Estrogen receptor alpha pathway is involved in the regulation of Calbindin-D9k in the uterus of immature rats.

It has been demonstrated in our previous studies that Calbindin-D9k (CaBP-9k) is a potent biomarker for screening estrogen-like chemicals in the rat model. Although treatments with 17beta-estradiol (E2) and endocrine disrupting compounds resulted in the up-regulation of uterine CaBP-9k, the mechanism of CaBP-9k induction by these compounds through two subtypes of estrogen receptors (ERalpha and ERbeta) is unclear. Thus, in the present study, immature rats were treated with propyl pyrazole triol (PPT, an ERalpha-selective ligand), diarylpropionitrile (DPN, an ERbeta-selective ligand), E2, or dimethyl sulfoxide (DMSO, a vehicle control) for three days in order to clarify which subtype of ER is involved in the uterine CaBP-9k induction. Following injection with these ER ligands, uterine CaBP-9k expression was analyzed by Northern blot and immunoblot assays. Uterine CaBP-9k expression is mainly mediated by PPT in a dose- and time-dependent manner in immature rats, whereas no significant alteration of the uterine CaBP-9k gene was observed after DPN treatment. In addition, an estrogenicity of PPT in inducing CaBP-9k expression was completely blocked by the anti-estrogen ICI 182,780, implying that uterine CaBP-9k is solely induced by ERalpha. A single treatment with PPT rapidly increased the protein levels of ERalpha and PR, an E2-mediated gene, in these tissues. Taken together, these results indicate that uterine CaBP-9k is induced by E2 and endocrine disrupting chemicals via the ERalpha pathway, but not ERbeta, in the uterus of immature rats.     

脉络宁弥可保治疗糖尿病周围神经病变的临床研究

目的观察脉络宁、弥可保联用治疗糖尿病周围神经病变(DPN)的临床疗效并探讨其作用机理.方法将102例DPN患者随机分为脉络宁与弥可保治疗组和弥可保时照组(各51例),观察其对DPN的临床疗效、NCV及血流变等指标的影响.结果治疗组在治疗后临床疗效明显改善(P＜0.05),NCV明显加快(P＜0.01),血流变学指标明显改善(P＜0.05).结论脉络宁与弥可保能够明显减轻DPN患者的临床症状,改变神经传导速度,改善血流变指标,对防治DPN有较好疗效.     

血糖控制情况对糖尿病周围神经病变(DPN)患者下肢神经减压术疗效的影响

目的 探讨糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)患者的血糖控制情况对周围神经减压手术疗效的影响。方法 2014年12月至2016年6月在复旦大学附属中山医院接受单侧下肢神经减压术的DPN患者共计40例,以HbA1c=8%为标准分为血糖控制尚可组和血糖控制不佳组。在术前1天和术后6个月,测量视觉模拟评分(visual analogue scale,VAS)、两点辨别觉(two point discrimination,TPD)和10 g单丝测验,比较两组患者的手术疗效。结果 所有患者术后VAS、TPD和10 g单丝测验结果均较术前均明显改善。血糖控制尚可的患者术后VAS、TPD和10 g单丝测验结果均优于血糖控制不佳的患者。结论 良好的血糖控制对DPN患者下肢神经减压术后疼痛的缓解和肢体感觉的恢复具有积极作用,血糖控制尚可的患者手术疗效明显优于血糖控制不佳的患者。     

健康指导配合前列腺素E1治疗糖尿病周围神经病变效果观察

目的:观察应用前列腺素E1(PGE1)治疗糖尿病周围神经病变(DPN)过程中配合系统化健康指导对患者康复的影响。方法:将72例静脉注射PGE1的DPN患者随机分为两组,指导组35例进行系统化健康指导,对照组37例进行一般常规护理。结果:指导组症状明显改善,总有效率达93.5%,对照组有效率为74.2%,两组比较有显著性差异(P<0.01)。结论:PGE1配合系统化健康指导有利于DPN患者的康复,提高了患者的生活质量。     

安糖通痹方对糖尿病周围神经病变大鼠作用的机理研究

目的:探讨安糖通痹方治疗大鼠糖尿病周围神经病变作用机制.方法:用小剂量链脲佐菌素(STZ)诱导的方法建立2型DPN大鼠模型,选取健康大鼠50只,随机分为正常组、安糖通痹方小剂量组、大剂量组和VitB12组,分别测定造模前后ET水平及NO水平,进行对比分析.结果:造模成功后各用药组血清NO水平明显低于正常组(P<0.05),ET水平明显高于正常组(P<0.05);经治疗后,安糖通痹方大剂量组的大鼠血清NO显著升高(与小剂量组、VitB12组比较,P<0.05),大鼠血浆ET显著降低(与小剂量组、VitB12组比较,P<0.05).结论:安糖通痹方可以升高血清NO水平,降低ET含量,具有对周围神经和血管的保护作用,且大剂量组效果优于小剂量组.     

