Intravitreal conbercept injection with panretinal photocoagulation for high-risk proliferative diabetic retinopathy with vitreous hemorrhage

AIM:To assess the clinical efficacy and safety of combining panretinal photocoagulation(PRP)with intravitreal conbercept(IVC)injections for patients with high-risk proliferative diabetic retinopathy(HR-PDR)complicated by mild or moderate vitreous hemorrhage(VH),with or without diabetic macular edema(DME).METHODS:Patients diagnosed with VH with/without DME secondary to HR-PDR and received PRP combined with IVC injections were recruited in this retrospective study.Upon establishing the patient’s diagnosis,an initial IVC was performed,followed by prompt administration of PRP.In cases who significant bleeding persisted and impeded the laser operation,IVC was sustained before supplementing with PRP.Following the completion of PRP,patients were meticulously monitored for a minimum of six months.Laser therapy and IVC injections were judiciously adjusted based on fundus fluorescein angiography(FFA)results.Therapeutic effect and the incidence of adverse events were observed.RESULTS:Out of 42 patients(74 eyes),29 were male and 13 were female,with a mean age of 59.17±12.74y(33-84y).The diabetic history was between 1wk and 26y,and the interval between the onset of visual symptoms and diagnosis of HR-PDR was 1wk-1y.The affected eye received 2.59±1.87(1-10)IVC injections and underwent 5.5±1.02(4-8)sessions of PRP.Of these,68 eyes received PRP following 1 IVC injection,5 eyes after 2 IVC injections,and 1 eye after 3 IVC injections.Complete absorption of VH was observed in all 74 eyes 5-50wk after initial treatment,with resolution of DME in 51 eyes 3-48wk after initial treatment.A newly developed epiretinal membrane was noted in one eye.Visual acuity significantly improved in 25 eyes.No complications such as glaucoma,retinal detachment,or endophthalmitis were reported.CONCLUSION:The study suggests that the combination of PRP with IVC injections is an effective and safe modality for treating diabetic VH in patients with HR-PDR.

Panretinal photocoagulation versus panretinal photocoagulation plus intravitreal bevacizumab for high-risk proliferative diabetic retinopathy

AIM： To evaluate the effects of panretinal photocoagulation （PRP） compared with PRP plus intravitreal bevacizumab （IVB） in patients with high-risk proliferative diabetic retinopathy （PDR） according to the Early Treatment Diabetic Retinopathy Study criteria.METHODS： The data were collected retrospectively from the eyes of high-risk PDR patients, which were divided into two groups. After treated with standard PRP, the eyes were randomly assigned to receive only PRP （PRP group） or PRP plus intravitreal injection of 1.25 mg of bevacizumab （PRP-Plus group）. Patients underwent complete ophthalmic evaluation, including best corrected visual acuity （BCVA）, intraocular pressure （IOP）, and new vessel size in fluorescein angiography （FA） and optical coherence tomography for the assessment of central subfield macular thickness （CSMT） at baseline and at weeks 12 （±2）, 16 （±2）, 24 （±2） and 48 （±2）. Main outcome measures also included vitreous clear-up time and neovascularization on the disc （NVD） regression time. Adverse events associated with intravitreal injection were investigated.RESULTS： Thirty consecutive patients （n=36 eyes） completed the 48-week follow-up. There was no significant difference between the PRP and PRP-Plus groups with respect to age, gender, type or duration of diabetes, area of fluorescein leakage from active neovascularizations （NVs）, BCVA or CSMT at baseline. The mean vitreous clear-up time was 12.1±3.4wk after PRP and 8.4±3.5wk after PRP combined with IVB. The mean time interval from treatment to complete NVD regression on FA examination was 15.2±3.5wk in PRP group and 12.5±3.1wk in PRP-Plus group. No significant difference in CSMT was observed between the groups throughout the study period. However, the total area of actively leaking NVs was significantly reduced in the PRP-Plus group compared with the PRP group （P〈0.05）. Patients received an average of 1.3 injections （range： 1-2）. Ten eyes （27.8%） underwent 2 injections. Two eyes had ocular complication of PDR progression to dense vitreous hemorrhage （VH）. No major adverse events were identified.CONCLUSION： The adjunctive use of IVB with PRP is associated with a greater reduction in the area of active leaking NVs than PRP alone in patients with high-risk PDR. Short-term results suggest combined IVB and PRP achieved rapid clearance of VH and regression of retinal NV in the treatment of high-risk PDR. Further studies are needed to determine the effect of repeated intravitreal bevacizumab injections and the proper number of bevacizumab injections as an adjuvant.

