门冬胰岛素与人普通胰岛素及胰岛素泵在2 型糖尿病患者围手术期 的疗效比较

目的:探讨速效胰岛素类似物(门冬胰岛素,诺和锐)与人普通胰岛素(诺和灵R)及胰岛素泵在2型糖尿病(T2DM)围手术期治疗中的有效性和安全性。方法:158例围手术期T2DM患者随机分为胰岛素泵输注门冬胰岛素治疗CSII组52例,门冬胰岛素多次皮下注射治疗MSII(A)组56例,人普通胰岛素多次皮下注射治疗MSII(B)组50例。观察各组患者治疗前后空腹和餐后2h血糖变化、血糖达标时间、胰岛素用量、低血糖发生率及术后并发症发生率。结果:3组治疗后血糖均明显低于治疗前,CSII组治疗后血糖低于MSII(A)组(P<0.05),MSII(A)组治疗后血糖低于MSII(B)组(P<0.05);术后并发症CSII组低于MSII(A)组(P<0.05),MSII(A)组低于MSII(B)组(P<0.05)。结论:门冬胰岛素对T2DM围手术期血糖控制有较好的有效性、安全性和顺应性,胰岛素泵是2型糖尿病患者围手术期胰岛素输注的最佳模式。     

甘精胰岛素联用瑞格列奈治疗初诊2型糖尿病的疗效研究

目的:通过甘精胰岛素联用瑞格列奈与预混人工合成胰岛素(诺和灵30R)治疗初诊2型糖尿病患者的比较,探讨其疗效与安全性.方法:将初诊2型糖尿病患者随机分为甘精胰岛素+瑞格列奈组(A组)和诺和灵30R组(B组),根据血糖情况调整用药剂量.治疗12周后,比较两组的空腹血糖、餐后2小时血糖、糖化血红蛋白(HbA1c)、体重指数(BMI)和低血糖发生率.结果:A组低血糖事件明显少于B组,在餐后2小时血糖方面也优于B组,差异有统计学意义(P<0.05);在空腹血糖、HbA1c和BMI方面差异无统计学意义(p0.05).结论:甘精胰岛素与瑞格列奈联用对于初诊2型糖尿病患者,其血糖控制满意,餐后血糖更加平稳,低血糖发生率低,是一种针对初诊2型糖尿病患者安全、有效、方便的治疗方案.     

门冬胰岛素与人普通胰岛素及胰岛素泵在2型糖尿病患者围手术期的疗效比较

目的：探讨速效胰岛素类似物（门冬胰岛素,诺和锐）与人普通胰岛素（诺和灵R）及胰岛素泵在2型糖尿病（T2DM）围手术期治疗中的有效性和安全性。方法：158例围手术期T2DM患者随机分为胰岛素泵输注门冬胰岛素治疗CSII组52例,门冬胰岛素多次皮下注射治疗MSII（A）组56例,人普通胰岛素多次皮下注射治疗MSII（B）组50例。观察各组患者治疗前后空腹和餐后2h血糖变化、血糖迭标时间、胰岛素用量、低血糖发生率及术后并发症发生率。结果：3组治疗后血糖均明显低于抬疗前,CSII组治疗后血糖低于MSII（A）组（P〈o．05）,MSII（A）组治疗后血糖低于MSII（B）组（P〈0．05）;术后并发症CSII组低于MSII（A）组（P〈0．05）,MSII㈧组低于MSII（B）组（P〈0．05）。结论：门冬胰岛素对T2DM围手术期血糖控制有较好的有效性、安全性和顺应性,胰岛素泵是2型糖尿病患者围手术期胰岛素输注的最佳模式。     

