中老年人牙周病与糖尿病的相关关系

目的探讨中老年人糖尿病与牙周病之间的相互影响。方法根据血糖水平,将120例伴有糖尿病的中老年慢性牙周病患者分为3组,测定各组的牙周治疗需要量指数(CPITN)和牙齿缺失数。再将120例患者分为A、B、C 3组,A组同时进行牙周病和糖尿病的系统治疗,B组仅进行牙周病治疗,C组仅进行糖尿病治疗,1个月后评定3组患者的牙周治疗和血糖控制情况。结果血糖<7.0 mmol/L组的CPITN明显低于血糖7.0～11.0 mmol/L和>11.0 mmol/L组(P值分别<0.05、0.01),血糖>11.0 mmol/L组的缺失牙数则明显多于其他两组(P值均<0.05)。A组的牙周病治疗显效率明显高于B组(P<0.05)。结论糖尿病与牙周病之间存在相关性,糖尿病治疗与牙周病治疗之间相互影响。     

牙周病与糖尿病的相关性分析

目的:研究牙周病与糖尿病的相互关系.方法:选择我院就诊的156例同时伴有糖尿病的牙周病患者,将其随机分成A、B、C3组,A组95例为实验组,同时进行牙周病与糖尿病的系统治疗;B、C组为对照组,其中B组23例只进行牙周病的治疗,C组37例只进行糖尿病的治疗.结果:牙周治疗效果A组明显高于B组(P＜0.05);糖尿病的治疗效果A组高于C组(P＞0.05).结论:牙周病与糖尿病存在明显的相关性,临床治疗时需两病同治.     

血糖水平对急性冠状动脉综合征患者预后的影响

目的 探讨入院时空腹血糖水平对急性冠状动脉综合征（ACS）患者预后的影响.方法 对307例ACS患者进行回顾性分析,按照术前空腹血糖（FBS）水平分为3组：A组FBS＜5.6mmol/L,B组5.6≤FBS＜6.1mmol/L,C组FBS≥7.0mmol/L.对3组患者的基础临床资料及30d内心力衰竭、全因病死率、新发生的心律失常发生率进行比较分析.结果 不同空腹血糖水平ACS患者其高血压、高血脂的发生率差异均无统计学意义（均P ＞0.05）,B、C两组与A组比较急性心肌梗死和糖尿病的发生率增高（均P＜0.01） B、C两组与A组比较多支病变增加,植入支架数明显增多（P＜0.05或0.01）,C组与A组比较B2、C型病变增多（P＜0.05） 随着血糖水平的增高,B、C两组与A组比较心力衰竭、全因病死率明显增多（均P＜0.01）,心律失常发生率也增高（均P＜0.05）.结论 空腹血糖升高提示ACS患者预后不良.     

动态血糖监测在胰岛素泵强化治疗2型糖尿病中的应用

目的 观察动态血糖监测(CGM)下应用胰岛素泵(CSII)强化治疗2型糖尿病(T2DM)的疗效及安全性.方法 将114例患者随机分为3组,A组为CGM联合CSII组(简称“双C”组),B组为常规强化应用胰岛素(CSII组),C组每天多次胰岛素皮下注射(MSII组),比较治疗3d的日内平均血糖(MBG)、平均血糖漂移幅度(MAGE),记录治疗2周后血浆C反应蛋白(CRP)、胰岛素抵抗指数(Homa-IR)、胰岛β细胞分泌指数(Homa-IS)、血糖达标所需时间、胰岛素用量及低血糖的情况.结果 3组患者经治疗3d后的MBG以A组、B组较C组下降更明显(P＜0.01),A组的MAGE显著低于B组和C组(P＜0.01).Homa-IR、CRP以A组、B组较C组下降更明显(P＜0.01或P＜0.05),A、B两组间差异无统计学意义(P＞ 0.05);FIns、FCP、Homa-IS以A组、B组较C组升高更明显(P＜0.01),A、B两组间差异无统计学意义(P＞0.05).血糖达标所需时间及所需胰岛素用量比较C组＞B组＞A组(P＜0.01或P＜0.05).A组在动态血糖监测时间段低血糖事件发生43次,无症状性低血糖37次,B组低血糖事件发生11次,C组低血糖事件发生14次.结论 CGMS监测CSII治疗T2DM的治疗达标时间更短,血糖波动更少,血糖达标时所需胰岛素量更少,胰岛β细胞功能的改善和CRP的降低明显优于MSII,且容易发现无症状性低血糖,较MSII疗效、安全性更好.     

