目的:糖尿病合并肺结核病的临床治疗效果的观察。方法:对我院2004~2008年收治糖尿病合并初治肺结核病56例患者的临床资料进行分析。结果:糖尿病合并初治肺结核病患者病情进展快,症状较重。血糖控制情况明显影响肺结核治疗效果。结论:积极控制血糖是治疗糖尿病合并初治肺结核病的关键。
目的:探讨锝99-亚甲基二膦酸盐(99Tc-MDP,商品名云克)对兔空腹血糖的影响。方法:实验兔30只随机分为99Tc-MDP组,地塞米松组,生理盐水对照组。分别测定给药前,给药后3 d、7 d、14 d、21 d五个不同阶段空腹血糖值。检测结果采用SPSS软件进行方差分析,作均数差异的显著性检验。结果:与生理盐水对照组比较,使用地塞米松14 d后,兔空腹血糖明显升高,且差异具有统计学意义(Plt;0.05)。但99Tc-MDP组血糖无升高,且与生理盐水对照组比较无显著性差异(Pgt;0.05)。结论:地塞米松大剂量使用可导致兔空腹血糖升高,而99Tc-MDP未导致兔空腹血糖升高
Objective To assess the influence of different digestive tract reconstruction on the blood glucose of gastric antral cancer patients with type 2 diabetes. Methods The clinical data of 51 cases of gastric antral cancer with type 2 diabetes treated radical surgery in this hospital from January 2006 to January 2012 were analyzed retrospectively. The patients were divided into three groups according to the different digestive tract reconstruction methods：BillrothⅠ anastomosis group （n=14）， BillrothⅡ anastomosis group （n=28）， and Roux-en-Y anastomosis group （n=9）. The indexes were analyzed and compared among three groups：① The levels of fast blood glucose （FBG） and 2h postprandial blood glucose （PG2h） were detected before operation and on 1 month and 6 months after the operation；② The level of glycated hemoglobin （HbA1c） was detected before operation and 6 months after the operation；③ The diabetes control was observed. Results The FBG and PG2h levels in the BillrothⅠ anastomosis group detected on 1 month and 6 months after the operation were not statistically different from those detected before the operation （P＞0.05）. The FBG and PG2h levels in the BillrothⅡanastomosis group and Roux-en-Y anastomosis group detected on 1 month and 6 months after the operation were significantly lower than those before the operation respectively （P＜0.05）. The FBG and PG2h levels in the BillrothⅡ anastomosis group detected on 1 month and 6 months after the operation were not statistically different from those in the Roux-en-Y anastomosis group respectively （P＞0.05）， but which were markedly lower than those in the BillrothⅠ anastomosis group， the differences were statistically significant （P＜0.05）. The HbA1c levels in the BillrothⅠ anastomosis group detected before the operation and on 6 months after the operation were not statistically different from each other （P＞0.05）. The HbA1c levels in the BillrothⅡ anastomosis group and Roux-en-Y anastomosis group detected on 6 months after the operation were markedly lower than those before the operation and the difference was statistically significant （P＜0.05）. On 6 months after the operation， the HbA1c levels in the BillrothⅡanastomosis group and Roux-en-Y anastomosis group were markedly lower than those in the BillrothⅠ anastomosis group and the differences were statistically significant （P＜0.05）；the HbA1c level was not statistically different between the BillrothⅡ anastomosis group and the Roux-en-Y anastomosis group （P＞0.05）. The total curative effects in the BillrothⅡ anastomosis and Roux-en-Y anastomosis groups were significantly better than those in the BillrothⅠ anastomosis group （P＜0.05）. Conclusion According to our limited clinical data， BillrothⅡ anastomosis and Roux-en-Y anastomosis for gastric antral cancer patients with type 2 diabetes may be the best surgical approach.
