肝移植术后糖尿病危险因素分析

目的 探讨肝移植术后糖尿病（PTDM）的发生及发展的危险因素。方法 回顾性分析98例肝移植受者的临床资料。根据其肝移植术后是否发生糖尿病，分为糖尿病组（36例）和非糖尿病组（62例）。以术前和术后可能的9个危险因素作为分析指标，进行这些指标的单因素分析和χ^2检验。结果 在对两组患者的年龄、乙型肝炎病毒（HBV）感染情况、有无肝硬化及肝硬化的程度、术前糖耐量情况、免疫抑制剂的选择及其血药浓度、激素的使用时间的比较分析中发现：术前肝硬化患者PTDM的发生率明显高于无肝硬化者；肝硬化失代偿期患者PTDM的发生率高于代偿期。术前糖耐量异常的患者PTDM的发生率明显高于糖耐量正常者。激素半年内撤离的患者PTDM的发生率明显低于半年内未撤离者。而两组患者的年龄、HBV的感染情况、免疫抑制剂的选择及其血药浓度相比较，差异均无统计学差异。结论 肝硬化、尤其是肝硬化失代偿期，糖耐量异常，长期使用激素是PTDM发生的危险因素。     

铜代谢异常相关疾病研究

铜是人类和动物重要的必需微量元素，参与体内蛋白质、氨基酸、核酸等营养物质的代谢，铜代谢异常会造成多种疾病。本文主要综述铜在糖尿病、动脉粥样硬化、冠心病、高脂血症、骨质疏松等的发生发展以及治疗方面的作用。     

链脲佐菌素致迟发型大鼠1型糖尿病模型的研究

目的 探讨链脲佐菌素(streptozocin,STZ)致迟发型大鼠1型糖尿病模型建立的方法.方法 将8只大鼠随机分为对照组3只,实验组5只;实验组将福氏完全佐剂(CFA)与小剂量STZ联合使用,连续3周大鼠腹腔注射,制造Wistar大鼠1型糖尿病模型,并对2组大鼠的进食量、饮水量、尿量、体重、血糖及尿糖进行密切监测,同时对实验组及对照组大鼠进行葡萄糖耐量实验(OGTT).结果 3只大鼠(60%)成模,实验组大鼠表现出多饮、多食、多尿、高血糖、高尿糖的1型糖尿病典型症状,与对照组大鼠的各项指标差异均有统计学意义(P＜0.05),且实验组大鼠表现出葡萄糖耐量异常.结论 CFA与小剂量STZ联合使用可制造Wistar大鼠1型糖尿病模型.     

Analysis of the strain relatedness of oral Candida albicans in patients with diabetes mellitus using polymerase chain reaction‐fingerprinting

To increase our understanding of Candida pathogenicity, the identification of those strains most frequently associated with infections is of paramount importance. Polymerase chain reaction (PCR)‐based methods are extremely effective in differentiating and determining reproducibility, they require minimum starting material and are rapid and simple to perform. In this study, the genetic relatedness of Candida albicans was assessed for two geographically different patient groups (London, UK and Parma, Italy) affected by diabetes mellitus. C. albicans samples from the oral cavities of non‐diabetic healthy subjects were also examined by PCR fingerprinting to evaluate the possible genetic differences among endogenous strains in individuals with and without diabetes mellitus. PCR fingerprinting, with subsequent phylogenetic analysis of C. albicans isolates from the diabetic patients from London and Italy and from the non‐diabetic subjects, revealed that there were significant differences (P < 0.0001) between C. albicans isolates indicative of the distinct ecological niches that occur in the oral cavities of these patient cohorts. The most diverse group comprised the isolates from the diabetic patients in the UK, possibly reflecting the antifungal treatment that these patients had received. Further studies that include isolates from patient cohorts with systemic diseases other than diabetes mellitus, and from more diverse geographic localities are required to explain the relatedness of C. albicans isolates in the mouth.     

垂体脓肿的诊断与治疗(附10例报告)

目的探讨垂体脓肿的临床特点、诊断和治疗。方法回顾性分析10例垂体脓肿的病史、临床表现、影像学表现、手术记录和随访结果。结果8例早期出现尿崩症,影像学表现为MRI检查T1像等信号或低信号,T2像等信号或高信号,环行强化,5例垂体柄增粗50%,随访6个月至4年,均未见复发。结论早期尿崩症、垂体柄增粗和环形强化的囊性病灶应首先怀疑垂体脓肿,早期诊断、及时手术和合理的抗生素治疗是提高垂体脓肿预后的关键。     

妊娠期糖尿病62例临床分析

目的 探讨妊娠期糖尿病的合理处理及预后.方法 选择62例妊娠期糖尿病患者进行回顾性分析.结果 妊娠期糖尿病62例,其中单纯饮食控制17例,饮食控制 胰岛素治疗43例,2例未治疗.剖宫产42例,阴道产20例.合并妊高症3例,羊水过多2例,羊水过少4例,羊水栓塞1例,早产5例,高胆红素血症3例,真性红细胞增多症2例,死胎2例,新生儿窒息4例,新生儿畸形1例.结论 对妊娠合并糖尿病的孕妇进行早期的诊断及治疗,选择合适的时间及方式终止妊娠可以减少母儿并发症的发生率.     

