血清铁、锌和铁蛋白在孕中期妊娠期糖尿病孕妇中的水平变化及其与糖代谢指标的关系分析

目的探讨血清铁、锌和铁蛋白在孕中期妊娠期糖尿病孕妇中的水平变化及其与糖代谢指标的关系。方法回顾性分析2019年6月至2021年6月郑州市第三人民医院收治的200例孕中期妊娠期糖尿病孕妇的临床资料作为观察组,并选取同期孕中期妊娠期血糖正常孕妇200例的产检资料作为对照组。比较两组孕妇血糖代谢指标,血清铁、锌、铁蛋白水平及血清铁、锌、铁蛋白水平与血糖代谢指标的相关性。结果观察组孕妇血清空腹血糖(FPG)、1 h血糖(1hPG)、2 h血糖(2hPG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)水平高于对照组;观察组孕妇血清铁、铁蛋白水平高于对照组,而血清锌水平低于对照组(均P<0.05);血清铁水平与血清FPG、1 h PG、2 h PG、FINS、HbA1c、HOMA-IR水平呈正相关关系(r=0.370,0.296,0.326,0.281,0.325,0.342,P<0.05),血清锌水平与血清FPG、1 h PG、2 h PG、FINS、HbA1c、HOMA-IR水平呈负相关关系(r=-0.345,-0.352,-0.527,-0.488,-0.422,-0.341,P<0.05),血清铁蛋白水平与血清FPG、1 h PG、2 h PG、FINS、HbA1c、HOMA-IR水平呈正相关关系(r=0.524,0.624,0.522,0.684,0.528,0.544,P<0.05)。结论血清铁、铁蛋白、糖代谢指标水平在孕中期妊娠期糖尿病孕妇中水平异常升高,而血清锌水平降低,同时血清铁、铁蛋白水平与糖代谢指标水平呈正相关关系,血清锌水平与糖代谢指标水平呈负相关关系。     

妊娠期糖尿病孕妇血清TNF-α水平与胰岛素抵抗的关系

目的探讨妊娠期糖尿病(GDM)孕妇血清肿瘤坏死因子-α(TNF-α)水平与胰岛素抵抗的关系。方法选择GDM孕妇39例(GDM组)、同期正常妊娠孕妇38例(正常妊娠组),采用酶联免疫吸附试验测定空腹血清TNF-α水平;同时测定2组孕妇空腹血糖、胰岛素、糖化血红蛋白(HbA1c)水平,并且根据公式计算2组孕妇的胰岛素敏感指数(ISI)。结果(1)GDM组空腹血清TNF-α、血糖、胰岛素、ISI、HbA1c水平分别为(5.3±0.9)ng/L、(6.1±0.7)mmol/L、(13.1±3.2)mU/L、-4.3±0.4、(5.7±0.4)%,正常妊娠组孕分别为(4.4±0.7)ng/L、(4.8±0.6)mmol/L、(9.1±2.6)mU/L、-3.8±0.4、(5.4±0.5)%,2组比较差异有统计学意义(P<0.01或P<0.05);(2)GDM组孕妇空腹血清TNF-α水平与ISI呈负相关(r=-0.388,P<0.01),与空腹血糖、HbA1c呈正相关(r=0.524,P<0.01;r=0.426,P<0.01),与胰岛素无相关性。正常妊娠组孕妇TNF-α水平与ISI呈负相关(r=-0.336,P<0.05),但相关性显著小于GDM组,与胰岛素、血糖及HbA1c无相关性。结论GDM组孕妇空腹血清TNF-α水平明显升高,且与ISI呈显著负相关,提示TNF-α参与了GDM孕妇的胰岛素抵抗。     

