Objective The aim of this study was to examine the association between serum complement 1q (C1q) and the associated factors of acute ischemic stroke in patients with type 2 diabetes (T2DM). Methods The baseline clinical variables of the participants were collected, and the levels of blood lipids, blood sugar, inflammatory cytokines, and C1q in the three groups were then compared. The variables which affected the associated factors of acute ischemic stroke in T2DM cases were determined. Results The levels of C1q in the DAIS group were increased significantly compared with those in the T2DM group. Receiver operating characteristic curve analyses showed that the AUC for C1q and the combined diagnosis of acute ischemic stroke were 0.830 (95%CI 0.747–0.914), with a sensitivity of 0.854 and specificity of 0.780. The results of Pearson’s correlation analyses demonstrated that C1q was associated positively with low-density lipoprotein cholesterol (LDL-C), fasting blood glucose (PBG), 2-h postprandial blood glucose (2h PG), and high-sensitive C reaction protein (hs-CRP) (all p < .05). Stratified analysis showed that there was a positive relationship between C1q and the associated factors of acute ischemic stroke for partial LDL-C, and hs-CRP strata. Logistic model analysis suggested that C1q was an independent risk factor for acute ischemic stroke in patients with T2DM. After adjusting for potential confounders, a one-standard deviation (SD) increase in C1q level was strongly related to an approximately 1.5-fold increased risk of acute ischemic stroke in cases with a hs-CRP ≥1.78 mg/L. Conclusion In DAIS patients, the levels of C1q were increased significantly and were an independent associated factor which affected the occurrence of acute ischemic stroke.

目的:探究围刺法配合温针灸治疗对肩周炎患者日常活动、压痛感及怕冷程度的影响.方法:收集2017年1月～2019年1月我院收治的肩周炎患者200例,按随机数表法分为观察组和对照组,各100例.对照组给予普通针刺配合温针灸,观察组在对照组基础上对主穴给予围刺法,观察比较各组临床疗效、日常活动功能评分、压痛评分、怕冷程度评分、实验室指标.结果:观察组临床疗效优于对照组,差异有统计学意义(P＜0.05);观察组日常活动功能评分低于对照组,差异有统计学意义(P＜0.05);观察组压痛评分低于对照组,差异有统计学意义(P＜0.05);两组治疗后怕冷程度评分均降低,观察组降低更为明显(P＜0.05);两组治疗后PGE2、IL-6水平均降低,观察组降低更为明显(P＜0.05).结论:围刺法配合温针灸治疗肩周炎临床治疗效果显著,能改善患者日常活动、减轻压痛感、缓解怕冷程度,提高生活质量,值得推广应用.

目的 探讨糖尿病足患者合并耐甲氧西林金黄色葡萄球菌感染的临床特征.方法 选取2016年9月至2019年9月恩施土家族苗族自治州中心医院收治的128例糖尿病足合并金黄色葡萄球菌感染者为研究对象,对患者溃疡部位细菌进行分离、培养和鉴定,并进行药敏试验,分析病原菌的分布特征及金黄色葡萄球菌耐药情况以及相关影响因素.128例患者所分离株金黄色葡萄球菌对甲氧西林敏感者为敏感菌组(33例),对甲氧西林耐药者为耐药菌组(95例).结果 共分离出128株菌株,其中革兰阳性菌79株(61.72％)、革兰阴性菌45株(35.16％)和真菌4株(3.12％);敏感菌组和耐药菌组患者中分别分离病原菌33株和95株;敏感菌组患者分离菌株对利福平、氧氟沙星、左氧氟沙星、苯唑西林、青霉素G、头孢呋辛、阿奇霉素、头孢噻肟、呋喃妥因菌株耐药率高于耐药组,差异均有统计学意义(χ2=7.856、12.309、19.998、15.682、4.072、30.258、6.089、22.233、5.264,P=0.004、0.001、<0.001、<0.001、0.041、<0.001、0.007、<0.001和0.018);多因素Logistic回归分析显示,低蛋白血症、溃疡面积、溃疡病程、入院前6个月使用抗菌药以及高血压均为糖尿病足患者合并耐甲氧西林金黄色葡萄球菌感染的影响因素,差异均有统计学意义(P=0.001、0.010、0.023、0.012和0.029).结论 金黄色葡萄球菌是糖尿病足疾病主要感染病原菌,低蛋白血症、溃疡面积、溃疡病程、入院前6个月使用抗菌药、高血压均为糖尿病足患者合并耐甲氧西林金黄色葡萄球菌感染的危险因素.

目的:分析针刺对脑卒中模型大鼠认知功能障碍影响及其与磷酸酰肌醇-3-激酶(PI3K)/蛋白激酶B(Akt)信号转导通路联系.方法:选取SPF级雄性大鼠30只,随机数字表法将大鼠分成3组,分别为针刺组、模型组和正常组,针刺组、模型组大鼠制备大脑中动脉梗塞(MCAO)模型,成功造模后电针仪对针刺组大鼠行针刺治疗,模型组与正常组不进行任何处理.观察大鼠神经功能评分、脑梗死面积、脑组织细胞凋亡率、脑组织PI3K、Bcl-2、p-Akt、t-Akt、Bax蛋白表达及Bax、Bcl-2及Bc1-2/Bax mRNA表达.结果:和正常组相比,模型组大鼠脑梗死面积增大;和模型组相比,针刺组大鼠脑梗死面积减少,差异有统计学意义(P＜0.05);和正常组相比,模型组大鼠凋亡阳性细胞比例升高;和模型组相比,针刺组大鼠凋亡阳性细胞比例降低,差异均有统计学意义(P＜0.05);和正常组相比,模型组大鼠Bax蛋白表达升高,PI3K、Bcl-2、p-Akt蛋白表达降低;和模型组相比,针刺组大鼠Bax蛋白表达降低,PI3K、Bcl-2、p-Akt蛋白表达升高,差异有统计学意义(P＜0.05);和正常组相比,模型组大鼠Bax mRNA表达升高,Bcl-2及Bc1-2/Bax mRNA表达降低;和模型组相比,针刺组大鼠Bax mRNA表达降低,Bcl-2及Bc1-2/BaxmRNA表达升高,差异有统计学意义(P＜0.05).结论:针刺脑卒中大鼠可显著改善其认知功能障碍,加速神经功能恢复,作用机制可能将PI3K/Akt路径激活,对神经细胞凋亡抑制有联系.

