Comparison of resistive index and shear-wave elastography in the evaluation of chronic kidney allograft dysfunction

BACKGROUND Detection of early chronic changes in the kidney allograft is important for timely intervention and long-term survival.Conventional and novel ultrasound-based investigations are being increasingly used for this purpose with variable results.AIM To compare the diagnostic performance of resistive index(RI)and shear wave elastography(SWE)in the diagnosis of chronic fibrosing changes of kidney allograft with histopathological results.METHODS This is a cross-sectional and comparative study.A total of 154 kidney transplant recipients were included in this study,which was conducted at the Departments of Transplantation and Radiology,Sindh Institute of Urology and Transplantation,Karachi,Pakistan,from August 2022 to February 2023.All consecutive patients with increased serum creatinine levels and reduced glomerular filtration rate(GFR)after three months of transplantation were enrolled in this study.SWE and RI were performed and the findings of these were evaluated against the kidney allograft biopsy results to determine their diagnostic utility.RESULTS The mean age of all patients was 35.32±11.08 years.Among these,126(81.8%)were males and 28(18.2%)were females.The mean serum creatinine in all patients was 2.86±1.68 mg/dL and the mean estimated GFR was 35.38±17.27 mL/min/1.73 m2.Kidney allograft biopsy results showed chronic changes in 55(37.66%)biopsies.The sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)of SWE for the detection of chronic allograft damage were 93.10%,96.87%%,94.73%,and 95.87%,respectively,and the diagnostic accuracy was 95.45%.For RI,the sensitivity,specificity,PPV,and NPV were 76.92%,83.33%,70.17%,and 87.62%,respectively,and the diagnostic accuracy was 81.16%.CONCLUSION The results from this study show that SWE is more sensitive and specific as compared to RI in the evaluation of chronic allograft damage.It can be of great help during the routine follow-up of kidney transplant recipients for screening and early detection of chronic changes and selecting patients for allograft biopsy.

Renal resistive index measurements by ultrasound in patients with liver cirrhosis:Magnitude and associations with renal dysfunction

BACKGROUND The hemodynamic alterations seen in liver cirrhosis lead to renal vasoconstriction,ultimately causing acute kidney injury(AKI).The renal resistive index(RRI)is the most common Doppler ultrasound variable for measuring intrarenal vascular resistance.AIM To evaluate the association of the RRI with AKI in patients with liver cirrhosis and to identify risk factors for high RRI.METHODS This was a prospective observational study,where RRI was measured using Doppler ultrasound in 200 consecutive hospitalized patients with cirrhosis.The association of RRI with AKI was studied.The receiver operating characteristic(ROC)curve analysis was utilized to determine discriminatory cut-offs of RRI for various AKI phenotypes.Multivariate analysis was conducted to determine the predictors of high RRI.RESULTS The mean patient age was 49.08±11.68 years,with the majority(79.5%)being male;the predominant etiology of cirrhosis was alcohol(39%).The mean RRI for the study cohort was 0.68±0.09,showing a progressive increase with higher Child-Pugh class of cirrhosis.Overall,AKI was present in 129(64.5%)patients.The mean RRI was significantly higher in patients with AKI compared to those without it(0.72±0.06 vs 0.60±0.08;P<0.001).A total of 82 patients(41%)had hepatorenal syndrome(HRS)-AKI,29(22.4%)had prerenal AKI(PRA),and 18(13.9%)had acute tubular necrosis(ATN)-AKI.The mean RRI was significantly higher in the ATN-AKI(0.80±0.02)and HRS-AKI(0.73±0.03)groups than in the PRA(0.63±0.07)and non-AKI(0.60±0.07)groups.RRI demonstrated excellent discriminatory ability in distinguishing ATN-AKI from non-ATN-AKI(area under ROC curve:93.9%).AKI emerged as an independent predictor of high RRI(adjusted odds ratio[OR]:11.52),and high RRI independently predicted mortality among AKI patients(adjusted OR:3.18).CONCLUSION In cirrhosis patients,RRI exhibited a significant association with AKI,effectively differentiated between AKI phenotypes,and predicted AKI mortality.

