空腹血糖受损患者脂联素水平的临床观察

目的探讨空腹血糖受损（IFG）患者脂联素水平的变化。方法入选糖耐量正常（NGT）、孤立性空腹血糖受损（I-IFG）、孤立性糖耐量低减（I-IGT）、空腹血糖受损并糖耐量低减（IFG／IGT）、新发2型糖尿病（T2DM）各30例，采用酶联免疫吸附法（ELISA）测定血清脂联素，同时检测胰岛素水平及血糖、血脂，计算胰岛素抵抗指数（HOMA．IR）。结果I-IFG组、1-IGT组、IFG／IGT组及新发T2DM组脂联素均明显低于NGT组（P均〈0．01）；新发T2DM组和IFG／IGT组的HOMA-IR均〉I-IGT组〉I-IFG组〉NGT组，各组间差异有统计学意义（P均〈0．05或P〈0．01）；脂联素与空腹血糖（FBG）、餐后2h血糖（2HBG）及HOMA-IR呈负相关（Pa〈0．01）。结论在I-IFG阶段已存在脂联素水平降低，胰岛素抵抗增加，具有向糖尿病转化及并发大血管病变的风险，提高脂联素水平可为糖尿病及其并发症的防治提供一条新的思路。     

2型糖尿病的胃运动功能

采用核素标记^113mIn液体试餐、^99mTc固体试餐SPECT显像技术胃半排空时间（GET1／2）和胃电图（ECG）对74例2型糖尿病（DM）进行胃运动功能研究，同时检测空腹血糖。结果（1）DM中，36例（48．6％）GET1／2延迟。60例（81．1％）EGG异常；（2）22例血糖≤7.8mmol/L，无1例固相或液相GET1／2延迟；血糖77．8mmol/L的52例中，36例（69．2％）固相GET1／2延迟，其中14例（26．9％）伴液相GET1／2延迟（P＜0．01）；（3）对照组和DM组的空腹和餐后FP、AP、FZ值均无显著差异，二组餐后AP均显著高于空腹（P＜0．05）。DM组的AR、DR和RT均较对照组显著增高或排空延迟相关。胃排空延迟与EGG异常相关。结论：血糖水平与胃排空延迟相关。血糖控制不良，胃排空与EGG异常相关。     

血糖控制对2型糖尿病患者载脂蛋白A水平的影响

目的 观察分析2型糖尿病患者载脂蛋白A（apoA）水平变化与血糖控制状态关系及其可能的影响机制。方法 采用自动生化仪检测213名2型糖尿病患者血浆总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL）、极低密度脂蛋白（VLDL）、低密度脂蛋白（LDL）、载脂蛋白A（apoA）、载脂蛋白B（apoB），用离子交换高效液相色谱分析法测定糖化血红蛋白（HbAlc），比较其与血脂指标的相关性。结果 两组HDL-C水平差异无统计学意义[（1．26±0．45）mmol／L vs （1．13±0．35）mmol／L，P〉0．05]；控制满意组apoA水平显著高于非满意组[（1．16±0．31）g／L vs （0．98±0．32）g／L，P〈0．01]，apoB／apoA显著低于非满意组（P〈0．05）。TC、TG、LDL、VLDL水平两组差异无统计学意义（P〉0．05）。直线相关分析显示apoA与HbAlc、FBG呈显著负相关（r=-0．30，P〈0．01；r=-0．24，P〈0．01）：apoA与HDL、TC呈显著正相关（r=0．74，P〈0．01；r=0．39，P〈0．01）。结论 2型糖尿病患者血糖控制状态显著影响apoA水平，这可能是HDL功能紊乱的重要原因。     

