糖尿病患者拔牙创区微生物分布的临床研究

探讨糖尿病患者拔牙术后创区微生物分布情况 ,为临床防治术后感染提供理论依据。随机选取 3 9例已确诊为糖尿病的拔牙患者 ,在术后即刻采取拔牙创的渗出物 ,按 1 0倍系列稀释 ,培养微生物 ,然后进行分离、纯化和鉴定菌。结果从标本中培养出 1 87株微生物 ,鉴定到属或种 ,共获得 1 1种不同的细菌 ,常见的 7种。研究结果表明 ,糖尿病患者拔牙创区常见微生物依次为链球菌、萘瑟氏菌、梭杆菌、产黑色素拟杆菌、拟杆菌 ,韦荣菌属、二氧化碳嗜纤维菌属等。其中 ,链球菌、萘瑟氏菌为优势菌。     

无创颅内压监测在创伤性急性弥漫性脑肿胀治疗中的临床应用研究

目的:探讨无创颅内压监测(Intracranial pressure,ICP)监测对救治创伤性急性弥漫性脑肿胀(Posttraumatic acute diffuse brains welling,PADBS)患者的辅助作用,为无创ICP检测的临床应用提供参考依据。方法:收集2011年1月至2016年1月我院神经外科收治的114例PADBS患者的临床资料进行回顾性分析,依据纳入与排除标准共取得病例组53例,对照组61例,分别给予采用无创颅内压监测和有创颅内压监测,根据患者资料进行组间比较及生存分析。结果:病例组与对照组不同分型颅内压检测值比较无统计学差异(P0.05);患者48h内进行大骨瓣开颅手术时间的生存分析,病例组中位手术时间为35.6个月,对照组中位DFS为33.5个月,两组患者检测进行手术时间的生存曲线无统计学差异(P0.05);有创ICP检测患者继发性出血率为3.2%,脑脊液感染病况为7.9%;两组患者预后情况差异并无统计学意义(P0.05)。无创ICP检测患者住院天数短于有创ICP检测患者(P0.05)。结论:无创ICP应用于PADBS治疗的临床价值与有创ICP相当,但无创ICP更便捷、创伤小,有利于对患者进行持续性检测。     

结核病合并糖尿病的流行现状及其防控

结核病与糖尿病是目前较为常见和多发的疾病,由于糖尿病患者数量增长迅速,结核病疫情一旦出现,这种交叉的双重负担相互影响。糖尿病引起免疫功能障碍,由此可增加结核易感性;而严重结核病患者,又加速了糖尿病的病程,由此给临床治疗带来极大困难。介绍了结核合并糖尿病的流行现状,总结了两病合并的可能机制、最新检测方法和防控措施,并对两病防控的未来发展方向进行了展望。     

糖尿病肾病患者红细胞免疫及抗氧化状态相关指标的变化研究

目的:研究与分析糖尿病肾病患者红细胞免疫及抗氧化状态相关指标的变化情况。方法:将2015年1月~2016年6月期间于本院进行治疗的66例糖尿病肾病患者设为观察组,同时将66名同龄健康人设为对照组。检测与比较两组同龄者的红细胞免疫及抗氧化状态相关指标,同时比较不同糖尿病肾病分期患者的红细胞免疫及抗氧化状态相关指标水平。结果:观察组的红细胞免疫及抗氧化状态相关指标明显差于对照组,且不同糖尿病肾病分期患者的检测水平也呈现明显差异,P均0.05,检测水平之间均存在显著性差异。结论:糖尿病肾病患者红细胞免疫及抗氧化状态相关指标明显较差,糖尿病分期较高者的检测结果也相对较差,因此应注意对糖尿病肾病患者进行上述方面的改善。     