Role of cystatin C and renal resistive index in assessment of renal function in patients with liver cirrhosis

AIM:To evaluate the clinical significance of cystatin C and renal resistive index for the determination of renal function in patients with liver cirrhosis.METHODS:We conducted a study of 63 patients with liver cirrhosis.A control group comprised of 30 age and gender-matched healthy persons.Serum cystatin C was determined in all study subjects and renal Doppler ultrasonography was made.Estimated glomerular filtration rate from serum creatinine(GFRCr)and cystatin C(GFRCys)was calculated.RESULTS:We confirmed significant differences in val-ues of cystatin C between patients with different stages of liver cirrhosis according to Child-Pugh(P=0.01),and a significant correlation with model of end stage liver disease(MELD)score(rs=0.527,P<0.001).More patients with decreased glomerular filtration rate were identified based on GFRCys than on GFRCr(P<0.001).Significantly higher renal resistive index was noted in Child-Pugh C than in A(P<0.001)and B stage(P=0.001).Also,a significant correlation between renal resistive index and MELD score was observed(rs=0.607,P<0.001).Renal resistive index correlated significantly with cystatin C(rs=0.283,P=0.028)and showed a negative correlation with GFRCys(rs=-0.31,P=0.016).CONCLUSION:Cystatin C may be a more reliable marker for assessment of liver insufficiency.Additionally,cystatin C and renal resistive index represent sensitive indicators of renal dysfunction in patients with liver cirrhosis.

Central retinal artery resistive index and optical coherence tomography in assessment of glaucoma progression

AIM: To assess the relation between central retinal artery(CRA) resistive index(RI) and retinal nerve fiber thickness measured by optical coherence tomography(OCT) in assessment of disease progress in cases of open angle glaucoma.METHODS: Twenty-three patients with diagnosed open angle glaucoma were included in this study. They were examined by colored duplex ultrasonography of CRA with estimation of RI of CRA and ophthalmic artery(OA)with estimation of CRA/OA RI ratio as well as OCT measurement of the average retinal nerve fiber layer(RNFL) thickness in order to assess the disease progress.RESULTS: There was strong inverse relation between the increased RI in CRA as well as the increased CRA/OA RI ratio and the decrease in average RNFL thickness in cases of open angle glaucoma.CONCLUSION: Assessment of CRA RI can indirectly assess the vascular changes associated with glaucoma and can assess the degree of retinal atrophy helping in evaluating prognosis thus guiding the choice of treatment.

A drought resistance index to select drought resistant plant species based on leaf water potential measurements

The water deficit in arid and semi-arid regions is the primary limiting factor for the development of urban greenery and forestation. In addition, planting the species that consume low levels of water is useful in arid and semi-arid regions that have poor water management measures. Leaf water potential(Ψ) is a physiological parameter that can be used to identify drought resistance in various species. Indeed, Ψ is one of the most important properties of a plant that can be measured using a pressure chamber. Drought avoiding or drought resistant species have a lower Ψ than plants that use normal or high levels of water. To determine drought resistance of species that are suitable for afforestation in arid urban regions, we evaluated twenty woody species in the Isfahan City, central Iran. The experimental design was random split-split plots with five replications. The species were planted outdoor in plastic pots and then subjected to treatments that consisted of two soil types and five drip irrigation regimes. To evaluate the resistance of each species to drought, we used the Ψ and the number of survived plants to obtain the drought resistance index(DRI). Then, cluster analysis, dendrogram, and similarity index were used to group the species using DRI. Result indicates that the evaluated species were classified into five groups:(1) high water consuming species(DRI>–60 MPa);(2) above normal water consuming species(–60 MPa≥DRI>–90 MPa);(3) normal water consuming species(–90 MPa≥DRI>–120 MPa);(4) semi-drought resistant species(–120 MPa≥DRI>–150 MPa);and(5) drought resistant species(DRI≤–150 MPa). According to the DRI, Salix babylonica L., Populus alba L., and P. nigra L. are high water consuming species, Platanus orientalis L. and Albizia julibrissin Benth are normal water consuming species, and Quercus infectoria Oliv. and Olea europaea L. can be considered as drought resistant species.