Optimized Deep Learning Approach for Efficient Diabetic Retinopathy Classification Combining VGG16-CNN

Diabetic retinopathy is a critical eye condition that,if not treated,can lead to vision loss.Traditional methods of diagnosing and treating the disease are time-consuming and expensive.However,machine learning and deep transfer learning(DTL)techniques have shown promise in medical applications,including detecting,classifying,and segmenting diabetic retinopathy.These advanced techniques offer higher accuracy and performance.ComputerAided Diagnosis(CAD)is crucial in speeding up classification and providing accurate disease diagnoses.Overall,these technological advancements hold great potential for improving the management of diabetic retinopathy.The study’s objective was to differentiate between different classes of diabetes and verify the model’s capability to distinguish between these classes.The robustness of the model was evaluated using other metrics such as accuracy(ACC),precision(PRE),recall(REC),and area under the curve(AUC).In this particular study,the researchers utilized data cleansing techniques,transfer learning(TL),and convolutional neural network(CNN)methods to effectively identify and categorize the various diseases associated with diabetic retinopathy(DR).They employed the VGG-16CNN model,incorporating intelligent parameters that enhanced its robustness.The outcomes surpassed the results obtained by the auto enhancement(AE)filter,which had an ACC of over 98%.The manuscript provides visual aids such as graphs,tables,and techniques and frameworks to enhance understanding.This study highlights the significance of optimized deep TL in improving the metrics of the classification of the four separate classes of DR.The manuscript emphasizes the importance of using the VGG16CNN classification technique in this context.

Glycyrrhizic acid promotes sciatic nerves recovery in type 1 diabetic rats and protects Schwann cells from high glucose-induced cytotoxicity

The present study aims to investigate the therapeutic effect and mechanism of glycyrrhizic acid(GA)in diabetic peripheral neuropathy(DPN).GA significantly mitigated nerve conduction velocity(NCV)deficit and morphological abnormality and reduced high-mobility group box-1(HMGB1)expression in the sciatic nerves of diabetic rats independent of blood glucose and body weight.Notably,GA alleviated the increase of HMGB1 and the decrease of cell viability in high glucose-stimulated RSC96 cells.Furthermore,GA obviously reduced the concentration of inflammatory cytokines in the sciatic nerves of diabetic rats and supernatants of high glucose-exposed RSC96 cells,then restored the decreased expression levels of nerve growth factor(NGF)and neuritin-1,and the increased expression levels of cleaved caspase-3 and neuron-specific enolase.Additionally,GA markedly inhibited receptor for advanced glycation end products(RAGE)expression,p38MAPK phosphorylation,and the nuclear translocation of NF-κBp65 in diabetic rats and high glucose-exposed RSC96 cells.The promotional effect of high glucose in RSC96 cells was diminished following Hmgb1 siRNA treatment.Our findings indicate that GA may exert neuroprotection on DPN by suppressing HMGB1,which lead to extenuation of inflammation response,balance of NGF,neuritin-1 and caspase-3,as well as inactivation of RAGE/p38MAPK/NF-κBp65 signaling pathway.

Seroprevalence of <i>Brucella</i>Antibodies and Risk Factors Associated with Human Brucellosis in High-Risk Occupational Groups of the Noun Division in the West Region of Cameroon

Brucellosis is an anthropozoonotic disease with an important public health impact. Although the transmission of Brucella from animals to humans can occur in different epidemiological settings of sub-Saharan African countries, little data has been published on human brucellosis. This study aimed to detect Brucella antibodies and the risk factors associated to brucellosis among high-risk occupational groups of people in the Noun Division of Cameroon. For this study, a structured questionnaire was used to assess risk factors associated with human brucellosis. Thereafter, blood samples were collected from high-risk occupational groups of people in four villages. Plasma was extracted from each sample and Brucella antibodies were detected using Rose Bengal Plate Test (RBPT) and indirect Enzyme-Linked Immunosorbent Assay (i-ELISA). Of the 273 participants enrolled, the overall seroprevalence of Brucella antibodies was 12.45% with RBPT and 10.26% with i-ELISA test. This seroprevalence was significantly (P = 0.04;X2 = 9.73) higher among livestock herdsmen (15.8%), slaughterhouse workers (9.8%), butchers (4.8%), participants having no educational level (14.3%) and those experiencing above 5 years of risky activity (15%). Raw milk consumption (OR: 4.8;P = 0.001), no formal education (OR: 6.4;P = 0.03) and assistance of animal during parturition (OR: 7.2;P < 0.0001) appeared as factors that may increase the risk of Brucella infections. The detection of Brucella antibodies indicates the risk of human brucellosis in some groups of people of the Noun division. Consuming unpasteurized milk, participating in parturition and lacking knowledge on brucellosis appeared as risk factors associated with human brucellosis in western Cameroon. It raises the need of developing and implementing control measures for human and animal brucellosis.

