探讨老年男性 2 型糖尿病(T2DM)患者血尿酸浓度与骨代谢标志物浓度、骨密度(BMD)的关系.T2DM组纳入 88 例 50 岁以上男性T2DM患者;健康人群组纳入 91 例平均年龄(61.25±8.43)岁的健康男性自愿者.收集研究对象的身体质量指数(BMI)、生化指标、骨钙素(OC)浓度、总Ⅰ型胶原氨基端延长肽(PINP)浓度、β-胶原特殊序列(β-CTX)浓度、股骨BMD、腰椎BMD等临床资料.比较研究对象的临床资料,并分析T2DM组尿酸浓度与各骨代谢标志物浓度、BMD之间的关系.结果显示:T2DM组尿酸、OC、PINP浓度与股骨BMD、腰椎BMD较健康人群组低;T2DM组BMI与股骨BMD存在显著正相关,尿酸浓度与PINP浓度、股骨BMD存在显著正相关.结果表明,对于老年男性T2DM患者来说,保持适当高的尿酸浓度可能是骨质疏松的保护因素.

Osteoporosis has gradually become a common human disease. The main cause of this common disease is caused by the degradation of the internal structure of bone and soft tissues, which causes great troubles to the lives of elderly patients. Quercetin is a flavonoid drug that is commonly used to treat osteoporosis. Therefore, it is very important to study the pharmacological and clinical effects of quercetin. The purpose of this article is to solve some problems in the clinical application of quercetin and to explore the effect of quercetin on bone metabolism and serum osteocalcin in osteoporotic rats. Taking 90 rats as the research object, an animal model of osteoporosis was constructed. The rats were randomly divided into sham operation control group, ovariectomy control group and quercetin observation group. Except for the sham operation group, all rats were subjected to ovariectomy, and the rats in the quercetin observation group were given quercetin drug intervention. 1 w later, all rats were tested for bone metabolism and serum osteocalcin levels, and related data were recorded and analyzed. The results of the study showed that with the intervention of quercetin, the bone metabolism index of osteoporosis rats increased from the original (53.49 +/- 3.41) to (86.27.2 +/- 4.22), and the serum calcium level from the original (16.28 +/- 0.56) mu g/l increased to (37.64 +/- 2.35) mu g/l, and the bone mineral density and bone tissue structure of rats also improved accordingly. It can be seen that quercetin can promote bone metabolism in osteoporotic rats, increase the content of osteocalcin in rats, and have a good effect on the prevention and treatment of osteoporosis.

目的 分析高频超声检查用于检查糖尿病患者关节病变情况及与血糖水平关系的价值.方法 选取莆田学院附属医院2020年1月—2021年10月收治的2型糖尿病患者120例(240个关节),设为糖尿病组;另选取同期在莆田学院附属医院接受体检的健康体检者120名(240个关节),设为对照组.全部研究对象均接受高频超声检查,对两组声像图特征进行总结,并分析糖尿病患者膝关节病变与餐后血糖、糖尿病病程的相互关系.结果 与对照组相比,糖尿病组的外侧滑囊积液、内侧滑囊积液及髌上囊积液均明显增加,差异有统计学意义(P<0.05).在糖尿病病程逐渐增加的过程中,膝关节滑囊病变的发生率显著增加,差异有统计学意义(P<0.05).餐后血糖水平<9 mmol/L者的膝关节病变率显著低于餐后血糖水平≥9 mmol/L者,差异有统计学意义(P<0.05).膝关节病变与糖尿病餐后血糖水平存在显著相关性(P<0.05).结论 采用高频超声检查能准确、清晰显示糖尿病患者膝关节早期病理改变,为早期诊治提供指导;且膝关节病变与糖尿病患者的病程、餐后血糖水平密切相关.