The concept and statistical method of drought resistance index in crops

There is evindence showing that stress susceptibility index(SSI)(1一Yd/Yp)/(1—(?)d/(?)p)used as a measure of drought resistance of crop on the field is an altered form of droughtresistance coefficient(DRC)(Yd/Yp).The correlative coefficient SSI and DRC is r=-1.Therefore,the SSI doesn’t improve the defect of the DRC.After two years experiments per-formed by using thirty winter wheat varieties as trial materials,the concept of drought resistanceindex in crops was put forward.Its expressing equation is:the yield in drylan×drought resis-tance coefficient/average yield in dryland.It makes the drought resistance coefficient(physicalindex)correlate well with the yield in dryland(agronomy index)and is suitable for breeder.

The Relationship of Carotid Plaque, Intima Media Thickness (IMT), Resistivity Index (RI) and Pulsatility Index(PI) in Asian-Indian Patients with Acute Ischemic Stroke with and without Type2 DM

Aim: To determine the relationship of carotid plaque, intima media thickness (IMT), resistivity index (RI) and pulsatility index (PI) and prevalence of different risk factors with acute ischemic stroke and stroke subtypes in both diabetic and non-diabetic subjects. Materials and methods: 80 cases of acute ischemic strokes and 40 healthy controls were included in the study. The plaque, IMT, RI and PI were measured by carotid duplex ultrasound. Results: 31 subjects were Type 2 diabetic, 54 hypertensive while 25 were both diabetic and hypertensive. 23 cases (28.75%) had lacunar stroke (LACI), 32 (40%) stroke involving partial anterior circulation(PACI), 10(12.5%) stroke in posterior circulation (PACI) and 15(18.75%) stroke involving total anterior circulation(TACI) respectively. The mean IMT (0.88 ± 0.19mm), RI(0.76 ± 0.05) and PI(1.71 ± 0.19) of patients and mean IMT (0.6±0.09mm), RI (0.61 ± 0.06) and PI (1.53 ± 0.11) of controls were statistically significant (p-0.000). The mean values of IMT, PI and RI were significantly higher in diabetics (IMT-0.90 ± 0.16 VS 0.64 ± 0.11, p-0.013;PI-1.76 ± 0.20 VS 1.49 ± 0.09, P-0.000 and RI-0.76 ± 0.04 VS 0.59 ± 0.06, P-0.000) and similarly the mean values for IMT, PI and RI in hypertensives as compared to controls (IMT-0.88 ± 0.16 vs 0.65 ± 0.10, P-0.006;PI1.69 ± 0.18 vs 1.49 ± 0.09, P-0.000 and RI 0.76 ± 0.04 vs 0.59 ± 0.06, P-0.000). The mean IMT, PI and RI were increased significantly in smokers compared to controls (IMT-0.93 ± 0.20 vs 0.63 ± 0.06, P-0.000;PI-1.82 ± 0.22 vs 1.49 ± 0.09, P-0.000 and RI-0.77 ± 0.04 vs 0.59 ± 0.06, P-0.000). Type 3 plaque accounted for 27 (56.2%) cases and Type 2 plaque 12 (25%) cases. The total number of plaques in patients as compared to controls were significantly more (P-0.0034) and the mean plaque area was 46 mm2 for cases and 20 mm2 for control (P-0.0001). TACI was the most common type of ischemic stroke seen in DM (60%), HTN (66.6%) and smokers (66.7%). Plaques (73.3%), IMT (0.90 ± 0.12), PI(1.72 ± 0.14) and RI (0.76 ± 0.13) were more commonly associated with TACI subtype. On multivariate analysis using ANOVA, the mean PI was highly significant (0.000) in relation to types of plaque. Summary and Conclusions: IMT, RI, PI and plaque type are useful diagnostic parameters for acute ischemic stroke and its subtypes. They can be used as noninvasive tools for predicting and preventing ischemic stroke in smokers as well as subjects with DM and hypertension.

