RESUMO
Objective:To explore correlation among serum levels of 25-hydroxyl vitamin D [25(OH)D],glycosylated hemoglobin (HbA1c),homocysteine (Hcy)and severity of intracranial arterial stenosis (ICAS)in patients with type 2 diabetes mellitus (T2DM).Methods:A total of 120 T2DM patients,whose ICAS was confirmed by transcranial Doppler ultrasound (TCD),were selected.According to TCD results,they were divided into stenosis group (n=45)and non-stenosis group (n= 75).Levels of blood glucose,blood lipids,serum 25 (OH)D,HbA1c and Hcy were measured and compared between two groups.Correlation among serum levels of 25(OH)D,HbA1c,Hcy and ICAS severity,and predictive value of these indexes for ICAS in T2DM patients were analyzed.Results:Compared with non-stenosis group,there were significant rise in age > 60 years (40.0% vs.60.0%),disease course > 5 years (36.0% vs.62.2%),smoking history (26.7% vs.46.7%),drinking history (36.0% vs.62.2%),percentages of CHD (25.3% vs.46.7%)and hypertension (26.7% vs.44.4%)in stenosis group,P <0.05 or <0.01. Compared with non-stenosis group,there were significant reductions in serum levels of high density lipoprotein cholesterol [(1.80±0.31)mmol/L vs.(1.02±0.23)mmol/L]and 25(OH)D [(68.37±15.29)nmol/L vs.(34.32±8.63) nmol/L],and significant rise in serum levels of low density lipoprotein cholesterol [(3.02 ± 0.75)mmol/L vs. (3.79±0.82)mmol/L],HbA1c [(6.35±2.36)% vs.(7.60 ±2.90)%]and Hcy [(10.24±3.98)μmol/L vs. (15.91±4.26)μmol/L]in stenosis group,P <0.05 or <0.01. Spearman correlation analysis indicated that ICAS severity was significant inversely correlated with serum 25(OH)D level (r = -0.840,P =0.001 ),and significant positively correlated with serum HbA1c,Hcy levels (r =0.454,0.812,P =0.023,0.001 ).ROC curve indicated that sensitivity and specificity of serum 25 (OH)D level predicting ICAS was 79.4% and 100% respectively;it's 40.3% and 67.6% for serum HbA1c,70.3% and 79.4% for serum Hcy.Conclusion:In T2DM patients with ICAS, serum 25(OH)D,HbA1c and Hcy levels are significantly correlated with ICAS,which can predict ICAS risk.
RESUMO
Objective:To explore correlation among serum levels of 25-hydroxyl vitamin D [25(OH)D],glycosylated hemoglobin (HbA1c),homocysteine (Hcy)and severity of intracranial arterial stenosis (ICAS)in patients with type 2 diabetes mellitus (T2DM).Methods:A total of 120 T2DM patients,whose ICAS was confirmed by transcranial Doppler ultrasound (TCD),were selected.According to TCD results,they were divided into stenosis group (n=45)and non-stenosis group (n= 75).Levels of blood glucose,blood lipids,serum 25 (OH)D,HbA1c and Hcy were measured and compared between two groups.Correlation among serum levels of 25(OH)D,HbA1c,Hcy and ICAS severity,and predictive value of these indexes for ICAS in T2DM patients were analyzed.Results:Compared with non-stenosis group,there were significant rise in age > 60 years (40.0% vs.60.0%),disease course > 5 years (36.0% vs.62.2%),smoking history (26.7% vs.46.7%),drinking history (36.0% vs.62.2%),percentages of CHD (25.3% vs.46.7%)and hypertension (26.7% vs.44.4%)in stenosis group,P <0.05 or <0.01. Compared with non-stenosis group,there were significant reductions in serum levels of high density lipoprotein cholesterol [(1.80±0.31)mmol/L vs.(1.02±0.23)mmol/L]and 25(OH)D [(68.37±15.29)nmol/L vs.(34.32±8.63) nmol/L],and significant rise in serum levels of low density lipoprotein cholesterol [(3.02 ± 0.75)mmol/L vs. (3.79±0.82)mmol/L],HbA1c [(6.35±2.36)% vs.(7.60 ±2.90)%]and Hcy [(10.24±3.98)μmol/L vs. (15.91±4.26)μmol/L]in stenosis group,P <0.05 or <0.01. Spearman correlation analysis indicated that ICAS severity was significant inversely correlated with serum 25(OH)D level (r = -0.840,P =0.001 ),and significant positively correlated with serum HbA1c,Hcy levels (r =0.454,0.812,P =0.023,0.001 ).ROC curve indicated that sensitivity and specificity of serum 25 (OH)D level predicting ICAS was 79.4% and 100% respectively;it's 40.3% and 67.6% for serum HbA1c,70.3% and 79.4% for serum Hcy.Conclusion:In T2DM patients with ICAS, serum 25(OH)D,HbA1c and Hcy levels are significantly correlated with ICAS,which can predict ICAS risk.