Fc-Asprosin融合蛋白表达及糖尿病患者血清Asprosin水平检测

Asprosin包含FBN1的羧基端最后两个外显子,是一种快速诱导的新型葡萄糖调控蛋白激素。本研究为了探讨Fc-Asprosin融合蛋白的表达以及Asprosin在糖尿病患者中表达水平,首先利用基因工程手段构建了Fc-Asprosin重组c DNA表达质粒Fc-Asprosin-p TT5,并在HEK293细胞进行了表达、亲和层析纯化和SDS-PAGE鉴定,然后采用Forte BIO Octet检测了Fc-Asprosin融合蛋白与FBN1抗体的结合以及糖尿病患者和对照组血清Asprosin水平。实验结果表明了经过载体构建、表达纯化和SDS-PAGE鉴定成功获得Fc-Asprosin融合蛋白。Forte BIO Octet检测结果表明该融合蛋白与FBN1抗体的结合良好;血清Asprosin水平检测分析表明Asprosin在糖尿病患者胰岛素抗性阴性组的表达量显著地低于糖尿病患者胰岛素抗性阳性组。本研究表明Asprosin的表达水平与胰岛素抗性存在明显的相关性,我们的研究有助于为糖尿病的防治提供新的靶点。     

PLOS ONE:糖尿病会降低睡眠质量

<正>日本大阪市立大学教授稻叶雅章率领的研究小组在新一期美国《科学公共图书馆综合卷》上报告说,他们通过脑电图仪检测,证实糖尿病患者的血糖控制情况恶化,血糖值上升后,睡眠质量也会随之降低。研究人员注意到,日本很多Ⅱ型糖尿病患者都并发睡眠障碍,失眠率是健康人的约2倍。为弄清血糖水平与睡眠障碍的直接关系,研究小组对63名Ⅱ型糖尿病患者进行了研究。     

慢性支气管炎住院患者机械通气的危险因素分析

目的：分析慢性支气管炎住院患者进行辅助机械通气的危险因素。方法：采取回顾性统计分析方法,收集2009-2014 年5 年 中共1746 例慢性支气管炎住院患者的临床资料,应用SPSS 17 软件分组对年龄、性别、肺气肿、慢性肺源性心脏病、肺性脑病、肺 大泡、肺炎、支气管扩张、哮喘、冠心病、高血压病、糖尿病、低蛋白血症、贫血、肝功能异常、肾功能异常等因素进行卡方检验及危 险因素分析。结果：1746 慢性支气管炎患者中,进行辅助机械通气治疗者626 人（无创辅助通气613人、有创辅助通气187 人）,未 进行辅助机械通气治疗者1120人。辅助机械通气治疗者中有439 人单纯行无创辅助通气、13 人单纯行有创辅助通气、174 人为 两种通气方式序贯。统计分析显示：高龄（＞ 65岁）、慢性肺气肿、慢性肺源性心脏病、肺性脑病、糖尿病、低蛋白血症、肝功能异常、 肾功能异常是慢性支气管炎患者行无创辅助通气的危险因素（OR＞1,P<0.05) ;高龄（＞65 岁）、男性、慢性肺源性心脏病、肺性脑 病、肺炎、糖尿病、低蛋白血症、贫血、肝功能异常、肾功能异常是慢性支气管炎患者行有创辅助通气的危险因素（OR＞1,P<0.05)。 结论：高龄、性别以及一些肺内外合并疾病是慢性支气管炎住院患者行辅助通气的危险因素,提示在临床工作中对这一类患者加 强教育、积极控制合并症具有重要的意义。     

2型糖尿病患者检测血脂的临床分析

目的探讨2型糖尿病患者在血脂检测过程中临床上的表现:方法选取2013年1月至2014年12月在我院进行血脂检测的68例2型糖尿病患者作为研究对象,将其定义为观察组,随之选取同期进行血脂检测的68例健康测试者作为对照组,分析两组人员的血脂水平:结果检测结果显示,对照组在TC(总胆固醇)、TG(甘油三酯)、LDL-C(低密度脂蛋白胆固醇)、HDL-C(高密度脂蛋白胆固醇)等血脂指标方面均优于观察组,相比差异具有统计学意义(P0.05):结论对2型糖尿病患者进行血脂检测是非常有必要的,具有较大的实际意义,应被推广使用。     

