【摘要】 目的 探討老年糖尿病患者血清胱抑素C與血脂及高敏C反應蛋白的關系。 方法 2008年5月-2009年10月糖尿病患者共141例，其中糖尿病合并癥組68例，單純糖尿病組73例；另選取對照組51例。對入選者的血清胱抑素C、血脂及高敏C反應蛋白進行分析。 結果 老年男女糖尿病合并癥組血清胱抑素C、高敏C反應蛋白、總膽固醇、甘油三酯及低密度脂蛋白膽固醇最高、高密度脂蛋白膽固醇最低，與對照組比較有統計學意義（Plt;0.05）、與單純糖尿病組比較，無統計學意義（Pgt;0.05）。老年男女單純糖尿病組高敏C反應蛋白、總膽固醇、甘油三酯高于對照組，組間比較，有統計學意義（Plt;0.05）。老年男女單純糖尿病組血清胱抑素C與對照組比較，無統率學意義（Pgt;0.05）。老年女性單純糖尿病組低密度脂蛋白膽固醇與對照組比較，有統計學意義（Plt;0.05）。老年男性糖尿病二組與對照組血清胱抑素C低于老年女性糖尿病二組與對照組，組間比較，無統計學意義（Pgt;0.05）。老年男性糖尿病患者血清胱抑素C與高敏C反應蛋白及血脂不相關。老年女性糖尿病合并癥組血清胱抑素C與空腹血糖正相關；單純糖尿病組血清胱抑素C與高密度脂蛋白膽固醇負相關、與低密度脂蛋白膽固醇正相關、與高敏C反應蛋白不相關。 結論 老年糖尿病患者高脂、高糖及低度炎癥狀態下，血清胱抑素C水平較高。血脂對血清胱抑素C的影響可能存在性別差異。隨著動脈粥樣硬化的加重，血清胱抑素C有升高趨勢。【Abstract】 Objective To investigate the relationship between serum cystatin C concentration and lipid, hs-C reactive protein in the elderly with diabetes. Methods A total of 192 senile people form May 2008 to October 2009 were investigated. There were 141 patients with diabetes, in whom 68 were with cardiovascular and cor, cerebrovascular diseases, 73 were with diabetes only.There were 51 control subjects. The data of serum cystatin C, hs-CRP, TC, TG, HDL-C and LDL-C were analyzed. Results Serum cystatin C of elderly men was lower than that in elderly women, but no signifcant correlation between them was found (Pgt;0.05). Serum cystatin C, hs-CRP, TC, TG and LDL-C was higher, and HDL-C was lower in male and female diabetes subjects with cardiovascular and cor, cerebrovascullar diseases, than that in control subjects (Plt;0.05). Serum hs-CRP, TC and TG were higher in the elderly with diabetes only, than that in control subjects (Plt;0.05). LDL-C was higher in senile women with diabetes only, than that in female control subjects (Plt;0.05). Serum cystatin C with LDL-C in elderly women with diabetes only, with FPG in female diabetes subjects with cardiovascular and cor, cerebrovascular diseases had position correlation (Plt;0.05). No correlation were observed between serum cystatin C and hs-CRP in male and female diabetes subjects, and lipid in male diabetes subjects. Conclusions We speculate that high serum lipid, high glucose and low level of inflammation may result in increasing of serum cystatin C in senily people with diabetes. The influence of serum lipid on serum cystatin C may be different in male and female senile people.Along with atherosclerotic aggravating, the level of serum cystatin C was increasing.
ObjectiveTo review the latest advances in diagnosis and treatment of gallbladder carcinoma.MethodsThe recent literatures on diagnosis and treatment of gallbladder carcinoma at home and abroad were reviewed, and the diagnosis, staging and treatment progress of gallbladder carcinoma were systematically reviewed.ResultsThere are many methods to diagnose gallbladder carcinoma, among which imaging methods are commonly used, as well as various tumor markers and gallbladder carcinoma-related genes. Surgical resection is still the only possible cure for gallbladder carcinoma, but the scope and timing of surgical resection are still controversial. Radiotherapy, chemotherapy and gene therapy also play an important role in the treatment of gallbladder carcinoma.ConclusionsImaging examination is still the first choice for the diagnosis of gallbladder carcinoma. The tumor markers and gene diagnosis has broad prospects. Gallbladder carcinoma is mainly treated by surgery. Gene intervention and precise targeted therapy are the future development direction.
Objective To investigate the management experience of type Ⅱ endoleak originating from inferior mesenteric artery (IMA) after endovascular abdominal aortic aneurysm repair (EVAR). Methods The clinical data of patients with type Ⅱ endoleak originating from IMA after EVAR treated in the Department of Vascular Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University from October 2016 to November 2021 were collected and analyzed. Results There were 12 males and 3 females at age of 57-89 (68.00±7.84) years. Eleven patients received embolization of the abdominal aortic aneurysm lumen and initial segment of the IMA via the superior mesenteric artery-middle colic artery-Riolan arch-left colic artery-IMA route. Three patients received embolization of the initial segment of the IMA by the above route. One patient underwent open dissection of the abdominal aortic aneurysm, and orifice of IMA was sutured in the aneurysm cavity while stents were retained. All 15 patients were successfully treated by surgery. The symptoms of back pain, abdominal pain and abdominal distension disappeared in 6 patients after surgery. Neither perioperative deaths nor complications happened during the treatment and follow-up period. The median follow-up time was 11.00 (9.00, 18.00) months. Two patients with typeⅡendoleak recurred during the follow-up period and were admitted to hospital for secondary embolization. No recurrence was observed at 12 months postoperative follow-up. Conclusion Type Ⅱ endoleak is one of the most common complications after EVAR. IMA is the most common criminal origin of typeⅡendoleak. TypeⅡendoleak that lead to persistent expansion of the aneurysm cavity requires aggressive intervention.
