目的 了解接受胰岛素治疗的糖化血红蛋白＞7.5%的2型糖尿病患者自我血糖监测现状及存在的问题，为帮助患者建立健康行为提供理论依据。 方法 对2008年12月－2011年2月住院治疗的128例符合纳入标准的患者进行问卷调查。调查内容包括患者一般资料、血糖控制情况、自我监测相关知识及技能等内容。 结果 共发放问卷128份，收回128份，其中有效问卷122份。糖尿病患者血糖自我监测知识获取渠道单一，且相关知识匮乏；不能制定正确血糖自我监测方案，不能对检测结果进行正确记录和汇报；血糖检测操作不正确，检测频率达不到标准要求。 结论 接受胰岛素治疗的2型糖尿病患者自我监测现状并不容乐观，患者自我监测行为缺乏。为此，提高糖尿病患者健康教育水平，帮助其建立并维持健康行为，是糖尿病教育工作的重点和挑战。
ObjectiveTo study the clinical significance of the 3-hydroxyisobutyrate dehydrogenase (HIBADH) expressions in gastric adenocarcinoma tissues and its biological function in gastric cancer cells.MethodsSeventy-six patients with gastric adenocarcinoma who were hospitalized in Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiaotong University, School of Medicine between January 2006 and December 2007 were recruited in our research. Immunohistochemical (IHC) staining was used to detect the HIBADH protein in primary gastric adenocarcinoma tissues, adjacent tissues, and metastatic lymph node tissues of gastric cancer. Then, the relationships among the expression of HIBADH protein, the clinical features, and the prognosis were analyzed. The MKN45 gastric cancer cell line of HIBADH overexpression was picked up and constructed as stable HIBADH knockdown cell lines. The biological function of HIBADH protein in gastric cancer cells was confirmed through in vitro experiments such as cell proliferation assay, migration and invasion assay, and scratch-wound assay.ResultsThe positive expression rate of HIBADH protein in the 76 gastric adenocarcinoma tissues was significantly higher than that of the adjacent tissues (χ2=54.738, P<0.001). Moreover, the higher expression level of HIBADH protein was related to the larger tumor diameter, the higher tumor lymphatic invasion rate, the later pT stage, the higher the lymph node metastasis rate, and the later pTNM stage (P<0.05). HIBADH protein was also highly expressed in lymph nodes with metastatic carcinoma, and positiverate was 100% (48/48). The 10-year survival rate of patients in the HIBADH protein positive group and HIBADH protein negative group were 16.4% and 69.4%, respectively, which showed the latter group had a longer survival time (χ2=19.612, P<0.001). The migration capacity, invasion capacity, and scratch-wound capacity of the MKN45 cells were significantly decreased after HIBADH protein knockdown (P<0.05), but the proliferation capacity of the cells was not significantly changed (P>0.05).ConclusionsThe overexpression of HIBADH protein in gastric cancer suggests later tumor stage and poor prognosis. Inhibition expression of HIBADH protein can reduce the motility capacity of gastric cancer cells.
ObjectiveTo analyze the effect of releasing the lower pulmonary ligament on right residual lung expansion after right upper lobe resection under different body mass index (BMI) levels. MethodsThe clinical data of patients who underwent thoracoscopic right upper lobe resection in the First Affiliated Hospital with Nanjing Medical University from 2021 to 2022 were retrospectively analyzed. Patients were divided into a group A (17 kg/m2＜BMI≤23 kg/m2), a group B (23 kg/m2＜BMI≤29 kg/m2) and a group C (BMI＞29 kg/m2) according to BMI. The presence of residual cavity was judged by chest X-ray at 7-10 days after operation, the degree of compensation change of the right main bronchus angle was measured, and the changes in lung volume were determined by CT three-dimensional reconstruction. ResultsA total of 157 patients who underwent thoracoscopic right upper lobe resection were included, including 71 males and 86 females, with an average age of 59.7±11.2 years. There were 50 patients in the group A, 75 patients in the group B, and 32 patients in the group C. In the group A, compared with those without releasing the lower pulmonary ligament, patients with releasing had a lower incidence of postoperative residual cavity (P=0.016), greater changes in bronchus angle (P<0.001), and smaller changes in lung volume (P<0.001). In the group B and C, there was no significant effect of releasing the lower pulmonary ligament on postoperative residual cavity, bronchus angle, and lung volume changes (P>0.05). ConclusionFor patients with thin and long body shape and low BMI, releasing the lower pulmonary ligament is helpful to promote the expansion of the residual lung after right upper lobe resection and reduce the occurrence of postoperative residual cavity in patients.