摘要:目的:探討經尿道前列腺電切術中糖尿病患者血糖變化以及處理對策。方法:2006年7月~ 2009年1月共對80例患有前列腺增生合并糖尿病患者行TURP,同期對80例單純性前列腺增生患者進行相同手術,回顧分析其術前、術中30 min、60 min、90 min 指尖血糖變化及干預情況。結果:治療組80例患者,51例術中血糖值明顯低于術前,分別為1.8～3 mmol/L;對照組術前與術中血糖值基本一致,血糖波動于4.5～5.6 mmol/L。結論:糖尿病患者糖的儲備能力差,在行經尿道電切術中易發生低血糖綜合征,術中及時的血糖監測及干預對保證患者的安全有重要意義。Abstract: Objective: To study the changes and measures against the glucose in the operation of the Diabetes by TURP. Methods:Eighty patients with prostate combining diabetes operated from July 2006 to Jan. 2009 were reviewed, and 80 prostate treated at the same period with the same operation measure were selected as control. The preoperative glucose, intraoperative glucose (30′, 60′,90′) of fingertip, and countermeasures were studied and compared between the two groups. Results:Fiftyone cases of the experimental group of intraoperative blood glucose was significantly lower than preoperative values, respectively 1.83 mmol/ L; control group preoperative and intraoperative blood glucose values were basically the same, blood glucose fluctuations in the 4.55.6 mmol/L. Conclusion: The capacity in patients with diabetes is poor, easy to hypoglycemia syndrome in the act of TURP surgery, intraoperative blood glucose monitoring and timely intervention to ensure patient safety significance.
Objective To investigate the correlation between stress hyperglycemia ratio (SHR) and acute ischemic stroke (AIS) 1-year prognosis, to provide more clinical basis to improve the prognosis of AIS patients and to target and control the influencing factors. MethodsThe patients with AIS diagnosed for the first time and received treatment at the Shijiazhuang Fifth Hospital between May 2019 and January 2022 were retrospectively and continuously included. According to the Modified Rankin Scale score 1-year after the onset of the disease, the patients were divided into a good prognosis group and a poor prognosis group. Also the patients were divided into 2 groups based on the median of SHR. The correlation between SHR and stress blood glucose was analyzed, and the factors affecting the prognosis of AIS patients were identified. The predictive value of SHR and stress blood glucose on the prognosis of AIS patients was compared using receiver operating characteristic. Results A total of 206 patients were included. Among them, there were 125 cases (60.7%) in the good prognosis group and 81 cases (39.3%) in the poor prognosis group. The median SHR (lower quartile, upper quartile) is 1.20 (1.08, 1.33). There were statistically significant differences between the two groups in the scores of the National Institutes of Health Stroke Scale, diabetes history, hypertension history, low-density lipoprotein cholesterol, stress blood glucose, age, SHR and SHR classification (P<0.05). There was no statistically significant difference in the other indicators compared between the two groups (P＞0.05). Stress blood glucose was positively correlated with SHR (7.95±1.78 vs. 1.21±0.19; r=0.294, P<0.001). Multivariate logistic analysis showed that stress blood glucose and SHR were independent factors influencing the 1-year prognosis of AIS patients (P<0.05), and the interaction between SHR and diabetes was not significant (P>0.05) After adjusting for confounding factors, the area under the receiver operating characteristic curve of SHR for the prognosis of AIS patients was higher than that of stress blood glucose [0.682 (0.614, 0.745) vs .0.585 (0.515, 0.653); Z=2.042, P=0.041]. Conclusions SHR and stress blood glucose are independent risk factors for 1-year prognosis in AIS patients. However, SHR has a better predictive value for 1-year prognosis in AIS patients than stress blood glucose. Whether the patient has diabetes or not, the impact of SHR on the prognosis of AIS patients is consistent.
ObjectiveTo explore the prognostic value of fasting blood glucose concentration in patients with newly diagnosed lung cancer.MethodsThe clinical data of 956 patients with lung cancer who were first diagnosed at West China Hospital of Sichuan University between January 2008 and December 2011 were retrospectively analyzed. The patients were followed up for more than 5 years. Using the fasting blood glucose concentration of 6.1 mmol/L as the cut-off value, the patients were divided into the hyperglycemia group and the control group. Kaplan-Meier method was used for survival analysis, and log-rank test was used to analyze the survival of different groups. Univariate and multivariate Cox proportional hazard models were used to evaluate the prognostic variables.ResultsThere were 166 patients in the hyperglycemia group with a 5-year overall survival rate of 23.5%, and 790 patients in the control group with a 5-year survival rate of 30.8%, and the difference between the two groups was statistically significant (P=0.008). Univariate Cox proportional hazard analysis found that blood glucose concentration, gender, age, smoking history, staging, and whether surgery were factors that affected the 5-year survival rate of patients (P<0.05); multivariate Cox proportional hazard analysis showed that blood glucose concentration [hazard ratio (HR)=1.235, 95% confidence interval (CI) (1.013, 1.504), P=0.036], age [HR=1.305, 95%CI (1.110, 1.534), P=0.001], smoking history [HR=1.210, 95%CI (1.033, 1.418), P=0.018], staging [HR=1.546, 95%CI (1.172, 2.040), P=0.002], and whether surgical treatment [HR=0.330, 95%CI (0.257, 0.424), P<0.001] were independent factors which influenced 5-year survival rate. Blood glucose concentration, age, smoking history, and staging were independent risk factors.ConclusionFasting blood glucose concentration is able to be a prognostic factor for patients with newly diagnosed lung cancer.
