肺结核患者的血糖控制

肺结核与糖尿病是两种严重危害人类健康的疾病。越来越多的研究证明,发生结核病的一个重要的危险因素为糖尿病,而且可能会影响肺结核患者的表现和治疗反应。另外,结核病可能会导致糖耐量异常,并使糖尿病患者的血糖控制不良。糖尿病引起肺结核发病增加,可能是因为持续的高血糖损害了针对结核杆菌的机体免疫。对结核病患者合并糖尿病者,药物治疗需考虑到药物动力学,监测血糖,谨慎用药。     

超越干涉主义，医疗也需要考虑“疾病耐受性”——兼论中医药介入新冠肺炎救治的新思考

部分新冠肺炎患者死因,确与炎症风暴等有关,而炎症风暴的产生,在一定程度上与现代医学干涉主义的一味对抗性治疗思路有关。引进"疾病耐受性"概念,认为提升机体耐受性也是应对病态时常用且有效之机制;重视这类机制,或许能在对抗性措施外,寻找到新的防范及缓解疾病反应的途径。此外,借"疾病耐受性"概念来分析中医药应对新冠肺炎疗效之机制,提出中医药可能不一定直接抗衡病因,也可能包括调动机体耐受性,减轻不适,以使机体更好地适应病态;在不同病理阶段下,中医药常运用不同思路与原则应对。这些,值得高度重视。     

2型糖尿病餐后高血糖与心血管危险

餐后高血糖比空腹高血糖更易引起全身大血管、微血管、肌肉、脂肪以及胰岛β细胞等功能和结构的改变,导致一系列慢性并发症的早期发生,因此,积极有效控制2型糖尿病患者餐后高血糖是心血管和内分泌科临床医师的重要任务.     

西藏老年病房2型糖尿病患者的血糖管理

西藏老年2型糖尿病患者有着知晓率低、病程长、慢性并发症多、其他相关疾病多等特点。加强糖尿病教育、控制饮食、合理用药、注意相关疾病的处理和个体化治疗是血糖管理的有效方案。     

心脑血管疾病患者高血糖的管理

糖尿病是心脑血管疾病的主要危险因素,血糖控制不佳会加重此类患者的病情,影响其预后,因此,急慢性心脑血管疾病患者的高血糖要积极处理。在血糖控制过程中,要综合考虑患者的病情,选择安全、有效的降糖方案,避免低血糖和药物的副作用。本文就心脑血管疾病患者高血糖的管理进行了总结。     

代谢综合征：一个颇具争论的病名

代谢综合征（MS）囊括了肥胖、高血糖、高血压、血脂紊乱等代谢异常,其预测心血管疾病和糖尿病的能力得到公认。但是,医学界对MS的探索并没有停步,有关其命名、病因、不同组分预测疾病的能力等存在着争议。客观评价MS将有助于提高医生对疾病相互关系的认识。     

线粒体在糖尿病发生发展中作用的再评价

糖尿病作为一种线粒体疾病,已成为世界面临的重大健康问题,线粒体医学的发展,大大推进了对糖尿病病因及病理机制的认识,为糖尿病的干预拓宽了道路,基于线粒体糖尿病与2型糖尿病病因的不同,对线粒体糖尿病的诊断与治疗也不同。     

从炎症在心力衰竭进展中的作用谈心力衰竭治疗策略的制订

心力衰竭是一个以免疫激活和低程度的慢性炎症为特点的疾病.一些炎症因子能通过促进心肌细胞肥厚、恶化心肌收缩功能以及诱导凋亡,在心衰的发展过程中具有重要作用.炎症因子能成为心衰治疗的重要目标.但炎症因子还有心脏代偿和保护作用.制订新的心衰治疗策略时需要进一步了解心衰中炎症反应激活的机制.     

从炎症在心力衰竭进展中的作用谈心力衰竭治疗策略的制订

心力衰竭是一个以免疫激活和低程度的慢性炎症为特点的疾病。一些炎症因子能通过促进心肌细胞肥厚、恶化心肌收缩功能以及诱导凋亡,在心衰的发展过程中具有重要作用。炎症因子能成为心衰治疗的重要目标。但炎症因子还有心脏代偿和保护作用。制订新的心衰治疗策略时需要进一步了解心衰中炎症反应激活的机制。     

线粒体在糖尿病发生发展中作用的再评价

糖尿病作为一种线粒体疾病,已成为世界面临的重大健康问题,线粒体医学的发展,大大推进了对糖尿病病因及病理机制的认识,为糖尿病的干预拓宽了道路,基于线粒体糖尿病与2型糖尿病病因的不同,对线粒体糖尿病的诊断与治疗也不同.     

The default self: feeling good or being right?

The medial prefrontal cortex exhibits a higher resting metabolic rate than many other brain regions. This physiological default mode might support a psychological default state of chronic self-evaluation that helps people consider their strengths and weaknesses when planning future actions. However, a recent imaging study that relates medial prefrontal cortex activity to self-evaluation raises new questions about whether the psychological default mode of self-evaluation is best characterized by accurate self-evaluations or by feeling good about yourself.     

代谢综合征发病机制研究进展

随着经济的发展和人们生活水平的提高以及生活方式的改变,代谢综合征（metabolic syndrome,MS）的患病率逐年上升。代谢综合征是一种涉及多种代谢异常、与心血管病紧密联系的疾病状态。肥胖或超重、糖调节异常或糖尿病、高血压和高血脂是MS的重要组成元素。代谢综合征一直是人们关注的热点,但截止目前确切机制仍不明确。主要围绕肥胖与胰岛素抵抗展开研究,特别是在脂毒性和脂肪分泌因子的调控以及各种炎性因子的影响方面取得了一些进展。     

Exposure-based treatment to control excessive blood glucose monitoring.

