2型糖尿病合并冠心病患者血清Hcy、HbAlc和血尿酸水平变化的临床意义

目的探讨2型糖尿病合并冠心病患者血清同型半胱氨酸(Hcy)、糖化血红蛋白(HbAlc)和血尿酸水平变化的临床意义。方法选取2型糖尿病合并冠心病患者60例为合并冠心病组,单纯2型糖尿病患者45例为单纯糖尿病组,健康志愿者30名为健康对照组。采集空腹外周静脉血,检测血清Hcy、HbAlc及血尿酸水平;行冠状动脉造影检查,记录冠脉狭窄程度50%及以上的病变累及左前降支、回旋支或右冠脉的支数(单支病变、双支病变、多支病变)。收集2型糖尿病合并冠心病患者的年龄、性别、身高、体质量、吸烟情况及低密度脂蛋白、总胆固醇、甘油三酯、空腹血糖、维生素B12、叶酸水平。进行3 a随访,记录患者病情加重再入院、死亡情况。结果合并冠心病组血清Hcy、HbAlc及血尿酸水平明显高于单纯糖尿病组和健康对照组(P<0.05);多支病变患者血清Hcy、HbAlc及血尿酸水平明显高于双支病变和单支病变患者(P<0.05);预后不良组患者血清Hcy、HbAlc及血尿酸水平明显高于预后良好组患者(P<0.05);预后不良组患者中吸烟比例、空腹血糖水平明显高于预后良好组(P<0.05)。Hcy、HbAlc、血尿酸是2型糖尿病合并冠心病患者预后的独立影响因素。ROC曲线分析显示,血清Hcy、HbAlc及血尿酸水平对2型糖尿病合并冠心病患者预后具有较高的预测价值(P<0.05),联合检测的预测价值最高(AUC=0.947)。结论2型糖尿病合并冠心病患者血清Hcy、HbAlc及血尿酸水平升高,且与冠脉病变程度密切相关,联合检测可用于患者预后评估。

Aqueous Extract of Ceiba pentandra Stimulates the Production of Fetal Hemoglobin in Sickle Cell Patients

Subsequent studies have demonstrated the reversed activity of the aqueous extract of Ceiba pentandra on the deformity of sickled red blood cells in hypoxia conditions. The observation which related to an in vitro study had given rise to hopes as to the management of sickle cell disease (SCD) by the use of this plant species. In this paper, the authors aimed to investigate the effect of the aqueous extract of C. pentandra on the production of fetal hemoglobin in SCD patients. The work carried out hemoglobin electrophoresis, for a period of six months, on blood samples from SCD patients who voluntarily undergone routine treatment, based on the medicinal recipe prepared from the bark of the trunk and branches of C. pentandra, in a hospital center of herbal medicines located in Kinshasa. The medicinal recipe called BEAT-SS is a patented product of the hospital center named Centre de Phytothérapie Moderne NIECA. Blood samples from patients under treatment were taken to evaluate the behavior of different forms of hemoglobin (hemoglobin S, hemoglobin F and hemoglobin A2). Agarose gel electrophoresis with integrated reading was used for the separation of the different forms of hemoglobin, as well as their dosage on each sample of sickle blood. A reduction in the proportion of hemoglobin S and an increase in the proportion of fetal hemoglobin were found in all sickle cell patients during the treatment period. This observation could affirm that the management of sickle cell patients using the recipe prepared from the aqueous extract of C. pentandra could increase the level of fetal hemoglobin in these patients.

Associations of serum D-dimer and glycosylated hemoglobin levels with third-trimester fetal growth restriction in gestational diabetes mellitus

