血糖控制良好的2型糖尿病患者血清VEGF-A及其受体VEGFR1和VEGFR2含量检测(英文)

研究目的:探讨血糖控制良好的2型糖尿病患者血管内皮生长因子-A(VEGF-A)及其受体VEGFR1和VEGFR2含量及其临床意义。研究方法:本文以31例血糖得到良好控制且没有明显大血管或微血管病变的2型糖尿病患者作为研究对象(实验组),30位健康志愿者为对照组,同期检测患者及健康志愿者的空腹血糖、血脂、糖化血红蛋白水平,及血清VEGF-A、VEGFR1和VEGFR2含量,并加以比较和统计学分析。重要结论:研究结果表明,血糖控制良好的2型糖尿病患者血清中的VEGF-A及其受体VEGFR1和VEGFR2的含量和健康志愿者基本一致,两者无统计学意义,这可能显示血糖水平的合理控制能延缓血管并发症的产生。同时,2型糖尿病患者的血清VEGFR2含量和高密度脂蛋白胆固醇水平之间存在负相关,而血清VEGF-A、VEGFR2含量和甘油三脂水平之间存在正相关,这也表明糖尿病患者的血脂紊乱可能参与了血管生成的调节。     

老年糖尿病患者出院后实施延续护理的效果分析

目的:探讨延续护理干预对老年糖尿病患者出院后远期的防治效果。方法:将128例老年糖尿病出院患者随机分为观察组68例和对照组60例,观察组实施延续护理干预,对照组给予常规出院指导,干预6、12、18个月后分别比较两组治疗依从性、血糖、糖化血红蛋白及并发症发生率,评价干预效果。结果:延续护理组患者各期治疗依从性明显高于对照组(P<0.05或P<0.01);延续护理组患者12个月和18个月的空腹血糖、餐后2h血糖水平均明显低于对照组(P<0.01);延续护理组患者各期糖化血红蛋白明显低于对照组(P<0.05或P<0.01);18个月时,延续护理组患者并发症发生率明显低于对照组(P<0.05)。结论:延续护理可提高老年糖尿病出院后患者的治疗依从性,更加有效地控制血糖、糖化血红蛋白及并发症,达到远期康复效果。     

胰岛素联合二甲双胍治疗2型糖尿病研究

目的：比较在胰岛素治疗血糖控制差的2型糖尿病患者中联用二甲双胍或单独增加胰岛素剂量的疗效。方法：选择50例2型糖尿病患者．每日应用胰岛素达40～50U，分2～4次皮下注射，空腹血糖〉7．0mmol／L，餐后2h血糖〉10．0mmol／L．糖化血红蛋白≥7．5％，所有患者均有使用胰岛素的适应症并且无使用二甲双胍的禁忌证。血清肌酐水平〈132．6μmol／L。入选患者随机进行二甲双胍联合治疗和单纯胰岛素治疗。结果：治疗前两组间空腹血糖、餐后2h血糖、糖化血红蛋白及每日胰岛素用量统计学上均无显著性差异（P〉0．05）；治疗后两组间空腹血糖无显著性差异（P〉0．05）。与单纯应用胰岛素治疗相比．胰岛素加用二甲双胍治疗后糖化血红蛋白、餐后2h血糖、每日胰岛素用量均显著降低（P〈0．05～0．01）。结论：在需要使用较大剂量胰岛素控制血糖的2型糖尿病患者中，联用二甲双胍有利于提高疗效；糖化血红蛋白浓度的下降比单纯胰岛素治疗多1．1％，达血糖控制的每日胰岛素需要量比单纯胰岛素治疗时少30％。     

关于“糖化血红蛋白”的医患对话

患者：医生开的化验单里除了有血糖以外。往往还有“糖化血红蛋白”这个项目,请问,“糖化血红蛋白”代表什么含义？ 医生：血液中红细胞内的血红蛋白可与血液中的葡萄糖（简称“血糖”）结合,两者结合的产物就是“糖化血红蛋白”（英文缩写叫HbA1c）。糖化血红蛋白的多少与血中葡萄糖的含量高低呈正相关,血糖浓度越高,被糖化的血红蛋白也就越多,临床用糖化血红蛋白占总蛋白的百分比来反映糖化血红蛋白的高低,其正常值为4％～6％。     

糖化血红蛋白检测在临床的应用

糖化血红蛋白A1c(haemoglobinA1c,HbA1c)是检测高血糖患者前60-90天内的血糖平均水平.在临床上,HbA1c是评估糖尿病患者对血糖控制的重要指标.在临场研究中显示,糖尿病、心血管疾病和神经系统疾病都与HbA1c有密切联系.文中就HbA1c检测在临床中的应用进行综述.     