RESUMO
Objective To discuss influence of different anesthetic methods on postoperative serum excitatory amino acid (EAA) levels and cognitive function of elderly patients operated with transurethral resection of prostate (TURP). Methods A total of 100 cases of elderly patients with benign prostatic hyperplasia (BPH), in Department of Anesthesiol-ogy of the hospital to be given the TURP operation at certain time were selected, and divided into general anesthesia group (n=50) and epidural group (n=50) in accordance with different anesthetic methods, who were given intubation anesthesia and epidural anesthesia respectively. The changes of serum EAA levels and cognitive function before anes-thesia, 4 hours, 8 hours, one day and four days after the operation of patients in two groups were observed and record-ed. Results Serum EAA levels 4 hours, 8 hours and one day after the operation of patients in two groups rose than be-fore (P<0.05), and the rising rates in epidural group were much lower than those in general anesthesia group (P<0.05). Meanwhile, MMSE scores of patients in two groups 4 hours, 8 hours and one day after the operation declined than be-fore (P<0.05), and the declining rates in epidural group were much lower than those in general anesthesia group (P<0.05). Four days after operation, the serum EAA levels and MMSE scores of patients in two groups returned to the levels before anesthesia (P>0.05). Conclusion Both intubation anesthesia and epidural anesthesia have effect on early cogni-tive function of elderly patients operated with TURP, and the former has less influence on early cognitive function of patients, which may have close effect on the lower rising rate of serum EAA level by epidural anesthesia.
RESUMO
ObjectiveTo find out if the immune system derived thyroid stimulating hormone(TSH) β splice variant(TSHβ-Ⅴ) would be regulated by circulating thyroid hormone levels to get a further understanding of the function and mechanism of this TSHβ-Ⅴ in thyroid homeostasis.MethodsA total of 20 weaning Balb/c mice (half male and half female) were selected and randomly divided into two groups according to their body mass and gender(n =10).Mice of control group were fed with common diet and deionized water.Mice of the low-iodine(LI) group were fed with low-iodine diet(containing iodine 20 - 40 μg/kg,iodine-intake about 0.25 μg/d) and deionized water.The experimental period was 3 months.At the end of the experiment,mice were executed and the blood was collected to observe the levels of TSH and thyroid hormone by chemiluminescence immunoassay (CIA) ; bone marrow (BM),peripheral blood(PBL),thyroid gland and pituitary were collected to assay the TSHβ-Ⅴ mRNA expression by real-time quantitative reverse transcriptase polymerase chain reaction (RT-PCR).ResultsThe serum free thyroxine(FT4) and total thyroxine(TT4) levels in LI group of mice[(0.47 ± 0.70)nmol/L,(2.41 ± 0.28)pmol/L] were significantly lower than that of the control group of mice [(55.2 ± 3.68) nmol/L, (32.72 ± 1.02) pmol/L,t =43.81,86.04 、all P ＜ 0.01 ] and the serum total triiodothyronine(TT3) and free triiodothyronine(FT3) reduction in LI group of mice[ (0.76 ± 0.08)nmol/L,(4.01 ± 0.40)pmol/L] were significantly lower than that of the control group of mice [ (1.10 ± 0.06)nmol/L,(5.40 ± 0.38)pmol/L,t =9.81,7.5 1,P ＜ 0.01 ].Iodine insufficiency strongly elevated the serum TSH in LI group of mice[ (35.67 ± 17.39)mU/L] than that in control group of mice[ (0.24 ± 0.10)mU/L,t =- 6.11,P ＜ 0.01 ].The mRNA levels of TSH β-Ⅴ in BM (9.62 ± 0.60) and in PBL( 9.25 ± 0.83 ) of LI group of mice were lower than those in control group of mice (7.69 ± 0.36,7.11 ± 0.41,t =6.77,5.64,P ＜ 0.01),while the mRNA level of TSH β-Ⅴ in pituitary of LI group of mice (1.99 ± 0.61) was increased compared with that in control group of mice (5.75 ± 0.98,t =- 8.02,P＜ 0.01).Compared with control group of mice(9.12 ± 0.62),the level of thyroid TSH β-Ⅴ mRNA in LI group of mice (9.32 ± 0.91 ) was not significantly changed (t =0.45,P ＞ 0.05).There was no detectable native TSHβ in BM,PBL and thyroid.The mRNA level of native TSHβ in pituitary in LI group of mice( - 7.17 ± 1.78) was dramatically elevated compared to that in control group of mice( - 1.43 ± 0.51,t =- 7.60,P ＜ 0.01 ).ConclusionsThe mRNA levels of TSHβ-Ⅴ are suppressed in BM and PBL in low iodinediet induced hypothyroidism mice,which suggest that immune system derived TSHβ-Ⅴ may be more important thannative TSHβ in immune-thyroid regulation.
