2型糖尿病湿热困脾证合并血脂紊乱胰岛功能变化及其影响因素分析

目的探讨2型糖尿病湿热困脾证合并血脂紊乱患者胰岛功能变化及其影响因素。方法选择2020年1月—2020年12月医院收治的2型糖尿病湿热困脾证患者100例,根据美国ATPIII评估标准将其分为血脂紊乱组62例与血脂正常组38例。比较各组SF-36积分、胰岛素分泌功能(Homeostasis model assessment-β,HOMA-β)、胰岛素抵抗水平(Homeostasis model assessment-IR,HOMA-IR)、胰岛素敏感指数(Insulin sensitivity index,ISI)、空腹C肽和空腹胰岛素。应用单因素和多因素分析法研究血脂异常的相关因素。结果高甘油三酯组与混合型高脂组空腹胰岛素水平显著高于高胆固醇组与血脂正常组,差异有统计学意义(P<0.05)。高甘油三酯组空腹C肽水平显著高于高胆固醇组,差异有统计学意义(P<0.05)。混合型高脂组与高甘油三酯组的ISI水平低于高胆固醇组(P<0.05)。高甘油三酯组HOMA-β水平明显高于高胆固醇组与血脂正常组,差异有统计学意义(P<0.05)。高甘油三酯组及混合型高脂组HOMA-IR水平显著高于高胆固醇组,差异有统计学意义(P<0.05)。两组患者在躯体疼痛、整体健康、活力、社会功能和精神健康维度方面比较,差异有统计学意义(P<0.01)。多因素Logistic分析显示,喜食油腻、吸烟史、腰围和空腹胰岛素是2型糖尿病湿热困脾证患者血脂异常的危险因素,有氧运动是2型糖尿病湿热困脾证患者血脂异常的保护因素(P<0.05)。结论不同血脂紊乱类型对胰岛功能的影响并不相同,应针对相关因素积极预防,降低胰岛分泌负担,促使胰岛功能恢复。

高天舒教授从厥阴湿热论治新诊断2型糖尿病经验总结

新诊断2型糖尿病(T2DM)归属于中医学“消渴”范畴,临床上常无明显“三多一少”症状,但是多表现为寒热错杂之象。高天舒教授结合当今社会-饮食-心理模式,从“厥阴湿热”角度出发,辨证论治,提出新诊断T2DM大多以厥阴阴虚为本、湿热内郁为标且具有肝郁、脾寒、胃热的病机特点;治疗方面以“疏肝理气、通腑泄热、温下实脾”为基本原则,灵活用药,取得显著效果,同时也为中草药缓解甚至逆转新诊断T2DM提供了新的诊疗思路。

基于“阳化气,阴成形”理论探析自身免疫性甲状腺炎中医病机与治疗思路

自身免疫性甲状腺炎(autoimmune thyroiditis,AIT)是进行性自身免疫性疾病,是最常见的自身免疫性甲状腺疾病,中医学称之为瘿病。重点阐述“阳化气,阴成形”理论内涵,“阳化气,阴成形”是气化的两个过程,有形与无形之间的相互转换,概括了人体阳气和阴精的主要功能。探析AIT中医病机,阳化气不足、阴成形太过为基本病机,脾虚血瘀痰凝气滞为主要病机,阳化气不足为其发病之基,阴成形太过为其病变之标,阴阳失和,浊毒内结为其病变之果,“阴平阳秘,精神乃治,阴阳离决,精气乃绝”,临证治疗应以阴阳为本,从脾论治,以虚则补之,滞则行之,痰则散之,瘀则化之为原则,温阳化气,散结消阴,健脾益气以温阳,辨证祛邪以消阴,解毒散结以防变,同时还应顾护胃气。

Domain structure of hard magnetic NdAlFeCo bulk metallic glass

Magnetic domain structure of hard magnetic Nd60Al10Fe20Co10 bulk metallic glass (BMG) has been studied by using magnetic force microscopy. In the magnetic force images it is shown that the exchange interaction type magnetic domains with a period of about 360 nm do exist in the BMG, which is believed to be associated with the appearance of hard-magnetic properties in this system. As the scale of the magnetic domain is much larger than the size of the short-range ordered atomic clusters existing in the BMG, it is believed that the large areas of magnetic contrast are actually a collection of a group of clusters aligned in parallel by strong exchange coupling interaction. After fully crystallization, the BMG exhibits paramagnetism. No obvious magnetic contrast is observed in the magnetic force images of fully crystallized samples, except for a small quantity of ferromagnetic crystalline phase with low coercivity and an average size of 900 nm.

Deformation behavior of Fe-based bulk metallic glass during nanoindentation

Fe-based bulk metallic glasses (BMGs) normally exhibit super high strength but significant brittleness at ambient temperature. Therefore,it is difficult to investigate the plastic deformation behavior and mechanism in these alloys through conven-tional tensile and compressive tests due to lack of distinct macroscopic plastic strain. In this work,the deformation behavior of Fe52Cr15Mo9Er3C15B6 BMG was in-vestigated through instrumented nanoindentation and uniaxial compressive tests. The results show that serrated flow,the typical plastic deformation feature of BMGs,could not be found in as-cast and partially crystallized samples during nanoinden-tation. In addition,the deformation behavior and mechanical properties of the alloy are insensitive to the applied loading rate. The mechanism for the appearance of the peculiar deformation behavior in the Fe-based BMG is discussed in terms of the temporal and spatial characteristics of shear banding during nanoindentation.

Microstructure and mechanical properties of a novel Zr-based bulk metallic glass composite

Zr48.5Cu46.5Al5 bulk metallic glass (BMG) com- posites with diameters of 3 and 4 mm were prepared through suction casting in an arc melting furnace by modulating the alloy composition around the monothetic BMG composition of the high glass forming ability. Microstructural charac- terization reveals that the composites contain micron-sized CuZr phase with martensite structure, as well as nano-sized Zr2Cu crystalline particles and Cu10Zr7 plate-like phase em- bedded in an amorphous matrix. Room temperature com- pression tests showed that the composites exhibited signifi- cant strain hardening and obvious plastic strain of 7.7% for 3 mm and 6.4% for 4 mm diameter samples, respectively.

Deformation behavior during nanoindentation in Ce-based bulk metallic glasses

The deformation behavior and the ef- fect of the loading rate on the plastic deformation in Ce-based bulk metallic glasses (BMGs) were inves- tigated through nanoindentation tests. The results showed that the loading rate dependence of plastic deformation during nanoindentation measurements in the Ce-based BMGs is quite unique in contrast to that of other BMG alloys. The load-displacement (P-h) curves of Ce60Al15Cu10Ni15 BMG exhibit a homoge- neous plastic deformation at low loading rates, and a prominent serrated flow at high strain rates, whereas, the P-h curves of Ce65Al10Cu10Ni10Nb5 exhibit ho- mogenous plastic deformation at all studied loading rates. The room temperature creep behavior could clearly be observed in these two alloys. The mecha- nism of the unique plastic deformation feature in the Ce-based BMGs was studied.