控制血糖的十大好处

很多人以为控制血糖只是糖尿病患者的事情.其实,无论是不是糖尿病患者,控制血糖水平,避免血糖大幅度波动,都会对健康有很大好处,而且这些好处很可能会超乎你的想象! 好处一:降低糖尿病风险 学过化学的人都知道,同样反应条件下,反应物浓度越高,则反应产物的量就越多.餐后血糖水平如果经常处于较高水平,则糖化血红蛋白的水平也会上升.     

罗格列酮治疗内脏脂肪性肥胖2型糖尿病临床观察

目的:观察罗格列酮治疗对2型糖尿病内脏脂肪含量变化.方法:60例内脏脂肪性肥胖2型糖尿病患者随机分为A组、B组各30例,两组体重指数、病程、FIG和餐后2h血糖(2hPG)等资料具有可比性.维持试验前磺脲类降糖药剂量不变,A组加服罗格列酮4mg,1次/d,时间为24W,观察空腹血糖、糖化血红蛋白、胰岛素、内脏脂肪含量的变化.结果:两组空腹血糖、糖化血红蛋白、胰岛素治疗后较治疗前明显下降(P＜0.05);治疗24周后A组内脏脂肪含量显著下降(P＜0.05),B组无明显差异(P＞0.05),2组问存在显著差异(P＜0.05).结论:罗格列酮能减少2型糖尿病的内脏脂肪含量,延缓并发症的发生.     

强化教育对新诊断的2型糖尿病患者糖代谢的影响

探讨结构化强化教育项目在新诊断的2型糖尿病门诊患者血糖控制中的作用。新诊断的2型糖尿病门诊患者74例随机分为强化教育组和对照组,对照组接受医院常规指导;教育组接受为期3天的强化教育项目,研究时间共12个月。经重复测量方差分析,两组患者教育前后空腹血糖(FBG)、糖化血红蛋白(GHbA1c)测量值差异有统计学意义(P<0.05);强化教育组在教育后6、12个月末各指标改善明显优于对照组(P<0.05或P<0.01)。结果表明,结构化糖尿病教育有助于新诊断的2型糖尿病门诊患者血糖的控制。     

农村牧区2型糖尿病患者实施健康教育的效果评价

目的:探讨通过健康教育提高农村牧区2型糖尿病患者的自我护理能力,改善糖尿病患者的血糖水平,控制病情的发展.方法:对住院的糖尿病患者,排除年龄、自控能力因素,筛选56例,建册登记,按计划实施个性化健康教育,随访6个月后,将患者的自护行为、空腹血糖、餐后2h血糖级及糖化血红蛋白与健康教育前对比.结果:实施健康教育后,患者的自我护理能力提高,血糖下降.经X2检验各项指标P0.05.结论:对2型农村牧区糖尿病患者实施健康教育,可以提高自我护理能力,有效的控制血糖.     

围生期护理干预对妊娠合并糖尿病患者血糖影响的探讨

为了对妊娠合并糖尿病患者围生期护理干预的临床效果进行分析和探讨,本研究选取:76例妊娠期糖尿病患者,随机分为参照组和观察组,每组38例。参照组患者选择常规的护理方法进行护理,观察组患者在常规护理的基础之上选择加强围生期护理干预的方式进行护理。分析并且比较两组患者的临床护理效果。发现与参照组患者相比,观察组在餐后2小时血糖和糖化血红蛋白(Hb A1c)水平方面优于参照组,差异具有统计学意义(P<0.05)。采用围生期护理干预的方式对妊娠合并糖尿病患者进行护理,能够使患者的Hb A1c水平和餐后2小时血糖水平得以明显改善,值得在临床上推广和应用。     

Stability of a type 2 diabetes rat model induced by high-fat diet feeding with low-dose streptozotocin injection

Objective

The present study aims at determining the stability of a popular type 2 diabetes rat model induced by a high-fat diet combined with a low-dose streptozotocin injection.

