2型糖尿病患者血糖波动与血清网膜素-1及氧化应激因子的关系

目的探讨2型糖尿病(T2DM)患者血糖波动与血清网膜素-1(Omentin-1)及氧化应激因子的关系。方法选取134例T2DM患者为T2DM组,另选取67例健康者为对照组。采用动态血糖监测系统(CGMS)对所有患者实施连续3 d的血糖跟踪检测。比较2组血糖波动参数[日内平均血糖波动幅度(MAGE)、平均血糖标准差(SDBG)、日间血糖波动幅度(MODD)、最大血糖波动幅度(LAGE)]、血清Omentin-1和氧化应激因子[血清丙二醛(MDA)、超氧化物歧化酶(SOD)、8-异前列腺素F2α(8-iso-PGF2α)、过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GPX)、谷胱甘肽(GSH)、8-羟化脱氧鸟苷(8-OHDG)]水平。根据MAGE的不同将T2DM组患者分为血糖平稳组(MAGE<3.9 mmol/L)81例和血糖波动组(MAGE≥3.9 mmol/L)53例,比较2组血清Omentin-1和氧化应激因子水平。采用Pearson相关性分析探讨MAGE与血清Omentin-1和氧化应激因子的关系。结果T2DM组MAGE、SDBG、MODD、LAGE、MDA、8-iso-PGF2α、8-OHDG水平均高于对照组,Omentin-1、SOD、CAT、GPX和GSH水平低于对照组,差异均有统计学意义(P<0.01)。血糖波动组Omentin-1、SOD、CAT、GPX和GSH水平低于血糖平稳组,MDA、8-iso-PGF2α、8-OHDG水平高于血糖平稳组,差异均有统计学意义(P<0.01)。Pearson相关性分析显示,MAGE与血清Omentin-1、SOD、CAT、GPX和GSH水平均呈负相关,与MDA、8-iso-PGF2α、8-OHDG水平均呈正相关(P<0.05或P<0.01)。结论T2DM患者血糖波动较大,血糖波动与血清Omentin-1及氧化应激因子水平密切相关。

具有连续转轴的对称2R1T三自由度并联机构型综合

为综合出更多具有连续转轴的并联机构新机型,提出一种具有连续转轴的两转一移(2R1T)并联机构型综合新方法。运用螺旋理论,给出该类机构约束螺旋的空间布置,提出并联机构连续转轴的判别条件,确定分支运动副类型及空间位置关系。基于分支约束力与分支运动副之间的几何位置关系,证明了该类机构能够实现连续转动。利用该方法对具有平面上任意直线为连续转轴的对称两转一移并联机构进行综合,并仿真验证了研究结果的正确性。该综合方法简单、有效。

动态监测1型及2型糖尿病患者血糖漂移变化

目的通过动态血糖监测系统(CGMS)监测1型及2型糖尿病患者的血糖漂移变化,并分别探讨糖化血红蛋白及C肽水平与血糖漂移参数的关系。方法对30例1型糖尿病(T1DM)患者、50例2型糖尿病(T2DM)患者以及30例糖调节正常(NGR)者进行连续72 h动态血糖监测,分析其血糖谱参数,包括日内平均血糖水平(24 h MBG)及标准差(SDBG)、三餐前后平均血糖水平、日内最大血糖漂移幅度(LAGE)、日内平均血糖漂移幅度(MAGE)及漂移次数(NGE)、不同血糖水平所占日内时间百分比(PT)及日间血糖平均绝对差(MODD)。结果①T1DM组和T2DM组的24 h MBG及三餐前后平均血糖明显高于NGR组(P<0.05)。②在昼夜24 h中,T1DM组处于理想血糖控制水平(>4.4且<8.0 mmol/L)所占日内时间百分比为(27.03±15.71)%,T2DM组为(37.77±25.40)%,均明显少于NGR组(89.20±10.34)%,P<0.05。③与NGR组相比,T1DM组及T2DM组日内血糖漂移参数(SDBG、LAGE、MAGE、晚餐PPGE)及日间血糖漂移参数(MODD)显著升高(P<0.05),且多数指标T1DM组显著高于T2DM组(P<0.05)。④T1DM组及T2DM组的HbAlc与日内及日间血糖漂移参数无明显相关,而其空腹C肽、餐后1 h及2 h C肽均与LAGE、SDBG、MODD呈负相关(P<0.05),且T1DM组相关程度多高于T2DM组。结论糖尿病患者存在慢性持续性高血糖及血糖漂移增加,在血糖漂移方面,T1DM较T2DM更显著。胰岛功能与血糖漂移密切相关。日内及日间血糖漂移参数是全面而精细反映血糖全方位变化的重要指标。

