目的:研究罗格列酮(ROS)治疗2型糖尿病,对患者组织胰岛素敏感性与血清炎症介质改变的关系。方法:选取符合1999年WHO标准确诊的2型糖尿病患者30例。试验采用前后自身配对方法。口服ROS 4mg每天一次,总疗程8周。测定指标包括常规临床检查项目、血糖,同时检测血浆胰岛素水平,糖化血红蛋白(HbA1c)水平、C反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α)水平,以 HOMA模型和胰岛素钳夹试验评价组织胰岛素敏感性。结果:应用ROS治疗的2型糖尿病患者组织胰岛素敏感性显著改善(Plt;0.05),并降低血浆CRP、IL-6、TNF-α水平,这些炎症介质的改变与组织胰岛素敏感性的改变相关。结论:应用ROS治疗2型糖尿病能降低患者血浆炎症介质水平,减轻胰岛素抵抗,延缓或减轻糖尿病大血管并发症的发生发展。
ObjectiveTo investigate the impact of comprehensive interventions on the prevention of the incidence of surgical site infection (SSI) after hip or knee arthroplasty.MethodsPatients who underwent total hip and knee arthroplasty for the first time in orthopedics department of Chengdu Fifth People’s Hospital from January 2016 to March 2018 were selected. The patients were observed after surgery for 1 year, and divided into the control group and the treatment group according to the odd or even hospitalization number. Basic precautions were taken in the control group, while further comprehensive preventive measures (preoperative chlorhexidine bath, intraoperative body temperature maintenance, using antibacterial film over surgery area without shearing, health and education after discharge from hospital) were taken in the treatment group. The incidence of SSI of the two groups was compared to evaluate the effects of comprehensive interventions.ResultsA total of 341 patients were included, including 174 in the control group and 167 in the treatment group. No one failed to be followed up. Among the 341 patients undergoing surgery, 13 had SSI, including 11 (6.3%) in the control group and 2 (1.2%) in the treatment group. The incidence of SSI in the treatment group was lower than that in the control group (χ2=6.102, P=0.014). Single factor analysis showed that sex (χ2=10.933, P=0.001), preoperative chlorhexidine sponge bath (χ2=8.837, P=0.003), intraoperative thermal insulation (χ2=13.917, P<0.001), health education (χ2=12.671, P<0.001), skin preparation methods (χ2=6.102, P=0.014), perioperative blood glucose control (χ2=17.512, P=0.003), and surgical type (χ2=8.360,factor P=0.004) were the effect factors of occurrence of SSI. Logistic regression analysis showed that surgical type [odds ratio (OR)=0.129, 95% confidence interval (CI)(0.026, 0.640), P=0.012] and strict blood glucose control [OR=9.868, 95%CI (2.158, 45.131), P=0.003] were the independent factors affecting the occurrence of SSI.ConclusionsComprehensive intervention measures can effectively reduce the occurrence of SSI after hip and knee arthroplasty. It is not confirmed that preoperative chlorhexidine bath can reduce the occurrence of SSI. But choosing selective operation and controlling the perioperative blood glucose below 200 mg/dL can reduce the risk of SSI.
Objective To investigate the death rate and life lost of the Xinjian district residents in Nanchang city, and to provide scientific evidence for the health administrators to formulate relevant policies and improve the life expectancy of the residents. Methods Based on the population and the death data in this area from 2011 to 2015, the mortality, the cause of death spectrum, the life expectancy, the life expectancy for death causes, the potential years of life lost (PYLL), the potential years of life lost rate (PYLLR), the average potential years of life lost (APYLL), the standardized potential years of life lost (SPYLL), the standardized potential years of life lost rate (SPYLLR) were analyzed by SPSS 20.0 software. Results From 2011 to 2015, the crude death rate of Xinjian district was 538.38/10 million, the standardized mortality rate was 563.00/10 million, the crude death rate of males is higher than that of females (χ2=788.91, P<0.01); the causes of death in the top five were follows: circulatory system diseases, tumor, respiratory system diseases, injury, endocrine, nutrition and metabolic diseases. The causes of death were in the same order whether in male or female. Mortality rates of different age groups showed that the mortality rates began to rise substantially after the age of 30, the main causes of death were different between the low age group and the high age group. The life expectancy of residents was 78.38 years, the PYLL for all causes of death was 129 087.5 years, the PYLLR was 39.84‰, the APYLL was 17.44 years, the SPYLL was 134 057.00 years, the SPYLLR was 38.61‰. The PYLL caused by injury was 46 191.5 years, the PYLLR was 14.26‰, APYLL was 33.14 years, of which were all ranked first. The SPYLL caused by tumor was 48 414.95 years, the SPYLLR was 13.94‰, of which were ranked first. Conclusion The mortality rate of Xinjian district residents is higher than that of Nanchang urban residents, but lower than the average level of Jiangxi province and the whole country. Life reduction analysis shows that chronic non-communicable diseases and injuries are the main causes of death for residents in the area. The three levels prevention is of great significance to reduce the death of residents and improve their life expectancy.
ObjectiveTo systematically review the safety of hand disinfectants. MethodsPubMed, EMbase, The Cochrane Library, INAHTA, WanFang Data, CNKI and VIP databases were electronically searched to collect studies on the safety of hand disinfectants from inception to February 1st, 2021. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies; then, a systematic review was conducted. ResultsA total of 50 studies were included. The reported adverse events were eye and nasal mucosal irritation, hand adverse events with skin itching, rash, erythema, edema and so on. A total of 29 brands such as 3M Avagard and 26 ingredients such as ethanol were reported to be related to the above adverse events. Hand disinfectants containing glycerin, silicone oil, vitamin B, plant extracts and other emollients could reduce the incidence of adverse events. ConclusionCurrent evidence shows that hand disinfectants containing emollients and free from ethanol, chlorhexidine and other ingredients are related to fewer adverse events. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.