胰岛素不同给药方式对妊娠期糖尿病患者围手术期血糖控制的效果研究

目的:研究胰岛素不同给药方式对妊娠期糖尿病患者围手术期血糖控制的效果与安全性。方法:选择2013年11月～2016年11月于我院接受治疗的92例妊娠期糖尿病患者,所有患者按随机数字表法分为对照组和研究组,每组46例。对照组围手术期予以皮下注射胰岛素治疗,研究组围手术期予以胰岛素泵治疗。比较两组空腹血糖(FBG),餐后2 h血糖(2hPBG),血糖达标情况,抗生素使用情况,切口愈合情况、住院时间及并发症的发生情况。结果:治疗后12 h、24 h及36 h,两组FBG、2hPBG水平均较治疗前显著下降,且研究组以上指标均低于对照组(P0.05)。研究组血糖达标、抗生素使用、切口愈合及住院时间均明显短于对照组(P0.05)。两组均有低血糖、切口感染发生,研究组并发症发生率低于对照组(P0.05)。结论:胰岛素泵输注胰岛素对妊娠期糖尿病患者围手术血糖的控制效果明显优于皮下注射胰岛素,且其安全性更高。     

门冬胰岛素联合地特胰岛素对2型糖尿病强化治疗的疗效评价

目的:探讨地特胰岛素联合门冬胰岛素与生物合成人胰岛素注射液R对2型糖尿病强化治疗的疗效.方法:回顾性分析近年来我院住院治疗的180例2型糖尿病患者的临床资料,随机分为两组,每组90例,观察组予门冬胰岛素联合地特胰岛素治疗,对照组予生物合成人胰岛素注射液R治疗,记录并分析两组治疗前后空腹血糖(FPG)、餐后2小时血糖(2h-PPG)、血糖达标时间、达标时胰岛素用量及低血糖发生情况.结果:观察组较对照组患者在治疗前后糖化血红蛋白值、空腹血糖值都有所降低,血糖达标时间(d),胰岛素日用量(U/kg*d)及低血糖发生率(次/人)都有所减少,疗前后Homa-IR有所降低,Homa-β及体重有所增加,两组患者在治疗后糖尿病并发症都有所好转,观察组较对照组改善情况更优,但无显著性差异;其中对照组较观察组在糖化血红蛋白值、空腹血糖值上的比较中无显著差异.结论:门冬胰岛素联合地特胰岛素较生物合成人胰岛素注射液R强化治疗2型糖尿病患者与疗效接近,但起效迅速,持续时间久,低血糖反应少,胰岛素用量低.     

持续皮下胰岛素注射对2型糖尿病合并肺部感染患者的疗效分析

目的:分析持续皮下注射胰岛素对2型糖尿病(T2DM)合并肺部感染患者的临床疗效。方法:将我院2010年6月至2013年6月收治的86例2型糖尿病合并肺部感染患者随机分为2组,分别采用胰岛素泵持续皮下注射(治疗组)和多次皮下注射胰岛素(对照组),观察患者血糖指标、血糖达标时间、低血糖发生率及肺部感染治愈率情况。结果:治疗后,两组患者的血糖均得到控制,治疗组的血糖指标变化、血糖达标时间及住院时间均优于对照组,差异均有统计学意义(均P0.05)。治疗组的低血糖发生率明显低于对照组,而肺部感染治愈率显著高于对照组,差异均有统计学意义(均P0.05)。结论:胰岛素泵持续皮下胰岛素注射在治疗2型糖尿病合并肺部感染患者中使用,血糖达标迅速,降低低血糖发生率,缩短住院时间,提高感染治愈率,临床效果好。     

持续皮下输注赖脯胰岛素治疗老年非初诊2 型糖尿病患者临床观察

目的:观察比较持续皮下输注赖脯胰岛素与常规注射预混赖脯胰岛素对老年非初诊2型糖尿病患者的疗效与安全性。方法:将58例老年2型糖尿病患者随机分为观察组(29例)与对照组(29例),观察组用赖脯胰岛素经胰岛素泵持续皮下输注(CSI-I),对照组用精蛋白锌重组赖脯胰岛素25注射液,2次/d,常规皮下注射。两组患者均给予糖尿病教育、饮食控制及适量运动,共治疗2周。比较治疗前后两组患者的血糖、胰岛素用量、血糖达标时间以及低血糖发生率。结果:治疗后两组患者空腹血糖、餐后血糖均较治疗前下降(P<0.05),观察组血糖达标时间、胰岛素用量均明显低于对照组(P<0.05)。两组低血糖发生率无明显差异。结论:持续皮下输注赖脯胰岛素具有较好的疗效与安全性,是控制老年非初诊2型糖尿病患者较佳的方法。     