人类DNA组中与糖尿病相关的基因

糖尿病分为Ⅰ型、Ⅱ型、特异型和妊娠糖尿病四大类糖尿病已成为现代社会的一种高发病,目前我国Ⅱ型糖尿病患者已经超过9400万,发病率居世界首位。为什么现代社会糖尿病患者人数会如此之多呢?近年来随着分子遗传学和分子生物学等新技术的不断发展,人们在人类基因组中发现了与糖尿病发病相关的基因已达60余个。糖尿病是多基因遗传性疾病,但其遗传表型对不同的个体具有很大的易感性差异,糖尿病基因表型的多态性是目前研究的重点和难点。     

Ⅱ型糖尿病易感基因研究的进展

Ⅱ型糖尿病是由基因和环境共同作用所引起的多基因遗传病,随着人类基因组计划的完成和单核苷酸多态性(single-nu-clcotide polymorphisms,SNP)扫描技术的发展,许多SNP位点被证实与Ⅱ型糖尿病相关,因此易感基因的检测是未来糖尿病预防和治疗的关键.本文主要介绍了目前Ⅱ型糖尿病易感基因的检测策略、方法、研究进展及今后的研究方向.     

近红外光谱技术无创测量人体血糖

人体血液中的各种化学成分一直是评价人体健康状况的重要信息,血糖含量是评价糖尿病的重要指标。传统方法需要患者从静脉取血,不仅费时、费钱,取血的麻烦和疼痛更使得大多数糖尿病患者不可能按理论上的要求每天多次监测血糖水平。应用近红外光谱法可以实现对人体血糖水平的元损检测,从而大大提高血糖检测的频度,降低糖尿病人长期并发症的危险性,并且摒弃一次性血糖试纸,使自测血糖的费用降低。     

The Impact of Elevated Blood Glycemic Level of Patients with Type 2 Diabetes Mellitus on the Erythrocyte Membrane: FTIR Study

In developed countries, medical awareness about the disease and how to deal with it is less acknowledged. With diabetes mellitus the situation becomes more serious due to the fact that it affects nearly all parts of the body and may lead to loss of vision. In this study, the variation of blood glucose level of type 2 diabetic patients was considered, and its effect(s) on their blood erythrocyte membranes was studied by Fourier transform infrared spectroscopy. Patients with type 2 diabetes mellitus were classified into two groups with mean fasting blood glucose level of 185 mg/dl (D-185 group) and 285 mg/dl (D-285 group). For comparison, healthy individuals were involved where their mean fasting blood glucose level is 86 mg/dl. Type 2 diabetes mellitus was found to induce change in the lipid and protein components and causing some important structural changes in the protein secondary structure with change in the β-sheet and β-turn structures at D-285 mg/dl group. Erythrocyte membrane disorder was increased associated with restriction in the vibrational motion around the phospholipids interface region.     

Management of diabetes mellitus during surgery.

Patients with diabetes mellitus are subjected to major operations more frequently than those without diabetes. Although many of these operations are done on an elective basis, the perioperative control of blood glucose levels--ranging from 6.7 to 13.3 mmol per liter (120 to 240 mg per dl)--remains a therapeutic challenge. In planning the management, the type of diabetes, current treatment, the degree of recent control, the presence of complications, and the type of surgical procedure must all be considered. All insulin-dependent patients and many non-insulin-dependent ones need insulin therapy perioperatively. The variable stress associated with major procedures such as coronary artery bypass and kidney transplantation makes a flexible insulin regimen desirable, which can be provided using a continuous insulin (regular) infusion system and frequent bedside blood glucose monitoring. Implementing such a regimen facilitates rapid control before an operation and a quick response to blood glucose changes during the procedure and provides a convenient and predictable method of control during the postoperative period.     

