2型糖尿病肾病患者血清血红素加氧酶-1检测的临床意义

目的 探讨2型糖尿病肾病患者血清血红素加氧酶-1(HO-1)的变化及意义.方法 将225例2型糖尿病患者根据尿微量白蛋白排泄率(UAER)分为3组:单纯糖尿病组96例(UAER＜ 30 mg/24 h),早期肾病组71例(30 mg/24 h≤UAER ＜300 mg/24 h),临床肾病组58例(UAER＞300 mg/24 h).另选取60例健康体检者作为对照组.采用酶联免疫吸附试验(ELISA)测定患者血清HO-1及丙二醛浓度,并比较各组HO-1的水平.结果 2型糖尿病肾病患者血清HO-1及丙二醛水平较单纯糖尿病组及对照组明显升高(P均＜0.01).糖尿病肾病患者中,临床肾病组HO-1水平明显高于早期肾病组(P＜0.01).Pearson相关分析显示,HO-1与UAER呈正相关(r=0.485,P＜0.01).结论 血清HO-1检测在2型糖尿病肾脏损伤早期即出现异常,并随着肾脏损害程度的加重而升高,其在2型糖尿病肾病的早期诊断及预测疾病进展中具有一定的临床意义.     

老年非糖尿病高血压患者尿微量白蛋白与颈动脉硬化相关性分析

目的:探讨老年非糖尿病原发性高血压患者尿微量白蛋白(MAU)与颈动脉硬化的相关性。方法:选取老年非糖尿病原发性高血压患者142例,根据24h尿MAU量分为正常组78例(MAU30 mg/24h)和MAU组64例(MAU 30~300mg/24h)。比较两组患者颈动脉内膜中层厚度(CIMT)、CIMT增厚率以及颈动脉斑块发生率。结果:BMI、总胆固醇(CHOL)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(HbA1c)在MAU组中均高于正常组,差异具有统计学意义(均P0.05);CIMT、CIMT增厚率以及颈动脉斑块发生率在MAU组均高于正常组,差异具有统计学意义(均P0.05);MAU量与HbA1c(r=0.205,P=0.014)和CIMT值(r=0.294,P=0.000)呈正相关性。结论:老年非糖尿病高血压患者MAU与颈动脉硬化相关,可能是颈动脉硬化的危险因素。     

疏血通注射液减少糖尿病肾病患者尿蛋白的疗效观察

目的 观察应用疏血通注射液对糖尿病肾病患者尿蛋白及肾功能的疗效.方法 糖尿病肾病患者96例分为治疗组与对照组.据24 h尿蛋白定量结果,每组再分为3个亚组:早期糖尿病肾病期组(尿蛋白定量30 mg/24 h~300 mg/24 h);临床糖尿病肾病期肾功能正常组和肾功能不全组,尿蛋白定量均在300 mg/24 h以上.在控制糖尿病患者血糖的基础上,治疗组加用疏血通注射液6 mL入生理盐水250 mL静脉输注,每日一次,14 d为1疗程.结果 治疗组治疗后24 h尿蛋白排出量与对照组相比明显减少.治疗组3个亚组患者,治疗后比较治疗前24 h尿总蛋白和白蛋白均有明显减少,肾功能有所改善;早期糖尿病肾病组及临床期肾功能正常组治疗前后相比,差异有统计学意义;肾功能正常的临床期肾病患者血肌酐水平有所下降.治疗组治疗后24 h尿白蛋白下降百分率,在早期糖尿病肾病组为50%,在临床期肾功能正常组为40%,而在临床期肾功能不全组为20%.结论 应用疏血通注射液治疗糖尿病肾病可有效使早期糖尿病肾病和临床肾功能正常期患者尿蛋白减少,肾脏功能得以保护,减缓肾脏病变发生发展速度.     

血浆同型半胱氨酸与2型糖尿病尿白蛋白的关系

目的探讨血浆同型半胱氨酸(Hcy)与2型糖尿病(DM)患者的尿白蛋白的关系.方法通过对80例2型DM患者及30例正常人测定Hcy、空腹血糖(FPG)、餐后2小时血糖(2hPG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三脂(TG)、尿素氮(BUN)、肌酐(Cr)、尿微量白蛋白排泄率(UAER).据UAER作为指标,将全部80例DM患者分成正常尿微量白蛋白排泄率组(UAER＜30mg/24h为Ⅰ组)、早期糖尿病肾病组(UAER≥30mg/24h、＜300mg/24h为Ⅱ组)、临床糖尿病肾病组(UAER≥300mg/24h或尿蛋白定量＞500mg/24h为Ⅲ组).四组的Hcy进行统计学的比较.结果Ⅲ组比Ⅰ、Ⅱ组(P分别为＜0.01、＜0.05)、Ⅱ组比Ⅰ组(P＜0.05)及Ⅰ、Ⅱ、Ⅲ组均比对照组(P值分别为＜0.05、＜0.01、＜0.01)的血浆Hcy水平高.存在高Hcy血症的2型DM患者,其UAER升高即早期糖尿病肾病发生率明显高于无高Hcy血症的患者.结论高Hcy血症与2型DM的尿白蛋白呈正相关系,其机制可能是通过血管内皮损伤有关.     