2型糖尿病患者血糖水平与应激指标相关性研究

目的比较2型糖尿病患者的血糖水平与应激反应的相关性及临床意义。方法随机选择200例糖尿病患者分为A组（血糖<6.1mmol/L者）组和B组（血糖>6.1mmol/L者）,比较两组的c-反应蛋白和白介素-6的变化。结果 B组C反应蛋白浓度增高值（16.7±8.5）mg/L大于A组（7.8±2.6）mg/L,两组相比有显著性差异（P＜0.05）;B组IL-6浓度增高值（52.6±11.7）ng/L大于A组（14.8±1.7）ng/L,两组相比有显著性差异（P＜0.05）。结论随着血糖水平的升高患者C反应蛋白浓度、IL-6浓度增高。血糖水平高低影响患者应激状态,血清IL-6及CRP水平与糖尿病的发生、发展有密切关系。     

糖尿病大鼠骨骼肌内脂素和磷脂酰肌醇3激酶的表达

目的 观察糖尿病大鼠骨骼肌中内脂素(visfatin)、磷脂酰肌醇3激酶(PI3K)的表达,探讨visfatin在糖尿病中的作用及可能机制.方法 8周龄雄性SD大鼠55只(造模成功39只),采用随机数字表法分为4组:正常对照组(A组)10只,饮食诱导肥胖组(B组)10只,血糖未控制糖尿病组(C组)10只,血糖控制糖尿病组(D组)9只.喂养至12周末,测定空腹血糖(FBG)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、游离脂肪酸(FFA)、空腹胰岛素(FINS),计算稳态模型评估的胰岛素抵抗指数(HOMA-IR)及胰岛素敏感指数(ISI);RT-PCR测定骨骼肌组织visfatin、PI3K mRNA表达;Western blot测定骨骼肌组织visfatin、PI3K蛋白表达.结果 C组FBG较A、B组明显增高(P＜0.01);D组FBG较C组明显降低(P＜0.01).B组TG较A组明显增高(P＜0.05);C组TG、TC、LDL-C、FFA较A、B组明显增高(P＜0.01);D组TG、TC、FFA较A组明显增高(P＜0.05);D组TG较A、B组明显增高(P＜0.05);D组TG、TC、LDL-C、FFA较C组明显降低(P＜0.01).B、C组较A组FINS、HOMA-IR明显增高,ISI明显降低(P＜0.01),C组较B组FINS、HOMA-IR明显增高,ISI明显降低(P＜0.01).C、D组visfatin mRNA和蛋白表达较A组均明显增高(P＜0.05),C组visfatin蛋白较B组明显增高(P＜0.01).C组PI3K mRNA和蛋白表达较A、B组均明显降低(P＜0.01),D组PI3K mRNA和蛋白表达较A组均明显降低(P＜0.05).结论 visfatin在骨骼肌中的表达水平与骨骼肌糖脂代谢状态有关,可能通过PI3K参与骨骼肌糖脂代谢的调节.     

糖尿病合并牙周病与糖脂代谢的关系

目的探讨糖尿病合并牙周病与血糖、血脂代谢的关系。方法将54例患者分为3组(A组:无糖尿病的中、重度牙周病患者16例;B组:2型糖尿病且牙周健康患者18例;C组:2型糖尿病合并中、重度牙周病患者20例),并检测TC、TG、LDL-C、HDL-C、空腹血糖(FBG)、糖基化血红蛋白(HbA1c)、高敏C反应蛋白(hsCRP)等。采用牙周治疗需要指数(CPI)评价牙周状况。结果 (1)B、C组患者FBG、TG、TC、LDL-C、HbA1c均明显高于A组(P<0.05)。(2)C组患者牙周袋探诊深度(probingdepth,PD)、牙周附着丧失(attachment loss,AL)均明显高于A组(P<0.01),B组患者PD、AL均明显低于A、C组(P<0.05)。(3)B、C组患者HDL-C均明显低于A组(P<0.05),C组患者HDL-C明显低于B组(P<0.01)。(4)C组患者hsCRP明显高于A、B组(P<0.01),A、B组患者hsCRP比较差异无统计学意义(P>0.05)。(5)CPI与FBG、HbA1c、hsCRP、TC、TG、LDL-C呈正相关(P<0.05、P<0.01),与HDL-C呈负相关(P<0.05、P<0.01)。结论牙周病的严重程度与血糖、TC、TG、LDL-C、HDL-C水平均有关,糖尿病合并牙周病患者更易发生糖脂代谢紊乱。     