目的:比较优泌乐(赖脯胰岛素)与优泌林R(常规人胰岛素)改善餐后2 h血糖波动疗效。方法:报道本院369例糖尿病患者强化治疗。结果:优泌乐治疗组餐后2 h血糖水平及血糖波动均显著降低,且无任何显著性不良事件或持久性低血糖发生.结论:优泌乐能够快速有效控制2型糖尿病患者的餐后血糖,方便患者,顺应性好,获得患者的喜爱。
ObjectiveTo investigate the clinical symptom and risk factors of diabetic seizures. MethodsThe clinical data of 44 patients with diabetes related seizures were analyzed with the clinical classification, blood glucose, Na+, Plasma Osmotic Pressure, HbA1c, EEG, brain MR, and the antiepileptic drugs. Results① Diabetic hyperglycemia (DH) related seizures: among the 28 patients, 17 cases were male patients, 11 cases were female patients. The mean age was 51.3 years old. Simple partial seizure without secondary generalized seizures (12/28, 42.8%) was the most common, 8 patients (8/28, 28.6%) showed complex partial seizure, 8 patients (8/28, 28.6%) showed no obvious focal origin generalized tonic-closure seizures. Patients with poor glycemic control (HbA1c > 9%) had significantly higher risk of generalized seizures (46.7% vs. 7.7 %, P < 0.05) (P < 0.05). ② Diabetic ketoa-cidosis or hypertonic state associated seizures: among the 7 patients, 6 cases were male patients, 1case was female patients. The mean age was 45.7 years old, 2 patients (2/7, 28.6%) had generalized tonic-clonic seizure, 2 patients (2/7, 28.6%) showed status epilepticus, 2 patients (2/7, 28.6%) showed local motor seizure, 1 patient (1/7, 14.2%) showed Jackson seizure. ③ Diabetic hypoglycemia related seizures: among the 9 patients, 7 cases were male patients, 2 cases were female patients. The mean age was 45.3 years old.5 patients showed generalized tonic-clonic seizure (5/9, 55.6%), 3 patients had complex partial seizure (3/9, 33.3%), 1 patients had generalized tonic-closure seizures (1/9, 11.1%). ConclusionSimple partial seizure is the most common in patients with diabetic hyperglycemia related seizures; so as to diabetic hypoglycemia and keto-acidosis, generalized seizures are relatively common. HbA1c can be an important risk factor of seizures for patients with hyperglycemia.
Objective To investigate the effect of glucagon-like peptide-1(GLP-1) on impaired glucose tolerance due to stress postoperatively. Methods The rats were allocated randomly to one of three groups, group Ⅰ was subdivided into group Ⅰg which received an intravenous glucose load (0.5 g/kg glucose), and group Ⅰglp which received the same glucose load with GLP-1 (0.3 nmol/kg) during intravenous glucose tolerance test (IVGTT). Rats in group Ⅱg and group Ⅱglp in group Ⅱ were infused respectively the same intravenous glucose tolerance test as group Ⅰ on the first, third and fifth day after 65% liver resection. And rats in group Ⅲ were injected the same glucose load with GLP-1 (0.45 nmol/kg) during IVGTT on the first day after hepatectomy. The peak glucose levels, glucose levels at 30 minutes and the area under the curve (AUC0-30) were investigated among groups. Results The peak glucose levels, glucose levels at 30 minutes and AUC0-30 were significantly lower in group Ⅰglp than those in group Ⅰg. And the values were significantly higher in group Ⅱg than those in group Ⅰg on the first, third and fifth day after operation. There was no significant difference between group Ⅱglp and group Ⅱg in the peak glucose levels on the first day after liver resection, but the peak glucose levels and AUC0-30 were significantly lower in group Ⅲ than those in group Ⅱg and group Ⅱglp, and the glucose levels at 30 minutes were significantly lower in group Ⅲ than those in group Ⅱg too on the first day. The peak glucose levels were significantly lower in group Ⅱglpthan those in group Ⅱg on the third and fifth postoperative day and in group Ⅱglp on the first day too, and the glucose levels at 30 minutes and AUC0-30 were also significantly lower in group Ⅱglp than those in group Ⅱg, but they were similar between group Ⅱglp and group Ⅰg. Conclusion Glucose intolerance is a feature of stress after hepatectomy, and GLP-1, injected in conjunction with the IVGTT, increased the clearance of glucose. The contribution of GLP-1 to reducing blood glucose was decreased significantly at early phase postoperatively, but its action was enhanced by the way of dosage dependence. The action of GLP-1 was enhanced with the degree of stress reduction and then returned to normal.