糖尿病肾病微量白蛋白尿影响因素分析

目的观察影响糖尿病肾病(DN)患者尿微量白蛋白(MAU)进展和缓解的因素。方法纳入尿蛋白定量30~300 mg/24 h,血清肌酐110μmol/L的2型糖尿病患者108例。记录患者一般情况(年龄、体重指数、腰围、糖尿病病程等),临床指标(血糖、Hb A1c、血脂、血压、尿酸、肾功能、24 h尿白蛋白定量等)。分析尿微量白蛋白影响因素。结果 108例患者中失访18例,MAU进展组22例(24.44%),MAU稳定组40例(44.45%),MAU转阴/缓解组28例(31.11%)。MAU转阴/缓解组患者基线尿白蛋白定量显著低于稳定组和进展组,高密度脂蛋白水平显著高于稳定组和进展组(P0.05)。多因素COX回归分析,显示糖尿病病程、糖化血红蛋白、血尿酸、总胆固醇、ACEI/ARB使用是MAU转阴/缓解的独立影响因素。结论临床表现MAU的DN患者基线临床指标能够预测MAU进展与缓解。     

血、尿NGAL在2型糖尿病肾病进展各阶段的变化及其临床意义

目的:探讨血、尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)在2型糖尿病肾病(T2DN)进展各阶段中的变化及临床意义。方法:选择2015年5月~2018年1月入院治疗的T2DN患者240例(T2DN组)。根据24h尿微量白蛋白排泄率(UAER)水平,患者被分为尿蛋白正常(NAU)组(88例,<20mg/24h)、微量蛋白尿(MAU)组(80例,30~300mg/24h)和大量蛋白尿(MPU)组(72例,>300mg/24h)。选择同期入院健康体检者100例,设为健康对照组。测量比较各组血、尿NGAL、血清尿素氮(BUN)、血肌酐(Scr)和胱抑素C(CysC)水平,分析血、尿NGAL水平与上述指标的相关性。结果:与健康对照组比较,T2DN组血NGAL[(0.03±0.00)μg/L比(22.32±3.21)μg/L]、尿NGAL[(1.53±0.08)μg/L比(7.35±2.39)μg/L]、血清BUN[(8.32±1.84)mmol/L比(16.46±2.15)mmol/L]、Scr[(138.46±34.09)μmol/L比(290.48±43.41)μmol/L]和CysC[(1.52±0.46)mg/L比(3.97±1.23)mg/L]水平均显著升高,P均=0.001。上述指标水平均符合:NAU组相似文献   

尿微量白蛋白与老年急性ST段抬高心肌梗死患者急诊介入治疗预后分析

目的探讨尿微量白蛋白(MAU)对直接PCI的老年ST段抬高心肌梗死(STEMI)患者预后的预测价值。方法选择老年STEMI患者101例,根据MAU水平分为MAU阳性组(MAU>20 mg/24 h.54例)和MAU阴性组(MAU≤20 mg/24 h,47例)。观察发病30天及1年的主要不良心血管事件(MACE)发生率。结果 MAU阳性组发病30天及1年发生MACE分别为15例(27.8%)和25例(46.3%);MAU阴性组发病30天未发生MACE,随访1年发生MACE 3 例(6.4%),两组比较差异显著(P<0.01)。MAU阳性组多支血管病变明显高于MAU阴性组(87.0% vs 53.2%,P<0.01)。结论 MAU是预测老年STEMI患者30天及1年发生MACE的危险因素。     

随机尿微量白蛋白肌酐比值在糖尿病肾损伤患者诊疗中的应用分析

目的 分析糖尿病肾损伤患者诊疗中随机尿微量白蛋白肌酐比值的应用.方法 回顾性选取2020年2月—2021年2月该院糖尿病患者90例为研究对象,依据肾损伤程度分为24 h尿白蛋白排泄率(UAER)＜30 mg/24 h组(正常白蛋白尿组)、UAER 30～300 mg/24 h组(微量白蛋白尿组)、UAER＞300 mg...     

锰超氧化物歧化酶基因V(16)A多态性与糖尿病肾病的相关性研究

目的探讨锰超氧化物歧化酶(MnSOD)基因V(16)A多态性与糖尿病肾病(DN)的关系。方法应用PCR-RFLP法在昆明地区汉族人中检测97例健康对照者和187例2型糖尿病(T2DM)患者[根据尿白蛋白(UAlb)定量分为DN0(UAlb<30mg/24h)、DN1(30mg/24h≤UAlb<300mg/24h)和DN2(UAlb>300mg/24h)]的MnSOD基因V(16)A多态性,比较各组间基因型分布和等位基因频率。结果DN组(DN1 DN2)VV基因型和V等位基因频率显著高于不伴肾病的DN0组(P<0·05)。MnSOD基因多态性与DN显著相关。结论MnSOD基因V(16)A多态性是中国昆明地区汉族T2DM发生DN的遗传危险因素。     

2型糖尿病肾病患者的Apelin、胱抑素C的变化及其临床意义

目的探讨血清胱抑素C（Cys-C）与Apelin水平在2型糖尿病肾病患者中的相关性及其临床意义。 方法2014年5月至2017年2月期间在广西壮族自治区人民医院老年内分泌病房接受治疗的63例2型糖尿病患者的病例资料,根据24 h尿微量蛋白是否>30 mg/24h,分为糖尿病肾病组（24 h尿微量蛋白>30 mg/24h,31例）和糖尿病非肾病组（24 h尿微量蛋白≤30 mg/24h,32例）,另设30例正常对照组,用酶联免疫吸附法测定空腹血清Apelin水平,同时测定Cys-C。 结果与对照组相比,糖尿病肾病组和糖尿病非肾病组血清Apelin及Cys-C均明显升高（P<0.05）。糖尿病肾病组血清Apelin及Cys-C高于糖尿病非肾病组（P<0.05）。糖尿病肾病组的Apelin与Cys-C水平呈正相关（P<0.05）。 结论血清Cys-C与Apelin水平在2型糖尿病肾病患者中存在正相关,考虑两者通过在肾小球的协同作用调控疾病的发展,可成为反映糖尿病肾病的早期指标发挥重要作用。     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.