替罗非班不同给药途径对DM合并急性STEMI患者PCI术后血小板α-颗粒膜蛋白及心肌灌注水平的影响

为探讨替罗非班不同给药途径对糖尿病（DM）合并急性ST段抬高型心肌梗死（STEMI）患者PCI术后血小板α-颗粒膜蛋白及心肌灌注水平的影响,对149例DM合并急性STEMI患者进行研究,测定并比较经静脉（A组）、冠脉给药途径（B组）和无替罗非班（C组）的患者术前及术中应用替罗非班后血小板α-颗粒膜蛋白GMP140浓度、造影结果、心肌酶及肌钙蛋白I水平峰值及峰值时间、心电图变化。结果显示A、B两组术中血小板α-颗粒膜蛋白浓度较术前明显降低（P〈0．05）,且B组较A组降低更明显（P〈0．05）,而C组未见明显变化（P〉0．05）,A、B两组术后即刻TIMI血流、2h sumSTR、心肌酶及肌钙蛋白Ⅰ峰值及峰值时间的变化均优于C组（P〈0．05）,且B组优于A组（P〈0．05）。因此,替罗非班可以降低血小板α-颗粒膜蛋白浓度和改善心肌灌注水平,与静脉途径给药相比,经冠脉给药更具有优势。     

这一次沃森的“猜想”对吗？——糖尿病是一种氧化还原性疾病

2型糖尿病发病机制的氧化应激学说被广泛地接受,可是大量的证据表明,服用抗氧化剂并不能增加胰岛素的敏感性,相反,体育锻炼能够增加氧化应激,却是治疗糖尿病的首选方案。分子机制的研究也表明,细胞内氧化应激不足时,会导致内质网无法合成二硫键,导致胰岛素生成不足。由此沃森推测,糖尿病是由于氧化应激不足所致。同理,氧化应激不足可能也是阿尔茨海默病、肿瘤等疾病的发病机制之一。沃森的呼声让现在普遍认为氧化应激有害理论的人们开始重新审视氧化应激在机体中的有益作用。     

骨髓干细胞移植治疗1型糖尿病的理论与实践

胰岛移植作为治疗1型糖尿病较理想的方法,由于其供体不足而受到限制。干细胞具有极强的自我更新能力与多向分化潜能,可成为提供1型糖尿病胰岛β细胞良好的细胞来源。造血千细胞移植通过诱导免疫耐受,修复受损胰腺组织改善胰岛功能。间充质干细胞移植可分化为胰岛β细胞,且通过免疫调节改善胰岛细胞微环境。     

诱导2型糖尿病的“蜜月期”——治疗糖尿病的新策略

在2型糖尿病β细胞功能早期失代偿阶段,通过短期治疗,可以逆转或改善其功能,从而获得病情的长期缓解,称为2型糖尿病的“蜜月期”。本文就2型糖尿病的“蜜月期”的病理生理基础、影响因素、诱导措施等进行分析,探索2型糖尿病治疗的新策略。     

肠促胰素对2型糖尿病胰岛功能的影响

胰岛β细胞功能障碍是2型糖尿病的重要发病机制之一,而现有治疗手段保护β细胞功能作用有限。最新的研究发现,肠促胰素不仅能够改善口细胞功能,而且能够避免低血糖、体重增加等不良反应,是治疗2型糖尿病的新途径。本文通过回顾公开发表的临床研究,对2型糖尿病口细胞功能、传统治疗及肠促胰素对β细胞功能的保护及延缓疾病进展作用进行了综...     

胰岛素抵抗与2型糖尿病关系的新思考

胰岛素抵抗(IR)与2型糖尿病关系密切,对IR的认识,经历了几十年反复的过程,胰岛素抵抗综合征(IRS)的提出使2型糖尿病防治观念发生了根本的转变,提出了2型糖尿病防治新策略:从以降糖治疗为主到全面防治心血管疾病.对IR的认识和IR与2型糖尿病的关系,体现了辩证唯物主义认识论和系统论的观点.     

