Promotive effect of comprehensive management on achieving blood glucose control in senile type 2 diabetics.

The aim of this study was to evaluate the control of blood glucose and glycosylated hemoglobin A1c (HbA1c) and its influencing factors, in elderly type 2 diabetic mellitus (T2DM) patients undergoing comprehensive management. After years of comprehensive prevention of and control measures for diabetes, elderly T2DM patients who were receiving long-term health care were comprehensively evaluated through an annual physical examination. In addition to routine health examination, the patients were required to undergo HbA1c measurement. Among 688 patients, 652 were men and 36 were women, with a mean age of 78.2 ± 9.1 years. The average HbA1c was 6.6 ± 0.9%. A total of 50.6% of the patients had HbA1c <6.5%, whereas 76.3% had HbA1c <7.0%. Among all patients, 77.1, 46.4, 66.1, 67.8, 36.3, and 57.4% achieved the target total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), blood pressure, and body mass index (BMI) levels, respectively. The duration of disease and type of treatment, as well as the LDL, HDL, TG, BMI, and blood pressure levels, were significantly associated with HbA1c control. No patient was admitted because of ketoacidosis or hyperosmolar nonketotic diabetic coma in 10 years. Approximately half of the T2DM patients achieved the target HbA1c level. The more effective blood glucose control observed in our study compared with previous studies can be attributed to the effective monitoring of medical conditions and comprehensive management of patients.

Application value of multislice spiral computed tomography angiography in the evaluation of renal artery variation in living donor kidney transplantation.

This study aims to investigate the accuracy and value of multislice spiral computed tomography (MSCT) angiography in the evaluation of renal artery variation in living donor kidney transplantation. Two hundred seventy-three kidney transplantation donors underwent preoperative MSCT scanning. Two doctors determined the running direction and variation of the renal artery through joint analysis of the preoperative original MSCT image and the recombination image using the blind reading method, compared the imaging results with the intraoperative results, and evaluated the accuracy and application value of MSCT angiography in the evaluation of renal artery variation in living donor kidney transplantation. CT angiography (CTA) can better show the renal artery and its variation. A total of 52 accessory renal arteries were found in the 273 kidney transplant operations, whereas 55 accessory renal arteries were found in preoperative MSCT. Four accessory renal arteries indicated in the MSCT were not found during the operation, and one accessory renal artery found during the operation was not indicated in the preoperative MSCT. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of MSCT in the diagnosis of accessory renal arteries were 98.1, 98.2, 92.7, 99.5, and 98.2%, respectively. MSCT angiography can sensitively and accurately show the renal artery and its variation in living donor kidney transplantation, and has important clinical value for the formulation of the operative scheme before the transplantation.