The use of non-invasive blood glucose detection techniques can help diabetic patients to alleviate the pain of intrusive detection, reduce the cost of detection, and achieve real-time monitoring and effective control of blood glucose. Given the existing limitations of the minimally invasive or invasive blood glucose detection methods, such as low detection accuracy, high cost and complex operation, and the laser source's wavelength and cost, this paper, based on the non-invasive blood glucose detector developed by the research group, designs a non-invasive blood glucose detection method. It is founded on dual-wavelength near-infrared light diffuse reflection by using the 1 550 nm near-infrared light as measuring light to collect blood glucose information and the 1 310 nm near-infrared light as reference light to remove the effects of water molecules in the blood. Fourteen volunteers were recruited for in vivo experiments using the instrument to verify the effectiveness of the method. The results indicated that 90.27% of the measured values of non-invasive blood glucose were distributed in the region A of Clarke error grid and 9.73% in the region B of Clarke error grid, all meeting clinical requirements. It is also confirmed that the proposed non-invasive blood glucose detection method realizes relatively ideal measurement accuracy and stability.
ObjectiveTo explore the relationship between blood glucose variability index and persistent organ failure (POF) in acute pancreatitis (AP). MethodsWe prospectively included those patients who were diagnosed with AP with hyperglycemia and were hospitalized in the West China Center of Excellence for Pancreatitis of West China Hospital of Sichuan University from July 2019 to November 2021. The patients were given blood glucose monitoring at least 4 times a day for at least 3 consecutive days. The predictive value of blood glucose variability index for POF in patients with AP was analyzed. ResultsA total of 559 patients with AP were included, including 95 cases of POF. Comparing with those without POF, patients with AP complicated by POF had higher levels of admission glucose (11.0 mmol/L vs. 9.6 mmol/L), minimum blood glucose (6.8 mmol/L vs. 5.8 mmol/L), mean blood glucose (9.6 mmol/L vs. 8.7 mmol/L), and lower level of coefficient of variation of blood glucose (16.6 % vs. 19.0 %), P<0.05. Logistic regression analyses after adjustment for confounding factors showed that the risk of POF increased with the increase of admission glucose [OR=1.11, 95%CI (1.04, 1.19), P=0.002], minimum blood glucose [OR=1.28, 95%CI (1.10, 1.48), P=0.001] and mean blood glucose [OR=1.18, 95%CI (1.04, 1.33), P=0.010]; with the higher level of coefficient of variation of blood glucose [OR=0.95, 95%CI (0.92, 0.99), P=0.021], the risk of POF decreased. The results of area under the curve (AUC) of the receiver operator curves showed that AG [AUC=0.787, 95%CI (0.735, 0.840)] had the highest accuracy in predicting POF, with sensitivities of 60.0% and specificities of 84.7%. ConclusionHigh admission glucose, minimum blood glucose, mean blood glucose, and low coefficient of variation of blood glucose were risk factors for the development of POF in patients with hyperglycemic AP on admission.
Existing near-infrared non-invasive blood glucose detection modelings mostly detect multi-spectral signals with different wavelength, which is not conducive to the popularization of non-invasive glucose meter at home and does not consider the physiological glucose dynamics of individuals. In order to solve these problems, this study presented a non-invasive blood glucose detection model combining particle swarm optimization (PSO) and artificial neural network (ANN) by using the 1 550 nm near-infrared absorbance as the independent variable and the concentration of blood glucose as the dependent variable, named as PSO-2ANN. The PSO-2ANN model was based on two sub-modules of neural networks with certain structures and arguments, and was built up after optimizing the weight coefficients of the two networks by particle swarm optimization. The results of 10 volunteers were predicted by PSO-2ANN. It was indicated that the relative error of 9 volunteers was less than 20%; 98.28% of the predictions of blood glucose by PSO-2ANN were distributed in the regions A and B of Clarke error grid, which confirmed that PSO-2ANN could offer higher prediction accuracy and better robustness by comparison with ANN. Additionally, even the physiological glucose dynamics of individuals may be different due to the influence of environment, temper, mental state and so on, PSO-2ANN can correct this difference only by adjusting one argument. The PSO-2ANN model provided us a new prospect to overcome individual differences in blood glucose prediction.
