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1.
虎静 《中国全科医学》2021,24(9):1057-1060
背景 糖尿病患者罹患骨质疏松症(OP)的风险较高,持续高血糖对骨密度(BMD)的不良影响已有较多报道,但血糖波动与OP的关系鲜有报道。目的 探讨新诊断男性2型糖尿病(T2DM)患者血糖波动与OP的相关性。方法 前瞻性选取2018年1月-2019年1月于宁夏回族自治区人民医院内分泌科就诊的115例新诊断男性T2DM患者,计算其体质指数(BMI);空腹8 h以上于次日清晨抽取肘静脉血,检测空腹血糖(FPG)、血钙(Ca)、血磷(P)、血脂指标〔总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)〕,测定餐后2 h血糖(2 hPG)、空腹胰岛素(FINS)、空腹C肽(FC-P)、餐后2 h胰岛素(2 hINS)、餐后2 h C肽(2 hC-P),评估胰岛素抵抗指数(HOMA-IR),测定糖化血红蛋白(HbA1c)和腰椎(L1~4)的BMD。通过监测患者的7段血糖(三餐前血糖、三餐后2 h血糖、2:00血糖)评估血糖波动,计算血糖的标准差(SDBG)、餐后血糖波动幅度(PPGE)、最大血糖波动幅度(LAGE)、空腹血糖变异系数(CV-FPG)、平均血糖(MPG)。依据患者是否合并OP分为T2DM合并OP组60例及T2DM组55例。分析两组各指标的差异及血糖波动与BMD的相关性。结果 T2DM 合并OP组HOMA-IR、HbA1c、SDBG、PPGE、LAGE、CV-FPG、MPG高于T2DM组,HDL、FC-P、2 hC-P、BMD低于T2DM组(P<0.05)。Pearson相关分析结果显示,新诊断男性T2DM患者的BMD与年龄、2 hPG、LDL、HOMA-IR、HbA1c、SDBG、PPGE、LAGE呈负相关(r值分别为-0.501、-0.325、-0.436、-0.111、-0.603、-0.506、-0.324、-0.712,P<0.05),与Ca、2 hC-P呈正相关(r值分别为0.029、0.015,P<0.05);校正年龄、BMI后,BMD与2 hC-P呈正相关(r=0.008,P<0.05),与HbA1c、SDBG、LAGE呈负相关(r值分别为0.519、0.285、0.399,P<0.05)。结论 对于新诊断男性T2DM患者来说BMD与2 hC-P呈正相关,与HbA1c、SDBG、LAGE呈负相关,血糖波动与其BMD密切相关,控制血糖波动对防治OP有积极作用。  相似文献   

2.

[摘要]目的: 研究2型糖尿病患者血糖波动水平与脂蛋白a和血尿酸水平的关系。方法: 以50例2型糖尿病伴蛋白尿患者作为观察组,50例2型糖尿病尿微量蛋白阴性患者作为对照组。测定并记录患者一般临床资料、血液生化指标;评估患者血糖浓度波动。分析血糖波动与脂蛋白a和血尿酸水平的关系。结果: 两组平均病程、餐后2小时血糖(2hPG)、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)、血尿酸、脂蛋白a和尿微量白蛋白(U-mALB)水平差异均有统计学意义(均P<0.01);观察组平均血糖波动幅度(MAGE)、最大血糖波动幅度(LAGE)、血糖水平标准差(SDBG)、平均餐后血糖波动幅度(MPPGE)均显著高于对照组(P<0.01);U-mALB与脂蛋白α和血尿酸呈显著正相关(r分别为0.886,0.943,均P<0.05),总胆固醇、MAGE与脂蛋白a呈独立正相关(r分别为0.560,0.965,均P<0.05),SDBG和MAGE与血尿酸呈独立正相关(r分别为0.641,0.495,均P<0.05)。 结论: 2型糖尿病血糖波动水平可影响脂蛋白a的表达和血尿酸的水平。  相似文献   

