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下丘脑泌素/进食素(Hypocretin/orexin)与睡眠:发作性睡病的病理生理和诊断
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作者 SebastiaanOvereem ThomasE.Scammell +2 位作者 GertJanLammers 黄颜 刘秀琴 《世界医学杂志》 2004年第7期48-52,共5页
综述目的:发作性睡病是一种睡眠障碍,临床特征是白天过度嗜睡和猝倒。研究发现大多数病人存在下丘脑神经肽-hypocretin-1的缺乏。这项发现推动了该研究的进展。最近研究:对发作性睡病和其他一些睡眠障碍病人的脑脊液hypocretin-1水... 综述目的:发作性睡病是一种睡眠障碍,临床特征是白天过度嗜睡和猝倒。研究发现大多数病人存在下丘脑神经肽-hypocretin-1的缺乏。这项发现推动了该研究的进展。最近研究:对发作性睡病和其他一些睡眠障碍病人的脑脊液hypocretin-1水平的研究显示,hypocretin缺乏对发作性睡病/猝倒具有高度敏感性和特异性。约有15%的发作性睡病病人,尽管其多次小睡潜伏期实验是阴性的,但其hypocretin的水平是降低的。hypocretin系统除了调节睡眠,还参与了能量平衡、植物神经功能和一些神经内分泌功能的调节。因而多达1/3的病人有肥胖(体重指数>30)。此外,无论体重是否超重,血致瘦素水平均降低。而新的发作性睡病的啮齿类动物模型的建立也许有助于对这些内分泌异常的了解。最后,对于hypocretin系统在睡眠和觉醒调节方面的生理作用的研究也在不断增加。摘要:hypocretin的测定有可能作为一种新的诊断方法,结合临床对发作性睡病进行诊断。发作性睡病病人的临床处理中,应注意其常见的伴发病肥胖。将来,拟hypocretin药物的可能出现为该病的治疗提供新的途径。而具有发作性睡病特征的的动物模型的建立毫无疑问会增加我们对这种疾病病理生理方面的认识。 展开更多
关键词 下丘脑泌 进食素 HYPOCRETIN OREXIN 发作性睡病 病理生理 诊断 睡眠障碍
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Ileal transposition rapidly improves glucose tolerance and gradually improves insulin resistance in non-obese type 2 diabetic rats
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作者 Hengliang Zhu Huaiming Wang +4 位作者 Zhihai Zheng Bailiang Ye Xiaojiao Ruan Xiaofeng Zheng Guoxin Li 《Gastroenterology Report》 SCIE EI 2018年第4期291-297,I0002,共8页
Background:Many studies have confirmed that ileal transposition can improve type 2 diabetes mellitus(T2DM),accompanied by increased glucagon-like peptide-1(GLP-1).We performed the experiment on diabetic rats to evalua... Background:Many studies have confirmed that ileal transposition can improve type 2 diabetes mellitus(T2DM),accompanied by increased glucagon-like peptide-1(GLP-1).We performed the experiment on diabetic rats to evaluate the effects and mechanisms of ileal transposition on the glycemic metabolism.Methods:Twenty Goto-Kakizaki(GK)rats were randomly divided into the ileal transposition group(IT group)and the sham operation group(Shamgroup).Weight,food intake,fasting plasma glucose(FPG),fasting insulin(F-ins),oral glucose tolerance test(OGTT)and GLP-1 were determined at baseline and 1,4,8,16 and 24weeks post-operatively.The homeostasis model assessment-insulin resistance(HOMA-IR)index and the area under the curve(AUC)during OGTT were measured.Histological determination of the GLP-1 receptor(GLP-1R)was performed on the pancreas and ileum24weeks post-operatively.Results:In comparison with the Sham group,the IT group showed a higher GLP-1 level and lower AUC at 4,8,16 and 24 weeks post-operatively(all P<0.05)and a lower FPG,F-ins levels and HOMA-IR at 8,16 and 24 weeks post-operatively(all P<0.05).Compared with baseline levels,the plasma GLP-1,AUC and FPG levels decreased significantly at each postoperative time point in the IT group(all P<0.05),but not in the Sham group(all P>0.05);F-ins and HOMA-IR significantly decreased at 8,16 and 24 weeks post-operatively in the IT group(all P<0.05).GLP-1R expression in the IT group was significantly higher than that of the Sham group in both the pancreas and the ileum at 24 weeks post-operatively(P<0.05).Conclusions:Ileal transposition ameliorated glucose metabolism without reduction in weight or food intake in GK rats,which may be induced by the increased GLP-1 expression.However,the delayed improvement of insulin resistance,accompanied by decreased plasma insulin levels,might not directly result from the increased GLP-1. 展开更多
关键词 Type 2 diabetes mellitus ileal transposition glucagon-like peptide-1 glycemic metabolism
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