Methods

Wistar rats were fed with a high-fat diet for 8 weeks followed by a one-time injection of 25 or 35 mg/kg streptozotocin to induce type 2 diabetes. Then the diabetic rats were fed with regular diet/high-fat diet for 4 weeks. Changes in biochemical parameters were monitored during the 4 weeks.

Results

All the rats developed more severe dyslipidemia and hepatic dysfunction after streptozotocin injection. The features of 35 mg/kg streptozotocin rats more resembled type 1 diabetes with decreased body weight and blood insulin. Rats with 25 mg/kg streptozotocin followed by normal diet feeding showed normalized blood glucose level and pancreatic structure, indicating that normal diet might help recovery from certain symptoms of type 2 diabetes. In comparison, diabetic rats fed with high-fat diet presented decreased but relatively stable blood glucose level, and this was significantly higher than that of the control group (P&gt;0.05).

Conclusions

This model easily recovers with normal diet feeding. A high-fat diet is suggested as the background diet in future pharmacological studies using this model.

     

Increasing the immune activity of exosomes: the effect of miRNA-depleted exosome proteins on activating dendritic cell/cytokine-induced killer cells against pancreatic cancer

Background

Tumor-derived exosomes were considered to be potential candidates for tumor vaccines because they are abundant in immune-regulating proteins, whereas tumor exosomal miRNAs may induce immune tolerance, thereby having an opposite immune function.

Objective

This study was designed to separate exosomal protein and depleted exosomal microRNAs (miRNAs), increasing the immune activity of exosomes for activating dendritic cell/cytokine-induced killer cells (DC/CIKs) against pancreatic cancer (PC).

Methods

PC-derived exosomes (PEs) were extracted from cultured PANC-1 cell supernatants and then ruptured; this was followed by ultrafiltered exosome lysates (UELs). DCs were stimulated with lipopolysaccharide (LPS), PE, and UEL, followed by co-culture with CIKs. The anti-tumor effects of DC/CIKs against PC were evaluated by proliferation and killing rates, tumor necrosis factor-α (TNF-α) and perforin secretion. Exosomal miRNAs were depleted after lysis and ultrafiltration, while 128 proteins were retained, including several immune-activating proteins.

Results

UEL-stimulated DC/CIKs showed a higher killing rate than LPS- and PE-stimulated DC/CIKs.

Conclusions

miRNA-depleted exosome proteins may be promising agonists for specifically activating DC/CIKs against PC.

     

Cognitive-enhancing effects of hydrolysate of polygalasaponin in SAMP8 mice

Objectives

The aim of the study is to evaluate the cognitive-enhancing effects of hydrolysate of polygalasaponin (HPS) on senescence accelerate mouse P8 (SAMP8) mice, an effective Alzheimer’s disease (AD) model, and to research the relevant mechanisms.

Methods

The cognitive-enhancing effects of HPS on SAMP8 mice were assessed using Morris water maze (MWM) and step-through passive avoidance tests. Then N-methyl-d-aspartate (NMDA) receptor subunit expression for both the cortex and hippocampus of mice was observed using Western blotting.

Results

HPS (25 and 50 mg/kg) improved the escape rate and decreased the escape latency and time spent in the target quadrant for the SAMP8 mice in the MWM after oral administration of HPS for 10 d. Moreover, it decreased error times in the passive avoidance tests. Western blotting showed that HPS was able to reverse the levels of NMDAR1 and NMDAR2B expression in the cortex or hippocampus of model mice.

Conclusions

The present study suggested that HPS can improve cognitive deficits in SAMP8 mice, and this mechanism might be associated with NMDA receptor (NMDAR)-related pathways.