3.
目的:探讨持续血糖水平及日内血糖、餐后血糖波动对2型糖尿病患者尿微量白蛋白排泄率的影响。方法:对108例2型糖尿病患者进行血糖监测,并检测糖化血红蛋白( HbA1c)和尿微量白蛋白排泄率( UAER)。监测一日三餐前30 min、餐后2h及晚睡前共7次指尖微量血糖,计算1天7次微量血糖的标准差( SDBG)、最大血糖波动幅度( LAGE)及餐后血糖波动幅度(PPGE),并根据PPGE水平分为2组:PPGE>2.2mmol/L 组和PPGE≤2/2 mmol/L组。结果:患者HbA1C、SDBG、LAGE和UAER水平,PPGE>2.2mmol/L组明显高于PPGE≤2.2mmol/L组(P<0.01)。相关分析显示,HbA1c与PPGE、SDBG及LAGE呈正相关(P<0.01)。 UAER与LAGE、PPGE、SDBG及HbA1C呈正相关(P<0.O1),其中与LAGE的相关性最强。线性多元逐步回归分析显示:调整其他血糖控制参数后,LAGE仍与UAER呈正相关,偏回归系数分别为0.497(P<0.001)。结论:随着HbA1e水平的升高,日内血糖及PPGE显著增加;血糖波动特别是日内最大血糖波动是造成2型糖尿病患者尿微量白蛋白排泄率增加的重要因素,其作用独立于持续血糖水平。  相似文献   

4.
《中国现代医生》2021,59(8):83-86+90
目的 探讨T2DM患者ROU严重程度的危险因素。方法 收集2017年1月至2020年1月于牡丹江医学院附属红旗医院就诊的T2DM合并ROU的患者73例,其中轻型ROU 48例、重型ROU 25例,采用二元Logistic回归及多元逐步回归的方法,对影响ROU严重程度的患者临床基本资料、血糖波动、危险因素、炎症因子、氧化应激和外周血淋巴细胞水平进行分析。结果 重型ROU患者的年龄、SDBG、PPGE、LAGE、HbA1c、PBG、VB12水平与轻型ROU比较,差异均有统计学意义(P0.05),但经二元Logistic回归分析后显示,PBG、HbA1c、SDBG及PPGE水平与ROU的严重程度呈独立正相关(P0.05),且以SDBG(OR=5.221,95%CI:1689~3.812)、PPGE(OR=3.141,95%CI:1.571~3.121)水平与ROU的严重程度更为密切。另外,重型ROU患者的SOD水平低于轻型ROU(P0.05),两组患者IL-2、IL-6、CD4+、CD8+、CD4+/CD8+水平比较,差异无统计学意义(P0.05),采用多元逐步回归分析显示,PBG、HbA1c、SDBG、PPG水平分别与SOD水平呈独立负相关(P0.05),且以SDBG、PPGE(标准化β=-0.321,-0.212,P0.05)水平与SOD关系更为密切。结论 在T2DM患者中,波动的高血糖通过加重氧化应激水平进而加剧ROU的严重程度。  相似文献   

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目的 探讨糖尿病合并下肢血管病变(DLEAD)患者血糖波动与踝肱指数(ABI)及8-异前列腺素F2α(8-iso-PGF2α)的相关性.方法 选择2013年9月~2014年2月北京军区总医院内分泌科收治的60例2型糖尿病(T2DM)患者,依据超声检查结果分为单纯2型糖尿病组(DM组),合并下肢血管病变组(DLEAD组),另选取健康者20例做为对照组(NC组).分别检测其血压、血脂、糖化血红蛋白(HbA1c)、8-iso-PGF2α、ABI等指标.应用动态血糖监测仪对各组行连续72 h血糖监测,采用全天血糖标准差(SDBG)、日内平均血糖波动幅度(MAGE)、全天有效血糖波动次数(FGE)、日间血糖平均绝对差(MODD)4个指标评价血糖波动,比较三组间ABI、8-iso-PGF2α及各血糖波动参数,并分析血糖波动参数及临床生化指标与ABI、8-iso-PGF2α的相关性.结果 ①DLEAD组患者的病程、MAGE、MODD、SDBG、FGE、8-iso-PGF2α较DM组均明显升高,差异均有统计学意义(P<0.05);DLEAD组ABI明显低于DM组,差异有统计学意义(P<0.05).②采用Pearson相关分析表明:MAGE、FGE、MODD与ABI呈负相关(r=-0.802、-0.147、-0.553,P< 0.05);MAGE、MODD与8-iso-PGF2α呈正相关(r=0.825、0.504,P<0.05).多因素逐步回归分析发现:MAGE、FGE、MODD与ABI独立相关(Y=1.26-0.046MAGE-0.017 FGE-0.042 MODD).结论 血糖波动与DLEAD密切相关,可能是通过诱发氧化应激水平引起及加重DLEAD.  相似文献   

