Lack of conclusive beneficial effects of strict glycemic control on macrovascular complications has been very frustrating for clinicians involved in care of patients with diabetes mellitus (DM). Highly publicized cont...Lack of conclusive beneficial effects of strict glycemic control on macrovascular complications has been very frustrating for clinicians involved in care of patients with diabetes mellitus (DM). Highly publicized controversy surrounding cardiovascular (CV) safety of rosiglitazone resulted in major changes in United States Food and Drug Administration policy in 2008 regarding approval process of new antidiabetic medications, which has resulted in revolutionary data from several large CV outcome trials over the last few years. All drugs in glucagon-like peptide-1 receptor agonist (GLP-1 RA) and sodium-glucose cotransporter-2 (SGLT-2) inhibitor classes have shown to be CV safe with heterogeneous results on CV efficacy. Given twofold higher CV disease mortality in patients with DM than without DM, GLP-1 RAs and SGLT-2-inhibitors are important additions to clinician’s armamentarium and should be second line-therapy particularly in patients with T2DM and established atherosclerotic CV disease or high risks for CV disease. Abundance of data and heterogeneity in CV outcome trials results can make it difficult for clinicians, particularly primary care physicians, to stay updated with all the recent evidence. The scope of this comprehensive review will focus on all major CV outcome studies evaluating CV safety and efficacy of GLP-1 RAs and SGLT-2 inhibitors.展开更多
Diabetes mellitus (DM) is marked as global health care challenge with almost 10% of the United States population being diagnosed with DM. A sizeable percentage of patients are oblivious of their disease, in spite of e...Diabetes mellitus (DM) is marked as global health care challenge with almost 10% of the United States population being diagnosed with DM. A sizeable percentage of patients are oblivious of their disease, in spite of easily accessibility knowledge about its early signs and symptoms and rapid diagnostic modalities. Critically ill patients with undiagnosed DM are likely to have an increased mortality as compared to intensive care unit (ICU) patients with diagnosed DM. DM may have adverse effect on ICU patients causing organ failure and complications. Early Screening of patients at the risk of developing disease may prevent long term complications. Early screening and management may be beneficial as controlled DM patients have similar morbidity as non DM patients in ICU. An intense glycaemic and blood pressure control improves retinopathy and albuminuria, but may not affect the macrovascular outcomes.展开更多
Objective: To explore the effect of intravenous thrombolysis bridge stent combined with aspiration embolectomy on serological indicators in patients with intracranial macrovascular infarction. Methods: 92 patients wit...Objective: To explore the effect of intravenous thrombolysis bridge stent combined with aspiration embolectomy on serological indicators in patients with intracranial macrovascular infarction. Methods: 92 patients with intracranial macrovascular infarction who received treatment in our hospital between February 2016 and January 2018 were selected as the research subjects and divided into the control group (n=46) and the study group (n=46) by random number table method. Control group received stent embolectomy alone, and study group received intravenous thrombolysis bridge stent combined with aspiration embolectomy. The differences in serum levels of inflammatory mediators, chemokines and nerve function-related indexes were compared between the two groups before treatment and 24h after embolectomy. Results: Before treatment, the differences in serum levels of inflammatory mediators, chemokines and nerve function-related indexes were not significant between the two groups. 24h after embolectomy, serum inflammatory mediators sICAM-1, hs-CRP and TNF-α levels of study group were lower than those of control group;serum chemokines CXCL16, Fractalkine and MCP-1 contents were lower than those of control group;serum nerve function-related indexes IGF-1, BDNF and CNTF levels were higher than those of control group whereas NSE level was lower than that of control group. Conclusion:Intravenous thrombolysis bridge stent combined with aspiration embolectomy can effectively reduce the systemic inflammatory response and optimize the nerve function in patients with intracranial macrovascular infarction.展开更多
Objective:To study the enhancement maximum slope of increase of magnetic resonance angiography in patients with diabetes lower extremity arterial disease and its correlation with endothelial injury and oxidative stres...Objective:To study the enhancement maximum slope of increase of magnetic resonance angiography in patients with diabetes lower extremity arterial disease and its correlation with endothelial injury and oxidative stress.Methods: Patients with diabetes lower extremity arterial disease accepting 3D-CEMRA examination in our hospital between May 2013 and December 2015 were selected as the pathology group, and the enhancement maximum slope of increase was measured;healthy volunteers receiving physical examination in our hospital during the same period were selected as control group, and serum levels of endothelial oxidative stress injury-related molecules of two groups of subjects were determined.Results:The enhancement maximum slope of increase of the lesion-side anterior tibial artery, posterior tibial artery, peroneal artery and dorsalis pedis artery of pathology group were significantly lower than those of the unaffected-side;serum CyPA, ERK1, ERK2, Akt, JAK, HO-1 and CO content of pathology group were significantly higher than those of control group and negatively correlated with the enhancement maximum slope of increase of lower extremity while Prdx6, SOD, CAT, GSH-Px, eNOS and NO content were significantly lower than those of control group and positively correlated with the enhancement maximum slope of increase of lower extremity.Conclusion: The enhancement maximum slope of increase of magnetic resonance angiography significantly reduces in patients with diabetes lower extremity arterial disease and is closely related to oxidative stress-induced endothelial injury as well as eNOS/NO and HO-1/CO system function change.展开更多
文摘Lack of conclusive beneficial effects of strict glycemic control on macrovascular complications has been very frustrating for clinicians involved in care of patients with diabetes mellitus (DM). Highly publicized controversy surrounding cardiovascular (CV) safety of rosiglitazone resulted in major changes in United States Food and Drug Administration policy in 2008 regarding approval process of new antidiabetic medications, which has resulted in revolutionary data from several large CV outcome trials over the last few years. All drugs in glucagon-like peptide-1 receptor agonist (GLP-1 RA) and sodium-glucose cotransporter-2 (SGLT-2) inhibitor classes have shown to be CV safe with heterogeneous results on CV efficacy. Given twofold higher CV disease mortality in patients with DM than without DM, GLP-1 RAs and SGLT-2-inhibitors are important additions to clinician’s armamentarium and should be second line-therapy particularly in patients with T2DM and established atherosclerotic CV disease or high risks for CV disease. Abundance of data and heterogeneity in CV outcome trials results can make it difficult for clinicians, particularly primary care physicians, to stay updated with all the recent evidence. The scope of this comprehensive review will focus on all major CV outcome studies evaluating CV safety and efficacy of GLP-1 RAs and SGLT-2 inhibitors.