【摘要】 目的 探讨颈动脉粥样硬化(CAS)斑块及血脂、血糖(BG)、纤维蛋白原(Fbg)水平与脑梗死的关系。方法 对2007年11月—2008年12月入院的91例脑梗死患者,应用彩色多普勒检测其颈动脉内中膜厚度(IMT)、斑块数和性状,同时检测血脂、血糖、纤维蛋白原水平,并与正常对照组比较。结果 ①与正常对照组比较,脑梗死组IMT明显增厚、CAS斑块检出率、软斑百分比明显增高(Plt;005)。②血清总胆固醇(TC)、低密度脂蛋白(LDL)、BG及Fbg水平脑梗死组明显高于正常对照组(Plt;005);脑梗死有斑块亚组明显高于无斑块亚组(Plt;005)。③脑梗死组IMT与TC、LDL、BG、Fbg水平(r分别为0.32、0.34、0.30、0.36,Plt;005)。结论 脑梗死患者IMT增厚,CAS斑块及软斑发生率高。BG、TC、LDL及Fbg水平增高是脑梗死及CAS斑块发生的危险因素。
ObjectiveTo understand the relation between blood glucose regulating hormones and gastric cancer, so as to provide some new ideas for diagnosis and treatment of gastric cancer. MethodBy reviewing and screening relevant domestic and foreign literatures, the latest researches on the relation between blood glucose regulating hormones and gastric cancer were summarized. ResultsThe insulin, glucagon, adrenaline, growth hormone, and the other blood glucose regulating hormones all played the roles in promoting the occurrence and development of gastric cancer. However, glucocorticoids and somatostatin were protective hormones that maintained gastric homeostasis and inhibited the proliferation of gastric cancer cells. ConclusionBlood glucose regulating hormones play some roles in diagnosis and treatment of gastric cancer, but specific mechanisms such as interaction between blood glucose regulating hormones, role of glucose metabolism in biological behavior of gastric cancer, and effect of blood glucose regulating hormones on oncogene initiation are unclear, so prospective clinical control studies still need to be studied.
ObjectiveTo explore the application effect of the new in-hospital blood glucose management model for patients with stroke and diabetes mellitus during the epidemic of coronavirus disease 2019.MethodsA total of 120 patients with stroke and diabetes mellitus who were admitted to Mianyang Central Hospital and were consulted by the Department of Endocrinology between October 1st 2019 and April 12th 2020 were recruited. Patients who used the traditional consultation model for blood glucose management between October 1st 2019 and January 19th 2020 were classified as the control group (60 cases). Patients who were managed by the virtual ward of remote blood glucose management combined with the video consultation mode between January 20th 2020 and April 12th 2020 were classified as the observation group (60 cases). The basic conditions, the time to reach target blood glucose, the completion time of the consultation, the accuracy of blood glucose related data, the satisfaction rate of the consultation, the rate of reaching target blood glucose, the incidence of hypoglycemia, the blood glucose fluctuation (standard deviation of blood glucose level, maximum blood glucose fluctuation range), the incidence of nosocomial infections, diabetes mellitus diagnosis and treatment related expenses, and average hospitalization expenses of the two groups were compared.ResultsThere was no significant difference in the basic conditions between the two groups of patients (P>0.05). The time to reach target blood glucose [(5.38±2.16) vs. (8.18±2.63) d], completion time ofthe consultation [(4.33±1.51) vs. (17.97±3.23) h], incidence of hypoglycemia (6.67% vs. 21.67%), standard deviation of blood glucose level [(2.16±0.34) vs. (2.52±0.34) mmol/L] and maximum blood glucose fluctuation range [(5.72±1.36) vs. (6.34±1.51) mmol/L] of the observation group were lower than those of the control group, the accuracy rate of blood glucose related data (100.00% vs. 83.33%), satisfaction rate of the consultation (93.33% vs. 73.33%) and rate of reaching target blood glucose (88.33% vs. 70.00%) of the observation group were higher than those of the control group, and the differences were statistically significant (P<0.05). There was no significant difference in the incidence of nosocomial infections, diabetes mellitus diagnosis and treatment related expenses, or average hospitalization expenses between the two groups of patients (P>0.05).ConclusionDuring the epidemic of coronavirus disease 2019, the combined video consultation model of remote blood glucose virtual ward for patients with stroke and diabetes mellitus has a good application effect, which has certain feasibility and clinical promotion value.