广西地区2型糖尿病患者直接卫生费用研究

目的分析广西地区近8年2型糖尿病患者的住院费用情况。方法收集广西医科大学第一附属医院2004年4月~2011年12月出院的2型糖尿病患者的病案资料,按有无并发症分为无并发症组2050例,有并发症组4795例,用两样本比较的秩和检验比较两组住院费用的差异。按并发症个数将有并发症组分为3个亚组,即B组（1个并发症组2478例）、C组（2个并发症1444例）、D组（3个及3个以上并发症组873例）,用多个样本比较Kruskal-Wallis H检验,组间比较用扩增t检验。按有无大血管病变将患者分为2型糖尿病无大血管病变组5711例,2型糖尿病并大血管病变组1134例,采用秩和检验比较两组住院费用的差异。结果 2型糖尿病患者中位住院费用为7009.55元;无并发症组的中位住院费用为5702.2元,有并发症组的中位住院费用为7726.65元;1个并发症组中位住院费用为6999.89元,2个并发症组的中位住院费用为8060.78元,3个及3个以上并发症组中位住院费用为10396.24元;2型糖尿病无大血管病变中位住院费用为6525.84元,2型糖尿病并大血管病变中位住院费用为11215.13元。结论有并发症较无并发症住院费用更高,有大血管病变较无大血管病变的2型糖尿病费用更高,并发症个数越多,费用越高。     

New potentials for 3-hydroxy-3-methyl-glutaryl-coenzymeA reductase inhibitors: Possible applications in retarding diabetic complications

The prevalence of diabetes mellitus is increasing all over the world and it is apparent that treatment of diabetic complications has the same importance as primary diabetes treatment and glycemic control. Diabetic complications occur as a result of prolonged hyperglycemia and its consequences, such as advanced glycation end products and reactive oxygen species. Impairment of lipid profile is also contributed to worsening diabetic complications. Therefore, it seems that the application of lipid-lowering agents may have positive effects on reversing diabetic complications besides glycemic control. Statins, a group of lipid-lowering compounds, have been shown to exert antioxidant, immunomodulatory, anti-inflammatory, and antiproliferative properties beyond their lipid-lowering effects. Furthermore, they have been reported to improve diabetic complications with different pathways. In this review, we will discuss the clinical importance, molecular biology of the most important microvascular/macrovascular diabetic complications, possible application of statins and their mechanism of action in retarding these complications.     

Nasal surgery complications

This study examines the incidence of serious complications in nasal surgery and discusses the diagnosis and management of these complications. The authors review 259 consecutive cases performed between January 1, 1983, and August 31, 1988. One-hundred and ninety-five patients had septorhinoplasties, 29 had septoplasties, and 35 had rhinoplasties. Thirteen of these cases involved serious complications as follows: hemorrhage (5), perforation (4), infections (3), and pneumocephalus (1). All the patients with these serious complications had associated septal and/or turbinate surgery. The diagnosis and management of these complications will be discussed. In this small series of nasal surgery patients, the incidence of serious complications was 5.0 percent, with no fatalities reported. The higher incidence of serious complications occurred when associated septal and/or turbinate surgery was required. Awareness of these complications is essential because of the increasing number of patients presenting to plastic surgeons for nasal surgery in whom associated septal and/or turbinate surgery is necessary.     

脂肪因子Chemerin与妊娠相关疾病的关系展望

<正>1 Introduction Recurrent pregnant loss,gestational diabetes,premature delivery,intrauterine growth restriction,preeclampsia and other pregnancy-related complications have severe impact on the fetus development and the health and life quality of the mother.These diseases are also causes of unstability and huge economic burden for the family as well as the     

腹腔镜术中二氧化碳异常弥散所致并发症

气腹是腹腔镜手术顺利进行的重要条件,二氧化碳(CO2)是气腹时最常用的气体。然而,腹腔镜手术除可引起开放式手术类似的并发症外,尚可引起腹腔镜技术相关的并发症。临床医生应当充分重视并及时处理各种并发症。这些并发症中以CO2异常弥散引起的并发症较为常见,且症状较严重。该类并发症主要包括CO2气体栓塞、气肿和气胸等,本文将就此进行综述。     

Prevention of complications of smallpox vaccination]

In observance of the rules of vaccination and unfavourable anamnesis in the vaccinated serve as the main causes of postvaccinal complications (30 and 22%, respectively). The great majority of complications occurs at the age of 1 to 3 years (76%). In 94% of cases complications are recorded in primarily vaccinated individuals. Solution of such problems as introduction into wide practice of sparing methods of immunization and special scheme of preliminary preparation to the vaccination of weak children and those with conditioned contraindications is necessary for the purpose of prevention of complications; a possibility of using, along with gamma-globulin, of synthetic preparations, and of subjecting older children to primary vaccination for prevention of complications is discussed.     