6.
目的 动态监测老年2型糖尿病患者日内血糖波动情况,探讨血糖漂移与糖化血红蛋白(HbA1c)及糖尿病慢性并发症的关系.方法 以70例老年2型糖尿病患者作为研究对象,其中35例伴糖尿病肾病,30例伴糖尿病视网膜病变.采用动态血糖监测系统(CGMS)进行连续72 h血糖监测,考察日内不同时点血糖水平、不同时段血糖漂移、餐后血糖漂移(PPGE)、平均血糖漂移幅度(MAGE)和24 h平均血糖水平(24h MBG).Pearson法分析患者HbA1c与血糖漂移的相关性,多元Logjstic回归分析与糖尿病肾病和糖尿病视网膜病变发生相关的影响因素.结果 HbA1c与日内7个时点血糖水平、24 h MBG及3:00~6:00、19:00~20:00时段血糖漂移呈显著正相关(P<0.05或P<0.01),与PPGE无明显相关(P>0.05);MAGE与13:00、19:00时点血糖水平和PPGE均呈显著正相关(P<0.05).0:00~3:00时段血糖漂移是糖尿病视网膜病变发生的影响因素(P<0.05).结论 CGMS能较详细地显示日内血糖波动情况.HbA1c能反映日内整体血糖水平.日内血糖波动主要归因于PPGE和夜间血糖漂移.糖尿病视网膜病变的发生可能与血糖漂移有关.  相似文献   

7.
目的 通过在不同血糖水平和糖尿病病程人群中进行骨钙素(BGP)、体质量指数(BMI)、空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、糖化血红蛋白(HbA1C)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)数值测定,探究在2型糖尿病患者中BGP与血糖、血脂间的相互关系及可能作用机制.方法 采用ELISA法、电化学发光法、高压液相法及全自动生化分析仪等检测BGP与相关实验室参数指标。结果 (1)BGP水平从NGT到IFG再到新诊断T2DM组最后到T2DM病程10年以上组逐渐降低(P<0.01).(2)BGP与FPG、HOMA-IR、HbA1C、TG呈负相关(P<0.01);BGP与BMI、TC无相关关系(P>0.05);BGP与FINS、HDL-C呈正相关,但相关性不显著(P>0.05).(3)新诊断T2DM组与T2DM病程10年以上组间BGP、FPG、FINS、HOMA-IR、HbA1C、TG、HDL-C水平均存在显著差异(P<0.05),且BGP与FPG、HOMA-IR、HbA1C、TG及病程呈负相关(P<0.05),BGP与FINS、HDL-C呈正相关(P<0.05)。结论 BGP与血糖及血脂关系密切,是糖、脂代谢调节的重要参与因子。  相似文献   

8.
目的 观察冠心病患者血液中miR-126表达的变化,探讨其与冠脉病变、血脂相关的临床意义.方法 收集2011年3月~2013年6月我院心内科诊治的冠心病患者98例,另取本院同期健康体检者40例作为对照组.miR-126表达使用荧光定量PCR检测.结果 对照组miR-126和HDL-C显著高于冠心病组(P<0.05),对照组TC和LDL-C显著低于冠心病组(P<0.05).miR-126、TC、LDL-C和HDL-C表达在单支病变组、双支病变组和多支病变组之间存在显著性差异(P<0.05).miR-126与TC表达呈显著负相关(r=-0.324,P<0.05),与LDL-C表达亦呈显著负相关(r=-0.381,P<0.05),而与HDL-C表达呈显著正相关(r=0.416,P<0.05).结论 冠心病患者中miR-126与TC和LDL-C表达呈显著负相关,与HDL-C表达呈显著正相关,miR-126表达随着冠脉病变分支的增加而逐渐下调,miR-126的检测可用于冠心病患者冠脉病变程度的评估.  相似文献   

