目的:研究LncRNA LINC00958对甲状腺乳头状癌细胞的影响及其作用机制.方法:TPC-1和K-1细胞分别分成Control、shRNA-NC、shRNA-LINC00958-1、shRNA-NC+inhibitor-NC、shRNA-LINC00958-1+inhibitor-NC和shRNA-LINC00958-1+miR-490-3p inhibitor组.TPC-1和K-1细胞移植的荷瘤鼠分别分为shRNA-NC、shRNA-LINC00958-1、shRNA-NC+inhibitor-NC、shRNA-LINC00958-1+inhibitor-NC和shRNA-LINC00958-1+miR-490-3p inhibitor组.用实时荧光定量PCR(RT-qPCR)检测LINC00958和miR-490-3p的表达水平;CCK-8检测细胞活力;Western blot检测蛋白表达水平;细胞划痕实验检测细胞迁移水平,Transwell小室检测细胞侵袭水平,克隆形成实验检测细胞增殖水平;双荧光素酶报告实验检测LINC00958和miR-490-3p的靶向关系.测定肿瘤质量及体积.结果:相比于正常组织,LINC00958在甲状腺癌组织中高表达;相比于Nthy-ori 3-1细胞,LINC00958在TPC-1和K-1细胞中高表达,miR-490-3p低表达.LINC00958沉默后,甲状腺乳头状癌细胞的增殖、侵袭和迁移能力显著降低.干扰miR-490-3p表达逆转LINC00958沉默对甲状腺乳头状癌细胞的增殖、迁移和侵袭效果,破坏LINC00958沉默对肿瘤生长的抑制效果.结论:抑制LINC00958表达可抑制TPC-1和K-1细胞增殖、迁移和侵袭能力,其机制与靶向miR-490-3p表达有关.

Objective: To investigate the correlation between insulin level and growth rate in children with growth without growth hormone（GWGH）, and to find the cause of spontaneous growth in these cases. Methods: A boy with GWGH after craniopharyngioma operation in our hospital was reported.The databases of PubMed, Embase, and CNKI were searched to extract the GWGH phenomenon and record the growth rate and insulin level. A total of 20 cases were analyzed retrospectively. Spearman correlation analysis was used to analyze the correlation between insulin-like growth factor-1（IGF-1）, insulin, and growth rate. Results: The average age of onset of GWGH was 9. 7 years, and the median time of growth acceleration was 2 years after surgery, and some patients’ bone age could advanced. The area under insulin curve was positively correlated with growth rate（r=0. 832, P＜0. 001）, and IGF-1 was not correlated with growth rate（r=-0. 012, P=0. 967）. There was no correlation between IGF-1 and insulin（r=-0. 052, P=0. 865）. Conclusion: Hyperinsulinemia can promote height growth independent of GH, and this mechanism is probably the main cause of GWGH.

目的 分析中性粒细胞-淋巴细胞比值(NLR)、血小板-淋巴细胞比值(PLR)联合检测对桥本甲状腺炎(HT)的诊断价值.方法 选取2019年6月至2020年6月该院门诊及住院部收治的HT患者116例为病例组,另选同期在该院就诊的甲状腺功能正常的其他患者和体检中心的健康者共50例作为对照组,检测两组研究对象甲状腺相关指标、血生化指标和血常规,分析两组患者NLR和PLR的差异及与其他指标间的相关性,采用受试者工作特征曲线(ROC曲线)对NLR和PLR的诊断价值进行分析.结果 病例组患者NLR、PLR、促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPOAb)、抗甲状腺球蛋白抗体(TGAb)水平升高,游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平降低,差异均有统计学意义(P<0.05).NLR、PLR与TPO-Ab和TGAb均呈正相关,NLR、PLR联合检测诊断HT的曲线下面积为0.830,显著优于单独使用任一指标的诊断价值,灵敏度为75.86％,特异度为80.00％.结论 该研究发现NLR和PLR与HT的病程变化密切相关,能反映HT患者自身免疫性抗体水平,NLR、PLR联合检测用来进行HT的筛查具有一定的临床价值.

