糖肾宝冲剂对糖尿病肾病患者外周血内皮祖细胞及相关炎性因子的影响

目的 观察糖肾宝冲剂对糖尿病肾病（diabetic nephropathy,DN）患者外周血内皮祖细胞（endothelial progenitor cells,EPCs）数量及其增殖能力的影响,探讨其可能的作用机制。方法 将92例DN患者,按随机数字表法分为治疗组和对照组,每组46例。对照组采用降血糖、降血压、降血脂等常规治疗,治疗组在对照组疗法基础上加服糖肾宝冲剂,疗程16周。观察两组治疗前后空腹血糖（fasting plasma glucose,FPG）、血清肌酐（serum creatinine,SCr）、尿白蛋白排泄率（urinary albumin excretion rate,UAER）、尿N-乙酰β-D氨基葡萄糖苷酶（N-acetyl β-D-glucosaminidase,NAG）,血清超敏C-反应蛋白（high-sensitivity C-reactive protein,hs-CRP）、肿瘤坏死因子-α（tumor necrosis factor,TNF-α）、白细胞介素-6（interleukin,IL-6）水平,以及血清EPCs数量及其增殖能力。结果 与治疗前比较,治疗后两组UAER、NAG、hs-CRP、TNF-α及IL-6均显著下降（P<0.01）,外周血EPCs数量及其增殖能力均显著升高 （P<0.01）, 但治疗组在改善上述指标方面均显著优于对照组（P<0.01）。结论 糖肾宝冲剂能显著提高DN患者外周血EPCs数量及其增殖能力,减轻肾损害,其作用机制可能与抑制DN的炎性反应有关。     

糖尿病性胃轻瘫病机特点与中医治法

糖尿病性胃轻瘫的病机可分为基本病机和前行病机。基本病机为脾失运化，前行病机为血瘀、痰浊、气滞、湿阻等。治疗应采取共性治疗和个性治疗。共性治疗包括理气运脾、燥湿运脾、益气健脾、淡渗实脾和消食健脾。个性治疗包括行气燥湿、化痰降浊、活血化瘀等。     

益气活血通痹法治疗糖尿病周围神经病变40例

目的 观察糖痹汤与甲钴胺联合治疗糖尿病周围神经病变(diabetic peripheral neuropathy, DPN)的临床疗效.方法 选择80例DPN患者,按排列表法随机分为两组,每组40例,对照组在基础治疗上予以甲钴胺1.5 mg加入100 ml氯化钠注射液中静脉滴注,每日1次,2周后改为口服,每次0.5 m...     

Fatalities Due to Failure of Continuous Subcutaneous Insulin Infusion Devices: A Report of Six Cases

Diabetes mellitus type 1 and type 2 are diseases characterized by impaired regulation of blood glucose due to decreased insulin production and insulin resistance, respectively. Management of diabetes mellitus often requires injection of exogenous insulin. Continuous subcutaneous insulin infusion (CSII or insulin pump) is a diabetes treatment modality utilizing a device to aid in regulation of glycemic control. Malfunctions in device components can have rare fatal consequences. Described in this report are six fatalities due to one such malfunction, the failure of plastic cannulas of CSII devices to penetrate the skin and deliver insulin, resulting in fatal diabetic ketoacidosis (DKA). The cases derive from four different death investigation systems. For each case, scene and autopsy findings are presented, as well as selected toxicology and histology findings. These cases illustrate the importance of careful examination of CSII devices in death investigations and introduce a discussion on discrepant manner of death classifications.     

死后生物化学在糖尿病酮症酸中毒法医学诊断中的应用

糖尿病酮症酸中毒是糖尿病患者一种处于高糖、高酮状态并且导致代谢失代偿的危险并发症。这类死者常规法医学检查无特异性表现,需要进行死后生物化学指标分析。死后生物化学是一种采集死者体液进行生物化学检测,从而判断死者生前的代谢状态进而明确死因的检查方法。本文综述了糖尿病酮症酸中毒死亡的基本情况、法医学检查表现,并着重阐述运用于诊断糖尿病酮症酸中毒的死后生化指标,从而总结糖尿病酮症酸中毒死亡的法医学诊断思路。     

电针夹脊穴治疗早期糖尿病性下肢动脉硬化闭塞症疗效观察

目的 观察电针夹脊穴治疗早期糖尿病性下肢动脉硬化闭塞症的临床疗效.方法 将60例患者随机分为对照组和治疗组,每组30例,对照组采用常规西药治疗,治疗组在此基础上增加电针夹脊穴治疗.结果 两组治疗后踝肱指数、临床症状(皮肤温度、皮肤疼痛、皮肤色泽)评分、足背动脉内径及血流速度峰值均高于治疗前(P<0.05),治疗后治疗组的跛行指数,皮肤温度、皮肤疼痛、皮肤色泽评分增加程度及踝肱指数、足背动脉内径及血流速度峰值升高程度均明显大于对照组(P<0.05);治疗组临床疗效显著优于对照组(P<0.05).结论 采用电针夹脊穴治疗早期糖尿病性下肢动脉硬化闭塞症可显著改善患者临床症状及踝肱指数,增加患者足背动脉内径及血流速度峰值,改善患者下肢血液循环.     

