ObjectiveTo observe the influence and interaction of duodenal jejunal bypass (DJB) and hepatic branch of vagus on glucose metabolism, and fasting serum glucagon like peptide-1 (GLP-1), peptide YY (PYY) in non-obese rat with type 2 diabetes mellitus (T2DM). MethodsForty non-obese Wistar rats (GK) with T2DM were randomly divided into four groups: sham operation group (SO group), sham operation plus hepatic branch of vagus resection (HBVR) group (SO+HBVR group), DJB group, and DJB+ HBVR group. The changes of preoperative and postoperative body weight, fasting blood glucose level, fasting serum insulin level, fasting serum GLP-1 and PYY contents among four groups were observed. ResultsIn the DJB group, the postoperative body weight and fasting blood glucose level were decreased significantly (P < 0.05) and the fasting insulin level, fasting serum GLP-1 and PYY contents were increased significantly (P < 0.05) as compared with the preoperative corresponding values in the same group, and it was found that the hepatic branch of vagus could more lastingly maintain postoperative lower body weight (P < 0.05), improve the level of insulin (P < 0.05), increase the fasting serum GLP-1 and PYY contents (P < 0.05) as compared with the DJB+HBVR group. ConclusionDJB could improve glucose metabolism effect of GK rats, the hepatic branch of vagus might play a role in it, too.
Objective To review the research progress of C terminal propeptide of collagen type II (CTX-II), a osteoarthritis (OA) biomarker. Methods Domestic and international l iterature about CTX-II was reviewed extensively and summarized. Results CTX-II is investigated broadly and has the best performance of all currently available biomarkers. CTX-II is a truly useful biomarker for early diagnosis, prognosis, and measurement of treatment response in OA. Conclusion Single CTX-II may be not sufficient for early diagnosis and prognosis of OA, so a combination of CTX-II and other biomarkers or diagnosis methods is needed.
Objective To review the research progress of cartilage ol igomeric matrix protein (COMP). Methods Domestic and abroad l iterature about COMP was reviewed and summarized. Results COMP was one of the osteoarthritis (OA) biomarkers of being widely studied. Most studies in recent years could draw the conclusion that COMP was associated with OA. COMP was the foremost biomarker among investgated biomarkers. It could been continuously expressed and predicted knee OA progression. Conclusion Precisely what role COMP plays in OA pathogenesis remains unclear, using COMP as a tool to early diagnose OA more studies would be needed.
【摘要】 目的 〖JP2〗研究质子泵抑制剂（PPI）是否为危重患者发生医院获得性肺炎的危险因素。 方法 收集2002年6月-2009年6月收治的198例重症患者资料，分为使用PPI组（96例）和未使用PPI组（102例）。采用logistic回归分析PPI使用情况和医院获得性肺炎的关系。 结果 使用PPI组肺炎的发生率较高（26.9%），尤其是PPI使用时间超过7 d者（37.5%）。在不同的多变量logistic回归模型中，分别用APACHE Ⅱ评分和入住重症监护室原因校正后，使用PPI以及使用天数均是医院获得性肺炎发生的危险因素（P=0.031，OR＝2.230，95%CI：1.957~2.947；P=0.002，OR＝1.824，95%CI：1.457~2.242）。 结论 长时间应用PPI可能是增加ICU患者发生医院获得性肺炎的一种风险因素。【Abstract】 Objective To identify whether proton pump inhibitors (PPI) is a risk factor of hospital-acquired pneumonia (HAP) in critical patients. Methods The clinical data of the critical patients admitted to ICU from June 2002 to June 2009 were retrospectively analyzed. A total of 198 patients were divided into two groups: 96 in PPI group and 102 in non-PPI group. The relationship between PPI and HAP was analyzed by logistic regression. Results The patients in PPI group had a higher risk of HAP (26.9%), especially who were treated with PPI more than 7 days (37.5%). Adjusted by APACHE Ⅱ score and reason for admission to ICU, PPI therapy and the using duration of PPI were both the risk factors of HAP in different multiple logistic models (P=0.031, OR=2.230, 95%CI: 1.957-2.947; P=0.002, OR=1.824, 95%CI: 1.457-2.242). Conclusion Long-term use of PPI is a risk factor of HAP.
目的:本文回顾性分析总结32例心脏瓣膜置换术同期改良迷宫术患者的麻醉处理。方法:32例瓣膜病合并心房颤动患者,ASA分级Ⅱ-Ⅳ级,心功能ⅢⅣ级,采用以芬太尼为主的全身麻醉,术中以硫酸镁和艾司洛尔调控应激反应,复温后多联合使用多巴胺或(和)多巴酚丁胺5～10μg/kg·min、硝酸甘油或硝普钠0. 5～5μg/kg·min等血管活性药物以达到扩张血管增强心肌收缩力、降低心脏负荷、维持循环稳定的目的。停机后预防性安置心外膜起搏导线,使用异丙肾上腺素后心率仍慢者,及时运用临时起搏,保证有效的心肌收缩和稳定的心率。结果:射频消融时间为32±5分钟,主动脉阻断时间89±12分钟; 体外循环时间109±20分钟。心脏自动复跳29例, 电除颤复跳3例, 32例患者术后均为窦性心律。5例患者使用临时起搏器。结论:完善的术前准备和围术期重视心肺功能的支持治疗, 合理调控应激反应等措施是手术成功的重要基础。
ObjectiveTo explore the effect of gastric bypass (GBP) on metabolic syndrome (MS) and the related mechanisms. MethodsThe literatures addressed the effect of GBP on glucose metabolism and blood pressure were retrospectively analyzed. ResultsIt showed that GBP achieved durable level of blood glucose, remission of dylipidemia and hypertension, however, which occurred before significant weight loss. The changes of many factors such as food intake, gastrointestinal hormones, adipocytokines, fat distribution might be involved in GBP to improve MS. ConclusionGBP seems to achieve the control of MS as a primary and independent effect, rather than secondary to the treatment of overweight.
