2型糖尿病合并高尿酸血症青年患者代谢相关因素分析

目的 探讨2型糖尿病合并高尿酸血症青年患者的临床特征及相关因素。方法 回顾性分析2013年1月—2017年6月在南充市第二人民医院就诊的20~45岁2型糖尿病合并高尿酸血症青年患者319例。将患者按诊断高尿酸血症的标准分为高尿酸血症组(156例)和血尿酸正常组(163例);分析两组的一般情况和临床资料,Logistic多元逐步回归分析相关危险因素。结果 与血尿酸正常组比较,高尿酸血症组的体重指数(BMI)、甘油三酯(TG)、尿酸(UA)、收缩压、舒张压、脉压、空腹胰岛素水平(FINS)、胰岛素抵抗指数(HOMA-IR)、血肌酐(Scr)、糖化血红蛋白(GHb)、代谢性疾病(高血压、代谢综合征和超重或肥胖)发病率和睡眠质量差患者构成比均升高(P<0.05)。UA与TG、Scr呈正相关(rs=0.165和0.698,P<0.05)。Logistic多元逐步回归分析显示高血压[■=2.584(95% CI:1.233,5.414)]、代谢综合征[■=6.751(95% CI:3.514,12.968)]和睡眠质量差[■=2.229(95% CI:1.290,3.851)]为2型糖尿病并发高尿酸血症青年患者的危险因素。结论 2型糖尿病合并高尿酸血症青年患者可能与高血压、代谢综合征及睡眠质量差相关。

Upregulated Ras/Raf/ERK1/2 signaling pathway:a new hope in the repair of spinal cord injury

An increasing number of studies report that the Ras/Raf/extracellular signal-regulated kinase 1/2 （ERK1/2） signaling pathway has a death-promoting apoptotic function in neural cells. We hypothesized that the Ras/Raf/ERK1/2 signaling pathway may be abnormally regulated in rat injured spinal cord models. The weight drop method was used to establish rat spinal cord injury at T9. Western blot analysis and immunohistochemical staining revealed Ras expression was dramatically elevated, and the phosphorylations of A-Raf, B-Raf and C-Raf were all upregulated in the injured spinal cord. Both mitogen-activated protein kinase kinase 1/2 and ERK1/2, which belong to the Ras/Raf signaling kinases, were upregulated. These results indicate that Ras/Raf/ ERK1/2 signaling may be upregulated in injured spinal cord and are involved in recovery after spinal cord injury.

Positron-emission tomography for hepatocellular carcinoma:Current status and future prospects

Hepatocellular carcinoma(HCC)is one of the leading causes of cancer mortality worldwide.Various imaging modalities provide important information about HCC for its clinical management.Since positron-emission tomography(PET)or PET-computed tomography was introduced to the oncologic setting,it has played crucial roles in detecting,distinguishing,accurately staging,and evaluating local,residual,and recurrent HCC.PET imaging visualizes tissue metabolic information that is closely associated with treatment.Dynamic PET imaging and dual-tracer have emerged as complementary techniques that aid in various aspects of HCC diagnosis.The advent of new radiotracers and the development of immuno-PET and PET-magnetic resonance imaging have improved the ability to detect lesions and have made great progress in treatment surveillance.The current PET diagnostic capabilities for HCC and the supplementary techniques are reviewed herein.

Long-term effect of triamcinolone acetonide in the treatment of upper lid retraction with thyroid associated ophthalmopathy