Cause-specific and total mortality in the Canterbury (New Zealand) insulin-treated Diabetic Registry population: a 15-year follow-up study.

AIMS: To establish all-cause and cause-specific death rates, and risk factors for mortality in insulin-treated diabetic individuals living in the province of Canterbury, New Zealand. METHODS: Insulin-treated diabetic subjects (n = 995) on the Canterbury Diabetes Registry were followed up over 15 years and vital status determined. Death rates were standardized and hazard regression was used to model the effects of demographic covariates on relative survival time. RESULTS: There were 419 deaths in 11 226.3 person-years of follow-up with a standardized mortality ratio (SMR) of 2.0 (95% confidence interval (CI) 1.8-2.2). Relative mortality was greatest for the group aged 0-29 years (SMR 3.0 (95% CI 2.4-3.7)). After controlling for diabetes duration and gender, a 10-year increment in age of onset was associated with a 33% decrease in relative hazard (95% CI 29-36%), indicating that excess mortality due to diabetes declines with rising age of onset. After controlling for age of onset and gender, each 10-year increment in duration of diabetes is associated with a 26% decrease in relative hazard (95% CI 24-29%), indicating that with longer survival the mortality hazard approaches the general population hazard. Relative mortalities were increased for cardiovascular, renal and respiratory disease, but not malignancy. Relative mortality from acute metabolic complications was increased in the subgroup with age of onset of diabetes < 30 years and requiring insulin within 1 year of diagnosis. CONCLUSIONS: Mortality rates are high for insulin-treated diabetic individuals relative to the general population.     

2型糖尿病患者绝经期骨密度与甲状旁腺素、雌激素相关性研究

目的 观察2型糖尿病妇女绝经期骨密度与甲状旁腺素、雌激素相关性研究.方法 测定绝经期2型糖尿病妇女伴骨质疏松（A）组及绝经期2型糖尿病妇女无骨质疏松（B）组的左侧髋部股骨颈、大转子、华氏三角区、及腰椎L2～L4正侧位的骨密度和血清中骨代谢指标,如：骨钙素、碱性磷酸酶、钙、磷、甲状旁腺素、雌二醇、Ⅰ型胶原羧基末端终肽（β-CTx）的浓度,对骨密度与多个变量之间的关系进行相关分析,并对（A）组血清中的甲状旁腺素、雌二醇、骨钙素、β-CTx与不同部位的骨密度之间的关系进行多元逐步回归分析.结果绝经期2型糖尿病妇女（B）组的腰椎、大转子、华氏三角区、股骨颈等骨密度指标明显低于对照组（A）（P＜0.05）;2型糖尿病绝经期妇女血清中雌二醇水平与腰椎L2～L4骨密度呈正相关（P＜0.032）;甲状旁腺素水平与股骨颈骨密度呈负相关（P＜0.034）.结论 绝经期2型糖尿病患者甲状旁腺素和雌激素水平与骨密度密切相关,分别可以用于预测骨质疏松发生的不同部位.     

非胰岛素依赖型糖尿病患者血清唾液酸的改变

测定20例NIDDM伴有心脑血管病变的患者、20例单纯NIDDM患者的血清唾液酸（SA）水平，并与20例正常人进行比较。结果发现所有NIDDM患者的血清SA水平均显著增高（P＜0．01），其中伴有心脑血管疾病患者的血清SA水平显著高于单纯NIDDM患者（P＜0．05），同时血清SA水平与血清胰岛素及C肽水平、收好压之间存在相关。提示血清SA水平与NIDDM患者的心脑血管疾病关系密切，可能是心脑血管并发症发生的一个危险因素。     

小儿糖尿病血胰岛细胞抗体与胰岛素自身抗体

报道并分析20例小儿糖尿病患儿的临床资料及血胰岛细胞抗体(ICA)及胰岛素自身抗体(IAA)的测定资料。在20例患儿中,临床表现多不典型。在酮症酸中毒的治疗中小剂量胰岛素疗法方法简便,安全可靠,并发症少。本组患儿ICA阳性率55%,IAA阳性率30%,经卡方检验均显著高于对照组,推测病毒感染引起自身免疫反应,产生ICA及IAA而致本病发生。