大肠癌肠道外少见表现5例报告

在临床上大肠癌常以大便习惯性改变、腹痛、腹块和肠梗阻等症状就医,然而,少数患者却以罕见症象为首发,给临床诊治带来困难,极易导致错误诊治。分析我们两院近数年来诊治928例大肠癌中,有5例     

2型糖尿病患者餐后血脂影响因素研究

目的探讨2型DM患者餐后脂代谢异常的影响因素。方法30例2型DM患者正常饮食下测定早餐前后及中餐前后血脂、血糖、C-肽，对可能影响2型DM患者餐后脂代谢异常的因素进行分析。结果早、中餐后TG、C-肽水平均较餐前明显升高（P〈0．001），HDL—C水平较餐前有所降低（P〈0．001）；早餐前后PC升高水平明显大于中餐前后PG变化（P〈0．05），TG水平升高则略低于中餐前后（P〈0．001），HDL—C变化不大，但早餐后TC、LDL—C较餐前降低，而中餐后TC、LDL—C较餐前升高，两者差异有显著性（P〈0．001）。结论2型DM患者存在明显的餐后脂代谢紊乱，饮食中脂肪、碳水化合物比例不同会导致餐后血糖、血脂及C-肽水平的不同变化。     

The effect of repaglinide on blood glucose and islet β-cell function in newly diagnosed type 2 diabetic patients

Objective To explore the effect of repaglinide intensive treatment on islet β-cell function and long-term control of blood glucose in newly diagnosed type 2 diabetic patients. Methods Self-control and inter-group control prospective study was conducted in 80 newly diagnosed type 2 diabetic patients who were treated with short-term repaglinide intensive treatment and islet β-cell function was assessed by 75 g oral glucose tolerance test (OGTT) before and after repaglinide treatment. The changes of △I30/△G30 ratio, blood lipid, HOMA A and HOMA B were examined. Results After treatment, in successful group, middle group and defeat group, the fasting plasma glucose levels were decreased from 8.9±1.5, 8.6±1.6,9.0±2.0 to 5.0±1.4,6.3±0. 7,6.5±0. 9 mmol/L, 0. 5 h postprandial glucose levels were decreased from (12.6±1.6, 12.6±1.5, 12.4±1.3 to 8.4±1.0, 6.8±0. 7, 8. 6±0. 9)mmol/L,and 2 h postprandial glucose levels were decreased from (13.0±1.2, 13. 1±1.3, 13. 3±1.4 to 9.2±0.9, 6.6±0. 7, 9.2±0. 9)mmol/L,respectively (all P <0. 005). The ratio of △I30/△G30 was increased froml. 69±0. 31, 1.72±0. 33, 1.79±0. 36 to 4. 47±0. 62, 4. 42±0.46,12. 00±0.46 in the three groups, respectively (P<0.05). HOMA B was significantly improved (P<0. 05), while triglycerides and HOMA A were decreased(P<0. 05). The levels of fasting blood glucose and postprandial blood glucose in 21 patients were maintained within normal range for more than six months. There were significant differences in the ratio of △I30/△G30, age, repaglinide dosage and the time of reaching target of glucose [4.47±0.62 vs. 2. 0± 0.46; 39±8 vs. 56±9; 2.0±1.5 vs. 5.0±2.5; 32.4±8.0 vs. 53.3±7.6; all P<0.05] between successful group and defeat group. Conclusions The short-term intensive treatment with repaglinide can significantly improve the early secretion phase of insulin and the islet β-cell function, reconstruct of the physiological model of insulin secretion and relieve the disease.     

The effect of repaglinide on blood glucose and islet β-cell function in newly diagnosed type 2 diabetic patients