目的 益生菌可辅助糖尿病患者控制血糖,其机制尚不明确,本文探索益生菌可通过调节2型糖尿病患者肠道菌群降低炎症反应、改善糖代谢.方法 选取莆田学院附属医院2020年1月—2022年1月收治的初诊2型糖尿病患者120例,将入组的2型糖尿病患者随机均分为双歧杆菌乳杆菌三联活菌片组(益生菌组,60例)和非双歧杆菌乳杆菌三联活菌片组(非益生菌组,60例).对比口服双歧杆菌乳杆菌三联活菌片对2型糖尿病患者糖代谢和炎症指标的影响.结果 益生菌组、非益生菌组患者的性别构成、年龄对比,差异无统计学意义(P>0.05).治疗开始前益生菌组、非益生菌组的糖代谢和炎症指标对比,差异无统计学意义(P>0.05);治疗16周后,两组的糖代谢均得到改善,且益生菌组的糖化血红蛋白、空腹血糖、餐后2 h血糖、白细胞计数、超敏C反应蛋白、白细胞介素-6、肿瘤坏死因子-α、脂多糖较非益生菌组下降更明显,差异有统计学意义(P<0.05).结论 口服益生菌可通过调节肠道菌群、降低炎症反应水平辅助改善2型糖尿病患者糖代谢.

目的 探究达格列净联合胰岛素强化治疗对老年2型糖尿病胰岛素用量及血糖指标的影响.方法 回顾性分析2021年1—12月莆田学院附属医院老年2型糖尿病患者86例的临床资料,随机分为对照组和研究组,每组43例.其中,对照组采用胰岛素强化方法治疗,研究组采取达格列净联合胰岛素强化方法治疗.比较两组血糖指标、血糖达标时间、胰岛素用量、血糖波动性及氧化应激水平情况.结果 治疗前,两组血糖值对比,差异无统计学意义(P>0.05);治疗后,研究组血糖指标改善情况明显优于对照组,差异有统计学意义(P<0.05).研究组每日胰岛素用量小于对照组,血糖达标时间短于对照组,差异有统计学意义(P<0.05).治疗前,两组血糖波动性对比,差异无统计学意义(P>0.05);治疗后,研究组血糖平均波动幅度及最大波动幅度均明显低于对照组,差异有统计学意义(P<0.05).治疗前,两组氧化应激水平对比,差异无统计学意义(P>0.05);治疗后,研究组氧化应激指标MDA、ROS明显低于对照组,SOD、GSH-Px指标明显高于对照组,差异有统计学意义(P<0.05).结论 达格列净联合胰岛素强化治疗能够有效控制老年2型糖尿病患者血糖水平,提升抗氧化能力,降低胰岛素用量,临床应用效果明显.

目的 探讨间断素食和限食对正常体重2型糖尿病患者糖脂代谢的影响.方法 选择2017年8月—2019年6月本院内分泌科门诊就诊的48例2型糖尿病患者作为研究对象,随机分为素食组、限食组和对照组三组,每组各16例.素食组每周五日素食两日普食,限食组每周五日普食两日限食,对照组进行常规营养学治疗.所有患者于入组前及治疗16周后分别检测:FPG、2 hPG、HbA1c、BMI、SBP、DBP、TG、CHOL、HDL-C、LDL-C,并计算HOMA-IR.结果 素食组和限食组治疗后的FPG、2 hPG、HbA1c、SBP、TG、CHOL、LDL-C、HOMA-IR均比对照组低,差异有统计学意义(P<0.05);素食组治疗后的CHOL、LDL-C比限食组低,差异有统计学意义(P<0.05);限食组治疗后的BMI比素食组和对照组低,差异有统计学意义(P<0.05).结论 间断素食和限食均能改善正常体重2型糖尿病患者的血糖、血压和血脂.间断限食模式有额外降低BMI的作用,间断素食则有额外降低CHOL和LDL-C的作用.两种饮食模式均值得临床推广.

