智能监护与健康管理系统在妊娠期糖尿病中的居家应用

目的:探讨智能监护与健康管理系统对妊娠期糖尿病患者居家期间的干预作用.方法:选取100例在医院就诊的妊娠期糖尿病患者用随机数字表法分为2组,对照组50例居家期间采取常规管理模式,研究组50例居家期间通过智能监护与健康管理系统进行干预,2组均干预至分娩.对比2组干预前后患者的健康认知评分、糖化血红蛋白(Glycated ...     

Advanced glycation end-products change placental barrier function and tight junction in rats with gestational diabetes mellitus via the receptor for advanced glycation end products/nuclear factor-κB pathway

The placenta plays an important role in nutrient transport to maintain the growth and development of theembryo. Gestational diabetes mellitus (GDM), the most common complication during pregnancy, highly affectsplacental function in late gestation. Advanced glycation end-products (AGEs), a complex and heterogeneous group ofcompounds engaged by the receptor for AGEs (RAGE), are closely associated with diabetes-related complications. Inthis study, AGEs induced a decrease in the expression of tight junction (TJ) proteins in BeWo cells and increased theparacellular permeability of trophoblast cells by regulating RAGE/NF-κB. Sprague-Dawley (SD) rats injected with100 mg/kg AGEs-rat serum albumin (RSA) via the tail vein from embryo day 2 were set as the placental barrierdysfunction model group (n = 10). The effect of AGEs on placental permeability was determined using the EvansBlue dye extravasation method. The ultrastructure of the placenta samples was observed by transmission electronmicroscopy. The effects of AGEs on the placenta were confirmed by treating rats with RAGE antagonist FPS-ZM1and soluble forms of RAGE (sRAGE). AGEs treatment increased placental permeability and disrupted the tightjunctions in pregnant rat placenta, but has no effect on blood glucose. The expression of TJ-related proteins,including ZO-1, Occludin, and Claudin 5, were downregulated after AGEs treatment. Further, AGEs treatmentincreased the expression of RAGE and nuclear factor-κB in the placenta of rats and upregulated the levels of vascularendothelial growth factor. The effects of AGEs on the placenta were blocked by RAGE antagonist FPS-ZM1 andsRAGE. This study demonstrates the mechanism underlying AGEs-induced disturbance in placental function inpregnant rats and highlights the potential of AGEs in the treatment of GDM.     

Albumin microvascular leakage in brains with diabetes mellitus

Their aim was to examine whether microvascular leakage of endogenous albumin, a representative marker for blood–brain barrier (BBB) damage, was induced in the periventricular area of diabetic db/db mice because periventricular white matter hyperintensity formation in magnetic resonance images was accelerating in elderly patients with diabetes mellitus. Using light and electron microscopes, and semi‐quantitative analysis techniques, immunoreactivity of endogenous albumin, indicating vascular permeability, was examined in the periventricular area and spinal cord of db/db mice and db/+m control mice. Greater immunoreactivity of albumin was observed in the vessel wall of the periventricular area of db/db mice than in controls. Additionally, weak immunoreactivity was observed in the spinal cord of both db/db mice and controls. The number of gold particles, indicating immunoreactivity of albumin, in the perivascular area of db/db mice was significantly higher than that of control mice, but there was no significant difference in the number of particles in the spinal cord between db/db mice and controls. These findings suggest that albumin microvascular leakage, or BBB breakdown, is induced in the periventricular area of diabetic mice. Microsc. Res. Tech. 79:833–837, 2016. © 2016 Wiley Periodicals, Inc.     