妊娠期糖尿病孕妇血清视黄醇结合蛋白4水平与糖脂代谢相关性的初步研究

目的了解妊娠期糖尿病孕妇血清视黄醇结合蛋白4（RBP4）水平与糖脂代谢的关系。方法采用酶联免疫吸附试验（ELISA）测定50例孕晚期妊娠期糖尿病孕妇及50例正常孕晚期孕妇血清RBP4水平;同时测定两组孕妇空腹血糖（FPG）、糖化血红蛋白（HbAlC）、血清总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL—C）、低密度脂蛋白（LDL—C）、栽脂蛋白A—I（ApoA-1）、载脂蛋白B（ApoB）水平。结果（1）妊娠期糖尿病组孕妇血清RBP4水平为（18．48±4．6）ng／ml,明显高于正常孕妇血清RBP4水平（13．26±2．35）ng／ml,差异有统计学意义（P〈0．01）。（2）妊娠期糖尿病组孕妇FPG、HbAlCs水平分别为（5．40±0．57）mmol／L、（5．68±0．58）％,明显高于正常孕妇血清水平（4．99±0．27）mmol／L、（4．75±0．51）％,差异有统计学意义（P〈0．01）。（3）妊娠期糖尿病组孕妇血清TC、TG、ApoB、分别为（5．70±0．88）mmol/L、（3．17±1．06）mmol／L、（0．3l±0．13）异／L,明显高于正常孕妇血清水平（5．25±0．75）mmol／L、（1．26±0．31）mmol／L、（0．20±0．09）∥L,差异有统计学意义（P〈0．01或P〈0．05）;妊娠期糖尿病组孕妇血清ApoA—Ⅰ水平为（2．12±0．30）g／L,明显低于正常孕妇血清水平（2．62±0．70）g／L,差异有统计学意义（P〈0．01）;妊娠期糖尿病组孕妇血清LDL—C血清水平为（3．51±0．75）mmol／L,高于正常孕妇血清水平（3．16±0．76）mmol／L,但差异无统计学意义（P〉0．05）。（4）Pearson相关分析结果显示,两组孕妇血清RBP4水平分别与TG、HbAlC呈显著正相关性（r=0．27,0．39,P〈0．05,P〈0．01）;与FPG、TC、HDL—C、LDL—C、ApoA-1、ApoB、孕晚期体质指数（bodymassindex,BMO无明显相关性（r=,0．063,0．075,0．127,0．046,－0．159,0．085,－0．3,P〉0．05）。结论妊娠期糖尿病孕妇糖脂代谢紊乱,血清RBP4水平明显升高,RBP4可能参与了妊娠期糖尿病孕妇糖脂代谢紊乱机制。     

2.42老年糖尿病患者血糖与胃排空的相互关系

目的研究老年2型糖尿病(DM)胃排空与血糖间的关系. 方法将63例2型DM患者根据血糖控制情况分成2组:血糖控制正常组(DM1组)30例,空腹血糖(FBG)≤7.8mmol/L,餐后2小时血糖≤11.1mmol/L,男29例,女1例,平均年龄80.1±4.2岁(75～88岁),病程13.4±8.5年(6～30年);血糖异常组(DM2组)33例,空腹血糖(FBG)≥7.8mmol/L,餐后2h血糖≥11.1mmol/L,男31例,女2例,平均年龄80.5±4.2岁,病程18.6±9.3年(5～35年);均空腹给予99mTc标记的试餐,测定固相胃排空时间,并与30例正常对照组(男28例,女2例,年龄81.3±4.3岁)比较.     

氯化镧对大鼠生长素分泌调节影响的体外研究

目的：研究氯化湖（LaCl3）对大鼠生长素分泌调节轴的影响。方法：采用荧光法检测离体脑片培育液中单胺类神经递质含量;用放射免疫法测垂体脑片育液中生长素（GH）含量。结果：①0．01mmol／LLaCl3垂体组育液中GH含量明显高于对照组（P＜0．05）;而1mmol／LLaCl3垂体组有液中GH含量明显低于对照组（P＜0．05）。②0.01mmol／LLaCl3下丘脑＋垂体组,其有液中GH含量则明显高于对照组（P＜0．01）和同剂量的单纯垂体组（P＜0．01）;但1mmol／L下丘脑＋垂体组育液中GH含量与对照组比较无显著差异（P＞0．05）。③0．01mmol／LLaCl3下丘脑组有液中NE含量明显高于对照组（P＜0．01）,5－HT明显低于对照组（P＜0.05）。④1mmol／L下丘脑组有液中NE和DA含量明显少于对照组（P＜0．01和0．05）,而5－HT含量则明显高于对照组（P＜0．001）。结论：低剂量氯化调可通过下丘脑和腺垂体双重作用促进GH分泌。     