Integrating Behavior into Health Research and Health Care: One Psychologist's Journey

The author narrates a history of the development of her interest in integrating behavior into heath research and health care. Using diabetes as an exemplar, she describes some of the challenges of integrating behavior into health research and health care: (1) becoming a member of interdisciplinary research and health care teams; (2) acquiring funding for behavioral research with medical populations; (3) communicating scientific findings; and (4) acquiring reimbursement for psychological services rendered. Specific examples of how the author and other psychologists can address these challenges are provided.     

Illness coping behaviour of outpatients with depression or diabetes mellitus in two tertiary hospitals in Enugu state,southeast Nigeria

The study aims to compare the coping styles of patients with diabetes with those with depression. A total of 224 patients, 112 with depression and an equal number with diabetes were recruited. Sociodemographic variables were determined with the sociodemographic questionnaire, and coping styles with the Mental Adjustment to Cancer (MAC) adapted and Brief Religious Coping (Brief RCOPE) Scales. Fighting Spirit and MAC Summary Positive Adjustment were used more by participants with depression. Both groups of participants used the Brief RCOPE positive method to the same extent. Brief RCOPE negative was used more by participants with depression. Positive coping skills were used more by participants with depression than those with diabetes. This underscores the need for clinicians to explore the coping resources available to their patients, both religious and non-religious, and projecting them to their patients for enhancement and application as an adjunct for the purpose of a better clinical outcome.     

Motivational,volitional and multiple goal predictors of walking in people with type 2 diabetes

BackgroundType 2 diabetes is a major public health problem. Effective diabetes self-management involves people engaging in multiple health behaviours, including physical activity. Walking is an effective, accessible and inexpensive form of physical activity, yet many people with Type 2 diabetes do not meet recommended levels. The present study aimed to: 1) identify demographic, motivational and volitional factors predictive of walking in people with Type 2 diabetes mellitus, and 2) test whether accounting for the perceived impact of other goal pursuits (goal facilitation and goal conflict) improved the prediction of walking.MethodsA theory-based cross-sectional study using the Health Action Process Approach was conducted in adults with Type 2 diabetes across Scotland. Assuming a 50% response rate 1000 questionnaires were mailed to achieve the target sample size (N = 500). Demographic information was collected, and intentional (outcome expectations, social support, risk perceptions), motivational (intention, self-efficacy), volitional (action planning, action control) and multiple goal (goal conflict, goal facilitation) factors were assessed as predictors of physical activity in general and walking specifically.ResultsThe final sample comprised 411 respondents. The majority (60%) were non-adherent to physical activity recommendations. Of 411 respondents, 356 provided walking data. Body Mass Index and age were the only demographic and anthropometric factors predictive of walking (overall R² = 0.04). When motivational factors were added, intention and self-efficacy added to the prediction (overall R² = 0.07). When volitional factors were added, only action control was predictive of walking (overall R² = 0.08). Finally, goal facilitation explained an additional 7% variance in walking when added to the model (final overall R² = 0.15).ConclusionThere was low adherence with physical activity recommendations in general and walking in particular. When testing predictors of motivational, volitional and competing goal constructs together, action control and goal facilitation emerged as predictors of walking. Future research should consider how walking can be embedded synergistically alongside other goal pursuits and how action control may help to ensure that they are pursued.     

关于糖尿病的几点认识

糖尿病及其并发症严重影响了人类的健康。随着科学技术的不断发展,人们对糖尿病 的认识逐步加深。目前关于糖尿病的命名、诊断分型标准和治疗原则在临床工作中逐渐显露 出其不足之处,这势必会影响人们对于糖尿病的进一步研究。本文从糖尿病的命名、诊断、 分型、治疗和糖尿病研究等方面发表了作者的看法,旨在引起大家的思考。