Objective To study the therapeutic effect of Roux-en-Y gastric bypass （RYGB） on type 2 diabetes mellitus （T2DM） rats and explore the possible mechanism of vaspin in RYGB on T2DM. Methods Twenty SD rats with T2DM and 20 age- and sex-matched normal SD rats were randomly divided into 4 groups according to the random digits table：T2DM-RYGB group， T2DM-sham operation （SO） group，RYGB group，and SO group，10 rats in each group. Fasting plasma glucose （FPG） level，serum insulin （INS） level，vaspin level，and homeostasis model of insulin resistance （HOMA-IR） were determined before operation and on week 4，8 after operation，respectively．At the same time，the correlation between vaspin and the indicators （FPG，INS，or HOMA-IR） was analyzed．Results Compared the indicators after operation with before operation，the FPG level，INS level，vaspin level，and HOMA-IR were not significantly different between the T2DM-RYGB group and T2DM-SO group （P＞0.05） or between the RYGB group and SO group （P＞0.05），but the FPG level，INS level，vaspin level，and HOMA-IR in the T2DM-RYGB group and T2DM-SO group were significantly higher than those in the RYGB group （P＜0.05） and SO group （P＜0.05），respectively. On week 4 after operation，the FPG level，INS level，vaspin level，and HOMA-IR decreased in the T2DM-RYGB group，except for the FPG level，the other indexes had no significant differences as compared with the values before operation. On week 8 after operation，the FPG level，INS level，vaspin level，and HOMA-IR further decreased in the T2DM-RYGB group，there were significant differences of these indicators between before operation and on week 8 after operation. Compared the indicators after operation with before operation，the FPG level，INS level，vaspin level，and HOMA-IR were not statistically significant （P＞0.05） in the T2DM-SO group，RYGB group，or SO group. The changes in serum vaspin level correlated positively with those in INS and HOMA-IR before operaion and on week 4，8 after operaion in the T2DM-RYGB group and T2DM SO group rats （P＜0.05），respectively. Conclusions RYGB surgery has a therapeutic effect on T2DM rats，and serum vaspin level decreases and insulin resistance is improved after RYGB surgery，which may be one of the mechanisms of the treatment for T2DM.
Objective To assess the influence of different digestive tract reconstruction on the blood glucose of gastric antral cancer patients with type 2 diabetes. Methods The clinical data of 51 cases of gastric antral cancer with type 2 diabetes treated radical surgery in this hospital from January 2006 to January 2012 were analyzed retrospectively. The patients were divided into three groups according to the different digestive tract reconstruction methods：BillrothⅠ anastomosis group （n=14）， BillrothⅡ anastomosis group （n=28）， and Roux-en-Y anastomosis group （n=9）. The indexes were analyzed and compared among three groups：① The levels of fast blood glucose （FBG） and 2h postprandial blood glucose （PG2h） were detected before operation and on 1 month and 6 months after the operation；② The level of glycated hemoglobin （HbA1c） was detected before operation and 6 months after the operation；③ The diabetes control was observed. Results The FBG and PG2h levels in the BillrothⅠ anastomosis group detected on 1 month and 6 months after the operation were not statistically different from those detected before the operation （P＞0.05）. The FBG and PG2h levels in the BillrothⅡanastomosis group and Roux-en-Y anastomosis group detected on 1 month and 6 months after the operation were significantly lower than those before the operation respectively （P＜0.05）. The FBG and PG2h levels in the BillrothⅡ anastomosis group detected on 1 month and 6 months after the operation were not statistically different from those in the Roux-en-Y anastomosis group respectively （P＞0.05）， but which were markedly lower than those in the BillrothⅠ anastomosis group， the differences were statistically significant （P＜0.05）. The HbA1c levels in the BillrothⅠ anastomosis group detected before the operation and on 6 months after the operation were not statistically different from each other （P＞0.05）. The HbA1c levels in the BillrothⅡ anastomosis group and Roux-en-Y anastomosis group detected on 6 months after the operation were markedly lower than those before the operation and the difference was statistically significant （P＜0.05）. On 6 months after the operation， the HbA1c levels in the BillrothⅡanastomosis group and Roux-en-Y anastomosis group were markedly lower than those in the BillrothⅠ anastomosis group and the differences were statistically significant （P＜0.05）；the HbA1c level was not statistically different between the BillrothⅡ anastomosis group and the Roux-en-Y anastomosis group （P＞0.05）. The total curative effects in the BillrothⅡ anastomosis and Roux-en-Y anastomosis groups were significantly better than those in the BillrothⅠ anastomosis group （P＜0.05）. Conclusion According to our limited clinical data， BillrothⅡ anastomosis and Roux-en-Y anastomosis for gastric antral cancer patients with type 2 diabetes may be the best surgical approach.