短期胰岛素泵治疗对初诊2型糖尿病患者血糖代谢和sICAM-1水平的作用

目的通过对初诊2型糖尿病(T2DM)患者进行短期持续皮下胰岛素输注(CSⅡ),观察短期强化血糖控制后患者可溶性细胞间黏附分子-1(sICAM-1)水平的动态变化。方法28名初诊T2DM患者接受为期14 d的CSⅡ,于治疗前、治疗3 d后和治疗14 d后分别测定空腹血糖(FBS)、糖化血红蛋白(GHbA1c)、血胰岛素、C肽、胰岛素原、sICAM-1水平,比较胰岛素泵强化治疗前后各项指标的变化。结果①治疗3 d后和14 d后患者空腹血糖、HOMA胰岛素抵抗指数(Homa-IR)均较治疗前显著降低,14 d后较3 d后明显降低;②治疗14 d后GHbA1c较治疗前显著减低;③胰岛素原于治疗3 d后和14 d后均较治疗前明显改善,但14 d后与3 d后相比未见明显差异;④sICAM-1水平于治疗3 d后和14 d后均较治疗前明显减低,治疗14 d后较3 d后进一步下降。结论对伴有明显高血糖的初诊T2DM患者,短期胰岛素泵强化治疗能明显改善患者的血糖控制、B细胞功能与胰岛素抵抗程度,降低sI-CAM-1水平,改善患者血管内炎症状态。

单变量离散混合l1/ H2 问题（英文）

本文描述了Ｈ２ 性能约束下的离散控制系统ｌ１ 设计问题，并提出了该无穷维优化问题的一种上逼近解法，通过求解一系列的截断问题能够得到无穷维问题的次优解，混合ｌ１／ Ｈ２ 问题最优值对Ｈ２

微通道反应器中1-甲氧基-2-丙醇的连续合成

在微通道反应器中,以甲醇和环氧丙烷为原料合成1-甲氧基-2-丙醇。考察尺度效应(管径和微反应器类型)对反应的影响并对反应条件(催化剂用量、反应物摩尔比、停留时间和反应温度)进行优化。结果表明:内径为0.5 mm、体积为10 mL的聚四氟乙烯毛细管及T形混合器能有效促进物料间混合;甲醇与环氧丙烷在微通道反应器中的最优反应条件为催化剂用量0.5%、甲醇与环氧丙烷摩尔比3∶1、120℃下反应7 min、压力2 MPa。在最优反应条件下,环氧丙烷转化率为99.4%,产率可高达99.1%。

1-(5-溴-2吡啶偶氮)-2-萘酚-6-磺酸作指示剂络合滴定连续测定铝和钛

在酸性溶液中加入对铝、钛过量的EDTA标准溶液，在pH4．0煮沸下，铝（Ⅲ）、钛（Ⅳ）与EDTA生成稳定的络合物。以5-Br-PAN-S作指示剂，用硫酸铜标准溶液返滴定过量的EDTA，测定铝钛合量，再用置换法测定钛的量。终点变色敏锐，准确度高，方法用于硅酸盐矿物中铝钛的连续测定，结果满意。

SHARP H?LDER CONTINUITY OF THE INTEGRATED DENSITY OF STATES FOR EXTENDED HARPER’S MODEL WITH A LIOUVILLE FREQUENCY

In this article, the non-self dual extended Harper's model with a Liouville frequency is considered. It is shown that the corresponding integrated density of states is 1/2-Holder continuous. As an application, the homogeneity of the spectrum is proven.

Performance of Dexcom G5 and FreeStyle Libre sensors tested simultaneously in people with type 1 or 2 diabetes and advanced chronic kidney disease