We investigated an exposure‐based procedure for reducing excessive checking of blood glucose by a child with diabetes. In a changing criterion design, an exposure‐based procedure was implemented by systematically exposing the child to decreasing amounts of information about blood sugar levels (checking) and thereby increasing exposure to potential hypoglycemia. Access to information was reduced in graduated increments, with the parents setting criteria to levels at which they were willing to adhere. Results demonstrated that the procedure was effective in reducing excessive blood glucose checking and in improving metabolic control.     

Diabetes, depression, and metabolic control in Latinas

Diabetes is steadily becoming an epidemic among Latinos, and depression has been found to complicate diabetes management. This study examined depressive symptoms and metabolic control in Latinas with diabetes in a community clinic setting. The association of depressive symptoms with metabolic control was supported in this study. Social support (but not acculturation) was found to be associated with depressive symptoms. Finally, age and metabolic control were related. These findings are explained in a culture-specific framework. The authors speculate that the role of the woman in Latino families makes it difficult for a Latina to attend to her own care needs until she ages.     

急性心理应激对多囊卵巢综合征患者的影响

为了了解PCOS患者易患抑郁症、肥胖、代谢综合征、心血管疾病、糖尿病的原因。通过对28例PCOS患者和28例体重指数、年龄匹配的健康对照组回应公众演讲压力进行分析,在回应公众演讲压力时,PCOS组和对照组均有比较显著的焦虑程度、ACTH、皮质醇、心率和血压升高（P均〈0．01）;但PCOS患者焦虑程度、ACTH、皮质醇...     

Ethnic differences in illness perceptions,self-efficacy and diabetes self-care

This study assessed differences between Europeans, South Asians and Pacific Islanders in illness perceptions, self-efficacy, self-care, metabolic control and retinopathy in diabetes. We also evaluated the role of illness perceptions and self-efficacy in diabetes self-care and metabolic control within each group. A total of 86 Europeans, 86 South Asians, and 87 Pacific Islanders with type-2 diabetes completed self-report measures of illness perceptions, self-efficacy and self-care. Metabolic control and retinopathy data were collected from patient records. Results showed that Pacific Islanders and South Asians held shorter illness timeline perceptions compared to Europeans. Relative to both the other groups, Pacific Islanders also had elevated scores on three illness perceptions subscales: consequences, identity and emotional representations. They had lower medication-specific self-efficacy as well as poorer medication self-care, metabolic control and retinopathy. In all three groups, self-efficacy was fairly consistently related to self-care, but not to metabolic control. Illness perceptions were less consistently related to self-care, but were associated with metabolic control.     

糖尿病专科护士在2型糖尿病防治中的作用与地位

当前我们对糖尿病防治措施和手段可以说是无所不先进,但患者血糖、血脂、血压达标情况仍旧令人担忧。防治领域的相关人员都在竭尽全力探讨其原因,结果令人失望。但是糖尿病作为慢性终生性习惯性疾病,当前几乎所有的有意义的研究均指向良好的生活习惯（饮食控制、增加体育锻炼）有利于减少糖尿病发病。糖尿病专科医生作为疾病防治的三级层面,很...     

Psychometric properties of the Chinese version of the diabetes empowerment scale

Metabolic control is central to positive clinical outcome in patients with diabetes. Empowerment has been linked to metabolic control in this clinical group. The current study sought to determine key psychometric properties of the Chinese version of the Diabetes Empowerment Scale (C-DES) and to explore the relationship of the C-DES sub-scales to metabolic control in 189 patients with a diagnosis of diabetes. Confirmatory factor analysis established that the five sub-scales of the C-DES offered a highly satisfactory fit to the data. Furthermore, C-DES sub-scales were found to have generally acceptable internal consistency and divergent reliability. However, convergent reliability of C-DES sub-scales could not be established against metabolic control. It is concluded that future research needs to address ambiguities in the relationship between empowerment and metabolic control in order to afford patients an evidenced-based treatment package to assure optimal metabolic control.     

An Introduction to Normalization and Calibration Methods in Functional MRI

In functional magnetic resonance imaging (fMRI), the blood oxygenation level dependent (BOLD) signal is often interpreted as a measure of neural activity. However, because the BOLD signal reflects the complex interplay of neural, vascular, and metabolic processes, such an interpretation is not always valid. There is growing evidence that changes in the baseline neurovascular state can result in significant modulations of the BOLD signal that are independent of changes in neural activity. This paper introduces some of the normalization and calibration methods that have been proposed for making the BOLD signal a more accurate reflection of underlying brain activity for human fMRI studies.     

Mood-as-input and depressive rumination

This article describes a test of mood-as-input theory predictions as applied to a rumination task in a nonclinical population. An experimenter-controlled interview was used to allow participants to reflect on a personal period of depression while in an experimentally-induced mood state (either negative or positive) or while deploying a specific stop rule for the task (either an “as many as can” or “feel like continuing” stop rule). As predicted by mood-as-input theory, persistence at the rumination task was greatest in the group experiencing negative mood while deploying an “as many as can” stop rule, and this suggests a mechanism that may contribute to perseverative depressive rumination. It is argued that the variables that contributed to perseveration in this study are already known to be characteristic of ruminative thinkers (e.g. negative mood and positive metacognitive beliefs about rumination that will command the deployment of “as many as can” stop rules for rumination). It is also argued that mood-as-input processes may provide a common mechanism for perseverative rumination and perseverative worry, and this common mechanism may account for many of the similarities between these two functionally-distinct activities.