Sequelae after AF ablation: Efficacy and Safety go Hand in Hand

Although nowadays performed on a routine basis, catheter ablation of atrial fibrillation is associated with the potential for major complications. Improving the safety remains therefore an important challenge. This article summarizes the different types of complications associated with AF ablation grouping them into clinically overt major complications, subclinical injury and permanent injury. Furthermore, it describes the potential predictors for complications and highlights the dynamic interplay between efficacy and safety.     

两种途径介入治疗急性心肌梗塞疗效分析

目的：探讨对急性心梗患者行不同途径急诊经皮冠状动脉治疗（PCi）的临床疗效及预后。方法：选取我院自2011年1月至2012年12月收治的75例sT段抬高的急性心肌梗死患者作为研究对象进行回顾性调查,对比分析经桡动脉PCI（TRA—Pet）和经股动脉PCI（TFA—PCI）两组治疗疗效及出现并发症情况,包括比较两组穿刺成功率,手术时间,术中出血及术后局部及其他并发症等方面,并作统计分析,取P〈0．05为有统计学意义。结果：两组穿刺成功率及PCI手术成功率差异无统计学意义,P〉0．05。在手术操作时间上,TFA—PCI组明显长于TRA—PCI组,差异有统计学意义,P〈0．05。TFA．PCI组局部并发症发生率为11．8％．远期并发症为2．9％。TRA-PCI组局部并发症发生率为2．4％,远期并发症为7．3％,两组差别显著,P〈0．05。结论：TRA—PCI和TFA—PCI在手术时间及术后并发症上有差异,TRA—PCI术中花时间较少,术后局部并发症要轻,值得在临床上推广,但是由于有远期并发症的危险,故术后应加强肝肾功能等的监测。     

Advanced glycation end-products and the progress of diabetic vascular complications

Epidemiological studies have confirmed that hyperglycemia is the most important factor in the onset and progress of vascular complications, both in Type 1 and 2 diabetes mellitus. The formation of advanced glycation end-products (AGEs) correlates with glycemic control. The AGE hypothesis proposes that accelerated chemical modification of proteins by glucose during hyperglycemia contributes to the pathogenesis of diabetic complications including nephropathy, retinopathy, neuropathy and atherosclerosis. Recent studies have shown that increased formation of serum AGEs exists in diabetic children and adolescents with or without vascular complications. Furthermore, the presence of diabetic complications in children correlates with elevated serum AGEs. The level of serum AGEs could be considered as a marker of later developments of vascular complications in children with Type 1 and 2 diabetes mellitus. The careful metabolic monitoring of young diabetics together with monitoring of serum AGEs can provide useful information about impending AGE-related diabetic complications. It is becoming clear that anti-AGE strategies may play an important role in the treatment of young and older diabetic patients. Several potential drug candidates such as AGE inhibitors have been reported recently.     

Complications of Oriental blepharoplasty

The complications of Oriental blepharoplasty are described according to their clinical appearance and anatomic findings at the time of surgery. The surgical correction of these complications is presented. A total of 42 patients with complications following blepharoplasty were treated. The types of deformities were categorized from their external appearance as asymmetry, retraction and ectropion, blepharoptosis, supratarsal depression, fading of the lid fold, and hemorrhage. The causes of each type of complication are identified according to the intraoperative findings, and the correlation between preoperative and intraoperative findings is explained. Correction of these complications follows identified guidelines, and the results were good to satisfactory.     