糖化血红蛋白在糖代谢异常患者中的改变及其与血糖的关系

目的探讨糖化血红蛋白（HbAlc）检测在不同糖代谢异常状态的临床价值。方法选取254名受试者（其中男149人,女105人）进行口服糖耐量试验（OGYr）和HbAlc检测。根据OGTY结果分为正常糖耐量（NGT）、单纯空腹血糖受损（I-IFG））、单纯糖耐量受损（I-IGT）、IFG合并IGT（IFG／IGT）和糖尿病（DM）5组,通过单因素方差分析比较各组HbAlc值,对各组HbAlc与空腹血糖（FPG）和OGTr2h血糖（2hPG）进行线性相关和回归分析。结果①HbAlc水平（％,下同）DM组（7．41±1．94）明显高于其余4组（以上P均〈0．01）,I-IFG组（6．06±0．37）、I-IGT组（5．91±0．39）、IFG／IGT组（6．12±0．38）3组间差异无统计学意义（P〉0．05）,但分别明显高于NGT组（P〈0．05）。②DM组HbAlc分别与FPG（r=0．934,P〈0．01）和2hPG（r=0．760,P〈0．01）存在着明显的正相关,回归方程为：HbAlc=2．957＋0．458（FPG）＋0．05（2hPG）;IFG／IGT组（r=0．326,P〈0．01）、I-IGT组（r=0．254,P〈0．05）HbAlc只与2hPG存在正相关;I-IFG组HbAlc只与FPG存在正相关（r=0．404,P〈0．01）;NGT组HbAlc与FPG（r=0．157）和2hPG（r=-0．006）均不存在相关性。结论糖化血红蛋白水平能够正确地反映正常糖代谢、糖调节受损和糖尿病3种不同糖代谢状态的血糖水平,是区分3种糖代谢状态的有用指标。     

老年糖尿病患者血糖与胃排空的相互关系

目的　研究老年 2型糖尿病 (DM)胃排空与血糖间的关系。方法　将 6 3例 2型DM患者根据血糖控制情况分成 2组 :血糖控制正常组 (DM1组 ) 30例 ,空腹血糖 (FBG )≤ 7 8mmol L ,餐后 2小时血糖≤11 1mmol L ,男 2 9例 ,女 1例 ,平均年龄 80 1± 4 2岁 (75～ 88岁 ) ,病程 13 4± 8 5年 (6～ 30年 ) ;血糖异常组 (DM2 组 ) 33例 ,空腹血糖 (FBG)≥ 7 8mmol L ,餐后 2h血糖≥ 11 1mmol L ,男 31例 ,女 2例 ,平均年龄 80 5± 4 2岁 ,病程 18 6± 9 3年 (5～ 35年 ) ;均空腹给予99mTc标记的试餐 ,测定固相胃排空时间 ,并与 30例正常对…     

Graves病患者治疗前在葡萄糖负荷时血清脑肠肽水平的变化

目的：探讨Graves病患者治疗前在葡萄糖负荷（OGTF）时血清脑肠肽（Ghrelin）水平的变化。方法：对36例初诊Graves病患者,葡萄糖氧化酶法测定血浆血糖（PG）、放射免疫分析胰岛素（INS）及血清Ghrelin;计算胰岛素敏感性指数（ISI）、胰岛素抵抗指数（IR）;30例健康成人作为正常对照组。结果：①Graves病患者治疗前腰围、体重、BMI、ISI明显低于正常对照组（P〈0．05）;②治疗前空腹血糖（fPG）、空腹胰岛素（fiNS）、IR高于正常对照组（P〈O．05）;空腹血清Ghrelin水平（9984-194）pg／ml,明显低于正常对照组（12414-225）pg／ml（P〈O．01）;但两组在餐后30min、60min和120min的Ghrelin水平无明显差异（P〉0．05）;③Graves病患者治疗前空腹血清Ghrelin水平与fINS呈负相关（r=-0．476,P〈0．05）;其它时间点的GhreIin与INS均无相关性。结论：Ghrelin可能参与了Graves病的发生和发展。     

