血清骨钙素水平与老年 2型糖尿病病人慢性炎症指标的相关性

目的 探讨在老年2型糖尿病(T2DM)病人中,血清骨钙素(OC)水平与慢性炎症指标的相关性.方法 选取2018年6月至2020年3月在华东师范大学附属芜湖医院老年医学科住院的192例病人作为研究对象,分为T2DM组92例,非T2DM组100例,比较两组受试者血清OC水平、一般生化指标以及慢性炎症指标的关系,并分析在T2DM组中,血清OC水平与慢性炎症指标的关系.结果 老年T2DM病人的血清OC水平较非T2DM组显著下降[(10.46±4.02)ng/mL比(15.76±5.81)ng/mL,P<0.01],而空腹血糖(FPG)、糖化血红蛋白(HbA1c)、餐后2 h血糖(2hPG)、血清铁蛋白(SF)、超敏C反应蛋白(Hs-CRP)、单核细胞计数(MONO)较非T2DM组显著升高[(10.05±3.48)mmol/L比(5.18±0.70)mmol/L、(8.18±1.47)％ 比(5.51±0.31)％、(7.24±0.57)mmol/L比(5.46±0.29)mmol/L、(224.09±190.01)ng/mL比(146.06±133.01)ng/mL、(2.71±0.97)mmol/L比(2.10±0.76)mmol/L、(0.42±0.16)×109/L比(0.37±0.12)×109/L,P<0.01].在老年T2DM病人中,相关性分析提示血清OC水平与SF、Hs-CRP、嗜酸性粒细胞计数(EO)呈负相关;校正血糖、BMI后进行多元回归分析发现,SF、Hs-CRP是影响血清OC水平的独立危险因素(P<0.05).结论 在老年T2DM病人中,慢性炎症指标可能与血清OC水平有一定的相关性.     

2型糖尿病患者血清高密度脂蛋白水平与动脉粥样硬化的相关性研究

目的探讨2型糖尿病患者血清高密度脂蛋白（HDL）水平与糖尿病血管并发症的相关性。方法对524例2型糖尿病患者空腹血脂、血糖、糖化血红蛋白等结果进行统计,并分析血脂异常组与血管动脉粥样硬化的相关性。结果524例2型糖尿病患者中,58．4％患者存脂代谢紊乱;动脉粥样硬化组血清HDL水平（0．80±0．26）mmol／L,明显低于与非动脉粥样硬化组的（0．95±0．43）mmol／L（t=1．648,P〈0．05）。结论高密度脂蛋白的降低与2型糖尿病动脉粥样硬化有相关性。     

急性心肌梗死患者血糖、糖化血清蛋白和N末端B型钠尿肽原的临床检测价值

目的 通过观察急性心肌梗死(AMI)患者血糖(Glu)、糖化血清蛋白(GSP)、B型钠尿肽原(NT-proBNP)水平变化及并发症发生状况,探讨联合检测的临床价值.方法 据AMI患者入院时有无合并糖尿病分为已知糖尿病组、未知糖尿病组及无糖尿病组,于入院时采集患者外周血,检测血清Glu(葡萄糖氧化酶法)、GSP(果糖胺法)及NT-proBNP(电化学发光免疫分析法)水平,并观察患者住院期间并发症的发生情况.结果 AMI各组患者入院时,已知糖尿病组血清Glu、GSP和NT-proBNP水平[(9.16±0.97) mmol/L、(2.14±0.47) mmol/L和(531.1±99.0) pg/ml]显著高于正常对照组[(5.08±0.91) mmol/L、(1.98±0.41) mmol/L和(47.7±11.6) pg/ml] (P＜0.05);未知糖尿病组血清Glu、GSP和NT-proBNP水平[(13.73±1.39) mmol/L、(3.49±0.62) mmol/L和(966.3±120.7 pg/ml)]显著高于正常对照组(P＜0.05);无糖尿病组血清Glu和NT-proBNP水平[(8.62±0.85) mmol/L和(319.2±87.4) pg/ml]显著高于正常对照组(P＜0.05),但血清GSP水平[(2.06±0.43) mmol/L]差异无统计学意义(P＞0.05);未知糖尿病组与已知糖尿病组及无糖尿病组比较,血清Glu、GSP和NT-proBNP水平差异均具有统计学意义(P＜0.05).住院期间,已知糖尿病组及未知糖尿病组心血管事件发生率(46.7％、64.1％)均显著高于无糖尿病组(28.0％)(x2=3.847、11.600,P＜0.05),未知糖尿病组与已知糖尿病组差异无统计学意义(x2=2.564,P＞ 0.05).结论 血清GSP可作为区分AMI患者Glu增高属于应激性还是糖尿病性的重要依据,血清NT-proBNP可判断AMI患者心功能损害程度.联合检测血清Glu、GSP及NT-proBNP水平,可作为指导AMI患者的临床治疗及预测预后的指标.     

