【摘要】 目的 探讨老年糖尿病患者血清胱抑素C与血脂及高敏C反应蛋白的关系。 方法 2008年5月-2009年10月糖尿病患者共141例，其中糖尿病合并症组68例，单纯糖尿病组73例；另选取对照组51例。对入选者的血清胱抑素C、血脂及高敏C反应蛋白进行分析。 结果 老年男女糖尿病合并症组血清胱抑素C、高敏C反应蛋白、总胆固醇、甘油三酯及低密度脂蛋白胆固醇最高、高密度脂蛋白胆固醇最低，与对照组比较有统计学意义（Plt;0.05）、与单纯糖尿病组比较，无统计学意义（Pgt;0.05）。老年男女单纯糖尿病组高敏C反应蛋白、总胆固醇、甘油三酯高于对照组，组间比较，有统计学意义（Plt;0.05）。老年男女单纯糖尿病组血清胱抑素C与对照组比较，无统率学意义（Pgt;0.05）。老年女性单纯糖尿病组低密度脂蛋白胆固醇与对照组比较，有统计学意义（Plt;0.05）。老年男性糖尿病二组与对照组血清胱抑素C低于老年女性糖尿病二组与对照组，组间比较，无统计学意义（Pgt;0.05）。老年男性糖尿病患者血清胱抑素C与高敏C反应蛋白及血脂不相关。老年女性糖尿病合并症组血清胱抑素C与空腹血糖正相关；单纯糖尿病组血清胱抑素C与高密度脂蛋白胆固醇负相关、与低密度脂蛋白胆固醇正相关、与高敏C反应蛋白不相关。 结论 老年糖尿病患者高脂、高糖及低度炎症状态下，血清胱抑素C水平较高。血脂对血清胱抑素C的影响可能存在性别差异。随着动脉粥样硬化的加重，血清胱抑素C有升高趋势。【Abstract】 Objective To investigate the relationship between serum cystatin C concentration and lipid, hs-C reactive protein in the elderly with diabetes. Methods A total of 192 senile people form May 2008 to October 2009 were investigated. There were 141 patients with diabetes, in whom 68 were with cardiovascular and cor, cerebrovascular diseases, 73 were with diabetes only.There were 51 control subjects. The data of serum cystatin C, hs-CRP, TC, TG, HDL-C and LDL-C were analyzed. Results Serum cystatin C of elderly men was lower than that in elderly women, but no signifcant correlation between them was found (Pgt;0.05). Serum cystatin C, hs-CRP, TC, TG and LDL-C was higher, and HDL-C was lower in male and female diabetes subjects with cardiovascular and cor, cerebrovascullar diseases, than that in control subjects (Plt;0.05). Serum hs-CRP, TC and TG were higher in the elderly with diabetes only, than that in control subjects (Plt;0.05). LDL-C was higher in senile women with diabetes only, than that in female control subjects (Plt;0.05). Serum cystatin C with LDL-C in elderly women with diabetes only, with FPG in female diabetes subjects with cardiovascular and cor, cerebrovascular diseases had position correlation (Plt;0.05). No correlation were observed between serum cystatin C and hs-CRP in male and female diabetes subjects, and lipid in male diabetes subjects. Conclusions We speculate that high serum lipid, high glucose and low level of inflammation may result in increasing of serum cystatin C in senily people with diabetes. The influence of serum lipid on serum cystatin C may be different in male and female senile people.Along with atherosclerotic aggravating, the level of serum cystatin C was increasing.
ObjectiveTo review the latest advances in diagnosis and treatment of gallbladder carcinoma.MethodsThe recent literatures on diagnosis and treatment of gallbladder carcinoma at home and abroad were reviewed, and the diagnosis, staging and treatment progress of gallbladder carcinoma were systematically reviewed.ResultsThere are many methods to diagnose gallbladder carcinoma, among which imaging methods are commonly used, as well as various tumor markers and gallbladder carcinoma-related genes. Surgical resection is still the only possible cure for gallbladder carcinoma, but the scope and timing of surgical resection are still controversial. Radiotherapy, chemotherapy and gene therapy also play an important role in the treatment of gallbladder carcinoma.ConclusionsImaging examination is still the first choice for the diagnosis of gallbladder carcinoma. The tumor markers and gene diagnosis has broad prospects. Gallbladder carcinoma is mainly treated by surgery. Gene intervention and precise targeted therapy are the future development direction.
