-A：4周DM大鼠肺泡Ⅱ型细胞、肺泡巨噬细胞、克拉拉细胞可见少量阳性细胞,12、20周可见大量SP-A阳性细胞,平均灰度值均低于对照组（12周75.63±6.70 vs 110.50±13.20;20周47.38±4.84 vs 97.25±9.87;P均＜0.01）.结论 DM大鼠随着病程的增加,出现肺泡Ⅱ型细胞的损伤,可能与AGEs的沉积有关.     

实验性糖尿病大鼠肺组织晚期糖基化终末产物、肺表面活性物质蛋白质A免疫组织化学分析

Objective To approach the changes of advanced glycosylated end products (AGEs),surfactant proteins A (SP-A) in the lung of experimental diabetic rats and their relationship. Methods 48 male SD rats were divided into diabetes mellitus (DM) group and control group, each group with 24 rats.The DM rat model was made by injecting streptozocin (60mg/kg) into caudal vein. The rats were killed and the lung was individually taken out at the end of 4, 12 and 20 weeks after the models were established. The changes of AGEs, SP-A in rats lung were observed with immunohistochemical assay and the images were analyzed( black is minimum of gray, white is maximum of gray ). Results We observed a great quantity of AGEs positive cells in the alveolar epithelial cells, bronchial mucosal epithelium, angio-endothelial cell and smooth muscle cells of the DM rats. The average gray (AG) was inferior to that of the controls(4weeks 93.92 ± 7.92 vs 104. 75 ± 8. 20; 12 weeks 76. 25 ± 6. 76 vs 93.50 ± 7.56; 20 weeks 47.63 ± 7.96 vs 142. 38 ± 19. 76; P ＜0. 05) and decreased with the DM course. In the 4 weeks DM rats, there were a few SP-A positive cells in the type Ⅱ alveolar epithelial cells, Clara cells and alveolar macrophage cells. In the 12 and 20 weeks DM rats, there were a great many CTGF and TGF-β1 positive cells. The AG was inferior to that of the controls( 12 weeks 75.63 ± 6. 70 vs 110. 50 ± 13.20;20 weeks 47.38 ± 4. 84 vs 97. 25 ± 9. 87; P ＜ 0. 01 ). Conclusion With the progress of diabetes, DM rats' pulmonary alveolar type Ⅱ cells injury appeared, that might be related with the deposition of AGEs.     

CO_2点阵激光治疗妊娠纹2例的临床疗效

目的:观察CO_2点阵激光治疗妊娠纹的临床疗效和安全性。方法 :妊娠纹患者2例,年龄分别为36岁和40岁。未曾使用过其他治疗,妊娠结束时间分别为8年和12年,妊娠纹色与皮肤接近或淡白色,部分妊娠纹有少许细纹和萎缩,患者均配合治疗和观察。采用CO_2点阵激光,波长10 600nm,能量40 m J,密度25%。根据妊娠纹形态选择不同的治疗图形,如正方形、长方形、多边形,治疗直径或治疗边长根据妊娠纹长度、宽度和形态调整,同一部位不重复治疗。术后3个月随访,观察疗效,记录不良反应发生情况。结果:2例患者CO_2点阵激光治疗后妊娠纹面积、数量、密度较治疗前显著下降,颜色更接近肤色。无一例发生不良反应。结论:CO_2点阵激光治疗腹部妊娠纹是一种安全有效的治疗方法,有待进一步观察。     

实验性糖尿病大鼠肺组织AGEs、TGF-β1、CTGF免疫组织化学分析

目的 探讨实验性糖尿病(DM)大鼠肺组织晚期糖基化终末产物(AGEs)、转化生长因子-β1(TGF-β1)、结缔组织生长因子(CTGF)的变化及其相关性. 方法 48只SD雄件大鼠随机分为DM组和对照组,每组24只.链脲佐菌素(STZ)60mg/kg尾静脉注射制造DM模型.分别于造模成功后4、12、20周末取材.免疫组织化学方法 观察肺组织AGEs、CTGF、TGF-β1的变化,并进行图像分析. 结果 DM大鼠肺泡上皮细胞、支气管黏膜上皮细胞、血管内皮细胞及平滑肌细胞可见大量AGEs阳性表达,平均灰度值低于对照组(P<0.05).随着DM病程的发展,AGEs阳性表达逐渐降低(P<0.01);4周DM大鼠支气管黏膜上皮细胞、血管内皮细胞、肺问质细胞可见少量CTGF、TGF-β1阳性细胞,12、20用时可见大量CTGF、TGF-β1阳性细胞,平均灰度值均低于对照组(P<0.01);Pearson相关分析显示,DM大鼠肺组织AGEs与CTGF、TGF-β1之间呈显著止相关(γ=0.939、0.904;P<0.01),CTGF与TGF-β1亦呈正相关(y=0.878;P<0.01). 结论 DM大鼠肺组织内AGEs随病程的延长其表达明显增加,并与CTGF、TGF-β1正相关.     