ObjectiveTo evaluate the influencing factors and explore a better method of making rat model of type 2 diabetes by high fat and sugar diet and streptozotocin(STZ) injection. MethodsSixty SPF grade of 6 weeks male SD rats were fed with high fat and glucose diet by 4 weeks and then randomly divided into 3 groups, the control group rats(n=20) were injected citric acid by 50 mg/kg and fed with normal diet, and the diabetes mellitus group rats were further divided into 2 subgroups by the different doses of STZ:the rats of diabetes mellitus model group 1(n=20) were injected by 50 mg/kg, while the rats of diabetes mellitus model group 2(n=20) were injected by 35 mg/kg. The diabetes mellitus model group rats were fed with high fat and glucose diet continually. The fasting blood glucose(FBG) were measured on day 3, 7, 10, and 14, respectively. The success model rate(blood glucose > 16.7 mmol/L after 14 days) and the mortality rate were calculated. Meanwhile fasting serum insulin level(FSI), total serum cholesterol(TC), and triglyceride(TG) were measured. ResultsCompared with the control group, the levels of FBG, FSI, TC, and TG were increased significantly in the diabetes mellitus model group 1 and 2(P < 0.05). And insulin sensitivity was worsen markedly(P < 0.05). But the diabetes mellitus model group 2 had higher success rate of making model(85% vs. 75%) and lower mortality(0 vs. 25%), P < 0.05. ConclusionRat model of type 2 diabetes induced by 4 weeks of high fat and sugar feeding and 35 mg/kg STZ injection has high morbidity, strongly security, and stable features.
目的 了解老年2型糖尿病动脉僵硬度与踝臂指数（ABI）对评价外周动脉硬化的价值。 方法 2010年1月－3月，应用超声、回声跟踪技术和动脉硬化检测仪检测80例老年2型糖尿病患者（观察组）和40例正常老年人（对照组）的颈总动脉内中膜厚度（IMT）、僵硬系数（β）、脉搏波传导速度（PWVβ）、ABI及动脉斑块情况。 结果 与对照组比较，观察组患者的IMT增厚、β增高、PWVβ增快、ABI降低及动脉斑块发生率增多，差异均具有统计学意义（P＜0.001）。 结论 老年2型糖尿病可导致IMT增厚、动脉僵硬度增高、PWVβ增快、ABI降低及更易发生动脉粥样硬化斑块，这些参数可以预测外周动脉粥样硬化的程度，利用彩色多普勒超声诊断仪和动脉硬化检测仪可以较容易得到这些参数，是评价外周动脉粥样硬化病变一种简便、易行，有临床实际意义的方法和手段。
【摘要】 目的 探讨心理干预对糖尿病患者血糖控制及情绪的影响。 方法 2001年3月-2009年7月将120例2型糖尿病患者随机分成干预组和对照组，每组各60例。两组均给予正规药物治疗，干预组同时予心理干预。8周后用焦虑自评量表（self-rating anxiety scale，SAS）、抑郁自评量表（self-rating depression scale，SDS）评定两组患者情绪变化，同时测定空腹血糖、餐后2 h血糖。 结果 干预前后干预组空腹血糖及餐后2 h 血糖下降值多于对照组，差异有统计学意义（Plt;0.05）；通过干预，干预组患者SAS、SDS评分均有明显改善，干预前后评分差异有统计学意义（Plt;0.05），对照组干预前后差异无统计学意义（Pgt;0.05）；患者血糖与SAS、SDS评分等因子呈现中等程度的相关性（|r|为0.4~0.6，Plt;0.05）。 结论 糖尿病患者血糖与SAS、SDS等情绪指标相关，心理干预能显著改善血糖和患者情绪。【Abstract】 Objective To study the effect of psychological intervention on blood-glucose control and emotions of diabetic patients. Methods A total of 120 patients with type 2 diabetes treated between March 2001 and July 2009 were randomly divided into the intervention group and the control group with 60 patients in each. Medicine treatment was carried out for patients in both groups, and psychological intervention was applied only to the intervention group. Eight weeks later, self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate emotion changes of the patients. Fasting blood glucose, post-meal blood glucose (P2hBG) examination were conducted at the same time. Results The result showed a significantly larger decrease of both fasting blood glucose and post-meal blood glucose in the intervention group than the control group (Plt;0.05). Through these methods, the SAS and SDS evaluation of patients in the intervention group improved significantly (Plt;0.05); However, the change of these two scores was not statistically significant in the control group (Pgt;0.05). There was a mid-level correlation between the blood sugar level of diabetic patients and SAS, SDS evaluation scores (0.4lt;|r|lt;0.6, Plt;0.05). Conclusion The blood sugar level of patients with diabetes is closely related to SAS and SDS scores, and psychological intervention can significantly improve the control of blood glucose and emotions of the patients.