目的 观察代谢综合征(MS)患者血浆颗粒蛋白前体(PGRN)水平变化,并探讨其临床意义.方法 依据中国MS诊断标准将118例受试者分为非MS组63例、MS组55例.测量两组腰围(WC)、体质量指数(BMI);用酶联免疫吸附法测定PGRN及白细胞介素6(IL-6),用全自动生化仪分析检测血脂、丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)、血肌酐,氧化酶法检测空腹血糖(FPG),化学发光法检测空腹胰岛素(FINS),氧化酶法测定餐后2 h血糖(2 h PG),计算稳态模型评估的胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β).采用Spearman相关分析PGRN与各指标的关系;用多元逐步回归、二分类变量逻辑回归分析PGRN与MS发病的关系.结果 MS组血浆PGRN水平高于非MS组(P<0.05),且MS组含5个代谢危险组分者血浆PGRN水平高于含3～4个代谢危险组分者(P<0.05).血浆PGRN与WC、BMI、FPG、2 h PG、FINS、HOMA-IR、ALT、IL-6呈正相关(r分别为0.328、0.254、0.201、0.117、0.185、0.394、0.199、0.273,P均<0.05),与HOMA-β呈负相关(r=-0.179,P<0.05).多元逐步回归、二分类变量逻辑回归分析显示,PGRN是MS发病的影响因素(OR=1.051,P<0.05).结论 MS患者血浆PGRN水平升高,其水平升高提示MS患病风险增大.

目的 分析电针疗法对缺血性脑卒中大鼠肢体肌张力增高抑制作用及对中枢系统γ-氨基丁酸(GABA)能中间神经元表达的影响.方法 选取由本院实验动物中心提供的健康雄性SD大鼠30只,制备大鼠右侧大脑中动脉阻塞(MCAO)模型,使用G6805多通路电针仪对观察组大鼠在造模后第3日行电针治疗,每次30 min,每日1次,共进行6d;观察大鼠治疗前后神经受损程度,观察治疗前后大鼠电生理描记肌张力状况,免疫组化检测大鼠微白蛋白(PV)、钙结合蛋白D-28K(CB),使用Motic Images Advanced分析软件检测其积分光密度数值.结果 治疗后观察组大鼠NSS评分较治疗前、对照组显著降低,电生理描记肌张力较治疗前、对照组显著升高,差异有统计学意义(P＜0.05);治疗后观察组大鼠脑干、颈膨大及腰膨大部位CB表达积分密度值均高于对照组,差异有统计学意义(P＜0.05);治疗后观察组大鼠脑干、颈膨大及腰膨大部位PV表达积分密度值均高于对照组,差异有统计学意义(P＜0.05).结论 电针治疗可提升缺血性脑卒中大鼠钙结合蛋白PV、CD表达,缓解其肢体痉挛状况.

Objective To investigate the influence of diabetic foot infection on the expression of autophagic-related proteins in granulation tissue of wounds, and to provid a theoretical basis for the treatment of diabetic foot infection. Methods Total of 88 patients with diabetic foot infection admitted to The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from January 2013 to July 2017 were selected, among whom, 44 patients in the infection stage were selected as observation group, and 44 patients who were controlled after infection were collected as control group. According to the ankle brachial index (ABI), 44 patients of the observation group were divided into 20 patients with ischemia (ischemic group) and 24 patients with non-ischemia (non-ischemic group). The wound tissue was extracted from these patients. After further treatment, wound tissue were detected by immunohistochemical staining and Western blot, and the patients’name, age, height, weight, course of disease and so on were recorded, respectively, the changes of the patients’condition were observed closely. The levels of autophagy protein microtubule-binding light chain protein-3 (LC3), autophagy specific gene (Beclin-1) and ubiquitin binding protein (p62) in wound tissue were recorded in detail. Results Immunohistochemical staining showed that the levels of LC3 and Beclin-1 in the observation group were significantly lower than those of the control group (t= 3.638,P= 0.0112; t = 2.682,P = 0.022), and the level of p62 was higher than that of the control group (t= 4.998,P= 0.009), all with significant differences. The levels of LC3 and Beclin-1 in the non-ischemic group were significantly higher than those of the ischemic group(t= 2.837,P = 0.018; t= 3.028, P= 0.012), and the level of p62 was lower than that of the ischemic group (t= 3.562,P = 0.010), the difference was statistically significant. The gray value of Beclin-1 in the study group was lower than that of the control group (t = 3.522,P= 0.013), while the gray value of p62 in the observation group was higher than that in the control group (t= 3.522, P= 0.013), with significant differences. However, the gray value of p62 was significantly higher than that of the control group (t = 6.927,P = 0.004), but the difference of LC3 gray value between the two groups was not significantly different (t = 1.037, P = 0.056). Conclusions The level of autophagy in patients with diabetic foot infection was lower than that in patients with ischemia, and the level of autophagy increased after infection control of diabetic foot. Key words: Diabetic foot infection; Granulation tissue of wound; Autophagy-related protein