缬沙坦联合氨氯地平治疗社区老年原发性高血压合并糖尿病的临床效果及安全性

目的探究在治疗老年性原发性高血压合并糖尿病患者中采用缬沙坦联合氨氯地平治疗的效果以及术后安全性,评估其临床意义,为临床治疗做出指导。方法以天津市滨海新区杭州道街社区卫生服务中心2013年5月—2014年6月间收诊的80例原发性高血压合并糖尿病老年患者的临床资料作为研究对象,按治疗方式不同将患者分成氨氯地平合并缬沙坦组40例(实验组)和单纯缬沙坦组40例(对照组)。测定分析两组患者治疗后情况,包括患者血压水平变化、空腹血糖、饭后2 h血糖以及胰岛素等指标,记录治疗情况。结果治疗后实验组血压水平下降的程度优于对照组(P0.05)。实验组空腹血糖等指标对比对照组均具有显著优势(P0.05)。结论联合氨氯地平缬沙坦治疗高血压合并糖尿病患者在血压下降水平、血糖前后变化水平等方面明显优于单纯使用缬沙坦治疗,不良反应发生率低,值得临床推广使用。     

优质护理在腹股沟疝合并糖尿病围手术期中的效果和体会

目的分析在腹股沟疝合并糖尿病患者的围手术期护理中,优质护理的临床应用价值。方法选取九江市第一人民医院于2014年1月至2015年1月收治的60例腹股沟疝合并糖尿病患者为研究对象,将所选患者随机分为对照组与干预组,对照组患者接受常规围手术期护理,干预组患者则接受优质护理,对比两组患者的术后疼痛情况、住院时间、并发症发生情况。结果干预组患者的术后疼痛程度明显弱于对照组患者,住院时间较短,并发症发生例数明显少于对照组患者,两组患者的数据经对比后差异存在统计学意义(P0.05)。结论在腹股沟疝合并糖尿病患者围手术期临床护理中,优质护理应用效果较好,值得推广。     

两种胰岛素方案治疗门诊初诊2型糖尿病患者的疗效及低血糖发生率比较

目的研究两种胰岛素方案治疗门诊初诊2型糖尿病患者的疗效及低血糖发生率。方法选取孝感市中心医院2013年3月—2014年8月84例门诊初诊2型糖尿病患者,抽签随机分为两组,其中42例采用餐前皮下注射门冬胰岛素治疗记为对照组,剩下42例采用餐前注射门冬胰岛素联合晚间注射甘精胰岛素强化治疗记为观察组。结果两组治疗后血糖相关指标比较无明显差异,不具有统计学意义(P0.05);观察组低血糖率11.90%较对照组30.95%显著较低,具有统计学意义(P0.05)。结论两种胰岛素方案治疗初诊2型糖尿病均较为有效,但早期采用强化治疗方案能有效稳定平衡血糖代谢、预防低血糖发生,可作为临床治疗初诊2型糖尿病的首选参考方法。     

Thermosensitive Microneedles Capable of On Demand Insulin Release for Precise Diabetes Treatment

As a novel painless and minimally invasive transdermal drug delivery method, microneedles have solved the challenges of microbial infection and tissue necrosis associated with multiple subcutaneous injections in patients with diabetes. However, traditional soluble microneedles cannot switch drug release on and off according to the patient's needs during long-term use, which is one of the most critical elements of diabetes treatment. Herein, an insoluble thermosensitive microneedle (ITMN) that can control the release of insulin by adjusting the temperature, enabling the precise treatment of diabetes is designed. Thermosensitive microneedles are produced by in situ photopolymerization of the temperature-sensitive compound N-isopropylacrylamide with the hydrophilic monomer N-vinylpyrrolidone, which is encapsulated with insulin and bound to a mini-heating membrane. ITMN are demonstrated to have good mechanical strength and temperature sensitivity, can release significantly different insulin doses at different temperatures, and effectively regulate blood glucose in type I diabetic mice. Therefore, the ITMN provides a possibility for intelligent and convenient on-demand drug delivery for patients with diabetes, and when combined with blood glucose testing devices, it has the potential to form an integrated and precise closed-loop treatment for diabetes, which is of great importance in diabetes management.     

Bioinspired Platelet-Anchored Electrospun Meshes for Tight Inflammation Manipulation and Chronic Diabetic Wound Healing

Tight manipulation of the initial leukocytes infiltration and macrophages plasticity toward the M2 phenotype remain a challenge for diabetic wound healing. Inspired by the platelet function and platelet–macrophage interaction, a platelet-anchored polylactic acid-b-polyethylene glycol-b-polylactic acid (PLA-PEG-PLA) electrospun dressing is developed for inflammatory modulation and diabetic wounds healing acceleration. PLA-PEG-PLA electrospun meshes encapsulated with thymosin β4 (Tβ4) and CaCl₂ is fabricated with electrospinning, followed by immersion of electrospun mesh in platelet-rich plasma to firmly anchor the platelets. It is demonstrated that the anchored platelets on electrospun mesh can enhance the initial macrophage recruitment and control the Tβ4 release from electrospun meshes to facilitate the macrophages polarization to the M2 phenotype. The inflammatory regulation promotes the expression of vascular endothelial growth factor and the migration of vascular endothelial cells for angiogenesis, resulting in accelerated diabetic wounds healing. Therefore, this work paved a new way to design platelet-inspired electrospun meshes for inflammation manipulation and diabetic wound healing.     

