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With the changes of lifestyle, type 2 diabetes mellitus(T2DM) is spreading among the adolescents. T2DM in adolescents is distinct from type 1 diabetes mellitus and T2DM in adults. T2DM in adolescent progresses more rapidly and is more difficult to treat than that in adults. The prevention and therapy of T2DM in youth is facing severe challenges. This article reviews the epidemiology, pathophysiology, risk factors, comorbidities and complications of T2DM in adolescents as well as evidence-based clinical trials for the management of this disease based on the related hot spots of the 81 st annual meeting of the American Diabetes Association and the results from the latest clinical trials, so as to provide enough reference for the formulation of clinical strategies of T2DM in adolescents.
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Objective:To analyze the changes in T lymphocyte subsets, B lymphocytes and NK cells in children with active tuberculosis (TB) and their clinical significance.Methods:T lymphocyte subsets, B lymphocytes and NK cells in peripheral blood samples of 106 patients with acute TB (TB group) and 106 healthy children (healthy control group) were detected by flow cytometry and compared between different groups.Results:The percentages of CD3 + T, CD4 + T and NK cells as well as the CD4 +/CD8 + T cell ratio were significantly lower in the TB group than in the healthy control group ( Z=-3.783, P=0.000; Z=-5.401, P=0.000; Z=-3.434, P=0.001; Z=-2.014, P=0.044). The percentages of double negative T (DNT) and B cells in the TB group were significantly higher than those in the healthy control group ( Z=2.765, P=0.006; Z=6.880, P=0.000). No significant difference in the percentage of CD8 + T or double positive T (DPT) cells was observed between the two groups ( P>0.05). The expression of peripheral lymphocyte subsets varied in TB children of different age groups (0-<3, 3-<6, 6-<10 and 10-<16 years old). There were significant differences in CD3 + T, DNT and B cells among the four age groups ( H=10.081, P=0.018; H=14.583, P=0.002; H=8.498, P=0.037). The percentage of CD4 + T cells was significantly lower in children with extrapulmonary TB than in those with pulmonary TB ( Z=-3.068, P=0.002). No statistically significant difference in other lymphocyte subsets was found between children with extrapulmonary and pulmonary TB ( P>0.05). Conclusions:Tuberculosis could lead to immune dysfunction in children. Dynamic monitoring of the changes in peripheral lymphocyte subsets in children with TB could be conducive to better assessment of immune status and providing personalized treatment.
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Diagnostics is one of the most important bridge courses for medical students from basic to clinical. Doctor-patient communication runs through the whole process of patient diagnosis and treatment. How to improve medical students' ability of doctor-patient communication? Our teaching team has carried out continuous reform and explored the scientific effective teaching mode. Recently, through the construction of "doctor-patient communication skills" quality online course, efforts have made to build an online and offline blended learning mode, which has gradually realize the integration with diagnostics teaching, and has achieved remarkable results. It also provides a scientific practical basis for the integration of doctor-patient communication and other clinical courses, which is worthy of promotion.
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Maffucci syndrome is characterized by multiple enchondromas and multiple hemangiomas. Here we report on a 24-year-old woman who was diagnosed with Maffucci syndrome. Our report reviews the literature and outlines of the treatment and management plans for patients with this rare and potentially dangerous disease.
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OBJECTIVE@#To explore the effectiveness of systematic self-management education on blood sugar level of patients in the community with type 2 diabetes.@*METHODS@#A total of 248 patients with type 2 diabetes from 10 communities of Changsha were randomized into intervention or control groups in February 2009. The intervention group received systematic self-management education, while the other received routine community education. Before and after intervention, fasting plasma glucose, 2 h postprandial plasma glucose and glycosylated hemoglobin were measured, and evaluated between the 2 groups.@*RESULTS@#Fasting plasma glucose, 2 h postprandial plasma glucose and glycosylated hemoglobin levels of patients with diabetes from the two groups were generally comparable at baseline (P>0.05). After the intervention, these three indicators were all statistically significant between the 2 groups (P0.05), 2 h plasma glucose and glycosylated hemoglobin levels were improved (P<0.01, P<0.05, respectively).@*CONCLUSION@#Systematic self-management education effectively encourages patients with type 2 diabetes to control their blood sugar levels, and deserves further promotion.
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Blood Glucose , China , Diabetes Mellitus, Type 2 , Blood , Therapeutics , Health Education , Methods , Patient Education as Topic , Methods , Self Care , Methods , Self ReportABSTRACT
OBJECTIVE@#To explore the effect of systematic self-management education on quality of life, anxiety and depression of patients with Type 2 diabetes in communities.@*METHODS@#A total of 248 patients with Type 2 diabetes from 10 communities of Changsha from February 2009 to July 2010 were randomized into an intervention group and a control group. The intervention group received systematic self-management education, while the controls received routine community education. The quality of life, anxiety and depression were measured by adjusted diabetes-specific quality of life scale (A-DQOL), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) respectively.@*RESULTS@#The quality of life, morbidity of anxiety or depression of the intervention and the control group were comparable at the baseline (P>0.05). One and half year later, there was significant difference between the two groups (P<0.01). Compared with the control group, the intervention group got better quality of life (P<0.01), less morbidity of anxiety (8.94% vs. 44.4%, P<0.01) and depression (23.58% vs. 56.00%, P<0.01).@*CONCLUSION@#Systematic self-management education can effectively improve the quality of life, reduce the level of anxiety and depression of patients with Type 2 diabetes in communities, which deserves further generalization.
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Anxiety , Psychology , Depression , Psychology , Diabetes Mellitus, Type 2 , Psychology , Health Education , Methods , Quality of Life , Self Care , MethodsABSTRACT
Objectives To investigate the effects of glucose on apoptosis rate of cultured endothelial progenitor cells (cEPCs). Methods The peripheral blood of healthy adults was isolated by density gradient centrifugation, and mononuclear cells (MNCs) were inducted to differentiate at cultured conditions.EPCs were identified by Dil-acLDL and FITC-UEA-1 as double fluorescent-positive cells. The effectsof glucose at different concentrations on apoptosis rate of the harvested EPCs were measured by fluorescent microscope and fluorescence-activated cell sorting (FACS) after staining with Annexin V-FITC and PI. Results No significant differences were observed in apoptosis rate between samples treatedwith 5.6mmol/l glucose and 11. 1 mmol/l. P ＞0. 05). 25.5 mmol/L glucose enhanced the EPCsapoptosis rate in a time-dependent manner( P ＜0. 05). Conclusion High concentration glucose can accelerate apoptosis rate of EPCs in a time-dependent manner.
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Objective To sum up the clinical characteristics of diabetic neuropathy (DN), and explore the risk factors of DN. Methods The Clincial characteristics of 452 cases of type 2 diabetic patients with DN were reviewed retrospectively, and the factors related with DN were statistically analyzed. Results Peripheral neuropathies were more common than automatic neuropathies in type 2 diabetes mellitus. Lipidic metabolism disturbance, long course of disease and poor control of postprandial hyperglycemia were positive correlation with the frequency of DN. Conclusion Peripheral neuropathy is the most common one in DN. The risk factors of DN include lipidic metabolism disturbance, long course of diabetes and bad control of systolic pressure.