AIM： To report the long-term outcomes of a large cohort of upper lid retraction patients treated with subconjunctival triamcinolone acetonide injections.METHODS： This retrospective clinical study was conducted from 2009 to 2016. The documents of 97 patients（126 eyes） were reviewed. The patients were treated with subconjunctival triamcinolone acetonide injections monthly and evaluated pre-and post-treatment by taking measurements of the upper margin reflex distance（MRD1, the distance between the upper-lid margin and the pupil center）, lid aperture, lagophthalmos and proptosis. The patients were divided into the cured group, the improved group and the ineffective group based on the final treatment effectiveness. The improved group and the ineffective group were combined into non-cured group.RESULTS： The follow-up time was 23.45±14.86 mo. Of the patients, 63（64.9%） were assigned to the cured group, 22（22.7%） in the improved group, 12（12.4%） in the ineffective group. Injection times for cured group was 4.66±1.74, and for non-cured group was 5.17±2.08（P≤0.05）. The MRD1 was significantly reduced between baseline and 1 mo after the initiation of treatment in the cured and improved groups（P〈0.001）. The values did not change significantly after 4 mo for the improved group, while they continued to decrease in the cured group. In the ineffective group, the MRD1 did not significantly change after treatment. A statistically significant difference was observed between the baseline and post-treatment values of the mean muscle thickness（2.95±0.99 mm vs 2.04±0.63 mm, P〈0.05） and surface area（27.27±10.5 mm2 vs 18.3±7.04 mm2,P〈0.05） of the levator superioris with magnetic resonance imaging examination. Twelve patients（12.4%） relapsed after treatment and required additional subconjunctival injections. The main side effects included menstrual cycle disturbances（32%） and elevations of intra-ocular pressure（18.6%）. CONCLUSION： A repeated subconjunctival injection of triamcinolone is an effective and relatively safe treatment for upper lid retraction due to thyroid-associated ophthalmopathy. This is related to the anti-inflammation effect of the medicine and the levator thickness can become thinner. Patients must be monitored regularly for recurrences and side effects.

Normative Measurements of Extraocular Musculature by Multislice Computed Tomography

Objective To establish the normal measurements of diameter of extraocular muscles (EOMs) by multislice computed tomography (CT). Methods Orbits of 50 volunteers (25 male and 25 female) were scanned with a multislice CT scanner. For each subject, one axial image at the central level of the eyeball, one coronal image about 1 cm behind globe, and two oblique sagittal images respectively along the left and right optic nerve were used for measurements of the thickness and width of EOMs. The statistic significance of measurement value between male and female and between left and right eyes was evaluated. Results There were no significant differences in the thickness and width of superior muscle group, lateral rectus, medial rectus, lateral rectus, superior oblique, inferior oblique and the thickness of levator palpebrae superioris between the left and right eyes as well as between male and female groups (all P>0.05). The thickness of superior muscle group and inferior rectus had not significant difference (2.9±0.7 vs. 3.3±0.8 mm, P=0.162), while the thickness of medial rectus was significantly higher than that of lateral rectus (3.1±0.5 vs. 2.2±0.6 mm, P=0.000). Conclusions The CT measurement of extraocular musculature is simple and time-saving and can be applied in the clinical work. The normative data obtained may be useful in determining pathologic enlargement of the EOMs in both thyroid-associated orbitopathy patients and other various orbital conditions.

Immunomodulatory effect of a formula developed from American ginseng and Chinese jujube extracts in mice

Background： American ginseng（Panax quinquefolius L.） and Chinese jujube（Zizyphus jujuba Mill.） are commonly used in traditional Chinese medicine to enhance immune function. Objective： The present study aimed to develop one Chinese prescription, Shenzao Cha（SZC）, consisting of American ginseng and Chinese jujube, and systematically investigate its immunomodulation in healthy ICR mice. Methods： Normal ICR mice received intragastric administration of SZC（1.3, 2.6, and 5.2 g raw material/kg body weight） once daily for four weeks, while a control group received the same amount of sterile water. Results： SZC significantly increased the spleen and thymus indices and T-lymphocyte proliferation, while the T-lymphocyte proliferation in the 5.2 g/kg group was 1.4-fold higher than that in the control. Further, 1.3 g/kg SZC could markedly improve hemolytic activity by 25.2%, and 2.6 g/kg SZC increased the NK cell activity by 78.6% relative to the control. In addition, the activities of antioxidant enzymes（superoxide dismutase, catalase, and glutathione peroxidase）, that participated in modulating oxidative stress, were significantly increased in the liver, spleen, thymus, and serum, while the contents of malondialdehyde were dramatically decreased. Conclusions： SZC exhibited potent immunomodulatory effects on innate and adaptive immunity in healthy ICR mice, as well as potential antioxidant activity for prevention of oxidative stress, which was suggested to partly contribute to the immune enhancement.

Resolution of Pseudoptosis after Anti-inflammatory Treatment of the Contralateral Eye in Thyroid-associated Ophthalmopathy

Thyroid-associated ophthalmopathy （TAO） is an autoimmune inflammatory disease. Pseudoptosis （or ptosis）, which involves a reduction in the opening of the upper eyelid with a normal levator muscle, is rarely reported in TAO patients. In this article, we reported three cases of unilateral pseudoptosis due to inflammation of the levator in the contralateral eye. The effect of the unilateral use of triamcinolone acetonide （TA） on contralateral lid position and contour was also investigated.