Objective To observe the curative effect on non-obese type 2 diabetes and the effect on change of glucagon-like peptide-1 (GLP-1) of gastric bypass operation. Methods Thirty-two cases of gastric ulcer with non-obese type 2 diabetes were suffered gastric bypass operation. Plasma glucose concentrations, insulin and GLP-1 were measured respectively in fasting and postprandial conditions before operation and in week 1, 2, 3 and month 1, 3, 6 after gastric bypass operation, and the body mass index (BMI), homeostasis model assessment β cell function index (HBCI) and glycosylated hemoglobin (HbA1c， the index was detected only before operation and in month 3, 6 after operation) were also measured. The turnover of the diabetes condition in the 6th month after surgery was observed. Results Compared with the levels before operation, the fasting and postprandial plasma glucose levels were descending (P＜0.05), fasting and postprandial plasma insulin and GLP-1 levels were ascending (P＜0.05), HBCI was ascending and HbA1c was descending significantly after operation respectively (P＜0.05), while BMI changed un-significantly after operation (Pgt;0.05). The diabetes control rate was 78.1%(25/32) overall six months after operation. Level of GLP-1 was negatively correlated with level of plasma glucose (P＜0.05) and positively correlated with level of insulin (P＜0.05). Conclusions Gastric bypass operation can markedly reduce plasma glucose level on the type 2 diabetes patients with non-obese, and the hypoglycemic effect may be contributed by more GLP-1 secretion that caused more insulin secretion, which doesn’t depend on the loss of weight.
ObjectiveTo explore the clinical effect of lidocaine mucilage diluent and simethicone emulsion in gastroscopy examination, in order to provide effective drugs for gastroscopy. MethodsWe selected 201 outpatients and the inpatients who underwent gastroscopic examination between August and October 2014 as the research subjects. Based on the kind of drug, the patients were randomly divided into research group (n=100) and control group (n=101). Patients in the research group accepted lidocaine mucilage diluent, while those in the control group received simethicone emulsion. Then we observed and compared the definition of gastroscopy, adverse drug reactions, examination time and drug price between the two groups. ResultsThe frequencies of high, medium, and low definition of gastroscopy were respectively 63.00%, 34.00% and 3.00% among the patients in the research group, and 69.31%, 26.73% and 3.96% among patients in the control group; there was no significant differences between the two groups (Z=-0.854, P=0.393). The adverse reaction rates, testing time, and drug prices for the two groups were 0.99% vs.1.00% (P>0.05), (6.5±2.1) minutes vs.(6.6±2.0) minutes (t=0.458, P>0.05), and RMB (9.0±1.2) yuan vs.(42.8±2.8) yuan (t=227.644, P<0.05), respectively. ConclusionLidocaine mucilage diluent and simethicone emulsion both have good effect for gastroscopic examination, which can raise the gastroscopic definition, promote endoscopic operation and observation by doctors, shorten examination time, and reduce adverse drug reactions. Both are of great value in clinical application, and lidocaine hydrochloride mucilage diluent is cheaper, which can be widely used and promoted clinically.
Pneumoconiosis ranks first among the newly-emerged occupational diseases reported annually in China, and imaging diagnosis is still one of the main clinical diagnostic methods. However, manual reading of films requires high level of doctors, and it is difficult to discriminate the staged diagnosis of pneumoconiosis imaging, and due to the influence of uneven distribution of medical resources and other factors, it is easy to lead to misdiagnosis and omission of diagnosis in primary healthcare institutions. Computer-aided diagnosis system can realize rapid screening of pneumoconiosis in order to assist clinicians in identification and diagnosis, and improve diagnostic efficacy. As an important branch of deep learning, convolutional neural network (CNN) is good at dealing with various visual tasks such as image segmentation, image classification, target detection and so on because of its characteristics of local association and weight sharing, and has been widely used in the field of computer-aided diagnosis of pneumoconiosis in recent years. This paper was categorized into three parts according to the main applications of CNNs (VGG, U-Net, ResNet, DenseNet, CheXNet, Inception-V3, and ShuffleNet) in the imaging diagnosis of pneumoconiosis, including CNNs in pneumoconiosis screening diagnosis, CNNs in staging diagnosis of pneumoconiosis, and CNNs in segmentation of pneumoconiosis foci to conduct a literature review. It aims to summarize the methods, advantages and disadvantages, and optimization ideas of CNN applied to the images of pneumoconiosis, and to provide a reference for the research direction of further development of computer-aided diagnosis of pneumoconiosis.