Objective:To investigate the effect of ultra-mini percutaneous(UMP) and extracorporeal shock wave lithotripsy(ESWL) on the treatment of renal calculi with diabetes mellitus and its effect on serum neutro-philgelatase-associated lipocalin (NGAL) and Hemoglobin (Hb) levels.Methods:From January 2017 to January 2019, 108 patients with kidney stones and diabetes mellitus were selected as the research objects. The patients were divided into two groups by simple randomization. The control group was treated by ESWL, while the observation group was treated by UMP. The calculi removal, intraoperative blood loss, postoperative hospital stay and NGAL level of the two groups were compared and observed. Postoperative Hb was detected in patients and postoperative complications were compared.Results:The results of this study showed that there was no difference in the calculus clearance rate between the two groups after treatment ( P>0.05). The operation time, blood loss and postoperative hospitalization time were significantly lower in the observation group ( P<0.01). There was no difference in serum NGAL between the two groups before surgery ( P>0.05). At 12 h after surgery, the serum NGAL level in the two groups reached a peak ( P<0.01). The serum NGAL levels of patients in the observation group were significantly lower than those in the control group at 24, 48 and 72 hours after surgery ( P<0.01). The serum NGAL level of the observation group was significantly lower at 72 hours after surgery ( P>0.05). The incidence of complications such as renal colic, subcapsular hematoma, severe hematuria and fever in the observation group was significantly lower than that in the control group ( P<0.05). Conclusions:The effect of UMP in the treatment of renal calculi combined with diabetes is good.

目的 观察老年2型糖尿病(type 2 diabetes mellitus, T2DM)合并临床甲状腺功能减退(overt hypothyroidism,OH)及亚临床甲状腺功能减退(subclinical hypothyroidism, SCH)患者血清apelin水平变化,探讨血清apelin与老年T2DM患者发生OH、SCH的关系.方法 老年T2DM患者175例,根据甲状腺功能分为OH组54例、SCH组59例和正常组62例.检测3组血清空腹血糖(fasting plasma glucose, FPG)、糖化血红蛋白(glycosylated hemoglobin A1c,HbA1c)、三酰甘油(triacylglycerol, TG)、总胆固醇(total cholesterol, TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol, LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol, HDL-C)、游离甲状腺素(free thyroxine,FT4)、游离三碘甲状腺原氨酸(free triiodothyronine, FT3)、促甲状腺激素(thyroid-stimulating hormone, TSH)、甲状腺过氧化物酶抗体(thyroid peroxidase antibody, TPOAb)、甲状腺球蛋白抗体(thyroglobulin antibody, TgAb)、apelin水平;Pearson相关法分析老年T2DM患者血清apelin水平与糖脂代谢、甲状腺功能指标的相关性;多重线性回归分析老年T2DM患者血清apelin水平的影响因素;多因素logistic回归分析老年T2DM患者发生OH或SCH的影响因素.结果 OH组、SCH组血清FPG[(9.23±1.95)、(9.10±1.83) mmol/L]、 HbA1 c[(10.13±1.47)％、(9.39±1.28)％]、TG[(2.71±1.35)、 (2.52±1.04) mmol/L]、TC[(7.31±1.92)、(6.09±1.64) mmol/L]、 TSH[(62.58±21.35)、(7.29±1.74)u/L] 、apelin[(483.19±43.05)、(401.29±40.18)pg/L]水平均高于正常组[FPG(8.11±1.59) mmol/L、HbA1 c(8.12±1.03)％、TG(1.83±0.76) mmol/L、 TC (4.77±1.18) mmol/L、 TSH(1.83±0.62) u/L、 apelin(327.91±30.42) pg/L],HDL-C水平[(1.06±0.26)、(1.17±0.21) mmol/L]低于正常组[(1.32±0.23) mmol/L](P＜0.05);OH组血清LDL-C、TPOAb、TgAb水平均高于正常组(P＜0.05),FT4、 FT3水平均低于正常组(P＜0.05);SCH组血清LDL-C、 FT4、 FT3、 TPOAb、 TgAb水平与正常组比较差异均无统计学意义(P＞0.05);OH组血清HbA1 c、TC、TSH、TPOAb、TgAb、 apelin水平均高于SCH组(P＜0.05), HDL-C、 FT4、 FT3水平均低于SCH组(P＜0.05),FPG、TG、LDL-C水平与SCH组比较差异均无统计学意义(P＞0.05).老年T2DM患者血清apelin水平与FPG(r=0.228,P=0.007)、 HbA1c(r=0.359, P=0.005)、TG(r=0.491, P=0.001)、TC(r=0.528, P＜0.001)、TSH(r=0.662,P＜0.001)水平呈正相关,与FT4(r=-0.601,P＜0.001)、FT3(r=-0.546,P＜0.001)水平呈负相关,与LDL-C、H DL-C、 TPOAb、 TgAb水平无线性相关(P＞0.05). FPG、TC、TSH正向影响老年T2DM患者血清apelin水平,FT4负向影响老年T2DM患者血清apelin水平(P＜0.05).血清FPG、TC、 HDL-C、FT4 、FT3 、TSH、TPOAb、TgAb、apelin是T2DM患者发生OH或SCH的影响因素(P＜0.05).结论 老年T2DM合并OH或SCH患者血清apelin水平明显升高,且与糖脂代谢、甲状腺功能有关,是老年T2DM患者发生OH或SCH的危险因素.