Effects of Single Administered Bofutsushosan-Composed Crude Drugs on Diabetic Serum Parameters in Streptozotocin-Induced Diabetic Mice

The 18 crude drugs in Bofutsushosan (BOF: Pulvis ledebouriellae compositae: 防風通聖散) are separated into 6 groups such as diaphoretic, cathartic, antidote, antipyretic, neutralizer and diuretic groups. The effects of single administered BOF and composed crude drugs in 6 groups were investigated on the levels of diabetic parameters (serum glucose, insulin, triglyceride and cholesterol) in streptozotocin-induced diabetic mice. The anti-hyperglycemic action of BOF was depended on Ephedrae Herba, Saposhnikoviae Radix and Schizonepetae Spica in diaphoretic group, Forsythiae Fructus, Saposhnikoviae Radix, Schizonepetae Spica and Cnidii Rhizoma in antidote group, Scutellariae Radix, Gardeniae Fructus and Gypsum Fibrosum in antipyretic group and Paeoniae Radix in neutralizer group. In these crude drugs, Ephedrae Herba, Saposhnikoviae Radix, Schizonepetae Spica, Forsythiae Fructus, Scutellariae Radix, Gypsum Fibrosum and Paeoniae Radix increased serum insulin level, but Cnidii Rhizoma and Gardeniae Fructus did not affect serum insulin level. From these results, it suggested that anti-hyperglycemic action of BOF was through insulin-dependent and insulin independent manners. The lowering effect of BOF on serum triglyceride level was dependent on actions of Platycodi Radix in antidote and diuretic groups and Gardeniae Fructus in antipyretic group. The lowering effect of Gardeniae Fructus was parallel with its anti-hyperglycemic action. The lowering effect of BOF on high serum triglyceride level also included both direct action and indirect action. The reducing effect of BOF on serum cholesterol level was observed together with the actions of Ephedrae Herba and Zingiberis Rhizoma in diaphoretic group, Schizonepetae Spica in diaphoretic and antidote groups and Paeoniae Radix in neutralizer group. The lowering effects of Ephedrae Herba, Schizonepetae Spica and Paeoniae Radix on serum cholesterol level were parallel with their anti-hyperglycemic actions. Zingiberis Rhizoma in diaphoretic group might be direct reducing effect on serum cholesterol level but no serum glucose level. The Ephedrae Herba in diaphoretic group, Schizonepetae Spica in diaphoretic and antidote groups and Paeoniae Radix in neutralizer group might have reduced serum cholesterol level by reducing blood glucose level. From these results, composed crude drugs in 6 groups show various mechanisms in the action of BOF.

Effect of inhibiting HMGB1 gene expression on ultrasonic blood flow characteristics, inflammatory response and apoptosis in diabetic retinopathy rats

Objective:To study the effect of inhibiting high mobility group box 1(HMGB1)gene expression on ultrasonic blood flow characteristics,inflammatory response and apoptosis in diabetic retinopathy rats.Methods:Male SD rats were chosen and randomly divided into control group,model group and HMGB1 inhibition group,the latter two groups were given intraperitoneal injection of streptozotocin to establish the diabetes model,and HMGB1 group were given tail vein injection of HMGB1-shRNA lentivirus for intervention.The peak end-systolic velocity(PSV),peak end-diastolic velocity(EDV),resistance index(RI)and pulsatility index(PI)of central retinal artery as well as the HMGB1,bcl-2,bax and cleaved caspase-3 expression and TNF-α,MCP-1 and ICAM-1 contents in retinal tissues were measured at 4 weeks after intervention.Results:The PSV and EDV levels as well as bcl-2 expression in the model group were lower than those in the control group,while the RI and PI levels as well as HMGB1,bax and cleaved caspase-3 expression and TNF-α,MCP-1 and ICAM-1 contents were higher than those in the control group;the PSV and EDV levels as well as bcl-2 expression in the HMGB1 inhibition group were higher than those in the model group,while the RI and PI levels as well as HMGB1,bax and cleaved caspase-3 expression and TNF-α,MCP-1 and ICAM-1 contents were lower than those in the model group.Conclusion:Inhibition of HMGB1 gene expression can improve the blood flow of central retinal artery and inhibit the inflammatory response and apoptosis in diabetic retinopathy rats.