代谢组学数据分析方法及在糖尿病研究中的应用

对NMR波谱数据的统计分析是基于NMR代谢组学研究的关键问题之一. 鉴于NMR波谱信号可以近似为样品中各种成分谱信号的线性叠加,本文将非负矩阵分解(NMF)方法引入基于NMR代谢组学的数据处理中,并与代谢组学中常用的统计方法--主成分分析(PCA)进行比较. 通过NMF和PCA两种方法对健康志愿者与2型糖尿患者血液和尿液的NMR谱图的统计分析,对所获取的特征代谢物进行比较和验证,并探讨了PCA方法可能存在的不足之处及其原因;阐明了NMF方法是基于NMR的代谢组学研究中较理想的数据分析方法. 最后,讨论了基于NMR代谢组学在糖尿病研究中的前景.     

Suppression Of Ages Formation In Spontaneous Diabetic OLETF Rat By Organic Germanium Compound [Poly-trans-(2-carboxyethyl) Germasesquioxane] (Ge-132)

The model rat for the type 2 diabetes mellitus (NIDDM) in human were observed for 72 weeks after birth, administering an organic germanium compound [Bis(2-Carboxyethyl) germasesquioxane, Ge-132] perorally 100 mg/kg/day since 24 weeks old. Clinical examinations were followed throughout the observation period. Blood and urinary glucose in positive control OLETF rats tended to be higher than those treated with Ge-132. At the end of the 72nd week, animals were sacriificed to examine the pathological changes, specifically in pancreas, kidney and brain. Anti-AGE antibody stained proximal and distal tubles and basement membrane of glomerules in kidney, and accumulated AGE masses in cortex, hippocampus and cerebellum of OLETF rat's brain. Amyloid stains by basic congo red on kidney and brain revealed that the deposits of amyloid in kidney mesangium and in cortex, hippocampus and cerebellum were observable in OLETF rats. Ge-132 suppressed the deposition of amyloid tangles in kidneys and brains. Anti rat complement C'3 antibody reacted with AGE and amyloid tangles that were sensitive to anti-AGE antibody. AGE generated in vitro by incubating human serum, human gammaglobulin (HGG), or bovine serum albumin (BSA) with glucose activated complements, showing the consumption of complements in the hemolysis of hemolysin-coated sheep red blood cells. A novel device Quantum Resonance Spectrometer (QRS) could read the subtle bio-magnetism memorized in serum samples, demonstrating quantitative values reflecting the patho-physiology of OLETF rats.     

Annexin A6 is highly abundant in monocytes of obese and type 2 diabetic individuals and is downregulated by adiponectin in vitro

Adiponectin stimulates cholesterol efflux in macrophages and low adiponectin may in part contribute to disturbed reverse cholesterol transport in type 2 diabetes. Monocytes express high levels of annexin A6 that could inhibit cholesterol efflux and it was investigated whether the atheroprotective effects of adiponectin are accompanied by changes in annexin A6 levels. Adiponectin reduces annexin A6 protein whereas mRNA levels are not affected. Adiponectin-mediated activation of peroxisome proliferator-activated receptor α (PPARα) and AMP-activated protein kinase (AMPK) does not account for reduced annexin A6 expression. Further, fatty acids and lipopolysaccharide that are elevated in obesity do not influence annexin A6 protein levels. Annexin A6 in monocytes from overweight probands or type 2 diabetic patients is significantly elevated compared to monocytes of normal-weight controls. Monocytic annexin A6 positively correlates with body mass index and negatively with systemic adiponectin of the blood donors. Therefore, the current study demonstrates that adiponectin reduces annexin A6 in monocytes and thereby may enhance cholesterol efflux. In agreement with these in vitro finding an increase of monocytic annexin A6 in type 2 diabetes monocytes was observed.     

4-(1-芳基-3-烃基-3-氧代丙胺基)-N-(5-甲基-3-异噁唑基)苯磺酰胺的 合成与抗糖尿病活性的初步研究

为寻找新型高效低毒的过氧化物酶体增殖物激活受体(PPAR)激动剂, 通过Mannich反应一步合成了13个含有磺胺甲噁唑结构单元的未见报道的β-氨基酮衍生物, 收率为39.8%～92.5%. 化合物的结构通过IR, 1H NMR, 13C NMR, ESI MS和HRMS表征. 生物活性测试结果表明, 化合物1a能够显著激活PPAR反应元件. 文中还对合成反应条件及化合物结构-活性关系进行了初步讨论.