目的 探讨分泌型卷曲相关蛋白1(SFRP1)及淀粉样蛋白-A(SAA)在糖尿病肾病(DN)患者中的表达及早期诊断价值.方法 将该院2016年1月至2018年6月收治的144例2型糖尿病(T2DM)患者纳入研究,根据T2DM患者尿清蛋白排泄率(UAER),将其分为单纯T2DM组(UAER<22μg/min,57例)、DN1组(UAER:22～220μg/min,53例)、DN2组(UAER>220μg/min,34例).另外,将50例同期于该院体检合格的健康者纳入研究并作为对照组.检测4组人群的常规生化指标及SFRP1、SAA水平,分析SFRP1、SAA水平与患者临床特征间的关系,绘制受试者工作特征(ROC)曲线,探讨SFRP1、SAA检测在DN早期诊断中的价值.结果 4组间糖尿病病程、体质量指数(BMI)、空腹血糖(FBG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、三酰甘油(TG)及胰岛素抵抗指数(HOMA-IR)水平比较,差异均有统计学意义(P<0.05);4组间性别比例、年龄、总胆固醇(TC)水平比较,差异无统计学意义(P>0.05);SFRP1及SAA水平在对照组、T2DM组、DN1组及DN2组呈依次上升的趋势,组间比较差异均有统计学意义(P<0.05).相关性分析显示,DN患者SFRP1水平与FBG、HOMA-IR、HbA1c及TG水平均呈正相关(P<0.05);相关性分析提示,DN患者外周血SAA水平与糖尿病病程、FBG、HOMA-IR及HbA1c水平呈正相关(P<0.05).ROC曲线分析显示,SFRP1及SAA单独应用于DN诊断的效能以SFRP1更高,两者联合应用能有效提高诊断效能.结论 DN患者SFRP1及SAA水平均异常升高,SFRP1、SAA水平与FBG、HO-MA-IR及HbA1c呈正相关,两者在诊断早期DN中均具有一定的应用价值.

目的 探讨维格列汀对糖尿病足溃疡(DFU)大鼠创面的愈合潜力.方法 90只健康SD大鼠随机分为9组,即空白组(3、6、9d组)、模型组(3、6、9d组)、维格列汀组(3、6、9d组),每组各10只.除空白组外,其余大鼠采用高糖高脂饲料+链脲佐菌(STZ)诱发大鼠DFU模型,造模成功后24 h,空白组和模型组灌胃双蒸水(10 mg/kg),维格列汀组按57 mg/kg剂量灌胃,分别于给药后的3、6、9 d,处死大鼠,取创面组织.采用苏木精-伊红染色(HE)观察创面组织病理变化;酶联免疫吸附法(ELISA)检测血清肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)水平;免疫组织化学法检测创面组织血管内皮细胞生长因子(VEGF)、表皮细胞生长因子(EGF)、E-钙黏蛋白(E-cadherin)、碱性成纤维细胞生长因子(bFGF)表达.结果 与空白组相比,模型组大鼠创面组织明显坏死脱落,血清IL-6、TNF-α水平在3、6、9d时均明显升高(P<0.05),创面组织EGF、VEGF、bFGF、E-cadherin表达明显降低(P<0.05);与模型组比较,维格列汀治疗3、6、9d可明显降低IL-6、TNF-α水平,明显升高EGF、VEGF、E-cadherin表达(P<0.05).结论 维格列汀对糖尿病足溃疡创面延迟愈合具有潜在作用,可抑制炎性因子、增加血管再生因子及再上皮化因子发挥其潜能,促进创面愈合.