The Role of Mutual Support Groups for the Control of Diabetes in a Mexican City: Achievements and Limitations from the Patients’ Perspective

Background: Mutual Support Groups (MSG) provides to the patient, the ability to effective self-management behaviors, such as taking prescribed medications, following diet and exercise regimens, self-monitoring, and coping emotionally with the rigors of living with diabetes. Physicians, nurses and health promoters from public primary Health Care Centers (HCC) are responsible for providing follow-up care through MSGs. However, although the MSG program has been carried out, in the last decade Mexico presents the most alarming statistics in the prevalence and complications of Diabetes Mellitus type II (DM-II), suggesting a low impact of MSG in the strategy to support the effective control of the disease. Objetive: The aim of this work was to assess whether knowledge or benefits of effective management to control of DM-II, also to identify strengths and limitations of MSGs, in six different Health Care Centers (HCC), in San Luis Potosi, Mexico. This research provides an overview of patients’ perception, and significant issues that demand to adjust MGSs strategies, with the goal of exceed the expectations of current health statistics. Methods: A qualitative evaluation was carried out, with an ethnographic approach design. The study included 28 diabetic persons, (21 women and 7 men from ruraland urban carecenters). Semi-structured interviews, non-participant observation, and structured content analysis were used. Results: Support groups give patients a way to address emotional issues, and learn about their disease and self-care, although some patients consider participation an inconvenient obligation. Support group users mention barriers such as lack of continuity in support group activities, inconvenient meeting times, and the difficulty of commuting to attend group sessions. They also mention that overworked health care workers find it difficult to provide leadership to keep the group going. These issues have multiple implications for the success of strategies to control the disease. Conclusions: This study shows the need to apply a participatory model to disease support group strategies to reorganize their actions in such a way as to meet the needs and requirements of patients and to ensure their participation and help them control their disease.

Diabetes group medical visits and outcomes of care in low-income, rural, uninsured persons

Purpose: The purpose of this study was to test the effectiveness of Diabetes Group Medical Visits (DGMVs) verses usual care in a sample of low-income patients with diabetes receiving care at a rural free clinic. Methods: Data were collected through chart review, using direct data entry into Microsoft Access. Participants were included if they met the inclusion criteria: 1) age ≥ 18 years;2) diagnosis of diabetes;3) uninsured and received care between May 2007 and August 2009. Fifty-three participants attended DGMVs and were compared to 58 participants who received usual care. Results: The personal characteristics and biophysical measures of this population differed from previously studied Group Visit populations. The majority of patients were female (73.9%), white (95.5%), younger than 50 (53.2%), driving long distances to receive care (mean miles = 21, SD 20.4) and had a high school education or less (95.4%). Participants were severely obese (mean BMI = 37.6, SD 28.48) and had 5 co-morbid conditions other than diabetes (mean = 5.5, SD 2.1). Those attending DGMVs had higher baseline A1C, depression scores, BMIs, and more pain than usual care. There was a statistically significant decrease in systolic pressure from time one to time two in patients who attended DGMVs t(52) = 2.18, (p = 0.03). There was no significant impact on outcomes of patients who received usual care. However, it is important to note that the majority of patients attended three or fewer DGMVs visits in one year. Conclusion: Group visits may not be enough to improve outcomes in this population. Previous studies suggest that improvements are seen in those who attend more frequently. Hence, the lack of improvement in biophysical outcomes may be due to low attendance. The limited impact of this traditional style intervention in relation to low attendance argues the need to test alternative interventions to reach this population.

Theory exploration of ginseng-jujube-licorice group in the prevention and treatment of type 2 diabetes mellitus

Diabetes is a chronic disease characterized by hyperglycemia,of which type 2 diabetes mellitus(T2DM)accounts for about 95%[1].In addition,the prevalence of T2DM is still rising,seriously threatening human health.As the mechanism of T2DM is not fully understood,most of the current drugs for the treatment of T2DM focus on lowering blood glucose without solving its underlying problem.This review discusses the application of ginseng-jujube-licorice group in T2DM based on theory of traditional Chinese medicine and research of modern pharmacology,in order to provide a reference for the development of new drugs and future research.