2型糖尿病病人估算肾小球滤过率与糖尿病视网膜病变的相关性研究

目的 探讨2型糖尿病病人估算肾小球滤过率(eGFR)与糖尿病视网膜病变(DR)的相关性.方法 2018年10月至2019年4月武汉大学人民医院内分泌科收治的204例2型糖尿病病人,根据其是否并发糖尿病视网膜病变,将其分为无视网膜病变(NDR)组88例,视网膜病变(DR)组116例.分别对两组研究对象的预估肾小球滤过率(eGFR)、糖化血红蛋白(HbA1c)、空腹血糖(FPG)等生化指标进行检测,对比分析两组研究对象的检测水平.Spearman相关性分析分析eGFR与DR危险因素的相关性.logistic回归分析eGFR与DR发生的相关性.结果 DR组HbA1c为9.65(7.93,11.15)mmol/L、尿素(urea)为6.12(4.73,7.66)mmol/L、血清肌酐(Scr)为62.00(53.00,93.50)μmol/L、尿酸(UA)为360.00(309.25,429.50)μmol/L、收缩压(SBP)为(133.19±18.46)mmHg,较NDR组(8.19±1.70)mmol/L、(5.30±1.39)mmol/L、(57.64±15.40)μmol/L、304.00(261.00,347.50)μmol/L、(126.98±13.90)mmHg显著升高;DR组ALB为40.60(38.50,42.50)g/L、eGFR为96.79(72.17,107.45)mL/min较NDR组白蛋白41.60(39.60,44.60)g/L、(107.67±13.97)mL/min显著降低,均差异有统计学意义(P<0.05).Spearman相关性分析显示,eGFR与年龄(rs=?0.422)、HbA1c(rs=?0.336)及SBP(rs=?0.190)呈显著的负相关(P<0.05).多因素logistic回归分析显示eGFR、HbA1c、ALB、urea、UA是DR发生的危险因素(P<0.05).结论 eGFR水平降低是2型糖尿病病人发生视网膜病变的危险因素.     

膀胱癌患者血清血管内皮生长因子水平测定的临床意义

目的探讨膀胱癌(BC)患者血清血管内皮生长因子(VEGF)水平与BC分期、分级的关系及手术前后变化的临床意义。方法采用酶联免疫吸附试验(ELISA)对62例BC患者术前、术后1个月、术后出现复发(19例)或远处转移(2例)者、50例正常人血清中VEGF水平进行检测。结果BC组的血清VEGF水平(269·2±58·3)ng/L明显高于正常对照组(125·5±22·3)ng/L(P<0·01),并与肿瘤的分期、分级相关;其中浸润性癌T2-T3(275·7±41·2)ng/L组明显高于浅表性癌Tis-T1(214·6±32·4)ng/L组(P<0·01),浸润性癌T4(338·8±43·7)ng/L组明显高于T2-T3组(P<0·01),G3级VEGF水平(332·9±45·6)ng/L显著高于G1级(231·2±38·5)ng/L和G2级(252·6±45·3)ng/L,G1级和G2级之间差异无统计学意义。与术前相比,术后血清VEGF水平(142·4±31·8)ng/L明显下降(P<0·01),而术后复发及转移组血清VEGF水平(256·3±93·2)ng/L再次明显上升高于正常对照组(P<0·01)。结论VEGF表达与膀胱癌的临床分期及病理分级相关,血清VEGF水平可作为膀胱癌患者手术前后病情监测及判断复发的一个新瘤标。     

超敏C反应蛋白在2型糖尿病肾病患者中的意义研究

目的 分析超敏C反应蛋白(hs-CRP)在2型糖尿病肾病患者的意义.方法 选取2009年1月-2010年1月在我院内分泌门诊及住院的2型糖尿病患者87例.分为单纯2型糖尿病组(45例)与糖尿病肾病组(42例),另选40例健康人为正常对照组.检测3组hs-CRP水平.结果 糖尿病肾病组血清hs-CRP水平为(7.2±2.9)mg/L;糖尿病组血清hs-CRP水平为(4.7±1.4)mg/L,正常对照组血清hs-CRP水平为(3.6±1.0)mg/L.糖尿病肾病组血清hs-CRP水平明显高于其他两组,差异有统计学意义(P＜0.05).结论 hs-CRP是诊断糖尿病早期肾病有价值的实验室指标,可预测糖尿病肾病的发生和进展.     

