骨髓间充质干细胞移植改善糖尿病肾病大鼠血糖及尿总蛋白

BACKGROUND: Common strategies for preventing diabetic nephropathy include effective control of blood sugar and blood pressure, inhibition of the rennin-angiotensin system and lipid-lowering therapy, but it is often difficult to get the desired results. OBJECTIVE: To investigate the effect of transplantation of bone marrow mesenchymal stem cells on levels of blood glucose and urinary total protein in diabetic nephropathy rats. METHODS: Forty-five Sprague-Dawley rats were randomly divided into three groups (n=15 per group): normal control group, diabetic nephropathy group and stem cell transplantation group. Rats in the diabetic nephropathy and stem cell transplantation groups were given single use of 60 mg/kg streptozotocin to make diabetic nephropathy models. The same dose of citric acid-sodium citrate buffer was injected in the normal control group. After modeling, 200 μL of bone marrow mesenchymal stem cell solution (2×106) was injected into the left ventricle of rats in the stem cell transplantation group, and then at 7 days after the first transplantation, the cell transplantation was conducted again. The same dose of serum-free L-DMEM was injected intracardially into the rats in the normal control and diabetic nephropathy groups. Levels of urinary total protein and blood glucose were detected.  RESULTS AND CONCLUSION: At 1, 4, 8 weeks after treatment, the urinary total protein and blood glucose levels were significantly higher in the stem cell transplantation group and diabetic nephropathy group than the normal control group (P < 0.05). At 1 week after treatment, the urinary total protein and blood glucose levels were significantly lower in the stem cell transplantation group than the diabetic nephropathy group (P < 0.05). At 4 and 8 weeks after treatment, the total urinary protein and blood glucose levels were slightly higher in the diabetic nephropathy group than the stem cell transplantation group, but there was no significant difference (P > 0.05). These findings indicate that bone marrow mesenchymal stem cell transplantation in diabetic nephropathy rats can get good results in a short period, significantly improve the blood glucose and urinary total protein levels, but the long-term treatment effect is poor.      

对老年糖尿病患者实施自我管理教育的方法及体会

糖尿病是一种常见的慢性终身性疾病，其并发症影响预后，是致残、致死的主要原因。近来年老年糖尿病的患病率显著升高，老年糖尿病的健康教育问题愈来愈受到重视，通过实施积极的自我管理教育，能提高糖尿病患者的疗效，改善预后，有效防止和延缓并发症的发生，提高生活质量。     

前列腺增生致尿潴留行导尿术的体会

前列腺增生是老年男性常见疾病之一,以排尿困难、尿潴留等为主要临床表现.导尿术是本病迅速、有效的治疗措施之一,由于增大的前列腺压迫尿道,插管很难一次性成功,还可造成尿道损伤,给患者带来痛苦.近几年来笔者所在科室对由前列腺增生导致的尿潴留患者运用整体护理技术,借鉴经验,不仅提高了导尿成功率,而且给患者减少了痛苦,提高了患者对护理人员的满意度,提高了急诊护理质量.     

护士潜在的职业危险因素及防护对策

护士在日常护理操作过程中,可能发生锐器伤、接触病人的血液和体液等职业危害,稍有不慎,极有可能感染医源性传播疾病。因此,护士必须充分认识职业防护的重要性,树立较强的职业防护意识,对潜在的职业危险因素进行评估,并针对性地应用职业防护技能;当职业危害发生后能及时进行妥善处理,将危害降到最低程度。现将有关体会介绍如下。     

静脉麻醉在肠镜检查中的应用

结肠镜检查是检查结肠疾病最直接最可靠的方法，但检查时间长且有明显的腹痛腹胀等不适感，部分患者因惧怕而放弃检查，失去诊疗的适当时机。为保证患者在无任何痛苦的情况下完成检查，2006年3月至2007年2月，我院采用芬太尼和异丙酚联合静脉麻醉肠镜检查105例，术后病人反应良好，现报告如下。     

2型糖尿病高血糖的处理：初始治疗和治疗调节的方法共识——美国糖尿病协会（ADA）和欧洲糖尿病研究协会（EASD）的共识声明

大量研究证实,严格控制血糖可以减少2型糖尿病(T2DM)患者慢性并发症的发生。因此,如何有效控制血糖已成为临床医生们密切关注的问题,但目前并没有一个明确的血糖控制方法可循。基于此,在循证医学原则的指导下,ADA和EASD就如何控制T2DM患者的血糖达成了共识,希望给临床医生以切实的指导和帮助,以下简要介绍该共识的主要内容。1高血糖的控制目标共识推荐将糖化血红蛋白(HbA1c)<7%作为T2DM患者的血糖总体控制目标。但就个体而言,HbA1c≥7%即应开始治疗或调整治疗策略,在没有明显低血糖的情况下,使HbA1c尽可能接近正常范围(<6%),至少应…     