Screening of Drought Resistance Identification Indexes for Rice(Oryza sativa L.) Cultivars in Ningxia

The morphological characters, physiological characters, yield traits and yield per plant of total 49 rice cultivars from Ningxia were investigated under conditions of water stress and non-water stress so as to determine the relationship between each trait and yield per plant under water stress and the relationship between each relative character and drought resistance coefficient under water stress and non-water stress. The correlation, grey correlation, stepwise regression and path analyses showed that the tiller number per plant, plant height, grain density, effective panicle number per plant and grain number per panicle, total 5 traits, were significantly correlated with the drought resistance of rice, and they could be used to identify the drought resistance of rice in Ningxia. In addition, the drought resistance of rice was graded qualitatively according to the subordinate function value of corresponding drought resistance coefficient. The results showed that among the 49 rice cultivars from Ningxia,6 rice cultivars were highly drought resistant, and 9 rice cultivars were moderately drought resistant, suggesting that the evaluation method was feasible and effective.

Resistive Index for the Evaluation of Renal Damage in Diabetes Mellitus Type 2

Background: One of the most common causes of renal impairment and development of chronic kidney disease is diabetes mellitus type 2 (DM 2). The aim of this prospective study was to determine the role of Resistive Index (RI) as a non-invasive marker for the evaluation of renal impairment in patients with DM 2. Material and Methods: 47 patients with DM 2 in mean age 62.66 ± 10.081 years were included in the study for the period of one year. All of them were with well-compensated diabetes mellitus (HbA1c Results: Patients with RI 0.05 for all). There was significant difference between the groups according to serum creatinine (p = 0.026), GFR (p = 0.044) and the degree of proteinuria (p = 0.001). There was a positive correlation between RI and serum creatinine (r = 0.418;p = 0.001) and between RI and proteinuria (r = 0.396;p = 0.004). A negative correlation relationship between RI and GFR values was found (r = –0.413;p = 0.011). Conclusions: RI may be used as an indicator for the assessment of the severity of renal impairment in patients with DM 2. It correlates well with serum creatinine, GFR and proteinuria, which are proven biochemical parameters indicating the degree of renal damage in patients with DM 2.

The Association of Visceral Adiposity Index with Insulin Resistance in Adults with Prediabetes

Visceral adiposity mediates insulin resistance, but their association among adults with prediabetes is scarce in the literature. This study is aimed to determine the association of visceral adiposity index (VAI) with insulin resistance in adults with prediabetes. This cross-sectional study was done among 117 adults with newly detected prediabetes [m/f;23/94;mean ± SD: Age 36.30 ± 9.99 years, BMI 28.89 ± 4.35 kg/m2] based on American Diabetes Association 2018 criteria and 141 matched healthy controls [m/f: 28/113;mean ± SD: 35.30 ± 6.88 years, BMI 25.03 ± 4.58]. Waist circumference, body mass index, fasting triglyceride, HDL cholesterol, fasting blood glucose and insulin were measured in each group to calculate VAI and homeostatic model assessment of insulin resistance (HOMA-IR). People with prediabetes had significantly higher median value of VAI {3.08 (2.26) vs. 1.86 (2.31);p < 0.001} with higher frequency of high VAI (>1) (98.3% vs. 85.8%;p < 0.001) than the control population. HOMA-IR level was significantly higher in prediabetes with high VAI (cut-off of 2.64) than control with normal VAI [2.78 (2.22, 4.15) vs. 2.20 (1.53, 3.36);p = 0.002]. VAI was positively correlated with HOMA-IR in females with prediabetes (r = 0.299, p = 0.003). VAI had predictive association with prediabetes [OR (95% CI: 9.504 (2.173, 41.576);p = 0.03] and high insulin resistance (HOMA-IR ≥ 2.6) in females with prediabetes [OR (95% CI) = 3.50 (1.476, 8.297);p = 0.004] only. It could satisfactorily discriminate prediabetes in both sexes (male: AUC = 0.767, p = 0.001;female: AUC = 0.641, p < 0.001) and high insulin resistance in females with prediabetes (AUC = 0.641;p = 0.019) only. So, VAI was associated with prediabetes and insulin resistance only in females with prediabetes.

