【摘要】 目的 研究2型糖尿病（type 2 diabetes mellitus，T2DM）合并非酒精性脂肪性肝病（non-alcoholic fatty liver disease， NAFLD）患者血浆脂肪细胞特异性脂肪酸结合蛋白（adipocyte-specific fatty acid-binding protein，A-FABP）的水平及其相关因素。 方法 2009年10月—2010年10月选取T2DM合并NAFLD组（A组）60例，未合并NAFLD组56例（B组）为研究对象。测定体质量指数（body mass index，BMI），检测血脂、糖化血红蛋白（hemoglobin A1c，HbA1c）等生化指标。放射免疫法测定空腹胰岛素（fasting insulin，FINS），空腹C肽水平（fasting C-peptide，FCP），计算胰岛素抵抗指数（homeostasis model of assessment-insulin resistance，HOMA-IR）、胰岛素敏感指数（insulin sensitivity index，ISI），测定A-FABP、C反应蛋白（C-reaction protein，CRP）及肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）。 结果 与B组患者相比，A组患者其血浆A-FABP水平、BMI、腰围、腰臀比、丙氨酸氨基转移酶、门冬氨酸氨基转移酶、CRP、TNF-α、FCP、FINS、总胆固醇、甘油三酯、Ln（HOMA-IR）升高，Ln（ISI）降低，差异有统计学意义（Plt;0.05）；两组HbA1c差异无统计学意义（Pgt;0.05）。A-FABP水平变化与TNF-α、HOMA-IR、CRP呈正相关，与ISI呈负相关。 结论 T2DM伴NAFLD中，A-FABP升高与胰岛素抵抗是并存的，且存在明显相关关系，二者在疾病的发生发展中均可能具有重要的作用。【Abstract】 Objective To analyze the serum level of adipocyte-specific fatty acid-binding protein (A-FABP) in patients with type 2 diabetes mellitus (T2DM) complicated with non-alcoholic fatty liver disease (NAFLD), and its related factors. Methods From October 2009 to October 2010, 112 patients with T2DM were categorized into two groups: the group with NAFLD (group A) with 60 patients, and the group without NAFLD (group B) with 56 patients. Body mass index (BMI), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and hemoglobin A1c (HbA1c) were detected. Radioimmunoassay was carried out to measure fasting insulin (FINS) and fasting C-peptide (FCP), and homeostasis model of assessment-insulin resistance (HOMA-IR) and insulin sensitivity index (ISI) were calculated. At the same time, A-FABP, C-reaction protein (CRP) and tumor necrosis factor-α (TNF-α) were also detected. Results Compared with patients in group B, plasma levels of A-FABP, BMI, waistline, waist to hip ratio, ALT, AST, TG, TC, HDL-C, LDL-C, CRP, FCP, FINS, and HOMA-IR for patients in group A were all higher, while ISI was lower; and the differences in the above-mentioned parameters were statistically significant (Plt;0.05). The levels of HbA1c in the two groups were not significantly different (Pgt;0.05). The change of A-FABP level was positively correlated with TNF-α, HOMA-IR and CRP, while it wasnegatively correlated with ISI. Conclusions In patients with T2DM with NAFLD, there is an obvious correlation between the coexisting A-FABP rise and insulin resistance. Both of them played critical roles in the onset and developing of the disease.
ObjectiveTo summarize the research progress of magnetic resonance imaging (MRI) for diagnosis of nonalcoholic steatohepatitis (NASH).MethodRelevant literatures at home and abroad were collected to make an review, then summarized the research status and progress of MRI for diagnosis of NASH. Their advantages and disadvantages were summarized.ResultsA variety of MRI techniques, including MR elastography, gadolinium-ethoxybenzyldiethylenetriaminepentaacetic acid (Gd-EOB-DTPA) enhanced MRI, diffusion-weighted MR imaging, and quantitative MR imaging of fat and iron, had been widely used in diagnosing NASH and shown to have some value. However, there were currently no effective MRI techniques recommended for diagnosing NASH.ConclusionsMRI plays an important role in noninvasive assessment of NASH. Future studies are needed to investigate more efficient noninvasive biomarkers and models consisting of imaging and non-imaging biomarkers for diagnosing NASH, to reduce unnecessary biopsies.
目的:探讨使用院前指数(Prehospital Index, PHI)及格拉斯哥昏迷评分(Glasgow Coma Score, GCS)两种创伤评分法对院前急救中急性酒精中毒合并外伤性颅内出血患者的评估价值。方法: 纳入68例院前急救中酒精中毒合并头外伤患者,院前均进行PHI及GCS两种创伤评分,随访至出院,以头部CT扫描及随访结果作为标准以判断患者是否伴有颅内出血。计算两种创伤评分的敏感度、特异度、阳性似然比、阴性似然比、阳性预测值、阴性预测值及Youden指数,并作出受试者工作特征曲线(ROC曲线),以正态离差值Z检验两种评分法ROC曲线下面积的差异。 结果: 院前指数以6分作为诊断界值,敏感度为94.7%,特异度为71.4%;格拉斯哥昏迷评分以9分作为诊断界值,敏感度为98.8%,特异度为30.6%,PHI及GCS的ROC曲线下面积分别是0.881和0.678,其差异有统计学意义。结论: 在对急性酒精中毒合并头外伤患者是否伴有颅内出血的院前评估中,院前指数较格拉斯哥昏迷评分更有价值。
摘要:目的:探讨纳络酮对急性酒精中毒的临床疗效及经验。方法: 将58例酒精中毒患者随机分为2组:常规治疗组29例,给予利尿剂、胃肠黏膜保护剂及静脉补液对症治疗;纳络酮治疗组29例,除了应用常规治疗方法外,加用纳络酮。结果:纳络酮治疗组患者症状改善,清醒时间明显提前于对照组(Plt;0.01)。结论: 纳络酮治疗急性酒精中毒疗效肯定、使用简单安全,值得临床推广使用。Abstract: Objective: To evaluate the clinical effect of naoxone on acute alcoholism. Methods: Fiftyeight cases of acute alcoholism were randomly divided into two groups: remedial group (29 cases) and the comparison group (29 cases). Both groups were given diuretic, protection of mucous membrane of stomach and fluid infusion. The remedial group was treated with naloxone. Results: Symptoms of the remedial group were obviously improved. Consciousness was regained much earlier than that of the comparison group (Plt;0.01). Conclusion: Naloxone can be used effectively and safely in treating acute alcoholism.