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[目的] 探讨痰湿与2型糖尿病(type 2 diabetes mellitus,T2DM)脂代谢紊乱的相关性。[方法] 收集833例T2DM患者的临床资料,分析比较痰湿证与非痰湿证患者的肾功能指标与总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)水平,并探究T2DM患者血脂水平与肾功能指标及痰湿程度的相关性。[结果] 与非痰湿证患者比较,痰湿证患者尿素氮、血肌酐、尿酸水平均升高(P<0.01),估算肾小球滤过率(estimated glomerular filtration rate,eGFR)降低(P<0.01);TC、TG、LDL-C水平升高(P<0.01),HDL-C水平降低(P<0.05)。TC与尿素氮呈正相关,与eGFR呈负相关;TG与血肌酐、尿酸呈正相关,与eGFR呈负相关;LDL-C与尿素氮、血肌酐呈正相关,与eGFR呈负相关;HDL-C与血肌酐、尿酸呈负相关;痰湿证与TC、LDL-C呈正相关,随痰湿程度加重,其相关系数增加,轻度痰湿证与HDL-C呈负相关。[结论] T2DM痰湿证患者脂代谢紊乱程度更严重,肾功能更差。痰湿证是血脂水平发生异常的危险因素之一,脂代谢紊乱与T2DM早期肾功能损伤密切相关。本研究为从痰湿纠正T2DM脂代谢异常、延缓肾脏损伤提供了新思路。  相似文献   

10.
目的:探讨2型糖尿病(T2DM )患者血清中内脂素、瘦素及其他指标的表达水平、相关关系及临床意义。方法选取性别和年龄匹配的T2DM患者82例(T2DM组)和健康者71例(健康对照组),测定其血清内脂素、瘦素、胰岛素及血脂、血糖水平。结果 T2DM组的内脂素、瘦素、血清胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FPG)、空腹胰岛素(FINS)、稳态胰岛素抵抗指数(HOMA-IR)、2 h FPG、2 h FINS与健康对照组比较,差异有统计学意义(P<0.05)。相关性分析显示,T2DM 组中内脂素与体质量指数(BMI)、FINS、HOMA-IR、TC、TG、LDL-C均呈正相关(P<0.05),与HDL-C成负相关(P<0.05);瘦素与BMI、FINS、HOMA-IR成正相关(P<0.05)。结论 T2DM 患者血清中内脂素及瘦素的表达水平高于健康者,与血脂、血糖及胰岛素密切相关,可能成为T2DM新的诊断指标。  相似文献   

11.
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.  相似文献   

12.
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.  相似文献   

13.
目的:评价使用安心颗粒对急诊经皮冠状动脉介入术(PPCI)术后生活质量的影响.方法:将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组(术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次)和对照组(仅接受基础药物治疗).所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表(MIDAS)、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果:入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异(P>0.05);出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低(P<0.05);组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低(P<0.05).两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血(P>0.05).两组发生轻度血小板减少症的患者数比较无差异(P>0.05).结论:PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.  相似文献   

14.
Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P<0.01);the MAP decreased(P<0.01)and the HR increased drastically(P<0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.  相似文献   

15.
Objective:To investigate the gene expression of osteoprotegerin(OPG) and osteoclast differentiation factor(ODF) in the bone tissue of patients with hip fracture due to osteoporosis. Methods:OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers(over 50 years old) with hip fracture(Observer Group) and 30 cases of hip facture sufferers with no osteoporosis(Control group) were analyzed with the Semi-Quantitative RT-PCR method. Results:The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion:Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.  相似文献   

16.
Objective:To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas(SPTP). Methods:Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin(HE) staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results:Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin(9/9 cases), AAT(9/9 cases), NSE(9/9 cases), ACT(7/9 cases), CK20(2/9 cases), CgA(1/9 cases), S-100(3/gcases), PR(4/gcases), Syn(3/9 cases) and CD56(5/9cases), negative in CEA and ER. Conclusion:SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.  相似文献   

17.
In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.  相似文献   

18.
Objective: To explore the role of matrix metalloproteinase-1,2 (MMP-1, MMP-2) and tissue inhibitor of matrix metalloproteinases-1 (TIMP-1) in endometriosis. Methods: The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects (excluding endometriosis) were collected and examined by in situ hybridization technology and western blot assay. Results: Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant (P 〈 0.01 ). Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion: The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.  相似文献   

19.
Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.  相似文献   

20.
《中国结合医学杂志》2008,14(2):159-159
The 6th National General Congress of Chinese Association of Integrative Medicine (CALM) was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.  相似文献   

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