Resistance Distance and Kirchhoff Index in Corona and Edge Corona of Two Graphs

Let G_1 and G_2 be vertex-disjoint graphs with n_1 and n_2 vertices,m_1 and m_2 edges,respectively.The corona G_1° G_2 of G_1and G_2 was defined as the graph obtained by taking one copy of G_1and n_1 copies of G_2,and then joining the ith vertex of G_1 to every vertex in the ith copy of G_2.The edge corona G_1° G_2 of G_1 and G_2was defined as the graph obtained by taking one copy of G_1 and m_1copies of G_2,and then joining two end-vertices of the ith edge of G_1to every vertex in the ith copy of G_2.Kirchhoff index of G_1 ° G_2 was obtained in a much simple proof and the resistance distance of G_1 °G_2 is obtained.Furthermore,the Kirchhoff index and the resistance distance of G_1 ° G_2 were obtained.

脾瘅方加减联合二甲双胍治疗肥胖型2型糖尿病的临床疗效及对其血脂、胰岛素抵抗指数的影响

目的分析脾瘅方加减联合二甲双胍治疗肥胖型2型糖尿病(Diabetes mellitus type 2,T2DM)患者的临床疗效及对其血脂、胰岛素抵抗指数(Homeostatic Model Assessment of Insulin Resistance,HOMA-IR)的影响。方法选取2022年1月—2023年2月期间就诊于济宁市中医院的肥胖型T2DM患者100例作为研究对象,按随机数表法分为对照组和观察组,每组各50例。对照组常规服用二甲双胍0.5 g/次,3次/d;观察组在对照组基础上加用脾瘅方对症加减治疗。治疗12周后观察比较两组患者临床疗效,治疗前后血糖指标[血糖(Fasting blood glucose,FBG)、餐后2 h血糖(2-hour postprandial blood glucose,2 h PBG)、糖化血红蛋(Glycosylated hemoglobinA1c,HbA1c)]、中医证候积分、血脂指标[总胆固醇(Total cholesterol,TC)、甘油三酯(Triglycerides,TG)、低密度脂蛋白(Low density lipoprotein,LDL-C)]、胰岛素指标[空腹胰岛素(Fasting insulin,FINS)、胰岛素抵抗指数(Homeostasis Model Assessment-Insulin Resistance,HOMA-IR)、胰岛β细胞功能指数(Homeostatic model assessment ofβ-cell function,HOMA-β)]及炎症因子[白介素-6(Interleukin-6,IL-6)、超敏C反应蛋白(Highsensitivity C-reactive protein,hs-CRP)]水平。结果治疗后观察组临床总有效率94.00%(47/50)明显高于对照组78.00%(39/50),差异有统计学意义(P<0.05)。治疗后两组患者血糖FBG、2 h PBG、HbAlc指标及中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组血糖FBG、2 h PBG、HbAlc指标及中医证候积分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血脂指标TG、TC、LDL-C均较治疗前降低,差异有统计学意义(P<0.05);且观察组血脂指标TG、TC、LDL-C均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者胰岛素FINS、HOMA-IR指标均较治疗前降低,HOMA-β指标均较治疗前升高,差异有统计学意义(P<0.05);且观察组胰岛素FINS、HOMA-IR指标明显低于对照组,HOMA-β指标明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者炎症因子IL-6、hs-CRP水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组炎症因子IL-6、hs-CRP水平均明显低于对照组,差异有统计学意义(P<0.05)。结论脾瘅方加减联合二甲双胍治疗肥胖型T2DM患者能有效调节血糖、血脂水平,改善胰岛素抵抗,减轻炎症反应,临床疗效显著。