Objective To investigate the management experience of type Ⅱ endoleak originating from inferior mesenteric artery (IMA) after endovascular abdominal aortic aneurysm repair (EVAR). Methods The clinical data of patients with type Ⅱ endoleak originating from IMA after EVAR were treated in the Department of Vascular Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University from October 2016 to November 2021 were collected and analyzed. Results There were 12 males and 3 females at age of 57-89 (68.00±7.84) years. Eleven patients received embolization of the abdominal aortic aneurysm lumen and initial segment of the IMA via the superior mesenteric artery-middle colic artery-Riolan arch-left colic artery-IMA route. Three patients received embolization of the initial segment of the IMA by the above route. One patient underwent open dissection of the abdominal aortic aneurysm, and orifice of IMA was sutured in the aneurysm cavity while stents were retained. All 15 patients were successfully treated by surgery. The symptoms of back pain, abdominal pain and abdominal distension disappeared in 6 patients after surgery. Neither perioperative deaths nor complications happened during the treatment and follow-up period. The median follow-up time was 11.00 (9.00, 18.00) months. Two patients with typeⅡendoleak recurred during the follow-up period and were admitted to hospital for secondary embolization. No recurrence was observed at 12 months postoperative follow-up. Conclusion Type Ⅱ endoleak is one of the most common complications after EVAR. IMA is the most common criminal origin of typeⅡendoleak. TypeⅡendoleak that lead to persistent expansion of the aneurysm cavity requires aggressive intervention.
目的 系统评价纳洛酮治疗病毒性脑炎的疗效与安全性。 方法 计算机检索Medline、Cochrane图书馆、EMbase、CBM、CNKI、万方从建库至2012年2月收录的相关中英文文献，收集所有关于在抗病毒、肾上腺皮质激素以及脱水、止惊、降温等综合治疗的基础上，辅助应用纳洛酮治疗病毒性脑炎对照试验。根据纳入与排除标准筛选文献、评价质量、提取资料，采用RevMan 5.1软件进行Meta分析。 结果 共纳入5个对照试验，包括279例病毒性脑炎患者。Meta分析结果显示：纳洛酮的应用对13岁以上病毒性脑炎患者的总有效率[RR=1.15，95%（0.94，1.42），P=0.18]及死亡率[RR=0.45，95%（0.17，1.16），P=0.10]并无影响，但可以缩短退热时间[WMD=−0.85，95%（−1.74，0.03），P=0.06]、头痛消失时间[WMD=−0.40，95%（−0.55，0.25），P＜0.000 01]、抽搐停止时间[WMD=−0.87，95%（−1.09，−0.66），P＜0.000 01]、意识恢复时间[WMD=−1.10，95%（−2.05，−0.15），P=0.02]、脑膜刺激征消失时间[WMD=−0.15，95%（−0.73，0.29），P＜0.000 01]、呼衰纠正时间[WMD=−1.22，95%（−2.11，−0.33），P=0.007]及病程[WMD=−1.38，95%（−2.65，−0.11），P=0.03]。 结论 现有证据表明，纳洛酮不能提高病毒性脑炎的疗效，但对改善症状有一定帮助。受本系统评价纳入研究数量和质量的限制，上述结论尚需更多高质量的随机对照试验验证。
目的 观察与分析体重异常老年男性血清前列腺特异性抗原（T-PSA）与生长激素（GH）水平及影响因素。 方法 以2009年1月－2012年6月，血清GH＜5 ng/mL、血清T-PSA＜4.5 ng/mL的老年男性共296例作为观察对象，依据体质量指数分为低体重组、正常体重组、超重组及肥胖组。依据年龄分为60～64、65～69、70～74及≥75岁四组。测定296例入选对象的血清T-PSA及GH并进行分析。 结果 随着年龄增长，血清T-PSA、GH渐增高。≥75岁年龄组血清T-PSA高于其他三组，差异无统计学意义（P＞0.05）。≥75岁年龄组血清GH高于其他三组，差异有统计学意义（P＜0.01）。超重组及肥胖组血清T-PSA低于正常体重组，差异有统计学意义（P＜0.01）。低体重组血清T-PSA稍低于正常体重组，差异无统计学意义（P＞0.05）。肥胖组血清GH低于超重及正常体重组，差异无统计学意义（P＞0.05）。低体重组血清GH低于正常体重组，差异无统计学意义（P＞0.05）。单因素相关分析显示血清T-PSA与年龄、GH正相关；与BMI负相关；与收缩压（SBP）、舒张压（DBP）、空腹血糖（FPG）及血脂不相关。血清GH与年龄、T-PSA、SBP、DBP正相关；与BMI、FPG及血脂不相关。校正年龄、BMI后，血清T-PSA与GH仍呈正相关。 结论 随着年龄增长，老年男性血清T-PSA、GH渐增高。老年男性非肢端肥大症者血清T-PSA与血清GH水平及BMI有关联，血清GH水平较高者，血清T-PSA也较高；血清T-PSA与BMI负相关。