妊娠糖尿病与维生素D的相关性研究

目的 探讨妊娠期糖尿病与血清维生素D的相关性.方法 回顾性分析2016年1月至2017年1月北京市仁和医院收治的200例妊娠期糖尿病孕妇(病例组)的临床资料,并于同期随机选取200例健康妊娠孕妇(对照组)作为对照,所有孕妇均在孕11~13+6周行维生素D检测,在孕24~28+6周行口服葡萄糖耐量试验(OGTT)测定血糖水平.分析妊娠期糖尿病孕妇血糖水平与孕期血清维生素D的相关性.结果 病例组孕妇的年龄、体质量指数(BMI)、空腹血糖(FBG)、餐后1 h血糖值(1 h PBG)、餐后2 h血糖值(2 h PBG)、空腹胰岛素(FINS)、低密度脂蛋白(LDL)、HOMA模型胰岛素抵抗指数(HOMA-IR)分别为(27.34±5.58)岁、(23.80±2.24)kg/m2、(6.89±0.82)mmol/L、(12.33±1.05)mmol/L、(9.90±0.78)mmol/L、(14.65±1.94)IU/mL、(3.18±0.44)mmol/L、(5.06±2.24),均高于对照组的(25.51±6.02)岁、(21.38±2.57)kg/m2、(4.21±0.67)mmol/L、(7.34±0.78)mmol/L、(6.12±0.89)mmol/L、(9.76±1.62)IU/mL、(2.76±0.39)mmol/L、(3.11±1.87),差异均有统计学意义(P<0.05);病例组孕妇的维生素D水平、HOMA模型β细胞功能指数(HOMA-IS)分别为(14.24±6.17)mg/L、(134.28±56.22),均低于对照组的(22.58±5.45)mg/L、(289.55±69.13),差异均有统计学意义(P<0.05);维生素D与FBG、1 h PBG、2 h PBG、HOMA-IR呈负相关(P<0.05),与HOMA-IS呈正相关(P<0.05).结论 维生素D水平在妊娠期糖尿病孕妇血清中显著降低;维生素D缺乏参与了妊娠期糖尿病的发生发展过程,其可能的机制为影响胰岛β细胞的功能而增加胰岛素抵抗.     

妊娠糖尿病患者血清维生素D与胰岛素抵抗的相关性分析

目的 探讨胰岛素抵抗与妊娠糖尿病（GDM）患者血清维生素D 的相关性。方法 选择我院2019 年1 月至2020 年1 月收治的GDM 患者32 例作为观察组,选择同期健康体检产妇32 例作为对照组。均检测空腹胰岛素、三酰甘油、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、25-羟维生素D 水平、空腹血糖,并分析胰岛素抵抗与血清25-羟维生素D 的相关性。结果 观察组三酰甘油（2.20±0.48）mmol/L、总胆固醇（4.43±0.15）mmol/L、低密度脂蛋白胆固醇（2.39±0.17）mmol/L、高密度脂蛋白胆固醇（1.31±0.29）mmol/L 与对照组[（2.17±0.42）mmol/L、（4.46±0.16）mmol/L、（2.43±0.19）mmol/L、（1.29±0.28）mmol/L]比较,差异无统计学意义（P＞0.05）;与对照组比较,观察组空腹胰岛素（24.79±2.43）U/L 及空腹血糖（7.29±0.81）mmol/L 水平均较高,差异有统计学意义（P＜0.05）;与对照组比较,观察组胰岛素抵抗指数（6.75±1.32）较高,25-羟维生素D 水平（18.86±3.48）nmol/L 较低,差异有统计学意义（P＜0.05）;经Pearson 相关性分析发现,GDM 患者血清25-羟维生素D 与胰岛素抵抗呈负相关（r=-0.733,P=0.000）。结论 GDM 患者血清维生素D 与胰岛素抵抗有关,推测GDM 患者的胰岛素抵抗可通过维生素D 补充进行调节,临床可根据生素D 与胰岛素抵抗情况,积极为患者实施高效的治疗方案。     

孕晚期血清铁蛋白水平与妊娠期糖尿病的相关性研究

目的研究孕晚期血清铁蛋白水平与妊娠期糖尿病的相关性。方法选取2012年1月-2014年1月来我院检查的80例孕晚期（36-41周）孕妇为研究对象,其中妊娠期糖尿病孕妇35例为研究组,正常孕妇45例为对照组,对所有孕妇血清铁蛋白、糖化血红蛋白及空腹胰岛素水平进行检测和比较,并分析血清铁蛋白水平与胰岛素抵抗的相关性。结果研究组血清铁蛋白水平、胰岛素抵抗指数等指标明显高于对照组,差异有统计学意义（P〈0.05）。另外,血清铁蛋白水平与胰岛素抵抗指数呈显著相关性（P〈0.05）。结论妊娠期糖尿病主要由胰岛素抵抗、胰岛素功能异常等引起,且血清铁蛋白水平与妊娠期胰岛素抵抗呈正相关,相关机制需深入探析。     

