CD_4~+ CD_(25)~+调节性T细胞在妊娠与分娩中的作用

近代生殖免疫学研究认为,正常妊娠维持有赖于母胎免疫耐受的形成,耐受一旦失调,就可能妊娠失败,发生如流产,妊娠期高血压疾病,胎膜早破,分娩发动等。近几年来,国内外学者逐渐认识到CD4+CD25+调节性T细胞在妊娠中的重要作用并进行系列研究。本文就目前CD4+CD25+调节性T细胞在妊娠与分娩中的作用作一综述。     

外科手术患者的血糖管理

随着糖尿病患患者数的迅速增加,需要接受外科手术治疗的糖尿病患者也越来越多。糖尿病患者的血糖控制与外科手术相互影响,一方面,手术应激可进一步加重糖尿病患者的糖代谢紊乱;另一方面,合并糖尿病使患者发生围手术期并发症甚至死亡的风险大大增加。因此,对糖尿病患者进行完整的术前评估,良好的术前、术中、术后血糖管理是糖尿病患者手术顺利进行、平稳渡过围手术期、改善预后的重要保证。     

腹膜间皮细胞EMT在腹膜纤维化中的研究进展及意义

腹膜透析是终末期肾衰患者肾脏替代治疗的重要手段,腹膜纤维化导致腹透效能下降及超滤衰竭,制约着腹膜透析的应用。腹膜间皮细胞上皮细胞间充质转化是腹膜纤维化的起始和可逆环节,因此预防和逆转EMT的发生发展可能是阻止和延缓腹膜纤维化、超滤衰竭的最佳策略,并将带来巨大的社会和经济效益。     

PCI术后患者的血糖管理

经皮冠状动脉介入治疗(PCI)已成为冠心病治疗及急性心肌梗死(AMI)血运重建的有效手段。取得令人满意的效果,而被临床广泛接受和应用。在冠心病患者中糖代谢异常发生率显著高于一般人群。有研究显示高血糖是引起冠状动脉支架再狭窄的独立危险因素。因此糖尿病患者PCI术后必须进行严格的血糖管理。根据目前研究结果,可能血糖目标定为餐前血糖7.8mmol/L,且随机血糖10.0mmol/L较为合适。     

肝性糖尿病

肝性糖尿病由严重慢性肝脏病变所引发,常见于非酒精性脂肪肝、病毒性肝炎、酒精性肝病及血色病等,多出现于肝硬化失代偿期,不论是发病机制,还是临床表现与治疗均与2型糖尿病不同。本文将就此方面对近几年的研究进展进行综述。     

儿童糖尿病血糖管理

儿童糖尿病的治疗目标是达到和维持正常的生长与发育,减少由低血糖或高血糖所引起的临床症状,减少或延缓慢性并发症的发生。要实现这一治疗目标其中心环节就是要保证患者具有良好的血糖控制水平。糖尿病治疗必须在自我监测的基础上选择合适的胰岛素/药物治疗方案和饮食管理等以及糖尿病知识教育和心理支持的综合管理下才能达到满意效果。     

非小细胞肺癌术后化疗循证医学证据引发的思考

肺癌是目前对人类生命威胁最大的恶性肿瘤之一.对非小细胞肺癌术后化疗的循证医学证据及由此引发的思考:对循证医学的局限性及认识真理的曲折性进行了阐述.     

Changing behaviors: Using norms to promote physical activity for type 2 diabetes patients

IntroductionGiven that diabetes is a major public heath issue around the world, it is vital that we find effective means to change behaviors, especially levels of physical activity among type 2 diabetes patients.ObjectiveThis study aims to provide proof of the effectiveness of programs promoting physical activity, based on cognitive dissonance and normative focus theories which are designed to produce behavioral changes in persons with type 2 diabetes.MethodNinety-six type 2 diabetes patients were assigned to one of three programs: a traditional information program, a norm-based program, and a dissonance-based program. The participants filled out a short French version of the International Physical Activity Questionnaire (IPAQ) one week before and one week after the program.ResultsThe results showed that the participants in the norm-based program made progress compared to those in the traditional information program. No significant difference was observed between the traditional information program and dissonance-based program.ConclusionsThese findings are consistent with both the focus normative theory and previous studies showing that recalling the norm increases compliance. The procedure to be used in diabetes prevention programs should focus on the normative dimensions of the desired behaviors in order to improve patients’ quality of life.     

Reducing adolescent cell phone usage using an interdependent group contingency

The purpose of this study was to test the effects of an interdependent group contingency on cell phone usage in an alternative high school classroom. We used an ABAB reversal design to test the effects of the contingency on the cell phone usage of the entire class and an individual student. Results showed a reduction in the cell phone use of the class and the individual when the group contingency was in effect, demonstrating a functional relation between the contingency and student cell phone usage. These findings suggest that group contingencies may be efficacious for teachers to use within their classrooms to curb cell phone usage. Further study of this intervention is warranted to determine its generality.     

Parental illness intrusiveness and youth glycaemic control in type 1 diabetes: intergenerational associations and processes

Objective: This study examined associations between the functioning of youth with type 1 diabetes and their parents, including parenting dimensions as intervening mechanisms. The study adds to the existing literature by focusing on (1) the concept of parental illness intrusiveness; (2) the (understudied) periods of adolescence and emerging adulthood; and (3) maternal and paternal functioning. Design: Questionnaires were completed by 317 patient-mother dyads and 277 patient-father dyads. All patients (aged 14–25) had type 1 diabetes. The hypothesised model was compared to an alternative model using structural equation modelling. Main Outcome Measures: Youth reported on depressive symptoms and treatment adherence; Physicians provided HbA_1c-values. Parents reported on illness intrusiveness, depressive symptoms, and their child’s treatment adherence. Patients and parents reported on psychological control and overprotection. Results: The hypothesised path model had a good fit to the data. Parental illness intrusiveness was positively associated with depressive symptoms and both were positively related to overprotection and psychological control. Psychological control was positively related to patients’ depressive symptoms and negatively to treatment adherence. Poorer treatment adherence was associated with worse HbA_1c-values. Conclusion: These findings underscore the relevance of parental illness intrusiveness and emphasise the importance of mothers’ and fathers’ roles throughout adolescence and emerging adulthood.