目的 观察不同浓度肾上腺素与利多卡因混合液头皮浸润注射对开颅术患者血流动力学的影响。方法 选取2010年5月－10月80例颅内肿瘤患者，随机分成4组，行1%利多卡因溶液混合不同浓度的肾上腺素16 mL头皮浸润注射。肾上腺素浓度：A组2.5 μg/mL、B组5.0 μg/mL、C组7.5 μg/mL、D组10.0 μg/mL。记录注射前（T0）、注射后5 min内（T1-10）心率（HR）、平均动脉压（MAP）、收缩压（SBP）、舒张压（DBP），根据各时段的MAP最低值和最高值，计算MAP的降低率和升高率，计数各组MAP下降10%以内、10%～20%和20%以上的例数。 结果 C组的MAP下降例数最多且MAP下降率最高，与其他组间比较差异有统计学意义（P＜0.05）。组内比较，C组MAP、SBP在1.5、2.0、2.5 min时、DBP在2 min时和D组MAP和DBP在1.5、2.0 min时下降差异有统计学意义（P＜0.05）。4组血压下降的同时伴HR增快，但HR组间差异无统计学意义（P＞0.05）。 结论 低浓度的肾上腺素与10%利多卡因混合液用于开颅术患者头皮浸润注射时可导致血压下降。
目的:探讨老年代谢综合征者血清尿酸与血压、甘油三脂的关系。方法:163例入选者,MS组96例,对照组67例,对二组的SUA、BMI、WC 、SBP、DBP及TG进行分析。结果:MS组SUA较对照组高。MS组男性SUA与BMI正相关、女性与WC正相关;男女性MS组及对照组SUA与SBP及TG不相关。对照组女性SUA与DBP正相关。结论:SUA对老年女性DBP的维持可能有一定作用。TG对老年人SUA的影响有限;体重及脂肪聚集部位对SUA的影响,存在性别差异。
Objective To assess the efficacy and safety of adalimumab on plaque psoriasis. Methods We searched the MEDLINE (1966 to December 2009), Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 12, 2009), EMbase (1980 to December 2009), CBM (1978 to December 2009), and CNKI (1979 to December 2009) to collect randomized controlled trials (RCTs) of adalimumab for plaque psoriasis. The language was confined to English and Chinese. We screened the retrieved studies according to the predefined inclusion and exclusion criteria, evaluated the quality of included studies, and performed meta-analyses by using the Cochrane Collaboration’s RevMan 4.2 software. Results Three RCTs involving 1?630 patients with chronic moderate or severe plaque psoriasis were included and assessed. At the end of 4th, 8th, 12th and 16th week, the PASI 75s of subcutaneous injection every other week in adalimumab (EOW) group were obviously higher than that of placebo group and methotrexate group. While at the end of 24th week and 60th week, the PASI 75s showed no difference between adalimumab EOW and placebo group. Twelve weeks after subcutaneous injection each week with adalimumab (QW), PASI 75 was obviously higher than those of placebo and EOW groups. However, at the end of 24th week and 60th week, there was no significant difference between adalimumab QW and placebo followed by adalimumab EOW. At end of week 12-16, there was no difference between adalimumab EOW group and placebo group in the incidence of adverse effects, with the exception of pain on injection site and upper respiration viral infection. At week 12-60, there was no difference between adalimumab QW and EOW groups in the incidence of adverse effects, with the exception of all serious adverse effects. Conclusion The limited evidence indicates that subcutaneous injection of adalimumab every other week for 12-16 weeks is safe and efficient for patients with moderate or severe plaque psoriasis. The efficacy can’t be enhanced when the treatment is prolonged to 24 weeks. The once-a-week protocol has no obvious advantage over every other week protocol. More RCTs are required to verify these conclusions owing to the limitations of the present study.
