难治性强迫障碍患者的认知功能、生命质量与职业状态的关系

目的:探讨难治性强迫症患者的认知功能、生命质量与职业状态的关系。方法:选取2009年5月至2015年10月在我院强迫症专病门诊就诊的98例难治性强迫症患者为研究对象。将患者分为职业组和失业组,其中职业组56例,失业组42例。给予SF-36量表、可反复测查的成套神经心理状态评估工具(RBANS)、Stroop色词测验进行测评,并将两组测查结果进行比较。结果:在SF-36中,职业组难治性强迫症患者在生理职能(RP)、社会功能(SF)维度分显著高于失业组(P<0.05)。在RBANS各项分及总分,职业组均高于失业组,差异有统计学意义(P<0.05)。结论:难治性强迫症患者存在认知职业和社会功能的障碍,工作和难治性强迫症患者心理特征可能是相互影响。

Effects and mechanism of glucagon-like peptide-1 on injury of rats cardiomyocytes induced by hypoxia-reoxygenation

Background Although the insulinotropic role of glucagon-like peptide-1 （GLP-1） in type 2 diabetes mellitus has been substantiated, its role in cardioprotection remains largely unknown. This study aimed to determine the effects of GLP-1 on injury of rats cardiac myocytes induced by hypoxia-reoxygenation （H/R） and the possible mechanisms. Methods The cultured neonatal rats cardiac myocytes were randomly divided into seven groups： the normal control group, the H/R group, the GLP-1＋H/R group, the GLP-1＋H/R＋UO126 （the p42/44 mitogen-activated protein kinase （MAPK） inhibitor） group, the GLP-1＋H/R＋LY294002 （phosphatidylinositol 3-kinase （PI3K） inhibitor） group, the H/R＋UO126 group, and the H/R＋LY294002 group. The lactate dehydrogenase （LDH） activity, apoptosis rate of cardiac myocytes, and caspase-3 activity were detected after the injury of H/R. Results Compared with the normal control group, the activity of LDH, cardiac myocyte apoptosis rate, and caspase-3 activity all increased significantly in the H/R group （P 〈0.01）. Compared with the H/R group, these three indices all decreased in the H/R＋GLP-1 group （P 〈0.01）. However, the changes of LDH activity, apoptosis rate, and caspase-3 activity were inhibited by LY294002 and UO126 respectively. Conclusions GLP-1 can directly act on cardiac myocytes and protect them from H/R injury mainly by inhibiting their apoptosis. Its mechanism may be through the PI3K-Akt pathway and the MAPK signaling pathway.

糖尿病足溃疡的危险因素探讨及亲水性纤维含银敷料促进患者伤口愈合的临床对照研究

目的:探讨糖尿病足溃疡(DFU)的危险因素,并研究亲水性纤维含银敷料促进患者伤口愈合的应用价值。方法:选取2017年8月-2020年12月期间我院收治的糖尿病患者230例。230例糖尿病患者中发生DFU的79例,纳为DFU组,剩余151例未发生DFU,纳为无DFU组。DFU组的患者采用随机数字表法分为治疗1组39例和治疗2组40例,治疗1组给予传统纱布敷料,治疗2组给予亲水性纤维含银敷料。采用多因素Logistic回归分析DFU发生的危险因素。观察治疗1组、治疗2组的临床疗效和临床指标。结果:DFU组、无DFU组在性别、年龄、户籍地、糖尿病病程、并发下肢血管病变、并发周围神经病变、足底有胼胝、血红蛋白(Hb)、C反应蛋白(CRP)、白蛋白(ALB)、总胆固醇(TC)、纤维蛋白原(FIB)、红细胞沉降率(ESR)、高密度脂蛋白(HDL)、胱抑C(CysC)、低密度脂蛋白(LDL)、脂蛋白a[Lp(a)]、糖化血红蛋白(HbAlc)方面对比差异有统计学意义(P<0.05)。男性、糖尿病病程、并发下肢血管病变、并发周围神经病变、足底有胼胝、ALB、ESR、Cys C、CRP、Lp(a)、HbAlc均是DFU发生的危险因素(P<0.05)。治疗2组的临床总有效率明显高于治疗1组(P<0.05)。治疗2组的创面愈合时间、出现明显肉芽时间、住院时间短于治疗1组,住院费用高于治疗1组(P<0.05)。结论:DFU的发生受到多种因素影响,包括男性、糖尿病病程、并发下肢血管病变等,因此临床应加强对这些因素的预防和控制。此外,亲水性纤维含银敷料可促进DFU患者创面愈合,疗效显著。