全自动检测血清Non-HDL-C在妊娠期糖尿病中的临床应用探讨

目的:研究非高密度脂蛋白(Non-HDL-C)在妊娠期糖尿病(GDM)患者中的血清水平及临床应用价值。方法:回顾性分析我院就诊的2017年1月到2019年12月共922例妊娠期妇女的临床资料,其中GDM组495例,427例正常妊娠妇女作为对照组。分析两组间血脂指标水平差异,使用Logistic回归分析Non-HDL-C与GDM之间的相关性。结果:GDM组和正常对照组的Non-HDL-C血清水平分别4.15(3.49,4.89)mmol/L和3.60(3.11,4.23)mmol/L,GDM组血清Non-HDL-C浓度显著高于正常对照组,差异具有统计学意义(P<0.01)。Logistic回归分析显示Non-HDL-C是GDM的危险因素(P<0.01),并且Non-HDL-C的OR值为1.68(95%CI,1.45,1.93;P=0.00),高于TC、TG、LDL-C的OR值,分别为1.49(95%CI,1.31,1.70;P=0.00)、1.26(95%CI,1.13,1.40;P=0.00)和1.27(95%CI,1.10,1.48;P=0.001)。结论:Non-HDL-C相较传统血脂指标能够更全面更敏感的显示孕期的血脂代谢水平,可以作为临床监测妊娠期糖尿病中血脂代谢的有效指标。     

辛伐他汀和罗格列酮对糖尿病患者动脉粥样硬化的影响

目的研究辛伐他汀和罗格列酮对2型糖尿病患者动脉粥样硬化的作用。方法 78例2型糖尿病伴颈动脉粥样斑块患者随机分为辛伐他汀组、罗格列酮组和联合组,分别口服辛伐他汀20mg/次、罗格列酮4mg/次及辛伐他汀20mg+罗格列酮4mg/次,每日1次,疗程3个月。在基线水平和疗程结束时经颈动脉超声检测CIMT,同时检测患者脂肪因子和炎症因子水平。观察治疗前后颈动脉内膜中层厚度及斑块变化。结果各组用药治疗3月后血脂、脂肪因子和炎性因子降低,CIMT厚度减低、斑块面积缩小,但斑块数量无减少,且联合用药比单一用药效果更显著。结论 2型糖尿病患者联合使用辛伐他汀和罗格列酮可改善胰岛素抵抗、改善脂类代谢、抑制大血管炎症反应、稳定和缩小动脉粥样斑块。     

Morphology of the intralobular duct of the submandibular gland in rats in case of experimental diabetes mellitus

The objective of study is to study the peculiarities of morphological changes in different subdivisions of the intralobular duct of the submandibular gland (SMG) in rats in case of experimental diabetes mellitus (DM). The study included sexually mature male Wistar rats. Experimental DM was induced by streptozotocin. Electron microscopic study of subdivisions of the intralobular duct of the SMG was carried out on the 14th, 28th, 42nd, 56th, and 70th days of the experiment. In early stages of experimental DM the intercalated ducts are characterized by a relatively unchanged structure, and in late stages vacuolization of the cytoplasm of their epithelial cells is observed. Since the 14th day vacuolization of mitochondria is observed in epithelial cells of the granular ducts being the most pronounced on the 28th day and not apparent over the subsequent periods. The degree of filling with granules reduces till 56th day, however, it increases sligthly on the last day of the experiment. On the 28th–70th days vacuolization of the cytoplasm is observed in epithelial cells of the striated ducts. In addition, on the 14th day the mitochondrial matrix of these cells condenses; over the next periods it becomes enlightened and mitochondrial cristae are clearly visualized and disorganized. Conclusion: In the intralobular duct of the SMG in experimental DM dystrophic changes of different intensity occur in the granular and striated ducts on the 14th day and in the intercalated ducts only since the 42nd day of the experiment.     

左卡尼汀联合辛伐他汀治疗老年冠心病合并2型糖尿病疗效观察

目的:观察左卡尼汀联合辛伐他汀治疗老年冠心病合并2型糖尿病的临床疗效。方法:选择2012年1月-2013年12月间收治的105例老年冠心病合并糖尿病患者为研究对象,按照随机数字表分为观察组(54例)和对照组(51例),对糖尿病和冠心病均给予对症治疗,对照组在此基础上予辛伐他汀调脂治疗,观察组在对照组基础上加服左卡尼汀口服液,3个月后对比2组血脂水平、心功能与冠心病疗效。结果:治疗3个月后,2组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)水平均较入组时明显降低,观察组TC(5.17±0.95)mmol/L vs.(5.65±0.90)mmol/L、TG(1.84±0.45)mmol/L vs.(2.07±0.49)mmol/L、LDL-C(2.39±0.54)mmol/L vs.(2.59±0.48)mmol/L水平显著低于对照组(P<0.05)。2组左室收缩末径(LVSD)较入组时明显降低,左室射血分数(LVEF)明显升高,观察组LVSD(43.4±4.6)mm低于对照组(45.5±4.9)mm,LVEF(49.1±6.3)%高于对照组(46.6±5.7)%,差异均具有统计学意义(P<0.05)。观察组冠心病治疗显效率(61.1%)与总体有效率(96.3%)均高于对照组水平(41.2%、86.3%),显效率差异有统计学意义(c2=4.173 P=0.041)。2组不良反应发生率(18.5%vs.11.8%)差异无统计学意义(χ2=0.926 P=0.336)。结论:单中心研究表明,在对老年冠心病联合2型糖尿病患者行调脂治疗基础上联合应用左卡尼汀能进一步降低血脂水平,且能提高心脏射血功能,减少心绞痛次数,不良反应较轻可控。     