目的 探究维格列汀对实验性糖尿病足溃疡创面的愈合作用及其机制.方法 45只健康SD大鼠随机分为3组,即空白组、模型组和维格列汀组,每组15只.采用高糖高脂饲料+链脲佐菌诱发大鼠糖尿病足溃疡模型,造模成功后24 h,空白组和模型组予以等量生理盐水(2 ml/100 g)灌胃,维格列汀组按57 mg/kg剂量灌胃,分别于给药3,6,9 d,每组各取5只大鼠处死,取创面组织.采用HE染色观察创面组织病理变化.生化分析血糖、TC、TG、HDL和LDL浓度.ELISA检测创面组织TNF-α、IL-6和IL-1β 水平.Western blot检测创面组织Nrf2、Keap1、collagen-Ⅰ、TGF-β 和 α-SMA蛋白表达.结果 与空白组相比,模型组大鼠创面组织明显坏死脱落,给药6,9 d模型组TC、HDL、LDL、IL-1β、IL-6、TNF-α水平明显升高(均P<0.05),创面组织Nrf2、collagen-Ⅰ、TGF-β和α-SMA蛋白表达明显降低(均P<0.05).给药9 d,与模型组比较,维格列汀组HDL、LDL、IL-1β、IL-6、TNF-α水平明显降低(均P<0.05),Nrf2、collagen-Ⅰ、TGF-β和 α-SMA蛋白表达明显升高(均P<0.05).结论 维格列汀对糖尿病足溃疡创面延迟愈合具有潜在作用,可抑制炎症标志物、影响Nrf2途径,促进创面愈合.

目的 探讨血清β淀粉样肽40(Aβ40)联合尿微量白蛋白(mAlb)检测对2型糖尿病(T2DM)患者下肢血管病变进展的预测价值.方法 选取2017年9月～2019年9月于我院就诊的T2DM患者186例,根据是否发生下肢血管病变将其分为观察组(97例)及对照组(89例),根据下肢血管病变程度将观察组患者分为轻度血管病变组(25例)、中度血管病变组(43例)及重度血管病变组(29例),根据晨尿mAlb结果将观察组患者分为晨尿mAlb阳性组(86例)和晨尿mAlb阴性组(11例).收集所有患者的临床资料及实验室检查指标并进行比较.采用酶联免疫吸附试验(ELISA)检测各组患者血清Aβ40水平并比较.采用免疫比浊法检测各组患者尿mAlb水平.采用彩色多普勒超声诊断仪检测所有患者的下肢血管病变情况.结果 观察组患者腰臀比、糖尿病视网膜病变及糖尿病周围神经病变发病率、收缩压(SBP)、糖化血红蛋白(HbA1c)、空腹血糖(FPG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、血清肌酐(Scr)、血浆同型半胱氨酸(Hcy)、Aβ40、mAlb水平均高于对照组,差异有统计学意义(P<0.05).发生下肢血管病变T2DM患者血清Aβ40与HbA1c、TG、Scr、Hcy、mAlb均呈正相关,尿mAlb与HbA1c、TC、TG、Scr、Hcy、Aβ40均呈正相关(P<0.05).中度血管病变组患者血清Aβ40和尿mAlb水平高于轻度血管病变组,重度血管病变组患者血清Aβ40和尿mAlb水平均高于轻度及中度血管病变组,差异有统计学意义(P<0.05).晨尿mAlb阳性组患者血清Aβ40水平和下肢血管病变发生率均高于晨尿mAlb阴性组(P<0.05).结论 血清Aβ40、尿mAlb水平与T2DM患者有无下肢血管病变及其程度密切相关.