Home blood glucose biosensors: a commercial perspective

Twenty years on from a review in the first issue of this journal, this contribution revisits glucose sensing for diabetes with an emphasis on commercial developments in the home blood glucose testing market. Following a brief introduction to the needs of people with diabetes, the review considers defining technologies that have enabled the introduction of commercial products and then reviews the products themselves. Drawing heavily on the performance of actual instruments and publicly available information from the companies themselves, this work is designed to complement more conventional reviews based on papers published in scholarly journals. It focuses on the commercial reality today and the products that we are likely to see in the near future.     

第一滴和第二滴末梢血血糖值差异性的多中心临床研究

目的:本研究旨在探讨在洗手消毒和不洗手消毒两种情况下,第一滴与第二滴末梢血血糖值之间的差异,以及第一滴末梢血血糖值与对照血糖值之间的差异,及此差异对临床治疗决策的影响。方法:研究于2014年5月20日至5月29日在全国四个城市的四家糖尿病专科医院中同步进行,共纳入住院糖尿病患者240例,分别测定洗手消毒以及不洗手不消毒情况下第一滴和第二滴末梢血的血糖值,使用Wilcoxon符号秩和检验方法比较第一滴与第二滴末梢血血糖值及第一滴末梢血与对照血糖值,利用误差栅格分析(Error Grid Analyze,EGA)图分析第一滴与第二滴末梢血血糖值及第一滴末梢血与对照血糖值的一致性。结果:分别获得洗手消毒和不洗手消毒情况下的血糖监测结果 1183对和715对。无论是否洗手消毒,第一滴与第二滴末梢血的血糖值以及第一滴末梢血与对照血糖值之间的差异均具有统计学意义(P值均为0.000)。在洗手消毒和不洗手消毒情况下,第一滴与第二滴末梢血血糖值偏差小于20%的百分比分别为98.6%和97.8%,落于EGA图的A区;第一滴末梢血与对照组血糖值的偏差小于10%的百分比分别为98.2%和97.6%,在EGA图中,落于A区的百分比分别为99.8%和99.6%。结论:在糖尿病的自我管理和临床实践中,无论是否洗手消毒,使用第一滴末梢血进行血糖监测已经足够准确可靠,且更为方便快捷。     

Investigation of the effect of clinically relevant interferents on glucose monitoring using near-infrared spectroscopy

Near infrared spectroscopy (NIR) is a promising technique for continuous blood glucose monitoring for diabetic patients. Four interferents, at physiological concentrations, were introduced to study how the glucose predictions varied with a standard multivariate calibration model. Lactate and ethanol were found to interfere strongly with the glucose predictions unless they were included in the calibration models. Lactate was mistaken for glucose and gave erroneously high glucose predictions, with a dose response of 0.46 mM/mM. The presence of ethanol resulted in too low glucose predictions, with a dose response of −0.43 mM/mM. Acetaminophen, a known interferent in the glucose monitoring devices used for diabetes management today, was not found to be an interferent in NIR spectroscopy, nor was caffeine. Thus, interferents that may appear in high concentrations, such as ethanol and lactate, must be included in the calibration or model building of future NIR-based glucose measurement devices for diabetes monitoring.     

肛周脓肿合并糖尿病64例治疗体会

目的探讨肛周脓肿合并糖尿病的有效治疗方法。方法对64例肛周脓肿合并糖尿病患者给予胰岛素控制血糖,局部切开引流,抗生素治疗,中药坐浴,营养支持对症治疗。结果64例全部治愈,2例复发再次入院,治愈时间26～64d。结论综合降糖、手术、应用抗生素,是治疗肛周脓肿合并糖尿病的有效方法。     