加味调肝汤联合西药治疗肝郁肾虚型月经过少疗效及对患者子宫内膜厚度的影响

目的:研究加味调肝汤联合西药治疗肝郁肾虚型月经过少临床疗效及对患者子宫内膜厚度的影响。方法:选取肝郁肾虚型月经过少患者共124例,采用随机数字表法分为观察组和对照组,其中对照组62例采用戊酸雌二醇(E2)、地屈孕酮治疗,观察组62例采用加味调肝汤联合戊酸雌二醇、地屈孕酮治疗。比较两组治疗效果、不良反应发生率,两组治疗前后中医证候积分、子宫内膜厚度、子宫血流阻力指数(RI)和卵泡期性激素水平。结果:观察组治疗总有效率为90.32%,较对照组总有效率75.81%高(P<0.05)。治疗前两组中医证候积分对比差异无统计学意义(P>0.05),治疗3个月后观察组上述积分较对照组更低(P<0.05)。治疗前两组卵泡期子宫内膜厚度、RI值比较,差异无统计学意义(P>0.05),治疗3个月后观察组卵泡期子宫内膜厚度较对照组更厚;RI较之于对照组更低(P<0.05)。治疗前两组卵泡期E2、FSH、LH水平比较无统计学差异(P>0.05);治疗3个月后观察组卵泡期性激素水平比对照组高(P<0.05)。观察组不良反应发生率为11.29%,与对照组的24.19%比较差异无统计学意义(P>0.05)。结论:加味调肝汤联合西药治疗肝郁肾虚型月经过少临床疗效比单用西药治疗效果更佳,能促进子宫内膜生长,降低RI值,调节卵泡期性激素水平。

不同施氮水平下硅肥对谷子抗倒伏能力、产量和品质的影响

[目的]倒伏严重影响谷子产量和品质。探究不同施氮水平下硅肥提高谷子茎秆强度、产量及品质的作用,为谷子高产高效施肥提供技术方案。[方法]以晋谷21和张杂13为供试谷子品种,在山西太谷进行大田试验。在常规施氮量N_(1)(180 kg/hm^(2))和高施氮量N_(2)(450 kg/hm^(2))下,分别设置不施硅、施用硅酸钠(Si_(1),SiO_(2) 68.85 kg/hm^(2))和硅钙肥(Si_(2),SiO_(2) 67.2 kg/hm^(2)),共6个处理。在谷子成熟期测量其株高、抗倒伏能力相关指标、光合特性、产量和品质相关指标,并观察茎秆横切面显微结构。[结果]N_(1)水平下,施用硅肥降低了谷子基节长度,增加了茎粗、茎秆抗折力和穿刺力,晋谷21和张杂13两品种前五基节的节间长度分别降低了4.1%~30.1%和9.5%~11.5%,茎粗分别增加5.3%~19.4%和13.0%~34.1%;晋谷21抗倒性在N_(1)-Si_(1)处理较强,第一、第二基节抗倒伏指数较N_(1)-Si_0处理分别增加37.4%和35.8%,张杂13在N_(1)-Si_(2)处理时较强,第一、第二基节抗倒伏指数较N_(1)-Si_0处理分别增加136.0%和94.7%。N_(2)水平下,施用硅肥后晋谷21和张杂13前五基节的节间长度分别降低了9.6%~30.3%和10.6%~14.9%,茎粗分别增加了9.56%~23.9%和16.2%~31.0%,茎秆扁平度降低。硅钙肥对谷子茎秆强度影响大于硅酸钠,N_(2)-Si_(2)处理晋谷21的第二基节抗折力、穿刺力和抗倒伏指数比N_(2)-Si_0分别增加97.9%、77.6%和83.3%,张杂13的第一基节抗折力、穿刺力和抗倒伏指数比N_(2)-Si_0分别增加74.0%、66.8%和128%。施硅后谷子茎秆中机械组织增厚,维管束数量增多且排列均匀,向茎秆中心延伸,且在N_(2)水平下,硅钙肥作用效果优于硅酸钠。硅可促进谷子穗码发育,增加穗粗、穗粒数和千粒重,在高氮水平下硅钙肥处理使晋谷21和张杂13的产量分别增加23.8%和24.0%。施用硅肥能够提高谷子脂肪、蛋白质和氨基酸含量,在高氮水平下可以降低谷子直链淀粉/支链淀粉值。[结论]在高氮条件下,施用硅钙肥使谷子前五基节长度降低,茎粗增加,机械强度增加,进而提高抗倒伏能力;施用硅肥还可增加光合速率和蒸腾速率,促进物质积累和运输,增加产量,改善品质。