BACKGROUND Gestational diabetes mellitus(GDM)is a special type of diabetes that commonly occurs in women during pregnancy and involves impaired glucose tolerance and abnormal glucose metabolism;GDM is diagnosed for the first time during pregnancy and can affect fetal growth and development.AIM To investigate the associations of serum D-dimer(D-D)and glycosylated hemoglobin(HbA1c)levels with third-trimester fetal growth restriction(FGR)in GDM patients.METHODS The clinical data of 164 pregnant women who were diagnosed with GDM and delivered at the Obstetrics and Gynecology Hospital of Fudan University from January 2021 to January 2023 were analyzed retrospectively.Among these women,63 whose fetuses had FGR were included in the FGR group,and 101 women whose fetuses had normal body weights were included in the normal body weight group(normal group).Fasting venous blood samples were collected from the elbow at 28-30 wk gestation and 1-3 d before delivery to measure serum D-D and HbA1c levels for comparative analysis.The diagnostic value of serum D-D and HbA1c levels for FGR was evaluated by receiver operating characteristic analysis,and the influencing factors of third-trimester FGR in GDM patients were analyzed by logistic regression.RESULTS Serum fasting blood glucose,fasting insulin,D-D and HbA1c levels were significantly greater in the FGR group than in the normal group,while the homeostasis model assessment of insulin resistance values were lower(P<0.05).Regarding the diagnosis of FGR based on serum D-D and HbA1c levels,the areas under the curves(AUCs)were 0.826 and 0.848,the cutoff values were 3.04 mg/L and 5.80%,the sensitivities were 81.0%and 79.4%,and the specificities were 88.1%and 87.1%,respectively.The AUC of serum D-D plus HbA1c levels for diagnosing FGR was 0.928,and the sensitivity and specificity were 84.1%and 91.1%,respectively.High D-D and HbA1c levels were risk factors for third-trimester FGR in GDM patients(P<0.05).CONCLUSION D-D and HbA1c levels can indicate the occurrence of FGR in GDM patients in the third trimester of pregnancy to some extent,and their combination can be used as an important index for the early prediction of FGR.

Hemoglobin loss method calculates blood loss during pancreaticoduodenectomy and predicts bleeding-related risk factors

BACKGROUND The common clinical method to evaluate blood loss during pancreaticoduoden-ectomy(PD)is visual inspection,but most scholars believe that this method is extremely subjective and inaccurate.Currently,there is no accurate,objective me-thod to evaluate the amount of blood loss in PD patients.We retrospectively analyzed the clinical data of 341 patients who underwent PD in Shandong Provincial Hospital from March 2017 to February 2019.According to different surgical methods,they were divided into an open PD(OPD)group and a laparoscopic PD(LPD)group.The differences and correlations between the in-traoperative estimation of blood loss(IEBL)obtained by visual inspection and the intraoperative calculation of blood loss(ICBL)obtained using the Hb loss method were analyzed.ICBL,IEBL and perioperative calculation of blood loss(PCBL)were compared between the two groups,and single-factor regression analysis was performed.RESULTS There was no statistically significant difference in the preoperative general patient information between the two groups(P>0.05).PD had an ICBL of 743.2(393.0,1173.1)mL and an IEBL of 100.0(50.0,300.0)mL(P<0.001).There was also a certain correlation between the two(r=0.312,P<0.001).Single-factor analysis of ICBL showed that a history of diabetes[95%confidence interval(CI):53.82-549.62;P=0.017]was an independent risk factor for ICBL.In addition,the single-factor analysis of PCBL showed that body mass index(BMI)(95%CI:0.62-76.75;P=0.046)and preoperative total bilirubin>200μmol/L(95%CI:7.09-644.26;P=0.045)were independent risk factors for PCBL.The ICBLs of the LPD group and OPD group were 767.7(435.4,1249.0)mL and 663.8(347.7,1138.2)mL,respectively(P>0.05).The IEBL of the LPD group 200.0(50.0,200.0)mL was slightly greater than that of the OPD group 100.0(50.0,300.0)mL(P>0.05).PCBL was greater in the LPD group than the OPD group[1061.6(612.3,1632.3)mL vs 806.1(375.9,1347.6)mL](P<0.05).CONCLUSION The ICBL in patients who underwent PD was greater than the IEBL,but there is a certain correlation between the two.The Hb loss method can be used to evaluate intraoperative blood loss.A history of diabetes,preoperative bilirubin>200μmol/L and high BMI increase the patient's risk of bleeding.