     

Activity of metalloproteinases and adiponectin in obese patients— a possible factor of incisional hernias after bariatric procedures

Purpose

Metalloproteinases are a key component of the pathogenesis of abdominal hernias. Obesity is considered a risk factor in herniogenesis and hernia recurrence. The aim of this study was to evaluate the serum concentrations of metalloproteinase-2 (MMP-2), MMP-9, MMP-13, and adiponectin in morbidly obese and nonoverweight controls.

Materials and methods

The participants were recruited from among patients undergoing bariatric and non-bariatric surgery and divided into two groups: I (body mass index (BMI)≥35 kg/m², n=40) and II (BMI<25 kg/m², n=30). Serum concentrations of MMP-2, MMP-9, MMP-13, and adiponectin were measured using enzyme-linked immunosorbent assay (ELISA).

Results

A statistically significant difference between groups was observed for MMP-2 concentration. The median MMP-9 concentration was higher in the obese group, but the difference was not statistically significant. Median MMP-13 concentrations did not differ between groups. Serum adiponectin concentration was insignificantly higher in the non-obese group.

Conclusions

The elevated serum MMP-2 and MMP-9 concentrations in obese individuals may be related to the higher incidence of incisional hernias in this population.

     

<Emphasis Type="Italic">Ureaplasma urealyticum</Emphasis>-derived lipid-associated membrane proteins introduce IL-6, IL-8, and TNF-α cytokines into human amniotic epithelial cells via Toll-like receptor 2

Objective

The purpose of this study was to determine the role of Ureaplasma urealyticum-derived lipidassociated membrane proteins (LAMPs) in the host innate immune system, specifically their effect on Toll-like receptors (TLRs).

Methods

LAMPs were derived from U. urealyticum strains, and human amniotic epithelial cells (HAECs) were isolated from healthy full-term placentas. Cytokine concentrations were determined by enzyme-linked immunosorbent assay (ELISA) and TLR2 mRNA by real-time PCR. Expression of TLR2 was confirmed by Western blotting and immunohistochemistry.

Results

LAMPs induced HAECs to produce inflammatory cytokines interleukin (IL)-6, IL-8, and tumor necrosis factor (TNF)-α. Cytokine production was reduced after blocking TLR2 using TLR2 inhibitor (anti-hTLR2-IgA).

Conclusions

LAMPs isolated from U. urealyticum induced TLR2-dependent up-regulation of inflammatory genes and cytokines in HAECs.

     

Enucleation of non-invasive tumors in the proximal pancreas: indications and outcomes compared with standard resections

Objective

The aim of this study was to evaluate the safety and efficiency of enucleation (EU) for proximal pancreatic non-invasive neoplasms.

Methods

Patients with solitary non-invasive neoplasms in the proximal pancreas from January 1998 to April 2014 at the Second Affiliated Hospital of Zhejiang University, Hangzhou, China were included. Different operations and outcomes were analyzed.

Results

A total of 123 patients were enrolled. Forty patients (32.5%) underwent EU including 18 patients who had tumors close to the main pancreatic duct (MPD). Sixty-one patients (49.6%) had pancreaticoduodenectomy (PD) performed and 22 (17.9%) underwent central pancreatectomy (CP). Pathological outcomes included neuroendocrine tumors, cystic lesions, and solid pseudopapillary tumors. Operation time, intra-operative blood loss, and duration of hospital stay were significantly reduced in the EU group. PD was associated with the greatest complication rate (55.7%), followed by EU (50%) and CP (40.9%), though the pancreatic fistula rate after EU was the highest (50%), especially in patients with tumors larger than 3 cm and tumors close to the MPD. EU had advantages in the preservation of pancreatic parenchyma and endocrine and exocrine function.

Conclusions

EU can be carried out safely and effectively for tumors in the proximal pancreas with improved outcomes compared with standard resections, even if the tumor is larger than 3 cm and close to the MPD.

     

Effect of ultraviolet photofunctionalization of dental titanium implants on osseointegration

Objective

The aim of the current study was to evaluate the effect of ultraviolet (UV) photofunctionalization of dental titanium implants with exposure to the oral cavity on osseointegration in an animal model.