某院肾功能不全患者用药监测系统及其数据分析

目的：通过某院肾功能不全患者用药监测系统及其数据分析,为肾功能不全患者合理用药提供参考。方法：进行肾功能不全用药建档,而后医院信息系统自动抓取相关数据,临床药师根据具体临床情况,参考相关资料,评估用药合理性,及时给出建议。结果：筛选分析2015年度873例成年慢性肾功能不全案例,抗菌药物占比最多;临床药师介入成效显著,包括建议调整用法用量164例,更换药品34例,停药6例,监测生化值40例,密切监测不良反应20例,监测血药浓度9例等。结论：通过肾功能不全患者用药监测,临床药师及时介入,进一步保障了肾功能不全患者合理用药。     

脐血干细胞对1型糖尿病大鼠血糖及PDX-1、MafA表达水平的影响

背景：1型糖尿病是一种自身免疫性疾病,以胰腺β细胞选择性破坏,导致患者体内胰岛素分泌绝对不足为特征。脐血干细胞具有多分化潜能,在体内外均可以诱导分化为胰岛细胞,发挥出一定的降糖作用。目的：探讨脐血干细胞对1型糖尿病大鼠血糖水平及胰腺组织PDX-1、MafA表达的影响。方法：30只SD大鼠随机分为3组,每组10只,治疗组和模型组大鼠建立1型糖尿病模型,造模成功后,治疗组尾静脉一次性注射脐血干细胞,正常组给予相同体积的生理盐水,模型组给予相同体积的脐血干细胞缓冲液。采用口服葡萄糖耐量试验评价大鼠胰岛功能,苏木精-伊红染色观察大鼠胰腺形态,Western blot 和PCR 检测胰腺组织PDX-1、MafA蛋白和mRNA表达。结果与结论：①模型组和治疗组大鼠0,30,60,90 min的血糖值均显著高于正常组,差异均有显著性意义(P < 0.05);120 min时间点模型组血糖值显著高于正常组(P < 0.05);治疗组则与正常组之间差异无显著性意义(P > 0.05)。②模型组胰岛数量出现下降,边界模糊不清,呈不规则形态,治疗组胰岛数量出现一定的减少,但尚维持清晰的结构。③治疗组PDX-1及MafA表达水平与正常组比较差异无显著性意义(P > 0.05),但显著高于模型组(P < 0.05)。以上结果表明,脐血干细胞可以显著降低1型糖尿病大鼠的血糖水平,改善胰岛功能及胰腺组织形态,并具有上调PDX-1、MafA表达的作用。中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程     

血小板反应蛋白1在纤维化模型大鼠肾组织中的表达

BACKGROUND:Thrombospondin-1 is an important endogenous activator of transforming growth factor beta 1 in this experimental inflammatory kidney disease model. Transforming growth factor beta 1 is considered the major cytokine that causes tissue fibrosis in many different inflammatory disease processes, in particular in renal disease. OBJECTIVE:To investigate the expression of thrombospondin-1 on renal fibrosis in rats. METHODS:Healthy male Sprague-Dawley rats were randomly divided into sham surgery group and model group. In the model group, right ureters of rats were ligated to construct models of renal fibrosis. 3 weeks after surgery, blood and urine were obtained weekly. Enzyme linked immunosorbent assay and Bradford method were used to detect the contents of serum creatinine, blood urea nitrogen and urinary protein. After rats were sacrificed, kidneys were fixed. Western blot assay was utilized to identify the expression of vascular endothelial growth factor, transforming growth factor beta 1 and thrombospondin-1 protein. Hematoxylin-eosin staining was applied to detect the changes in pathological structure of the kidney after surgery. RESULTS AND CONCLUSION: (1) One week after model induction, urinary protein, serum creatinine and urea nitrogen levels were significantly higher in the model group than in the sham surgery group (P < 0.05). Three weeks later, the difference in each index was significant (P < 0.01), which showed that the injury of the kidney was aggravated. (2) Transforming growth factor beta 1 protein and thrombospondin-1 expression was significantly higher in the model group than in the sham surgery group, but vascular endothelial growth factor protein expression was significantly lower in the model group than in the sham surgery group. (3) Hematoxylin-eosin staining results demonstrated that severe pathological changes of renal tissue in rats were detected after ligation of renal tubule. (4) These results confirmed that thrombospondin-1 expression increased in renal tissue, and its expression was strongly associated with vascular endothelial growth factor protein and transforming growth factor beta 1, which may play an important role in the renal fibrosis.