Effect Observation of Process Diabetes Group Nursing on Patients with Diabetes Mellitus

Objective:Discuss the clinical effect of the process diabetes nurse group in the treatment of diabetes patients.Methods:A total of 58 patients with diabetes who received treatment in our hospital from January 2021 to June 2021 were selected,and the 58 patients were divided into two groups by random number table.In one group,29 patients were treated with process diabetes group nursing,which was recorded as the observation group;in the other group,29 patients were treated with conventional care,which was recorded as the control group.Nursing satisfaction,compliance behavior of patients,and adverse incidence were analyzed.Results:After nursing,the data of the two groups were summarized.The score of compliance behavior in the observation group was 91.23±4.56,which was significantly better than that in the control group(75.13土5.23).The t values of the score of compliance behavior were 12.4952,P<0.05.The qualified rate of fasting blood glucose in the observation group was 100%,which was significantly higher than that in the control group(62.07%),P<0.05.According to the questionnaire analysis,there were 18 patients in the observation group who were very satisfied,8 patients who were satisfied and 3 patients who were not satisfied,with a total satisfaction rate of 89.66%,and in the control group,there were 4 patients who were very satisfied,15 patients who were satisfied and 10 patients who were not satisfied,with a total satisfaction rate of 65.52%.The control group was significantly inferior to the observation group,and P<0.05 was regarded as statistically significant.Conclusion:Adopting the process of diabetes group nursing can effectively enhance the compliance behavior of patients,and effectively control the blood sugar index of patients,and improve the satisfaction degree of patients.

Relationship of plasma homocysteine, soluble intercellular adhesion molecule-1, high mobility group box 1 protein with carotid intima-media thickness in elderly patients with type 2 diabetes mellitus

Objective:To explore the relationship of plasma homocysteine(Hcy),soluble intercellular adhesion molecule-1(sICAM-1)and high mobility group box 1 protein(HMGB1)with carotid intima-media thickness(c-IMT)in elderly patients with type 2 diabetes mellitus.Methods:A total of 100 elderly patients who were diagnosed as type 2 diabetes mellitus in Baogang Hospital of Inner Mongolia from June 2017 to May 2020 were chosen as research objects.According to c-IMT,they were divided into the normal group(n=35),the mild to moderate group(n=41)and the severe group(n=24).The expression levels of plasma Hcy,sICAM-1 and HMGB1 were compared between groups respectively.Pearson’s correlation coefficient was used to analyze the relationship of plasma Hcy,sICAM-1,HMGB1 with c-IMT.Results:The comparison in plasma Hcy,sICAM-1,HMGB1 and c-IMT among the three groups of patients was of statistical significance(p<.05).The results of correlation analysis showed that the expression levels of plasma Hcy,sICAM-1 and HMGB1 were positively correlated with c-IMT in elderly patients with type 2 diabetes mellitus(r=.627,.598,.614;p<.05).Conclusions:The expression levels of plasma Hcy,sICAM-1 and HMGB1 are abnormally increased in elderly patients with type 2 diabetes mellitus,and related to c-IMT,which can provide a strong evidence for clinical diagnosis and treatment by detecting their levels in clinical practice.

Bone marrow-derived mesenchymal stem cell-derived exosomeloaded miR-129-5p targets high-mobility group box 1 attenuates neurological-impairment after diabetic cerebral hemorrhage