目的 探讨曲尼司特对早期糖尿病肾病(DN)患者血清氧化应激指标及人骨形态发生蛋白7(BMP-7)、转化生长因子-β1 (TGF-β1)水平的影响.方法 将医院收治的94例早期DN患者按随机数字表法分为对照组与观察组,每组47例,二组均给予常规对症治疗,观察组加用曲尼司特治疗,疗程6个月,监测治疗前后二组肾功能指标[尿素氮(BUN)、血肌酐(Scr)、24 h尿蛋白定量]、血糖指标[空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)]、脂质指标[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)、活性氧(ROS)、谷胱甘肽过氧化物酶(GSH-Px)]及BMP-7、TGF-β1的变化,统计治疗不良反应发生情况.结果 治疗前,二组肾功能、血糖、脂质、氧化应激指标及BMP-7、TGF-β水平比较差异均无统计学意义(均P＞0.05),治疗后6个月,二组BUN、Scr、24 h尿蛋白定量、FPG、2hPG、HbA1c、TC、TG、LDL-C、MDA、ROS、TGF-β1降低,HDL-C、SOD、GSH-Px、BMP-7上升(均P＜0.05),观察组BUN、Scr、24 h尿蛋白定量、FPG、2hPG、HbA1c、TC、TG、LDL-C、MDA、ROS、TGF-β1低于对照组,HDL-C、SOD、GSH-Px、BMP-7高于对照组(均P＜0.05);二组不良反应发生率比较差异无统计学意义(P＞0.05).结论 曲尼司特可减轻早期DN患者血清氧化应激反应,上调BMP-7表达,降低TGF-β1水平.为曲尼司特治疗DN提供了新思路,利于拓展曲尼司特在DN治疗中的应用.

目的 观察格列美脲对T2DM患者代谢指标及血清护骨素(OPG)水平的影响.方法 选取2015年1月至2016年12月T2DM患者102例,其中将服用格列美脲治疗患者分为观察组(50例),服用格列本脲治疗患者分为对照组(52例).分别于治疗前、治疗后12周、24周测定两组空腹血糖(FBG)、餐后2小时血糖(2 hBG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、血甘油三脂(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、血尿酸(SUA),血清OPG水平.稳态模型评估胰岛素抵抗指数(HOMA-IR)和胰岛 β细胞功能指数(HOMA-β).结果 观察组治疗后FBG、2 h BG、HbA1c、OPG低于治疗前(P<0.05),且观察组治疗24周后患者血清OPG水平明显低于对照组(P<0.05),对照组治疗后HOMA-IR明显低于治疗前,而HOMA-β明显高于治疗前(P<0.05),观察组治疗24周后患者BMI、TC、LDL、SUA水平低于治疗前,差异均有统计学意义(P<0.05).结论 格列美脲可有效降低T2DM患者的血糖水平,改善代谢紊乱,并降低血清OPG水平,是一种安全有效的口服降糖药.

Objective To assess the trend of prevalence, awareness, treatment and control rate of diabetes among elderly residents (≥45 years old) of Shunqin District in Nanchong City, and provide scientific references for the prevention and control of diabetes. Methods From February 2013 to August 2015,a cross-sectional survey was conducted in 9 sub-district offices of Shunqing District of Nanchong City. Households as a unit, the questionnaires and blood tests were investigated by clustering sampling in residents aged ≥45 years old. Results A total of 82 225 residents with complete information were enrolled in this study. Among them, 11 857 were with diabetes, in whom 6 260 had been diagnosed as diabetes before, only 5 054 were under treatment, and only 1 986 could control blood glucose to target level. The prevalence of diabetes was 14.4％ among the participants. The rate of awareness, treatment, and control of diabetes in the 11 857 diabetes patients identified was 52.8％,42.6％, and 16.7％, respectively. Conclusions The prevalence rate of diabetes is high, but the rate of awareness, treatment, and control of diabetes is low. It is necessary to popularize the knowledge and the cognition of diabetes, and it is urgent to make efficient measures to prevent and control diabetes in Nanchong City.

