健康教育联合降糖药治疗2型糖尿病患者生存质量的影响研究

目的 探讨心理健康教育联合降糖治疗对2型糖尿病（T2DM）患者生存质量的影响.方法 将96例T2DM患者随机分为观察组和对照组.对照组给予常规临床护理联合降糖治疗,观察组采用心理健康教育联合降糖治疗.两组患者在干预前后分别进行量表和血糖指标测查.结果 干预后,观察组GQOL-74总分与干预前和对照组比较显著上升（P＜0.05）,心理维度评分、社会维度评分与干预前和对照组比较显著下降（P＜0.05）,而身体维度评分、治疗维度评分与干预前和对照组比较差异无统计学意义（P＞0.05）：两组空腹血糖、餐后2 h血糖和糖化血红蛋白与干预前比较显著降低（P＜0.05）,且观察组空腹血糖、餐后2 h血糖和糖化血红蛋白与对照组比较显著降低（P＜0.05）.结论 心理健康教育联合降糖治疗能够提高T2DM患者的生存质量,对患者的血糖控制有明显的改善作用.     

阿卡波糖预防IGT人群发展为2型糖尿病的效果观察

目的探讨预防糖耐量异常（IGT）人群发展为2型糖尿病（T2DM）的有效方法,降低T2DM发生的危险性。方法对226例IGT人群分两组采用单纯生活方式干预及生活方式加药物干预,观察两组人群T2DM发病情况的差异。结果治疗组（生活方式加药物干预组）和对照组（单纯生活方式干预组）治疗6个月后,治疗组空腹血糖（FPG）、葡萄糖耐量试验后2h血糖均明显下降,且与对照组比较差异有统计学意义。结论应用生活方式加药物（拜糖平）干预IGT发展为T2DM明显强于单纯生活方式干预。     

门诊糖尿病健康教育效果观察

目的观察门诊糖尿病健康教育的临床效果。方法门诊2型糖尿病（T2DM）患者50例随机分为观察组26例和对照组24例,经门诊正规口服降糖药物和（或）皮下注射胰岛素控制血糖,并定期监测血糖和复查糖化血红蛋白（HbAIC）,记录血糖达标所用时间,观察组同时由门诊医师给予规范性健康教育,半年后进行效果评价。结果观察组血糖达标所用时间较对照组短,差异有统计学意义（P〈0．01）。2组FPG、2hPG、HbAIC治疗后均低于治疗前,差异有统计学意义（P〈0．01）,治疗后观察组各指标低于对照组,差异有统计学意义（P〈0．05）。结论在门诊对T2DM患者进行系统规范的健康教育有利于患者血糖尽早达标。     

糖尿病社区干预对2型糖尿病患者血糖水平的影响

目的：探讨社区干预对2型糖尿病患者空腹血糖与餐后2 h血糖水平的影响。方法：收集2015年2型糖尿病患者100例,分为研究组和对照组各50例,对照组给予常规综合健康教育方式干预,研究组采取KTH糖尿病社区干预的健康教育模式,两组均干预3个月。比较干预前后空腹血糖与餐后2 h血糖水平以及患者的遵医行为变化。结果：在干预前两组空腹血糖、餐后2 h血糖差异无统计学意义（P＞0.05）。干预后,研究组空腹血糖、餐后2 h血糖显著低于对照组（P＜0.05）。两组干预前的按时复诊、规范服药、血糖自我检测、选择健康生活方式比较差异无统计学意义（P＞0.05）。干预后,研究组按时复诊、规范服药、血糖自我检测、选择健康生活方式的比例显著高于对照组（P＜0.05）。结论：KTH糖尿病社区干预有利于充分发挥健康教育在糖尿病治疗中的功能,值得社区推广应用。     

高血糖人群血清脂联素、胰岛素抵抗指数和血管内皮功能变化及相关性研究

目的探讨高血糖人群血清脂联素、胰岛素抵抗（IR）指数和血管内皮功能变化及相关性。方法从35。55岁健康体检人群经口服葡萄糖耐量试验（OGTT）筛选出糖耐量正常（NGT）43例,空腹血糖调节受损（IFG）47例,糖耐量受损（IGT）52例,糖尿病（DM）41例,检测并比较血糖、血清脂联素水平、IR指数及血管内皮功能。结果空腹胰岛素水平在IFG、IGT、DM3组均高于NGT组（P〈0．05）;餐后2h胰岛素水平从DM、IGT、IFG组到NGT组依次降低,且差异有统计学意义（P〈0．05）。IFG、IGT、DM组IR指数明显高于NGT组,DM组IR指数高于IFG和IGT组（P〈0．05）。血清脂联素水平及血管内皮功能在NGT、IFG、IGT、DM组依次降低（P〈0．05）。脂联素与空腹血糖、IR指数呈负相关（P〈0．01）。结论血清脂联素水平、IR指数和血管内皮功能可作为OGTT异常人群动脉硬化的早期监测指标。     