糖尿病信息管理系统与健康教育在2型糖尿病治疗中的联合应用

目的 探讨糖尿病信息管理系统(DIMS)与健康教育相结合的糖尿病管理模式对患者预后的作用,以提高糖尿病及其并发症的防治水平.方法 选取在上海市同仁医院糖尿病专科门诊连续治疗1年以上的患者,分为3组.A组:应用DIMS为患者建立电子病历并进行健康教育,每季度举办糖尿病俱乐部进行强化教育.B组:在患者接受门诊治疗的同时对其进行健康教育.C组:仅接受普通门诊治疗.观察治疗后6、12个月时的空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)、平均动脉压(MAP)及总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)变化情况.同时,采用糖尿病控制状况评价量表(CSSD70)评价所有入选患者治疗前及治疗12个月时的综合情况.结果 治疗6、12个月时,3组的FPG、2hPG和HbA1c达标率均显著高于同组治疗前(P值分别＜0.05、0.01).治疗6个月时,A、B组的2hPG、HbA1c、TG和LDL-C达标率显著高于C组(P值均＜0.05),A组的MAP达标率显著高于C组(P＜0.05).治疗12个月时,A组的血糖、血压和血脂各项指标的达标率均显著高于B、C组(P值分别＜0.05、0.01),且A组的HbA1c达标率也显著高于C组(P＜0.01);A、B组CSSD70量表的各项指标评分均显著高于C组(P值分别＜0.05、0.01),A组的生活习惯评分显著高于B、C组(P值均＜0.05).结论 DIMS和健康教育的联合应用有助于糖尿病患者实现良好的血糖、血压和血脂控制.     

牙周病治疗对2型糖尿病患者血糖控制效果的影响

目的:探讨牙周治疗对2型糖尿病患者血糖控制效果的影响,以及牙周病与糖尿病之间的相互关系。方法:120例患有糖尿病同时伴有牙周病的患者,将其随机分成牙周治疗组和对照组两组,所有患者均进行糖尿病的系统治疗,牙周治疗组增加牙周病的系统治疗。结果:牙周病治疗组糖尿病治疗效果明显高于单纯糖尿病治疗组(P<0.05)。结论:牙周病和糖尿病之间存在相关性,牙周病治疗有助于糖尿病的控制,并有助于改善糖尿病患者的口腔美学效果。     

双相门冬胰岛素两种给药方式对糖尿病患者胰岛细胞功能影响的对比研究

目的 对比分析双相门冬胰岛素(诺和锐30)两种给药方式(三餐前与早晚餐前分别皮下给药)对2型糖尿病患者临床疗效及胰岛细胞功能的影响.方法 96例2型糖尿病患者分为两组:A组(48例,1日3次使用双相门冬胰岛素,三餐前)和B组(48例,1日2次使用双相门冬胰岛素,早晚餐前),治疗12周.治疗前后均测定0、0.5、1.0、2.0 h血糖和血浆胰岛素、C肽浓度,比较两组患者血糖达标的时间、低血糖发生次数、糖化血红蛋白、三酰甘油、总胆固醇水平和胰岛细胞功能.结果 A组糖化血红蛋白和血糖达标时间明显少于B组,差异均有统计学意义(P＜0.05);两组胰岛素日用量及低血糖发生次数间差异均无统计学意义(P＞0.05).治疗12周后两组三酰甘油和总胆固醇水平均较治疗前明显下降,且治疗后两组比较差异有统计学意义(P＜0.05);治疗后两组空腹及餐后2.0 h C肽水平明显升高,A组C肽水平明显高于B组,差异有统计学意义(P＜0.05);两组患者胰腺功能均明显改善,表现为胰岛β细胞功能指数和早时相胰岛素分泌指数均升高,且A组明显优于B组,差异有统计学意义(P＜0.05).结论 1日3次使用双相门冬胰岛素是一种更有效改善患者胰岛细胞功能的方法,值得临床推广应用.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.