The Effects of Gastroesophageal Reflux Disease on Forensic Breath Alcohol Testing

Fifteen test subjects, 10 of whom were diagnosed with gastroesophageal reflux disease (GERD), were dosed with alcohol to BACs above 0.150 g/dL. Blood and breath assays taken at 20-min intervals for 8 h after dosing demonstrated close agreement between postabsorptive BAC and BrAC values. Three subjects exhibited elevated breath alcohol concentrations up to 0.105 g/dL during the absorptive phase that were apparently due to the passage of gastric alcohol through the lower esophageal sphincter not attributable to eruction or regurgitation. The effect of gastric alcohol was not consistently proportional to the amount of unabsorbed gastric alcohol. Absorption of alcohol in the esophagus explains the nonproportionality. Breath samples contaminated by GERD-related alcohol leakage from the stomach into a breath sample were found only when there was a high concentration of alcohol in the stomach. When contaminated breath samples were encountered, they were irreproducible in magnitude.     

益气活血通络法治疗糖尿病周围神经病变52例

目的 观察益气活血通络法治疗糖尿病周围神经病变（diabetic peripheral neuropathy,DPN）的疗效。方法 将74例气阴两虚、瘀血阻络型DPN患者随机分为对照组（22例）和治疗组（52例）,对照组给予常规疗法,治疗组在对照组疗法基础上加用益气通络活血中药口服,疗程为30 d。观察两组患者神经传导速度、中医证候积分及血液流变学指标的变化。结果 治疗组临床疗效显著优于对照组 （P＜0.01）,治疗组在提高腓总神经和正中神经的感觉、运动神经传导速度,降低中医证候积分及全血黏度、血浆黏度和纤维蛋白原方面明显优于对照组（P＜0.05,或P＜0.01）。结论 益气活血通络法对DPN有较好的疗效,其机制与改善血液流变性及感觉和运动神经传导速度有关。     

芪贞降糖颗粒治疗糖尿病自主神经病变30例

目的 观察芪贞降糖颗粒治疗糖尿病自主神经病变（diabetic autonomic neuropathy DAN）的临床疗效。方法 将60例DAN患者随机分为对照组（30例）和治疗组（30例）。在糖尿病基础治疗的基础上,对照组口服甲钴胺,治疗组加用芪贞降糖颗粒口服。连续治疗3个月后,观察并比较两组DAN疗效、单个中医症状疗效及足汗腺神经受损风险的改善情况。结果 治疗组的DAN疗效显著优于对照组（P＜0.05）,总有效率显著高于对照组（P＜0.05）;治疗组在改善倦怠乏力、口干咽燥、口渴喜饮、气短懒言、自汗盗汗方面显著优于对照组（P<0.05）;治疗组在降低足汗腺神经受损风险方面显著优于对照组（P<0.01）。结论 芪贞降糖颗粒可以明显改善DAN患者泌汗运动神经功能和DAN相关症状。     

载黄芪多糖组织工程支架促糖尿病大鼠皮肤创伤修复研究

目的 研究载黄芪多糖（Astragalus polysaccharides,APS）组织工程支架(APS/PDLGA)对糖尿病大鼠皮肤创面愈合的影响。方法 采用高压静电纺丝技术制备APS/PDLGA超细纤维,构成三维纤维网状组织工程支架;扫描电子显微镜观察纤维形貌,并计算直径;采用苯酚-浓硫酸法检测载药量与包封率;将APS/PDLGA用于糖尿病大鼠皮肤溃疡创面修复,采用苏木精-伊红染色观察各实验组皮肤修复进程。结果 APS/PDLGA纤维表面光滑、粗细均匀、直径（2.56±0.50）μm、载药量（5.22±0.076）%、包封率（90.06±1.31）%,覆盖APS/PDLGA纤维膜组的糖尿病大鼠皮肤创面约在第18天完全愈合,新生上皮外观与结构和正常皮肤相似,愈合速度明显快于空白PDLGA纤维膜组和对照组创面（P＜0.01）。结论 APS/PDLGA纤维组织工程支架可促进糖尿病大鼠皮肤创面愈合,有望应用于糖尿病皮肤溃疡治疗。