Objective To explore the effect of repaglinide intensive treatment on islet β-cell function and long-term control of blood glucose in newly diagnosed type 2 diabetic patients. Methods Self-control and inter-group control prospective study was conducted in 80 newly diagnosed type 2 diabetic patients who were treated with short-term repaglinide intensive treatment and islet β-cell function was assessed by 75 g oral glucose tolerance test (OGTT) before and after repaglinide treatment. The changes of △I30/△G30 ratio, blood lipid, HOMA A and HOMA B were examined. Results After treatment, in successful group, middle group and defeat group, the fasting plasma glucose levels were decreased from 8.9±1.5, 8.6±1.6,9.0±2.0 to 5.0±1.4,6.3±0. 7,6.5±0. 9 mmol/L, 0. 5 h postprandial glucose levels were decreased from (12.6±1.6, 12.6±1.5, 12.4±1.3 to 8.4±1.0, 6.8±0. 7, 8. 6±0. 9)mmol/L,and 2 h postprandial glucose levels were decreased from (13.0±1.2, 13. 1±1.3, 13. 3±1.4 to 9.2±0.9, 6.6±0. 7, 9.2±0. 9)mmol/L,respectively (all P <0. 005). The ratio of △I30/△G30 was increased froml. 69±0. 31, 1.72±0. 33, 1.79±0. 36 to 4. 47±0. 62, 4. 42±0.46,12. 00±0.46 in the three groups, respectively (P<0.05). HOMA B was significantly improved (P<0. 05), while triglycerides and HOMA A were decreased(P<0. 05). The levels of fasting blood glucose and postprandial blood glucose in 21 patients were maintained within normal range for more than six months. There were significant differences in the ratio of △I30/△G30, age, repaglinide dosage and the time of reaching target of glucose [4.47±0.62 vs. 2. 0± 0.46; 39±8 vs. 56±9; 2.0±1.5 vs. 5.0±2.5; 32.4±8.0 vs. 53.3±7.6; all P<0.05] between successful group and defeat group. Conclusions The short-term intensive treatment with repaglinide can significantly improve the early secretion phase of insulin and the islet β-cell function, reconstruct of the physiological model of insulin secretion and relieve the disease.     

The effect of repaglinide on blood glucose and islet β-cell function in newly diagnosed type 2 diabetic patients

Objective To explore the effect of repaglinide intensive treatment on islet β-cell function and long-term control of blood glucose in newly diagnosed type 2 diabetic patients. Methods Self-control and inter-group control prospective study was conducted in 80 newly diagnosed type 2 diabetic patients who were treated with short-term repaglinide intensive treatment and islet β-cell function was assessed by 75 g oral glucose tolerance test (OGTT) before and after repaglinide treatment. The changes of △I30/△G30 ratio, blood lipid, HOMA A and HOMA B were examined. Results After treatment, in successful group, middle group and defeat group, the fasting plasma glucose levels were decreased from 8.9±1.5, 8.6±1.6,9.0±2.0 to 5.0±1.4,6.3±0. 7,6.5±0. 9 mmol/L, 0. 5 h postprandial glucose levels were decreased from (12.6±1.6, 12.6±1.5, 12.4±1.3 to 8.4±1.0, 6.8±0. 7, 8. 6±0. 9)mmol/L,and 2 h postprandial glucose levels were decreased from (13.0±1.2, 13. 1±1.3, 13. 3±1.4 to 9.2±0.9, 6.6±0. 7, 9.2±0. 9)mmol/L,respectively (all P <0. 005). The ratio of △I30/△G30 was increased froml. 69±0. 31, 1.72±0. 33, 1.79±0. 36 to 4. 47±0. 62, 4. 42±0.46,12. 00±0.46 in the three groups, respectively (P<0.05). HOMA B was significantly improved (P<0. 05), while triglycerides and HOMA A were decreased(P<0. 05). The levels of fasting blood glucose and postprandial blood glucose in 21 patients were maintained within normal range for more than six months. There were significant differences in the ratio of △I30/△G30, age, repaglinide dosage and the time of reaching target of glucose [4.47±0.62 vs. 2. 0± 0.46; 39±8 vs. 56±9; 2.0±1.5 vs. 5.0±2.5; 32.4±8.0 vs. 53.3±7.6; all P<0.05] between successful group and defeat group. Conclusions The short-term intensive treatment with repaglinide can significantly improve the early secretion phase of insulin and the islet β-cell function, reconstruct of the physiological model of insulin secretion and relieve the disease.     

乳腺癌病人甲状腺变化的初步探讨

乳腺癌病人甲状腺变化的初步探讨王怡淳，张筱骅温州市第二人民医院（３２５００）乳癌病人血清中甲状腺激素水平紊乱已引起一些学者关注。但其甲状腺的变化报导甚少。本文就乳腺癌病人的甲状腺变化及与乳腺癌病期关系作初步探讨。临床资料一、观察对象及方法：为１９８５...     