血清尿酸与2型糖尿病关系研究

目的 研究血清尿酸与2型糖尿病发生发展之间的关系.方法 检测并比较整群选取的该院2015年11月—2016年11月进行体检的184例2型糖尿病患者(2型糖尿病组)、271例空腹血糖受损者(空腹血糖受损组)和3747名健康体检者(血糖正常组),对其血清尿酸水平和相关代谢指标进行比较分析,研究血清尿酸水平和相关代谢指标的相关性.结果 该研究2型糖尿病发病率为4.37%,空腹血糖受损发生率为6.45%.2型糖尿病组年龄为(64.47±11.55)岁、体重指数(25.23±2.94)kg/m2、甘油三酯(2.04±1.62)mmol/L、胆固醇(5.31±1.05)mmol/L、血清尿酸(356.45±81.24)μmol/L、空腹血糖(8.77±2.31)mmol/L;空腹血糖受损组年龄为(61.41±12.37)岁、体重指数(25.11±2.87)kg/m2、甘油三酯(1.89±1.54)mmol/L、胆固醇(5.24±1.01)mmol/L、血清尿酸(351.21±81.45)μmol/L、空腹血糖(6.44±0.28)mmol/L;健康对照组年龄为(53.34±14.27)岁、体重指数(23.88±3.35)kg/m2、甘油三酯(1.57±1.21)mmol/L、胆固醇(5.11±0.94)mmol/L、血清尿酸(341.99±87.21)μmol/L、空腹血糖(5.01±0.47)mmol/L.血糖水平和血清尿酸水平具有正向相关性.男性2型糖尿病患者血清尿酸水平高于女性患者.对患者按性别进行血清尿酸分层分析显示,体重指数、甘油三酯、胆固醇、空腹血糖与血清尿酸水平具有正向相关性.结论 血清尿酸是2型糖尿病发展的独立危险因素,高尿酸血症在2型糖尿病变化进展中具有重要作用,可将血清尿酸可作为监测2型糖尿病的重要指标.     

妊娠期糖尿病患者血尿酸水平与胰岛素抵抗的相关性研究

目的探讨妊娠期糖尿病（GDM）患者血尿酸与胰岛素水平,及胰岛素抵抗的关系。方法选取56例妊娠糖尿病患者为观察组,选取同期健康妊娠妇女50例为对照组,检测两组血空腹血糖、血尿酸及空腹胰岛素水平,同时按照血尿酸值再将GDM组分为尿酸升高组及尿酸正常组两个亚组,比较两亚组的血清空腹胰岛素水平。结果 GDM组孕妇血尿酸值为（317.25±82.22）μmol/L,血清空腹胰岛素（15.68±4.52）mU/L,对照组孕妇血尿酸值为（208.37±59.28）μmol/L,血清空腹胰岛素（11.96±3.53）mU/L,两组比较有显著性差异（P〈0.01）。GDM高尿酸组血清空腹胰岛素（17.29±3.23）mU/L,正常尿酸组血清空腹胰岛素（13.74±3.96）mU/L,两亚组比较有显著性差异（P〈0.05）。结论 GDM患者血尿酸水平增高,与胰岛素抵抗有密切关系。     