老年急性冠状动脉综合征患者血糖异常的临床意义

目的探讨老年急性冠状动脉综合征（ACS）患者血糖异常的意义与疾病的关系。方法对151例住院的老年ACS患者做标准75g葡萄糖口服试验。根据血糖水平,将患者分为血糖正常组、空腹血糖异常组（IFG组）、餐后血糖异常组（IGT组）和糖尿病（DM）组。利用心电图和B型超声心动图检测各组中大面积心肌缺血/心肌梗死率、心力衰竭发生率、严重心律失常发生率以及住院期间病死率。结果 DM组DM检出率均高于血糖正常组、IFG组及IGT组,差异有统计学意义（P〈0.05）。IGT组大面积心肌缺血/梗死率高于血糖正常组和IFG组,且DM组高于血糖正常组、IFG组和IGT组,差异均有统计学意义（P〈0.05或P〈0.01）;DM组心力衰竭、严重心律失常发生率均高于前3组,差异均有统计学意义（P〈0.01）;DM组病死率高于前3组（P〈0.05）,且IFG组和IGT组病死率亦高于血糖正常组（P〈0.05）。结论老年ACS患者血糖异常水平与心肌梗死及（或）心肌缺血范围、心力衰竭的发生率、严重心律失常发生率及住院期间病死率密切相关,餐后血糖水平增高及DM患者不良事件的发生率明显增加。     

糖耐量降低患者的中药辨证干预研究

目的观察中药对糖耐量降低（IGT）患者辨证干预治疗的临床疗效,阐明早期干预治疗对IGT的意义.方法将60例IGT患者随机分为2组,中药辨证干预治疗30例为治疗组,生活方式干预30例为对照组.疗程1个月,观察两组患者治疗前后空腹血糖及口服葡萄糖耐量试验（OGTT）餐后2小时血糖水平的变化,进行统计学分析比较.结果与对照组相比,治疗组患者餐后2小时血糖明显改善（P＜0.01）.两组空腹血糖经治疗后均有所改善,但治疗组疗效优于对照组（P＜0.05）.结论中药辨证干预治疗能有效改善IGT,这对于预防IGT向糖尿病发展具有十分重要的临床意义.     

糖耐量异常患者社区综合干预效果评价

目的评价糖耐量异常患者社区综合干预的效果。方法依照1999年WHO关于IGT的诊断标准,选取本中心辖区内IGT患者81例作为研究对象,设立对照组,对干预组实施社区综合干预措施,观察干预前后一系列相关指标的变化情况。结果干预组空腹血糖、餐后2h血糖、体重指数、甘油三酯、总胆固醇、低密度脂蛋白较干预前均显著降低,高密度脂蛋白升高(P<0.05),对照组的以上指标前后差异无统计学意义。干预组糖尿病发生率为2.4%,而对照组的DM发生率为20.0%,两组转归存在的差异有统计学意义(P<0.05)。结论实施社区综合干预可明显改善IGT患者糖、脂代谢,从而降低此类人群DM的发病率。     

萍乡矿业集团公司2968例糖耐量减低患者6年的演变及影响因素分析

目的观察萍乡矿业集团公司糖耐量减低（IGT）患者的演变及其影响因素。方法对2002年普查出的IGT患者根据患者意愿分为IGT非干预治疗人群（2126例）和IGT干预治疗人群（842例）,6年后复查OGTT、BMI、血压、血脂。结果 2126例IGT非干预治疗人群中有486例（22.9%）转变为DM,年转变率为3.82%,有963例（45.3%）例仍为IGT,有677（31.8%）例转为正常糖耐量。842例IGT干预治疗人群中有81例（9.62%）转变为DM,年转变率为1.60%,有275例（32.7%）例仍为IGT,有486例（57.7%）转为正常糖耐量（NGT）。年龄增加,2型糖尿病阳性家族史的IGT患者DM转变率高。IGT非干预治疗人群,DM转归组的其基线空腹静脉血糖（FPG）均明显高于其他转归组（P〈0.05）,收缩压（SBP）、体质量指数（BMI）均明显高于糖耐量正常（NGT）转归组（P〈0.05）。血清甘油三脂DM转归组〉IGT转归组〉NGT转归组。影响IGT向DM转变的主要影响因素为、2hPG、SBP、BMI血清甘油三脂（TG）。结论年龄、DM阳性家族史、空腹（FPG）、餐后2h血糖（2hPG）、血清甘油三脂（TG）、体重、血压为IGT转变为DM的危险因素。改变生活方式、控制血糖、血压、血脂,对降低IGT转变为DM有显著差异。     