目的 探讨视网膜微血管直径与2型糖尿病(DM2)并发症糖尿病视网膜病变(DR)的关系。 方法 选取2009年1月-11月住院确诊DM2患者200例，根据眼底彩色照相结果将患者分为DR组和NDR组，测量视网膜血管直径、测定生化指标及血压，用非条件Logistic回归分析糖尿病视网膜病变发生的危险因素。 结果 V1扩张10 μm时，DM2患者并发DR危险性增加(OR 1.75，95% CI 1.14～3.04，Plt;0.05)；空腹血糖水平增加1 mmol/L，DM2患者并发DR的危险性增加(OR 1.87，95% CI 1.43～2.81，Plt;0.05)； 糖化血红蛋白增加1个单位，DM2患者并发DR的危险性增加(OR 1.08，95% CI 1.02～1.13，Plt;0.05)；DM病程增加1年，DM2患者并发DR的危险性增加(OR 1.41，95% CI 1.18～1.70，Plt;0.05)。 结论 在DM2患者中，视网膜静脉直径大小、空腹血糖水平、糖化血红蛋白水平、糖尿病病程是DR发生的危险因素。
ObjectiveTo understand the role of metformin on reducing incidence of type 2 diabetes mellitus (T2MD) patients complicated with liver cancer. MethodThe related literatures of metformin treated patients with T2MD complicated with liver cancer at home and abroad in recent years were reviewed. ResultsA large number of epidemiological and clinical data showed that the metformin might prevent the occurrence of the T2MD patients complicated with liver cancer, its mechanism was mainly inhibited the proliferation of hepatoma cells through the ATM-LKB1-AMPK-mTOR pathway, PI3K/Akt/mTOR pathway, or miRNA. The current controversy was the authenticity of the data, the influencing factors included the aging problem and characteristics of metformin user. The prospective study design rigorous remained to be clarified. ConclusionMetformin could reduce the incidence of T2MD patients complicated with liver cancer, and could inhibit the growth of liver cancer cells, which provides a new way of thinking for the comprehensive treatment of liver cancer.
摘要:目的: 观察瑞格列奈、阿卡波糖联合治疗老年性2型糖尿病患者的临床疗效及安全性。 方法 :观察58例2型糖尿病患者服用瑞格列奈及阿卡波糖,疗程12周,监测治疗前后空腹及餐后2 h血糖(FBG、PBG)、糖化血红蛋白(HbAlc)、肝功、肾功。 结果 :FBG、PBG及HbAlc较治疗前显著下降(Plt;005),尤其是餐后血糖更为明显(Plt;001)。无一例肝肾功能损害,也无严重低血糖及其它严重不良反应发生。 结论 :瑞格列奈联合阿卡波糖治疗2型糖尿病降糖作用确切,而且安全性、耐受性良好。Abstract: Objective: To observe the clinical efficacy and safety of combined treatment of repaglinide and acarbose in aged patients with diabetes type 2 Methods : After oral administration of repaglinide and acarbose for 12 weeks, 58 patients with type 2 diabetes were observed. The concentrations of fasting blood glucose (FBG), 2 h postprandial blood glucose (PBG), glycosylated hemoglobin (HbAlc), liver and kidney functions were monitored before and after treatment. Results : The levels of FBG, PBG and HbAlc were significantly decreased compared with pretreatment (Plt;005), especially PBG (Plt;001). No case of liver and kidney dysfunction was found, without serious hypoglycemia and other serious adverse events as well. Conclusion : Repaglinide and acarbose have the precise function in the treatment of type 2 diabetes, with good security and good tolerance.