目的 观察初发的2型糖尿病患者中,素食人群和普食人群糖脂代谢、体重和血压的区别.方法 选取2017年8月—2018年12月本院内分泌科门诊及体检中心体检新发现的2型糖尿病患者共48例作为研究对象,其中素食者24例作为素食组,普食者24例作为普食组.对比两组患者的空腹血糖(FPG)、口服葡萄糖耐量试验2小时血糖(2hPG)、糖化血红蛋白(HbA1c)、体重指数(BMI)、收缩压(SBP)、舒张压(DBP)、甘油三酯(TG)、总胆固醇(CHOL)、高密度脂蛋白胆固醇(HDL)和低密度脂蛋白胆固醇(LDL),并进行统计学分析.结果 素食组的空腹血糖低于普食组,但餐后两小时血糖高于普食组,差异有统计学意义(P<0.01).两组之间糖化血红蛋白和体重指数的差异无统计学意义(P>0.05).在血压上,素食组的收缩压比普食组低,差异有统计学意义(P<0.01),而两组之间舒张压的差异无统计学意义(P>0.05).在血脂上,素食组的甘油三酯、总胆固醇和低密度脂蛋白胆固醇低于普食组,差异有统计学意义(P<0.01),但两组之间高密度脂蛋白胆固醇的差异无统计学意义(P>0.05).结论 素食对于改善2型糖尿病患者的空腹血糖、收缩压、甘油三酯、总胆固醇和低密度脂蛋白胆固醇可能有益.

目的 评价持续皮下注射胰岛素在糖尿病合并甲亢治疗中的应用效果.方法选取2016年3月—2017年3月该院收治的糖尿病合并甲亢患者90例,采用随机数字表法的分组形式将其平均分为实验组与对照组,每组均45例.对照组行传统皮下注射胰岛素治疗,实验组行持续皮下注射胰岛素治疗,对比治疗效果以及药物总剂量指标﹑血糖达标时间指标.结果经过调查对照组的治疗效果低于实验组,两组数据比较差异有统计学意义(P<0.05).实验组的药物总剂量指标以及血糖达标时间指标优于对照组,差异有统计学意义(P<0.05).结论在糖尿病合并甲亢实际治疗的过程中,采用持续皮下注射胰岛素法,能够加快安抚速度,改善预后,减少血糖达标时间,具有较高的推广价值.

Objective To explore the effect of health guidance on medication compliance and effectiveness of patients with osteoporosis (OP) treated by alendronate sodium. Methods 130 cases of patients with OP treated in our hospital from August 2015 to August 2016 were selected as the object of study, and were randomly divided into two groups. 65 cases in the control group were treated with small dose of alendronate sodium, 65 cases in the observation group were given health guidance on the basis of the control group. After continuous treatment of 12 months, compared the medication compliance at different time points, adverse reactions, cognitive function on OP of the two groups. Medication compliance included medication continuity and compliance, which were represented by the duration of medication and medication possession ratio (MPR) respectively. Results There were no statistically significant differences in MPR and compliance between the two groups at 3 months after treatment (P>0.05); MPR and compliance in the observation group were higher than those in the control group at 6 and 12 months after treatment, with statistically significant differences (P 0.05); the scores in the observation group were higher than those in the control group after treatment (P 0.05). Conclusion Health education can improve medication compliance and the safety of treatment of patients treated by alendronate sodium, strengthen the understanding on disease related knowledge of the patients, is worth promoting. Key words: Osteoporosis; Alendronate sodium; Health guidance; Compliance

Objective To observe the mechanism of genistein (Gen) on osteoporosis in ovariectomized rats by promoting VEGF expression.Methods Forty 6-month-old female rats were randomly divided into control group,sham operation group,castration group,Gen intervention 6-week group,and Gen intervention 10-week group.Femoral head structure of each group was observed under light microscope.The changes of the number of vacancy lacunae in rat femoral head was analyzed.Vascular endothelial growth factor (VEGF) was detected with ELISA,and the expression intensity of VEGF mRNA in situ hybridization was observed and analyzed.Results Compared with that in the control group,bone mineral density and Tb.Th decreased significantly (P ＜ 0.05) in the castration group.Bone mineral density and Tb.Th increased significantly in the Gen intervention 10-week group,and the differences were statistically significant (P ＜ 0.05).The trabecular bone became thinner with the development of disease course in the diabetic rat femoral head.Gen had no effect on the expression of VEGF in serum of ovariectomized rats.The expression of VEGF mRNA in bone marrow-derived vascular endothelial cells increased (P ＜ 0.05).Conclusion Gen promotes the proliferation of vascular endothelial cells,promotes angiogenesis,and improves the anti-osteoporosis tendency in ovariectomized rats.