BACKGROUND Diabetic intracerebral hemorrhage(ICH)is a serious complication of diabetes.The role and mechanism of bone marrow mesenchymal stem cell(BMSC)-derived exosomes(BMSC-exo)in neuroinflammation post-ICH in patients with diabetes are unknown.In this study,we investigated the regulation of BMSC-exo on hyperglycemia-induced neuroinflammation.AIM To study the mechanism of BMSC-exo on nerve function damage after diabetes complicated with cerebral hemorrhage.METHODS BMSC-exo were isolated from mouse BMSC media.This was followed by transfection with microRNA-129-5p(miR-129-5p).BMSC-exo or miR-129-5poverexpressing BMSC-exo were intravitreally injected into a diabetes mouse model with ICH for in vivo analyses and were cocultured with high glucoseaffected BV2 cells for in vitro analyses.The dual luciferase test and RNA immunoprecipitation test verified the targeted binding relationship between miR-129-5p and high-mobility group box 1(HMGB1).Quantitative polymerase chain reaction,western blotting,and enzyme-linked immunosorbent assay were conducted to assess the levels of some inflammation factors,such as HMGB1,interleukin 6,interleukin 1β,toll-like receptor 4,and tumor necrosis factorα.Brain water content,neural function deficit score,and Evans blue were used to measure the neural function of mice.RESULTS Our findings indicated that BMSC-exo can promote neuroinflammation and functional recovery.MicroRNA chip analysis of BMSC-exo identified miR-129-5p as the specific microRNA with a protective role in neuroinflammation.Overexpression of miR-129-5p in BMSC-exo reduced the inflammatory response and neurological impairment in comorbid diabetes and ICH cases.Furthermore,we found that miR-129-5p had a targeted binding relationship with HMGB1 mRNA.CONCLUSION We demonstrated that BMSC-exo can reduce the inflammatory response after ICH with diabetes,thereby improving the neurological function of the brain.

接纳与承诺团体干预对维持性血液透析糖尿病肾病患者营养状况的影响

目的研究接纳与承诺团体干预对糖尿病肾病维持性血液透析患者营养状况的影响,为提高患者的生活质量、延长其生存时间提供心理干预方法。方法选取2022年7—10月在山东省某三级甲等综合医院行血液透析的糖尿病肾病63例患者为研究对象,按照组间资料具有可比性的原则分为观察组31例和对照组32例。对照组接受常规的健康教育和心理指导,观察组在对照组基础上实施接纳与承诺团体干预。比较两组患者糖尿病肾病维持性血液透析营养管理知信行评分、营养不良-炎症评分(MIS),检查两组患者血磷、血钙、白蛋白、C反应蛋白(CRP)指标。结果透析3个月后,观察组患者营养管理知信行评分均高于对照组,差异具有统计学意义(P<0.05)。透析3个月后,观察组MIS评分低于对照组,差异具有统计学意义(P<0.05)。透析3个月后,观察组患者血钙高于对照组,血磷低于对照组,白蛋白及CRP优于对照组,差异具有统计学意义(P<0.05)。结论接纳与承诺疗法通过接纳、认知解离、体验当下、以己为景、澄清价值观和承诺行动6个过程,利用正念、隐喻、知识传授及有氧运动等方法,可以提高糖尿病肾病维持性血液透析患者营养管理知信行水平和营养管理依从性,改善营养状况,维持钙磷代谢平衡。

不同年龄住院T2DM患者心血管事件发生的 相关因素分析

目的:探讨不同年龄段住院2型糖尿病(type 2 diabetes mellitus,T2DM)患者临床特征及心血管事件发生影响因素。方法:收集2019年1月至12月石家庄市第二医院108例住院T2DM患者的临床资料,根据心血管事件发生分为发生组和未发生组,比较两组临床特征及不同年龄住院T2DM患者临床特征,采用Logistic回归方程分析住院T2DM患者心血管事件发生影响因素。结果:(1)所有患者均获得2年随访结果,心血管事件发生率为37.04%;(2)发生组年龄、T2DM病程、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、半乳糖凝集素-3(galectin-3,Gal-3)、高血压病史均大或长或高于未发生组,踝肱指数、C1q/肿瘤坏死因子相关蛋白9(C1q/tumor necrosis factor related protein 9,CTRP9)低于未发生组(P<0.05);(3)老年组T2DM病程、HbA1c、Gal-3、高血压病史均大或长或高于中青年组,踝肱指数、CTRP9低于中青年组(P<0.05);(4)T2DM病程、踝肱指数、年龄、CTRP9是住院T2DM患者心血管事件发生影响因素(P<0.05)。结论:T2DM病程、踝肱指数、年龄、CTRP9可能是导致住院T2DM患者心血管事件发生的影响因素,临床实际中应密切关注伴有上述情况的住院T2DM患者,积极防治,促进预后改善。