持续皮下输注赖脯胰岛素治疗老年非初诊2型糖尿病患者临床观察

目的：观察比较持续皮下输注赖脯胰岛素与常规注射预混赖脯胰岛素对老年非初诊2型糖尿病患者的疗效与安全性。方法：将58例老年2型糖尿病患者随机分为观察组（29例）与对照组（29例）,观察组用赖脯胰岛素经胰岛素泵持续皮下输注（CSI-I）,对照组用精蛋白锌重组赖脯胰岛素25注射液,2次／d,常规皮下注射。两组患者均给予糖尿病教育、饮食控制及适量运动,共治疗2周。比较治疗前后两组患者的血糖、胰岛素用量、血糖达标时间以及低血糖发生率。结果：治疗后两组患者空腹血糖、餐后血糖均较治疗前下降（P〈0．05）,观察组血糖达标时间、胰岛素用量均明显低于对照组（P〈0．05）。两组低血糖发生率无明显差异。结论：持续皮下输注赖脯胰岛素具有较好的疗效与安全性,是控制老年非初诊2型糖尿病患者较佳的方法。     

短期胰岛素泵强化治疗糖尿病的临床疗效观察

目的 观察比较短期应用胰岛素泵连续皮下输注(CSII)和多次皮下胰岛素注射治疗(MSII)糖尿病患者的疗效.方法 156例糖尿病患者随机分为CSII组和MSII组,分析比较两组血糖控制达标所需时间、胰岛素量及低血糖的发生率.结果 CSII组血糖达标所需时间、胰岛索量、低血糖发生率明显低于MSII组,差异具有统计学意义(P<0.01).结论 短期胰岛索泵强化治疗能较好模拟胰岛素分泌的生理节律,更快、更有效地控制高血糖,明显缩短血糖达标所需时间,减少血糖波动和低血糖的发生.     

低血糖与2型糖尿病

糖尿病（DM）是一种慢性终身性疾病,目前已成为严重威胁人类健康的世界性公共卫生问题,2型糖尿病患者也逐渐增加。流行病学调查显示,目前全球大约有近2亿糖尿病患者,其中2型糖尿病占90%～95%。2型糖尿病发病机理是胰岛素分泌的相对或绝对不足伴有或不伴有胰岛素抵抗,持续的高血糖可严重抑制胰岛功能。严格的血糖控制能够延缓糖尿病慢性并发症的发生和发展,延长了患者的预期寿命。但是随着血糖控制达标,发生低血糖的危险性增加了,低血糖不仅严重阻碍了良好血糖控制,而且严重低血糖还是2型糖尿病致死、致残的重要原因。本文探讨2型糖尿病患者治疗中低血糖发生的原因、诱发因素以及可能的解决方案。     

Scurvy in capybaras bred in captivity in Argentine

In order to determine if the absence of vitamin C in the diet of capybaras (Hydrochoerus hydrochaeris) causes scurvy, a group of seven young individuals were fed food pellets without ascorbic acid, while another group of eight individuals received the same food with 1 g of ascorbic acid per animal per day. Animals in the first group developed signs of scurvy-like gingivitis, breaking of the incisors and death of one animal. Clinical signs appeared between 25 and 104 days from the beginning of the trial in all individuals. Growth rates of individuals deprived of vitamin C was considerably less than those observed in the control group. Deficiency of ascorbic acid had a severe effect on reproduction of another population of captive capybaras. We found that the decrease in ascorbic acid content in the diet affected pregnancy, especially during the first stages. The results obtained suggest that it is necessary to supply a suitable quantity of vitamin C in the diet of this species in captivity.     