文摘Diabetes mellitus (DM) is marked as global health care challenge with almost 10% of the United States population being diagnosed with DM. A sizeable percentage of patients are oblivious of their disease, in spite of easily accessibility knowledge about its early signs and symptoms and rapid diagnostic modalities. Critically ill patients with undiagnosed DM are likely to have an increased mortality as compared to intensive care unit (ICU) patients with diagnosed DM. DM may have adverse effect on ICU patients causing organ failure and complications. Early Screening of patients at the risk of developing disease may prevent long term complications. Early screening and management may be beneficial as controlled DM patients have similar morbidity as non DM patients in ICU. An intense glycaemic and blood pressure control improves retinopathy and albuminuria, but may not affect the macrovascular outcomes.
基金Projects of Natural Science Foundation of Tibet Autonomous Region.Project No:2015ZR-13-16.
文摘Objective: To explore the effect of intravenous thrombolysis bridge stent combined with aspiration embolectomy on serological indicators in patients with intracranial macrovascular infarction. Methods: 92 patients with intracranial macrovascular infarction who received treatment in our hospital between February 2016 and January 2018 were selected as the research subjects and divided into the control group (n=46) and the study group (n=46) by random number table method. Control group received stent embolectomy alone, and study group received intravenous thrombolysis bridge stent combined with aspiration embolectomy. The differences in serum levels of inflammatory mediators, chemokines and nerve function-related indexes were compared between the two groups before treatment and 24h after embolectomy. Results: Before treatment, the differences in serum levels of inflammatory mediators, chemokines and nerve function-related indexes were not significant between the two groups. 24h after embolectomy, serum inflammatory mediators sICAM-1, hs-CRP and TNF-α levels of study group were lower than those of control group;serum chemokines CXCL16, Fractalkine and MCP-1 contents were lower than those of control group;serum nerve function-related indexes IGF-1, BDNF and CNTF levels were higher than those of control group whereas NSE level was lower than that of control group. Conclusion:Intravenous thrombolysis bridge stent combined with aspiration embolectomy can effectively reduce the systemic inflammatory response and optimize the nerve function in patients with intracranial macrovascular infarction.
基金Medical and Health Science and Technology Plan Projects of Dongguan No:2015105101070.
文摘Objective:To study the enhancement maximum slope of increase of magnetic resonance angiography in patients with diabetes lower extremity arterial disease and its correlation with endothelial injury and oxidative stress.Methods: Patients with diabetes lower extremity arterial disease accepting 3D-CEMRA examination in our hospital between May 2013 and December 2015 were selected as the pathology group, and the enhancement maximum slope of increase was measured;healthy volunteers receiving physical examination in our hospital during the same period were selected as control group, and serum levels of endothelial oxidative stress injury-related molecules of two groups of subjects were determined.Results:The enhancement maximum slope of increase of the lesion-side anterior tibial artery, posterior tibial artery, peroneal artery and dorsalis pedis artery of pathology group were significantly lower than those of the unaffected-side;serum CyPA, ERK1, ERK2, Akt, JAK, HO-1 and CO content of pathology group were significantly higher than those of control group and negatively correlated with the enhancement maximum slope of increase of lower extremity while Prdx6, SOD, CAT, GSH-Px, eNOS and NO content were significantly lower than those of control group and positively correlated with the enhancement maximum slope of increase of lower extremity.Conclusion: The enhancement maximum slope of increase of magnetic resonance angiography significantly reduces in patients with diabetes lower extremity arterial disease and is closely related to oxidative stress-induced endothelial injury as well as eNOS/NO and HO-1/CO system function change.