Methods

Forty-eight titanium implants (Camlog® Conelog® 4.3 mmx9.0 mm) were placed epicrestally into the edentulous jaws of three minipigs and implant stability was assessed by measuring the implant stability quotient (ISQ). Prior to implantation half of the implants were photofunctionalized with intense UV-light. After three months, the implants were exposed and ISQ was measured again. After six months of implant exposure, the minipigs were sacrificed and the harvested specimens were analyzed using histomorphometric, light, and fluorescence microscopy.

Main results

Forty-two of 48 implants osseointegrated. The overall mean bone-implant contact area (BIC) was (64±22)%. No significant differences were found in BIC or ISQ value (multivariate analysis of variance (MANOVA), P&gt;0.05) between implants with and without exposure to UV photofunctionalization.

Conclusions

No significant effects were observed on osseointegration of dental titanium implants nine months after exposure of UV photofunctionalization.

     

匹伐他汀钙对高胆固醇血症患者动脉粥样硬化的影响（英文）

目的:观察匹伐他汀钙对高胆固醇血症患者外周血管的影响。创新点:首次在国内发现匹伐他汀钙能够改善高胆固醇血症患者肱动脉和颈动脉血管内皮功能而且延缓其动脉粥样硬化发展,并首次证实改善内皮功能是匹伐他汀钙延缓其动脉粥样硬化发展的重要原因。方法:按照入选排除标准,选取本院高胆固醇血症患者(HC),完成超声心动图检查的40例。根据剂量不同,分为两个剂量组:1 mg剂量组20例(男性5例,女性15例,平均年龄(55.20±8.35)岁),2 mg剂量组20例(男性9例,女性11例,平均年龄(57.56±6.09)岁)。访视结束后完成超声心动图检查的HC组36例,两个剂量组分别有2人失访。治疗后1 mg剂量组18例(男性3例,女性15例,平均年龄(56.00±7.85)岁),2 mg剂量组18例(男性7例,女性11例,平均年龄(57.79±6.46)岁)。选择本院同期体检中心30例正常人作为对照(年龄和性别均与病例组匹配,男性14例,女性16例,平均年龄(54.94±6.90)岁)。所有研究对象,均经隔夜禁食12~14小时,次日清晨抽取空腹肘静脉血,测定临床生化指标。采用Sequia512彩色多普勒超声诊断仪,应用高分辩率外周血管超声技术,检测HC治疗前后肱动脉血流介导性舒张功能(FMD)、颈动脉结构和功能。结论:经匹伐他汀钙治疗8周后,高胆固醇血症患者血管功能明显改善,表现为FMD升高,僵硬度减小;颈动脉僵硬度和内中膜厚度(IMT)延缓进展与其内皮功能改善密切相关。     

Hyperbaric oxygen therapy improves the effect of keloid surgery and radiotherapy by reducing the recurrence rate

Objective

Keloids are exuberant cutaneous scars that form due to abnormal growth of fibrous tissue following an injury. The primary aim of this study was to assess the efficacy and mechanism of hyperbaric oxygen therapy (HBOT) to reduce the keloid recurrence rate after surgical excision and radiotherapy.

Methods

(1) A total of 240 patients were randomly divided into two groups. Patients in the HBOT group (O group) received HBOT after surgical excision and radiotherapy. Patients in the other group were treated with only surgical excision and radiotherapy (K group). (2) Scar tissue from recurrent patients was collected after a second operation. Hematoxylin and eosin (H&E) staining was used to observe keloid morphology. Certain inflammatory factors (interleukin-6 (IL-6), hypoxia-inducible factor-1α (HIF-1α), tumor necrosis factor-α (TNF-α), nuclear factor κB (NF-κB), and vascular endothelial growth factor (VEGF)) were measured using immunohistochemical staining.

Results

(1) The recurrence rate of the O group (5.97%) was significantly lower than that of the K group (14.15%), P<0.05. Moreover, patients in the O group reported greater satisfaction than those in the K group (P<0.05). (2) Compared with the recurrent scar tissue of the K group, the expression levels of the inflammatory factors were lower in the recurrent scar tissue of the O group.

Conclusions

Adjunctive HBOT effectively reduces the keloid recurrence rate after surgical excision and radiotherapy by improving the oxygen level of the tissue and alleviating the inflammatory process.