Relationship between hemoglobin glycation index and risk of hypoglycemia in type 2 diabetes with time-in-range in target

BACKGROUND In patients with type 2 diabetes mellitus(T2DM),the risk of hypoglycemia also occurs in at a time-in-range(TIR)of>70%.The hemoglobin glycation index(HGI)is considered the best single factor for predicting hypoglycemia,and offers new perspectives for the individualized treatment of patients with well-controlled blood glucose levels that are easily ignored in clinical settings.All participants underwent a 7-days continuous glucose monitoring(CGM)using a retrospective CGM system.We obtained glycemic variability indices using the CGM system.We defined HGI as laboratory hemoglobin A1c minus the glucose management indicator.Patients were categorized into low HGI(HGI<0.5)and high HGI groups(HGI≥0.5)according to HGI median(0.5).Logistic regression and receiver operating characteristic curve analyses were used to determine the risk factors for hypoglycemia.RESULTS We included 129 subjects with T2DM(54.84±12.56 years,46%male)in the study.Median TIR score was 90%.The high HGI group exhibited lower TIR and greater time below range with higher hemoglobin A1c than the low HGI group;this suggests more glycemic excursions and an increased incidence of hypoglycemia in the high HGI group.Multivariate analyses revealed that mean blood glucose,standard deviation of blood glucose and HGI were independent risk factors for hypoglycemia.Receiver operating characteristic curve analysis indicated that the HGI was the best predictor of hypoglycemia.In addition,the optimal cut-off points for HGI,mean blood glucose,and standard deviation of blood glucose in predicting hypoglycemia were 0.5%,7.2 mmol/L and 1.4 mmol/L respectively.CONCLUSION High HGI was significantly associated with greater glycemic excursions and increased hypoglycemia in patients with TIR>70%.Our findings indicate that HGI is a reliable predictor of hypoglycemia in this population.

Cut-off value of glycated hemoglobin A1c for detecting diabetic retinopathy in the Chinese population

BACKGROUND Glycated hemoglobin A1c(HbA1c)is considered the most suitable for diabetes mellitus diagnosis due to its accuracy and convenience.However,the effect of HbA1c on diabetic retinopathy(DR)in the Han and Korean populations in Jilin,China,remains inconclusive.AIM To determine the best cut-off of HbA1c for diagnosing DR among the Chinese.METHODS This cross-sectional study included 1933 participants from the Yanbian area of Jilin Province,China.Trained investigators employed a questionnaire-based survey,physical examination,laboratory tests,and fundus photography for the investigation.The best cut-off value for HbA1c was established via the receiver operating characteristic curve.The factors associated with HbA1c-associated risk factors were determined via linear regression.RESULTS The analysis included 887 eligible Chinese Han and Korean participants,591 of whom were assigned randomly to the training set and 296 to the validation set.The prevalence of DR was 3.27% in the total population.HbA1c of 6.2% was the best cut-off value in the training set,while it was 5.9% in the validation set.In both Chinese Han and Korean populations,an HbA1c level of 6.2% was the best cut-off value.The optimal cut-off values of fasting blood glucose(FBG)≥7 mmol/L and<7 mmol/L were 8.1% and 6.2% respectively in Han populations,while those in Korean populations were 6.9%and 5.3%,respectively.Age,body mass index,and FBG were determined as the risk factors impacting HbA1c levels.CONCLUSION HbA1c may serve as a useful diagnostic indicator for DR.An HbA1c level of 6.2% may be an appropriate cut-off value for DR detection in the Chinese population.

Cloning of hemoglobin-α1 from half-smooth tongue sole (Cynoglossus semilaevis) and its expression under short-term hypoxia

This study cloned the hemoglobin a1 from the marine teleost, the half-smooth tongue sole （Cynoglossus semilaevis）, and then examined its expression under hypoxia exposure. The full-length of CsHb-a1 （594 bp） cDNA contains an open reading frame encoding 144 amino acids. Sequence analysis shows that the predicted CsHb-a1 amino acids shares high identities with that of other species. Real-time PCR showed that CsHb-a1 was highly expressed in the heart, liver, spleen, kidney and blood. Five to 120 min esposure and long-term （36 h） exposure to hypoxia （1.0 mg/L） significantly increased CsHb-a1 mRNA expression in most tissues compared to those fish held in normoxic conditions （dissolved oxygen （DO）： 6.2 mg/L）. These results suggested that the up-regulation of Hb-a1 is an important component for adaptation of half-smooth tongue sole to short-term hypoxia.