低剂量雷米普利对2型糖尿病肾病患者尿蛋白的影响

目的:观察雷米普利(ramipril)对不同时期2型糖尿病肾病患者尿蛋白及肾功能的影响.方法:选择2型糖尿病肾病患者90例,年龄42岁～76岁.分为治疗组54例,对照组36例.两组患者均根据尿蛋白和肾功能的不同再分为早期肾病组、临床期肾功能正常组和临床期肾功能不全组.治疗组给予口服雷米普利(2.5 mg/d),连续应用12周.对照组不予上述治疗.结果:与对照组比较,治疗组患者尿总蛋白和尿白蛋白明显降低,其中2型糖尿病早期肾病组尿总蛋白由治疗前的(0.34±0.11)g/24 h下降到(0.24±0.09)g/24 h(P＜0.01),尿白蛋白由(199±50)g/24 h下降到(148±35)g/24 h(P＜0.01);临床期肾功能正常组尿总蛋白由治疗前的(2.15±1.01)g/24 h下降到(1.66±0.86)g/24 h(P＜0.01);临床期肾功能不全组尿总蛋白由治疗前的(1.93±0.91)g/24 h下降到(1.68±0.81)g/24 h(P＜0.05).结论:应用雷米普利对不同时期的2型糖尿病肾病患者均有减少尿蛋白的作用,且早期应用效果尤佳.     

光动力疗法在宫颈上皮瘤变中的应用

目的:本研究系统分析了光动力疗法(photodynamic therapy,PDT)治疗宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)的疗效和安全性。方法:通过对Pubmed及中国知网中涉及的相关文献以及2012年8月至2017年12月,笔者采用PDT治疗宫颈上皮瘤变的情况进行分析和总结。结果:局部和系统给药途径的光敏剂均可用于宫颈上皮瘤变的PDT治疗,系统给药方式采用的光敏剂主要为Photofrin和血卟啉注射液,局部给药方式采用的光敏剂5-氨基酮戊酸(ALA)为主,亦可使用氨基酮戊酸甲酯(MAL)、氨基己糖酮戊酸(HAL)、dihematoporphyrin ether(DHE)等。PDT照射光源通常采用波长630～635 nm的红光,多种PDT治疗光参量被用于CIN的治疗。基于局部用光敏剂的PDT疗法治疗主要用于CINⅠ～Ⅱ级的治疗,其有效率为50%～95%,基于系统用光敏剂的PDT疗法主要用于CINⅡ～Ⅲ级的治疗,其有效率为CR 88%～100%。基于局部和系统用光敏剂的PDT疗法对宫颈结构和机能均有较好的保护作用。结论:PDT治疗宫颈上皮内瘤变是一种安全、有效的方法,但局部和系统两种给药方式的PDT治疗的疗效比较还需进行大样本的研究,从而对PDT治疗的光参量进行优化。     

糖尿病大鼠肺组织糖基化终产物、结缔组织生长因子免疫组化观察分析

目的 探讨糖尿病(DM)大鼠肺组织糖基化终末产物(AGEs)、结缔组织生长因子(CTGF)的变化及其相关性.方法 48只雄性SD大鼠随机分为DM模型组(DM组)和对照组各24只.DM组大鼠成模后4、12、20周末各杀检8只.免疫组化法观察肺组织AGEs、CTGF变化并分析图像.结果 大量AGEs和CTGF阳性细胞分别出现于4、12、20周和12、20周DM大鼠肺组织内,其平均灰度值低于对照组,并随病程进展而降低(P<0.05,P<0.01).Pearson相关分析示:DM大鼠肺组织AGEs与CTGF呈显著正相关.结论 高血糖状态下,肺组织内AGEs和CTGF显著增加并正相关,可能共同参与了DM肺损害;蛋白非酶糖基化通路可能是DM肺损害重要发病机制之一.