电针对2型糖尿病大鼠骨骼肌GLUT4表达影响的研究

[目的]观察电针对2型糖尿病大鼠骨骼肌葡萄糖转运蛋白4(glucose transporter 4,GLUT4)表达的影响,探讨电针调节血糖的机制。[方法]将24只2型糖尿病大鼠随机分为空白对照组、运动干预组及电针组,每组8只,运动干预组大鼠给予2周跑台运动干预;空白对照组大鼠不给予任何干预;电针组大鼠开始将电针置于大鼠双侧足三里穴,进行连续波穴位刺激2周。分别检测各组大鼠治疗前后空腹血糖水平、胰岛素抵抗指数及治疗后大鼠骨骼肌细胞GLUT4水平。[结果]与干预前比较,运动干预组和电针组空腹血糖水平显著下降(P<0.001,P=0.028),胰岛素抵抗指数显著下降(P<0.001,P<0.001)。干预后组间比较,三组大鼠空腹血糖水平及胰岛素抵抗指数差异均有统计学意义(P<0.001),GLUT4表达水平差异有统计学意义(P<0.001)。[结论]电针刺激能改善2型糖尿病大鼠的胰岛素敏感性,并降低其血糖水平,其中调节骨骼肌细胞GLUT4水平可能是其调节血糖的一个重要机制。

急性前壁ST段抬高型心肌梗死患者直接冠状动脉介入术后微循环阻力指数与左心室不良重构的相关性

目的:评估急性前壁ST段抬高心肌梗死(acute anterior ST elevation myocardial infarction,STEMI)患者直接经皮冠状动脉介入术(primary percutaneous coronary intervention,PPCI)后微循环阻力指数(index of microcirculatory resistance,IMR)与1年后左心室不良重构(left ventricular adverse remodeling,LVAR)之间的关系。方法:采用单中心回顾性队列研究,连续选择2014年1月至2017年8月在北京大学第三医院住院的前壁STEMI并行PPCI患者,术后即刻通过压力/温度导丝测量IMR。利用血清肌酸激酶(creatine kinase,CK)峰值评估梗死面积,心肌梗死(myocardial infarction,MI)后1 d和1年时评估超声心动图,将左心室舒张末期容积(left ventricular end-diastolic volume,LVEDV)较基线增加≥20%定义为LVAR。结果:共入选43例患者,平均年龄(58.7±12.4)岁。根据IMR正常参考值将患者分为两组,IMR>25(n=23)组较IMR≤25组(n=20)患者冠状动脉造影显示梗死相关血管完全闭塞率(95.7%vs.65.0%,P=0.029)更高,血清CK峰值水平更高[4090(383,15833)vs.1580(396,5583),P=0.004],室壁瘤发生率更高(30.4%vs.5.0%,P=0.021)。MI后1 d两组LVEDV差异无统计学意义[(111.0±18.8)mL vs.(115.0±23.6)mL,P=0.503],而1年后IMR>25组LVEDV明显高于IMR≤25组[(141.5±33.7)mL vs.(115.9±27.9)mL,P=0.018]。IMR>25组LVAR发生比例更高(47.4%vs.11.8%,P=0.024)。二元Logistics回归显示IMR[B=0.079,exp(B)(95%CI)为1.082(1.018~1.149),P=0.011]和血清甘油三酯(triglyceride,TG)水平[B=1.610,exp(B)(95%CI)为5.005(1.380~18.152),P=0.014]是患者MI后1年发生LVAR的预测因素,IMR对1年后发生LVAR具有良好的预测价值(曲线下面积=0.749,P=0.019),IMR>29为良好的临界点,敏感性81.8%,特异性68.0%。结论:STEMI患者PPCI术后即刻测定IMR可以反映微血管功能,而微血管功能障碍是STEMI后1年左心室不良重构的有力预测指标。

血清丝氨酸蛋白酶Corin联合子宫动脉多普勒血流评分对子痫前期的预测价值评价

目的探讨Corin联合子宫动脉RI、PI、S/D值对子痫前期的预测价值。方法选择2015年12月-2020年9月在兰州大学第二医院行常规产检并诊断为子痫前期的孕妇(55例);同期单胎健康孕妇为对照组(55例)。ELISA方法测定孕中期(16~24周),孕晚期(28~32周)血清Corin浓度,超声多普勒检测孕中、晚期子宫动脉RI、PI、S/D值。ROC曲线分析上述指标联合对妊娠中晚期孕妇发生子痫前期的预测价值。结果孕中、晚期血清Corin含量联合子宫动脉PI、RI、S/D值得到的联合预测概率作ROC曲线下面积分别为0.850、0.862,敏感度分别为80.1%、88.3%,特异度分别为82.6%、83.9%,明显高于各指标单独使用的预测作用。结论联合检测孕妇血清Corin可提高子宫动脉血流动力参数对子痫前期的预测价值。