尘肺患者早期血清特异性miRNA水平变化

目的:分析尘肺患者早期血清特异性miRNA水平变化特征,为尘肺筛查提供依据。方法:选取我院2014年7月至2018年3月收治的160例尘肺患者进行研究,按病程分为I期组与II期组,另选取80例健康体检者作为对照组,采用TaqMan低密度芯片及实时荧光定量-聚合酶链反应技术筛查三组研究对象miRNA表达水平,并对结果进行统计学分析。结果 :方差分析提示miR-21、miR-200c、miR-16、miR-204、miR-206、miR-29a及miR-155表达水平比较差异有统计学意义,组间比较发现I期组及II期组miR-21、miR-200c、miR-16、miR-206、miR-29a及miR-155表达水平均高于对照组,而miR-204表达水平低于对照组,其中I期组miR-21表达水平低于II期组,而miR-204表达水平高于II期组,差异均有统计学意义(P<0.05)。Spearman相关性分析发现,miR-21与病程进展正相关(rs=0.682),miR-204与病程进展负相关(rs=-0.713),相关关系均有统计学意义(P<0.001)。结论 :miR-200c、miR-16、miR-21、miR-206、miR-204、miR-29a及miR-155等miRNA在尘肺患者血清中表达水平异常,其中miR-21与miR-204在不同病程时表达水平差异较大,可为尘肺患者早期筛查提供新的思路。     

重症超声在感染性休克患者液体复苏的指导价值分析

目的:探讨重症超声在感染性休克患者液体复苏的指导价值。方法:选取2018年6月-2019年6月120例我院收的感染性休克患者,采用重症超声指导液体复苏,测量呼气末、吸气末下腔静脉管径(IVC)和左室舒张末期容积(LVEDV),按照公式计算下腔静脉呼吸变异指数(RVI)。水柱法测定中心静脉压(CVP),PiCCO导管法测定血管外肺指数(EVLWI)和胸腔内血容量指数(ITBWI),比较液体复苏前后上述指标,并行相关性分析。结果:复苏后2h、6h感染性休克患者IVC最大径(IVCmax)、IVC最小径(IVCmin)、CVP及LVEDV均较复苏前显著升高,CVP较复苏前显著降低(P<0.05)。复苏后2h、6h感染性休克患者ITBVI、EVLWI均较复苏前显著升高(P<0.05)。IVCmax、IVCmin、LVEDV均与ITBVI、EVLWI呈显著的正相关关系,RVI与ITBVI、EVLWI呈明显的负相关关系(P<0.05)。复苏6h后,感染性休克患者SOFA评分和APACHEⅡ评分均较复苏前显著降低(P<0.05)。结论:重症超声在感染性休克患者的液体复苏过程中发挥重要作用,监测IVC、RVI及LVEDV能够有效评估患者的容量反应性,充分实现液体复苏目标,改善患者病情预后。     

偏头痛与脑血管发育异常、脑白质变性、脑腔梗关系分析

目的 :观察偏头痛患者脑血管情况及颅内病变情况。方法 :以住院偏头痛患者为研究对象、同一时期无偏头痛患者为对照,进行神经影像学比较。结果 :58例偏头痛患者中,有脑腔梗病灶19例(32.76%),有脑白质变性17例(29.31%),有脑血管异常37例(63.79%)。61例对照组中有脑腔梗病灶9例(14.75%),有脑白质变性5例(8.20%),有脑血管异常13例(21.31%)。2组比较差异均有统计学意义(P<0.05)。结论:偏头痛与脑白质病变、脑腔梗有关,血管因素可能参与偏头痛的发作。