BACKGROUND Advanced chronic kidney disease(CKD) is a common complication for people with type 1 and 2 diabetes and can often lead to glucose instability. Continuous glucose monitoring(CGM) helps users monitor and stabilize their glucose levels. To date, CGM and intermittent scanning CGM are only approved for people with diabetes but not for those with advanced CKD.AIM To compare the performance of Dexcom G5 and FreeStyle Libre sensors in adults with type 1 or 2 diabetes and advanced CKD.METHODS This was a non-randomized clinical trial that took place in two outpatient clinics in western Sweden. All patients with type 1 or 2 diabetes and an estimated glomerular filtration rate(eGFR) of < 30 mL/min per 1.73 m^(2) were invited to participate. Forty patients(full analysis set = 33) carried the Dexcom G5 sensor for 7 d and FreeStyle Libre sensor for 14 d simultaneously. For referencing capillary blood glucose(SMBG) was measured with a high accuracy glucose meter(HemoCue®) during the study period. At the end of the study, all patients were asked to answer a questionnaire on their experience using the sensors.RESULTS The mean age was 64.1(range 41-77) years, hemoglobin A1 c was 7.0% [standard deviation(SD) 3.2], and diabetes duration was 28.5(SD 14.7) years. A total of 27.5% of the study population was on hemodialysis and 22.5% on peritoneal dialysis. The mean absolute relative difference for Dexcom G5 vs SMBG was significantly lower than that for FreeStyle Libre vs SMBG [15.2%(SD 12.2) vs 20.9%(SD 8.6)], with a mean difference of 5.72 [95% confidence interval(CI): 2.11-9.32;P = 0.0036]. The mean absolute difference was also significantly lower for Dexcom G5 than for FreeStyle Libre, 1.21 mmol/L(SD 0.78) and 1.76 mmol/L(SD 0.78), with a mean diffrenec of 0.55(95%CI: 0.27-0.83;P = 0.0004).The mean difference(MD) was-0.107 mmol/L and-1.10 mmol/L(P = 0.0002), respectively. In all, 66% of FreeStyle Libre values were in the no risk zone on the surveillance error grid compared to 82% of Dexcom G5 values.CONCLUSION Dexcom G5 produces more accurate sensor values than FreeStyle Libre in people with diabetes and advanced CKD and is likely safe to be used by those with advanced CKD.

利司那肽(早餐前或主餐前注射)改善2型糖尿病全天血糖谱:来自于动态血糖监测的分析

进餐后的血糖波动是2型糖尿病患者服用降糖药后血糖不达标的原因之一。近期研究发现,新型胰高糖素样肽-1(glucagon-like peptide-1,GLP-1)受体激动剂——利司那肽能改善服用二甲双胍血糖控制不佳患者的糖化血红蛋白(glycatedhemoglobin,HbA1c)。通过动态血糖监测(continuous glucose monitoring,CGM)发现,利司那肽两种给药时间,一是早餐前注射(早餐可能不是全天的主餐),第二种是全天的主餐前注射,降糖效果相当,均可减少餐后血糖波动。本文对2017年5月发表在Diabetes Metabolism Research And Reviews杂志上的文章"利司那肽(早餐前或主餐前注射)改善2型糖尿病全天血糖谱:来自于动态血糖监测的分析"进行中文摘译。同时,特邀李小英教授对此文做一点评。

融合酶CR2-GDH合成度洛西汀前体的体系与过程调控

以具有高选择性的羰基还原酶(CR2)与可实现辅酶原位循环的葡萄糖脱氢酶(GDH)通过柔性连接肽得到的融合酶CR2-GDH为生物催化剂,催化N,N-二甲基-3-酮-3-(2-噻吩)-1-丙胺(DKTP)不对称还原合成手性药物度洛西汀重要中间体(S)-N,N-二甲基-3-羟基-3-(2-噻吩)-1-丙胺((S)-DHTP)。通过过程调控反应体系的pH,并进一步优化反应转速、底物同辅底物比例、温度及底物浓度,确定单批次反应条件:底物20 g/L、葡萄糖40 g/L、NADP^(+)0.1 mmol/L及酶活7 U,恒定pH 8.4、45℃、150 r/min反应12 h,产物产率达到97.70%,对映体过量值(e.e.)≥99.9%。通过分批补料催化30 g/L底物的反应,产率达92.96%,进一步利用反应器放大体系至100 mL,实现40 g/L底物的转化反应,产率达到85.05%。

曲面片的GC^2连续性

利用微分几何知识给出了一个保证曲面片二阶几何连续(GC^2)的条件。所给出的方法同样适用于公共交界曲线正好是曲面渐近线这种特殊情况。

Analysis on blood glucose excursions in well-controlled patients with type 2 diabetes mellitus