183例早产儿围产期高危因素及并发症分析

目的：探讨早产儿发生的围产期高危因素及并发症。方法：收集我院2006．1—2009．12出生的早产儿183例的临床资料,总结其早产的相关围产期高危因素及并发症。结果：胎膜早破、多胎妊娠、妊娠高血压综合征是早产发生的主要原因;早产儿的主要并发症为肺炎和颅内出血等。结论：加强围生期保健,早期干预各种围产期高危因素,积极防治早产儿各种并发症,是提高早产儿存活率降低致残率的关键。     

Assessment of post extraction complications in Indians

Extraction is one of the commonest procedures in dentistry. Therefore, it is of interest to evaluate the post extraction complications in patients undergoing extractions of permanent teeth. A total of 70 adult patients who had undergone dental extractions and presented with post -operative complications were included in the study and evaluated. Data collected was statistically analyzed using SPSS software and results obtained. Most of the patients with post extraction complications were in the age group of 31-40 years (21.6%), followed by 21-30 (20.2%) and 61-70 years (20.2%). Dry socket (39.19%) was the common post extraction complication in our study especially in the age group of 31-40 years. There was a statistically significant association between age of the patients and the post extraction complications (p<0.001). In our study, post extraction complications were commonly observed in age group of 31-40 years with a predilection for males. Dry socket was the most common post extraction complication. Age of the patient has a significant effect on post extraction complications. However, gender, smoking habits and systemic diseases have no influence on post extraction complications.     

AMPK in microvascular complications of diabetes and the beneficial effects of AMPK activators from plants

BackgroundDiabetes mellitus is a multifactorial disorder with the risk of micro- and macro-vascular complications. High glucose-induced derangements in metabolic pathways are primarily associated with the initiation and progression of secondary complications namely, diabetic nephropathy, neuropathy, and retinopathy. Adenosine monophosphate-activated protein kinase (AMPK) has emerged as an attractive therapeutic target to treat various metabolic disorders including diabetes mellitus. It is a master metabolic regulator that helps in maintaining cellular energy homeostasis by promoting ATP-generating catabolic pathways and inhibiting ATP-consuming anabolic pathways. Numerous pharmacological and plant-derived bioactive compounds that increase AMP-activated protein kinase activation has shown beneficial effects by mitigating secondary complications namely retinopathy, nephropathy, and neuropathy.PurposeThe purpose of this review is to highlight current knowledge on the role of AMPK and its activators from plant origin in diabetic microvascular complications.MethodsSearch engines such as Google Scholar, PubMed, Science Direct and Web of Science are used to extract papers using relevant key words. Papers mainly focusing on the role of AMPK and AMPK activators from plant origin in diabetic nephropathy, retinopathy, and neuropathy was chosen to be highlighted.ResultsAccording to results, decrease in AMPK activation during diabetes play a causative role in the pathogenesis of diabetic microvascular complications. Some of the plant-derived bioactive compounds were beneficial in restoring AMPK activity and ameliorating diabetic microvascular complications.ConclusionAMPK activators from plant origin are beneficial in mitigating diabetic microvascular complications. These pieces of evidence will be helpful in the development of AMPK-centric therapies to mitigate diabetic microvascular complications.     

Relationship between Neutrophins and Gut Microbiome in Various Metabolic Types of Obesity

Journal of Evolutionary Biochemistry and Physiology - Obesity is associated with a gut microbiome imbalance and the risk of neurological complications. However, the risk of complications is...     

Skin fluorescence as a clinical tool for non-invasive assessment of advanced glycation and long-term complications of diabetes

Glycation is important in the development of complications of diabetes mellitus and may have a central role in the well-described glycaemic memory effect in developing these complications. Skin fluorescence has emerged over the last decade as a non-invasive method for assessing accumulation of advanced glycation endproducts. Skin fluorescence is independently related to micro- and macrovascular complications in both type 1 and type 2 diabetes mellitus and is associated with mortality in type 2 diabetes. The relation between skin fluorescence and cardiovascular disease also extends to other conditions with increased tissue AGE levels, such as renal failure. Besides cardiovascular complications, skin fluorescence has been associated, more recently, with other prevalent conditions in diabetes, such as brain atrophy and depression. Furthermore, skin fluorescence is related to past long-term glycaemic control and clinical markers of cardiovascular disease. This review will discuss the technique of skin fluorescence, its validation as a marker of tissue AGE accumulation, and its use as a clinical tool for the prediction of long-term complications in diabetes mellitus.     