Objective To investigate the long-term dynamic changes of liver function and glucose-lipid metabolism in human immunodeficiency virus (HIV)-infected patients with metabolic dysfunction-associated fatty liver disease (MAFLD) after antiretroviral therapy (ART). Methods HIV-infected patients who visited Public Health Clinical Center of Chengdu between October 1st, 2012 and June 30th, 2013 were recruited and divided into two groups according to whether they had MAFLD or not. All of them were treated with the first-line regimen of tenofovir + lamivudine + efavirenz for 156 weeks, and the anthropometric indices, liver function, and levels of glucose, lipids and uric acid were measured at baseline and at each follow-up time point. In addition, the long-term dynamic characteristics of liver function and glucose and lipid metabolism parameters of the two groups were compared during the 156 weeks of ART treatment. Results A total of 61 male HIV-infected patients were enrolled. The prevalence of MAFLD in them was 31.1% (19/61) at baseline and increased by 4.9 percentage points per year after ART. Before the start of follow-up (week 0), the levels of alanine aminotransferase (ALT) [(46.23±27.09) vs. (28.00±17.43) U/L, P=0.002] and γ-glutamyl transpeptidase (GGT) [(41.46±9.89) vs. (24.02±10.72) U/L, P<0.001] were higher in the MAFLD group than those in the non-MAFLD group, while the between-group differences in the levels of aspartate aminotransferase (AST) [(33.33±15.61) vs. (28.98±12.43) U/L, P=0.248] and alkaline phosphatase [(85.30±21.27) vs. (83.41±24.47) U/L, P=0.773] were not statistically significant. During the 156-week follow-up period, the 4 items of liver function gradually increased in the MAFLD group, especially from week 120 onwards, 3 of which (ALT, AST and GGT) were significantly higher than those in the non-MAFLD group (P<0.05). In addition, the levels of fasting blood glucose, triglyceride, total cholesterol, and low-density lipoprotein were also significantly higher in the MAFLD group than those in the non-MAFLD group at some time points during the 156-week follow-up period (P<0.05). Conclusions Compared with HIV-infected patients without MAFLD, HIV-infected patients with MAFLD are more likely to develop impaired liver function and disorders of glucose and lipid metabolism during long-term tenofovir + lamivudine + efavirenz regimen ART treatment. Therefore, close clinical monitoring of liver function and glucose and lipid metabolism related parameters is required for such patients.
ObjectiveTo investigate the change of blood glucose and its clinical significance in patients with acute pancreatitis (AP). MethodsThe regularity of blood glucose change and the relation between the regularity and the prognosis were analyzed in 115 patients with AP and hyperglycemia.ResultsBlood glucose was increased with a median (M) of 8.7 mmol/L，18.45 mmol/L and 27.22 mmol/L, which gradually decreased to normal value within 3-17 days, 7-26 days and 24-46 days after treatment,respectively in patients with mild AP, type Ⅰ of severe acute pancreatitis (SAP) and type Ⅱ of SAP. There was marked statistical difference among the three groups. A smaller dose of regular insulin was used for 36 patients with mild AP; however, a larger dose of regular insulin was used for all 30 patients with SAP.ConclusionThe level of blood glucose, the dose of regular insulin and the duration of hyperglycemia increase with the severity of AP.
For the near-infrared (NIR) spectral analysis of the concentration of blood glucose, the calibration accuracy can be affected because of the existing of outlier samples. In this research, a Monte-Carlo cross validation (MCCV) method is constructed for eliminating outlier samples. The human blood plasma experiment in vitro and the human body experiment in vivo were introduced to evaluate the MCCV method for its application effect in NIR spectral analysis of blood glucose. And the uninformative sample elimination method based on modified uninformative variable elimination (MUVE-USE) was employed in this study for the comparison with MCCV. The results indicated that, like the MUVE-USE method, the outlier samples elimination method based on MCCV could be used to eliminate the outlier samples which came from gross errors (such as bad sample) or system errors (such as baseline drift). In addition, the outlier samples from the random errors of uncertain causes which affect model accuracy can be eliminated simultaneously by MCCV. The elimination of multiple outlier samples is beneficial to the improvement of prediction accuracy of calibration model.
ObjectiveTo understand the relation between blood glucose regulating hormones and gastric cancer, so as to provide some new ideas for diagnosis and treatment of gastric cancer. MethodBy reviewing and screening relevant domestic and foreign literatures, the latest researches on the relation between blood glucose regulating hormones and gastric cancer were summarized. ResultsThe insulin, glucagon, adrenaline, growth hormone, and the other blood glucose regulating hormones all played the roles in promoting the occurrence and development of gastric cancer. However, glucocorticoids and somatostatin were protective hormones that maintained gastric homeostasis and inhibited the proliferation of gastric cancer cells. ConclusionBlood glucose regulating hormones play some roles in diagnosis and treatment of gastric cancer, but specific mechanisms such as interaction between blood glucose regulating hormones, role of glucose metabolism in biological behavior of gastric cancer, and effect of blood glucose regulating hormones on oncogene initiation are unclear, so prospective clinical control studies still need to be studied.
