Objective:To investigate the correlation of serum soluble intercellular adhesion molecule 1 (sICAM-1), soluble CD146 (sCD146), and soluble interleukin-2 receptor (sIL-2R) levels with inflammatory factors and lipid metabolism in diabetic nephropathy (DN) patients.Methods:A total of 212 diabetic patients admitted to our hospital from January 2019 to January 2022 were selected as the research objects. Among them, patients with nephropathy were included in the DN group (100 cases), and patients without nephropathy were included in the experimental group (112 cases). At the same time, 112 healthy subjects were selected as the control group. Then various parameters were compared, including sICAM-1, sCD146, sIL-2R, inflammatory factors [interleukin-6 (IL-6), C-reactive protein (CRP), tumour necrosis factor-α (TNF-α)], and lipid metabolism indicators [total cholesterol (TC), triacylglycerol (TG), low-density lipoprotein cholesterol (LDL-C)]. Pearson correlation analysis was used to analyze the correlation between serum sICAM-1, sCD146, sIL-2R and inflammatory factors and lipid metabolism indicators.Results:The levels of serum sICAM-1, sCD146, sIL-2R, IL-6, CRP, TNF-α, TC, TG and LDL-C in DN group were higher than those in experimental group and control group, and the differences were statistically significant (all P<0.05). Compared with the control group, the serum levels of sICAM-1, sCD146, sIL-2R, IL-6, CRP, TNF-α, TC, TG and LDL-C in the DN group and the experimental group were higher, and the differences were statistically significant (all P<0.05). Compared with the experimental group, the serum levels of sICAM-1, sCD146, sIL-2R, IL-6, CRP, TNF-α, TC, TG and LDL-C in the DN group were higher, and the differences were statistically significant (all P<0.05). Serum sICAM-1, sCD146, sIL-2R levels were positively correlated with inflammatory factors IL-6, CRP, TNF-α, and lipid metabolism indicators TC, TG, LDL-C (all P<0.001). Conclusions:The levels of serum sICAM-1, sCD146 and sIL-2R in patients with diabetic nephropathy are significantly increased, and there is a significant correlation between the expression levels of serum sICAM-1, sCD146 and sIL-2R and inflammatory factors and lipid metabolism.

目的:探讨BRAFV600E基因突变在鉴别桥本甲状腺炎合并甲状腺良恶性及中医症候分型方面的临床诊断价值.方法:选取马鞍山十七冶医院2020年9月—2021年9月行高分辨率超声诊断为桥本甲状腺炎合并甲状腺结节患者30例,所有患者均接受甲状腺细针穿刺细胞学活检及BRAFV600E基因检测和中医四诊资料问诊,比较BRAFV600E基因突变评估桥本甲状腺炎合并甲状腺恶性结节的灵敏度和特异性以及鉴别中医症候分型的临床价值.结果:所有30例纳入研究的桥本甲状腺炎并甲状腺结节患者中,病理提示为乳头状癌的患者7例,可疑乳头状癌患者3例,甲状腺炎患者5例,良性结节患者15例.无BRAFV600E突变者为21例,其中13例为良性结节,5例为甲状腺炎,2例为可疑乳头状癌,1例为乳头状癌;2例属"气郁痰阻"型,7例"肝火旺盛"型,6例"心肝阴虚"型,6例"痰结血瘀"型.BRAFV600E突变者9例,其中2例为良性结节,1例为可疑乳头状癌,6例为乳头状癌;6例属"气郁痰阻"型,1例"肝火旺盛"型,1例"心肝阴虚"型,1例"痰结血瘀"型.结论:桥本甲状腺炎合并BRAFV600E突变者出现甲状腺乳头状癌的概率更高,甲状腺细针穿刺细胞学活检联合BRAFV600E基因检测诊断合并桥本甲状腺炎的甲状腺结节的良恶性更有效,桥本甲状腺炎合并甲状腺结节BRAFV600E突变者诊断为"气郁痰阻"证型概率更高.

目的 探讨厄贝沙坦辅助治疗糖尿病肾病的疗效及对患者肾功能和胰岛素样生长因子1(insulin-like growth factor-1,IGF-1)、高迁移率族蛋白B1(high-mobility group box-1,HMGB1)、血管内皮生长因子165(vascular endothelial growth factor,VEGF165)水平的影响.方法 前瞻性选取2016年5月～2018年5月马鞍山十七冶医院收治的糖尿病肾病患者86例,按照随机数表法分为对照组和观察组各43例.对照组于每餐前皮下注射门冬胰岛素30注射液,0.5～1.0 U/(kg?d),3次/d,并根据患者情况调整剂量;观察组在对照组的治疗基础上,予以厄贝沙坦150 mg,1次/d,口服.两组患者均连续治疗3个月,观察临床疗效,比较治疗前后两组患者空腹血糖(fasting plasmaglucose,FPG)、餐后2h血糖(2 hours plasmaglucose,2hPG)和糖化血红蛋白(HbAlc)、血压、肾功能[血包括血清肌酐(serum creatinine,Scr)、尿素氮(BUN)、同型半胱氨酸(Homocysteine,Hcy)、胱抑素C(cystain C,Cys C)]及IGF-1、HMGB1、VEGF165水平.结果 两组治疗后总有效率对比,观察组高于对照组(93.02％vs.74.42％),差异有统计学意义(P ＜ 0.05).治疗后,观察组FPG、2hPG、HbA1C、收缩压、舒张压、Scr、BUN、Hcy及Cys C水平明显低于对照组,观察组血清IGF-1、HMGB1、VEGF165水平明显低于对照组,差异有统计学意义(P ＜ 0.05).结论 厄贝沙坦联合门冬胰岛素30注射液治疗糖尿病肾病可提高临床疗效,降低血糖和血压水平,改善肾功能及血清炎性细胞因子水平.

目的探讨亚急性甲状腺炎治疗方法选择与临床症状、预后的关系。方法回顾性分析2009年6月至2012年10月在十七冶医院内分泌科诊断的33例亚急性甲状腺炎患者的病历资料和随访资料。结果 10例口服非甾体类消炎药(布洛芬或芬必得)患者10～30d后颈痛、甲状腺肿消失,2例发生甲状腺功能减退(甲减);23例甲状腺内注射糖皮质激素(地塞米松)患者7～30d后颈痛、甲状腺肿消失,3例发生甲减,1例为亚临床甲减,未发生明显血糖、血压波动和其他副作用。结论甲状腺内局部注射用药是治疗病程长、病情重的亚急性甲状腺炎的安全有效的新方法。