T3测定对胃溃疡性病变的临床实用意义

 晚期恶性肿瘤患者的血清中甲状腺激素异常已引起了临床工作者注意。但有关与胃溃疡性病变的关系尚未见报道。本文通过对胃良性溃疡、恶性溃疡患者血清甲状腺激素水平观察，试图评价其对这类疾病的临床实用意义。     

甘精胰岛素加三餐前短效胰岛素和胰岛素泵短期强化治疗对2型糖尿病疗效比较

目的探讨甘精胰岛素联合三餐前短效胰岛素和胰岛素泵治疗对口服降糖药效果不佳的2型糖尿病的疗效、安全性及性价比。方法60例T2DM患者分为甘精胰岛素注射（甘精组）和胰岛素泵（CSII组）,两组的年龄、BMI、FDP、FPG、2hC-P、2hPG、HbA1C差异无统计学意义（P〉O．05）。结果甘精组和CSII组治疗均有效,FPG、2hPG均较治疗前明显下降,FC-P、2hC-P均较治疗前明显升高（P〈0．05）。两组达到相同血糖水平所需的治疗时间以及低血糖发生率无统计学差异（P〉O．05）,但甘精组的胰岛素用量明显低于CSII组（P〈0．05）。结论甘精胰岛素配合三餐前短效胰岛素能有效模拟人生理胰岛素分泌,有效控制高血糖,且效价比高于胰岛素泵。     

罗格列酮和胰岛素对治疗磺脲类降糖药继发性失效患者的胰岛功能改善的比较

目的 观察罗格列酮和胰岛素对治疗磺脲类降糖药继发性失效患者的胰岛功能改善的比较.方法 选择60例磺脲类降糖药继发性失效的2型糖尿病患者,分为胰岛素组、罗格列酮组及胰岛素联合罗格列酮组,治疗24周,治疗前后分别测糖化血红蛋白(HbAlc)、空腹血糖(FPG)、餐后2 h血糖(2hPG)、空腹胰岛素(FIns)、血脂三酰甘油(TG)、胆固醇(TG)高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、体重指数(BMI)、HOMA-IR、HOMA-IS、ISI、△130/△G30.结果 HbAlc、FPG、2hPG、HOMA-IR、治疗后三组均明显下降,有统计学意义(P《0.05),HOMA β胰岛细胞分泌指数、ISI治疗后三组均明显升高,有统计学意义(P《0.01);△130/△G30治疗前后的差值罗格列酮组及胰岛素联合罗格列酮组与胰岛素组比较有统计学意义(P《0.01),而罗格列酮组及胰岛素联合罗格列酮组之间比较差异无统计学意义(P》0.05).结论 本研究表明罗格列酮有助于诱导β细胞功能的恢复,这种作用与纠正葡萄糖毒性作用无关.     

The effect of repaglinide on blood glucose and islet β-cell function in newly diagnosed type 2 diabetic patients

Objective To explore the effect of repaglinide intensive treatment on islet β-cell function and long-term control of blood glucose in newly diagnosed type 2 diabetic patients. Methods Self-control and inter-group control prospective study was conducted in 80 newly diagnosed type 2 diabetic patients who were treated with short-term repaglinide intensive treatment and islet β-cell function was assessed by 75 g oral glucose tolerance test (OGTT) before and after repaglinide treatment. The changes of △I30/△G30 ratio, blood lipid, HOMA A and HOMA B were examined. Results After treatment, in successful group, middle group and defeat group, the fasting plasma glucose levels were decreased from 8.9±1.5, 8.6±1.6,9.0±2.0 to 5.0±1.4,6.3±0. 7,6.5±0. 9 mmol/L, 0. 5 h postprandial glucose levels were decreased from (12.6±1.6, 12.6±1.5, 12.4±1.3 to 8.4±1.0, 6.8±0. 7, 8. 6±0. 9)mmol/L,and 2 h postprandial glucose levels were decreased from (13.0±1.2, 13. 1±1.3, 13. 3±1.4 to 9.2±0.9, 6.6±0. 7, 9.2±0. 9)mmol/L,respectively (all P <0. 005). The ratio of △I30/△G30 was increased froml. 69±0. 31, 1.72±0. 33, 1.79±0. 36 to 4. 47±0. 62, 4. 42±0.46,12. 00±0.46 in the three groups, respectively (P<0.05). HOMA B was significantly improved (P<0. 05), while triglycerides and HOMA A were decreased(P<0. 05). The levels of fasting blood glucose and postprandial blood glucose in 21 patients were maintained within normal range for more than six months. There were significant differences in the ratio of △I30/△G30, age, repaglinide dosage and the time of reaching target of glucose [4.47±0.62 vs. 2. 0± 0.46; 39±8 vs. 56±9; 2.0±1.5 vs. 5.0±2.5; 32.4±8.0 vs. 53.3±7.6; all P<0.05] between successful group and defeat group. Conclusions The short-term intensive treatment with repaglinide can significantly improve the early secretion phase of insulin and the islet β-cell function, reconstruct of the physiological model of insulin secretion and relieve the disease.