合并类风湿关节炎的2型糖尿病患者血糖及血脂代谢特点研究

目的 探讨合并类风湿关节炎（RA）的2型糖尿病（T2DM）患者血糖及血脂代谢的特点.方法 选择73例合并RA的T2DM患者作为观察组,不合并RA的T2DM患者60例作为对照组.2组分别检测体重指数、收缩压、舒张压、血清中三酰甘油、总胆固醇、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、空腹血糖,餐后2h血糖（PBG）、C反应蛋白（CRP）、糖化血清白蛋白（GA）及糖化血红蛋白（HbA1c）及红细胞沉降率（ESR）,比较2组患者各指标的差异.按照ESR是否升高将T2DM合并RA患者分为2组,比较各实验室指标的差异.结果 合并RA的T2DM患者血清总胆固醇为（4.3±1.0） mmol/L,明显低于不合并RA的T2DM患者（4.7±0.9） mmol/L,差异有统计学意义（P＜0.05）;合并RA的T2DM患者总胆固醇/HDL-C （4.0±1.0）明显低于不合并RA的T2DM患者（4.5±1.4）,差异有统计学意义（P＜0.05）;LDL-C水平（2.6±0.7） mmol/L与不合并RA的T2DM患者（3.0±0.4）mmol/L比较,差异有统计学意义（P＜0.01）;合并RA的T2DM患者血清CRP中位数为14.54（1.62,17.95） mg/L,明显高于不合并RA的T2DM患者2.13（0.83,4.77） mg/L（P＜ 0.01）,ESR（38±22） mm/1 h也较不合并RA的T2DM患者（16±11）mm/1 h明显升高,差异有统计学意义（P＜0.01）;2组患者体重指数、收缩压及舒张压比较差异无统计学意义,2组三酰甘油、空腹血糖、PBG、GA及HbA1c比较差异亦无统计学意义.在合并RA的T2DM患者中,ESR升高组总胆固醇/HDL-C （4.2 ± 1.0） mmol/L明显高于ESR正常组（3.7±0.8） mmol/L（P＜0.05）,ESR升高组GA水平（28±11）％明显高于ESR正常组（18±5）％（P＜0.05）,CRP水平中位数为15.52（6.47,28.67） mmol/L亦明显高于ESR正常组3.14（1.17,6.18） mmol/L（P ＜0.01）;2组空腹血糖、PBG及HbA1c比较差异无统计学意义.结论 合并RA的T2DM患者血脂水平明显低于不合并RA的T2DM患者,RA患者风湿活动使机体维持在高水平的炎症状态,导致血糖及血脂代谢紊乱,可能进一步加重T2DM患者的患心血管疾病的风险.     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

---

Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Lung disease and PKCs

The lung offers a rich opportunity for development of therapeutic strategies focused on isozymes of protein kinase C (PKCs). PKCs are important in many cellular responses in the lung, and existing therapies for pulmonary disorders are inadequate. The lung poses unique challenges as it interfaces with air and blood, contains a pulmonary and systemic circulation, and consists of many cell types. Key structures are bronchial and pulmonary vessels, branching airways, and distal air sacs defined by alveolar walls containing capillaries and interstitial space. The cellular composition of each vessel, airway, and alveolar wall is heterogeneous. Injurious environmental stimuli signal through PKCs and cause a variety of disorders. Edema formation and pulmonary hypertension (PHTN) result from derangements in endothelial, smooth muscle (SM), and/or adventitial fibroblast cell phenotype. Asthma, chronic obstructive pulmonary disease (COPD), and lung cancer are characterized by distinctive pathological changes in airway epithelial, SM, and mucous-generating cells. Acute and chronic pneumonitis and fibrosis occur in the alveolar space and interstitium with type 2 pneumocytes and interstitial fibroblasts/myofibroblasts playing a prominent role. At each site, inflammatory, immune, and vascular progenitor cells contribute to the injury and repair process. Many strategies have been used to investigate PKCs in lung injury. Isolated organ preparations and whole animal studies are powerful approaches especially when genetically engineered mice are used. More analysis of PKC isozymes in normal and diseased human lung tissue and cells is needed to complement this work. Since opposing or counter-regulatory effects of selected PKCs in the same cell or tissue have been found, it may be desirable to target more than one PKC isozyme and potentially in different directions. Because multiple signaling pathways contribute to the key cellular responses important in lung biology, therapeutic strategies targeting PKCs may be more effective if combined with inhibitors of other pathways for additive or synergistic effect. Mechanisms that regulate PKC activity, including phosphorylation and interaction with isozyme-specific binding proteins, are also potential therapeutic targets. Key isotypes of PKC involved in lung pathophysiology are summarized and current and evolving therapeutic approaches to target them are identified.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.