Objective To investigate the effect of Alendronate combined with Jin Tiange capsule on blood IGF -1, osteocalcin and insulin resistance in patients with type 2 diabetic osteoporosis. Methods From July 2015 to July 2016, 200 patients with type 2 diabetic osteoporosis were selected as the subjects. According to the random number table method, they were divided into control group and observation group, each group of 100 cases. Patients in the control group were treated with Alendronate tablets at lOmg daily and once daily. The observation group were treated Jin Tiange capsule in the control group based on the treatment, and a course of treatment is 24 weeks. The bone mineral density was compared between the two groups before and after treatment. The clinical outcomes of the two groups were compared. The fasting blood glucose (FBG) of the two groups was measured by glucose oxidase method. FINS was measured by radioimmunoassay. The levels of serum IGF - 1 were measured by enzyme - linked immunosorbent assay (ELISA). The levels of serum BGP were measured before and after treatment by radioimmunoassay. Results The effective rate and total effective rate were 63. 00％ and 96. 00％ in the observation group, which was significantly higher than the control group (46. 00％ and 88. 00％). After treatment, the BMD of the observation group was significantly increased compared with the control group; HOMA - IR and FBG were significantly decreased; the content of IGF - 1 and BGP was significantly increased. Conclusion Alendronate combined with Jin Tiange capsule has a good effect in the treatment of type 2 diabetic osteoporosis, and can significantly increase the content of IGF - 1 and BGP, reduce insulin resistance.

将64例口服降糖药T2DM患者,随机分为实验组(31例);对照组(33例);正常组(32例).实验组均加服罗格列酮(4mg/日),疗程6个月;分别测量T2DM实验组、T2 DM对照组治疗前后及正常对照组骨密度(BMD)并进行比较.结果:T2 DM患者BMD低于正常对照组(P＜0.05);实验组治疗后髋部及腰椎BMD均有所下降(0.90 ±0.17:0.77 ±0.15;1.02 ±0.19:0.82 ±0.08,P＜0.05),对照组治疗前后髋部及腰椎BMD无显著变化(1.00±0.05:1.10±0.02;1.08±0.05:1.07±0.06,P＞0.05).结论:罗格列酮可致T2DM骨密度降低,T2DM在应用此类药物时有潜在的发生骨质疏松性骨折的风险.

Objective To investigate the correlation between serum uric acid level and severity of coronary artery disease in patients with coronary heart disease.Methods The serum uric acid level of 202 patients with coronary heart disease and 50 patients with non-coronary heart disease (control group) was measured,at same time the severity of coronary artery disease was assessed by Gensini score.The patients with coronary heart disease were divided into four groups according to the quartile of serum uric acid level:the first quartile group(n =50),the second quartile group (n =51),the third quartile group (n =49),the fourth quartile group(n =52).The general information and coronary angiography results were compared between 5 groups.Results The detection rate of carotid artery plaque,HDL-C,uric acid (UA) and Gensini score were statistically significant between 5 groups (P ＜ 0.05),and the detection rate of multi-vessel disease in the fourth quartile was significantly higher than that of control group and the first quartile group (P ＜ 0.05).Correlative analysis revealed that blood UA was still positively correlated with Gensini score (r =0.148,P =0.023)after the effects of the age and sex were controlled.Linear regression analysis revealed that UA was associated with Gensini scores in patients with coronary heart disease and multivariate stepwise regression analysis suggested that UA was an independent risk factor for Gensini score (b =0.159,P =0.037).Conclusion Serum uric acid is positively correlated with Gensini score in patients with Coronary heart disease.The level of serum uric acid in patients with coronary heart disease is an important independent indicator of the severity of coronary artery disease.