Objective To systematically evaluate the efficacy and safety of traditional Chinese medicine (TCM) for non-alcoholic steatohepatitis (NASH). Methods Such databases as CNKI, VIP, CBM, and PubMed (from the date of their establishments to November 2009) were searched. Randomized controlled trials of TCM treatment of NASH were included. According to the principle of ZANG-fu Differentiation, the method recommended by the Cochrane Collaboration was applied to evaluate the quality of the studies and to conduct meta-analysis. Results Twenty-two studies were included, of which 18 were of low quality and 4 of high quality. The results of meta-analyses showed: there was no difference between liver-oriented TCM treatment and western medicine treatment in terms of the recovery rate, total effective rate, liver function, and blood lipid; the liver and spleen oriented TCM treatment was better than the western medicine treatment in terms of the recovery rate, total effective rate, liver function, and blood lipid, but similar to that of western medicine on TG and HDL-C; the liver, spleen and kidney oriented TCM treatment was better than the western medicine in terms of the recovery rate, total effective rate, liver function, lipids, but showed no difference on HDL-C; the liver and kidney oriented TCM treatment was better than the western medicine treatment in terms of the recovery rate, total effective rate, liver function, LDL-C, and HDL-C, but showed no differences on TC and TG. Conclusion The TCM has significant effects on NASH. The liver, spleen and kidney oriented TCM treatment is significantly better than the western medicine treatment in terms of the recovery rate, total effective rate, and liver function. TCM has no serious adverse reactions.
Non-alcoholic fatty liver disease (NAFLD) is one of the major chronic liver diseases that endanger human health. It is characterized by hepatic steatosis and absence of other causes of hepatic fat accumulation, such as alcohol abuse. The incidence of NAFLD is increasing year by year. However, the pathogenesis is still undefined. Porphyromonas gingivalis is a major periodontal pathogen of various periodontal disease. Apart from affecting periodontal health, Porphyromonas gingivalis is also related to the incidence of many systemic diseases. In recent years, Porphyromonas gingivalis is considered to be a risk factor of NAFLD. In this paper, the relationship between NAFLD and Porphyromonas gingivalis, as well as the possible pathogenesis are discussed.
【摘要】 目的 观察长期大量酒精摄入对大鼠心肌结构及心肌组织中丙二醛(MDA)、超氧化物歧化酶(SOD)和金属硫蛋白(MT)含量的影响,探讨氧化应激在酒精性心肌病大鼠中的作用。 方法 雄性健康SD大鼠45只,随机分为2组,即对照组20只和模型组25只。模型组酒精浓度从5%、10%、20%和30%依次各自由饮1周,然后递增至36%后以该浓度维持饲喂。对照组每日饮用与模型组酒精同等热量的葡萄糖水。6个月后,观察大鼠心肌组织的形态学改变及超微结构的变化,测定心肌组织中MDA、SOD及MT的含量。结果 模型组大鼠心肌细胞排列紊乱、间质充血、炎细胞浸润、线粒体肿胀、空泡形成、肌丝溶解、核膜不规则和核仁裂解。心肌组织中MDA含量明显升高(Plt;0.01),SOD活力含量明显降低(Plt;0.01),MT含量明显降低(Plt;0.01)。 结论 长期摄入大量酒精可使氧自由基代谢失衡,导致心肌损伤。氧化应激在酒精性心肌病发病机制中发挥着重要的作用。【Abstract】 Objective To observe the effect of longterm and large quantities of alcohol intake on myocardial structure of rats and the content of malondialdehyde (MDA), superoxide dismutase (SOD) and metallothionein (MT) in myocardium tissue. To study the effect of oxidative stress on the rats with alcoholic cardiomyopathy. Methods Fortyfive male and healthy SD rats were randomly divided into the control group (20 rats) and model group (25 rats).The alcoholic concentrate in model group was increased from 5%,10%,20% to 30% every week, and maintain free drinking mass concentration of 36% alcohol. The control group drink the same calories of glucose water. Six months later, the myocardial tissues were observed both in light microscope and electron microscope .The level of MDA、SOD and MT were tested in myocardium tissue. Results In the model rats, the cells of myocardial disarray, interstitial congestion, inflammatory cell infiltration, mitochondrial swelling, vacuole formation, melt filaments, irregular nuclear membrane and nucleolus cracking. The content of MDA incresed(Plt;0.01)and the activities of SOD decreased(Plt;001),levels of MT decreased (Plt;0.01) in the cardiac muscular tissues in the model group compared with the control group. Conclusion Longterm intake of large amounts of alcohol can break the balance of oxygen free radicals, which leading to the damage of myocardial. Oxidative stress plays an important role in the etiopathogenesis of alcoholic cardiomyopathy.