目的:研究羅格列酮(ROS)治療2型糖尿病,對患者組織胰島素敏感性與血清炎癥介質改變的關系。方法:選取符合1999年WHO標準確診的2型糖尿病患者30例。試驗采用前后自身配對方法。口服ROS 4mg每天一次,總療程8周。測定指標包括常規臨床檢查項目、血糖,同時檢測血漿胰島素水平,糖化血紅蛋白(HbA1c)水平、C反應蛋白(CRP)、白細胞介素6(IL-6)、腫瘤壞死因子-α(TNF-α)水平,以 HOMA模型和胰島素鉗夾試驗評價組織胰島素敏感性。結果:應用ROS治療的2型糖尿病患者組織胰島素敏感性顯著改善(Plt;0.05),并降低血漿CRP、IL-6、TNF-α水平,這些炎癥介質的改變與組織胰島素敏感性的改變相關。結論:應用ROS治療2型糖尿病能降低患者血漿炎癥介質水平,減輕胰島素抵抗,延緩或減輕糖尿病大血管并發癥的發生發展。
ObjectiveTo investigate the impact of comprehensive interventions on the prevention of the incidence of surgical site infection (SSI) after hip or knee arthroplasty.MethodsPatients who underwent total hip and knee arthroplasty for the first time in orthopedics department of Chengdu Fifth People’s Hospital from January 2016 to March 2018 were selected. The patients were observed after surgery for 1 year, and divided into the control group and the treatment group according to the odd or even hospitalization number. Basic precautions were taken in the control group, while further comprehensive preventive measures (preoperative chlorhexidine bath, intraoperative body temperature maintenance, using antibacterial film over surgery area without shearing, health and education after discharge from hospital) were taken in the treatment group. The incidence of SSI of the two groups was compared to evaluate the effects of comprehensive interventions.ResultsA total of 341 patients were included, including 174 in the control group and 167 in the treatment group. No one failed to be followed up. Among the 341 patients undergoing surgery, 13 had SSI, including 11 (6.3%) in the control group and 2 (1.2%) in the treatment group. The incidence of SSI in the treatment group was lower than that in the control group (χ2=6.102, P=0.014). Single factor analysis showed that sex (χ2=10.933, P=0.001), preoperative chlorhexidine sponge bath (χ2=8.837, P=0.003), intraoperative thermal insulation (χ2=13.917, P<0.001), health education (χ2=12.671, P<0.001), skin preparation methods (χ2=6.102, P=0.014), perioperative blood glucose control (χ2=17.512, P=0.003), and surgical type (χ2=8.360,factor P=0.004) were the effect factors of occurrence of SSI. Logistic regression analysis showed that surgical type [odds ratio (OR)=0.129, 95% confidence interval (CI)(0.026, 0.640), P=0.012] and strict blood glucose control [OR=9.868, 95%CI (2.158, 45.131), P=0.003] were the independent factors affecting the occurrence of SSI.ConclusionsComprehensive intervention measures can effectively reduce the occurrence of SSI after hip and knee arthroplasty. It is not confirmed that preoperative chlorhexidine bath can reduce the occurrence of SSI. But choosing selective operation and controlling the perioperative blood glucose below 200 mg/dL can reduce the risk of SSI.
Objective To investigate the death rate and life lost of the Xinjian district residents in Nanchang city, and to provide scientific evidence for the health administrators to formulate relevant policies and improve the life expectancy of the residents. Methods Based on the population and the death data in this area from 2011 to 2015, the mortality, the cause of death spectrum, the life expectancy, the life expectancy for death causes, the potential years of life lost (PYLL), the potential years of life lost rate (PYLLR), the average potential years of life lost (APYLL), the standardized potential years of life lost (SPYLL), the standardized potential years of life lost rate (SPYLLR) were analyzed by SPSS 20.0 software. Results From 2011 to 2015, the crude death rate of Xinjian district was 538.38/10 million, the standardized mortality rate was 563.00/10 million, the crude death rate of males is higher than that of females (χ2=788.91, P<0.01); the causes of death in the top five were follows: circulatory system diseases, tumor, respiratory system diseases, injury, endocrine, nutrition and metabolic diseases. The causes of death were in the same order whether in male or female. Mortality rates of different age groups showed that the mortality rates began to rise substantially after the age of 30, the main causes of death were different between the low age group and the high age group. The life expectancy of residents was 78.38 years, the PYLL for all causes of death was 129 087.5 years, the PYLLR was 39.84‰, the APYLL was 17.44 years, the SPYLL was 134 057.00 years, the SPYLLR was 38.61‰. The PYLL caused by injury was 46 191.5 years, the PYLLR was 14.26‰, APYLL was 33.14 years, of which were all ranked first. The SPYLL caused by tumor was 48 414.95 years, the SPYLLR was 13.94‰, of which were ranked first. Conclusion The mortality rate of Xinjian district residents is higher than that of Nanchang urban residents, but lower than the average level of Jiangxi province and the whole country. Life reduction analysis shows that chronic non-communicable diseases and injuries are the main causes of death for residents in the area. The three levels prevention is of great significance to reduce the death of residents and improve their life expectancy.
ObjectiveTo systematically review the safety of hand disinfectants. MethodsPubMed, EMbase, The Cochrane Library, INAHTA, WanFang Data, CNKI and VIP databases were electronically searched to collect studies on the safety of hand disinfectants from inception to February 1st, 2021. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies; then, a systematic review was conducted. ResultsA total of 50 studies were included. The reported adverse events were eye and nasal mucosal irritation, hand adverse events with skin itching, rash, erythema, edema and so on. A total of 29 brands such as 3M Avagard and 26 ingredients such as ethanol were reported to be related to the above adverse events. Hand disinfectants containing glycerin, silicone oil, vitamin B, plant extracts and other emollients could reduce the incidence of adverse events. ConclusionCurrent evidence shows that hand disinfectants containing emollients and free from ethanol, chlorhexidine and other ingredients are related to fewer adverse events. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.