RESUMO
<p><b>OBJECTIVE</b>To compare the number of harvested perisplenic hilar lymph nodes by laparoscopy-assisted total gastrectomy (LATG) and conventional open total gastrectomy (OTG) for advanced upper and middle gastric cancer.</p><p><b>METHODS</b>Three hundred twelve patients with advanced gastric cancer treated in a single institution between Sept 2008 and Jan 2011 were included in this study. They were divided into two groups: the LATG group and OTG (D2) group. All the surgical operations were performed by one surgeon or under his supervision. The lymph node clearance outcomes of the patients treated by those two surgical procedures were analyzed.</p><p><b>RESULTS</b>The harvested lymph node numbers of the two groups were (29.57 ± 9.62) and (29.38 ± 11.22) respectively, statistically with no significant difference (P = 0.875). The numbers of lymph node dissected around the splenic area in the LATG group and OTG group (Section 10, 11 group) were (2.01 ± 1.34) and (1.33 ± 1.11), respectively, indicating a significant difference (P = 0.000). The numbers of lymph nodes dissected around the celiac region (Section 7, 8, 9, 11p and 12a(2) group) were (7.90 ± 3.41) and (7.22 ± 2.65), respectively, with a non-significant difference (P = 0.050). There were also no significant differences while comparing with the numbers of lymph nodes dissected in the cardiac area (group 1, 2), pyloric region (5, 6 group) and the greater and lesser omentum area (group 3 and 4) between the two groups (P = 0.605, P = 0.248, P = 0.262).</p><p><b>CONCLUSION</b>Short-term results of this study indicate that laparoscopy-assisted total gastrectomy (D2) is better than conventional open surgery in perisplenic hilar lymph node dissection.</p>
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gastrectomia , Métodos , Laparoscopia , Excisão de Linfonodo , Métodos , Linfonodos , Patologia , Cirurgia Geral , Metástase Linfática , Estadiamento de Neoplasias , Baço , Estômago , Neoplasias Gástricas , Patologia , Cirurgia GeralRESUMO
Objective To understand well this disease,8 children with familial periodic paralysis(FPP) were reported and the(rela)-ted literatures were reviewed.Methods The hereditary characters,clinical manifestations,auxiliary examination and managements were summarized retrospectively in 8 cases of FPP patients hospitalized from January 1996 to December 2005,and etiopathogenis and diagnosis were also analyzed.Results Six cases of FPP were diagnosed as hypokalemic periodic paralysis,and all occured as an autosomal dominant condition.During paralytic episodes,the patients showed obviously low serum potassium levels [1.9-2.8 mmol/L,(2.4?0.38) mmol/L)] and hypokalemic electrocardiogram findings,such as U-wave.The level of blood glucose was lower than normal range.Other 2 cases with normal serum potassium ion level at attack were diagnosed as normokalemic periodic paralysis with autosomal dominant pattern.One of the two cases,the level of blood glucose was lower.Thyroid functions,renal functions and electromyograms were all normal in 8 cases.Conclusions FPP is a group of relatively uncommon inherited disorders known as the skeletal muscle channelophathies.It can be diagnosed by hereditary characters,clinical manifestataions,auxiliary examinations.
RESUMO
Objective To study the effect of esomeprazole,clarithromycin,metronidazole triple therapy for helicobactor pylori(Hp) infection in children.Methods Ninty-eight cases of children,identified by ~ 13 C-urea breath test(~ 13 C-UBT) Hp infection,deparded into therapy group(66 cases) and control group(32 cases).Therapy group were given Esomeprazole[0.8 mg/(kg?d),1 time/d],clarithromycin[15 mg/(kg?d),2 times/d],metronidazole[30 mg/(kg?d),3 times/d]triple therapy.Control group were given the same treatment except ameprazole.The course was 1 week.They were followed up 4 weeks later after the course and re-tested by ~ 13 C-UBT.Results The recurrent abdominal pain of the two groups recovered in different degrees,and the efficacy rate was 100%.The eradication rate of Hp in therapy group and control group were separately 90.9%(60/66) and 87.5%(28/32).There was no significance difference of the eradication of Hp.Conclusions The trearment of esomeprazole,clarithromycin,metronidazole triple therapy on Hp infection in children is quite effective and safe.The side effect is moderate.