血清蛋白质酪氨酸磷酸酶 1B、雌二醇水平与青少年脾虚肝郁型闭经病人肥胖的关系

目的 检测青少年脾虚肝郁型闭经病人血清蛋白质酪氨酸磷酸酶1B(PTP1B)、雌二醇(E2)水平,并探讨其与肥胖的关系.方法 选取2019年1―8月于张家口市中医院妇科门诊确诊的青少年脾虚肝郁型闭经病人110例作为研究对象,按照青少年肥胖诊断标准分为青少年脾虚肝郁型闭经发生肥胖60例(闭经肥胖组)和青少年脾虚肝郁型闭经未发生肥胖50例(闭经未肥胖组).另选取同期健康体检者60例作为对照组.收集研究对象的体质量、肥胖度、体质量指数(BMI)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)等资料.酶联免疫吸附法(ELISA)检测受试者外周血血清中PTP1B、E2水平.logistic回归分析青少年脾虚肝郁型闭经病人发生肥胖的影响因素.受试者工作特征曲线(ROC)分析二者对青少年脾虚肝郁型闭经病人发生肥胖的诊断效能.结果 与对照组、闭经未肥胖组相比,闭经肥胖组体质量[(77.25±12.43)kg比(49.65±7.13)kg、(51.89±8.27)kg]、肥胖度[(41.64±13.26)％比(16.75±2.85)％、(17.75±3.26)％]、BMI[(29.75±5.36)kg/m2比(20.86±4.13)kg/m2、(21.26±4.35)kg/m2]、TC[(4.62±0.93)mmol/L比(3.25±0.65)mmol/L、(3.34±0.81)mmol/L]、TG[(1.94±0.26)mmol/L比(0.86±0.12)mmol/L、(0.88±0.18)mmol/L]、LDL[(2.75±0.53)mmol/L比(1.87±0.35)mmol/L、(1.95±0.42)mmol/L]水平明显升高(P<0.05);对照组、闭经未肥胖组、闭经肥胖组PTP1B[(53.63±12.56)ng/mL、(72.16±16.42)ng/mL、(85.24±21.35)ng/mL]、E2水平[(283.76±73.15)ng/mL、(357.46±83.81)ng/mL、(426.63±95.52)ng/mL]均依次升高(P<0.05).TC、LDL、PTP1B、E2水平均是青少年脾虚肝郁型闭经病人发生肥胖的独立危险因素(P<0.05),PTP1B、E2联合检测对青少年脾虚肝郁型闭经病人发生肥胖的ROC曲线下面积为0.750.结论 PTP1B、E2水平在青少年脾虚肝郁型闭经发生肥胖病人体内均升高,二者均是致病的独立危险因素,有一定的诊断效能,可能为临床诊断青少年脾虚肝郁型闭经病人发生肥胖提供一定参考.     

2型糖尿病慢性并发症与血清生长激素关系探讨

目的 :探讨生长激素 (growthhormone,GH)水平与2型糖尿病患者慢性并发症的关系。方法 :用化学发光法测定21例2型糖尿病伴慢性并发症患者和18例2型糖尿病无慢性并发症患者 ,及11例正常对照者的血清GH水平 ,用t检验等统计学方法分析各组间测量值。结果 :糖尿病慢性并发症组GH(3 9±2 3)μg/L ,明显高于糖尿病无慢性并发症组GH(1 6±1 3)μg/L(P<0 05) ,而无慢性并发症组与正常对照组GH(1 5±1 4)μg/L相比 ,虽有升高趋势 ,但差异无显著性 (P>0 05)。结论 :GH可能与糖尿病慢性并发症的发生有关。     

妊高征与尿酸、血脂水平的相关性探讨

目的进一步研究妊高征与高尿酸血症,高血脂的关系及其临床意义。方法检测173例妊娠期各期孕妇及164例正常非孕健康女性的血清尿酸三酰甘油胆固醇水平。结果妊娠孕妇组的血清尿酸水平(367.8±58.7)μmol/L,正常非孕健康组(242.6±43.6)μmol/L三酰甘油水平分别为(1.30±0.25)mmol/L,(1.56±0.30)mmol/L,胆固醇水平(3.95±0.55)mmol/L与(4.53±0.95)mmol/L;妊娠组中高尿酸血症孕妇发生妊高征的比率83.95%(68/81)明显高于尿酸值正常孕妇28.26%(26/92)。妊高征组明显高于对照组,胆固醇水平差异有极显著性t=13.86,P<0.01,三酰甘油水平差异有显著性(t=8.62,P<0.01)。结论妊娠期女性比正常非孕期女性血清尿酸水平升高,妊娠期高尿酸血症发生妊高征的比率明显增加。     

瑞格列奈治疗2型糖尿病40例的疗效观察

目的评估瑞格列奈治疗2型糖尿病的降糖作用和安全性。方法按门诊就诊顺序连续选择血糖控制欠佳的2型糖尿病患者40例。在原治疗方案的基础上加用或将磺脲类药物换为瑞格列奈疗程16周,观察治疗前后空腹血糖(FBG)、餐后2h血糖PBG2h、糖化血红蛋白Alc(GHbAlC)体重变化及低血糖的情况。结果试验前FBG、PBG2h、GHbAlc分别是(7.9±1.6)mmol/L、(13.1±1.9)mmol/L、(2.5±1.5)mmol/L;16周后FBG、PBG2h、GHbAlc分别是(5.6±0.6)mmol/L、(7.8±1.7)mmol/L、(6.1±0.5)mmol/L,前后比较差异无统计学意义(P<0.05),试验前体重指数(24.3±1.6)kg/m2、终点时为(23.9±1.8)kg/m2,两者比较差异无统计学意义,(P<0.05)。治疗过程中低血糖发生少,仅4例次。结论瑞格列奈可以使2型糖尿病患者的FBG、HbAlc均达到理想控制水平,而不需要增加体重,低血糖发生率低使用方便。     

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.

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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.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

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.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.