群组化孕期保健模式对妊娠期糖尿病孕妇血糖控制与妊娠结局影响的Meta分析

目的系统评价群组化孕期保健模式(GPC)对妊娠期糖尿病(GDM)孕妇血糖控制与妊娠结局的影响。方法计算机检索PubMed、Web of Science、Springer Link、中国知网(CNKI)、维普(VIP)与万方数据库等数据库中关于GPC对GDM孕妇血糖控制及妊娠结局影响的随机对照试验(RCT),采用Rev Man 5.4.1软件对数据进行meta分析。检索时间为2013年1月1日-2023年1月1日。结果共纳入6篇文献。meta分析结果表明:干预组(GPC)孕妇空腹血糖[WMD=-0.41,95%CI(-0.49,-0.33),P<0.00001]、餐后2 h血糖[WMD=-0.58,95%CI(-0.77,-0.38),P<0.001]及妊娠不良结局{妊娠高血压综合征[OR=0.37,95%CI(0.14,0.96),P=0.04]、剖宫产[OR=0.46,95%CI(0.27,0.78),P=0.04]、巨大儿[OR=0.19,95%CI(0.09,0.41),P<0.001]、产后出血[OR=0.19,95%CI(0.06,0.57),P=0.003]发生情况均低于对照组(传统孕期保健模式),差异均有统计学意义(P<0.05)。结论GPC能有效控制GDM孕妇血糖,减少妊娠不良结局的发生。

穿心莲内酯调节HMGB1/RAGE信号通路对糖尿病周围神经病变大鼠坐骨神经功能损伤的影响

目的探讨穿心莲内酯调节高迁移率族蛋白B1(HMGB1)/晚期糖基化终产物受体(RAGE)信号通路对糖尿病周围神经病变(DPN)大鼠坐骨神经功能损伤的影响。方法将84只大鼠随机分为对照组(生理盐水)、DPN组(生理盐水)、穿心莲内酯低剂量组(0.833 mg/kg)、穿心莲内酯高剂量组(3.332 mg/kg)、硫辛酸组(阳性对照,0.1 g/kg)、重组大鼠HMGB1蛋白(rHMGB1,8μg/kg)组、穿心莲内酯高剂量+rHMGB1组,每组12只。除对照组外,其余各组大鼠均采用高糖高脂饲料喂养联合腹腔注射链脲佐菌素的方式构建DPN模型。造模成功24 h后,进行给药处理,每天1次,持续8周。给药结束后,检测大鼠空腹血糖、机械痛阈值、热痛阈值、坐骨神经传导速度的变化;观察大鼠坐骨神经病理变化;检测大鼠坐骨神经中超氧化物歧化酶(SOD)活性及丙二醛(MDA)含量;检测大鼠坐骨神经中HMGB1、RAGE蛋白表达水平和核因子κB p65(NF-κB p65)蛋白磷酸化水平。结果与对照组比较,DPN组大鼠坐骨神经病理损伤严重,空腹血糖、热痛阈值、MDA含量及HMGB1、RAGE蛋白表达水平和NF-κB p65蛋白磷酸化水平均显著升高(P<0.05),机械痛阈值、感觉神经传导速度、运动神经传导速度、SOD活性显著降低/减慢(P<0.05);与DPN组比较,穿心莲内酯低、高剂量组和硫辛酸组大鼠上述指标均显著改善(P<0.05),rHMGB1组对应指标变化趋势与上述3个给药组相反(P<0.05);并且,rHMGB1可减弱高剂量穿心莲内酯对DPN大鼠血糖的降低作用及坐骨神经氧化应激损伤的改善作用(P<0.05)。结论穿心莲内酯可能通过抑制HMGB1/RAGE信号通路来降低血糖、抑制氧化应激,进而改善DPN大鼠坐骨神经损伤。

老年2型糖尿病患者团体心理干预效果分析

目的 分析老年2型糖尿病(T2DM)患者团体心理干预效果。方法 选取2020年1月至2022年1月期间在南阳医学高等专科学校第一附属医院收治的75例老年T2DM患者,按照随机数表法将患者分为研究组(38例)、对照组(37例)。对照组接受常规护理干预,研究组接受常规护理干预加团体心理干预。比较两组干预前后负性情绪[抑郁自评量表(SDS)、焦虑自评量表(SAS)]、健康素养[慢性病患者健康素养量表(HeLMS)]、自我效能感[自我效能感量表(GSES)]、自我管理能力[成年人健康自我管理能力测评量表(AHSMSRS)]及护理满意度。结果 干预后,研究组SDS评分、SAS评分均低于对照组,差异有统计学意义(P <0.05)。干预后,研究组信息获取能力评分、改善健康意愿评分、交流互动能力评分、经济支持意愿评分分值均高于对照组,差异有统计学意义(P <0.05)。干预后,研究组GSES评分、AHSMSRS评分分值均高于对照组,差异有统计学意义(P <0.05)。研究组护理满意度(94.74%)明显高于对照组(67.57%),差异有统计学意义(P <0.05)。结论 老年T2DM患者接受团体心理干预,可增强健康素养,改善负性情绪、自我管理能力、自我效能感,提高护理满意度。