Objective To investigate the evolution characteristics of bone microstructure in rats with diabetes combined with castration.Methods Forty 6-month-old female SD rats were randomly divided into sham operation group,castration group,diabetes mellitus group,and diabetes combined with castration group.Bone mineral density and bone microstructure of the femurs were measured using micro-CT after 6 weeks and 15 weeks.Deposition changes of collagen fiber were observed by van Gieson collagen staining.The changes of the trabecular thickness (Tb.Th) and the trabecula separation (Tb.Sp) were analyzed by HE staining.Results Compared with the sham group,the levels of bone β-collagen degradation products and Tb.Sp significantly increased,bone mineral density and Tb.Th significantly decreased,and the differences were statistically significant (P ＜ 0.05) in the 6-week and 15-week castration group.The levels of β-collagen degradation products and Tb.Sp significantly increased,bone mineral density and Tb.Th significantly decreased,and the collagen decreased in the 15-week castration group.The difference was statistically significant (P ＜ 0.05) in the 15-week diabetes mellitus group.The levels of β-collagen degradation products and Tb.SP significantly increased,bone mineral density,collagen,and Tb.Th significantly decreased,and the differences were statistically significant (P ＜ 0.05) in the 6-week and 15-week diabetes combined with castration group.Conclusion In the early stage of diabetes mellitus combined with castration,osteoporosis is mainly caused by castration.However,in the later period,osteoporosis continues to develop due to slow bone decomposition of diabetes.

评价利拉鲁肽在初发2型糖尿病伴肥胖及微炎症状态患者中的应用价值,选择莆田学院附属医院2015年1月1日至2016年12月31日期间收治的94例初发2型糖尿病伴肥胖及微炎症患者为研究对象,根据用药方案不同将其平均分成对照组与观察组,分别给予二甲双胍与利拉鲁肽治疗,对比两组患者治疗后的血糖水平、微炎症状态、体重、身体质量指数(BMI)及不良反应的异同.对比对照组,观察组患者治疗后血糖指标与微炎症指标得到更好控制,体重与BMI下降更为明显,不良反应发生情况较少,差异均具有显著的统计学意义(P<0.05).对合并肥胖及微炎症的初发2型糖尿病患者治疗而言,应用利拉鲁肽效果较好.

目的:观察非布司他治疗痛风伴高尿酸血症患者的疗效.方法:按照随机数字表法将40例痛风伴高尿酸血症患者分为非布司他组(非布司他,40 mg/d)和别嘌醇组(别嘌醇,30 mg/d),每组20例,治疗24周.检测治疗前后的尿酸变化与治疗后各组尿酸低于360μmol/L的例数.结果:治疗24周后,两组患者尿酸均较治疗前下降,差异均有统计学意义(P＜0.01).非布司他组尿酸下降程度高于别嘌醇组,但两组比较差异无统计学意义(P＞0.05).非布司他组较别嘌醇组有更多患者尿酸水平达到低于360μmol/L的控制目标,但差异无统计学意义(P＞0.05).结论:非布司他每日40 mg与别嘌醇每日300 mg治疗痛风伴高尿酸血症疗效相当.

目的：研究利拉鲁肽联合二甲双胍缓释片、格列吡嗪控释片治疗2型糖尿病的疗效。方法选取33例联合应用格列吡嗪控释片和二甲双胍缓释片血糖控制仍欠佳的2型糖尿病患者，加用利拉鲁肽皮下注射1日0.6mg～1.8mg，对比治疗前后的空腹和餐后2h血糖、糖化血红蛋白以及体重指数。结果加用利拉鲁肽后，患者的空腹和餐后2h血糖，以及糖化血红蛋白和体重指数均有下降，而且有统计学意义（P＜0.01）。结论利拉鲁肽应用于2型糖尿病患者降糖疗效显著，同时还可以降低患者体重。