ObjectivesTo systematically review the prevalence of rosacea in China.MethodsPubMed, The Cochrane Library, EMbase, CNKI, WanFang Data and VIP databases were electronically searched to collect literature of the prevalence of rosacea in China from inception to September 5th, 2018. Two reviewers independently screened literature, extracted data and then meta-analysis was performed by using Stata 12.0 software.ResultsA total of 54 studies were included. The pooled prevalence of rosacea from 44 population-based or community-based studies was 0.27% (95%CI 0.22 to 0.32) and from 10 hospital-based studies was 1.47% (95%CI 1.08 to 1.86). Based on population-based or community-based studies, the highest prevalence was in the early 1980s (2.19%), followed by a gradual decline, to the lowest (0.17%) in the early 1990s, after that the prevalence increased to 1.24% till 2015. Based on hospital-based studies, the prevalence had a maximum of 4.64% in the past decade. The Northwest China and North China had higher prevalence of rosacea (population-based or community-based studies: 1.24% in Northwest China, 1.1% in North China; hospital-based studies: 6.03% in Northwest China, 2.83% in North China). The prevalence in East China and South China was relatively low (population-based or community-based studies: 0.02% in East China and 0.32% in South China; Hospital-based studies: 0.28% in South China). The prevalence of rosacea in female (0.36%) was higher than that of male (0.19%) in population-based or community-based studies.ConclusionsIn China, the pooled prevalence of rosacea is 0.27% in population-based or community-based studies and 1.47% in hospital-based studies. Rosacea is common in North China and Northwest China. Female has higher prevalence than male.
ObjectiveTo evaluate the clinical value of in vitro fenestration and branch stent repair in the treatment of thoracoabdominal aortic aneurysm in visceral artery area assisted by 3D printing.MethodsThe clinical data of 7 patients with thoracoabdominal aortic aneurysm involving visceral artery at the Department of Vascular Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University from March 2016 to May 2019 were analyzed retrospectively. There were 5 males and 2 females with an average age of 70.2±3.9 years. Among them 4 patients had near-renal abdominal aortic aneurysm, 3 had thoracic aortic aneurysm, 4 had asymptomatic aneurysm, 2 had acute symptomatic aneurysm and 1 had threatened rupture of aneurysm. According to the preoperative CT measurement and 3D printing model, fenestration technique was used with Cook Zenith thoracic aortic stents, and branch stents were sewed on the main stents in vitro, and then the stents were modified by beam diameter technique for intracavitary treatment.ResultsAll the 7 patients completed the operation successfully, and a total of 18 branch arteries were reconstructed. The success rate of surgical instrument release was 100.0%. The average operation time was 267.0±38.5 min, the average intraoperative blood loss was 361.0±87.4 mL and the average hospital stay was 16.0±4.2 d. Immediate intraoperative angiography showed that the aneurysms were isolated, and the visceral arteries were unobstructed. Till May 2019, there was no death, stent displacement, stent occlusion, ruptured aneurysm or loss of visceral artery branches. Conclusion3D printing technology can completely copy the shape of human artery, intuitively present the anatomical structure and position of each branch of the artery, so that the fenestration technique is more accurate and the treatment scheme is more optimized.