中药纠正口服降糖药物继发失效Ⅱ型糖尿病HbAlc水平的临床报道

为观察中药纠正口服降糖药物继发失效的Ⅱ型糖尿病的疗效，以“梅杞汤”为基本方加减治疗２０例。结果：治疗后ＨｂＡｌｃ显著下降（Ｐ＜０．００１），ＦＰＧ无显著下降（Ｐ＞０．０５），ＨｂＡｌｃ与ＦＰＧ出现不平行现象。

血清HbAlc、CysC及Hcy检测对糖尿病早期肾损伤的诊断价值分析

目的总结并归纳血清糖化血红蛋白(HbAlc)、胱抑素C(CysC)及同型半胱氨酸(Hcy)检测对糖尿病早期肾损伤的诊断价值。方法本文选取2017年10月至2018年10月本院收治的57例糖尿病早期肾损伤患者为观察组,以同期57名健康体检者为对照组。两组受检者均接受常规检验方法,检测两组血清HbAlc、CysC及Hcy水平。比较各指标单一诊断和联合诊断糖尿病肾病的阳性检出率,分析血清HbAlc、CysC及Hcy检测对糖尿病早期肾损伤的诊断价值。结果观察组的血清HbAlc、CysC及Hcy水平远高于对照组;血清HbAlc、CysC及Hcy联合诊断糖尿病肾病的阳性检出率为96.49%(55/57),均远优于HbAlc、CysC及Hcy各项指标单一诊断的82.46%(47/57)、61.40%(35/57)和71.93%(41/57),组间比较差异有统计学意义(P<0.05)。结论同时检测血清HbAlc、CysC及Hcy水平并对患者糖尿病早期肾损伤进行分析,可显著提高糖尿病肾病的阳性检出率,且联合诊断的临床应用价值更高。

血清Cys-C、β2-MG、尿M-ALB与HbAlc联合检测在早期诊断糖尿病肾病中的意义

本研究选取我院收治的62例早期糖尿病肾病患者,以探讨血清Cys-C、β2-MG、尿M-ALB与HbAlc联合检测在早期诊断糖尿病肾病中的诊断价值。

探讨空腹胰岛素、C肽、HbAlc在Ⅱ型糖尿病肾病诊断中的临床意义

目的探讨空腹胰岛素、C肽、HbAlc在Ⅱ型糖尿病肾病诊断中的临床意义。方法选取56例Ⅱ型糖尿病患者为观察组,依据患者尿微量白蛋白排泄率24 h检测结果,分为早期糖尿病肾病组(30例)与中晚期糖尿病肾病组(26例)。选取同期健康体检者56例为对照组。检测空腹GLU、INS、C肽及HbAlc,分析检测结果。结果观察组空腹GLU、INS、C肽及HbAlc,均高于对照组,组间比较差异有统计学意义(P<0.05);早期糖尿病肾病组的空腹GLU、HbAlc水平,均低于中晚期糖尿病肾病组,组间比较差异无统计学意义;早期糖尿病肾病组的空腹INS、C肽水平,均高于中晚期糖尿病肾病组,组间比较差异有统计学意义(P<0.05)。结论空腹胰岛素、C肽及HbAlc应用于Ⅱ型糖尿病患者的临床诊断中,能够及时了解患者的胰岛β细胞功能及肾功能状况,为临床诊治提供参考意见。

2型糖尿病患者微血管病变同MPV、hs-CRP、CD62P及HbAlc指标的关系

目的该研究主要分析2型糖尿病患者微血管病变同平均血小板体积(MPV)、超敏C反应蛋白(hs-CRP)、血小板α蛋白(CD62P)及糖化血红蛋白(HbAlc)指标间的关系情况。方法选取2017年4月—2019年1月间于该院住院诊疗的2型糖尿病患者94例作为观察组,并根据患者有无微血管病变将患者分为病变组43例及无病变组51例,另选取同期94名无2型糖尿病体检者作为对照组。运用不同检测仪器对入组受试者进行MPV、hs-CRP、CD62P及HbAlc指标记录,并进行统计学分析。结果观察组患者MPV、hs-CRP、CD62P及HbAlc指标均高于对照组,差异有统计学意义(P<0.05);病变组患者MPV、hs-CRP、CD62P及HbAlc指标均高于无病变组,差异有统计学意义(P<0.05);观察组患者的MPV同CD62P、HbA1c及hs-CRP指标间均呈正相关(P<0.05)。结论2型糖尿病患者微血管病变同MPV、hs-CRP、CD62P及HbAlc指标间的关系密切,对早期发现及治疗提供了帮助。

