Diabetic neuropathies are a family of nerve disorders caused by diabetes. Symptoms of the disease include nerve palsy, mononeuropathy, mononeuropathy multiplex, diabetic amyotrophy, painful polyneuropathy, autonomic n...
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Diabetic neuropathies are a family of nerve disorders caused by diabetes. Symptoms of the disease include nerve palsy, mononeuropathy, mononeuropathy multiplex, diabetic amyotrophy, painful polyneuropathy, autonomic neu- ropathy, and thoracoabdominal neuropathy. In this study, type 2 diabetes in rats was induced with nicotinamide- streptozotocin. Drug treatment was initiated on the d 15, with the combination regimen of metformin, pioglitazone and glimipiride or metformin and sitagliptin or sitagliptin, amitriptyline and sitagliptin and led to significantly im- proved glycemic control, increased grip strength and paw jumping response on d 21, 28 and 35 (P 〈 0.001). Signif- icant increases in blood protein levels and decreases in urinary protein levels were observed in the animals treated with the different regimens on d 21, 28 and 35 (P 〈 0.001). Combined treatment of streptozotocin and nicotinamide caused marked degeneration of nerve cells, while administration of metformin and sitagliptin showed tissue regen- eration and no body weight gain. In conclusion, treatment with sitagliptin and sitagliptin combined with metformin or amitriptyline results in no body weight gain, but causes an increase in grip strength and pain sensitivity, exhibits neural protection, and reverses the alteration of biochemical parameters in rats with streptozotocin-nicotinamide induced type 2 diabetes.
背景和目的下呼吸道感染常并发于卒中并对转归造成不利影响。对于并发于卒中的下呼吸道感染性疾病,目前尚无公认的专业术语或诊断金标准,这导致临床诊疗和研究受到影响。本共识旨在提出急性卒中并发下呼吸道感染的标准化术语和可操作性诊断标准。方法对多个文献数据库进行系统检索,经过证据回顾和2轮讨论,最后于2014年9月在英国曼彻斯特召开共识会议,经75%以上共识小组成员达成一致意见后形成共识。结果达成的共识如下:(1)推荐使用卒中相关性肺炎(stroke-associated pneumonia, SAP )作为卒中发病后7 d内发生的下呼吸道感染性疾病的专业术语。(2)提议对 SAP 使用经过改良的美国疾病控制预防中心(Centers for Disease Control and Prevention, CDC)诊断标准:①很可能的 SAP:符合 CDC 诊断标准,但复查或动态监测胸部 X 片仍缺乏典型改变;②确诊的 SAP:符合 CDC 诊断标准,且胸部 X 片有典型改变。(3)关于白细胞计数或 C反应蛋白在 SAP 诊断中的作用证据有限。(4)其他生物学标记物(如降钙素原)的证据不足。结论提议根据 CDC 诊断标准对 SAP 的术语和诊断制定可操作性的共识标准,需要在卒中患者中进行前瞻性研究来确定其信度、效度以及对医生行为(包括抗生素选择)和临床转归的影响。
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