Objective: To explore the relationship between hypertriglyceridemic-waist (HTWC) phenotype and clustering of cardiovascular risk factors in middle and aged population. Methods: A community-based cross-sectional survey was conducted in 5 communities of Chengdu city from 2013-10 to 2014-05 and 1004 subjects from (40-79) years of age were investigated. HTWC was defined by TG≥2.0 mmol/L and waist circumference≥90 cm in male, ≥85 cm in female. The subjects were divided into 4 groups:①Normal group, the subjects with TG<2.0 mmol/L, waist circumference<90 cm in male, <85 cm in female,n=492,②Simple abdominal obesity group, TG<2.0 mmol/L, waist circumference≥90 cm in male, ≥85 cm in female,n=301,③Simple hipertrigliceridemia group, TG≥2.0 mmol/L, waist circumference<90 cm in male, <85 cm in female,n=79 and④HTWC group,n=132. The detection rate of HTWC and its correlation with clustering of cardiovascular risk factors were analyzed. Results: The prevalence of HTWC phenotype was 13.15% (12.69% in male and 13.37% in female). In HTWC group, the detection rate of clustering of cardiovascular risk factors was 41.67% (13.21% in both Simple abdominal obesity group and Simple hipertrigliceridemia group). Multi Logistic regression analysis indicated that with adjusted age, gender, body mass index, smoking history and family history of diabetes and hypertension, the detection rate of clustering of cardiovascular risk factors in HTWC group was 4.50 folds of Simple abdominal obesity group and Simple hipertrigliceridemia group (OR=4.50, 95% CI 2.84-7.12,P<0.05). Conclusion: HTWC phenotype was closely related to clustering of cardiovascular risk factors, it could be used as an indicator for screening clustering of cardiovascular risk factors in middle and aged population.

符合入选标准的60例糖尿病周围神经病变患者,随机分为A组(静脉滴注α-硫辛酸注射液600mg,1次/天,同时口服依帕司他片50mg/次,3次/天),B组(静脉滴注α-硫辛酸注射液600mg,1次/天),连续用药2周.治疗前后分别记录TCSS评分、神经症状评分、神经反射评分及感觉功能评分.结果两组患者治疗后TCSS评分、神经症状评分、神经反射评分及感觉功能评分均较治疗前显著降低(P＜0.05);A组患者神经症状评分改善程度较B组大(P ＜0.05),神经反射与感觉功能评分改善程度两组无统计学差异(P＞0.05).结论α-硫辛酸联合依帕司他片治疗糖尿病周围神经病变是有效的,联合治疗组患者主观症状改善较单一治疗组明显.

筛选84例血糖控制欠佳的肥胖2型糖尿病患者.随机分为两组,治疗组患者在原方案上加用沙格列汀5mg qd治疗,治疗12周,结果:治疗组治疗后FPG、2hPG、HbA1、BMI、TG、TC差异均有统计学意义(t分别=14.15、5.97、12.88、58.68,(t分别=13.03、7.34,P均＜0.05),胰岛素用量减少(t=12.76,P＜0.05).结论:加用沙格列汀是治疗2型糖尿病肥胖患者有效且安全的口服降糖药.

将DPN 76例患者随机分成两组。A组:α-硫辛酸联合甲钴胺、依帕司他,B组:甲钴胺联合依帕司他,连续治疗三周。比较两组治疗前后症状、体征和神经传导速度。结果两组患者的神经症状和体征及神经传导功能都得到明显改善,其应用α-硫辛酸联合甲钴胺、依帕司他治疗组可以更加明显改善DPN患者症状及体征,更明显增加神经病变组织的传导速度,疗效显著。结论运用α-硫辛酸联合甲钴胺、依帕司他治疗糖尿病周围神经病变,可显著提高临床疗效,改善患者的生活质量。

Objective Discussion of alprostadil combined with alpha lipoic acid in the treatment of diabetic foot.Methods 49 cases of type 2 diabetic patients with diabetic foot were randomly divided into two groups.The control group(n = 24) were treated with standard systemic therapy and local treatment,the treatment group(n = 25),added alpha lipoic acid and prostaglandin saline infusion.Results Clinical outcomes of the two groups had significant differences,P<0.05.Conclusion Alprostadil combined with alpha lipoic acid could effectively improve the cure rate in patients with diabetic foot.