Résumé
Cranial magnetic resonance imaging (MRI) examinations were performed in 419 patients with type 2 diabetes mellitus (T2DM) from June to December 2016.The brain white matter lesions were defined by white matter hyperintensity (WMH) in MRI,which was detected in 380 cases (WMH group) and not detected in 39 cases (non-WMH group).The Montreal Cognitive Assessment (MoCA) was used to evaluate the cognitive function.The study showed that there were significant differences in the duration of diabetes,the proportion of hypertension,total cholesterol (TC) and MoCA scores between the two groups (all P＜0.05).The age,duration of diabetes,hypertension and glyclated hemoglobin (HbA1c) were significantly correlated with white matter lesions(OR=1.157,1.116,5.184,1.128;P＜0.05);and the white matter lesions,age,and body mass index (BMI) were significantly correlated with cognitive dysfunction in diabetic patients (OR=2.137,1.175,1.247;P＜0.05).The study result indicates that control of white matter lesions may prevent and improve cognitive dysfunction in T2DM patients.
Résumé
Objective To discuss the relationship between and value of Leptin with disorder of lipid metabolism in gestational diabetes mellitus. Method Research objects are divided into three groups including GDM group, normal glucose tolerance group (NGT group), normal non-pregnant group. Blood lipid, fasting blood glucose, fasting insulin, serum leptin and placental leptin levels were detected and HOMA-IR was calculated. Result (1) Serum leptin, TC, TG, placental leptin and HOMA-IR in GDM group were higher than those of NGT group and TC, serum leptin and HOMA-IR of NGT group were higher than those of control group. There were statistical significances (P<0.05). (2)Serum leptin levels were positively correlated with BMI, HOMA-IR, TC and TG respectively (r = 0.593, 0.688, 0.722, 0.492 respectively, P < 0.05). Conclusion Leptin may cause lipid metabolism disorders, and together they participate in the pathogenesis of GDM. Maternal serum leptin level is expected to become an observation index of GDM.
Résumé
Objective To study the effects of cardiovascular and stress responses and the feasibility during thoracic surgery for geriatric patients under general anesthesia combined with epidural block. Methods Thirty elderly patients ASAⅠ-Ⅱ, scheduled for elective thoracic surgery, were divided randomly into combined general and epidural anesthesia group(G+E)and general anesthesia group(G). In both groups general anesthesia was induced with propofol 1.5mg/kg, fentanyl 4?g/kg, atracurium 0.6mg/kg, and maintained with intravenous continuously of propofol 5～7 mg?kg -1 ?h -1 , intermittent iv bolus of fentanyl and atracurium. In group GE epidural was performed at T_ 5-9 and an epidural catheter was placed and 1% lidocain 5 ml was given before induction of general anesthesia, after intubation and remained the cardiovascular stable, 1% lidocain 5～10 ml was infused epidural space. Appropriate fentanyl was given before skin incision for analgesia. Blood samples were taken before anesthesia, 10 min, 30 min, 1 h, 2 h after skin incision and the end of surgery for determining of cortisol, norepinephrine(NE), epinephrine(E)and interleukin-6(IL-6); measured and recorded the mean artery pressure(MAP), heart rate(HR), general anesthetic dosage and the duration of postoperative revival. Results In group GE, serum cortisol at 10 min,30 min and 1 h after skin incision decreased significantly compared with those in group G( P