基于内聚力模型的再生沥青混合料低温断裂性能研究

内聚力模型(CZM)在沥青混凝土开裂研究中得到了广泛应用,但采用内聚力模型对再生沥青混凝土断裂的研究还很少。本文采用随机算法和坐标控制法建立包含旧集料和新集料的再生沥青混合料半圆弯拉模型,将模型分为集料同分布模型和集料随机分布模型两类。研究-10℃时不同RAP掺量(0、25%、50%、75%、100%,质量分数)对再生沥青混合料SCB试件应力强度因子K_(IC)、断裂能G_(F)和抗裂指数I_(CR)的影响。研究结果表明:无RAP掺入的SCB试件具有较好的断裂性能;随着RAP掺量增大,应力强度因子K_(IC)、断裂能G_(F)和抗裂指数I_(CR)均减小,表明RAP的掺入会削弱沥青混合料的低温断裂性能;采用有限元模型得到的断裂参数与室内试验结果一致;相比于集料同分布模型,集料随机分布模型各评价指标的变异性系数整体更大,表明集料分布状态对开裂结果有一定影响;当计算样本足够多时,这两类模型获得的抗裂参数变化规律一致,可有效评价再生沥青混合料断裂性能。

新发2型糖尿病患者维生素D与胰岛素抵抗的相关性

目的探讨新发2型糖尿病(type 2 diabetes mellitus,T2DM)患者25-羟基维生素D3[25(OH)D3]水平与胰岛素抵抗、尿pH值等因素的相关性。方法分别测定325例非糖尿病患者(对照组)及208例新发T2DM患者(新发T2DM组)的25(OH)D_(3)水平,并根据25(OH)D_(3)水平将新发T2DM患者分成新发T2DM患者维生素D缺乏组(n=92)及新发T2DM患者维生素D非缺乏组(n=116)。非缺乏组25(OH)D_(3)水平为20~100 ng/mL;缺乏组25(OH)D_(3)水平为<20 ng/mL;25(OH)D_(3)与胰岛素抵抗、尿pH值等的相关性采用SPSS 26.0统计软件来进行统计分析。结果新发T2DM组25(OH)D_(3)水平低于对照组(P<0.01);新发T2DM患者维生素D缺乏组的年龄、糖化血红蛋白、胰岛素抵抗指数、尿pH值、游离三碘甲状腺原氨酸(FT_(3))和游离甲状腺素(FT_(4))均高于非缺乏组(P<0.05),而组间的胰岛功能指数、空腹C肽、血清钙、促甲状腺激素(TSH)差异无统计学意义(P>0.05)。Logistic回归分析显示,糖化血红蛋白(OR=1.776,P<0.05)、胰岛素抵抗指数(OR=1.289,P<0.05)是新发T2DM患者维生素D缺乏的危险因素。结论新发T2DM患者25(OH)D_(3)水平低于对照组。较高的糖化血红蛋白和胰岛素抵抗指数是T2DM合并维生素D缺乏的危险因素。

干旱胁迫下丛生福禄考的生理响应

以丛生福禄考(Phlox subulata)为材料,采用干旱胁迫的方法,研究不同干旱处理时间对丛生福禄考生理指标的影响,以期为研究丛生福禄考响应干旱胁迫的分子机制提供理论依据,为福禄考属植物园林应用及种质资源创新提供参考依据。结果表明,随着干旱时间的延长,丛生福禄考根系MDA含量在干旱4天时含量较高,之后呈下降趋势。总糖含量在干旱8天时达到最低值,之后缓慢增加。Pro含量呈现升-降-升-降变化,SOD活性先下降然后上升,POD活性呈现先下降后上升再下降的趋势。综上所述,丛生福禄考在遭受到干旱胁迫损伤后,积累了一定的活性氧,进而激发了氧化过程,复水后恢复。可见,丛生福禄考具有较强的耐旱能力。