Objective:To probe glycemic excursions in type 2 diabetic patients whose hemoglobin A1c(HbA1c) was kept ≤6.0%.Methods:Totally 36 cases with type 2 diabetes(T2DM) with HbA1c≤6.0% and 30 cases with normal glucose tolerance(NGT) from December 2005 to December 2007 in our department were subjected prospectively.Continuous glucose monitoring system(CGMS) was employed to record their continuous blood glucose level for 3 d.The blood glucose profiles including the mean blood glucose(MBG),standard differentiation(SD),mean amplitude of glycemic excursions(MAGE) and absolute means of daily differences(MODD) were analyzed.Results:T2DM group had obviously postprandial hyperglycemia,in about 2 h after meal,especially after breakfast.Fifty-two hypoglycemic episodes occurred during the monitoring period in T2DM groups,of which 73.1%(38 episodes) were absence of symptomatic hypoglycemia with the lowest value of blood glucose only 2.0 mmol/L.And 20 episodes took place during the day hours,while 32 episodes observed during the night hours.Compared with NGT groups,SD,MAGE and MODD were all significantly higher in T2DM groups.MBG was significantly correlated with HbA1c in T2DM groups,but SD,MAGE,NGE and MODD were all independent of HbA1c.MAGE was independent of MODD.Conclusion:The amplitude of glycemic excursions is higher in normol-controlled T2DM groups than the NGT groups.Thus ideally glycemic control is not only to make HbA1c reach standard,but also to lessen glycemic excursions and reduce hypoglycemia episodes.

Almost sure, L1-and L2-growth behavior of supercritical multi-type continuous state and continuous time branching processes with immigration

Under a first order moment condition on the immigration mechanism,we show that an appropriately scaled supercritical and irreducible multi-type continuous state and continuous time branching process with immigration(CBI process)converges almost surely.If an x log(x)moment condition on the branching mechanism does not hold,then the limit is zero.If this x log(x)moment condition holds,then we prove L1 convergence as well.The projection of the limit on any left non-Perron eigenvector of the branching mean matrix is vanishing.If,in addition,a suitable extra power moment condition on the branching mechanism holds,then we provide the correct scaling for the projection of a CBI process on certain left non-Perron eigenvectors of the branching mean matrix in order to have almost sure and L1 limit.Moreover,under a second order moment condition on the branching and immigration mechanisms,we prove L2 convergence of an appropriately scaled process and the above-mentioned projections as well.A representation of the limits is also provided under the same moment conditions.

PAN-6S作络合指示剂连续滴定测定汞和铅的研究

试验研究了pH3.0和pH5.4的介质中,以1 (2 吡啶偶氮) 2 萘酚 6 磺酸(PAN 6S)作为指示剂,以EDTA为滴定剂连续滴定汞和铅,其终点颜色变化敏锐,准确度高。

EDTA连续滴定法测定钢帘线镀层中铜和锌

研究了以亚甲蓝-PAN-6S作混合指示剂，EDTA滴定法测定钢帘线镀层中的铜和锌。在pH5．4的六次甲基四胺-盐酸缓冲介质中，以亚甲蓝-PAN-6S试剂作络合滴定指示剂，以EDTA为滴定剂进行了铜和锌的连续滴定，终点颜色变化敏锐，准确度高，铜锌比例在1：10～10：1范围之间相互无影响。方法可用于钢帘线镀层中铜、锌的测定，结果满意。

基于矩形域的Bézier曲面及其拼接技术

首先讨论了Bézier曲面及其性质、作为相邻的Bézier曲面片在拼接时边界处容易引起连续性和光顺性的问题,同时指出在实际应用中的一些复杂曲面很难用一片Bézier曲面来构造.针对这个问题,阐述了几种不同的连续和光顺拼接条件,以供在实际应用中根据要求来选择不同的约束条件.

用有理双三次Bézier曲面片混合二次曲面

提出一种二次曲面混合方法,混合曲面由2张有理双三次Bézier曲面片构成,它们之间保持G2连续,混合曲面与二次曲面间保持G1连续.给出了混合曲面片控制顶点的显式表示,通过修改2类混合参数可以直观地调节混合方向及混合曲面的形状.另外,混合5个圆锥曲面的例子表明,该方法为多个二次曲面的混合问题提供了有效途径.

Bézier曲线拼接误差关系的研究

介绍了两n次Bézier曲线G1,G2连续的几何条件,导出了其G1,G2连续的误差关系,并给出了示例证明其正确性.

L-fuzzy保序算子空间上的Moore-Smith收敛理论

在L fuzzy保序算子空间上引入分子网和理想的ω 极限点和ω 聚点等概念 ,系统地讨论这些概念的基本性质以及它们之间的关系 .同时 ,利用分子网和理想的ω 收敛性概念 ,给出ω 闭集以及序同态的(ω1,ω2 ) 连续性的若干特征定理 .较为完整地建立L fuzzy保序算子空间上的Moore Smith收敛理论 .