Hyperglycemia-induced insulin resistance in diabetic dyslipidemic Yucatan swine

Hyperglycemia, dyslipidemia, and associated insulin resistance are hallmarks of diabetes mellitus. Purposes of the study reported here were to develop practical methods for assessment of in vivo insulin sensitivity and determine contributions of hyperglycemia and dyslipidemia to insulin resistance in the porcine model of alloxan-induced diabetes mellitus and dyslipidemia. Male Yucatan swine groups were treated for 20 weeks: control (C), high fat-fed (2% cholesterol) hyperlipidemic (H), alloxan-induced diabetic normolipidemic (D), diabetic high fat-fed (diabetic dyslipidemic, DD), and diabetic dyslipidemic treated with the lipid-lowering agent atorvastatin (DDA). Plasma cholesterol concentration increased sixfold in animals of groups H, DD, and DDA, whereas triglyceride concentration increased threefold in animals of group DD only. Diabetics had decreases in glucose tolerance and pancreatic immunostaining for insulin. Use of the gold standard hyperinsulinemic euglycemic clamp procedure indicated that maximal insulin-stimulated glucose uptake was similar to that in humans, but this method was not practical for use in pigs. Instead, a more convenient and valid insulin sensitivity test involving suppression of insulin secretion with somatostatin and a single insulin injection was used. Insulin sensitivity was greatly impaired by anesthesia with isoflurane, but was not affected by use of the anxiolytic agent diazepam. Insulin sensitivity decreased by 75% in diabetics (groups D, DD, DDA), compared with animals of groups C and H, and was inversely related to fasting blood glucose concentration (r = -0.72). Insulin treatment to restore blood glucose values of diabetics (> 250 mg/dl) to near control values (< 100 mg/dl) promptly restored insulin sensitivity to control values. We conclude that hyperglycemia is a major cause of insulin resistance in the porcine model of alloxan-induced diabetes mellitus and dyslipidemia.     

Assessment of type II diabetes mellitus using irregularly sampled measurements with missing data

Diabetes mellitus is one of the leading diseases in the developed world. In order to better regulate blood glucose in a diabetic patient, improved modelling of insulin-glucose dynamics is a key factor in the treatment of diabetes mellitus. In the current work, the insulin-glucose dynamics in type II diabetes mellitus can be modelled by using a stochastic nonlinear state-space model. Estimating the parameters of such a model is difficult as only a few blood glucose and insulin measurements per day are available in a non-clinical setting. Therefore, developing a predictive model of the blood glucose of a person with type II diabetes mellitus is important when the glucose and insulin concentrations are only available at irregular intervals. To overcome these difficulties, we resort to online sequential Monte Carlo (SMC) estimation of states and parameters of the state-space model for type II diabetic patients under various levels of randomly missing clinical data. Our results show that this method is efficient in monitoring and estimating the dynamics of the peripheral glucose, insulin and incretins concentration when 10, 25 and 50 % of the simulated clinical data were randomly removed.     

胰岛素对不同孕期妊娠糖尿病患者血糖水平及妊娠结局的影响

目的:探讨胰岛素对不同孕期妊娠合并糖尿病孕产妇血糖水平及妊娠结局的影响。方法:选择2011年7月-2015年4月在我院接受治疗的妊娠期糖尿病患者200例,均采用胰岛素治疗。检测患者血糖变化、妊娠期并发症的发生情况,并分析孕期对胰岛素治疗效果的影响。结果:治疗后产妇空腹血糖及餐后2 h血糖均低于治疗前,差异具有统计学意义(P0.05);孕期32周的产妇治疗后空腹血糖及餐后2 h血糖均低于孕期≥32周的产妇,差异具有统计学意义(P0.05)。孕期32周的产妇妊娠高血压及产后出血的发生率均低于孕期≥32周的产妇,但早产及剖宫产的发生率高于孕期≥32周的产妇,差异具有统计学意义(P0.05)。结论:胰岛素治疗能够有效控制妊娠期糖尿病产妇的血糖水平,改善妊娠结局,早期干预效果较好。