ObjectiveTo study the effect of exogenous insulin on inducing angiogenesis and the expression of vascular endothelial growth factor (VEGF) of hindlimb ischemia of rats with diabetic. MethodsThe hindlimb ischemic model of diabetic rat was established by the ligation of femoral blood vessels of hindlimb in twenty healthy male SD rats and which were divided into model group (n=10) and treatment group (n=10). Another 10 normal rats were selected as control group. Then the expression of VEGF protein and capillary density of muscle tissues of rat hindlimb were detected by Western blot analysis and alkaline phosphatase (APK) stain method, respectively. ResultsThe differences of body weight and blood glucose level of rats before operation and on day 7 after operation were not significant in the control group (Pgt;0.05). The body weight of rat was significantly lower on day 7 after operation than that before operation in the model group (Plt;0.05), while the difference of blood glucose level of rats was not significant in the model group (Pgt;0.05). The body weight and blood glucose level of rat significantly decreased in the treatment group on day 7 after subcutaneous injection of insulin as compared with the level before operation (Plt;0.05). Compared with the control group, the body weight decreased and blood glucose level increased in the model group and treatment group, and the difference was significant (Plt;0.05, Plt;0.01). The body weight of rat in the treatment group was not different from that in the model group (Pgt;0.05), but the blood glucose level of rat on day 7 after operation in the treatment group was significantly lower than that in the model group (Plt;0.05). The relative expression of VEGF protein of muscle tissues of ischemic hindlimbs in the treatment group (155.06±10.26) was significantly higher than that in the model group (94.30±11.23), Plt;0.05, while no expression was found in the control group. The capillary density of muscle tissues of right hindlimb in the control group was significantly higher than that in the model group or treatment group (Plt;0.05), and furthermore, which was higher in the treatment group than that in the model group (Plt;0.05). The difference of capillary density of muscle tissues of left hindlimb was not different among three groups (Pgt;0.05). The capillary density of muscle tissues of right hindlimb was not different from that of left hindlimb in the control group (Pgt;0.05) and which was significantly lower than that of left hindlimb in the model group or treatment group (Plt;0.05). ConclusionInsulin may increase the expression of VEGF protein in ischemic muscle tissue of diabetic rats and protect the ischemic muscle.
Objective To explore the effect of pain management by anesthesia nurses on labor analgesia. Methods A total of 100 parturient women in the Affiliated Hospital of North China University of Science and Technology between July and August 2015 were randomly divided into two groups: analgesia group and control group with 50 in each. Both two groups accepted labor analgesia routine maternity nursing. Analgesia group accepted maternal perinatal term pain management in addition to the routine nursing. Then we compared degree of pain during the production process, labor time and perineal injury between the two groups of women. Results The number of women with a labor pain degree of 0-Ⅲ in the analgesia group was respectively 36 (72%), 12 (24%), 2 (4%) and 0 (0%), and the number in the control group was respectively 23 (46%), 17 (34%), 8 (16%), and 2 (4%). The above difference between the two groups was statistically significant (Z=–2.908, P =0.004). The number of women with intact perineum, perineal injury of lateral and median cut, and Ⅰ-Ⅲ degree laceration in the analgesia group was respectively 31 (62%), 7 (14%), 8 (16%), 4 (8%) and 0 (0%); and the number in the control group was respectively 21 (42%), 12 (24%), 10 (20%), 7 (14%) and 0 (0%), also with significant difference between the two groups (Z =–2.028, P =0.043). The first and second labor stage of the analgesia group was (462.32±101.27) and (63.58±10.38) minutes, and was (568.27±113.28) and (76.92±11.24) minutes in the control group, with significant differences between the two groups (P<0.001). There was no statistically significant difference between the two groups in the third labor stage (5.78±3.02) and (5.97±2.96) minutes, (P=0.654). Conclusions The implementation of pain management by anesthesia nurses on labor analgesia can significantly reduce maternal labor pain, shorten the time of labor, and the condition of the perineal injury is mild and easily acceptable. It is worthy of clinical promotion.
【摘要】 目的 研究2型糖尿病（type 2 diabetes mellitus，T2DM）合并非酒精性脂肪性肝病（non-alcoholic fatty liver disease， NAFLD）患者血浆脂肪细胞特异性脂肪酸结合蛋白（adipocyte-specific fatty acid-binding protein，A-FABP）的水平及其相关因素。 方法 2009年10月—2010年10月选取T2DM合并NAFLD组（A组）60例，未合并NAFLD组56例（B组）为研究对象。测定体质量指数（body mass index，BMI），检测血脂、糖化血红蛋白（hemoglobin A1c，HbA1c）等生化指标。放射免疫法测定空腹胰岛素（fasting insulin，FINS），空腹C肽水平（fasting C-peptide，FCP），计算胰岛素抵抗指数（homeostasis model of assessment-insulin resistance，HOMA-IR）、胰岛素敏感指数（insulin sensitivity index，ISI），测定A-FABP、C反应蛋白（C-reaction protein，CRP）及肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）。 结果 与B组患者相比，A组患者其血浆A-FABP水平、BMI、腰围、腰臀比、丙氨酸氨基转移酶、门冬氨酸氨基转移酶、CRP、TNF-α、FCP、FINS、总胆固醇、甘油三酯、Ln（HOMA-IR）升高，Ln（ISI）降低，差异有统计学意义（Plt;0.05）；两组HbA1c差异无统计学意义（Pgt;0.05）。A-FABP水平变化与TNF-α、HOMA-IR、CRP呈正相关，与ISI呈负相关。 结论 T2DM伴NAFLD中，A-FABP升高与胰岛素抵抗是并存的，且存在明显相关关系，二者在疾病的发生发展中均可能具有重要的作用。【Abstract】 Objective To analyze the serum level of adipocyte-specific fatty acid-binding protein (A-FABP) in patients with type 2 diabetes mellitus (T2DM) complicated with non-alcoholic fatty liver disease (NAFLD), and its related factors. Methods From October 2009 to October 2010, 112 patients with T2DM were categorized into two groups: the group with NAFLD (group A) with 60 patients, and the group without NAFLD (group B) with 56 patients. Body mass index (BMI), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and hemoglobin A1c (HbA1c) were detected. Radioimmunoassay was carried out to measure fasting insulin (FINS) and fasting C-peptide (FCP), and homeostasis model of assessment-insulin resistance (HOMA-IR) and insulin sensitivity index (ISI) were calculated. At the same time, A-FABP, C-reaction protein (CRP) and tumor necrosis factor-α (TNF-α) were also detected. Results Compared with patients in group B, plasma levels of A-FABP, BMI, waistline, waist to hip ratio, ALT, AST, TG, TC, HDL-C, LDL-C, CRP, FCP, FINS, and HOMA-IR for patients in group A were all higher, while ISI was lower; and the differences in the above-mentioned parameters were statistically significant (Plt;0.05). The levels of HbA1c in the two groups were not significantly different (Pgt;0.05). The change of A-FABP level was positively correlated with TNF-α, HOMA-IR and CRP, while it wasnegatively correlated with ISI. Conclusions In patients with T2DM with NAFLD, there is an obvious correlation between the coexisting A-FABP rise and insulin resistance. Both of them played critical roles in the onset and developing of the disease.