Objective To evaluate the clinical efficacy of severe pneumonia and diabetes with ambroxol adjuvant treatmen.Methods 120 patients of severe pneumonia and diabetes were divided into study group and the control group(60 cases) by a random number table, The control group used of antibiotics and insulin routine treatment, study group with ambroxol on conventional treatment, observed the clinical efficacy of the two groups of patients. Results Lung inflammation control time and hospitalization time of study group were significantly shorter than the control group(P0.05); the cure rate of the study group was 36.67%, significantly higher than the 21.67% of control group(P0.05); the total effective of study group was91.67%, significantly higher than the 66.67% of control group(P0.05); mortality rate of study group was significantly lower than the control group, focus absorption rate was significantly higher(P0.05); there was no significant difference(P0.05)incidence of adverse reactions between the two groups. Conclusion Use ambroxol adjuvant treatment of severe pneumonia and diabetes, can effectively relieve symptoms, lesions accelerate absorption and improve clinical efficacy. It has significant clinical advantages, should be promoted.

目的 探究左旋甲状腺素应用于亚临床甲减、临床甲减患者的疗效及对血脂水平的影响.方法 选取某院2011年2月至2012年12月临床、亚临床甲状腺功能减退患者各100例,给予左旋甲状腺素雷替斯治疗,分别在治疗前后测定甲状腺功能、血脂指标,统计患者治疗转归与副作用反应.结果 所有患者甲减症状消失,甲状腺功能恢复正常,出现3例不良反应减少剂量后正常;临床甲减者治疗后TC、TG、LDL较治疗前显著改善(P＜0.05),其中TC、LDL指标差异极其显著(P＜0.01),亚临床甲减者治疗后TC、LDL相较于治疗前显著改善(P＜0.05),其中LDL指标差异极其显著(P＜0.01).结论 左旋甲状腺素应用于亚临床甲减、临床甲减患者的疗效显著,安全可靠,能有效改善患者血脂状况.

目的:探讨电刺激法皮肤交感反应(eSSR)在甲状腺功能异常中的应用价值.方法:病例组46例(甲亢30例,甲减16例),对照组30例,检查eSSR、自主神经症状量表(ASP).结果:病例组eSSR异常率差别有统计学意义,P<0.01.且eSSR波幅、面积与ASP评分存在相关性,P<0.01,R2=0.23.结论:eSSR可用于甲状腺功能异常自主神经功能障碍的检查.

目的观察早期糖尿病大鼠股骨头形态的变化,探讨早期糖尿病大鼠股骨头组织醛糖还原酶(AR)活性变化。方法建立速发型糖尿病大鼠(STZ)模型,光镜下观察各组股骨头结构;电镜下观察股骨头超微结构;各组股骨头组织匀浆生化检测AR的活性。结果早期糖尿病大鼠股骨头,骨小梁排列较稀疏,骨小梁厚度变窄,数量减少,骨小梁明显变细、间距加宽,小梁间出现较多空白区域,电镜下观察,骨小梁排列稀疏,骨小梁间隙增宽,部分区域骨小梁出现断裂、游离残端,三维结构受到破坏,骨小梁出现缺失。随病情发展,AR活性增大。结论糖尿病大鼠股骨头的早期,骨吸收大于骨形成,出现骨质疏松倾向变化。组织AR活性增大。

Objective To explore the effects of cinepazide maleate and epalrestat in treatment of diabetic peripheral neuropathy(DPN). Methods Seventy-two DPN patients,with a satisfactory level of blood glucose,were divided into 2 groups:treatment group(n=36,treated with cinepazide maleate and epalrestat)and control group(n=36,treated with mecobalamin).Then the conduction velocity of common peroneal nerve and tibial nerve were detected,and the effect on the symptoms of diabetic microangopathy caused by DPN were observed. Results The effective rate and the conduction velocity of common peroneal nerve and tibial nerve in treatment group were significantly higher than those in control group(P<0.05),and no obvious adverse reactions were found. Conclusion The cinepazide maleate combined with epalrestat is better in treatment of DPN than mecobalamin.