ObjectivesTo systematically review the prevalence of rosacea in China.MethodsPubMed, The Cochrane Library, EMbase, CNKI, WanFang Data and VIP databases were electronically searched to collect literature of the prevalence of rosacea in China from inception to September 5th, 2018. Two reviewers independently screened literature, extracted data and then meta-analysis was performed by using Stata 12.0 software.ResultsA total of 54 studies were included. The pooled prevalence of rosacea from 44 population-based or community-based studies was 0.27% (95%CI 0.22 to 0.32) and from 10 hospital-based studies was 1.47% (95%CI 1.08 to 1.86). Based on population-based or community-based studies, the highest prevalence was in the early 1980s (2.19%), followed by a gradual decline, to the lowest (0.17%) in the early 1990s, after that the prevalence increased to 1.24% till 2015. Based on hospital-based studies, the prevalence had a maximum of 4.64% in the past decade. The Northwest China and North China had higher prevalence of rosacea (population-based or community-based studies: 1.24% in Northwest China, 1.1% in North China; hospital-based studies: 6.03% in Northwest China, 2.83% in North China). The prevalence in East China and South China was relatively low (population-based or community-based studies: 0.02% in East China and 0.32% in South China; Hospital-based studies: 0.28% in South China). The prevalence of rosacea in female (0.36%) was higher than that of male (0.19%) in population-based or community-based studies.ConclusionsIn China, the pooled prevalence of rosacea is 0.27% in population-based or community-based studies and 1.47% in hospital-based studies. Rosacea is common in North China and Northwest China. Female has higher prevalence than male.
Objective To assess the efficacy and safety of adalimumab on plaque psoriasis. Methods We searched the MEDLINE (1966 to December 2009), Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 12, 2009), EMbase (1980 to December 2009), CBM (1978 to December 2009), and CNKI (1979 to December 2009) to collect randomized controlled trials (RCTs) of adalimumab for plaque psoriasis. The language was confined to English and Chinese. We screened the retrieved studies according to the predefined inclusion and exclusion criteria, evaluated the quality of included studies, and performed meta-analyses by using the Cochrane Collaboration’s RevMan 4.2 software. Results Three RCTs involving 1?630 patients with chronic moderate or severe plaque psoriasis were included and assessed. At the end of 4th, 8th, 12th and 16th week, the PASI 75s of subcutaneous injection every other week in adalimumab (EOW) group were obviously higher than that of placebo group and methotrexate group. While at the end of 24th week and 60th week, the PASI 75s showed no difference between adalimumab EOW and placebo group. Twelve weeks after subcutaneous injection each week with adalimumab (QW), PASI 75 was obviously higher than those of placebo and EOW groups. However, at the end of 24th week and 60th week, there was no significant difference between adalimumab QW and placebo followed by adalimumab EOW. At end of week 12-16, there was no difference between adalimumab EOW group and placebo group in the incidence of adverse effects, with the exception of pain on injection site and upper respiration viral infection. At week 12-60, there was no difference between adalimumab QW and EOW groups in the incidence of adverse effects, with the exception of all serious adverse effects. Conclusion The limited evidence indicates that subcutaneous injection of adalimumab every other week for 12-16 weeks is safe and efficient for patients with moderate or severe plaque psoriasis. The efficacy can’t be enhanced when the treatment is prolonged to 24 weeks. The once-a-week protocol has no obvious advantage over every other week protocol. More RCTs are required to verify these conclusions owing to the limitations of the present study.
ObjectiveTo evaluate the clinical value of in vitro fenestration and branch stent repair in the treatment of thoracoabdominal aortic aneurysm in visceral artery area assisted by 3D printing.MethodsThe clinical data of 7 patients with thoracoabdominal aortic aneurysm involving visceral artery at the Department of Vascular Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University from March 2016 to May 2019 were analyzed retrospectively. There were 5 males and 2 females with an average age of 70.2±3.9 years. Among them 4 patients had near-renal abdominal aortic aneurysm, 3 had thoracic aortic aneurysm, 4 had asymptomatic aneurysm, 2 had acute symptomatic aneurysm and 1 had threatened rupture of aneurysm. According to the preoperative CT measurement and 3D printing model, fenestration technique was used with Cook Zenith thoracic aortic stents, and branch stents were sewed on the main stents in vitro, and then the stents were modified by beam diameter technique for intracavitary treatment.ResultsAll the 7 patients completed the operation successfully, and a total of 18 branch arteries were reconstructed. The success rate of surgical instrument release was 100.0%. The average operation time was 267.0±38.5 min, the average intraoperative blood loss was 361.0±87.4 mL and the average hospital stay was 16.0±4.2 d. Immediate intraoperative angiography showed that the aneurysms were isolated, and the visceral arteries were unobstructed. Till May 2019, there was no death, stent displacement, stent occlusion, ruptured aneurysm or loss of visceral artery branches. Conclusion3D printing technology can completely copy the shape of human artery, intuitively present the anatomical structure and position of each branch of the artery, so that the fenestration technique is more accurate and the treatment scheme is more optimized.