2型糖尿病患者Hcy、HbAlc、MAU与肾脏微血管病变的关系探讨

目的探讨2型糖尿病(T2DM)患者同型半胱氨酸(Hcy)、糖化血红蛋白(HbAlc)、尿微量白蛋白(MAU)与肾脏微血管病变的关系。方法 216例T2DM患者分为合并微血管病变组95例,无微血管病变组121例,治疗后按糖化血红蛋白(HbAlc)控制水平又分别分为HbAlc<7.0%组、HbAlc>7.0%组,以46例健康体检者为对照组;分别测定空腹血糖(FPG)、HbAlc、Hcy、脂蛋白a(Lpa)、MAU和尿β2微球蛋白(β2-MG)。结果 T2DM合并微血管病变患者HbAlc、Hcy、MAU和尿β2-MG明显高于无微血管病变患者(P<0.05);T2DM合并微血管病变患者治疗后HbAlc>7.0%组Lpa、Hcy、MAU、尿β2-MG水平明显高于HbAlc<7.0%组(P<0.05)。结论联合检测HbAlc、Hcy、Lpa、MAU和尿β2-MG可以动态观察DM患者肾脏微血管病变程度;强化血糖控制,改善Hcy、Lpa代谢对延缓T2DM微血管病变具有重要的临床意义。

2型糖尿病微血管病变患者血浆D-D、HbAlc和Hcy检测的临床意义

本文对2型糖尿病（DM2）微血管病变患者与无微血管病变患者血浆D．二聚体（D．D）、糖化血红蛋（HbAle）和同型半胱氨酸（Hey）检测，探讨它们在DM2微血管病变中的临床意义。现将结果报告如下。

新诊2型糖尿病患者血清相关炎症因子与HbAlc联检的临床意义

目的:探讨血清肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hsCRP)与糖化血红蛋白(HbAlc)在新诊2型糖尿病患者体内水平及其相关关系。方法:新诊2型糖尿病患者50例(A组)与50例正常对照(B组)同时应用RIA与微柱层析法测定空腹血清TNF-α、hsCRP和HbAlc的水平。结果:新诊2型糖尿病患者血清TNF-α、hsCRP与HbAlc的水平与正常对照组比较均显著升高,独立样本的t检验有显著性差异(t=8.7～11.3,P<0.001)。控制年龄与性别后的相关分析表明:hsCRP、TNF-α、HbAlc和空腹血糖(FBG)之间呈正相关(r=0.208～0.669),相关系数均有显著性意义(P<0.05);以HbAlc为因变量的多元线性逐步回归分析表明,TNF-α、hsCRP均进入回归模型,三者间存在一定的因果关系。结论:新诊2型糖尿病患者血清TNF-α、hsCRP和HbAlc水平明显增高;炎症因子参与了糖尿病的发生发展,联检血清TNF-α、hsCRP和HbAlc对糖尿病的病情监测和预后有重要的临床意义。

Reflotron-Hemoglobin干式血红蛋白检测系统的性能评价

目的：对Reflotron-Hemoglobin干式血红蛋白检测系统进行性能评价。方法对仪器的批内精密度、批间精密度、线性、相关性及参考范围进行验证。结果 Reflotron-Hemoglobin干式血红蛋白检测系统的批内精密度为2．54％～2．84％；批间精密度为0．68％～3．38％；线性范围为52～191 g/L；与 BECKMAN-COULTER LH750全自动血液分析仪的相关方程为 Y＝1．0316X-2．7969；参考区间验证符合率为100％。结论Reflotron-Hemoglobin 干式血红蛋白检测系统批内、批间精密度较好；在正常及病理范围内检测结果可靠；常用参考区间适用于本仪器。