胃旁路术对糖尿病大鼠的降糖作用及其机制分析

目的：探讨胃旁路术对糖尿病大鼠的降糖作用及其作用机制。方法将40例糖尿病大鼠按照随机数字法分组,即手术组和对照组,各20例,手术组大鼠接受胃旁路术治疗,对照组大鼠仅采取饮食控制治疗,比较两组大鼠治疗前后的血糖水平以及血浆胰岛素、血浆抵抗素变化。结果手术组治疗后的大鼠空腹血糖、餐后2 h血糖分别是（10.1±2.1）mmol/L、（13.9±2.2）mmol/L,血浆胰岛素、血浆抵抗素水平分别是（10.5±2.8）μIU/mL、（5.6±1.7）mmol/mL;对照组治疗后的大鼠空腹血糖、餐后2h血糖分别是（15.6±3.0）mmol/L、（29.8±5.7） mmol/L,血浆胰岛素、血浆抵抗素水平分别是（22.5±3.9）μIU/mL、（20.5±1.1）mmol/mL;两组大鼠血糖、血浆胰岛素和血浆抵抗素水平的组间比较差异均有统计学意义（P＜0.05）。结论胃旁路术对糖尿病大鼠的降糖作用明显,其作用机制可能是胃旁路术降低大鼠血浆胰岛素、血浆抵抗素,从而降低其血糖水平。     

糖尿病合并妊娠及妊娠期糖尿病筛查治疗的临床研究

目的探讨糖尿病合并妊娠及妊娠期糖尿病空腹血糖、血清果糖胺、糖化血红蛋白的诊断价值,以及不同的治疗方法在临床上的疗效。方法选择妇产科门诊孕期检查的孕妇,对糖尿病合并妊娠及筛查确诊的妊娠期糖尿病患者进行空腹血糖、血清果糖胺、糖化血红蛋白监测,然后将两组再次随机分为两组,治疗组给予饮食运动和胰岛素＋中药治疗,对照组给予饮食运动和胰岛素治疗,3个月后进行空腹血糖、血清果糖胺、糖化血红蛋白监测,进行比较。所获数据采用均数±标准差表示,均数间比较采用t检验。结果各组血糖、果糖胺、糖化血红蛋白水平比较：治疗前两组血糖水平无明显差异（P〉0.05）,血清果糖胺有显著性差异（P〈0.05）,糖化血红蛋白有非常显著差异（P〈0.001）;治疗前后两组血糖水平、血清果糖胺有差异（P〈0.05）,糖化血红蛋白无明显著差异（P〉0.05）。结论对孕妇进行空腹血糖、血清果糖胺、糖化血红蛋白的监测更能准确的了解孕期糖尿病的病情,使用饮食运动胰岛素＋中药治疗孕期糖尿病,疗效更优于饮食运动和胰岛素治疗组。     

二甲双胍联合沙格列汀对2型糖尿病患者血糖控制及不良反应的影响

目的：探讨二甲双胍联合沙格列汀对2型糖尿病患者血糖控制及不良反应的影响。方法：糖尿病患者88例,随机分为对照组和观察组各44例。两组均给予常规饮食及运动指导,对照组单用盐酸二甲双胍片治疗,观察组在此基础上加以沙格列汀片。比较两组空腹血糖、餐后2 h血糖、糖化血红蛋白、胰岛素抵抗指数、BMI及不良反应发生情况。结果：治疗前FPG、2 hPPG、HbAlc及IRI对照组分别为8.27±1.33 mmol/L,11.38±2.40 mmol/L,（7.39±1.27）%,2.94±0.48;观察组分别为8.25±1.30 mmol/L,11.33±2.47 mmol/L,（7.50±2.08）%,2.96±0.49,治疗后FPG、2hPPG、HbAlc及IRI对照组分别为6.65±2.08 mmol/L,9.62±4.17 mmol/L,（6.65±1.08）%,2.58±0.25,观察组分别为5.53±1.82 mmol/L,7.83±3.8 mmol/L,（5.42±1.53）%,2.18±0.22,均较治疗前明显降低,差异均有统计学意义（P<0.05）;观察组较对照组更低,差异均有统计学意义（P<0.05）。治疗前后两组BMI比较,差异均无统计学意义（P>0.05）。结论：二甲双胍联合沙格列汀较单独使用二甲双胍可明显降低患者空腹血糖、餐后2h血糖、糖化血红蛋白及胰岛素抵抗指数,未增加不良反应发生率,对BMI指数无显著影响。     

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.     

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…     

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.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.