胰岛素不同给药方式治疗2型糖尿病合并社区获得性肺炎研究

目的观察应用双C和MSII治疗2型糖尿病（type 2 diabetes mellitus,T2DM）合并社区获得性肺炎（community acquired pneumonia,CAP）患者强化血糖控制的有效性和安全性。方法将2004年10月至2009年10月在我院住院的未使用过胰岛素治疗的T2DM合并CAP患者99例随机分为双C组（50例）和MSII组（49例）,分别给予双C和MSII。双C是应用持续皮下胰岛素输注（CSII）结合动态血糖监测系统（CGMS）一即“双C”方案。MSII是每日多次皮下注射胰岛素（MSII）结合每日八次指尖血糖监测。两组患者应用胰岛素和抗生素治疗后,观察CAP主要症状缓解时间、血糖达标时间、胰岛素用量、低血糖发生频率及肺炎控制时间的差异。结果双C组和MSII组患者治疗后空腹血糖分别为（6．3±0．2）mmol／L和（6．8±1．2）mmol／L,餐后2h血糖分别为（8．7±0．4）mmol／L和（9．3±1．2）mmol／L,均能达标。治疗后双C组患者果糖胺（7．2±0．13）mmol／L与MSII组（9．0±0．11）mmol／L比较,差异有统计学意义（P〈0．01）。双C组患者肺炎主要症状（发热、胸痛、咳黄痰、剧烈咳嗽、呼吸困难和湿啰音）缓解时间分别为（4．2±1．8）d、（3．7±1．2）d、（d．7±1．8）d、（8．2±1．3）d、（8．3±1．1）d和（9．2±2．6）d,血糖达标时间为（3．7±0．6）d、肺炎控制时间（12．8±4．5）d、胰岛素用量（37．6±6．5）次／d及低血糖发生频率（0．6±0．4）次／例;MSII组分别为（6．2±1．7）d、（4．3±1．4）d、（8．4±2．5）d、（9．6±3．5）d、（9．6±3．4）d、（12．4±4．1）d、（7．2±1．2）d、（18．2±6．8）d、（57．2±10．3）U／d和（4．3±0．7）次／例,两组比较差异均有统计学意义（P〈0．05）。结论在配合抗生素的前提下,“双C”方案治疗能及时、有效地控制T2DM合并CAP患者的血糖水平．肺炎症状缓解时间及治愈肺炎的时间均较MSII组短,而且胰岛素用量少,低血糖发生率低,是理想的治疗方法。     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

Class II HLA in Georgia Caucasus Tbilisi Georgians and their Mediterranean ancestry: The Usko Mediterranean languages

Georgia (or Sakartvelo in its own language) is a South Caucasus Mts. country with its easternmost part is enigmatically named Iberia, like the Iberian Peninsula, which may refer to rivers “Kura” and “Ebro” or their valleys respectively. Most of their inhabitants speak Georgian which is included within Dene-Caucasian group and Usko-Mediterranean subgroup of languages. The latter includes Basque, Berber, ancient Iberian-Tartessian, Etruscan, Hittite, Minoan Lineal A and others. In the present paper, HLA class II -DRB1 and -DQB1 alleles has been studied and extended haplotypes calculated. Most frequent haplotypes are also of Mediterranean origin (i. e.: (A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*51)-DRB1*13:01-DQB1*06:03, or (A*24-B*35)-DRB1*01:01-DQB1*05:01) and DA genetic distances show that closest world populations to Georgians are Mediterraneans. Georgians also show common extended haplotypes ((A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*13)-DRB1*07:01-DQB1*02:01 and (A*03-B*35)-DRB1*11:01-DQB1*03:01) with Svan people, a secluded population in North Georgia mountains. We can conclude that Georgians belong to a very old Mediterranean substratum according to both linguistics (Usko Mediterranean languages) and HLA genetics.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.