乳胶凝集法HbAlc测定及其临床应用

目的 :探讨乳胶增强免疫凝集法测定糖化血红蛋白在临床中的应用价值。方法 :采用乳胶增强免疫比浊法测定糖化血红蛋白。结果 :本法测定健康人群参考范围为 3.8%～ 5 .8%。糖尿病以及高危人群和部分自愿者 12 9例 ,Hb Alc均值为 (6 .2 2± 3.2 6 ) % ,与 FPG、2 h PG水平呈显著性相关 ,γ分别为 0 .711、0 .6 9(P<0 .0 5 )。结论 :该法最大的优点是能进行自动化分析。虽然 Hb Alc测定简便、重复性、但其敏感性低所以不能作为惟一的诊断标准。与 FPG结合可提高糖尿病诊断率并指导临床治疗。

探讨空腹胰岛素、C肽、HbAlc在Ⅱ型糖尿病肾病诊断中的临床意义

目的探讨空腹胰岛素(INS)、C肽、糖化血红蛋白(HbAlc)水平变化在Ⅱ型糖尿病肾病(T2DN)诊断中的临床价值。方法选择2013年12月-2014年6月在枣阳市第一人民医院糖尿病门诊确诊的79例2型糖尿病(T2DM)患者和76例同期进行健康体检者,分别在贝克曼DXI 800和罗氏Cobax 601全自动化学发光分析仪上采用化学发光法检测INS和C肽,奥林巴斯全自动生化分析仪(AU2700)上采用免疫比浊法检测HbAlc,采用酶法检测血糖(GLU),并对检测结果进行统计分析。结果实验组检测空腹GLU、INS、C肽和HbA1c水平高于正常对照组,组间比较差异有统计学意义或高度统计学意义(P<0.05或P<0.01);早期糖尿病肾病组和中晚期糖尿病肾病组GLU和HbAlc检测水平高于单纯糖尿病组,组间比较差异无统计学意义(P>0.05),早期糖尿病肾病组INS和C肽检测水平高于单纯糖尿病组,组间比较差异有高度统计学意义(P<0.01);中晚期糖尿病肾组INS和C肽检测水平低于单纯糖尿病组,组间比较差异有统计学意义(P<0.05);中晚期糖尿病肾组INS和C肽检测水平低于早期糖尿病肾病组,组间比较差异有统计学意义(P<0.05)。结论联合检测INS、C肽和HbAlc有助于较准确地了解胰岛β细胞的功能状况以及早期了解糖尿病患者的肾功能状况,其水平变化对判定T2DN患者的胰岛β细胞功能、血糖水平监控、诊断、病情控制及指导治疗等方面有较高的临床应用价值。

控制HbAlc水平对糖尿病肾病患者24小时尿微量蛋白影响的研究

糖尿病肾病是糖尿病微血管病变导致,是其严重并发症之一。尿微量蛋白是评价糖尿病肾病病情的重要指标,研究糖化血红蛋白水平的高低对糖尿病肾病患者24小时尿微量蛋白是否存在影响可指导患者更好的控制血糖,延缓糖尿病肾病的进展。

Synthesis of Chiral Polyaniline Induced by Modified Hemoglobin

The synthesis of chiral polyaniline （PANI） induced by modified hemoglobin （Hb） was pro- foundly explored for the first time. Results revealed that after being separated, inactivated or immobilized, Hb can still induce the formation of chiral PANI successfully, suggesting that Hb can be used as the chiral inducers regardless of harsh reaction conditions. By examining the properties of PANI induced by modified Hb, it was found that Hb（inactivated）-PANI possessed excellent chirality, stability, and crystalline structure. The globin separated from Hb was demonstrated to have the ability of inducing the production of chiral PANI whereas the hematin from Hb had no capacity to direct enantio specificity for the PANI chains. Results indicated that Hb（immobilized）-PANI exhibited poor yield, doping state, and crys- talline structure, indicating that the immobilization of Hb by entrapment was not beneficial to the polymerization reaction. Results also showed that the structure of Hb may have significant effects on the morphologies of chiral PANI.