Complications in surgery: root cause analysis and preventive measures

Patients expect to receive quality medical care by relying on the concepts of evidence-based medicine. This quality care is expected to be provided at decreased costs for payors, some of whom have stopped reimbursement for cases involving "reasonably preventable" surgical complications. The purpose of this article is to introduce root cause analysis as a tool for identifying the causes of surgical complications. The authors also discuss preventive measures, such as improved communication, checklists, reporting systems, and the use of evidence-based medicine, that have been implemented to decrease surgical complications. These preventive measures can be used alone or together to decrease complications and improve overall patient care.     

Nrf2及其药理性活化剂在糖尿病心血管并发症中的作用

糖尿病(DM)导致的心脑血管并发症是危害人类健康的重大疾病。氧化应激被认为是DM相关心血管并发症发生、发展的重要机制,但通过补充外源性抗氧化剂并未能使心血管疾病患者远期获益。核因子E2相关因子2(Nrf2)可增加内源性抗氧化酶的活性从而提高机体的抗氧化应激能力,可能是治疗糖尿病心血管并发症的一个重要靶点,提示靶向Nrf2药物的开发可能获得防治糖尿病相关血管并发症的新一代药物。本文就Nrf2在糖尿病相关心血管并发症发生、发展中的作用及其药理性活化剂对糖尿病(DM)相关心血管病变的治疗作用进行综述。     

Proton-pump inhibitors are associated with a reduced risk for bleeding and perforated gastroduodenal ulcers attributable to non-steroidal anti-inflammatory drugs: a nested case-control study

Treatment with non-steroidal anti-inflammatory drugs (NSAIDs) is hampered by gastrointestinal ulcer complications, such as ulcer bleeding and perforation. The efficacy of proton-pump inhibitors in the primary prevention of ulcer complications arising from the use of NSAIDs remains unproven. Selective cyclooxygenase-2 (COX-2) inhibitors reduce the risk for ulcer complications, but not completely in high-risk patients. This study determines which patients are especially at risk for NSAID ulcer complications and investigates the effectiveness of different preventive strategies in daily clinical practice. With the use of a nested case-control design, a large cohort of NSAID users was followed for 26 months. Cases were patients with NSAID ulcer complications necessitating hospitalisation; matched controls were selected from the remaining cohort of NSAID users who did not have NSAID ulcer complications. During the observational period, 104 incident cases were identified from a cohort of 51,903 NSAID users with 10,402 patient years of NSAID exposure (incidence 1% per year of NSAID use, age at diagnosis 70.4 ± 16.7 years (mean ± SD), 55.8% women), and 284 matched controls. Cases were characterised by serious, especially cardiovascular, co-morbidity. In-hospital mortality associated with NSAID ulcer complications was 10.6% (incidence 21.2 per 100,000 NSAID users). Concomitant proton-pump inhibitors (but not selective COX-2 inhibitors) were associated with a reduced risk for NSAID ulcer complications (the adjusted odds ratio 0.33; 95% confidence interval 0.17 to 0.67; p = 0.002). Especially at risk for NSAID ulcer complications are elderly patients with cardiovascular co-morbidity. Proton-pump inhibitors are associated with a reduced risk for NSAID ulcer complications.     

The safety of microvascular free tissue transfer in the elderly population

The objective of this study was to evaluate the safety and thus the efficacy of microvascular free tissue transfer in the elderly patient population. Free flaps for different types of reconstructions were analyzed to verify whether free tissue transfer is feasible in the elderly. Between 1993 and 2003, 102 free flaps were performed in 94 patients who were aged 70 years or older. There were 75 male and 19 female patients, with a mean age of 73.8 years (range, 70 to 87 years). Different types of free flaps were performed for head and neck (n = 78), lower extremity (n = 12), and trunk and upper extremity (n = 4) reconstruction. Nine flaps underwent reexploration and four of them were lost, for an overall success rate of 96 percent. Medical complications in the postoperative period were further evaluated. A total of 32 medical complications were seen in 29 patients. Only one patient died because of postoperative complications. The frequency of medical complications was further analyzed in detail. Effects of American Society of Anesthesiologists status, operation time, and age on complication rate were evaluated statistically. Only American Society of Anesthesiologists status was statistically significant for the occurrence of postoperative medical complications; class III and IV patients were at higher risk than class I and II. Neither operation time nor age was predictive of postoperative complications. Microvascular free tissue transfer is a safe and reliable option in the elderly population. The success rate of free flaps is not different from that for other age groups. The rate of postoperative medical complications was 31 percent (29 of 94 patients); most complications were in American Society of Anesthesiologists class III and IV patients.