妊娠期糖尿病对于子代新生儿B族链球菌感染免疫功能的影响研究

目的探讨妊娠期糖尿病(GDM)对于子代新生儿B族链球菌(GBS)感染的免疫功能的影响。方法102例GBS感染新生儿,将48例母亲存在GDM的新生儿纳入孕母GDM新生儿感染组,其余54例母亲孕期血糖监测正常的新生儿纳入孕母非GDM新生儿感染组,另选择单纯性高胆红素血症新生儿52例为非感染对照组。入组新生儿均于起病急性期采集血样,使用流式细胞术检测淋巴细胞亚群、自然杀伤细胞(NK细胞)以及细胞因子的水平。比较三组新生儿免疫指标水平,分析NK细胞与淋巴细胞亚群的相关性。结果孕母GDM新生儿感染组新生儿的CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、CD3^(-)CD56^(+)CD16^(+)细胞计数均明显低于孕母非GDM新生儿感染组和非感染对照组,孕母非GDM新生儿感染组低于非感染对照组,差异有统计学意义(P<0.05);孕母GDM新生儿感染组新生儿的IL-6、IL-6/IL-10水平均高于孕母非GDM新生儿感染组,孕母GDM新生儿感染组和孕母非GDM新生儿感染组新生儿的IL-6、IL-10水平均高于非感染对照组,孕母GDM新生儿感染组新生儿的IL-6/IL-10水平高于非感染对照组,差异存在统计学意义(P<0.05);孕母GDM新生儿感染组和孕母非GDM新生儿感染组新生儿的IL-10水平比较差异无统计学意义(P>0.05);孕母非GDM新生儿感染组和非感染对照组新生儿的IL-6/IL-10水平比较差异无统计学意义(P>0.05)。经Pearson相关性分析,CD3^(-)CD56^(+)CD16^(+)NK细胞与CD3^(+)、CD4^(+)以及CD8^(+)T细胞呈正相关(r=0.588、0.580、0.461,P<0.05)。结论母亲患GDM所分娩的新生儿在感染情况下会出现更明显的免疫功能受损,促炎/抗炎功能紊乱,因此对GDM的防治在提高新生儿免疫功能、改善新生儿感染性疾病预后方面存在积极意义。

miR-92b-5p、HMGB1与2型糖尿病肾病患者肾功能的相关性

目的探讨微小核糖核酸-92b-5p(miR-92b-5p)、血清高迁移率族蛋白B1(HMGB1)与2型糖尿病肾病患者肾功能的相关性。方法选取2021年1月至2023年12月期间河南省驻马店市中心医院内分泌科收治的212例2型糖尿病肾病患者作为肾病组,另选取同期来本院就诊的单纯2型糖尿病患者95例作为2型糖尿病组。比较二组患者的肾功能相关指标以及miR-92b-5p、HMGB1水平;以Pearson相关性分析评估2型糖尿病肾病患者血清miR-92b-5、HMGB1水平与肾功能的相关性;以单、多因素Logistic回归分析2型糖尿病患者并发肾病的危险因素,并绘制受试者工作特性曲线(ROC)进一步评估miR-92b-5p、HMGB1二者联合检测对2型糖尿病患者并发肾病的预测价值。结果两组糖尿病病程、BUN、Scr、eGFR、miR-92b-5p以及HMGB1水平的比较差异有统计学意义(P<0.05);Pearson分析显示,HMGB1与BUN、Scr呈正相关,与eGFR呈负相关(r=0.570,0.646,-0.485,P<0.05);miR-92b-5与BUN、Scr呈负相关,与e GFR呈正相关(r=-0.526,-0.562,0.442,P<0.05)。多因素回归分析显示,糖尿病病程增加、BUN、Scr、HMGB1水平升高、eGFR、miR-92b-5p水平降低均是2型糖尿病患者并发肾病的独立危险因素(P<0.05);ROC曲线分析显示,miR-92b-5p、HMGB1以及二者联合检测曲线下面积为0.898、0.932、以及0.961(P<0.05)。结论2型糖尿病肾病患者肾功能异常可能与血清中miR-92b-5p表达量下降、HMGB1表达量上升有关,二指标可作为2型糖尿病肾病的有效预测指标。