Changes in lactate dehydrogenase activity in chicken tissues in hyperthyreosis in ontogenesis

The lactate dehydrogenase activity in reactions of lactate oxidation and synthesis was studied in subfractions of the chicken brain, heart and liver at the embryonal, early postembryonal and adult stages of development after thyroxine administration. It has been shown that during embryogenesis thyroxine predominantly enhanced the rate of lactate oxidation in the mitochondrial tissues. A marked increase in the lactate synthesis was found in cytoplasm of the adult chicken tissues. Specificity of enzyme activity alterations was detected in the chicken brain during ontogenesis after thyroxine administration.     

Role for dopamine in malonate-induced damage in vivo in striatum and in vitro in mesencephalic cultures

Defects in mitochondrial energy metabolism have been implicated in the pathology of several neurodegenerative disorders. In addition, the reactive metabolites generated from the metabolism and oxidation of the neurotransmitter dopamine (DA) are thought to contribute to the damage to neurons of the basal ganglia. We have previously demonstrated that infusions of the metabolic inhibitor malonate into the striata of mice or rats produce degeneration of DA nerve terminals. In the present studies, we demonstrate that an intrastriatal infusion of malonate induces a substantial increase in DA efflux in awake, behaving mice as measured by in vivo microdialysis. Furthermore, pretreatment of mice with tetrabenazine (TBZ) or the TBZ analogue Ro 4-1284 (Ro-4), compounds that reversibly inhibit the vesicular storage of DA, attenuates the malonate-induced DA efflux as well as the damage to DA nerve terminals. Consistent with these findings, the damage to both DA and GABA neurons in mesencephalic cultures by malonate exposure was attenuated by pretreatment with TBZ or Ro-4. Treatment with these compounds did not affect the formation of free radicals or the inhibition of oxidative phosphorylation resulting from malonate exposure alone. Our data suggest that DA plays an important role in the neurotoxicity produced by malonate. These findings provide direct evidence that inhibition of succinate dehydrogenase causes an increase in extracellular DA levels and indicate that bioenergetic defects may contribute to the pathogenesis of chronic neurodegenerative diseases through a mechanism involving DA.     

SSTR5 ablation in islet results in alterations in glucose homeostasis in mice

Somatostatin (SST) peptide is a potent inhibitor of insulin secretion and its effect is mediated via somatostatin receptor 5 (SSTR5) in the endocrine pancreas. To investigate the consequences of gene ablation of SSTR5 in the mouse pancreas, we have generated a mouse model in which the SSTR5 gene was specifically knocked down in the pancreatic beta cells (betaSSTR5Kd) using the Cre-lox system. Immunohistochemistry analysis showed that SSTR5 gene expression was absent in beta cells at three months of age. At the time of gene ablation, betaSSTR5Kd mice demonstrated glucose intolerance with lack of insulin response and significantly reduced serum insulin levels. Insulin tolerance test demonstrated a significant increase of insulin clearance in vivo at the same age. In vitro studies demonstrated an absence of response to SST-28 stimulation in the betaSSTR5Kd mouse islet, which was associated with a significantly reduced SST expression level in betaSSTR5Kd mice pancreata. In addition, betaSSTR5Kd mice had significantly reduced serum glucose levels and increased serum insulin levels at 12 months of age. Glucose tolerance test at an older age also indicated a persistently higher insulin level in betaSSTR5Kd mice. Further studies of betaSSTR5Kd mice had revealed elevated serum C-peptide levels at both 3 and 12 months of age, suggesting that these mice are capable of producing and releasing insulin to the periphery. These results support the hypothesis that SSTR5 plays a pivotal role in the regulation of insulin secretion in the mouse pancreas.     

我国葫芦科植物离体培养研究进展

葫芦科植物包括多种瓜类蔬菜,对其进行离体培养研究具有重要的理论和实践意义。综述了国内在葫芦科植物器官培养、体细胞胚胎发生、花药培养、原生质体培养和体细胞杂交及离体遗传转化等方面取得的研究进展,并对葫芦科植物离体培养、遗传转化与育种的前景作了展望。