糖尿病大鼠周围神经bFGF的动态表达及巴曲酶对其的影响

目的探讨碱性成纤维生长因子(bFGF)在糖尿病周围神经病(DPN)大鼠中的动态变化规律;观察巴曲酶对bFGF的影响及其机制,为临床上治疗DPN提供理论依据。方法将大鼠腹腔注射链脲佐菌素制作实验性糖尿病模型,分别于成模后2m和3m时腹腔注射巴曲酶进行干预。通过免疫组织化学和原位杂交双重检测bF-GF在坐骨神经中的表达。结果DM造模后2m时坐骨神经中bFGF的含量明显减少,且随时间变化有统计学差异,巴曲酶治疗后bFGF的表达明显增加。结论DPN大鼠坐骨神经中bFGF表达减少可能参与DPN的发病机制。巴曲酶对DPN有保护作用,其机制可能包括对bFGF的调节。     

糖尿病周围神经病变护理与预后的研究

目的观察我科综合护理配合治疗对DPN患者预后的作用。方法我科120例患者,用基本护理、健康宣教、饮食调理、运动保健等综合护理配合治疗,疗程14d。结果总有效率90.8%,治疗前后空腹血糖与餐后血糖相比均有统计学差异（P〈0.01）。结论正确的治疗必须配合基本护理、健康宣教、饮食调理、运动保健等综合护理,才能达到很好的疗效,改善患者预后。     

肌电图对糖尿病周围神经病的诊断价值

目的：探讨神经肌电图在糖尿病性周围神经病（DPN ）诊断中的应用价值。方法：选择我院2012年1月～2014年6月收治的200例DPN患者的临床资料,分析肌电诱发电位仪对患者的相关神经进行检测的结果。结果：在200例DPN患者中,神经电图总异常率高达71．5％。且随着病程的延长,其EM G异常率的发生逐渐增加。病程在1年以内的患者EM G异常率为40．8％,而病程在10年以上者异常率达到92．2％。病程在1年以内的患者H反射异常率为46．9％,而病程在10年以上者H反射异常率达到94％。其次是腓总神经运动传导速度（MCV）、腓浅神经感觉传导速度（SCV）异常率,分别是43．1％和58．8％,均超过40％。EM G结果提示：病程＜1年组拇短展肌、肱二头肌、胫前肌、趾总伸肌EM G异常率均为0,病程≥10年组异常率分别为17．6％、9．8％、21．5％、31．4％,同样随病程延长而异常率增加。结论：EM G在诊断DPN中具有较高的准确性,有利于早期发现和进行治疗。     

Independent Risk Factors for Positive and Negative Symptoms in Patients with Diabetic Polyneuropathy

Patients with diabetes occasionally develop diabetic polyneuropathy (DPN), which is characterized by both positive symptoms such as pain and negative symptoms such as numbness/dysesthesia. However, these symptoms have always been collectively analyzed to determine their risk factors. This study aimed to independently analyze the risk factors for neuropathic pain and numbness/dysesthesia in DPN patients. In total, 298 patients with diabetes (age: 61.1 ± 10.4 years; 176 male) were included. The relationships among the incidence of DPN and its clinical parameters were determined using logistic regression models. Then, the statistical model was applied in two groups of DPN patients: those with pain only or both pain and the negative symptoms (pain group; n = 25) and those with the negative symptoms only or both pain and the negative symptoms (numbness/dysesthesia group; n = 60). All logistic regression models were adjusted for the duration of diabetes, glycosylated hemoglobin levels, and age. The depression score was higher for patients with DPN than for those without, although it did not reach an abnormal level. An abnormal Achilles tendon reflex (ATR) and insulin treatment, but not smoking, hypertension, hyperlipidemia, and diabetic retinopathy, were associated with DPN. Furthermore, female sex and an abnormal ATR and insulin treatment were significant clinical features in the pain and numbness/numbness groups, respectively. Overweight and obesity were the common clinical features in both groups. We conclude that the positive and negative symptoms of DPN possibly have independent risk factors, suggesting different underlying mechanisms and the need for separate diagnosis and treatment.     

远志对DPN大鼠血糖和尾部SNCV的影响

目的:观察远志对糖尿病周围神经病变(DPN)大鼠血糖和尾部感觉神经传导速度(SNCV)及血糖的影响.方法:48只雄性Wistar大鼠随机分为4组,正常对照组、DPN模型组、远志治疗组和远志预防组,每组12只.测定各组大鼠尾部SNCV及空腹血糖.结果:与正常对照组比较,DPN模型组大鼠血糖明显升高、尾部SNCV明显降低(P＜0.01);远志治疗组、远志预防组大鼠血糖明显低于DPN模型组、尾部SNCV明显高于模型组(P＜0.01).结论:远志可明显提高DPN大鼠尾部SNCV、降低血糖,并对DPN大鼠尾部SNCV降低、血糖升高具有预防作用.