【摘要】 目的 觀察糖代謝異常不同階段患者空腹及口服75 g葡萄糖后血清游離脂肪酸（free fatty acid，FFA）的變化，探討FFA隨糖代謝異常進展的變化趨勢及其與胰島β細胞功能、胰島素抵抗的關系。 方法 2003年5月-2005年4月對123 例受試者通過口服葡萄糖耐量試驗（OGTT）分為正常糖耐量組（NGT）20例，糖調節受損組（IGR）30例，初診2型糖尿病組（NDM）41例，已診2型糖尿病組（TDM）32例。測定其空腹及口服75 g葡萄糖后的FFA、血糖、胰島素及血脂的水平。 結果 ①空腹FFA、OGTT FFA曲線下面積在IGR組、NDM組、TDM組均較NGT組明顯增高，有統計學意義（Plt;0.05）；各組OGTT 2 h FFA數值無差異，但隨著2型糖尿病病情發展有逐漸增高的趨勢。②空腹FFA、OGTT 2 h FFA與血糖、血脂均有相關性，且與胰島β細胞功能有一定的負相關，OGTT 2 h FFA與胰島素抵抗指數有一定的正相關。 結論 FFA對胰島β細胞功能及胰島素抵抗均有影響。【Abstract】Objective To investigate the changes of free fatty acid (FFA ) in fasting state and 2 hours later in 75 g glucose absorbed state, and the relationships between FFA and pancreatic beta-cell function or insulin resistance. Methods From May 2003 to April 2005, 123 subjects in policlinic were divided into four groups:group A included 20 subjects with normal glucose tolerance (NGT), group B 30 subjects with impaired glucose regulation (IGR, include IFG and IGT ), group C 41 newly proved type 2 diabetes mellitus (DM2 )subjects (NDM ), and group D 32 drug-treated DM2 subjects (TDM ). 75 g of glucose was given to all subjects.Fasting FFA and FFA 2 hours after oral glucose tolerance test (OGTT ), serum insulin levels, plasma glucose levels and fasting triglycerol, cholesterol, high-density lipoprotein, low-density lipoprotein were assessed. Results Fasting FFA and the area under the curve of FFA (AUCFFA )in OGTT were significantly higher in IGR group, NDM group and TDM group than in NGT group (Plt;0.05 ).Serum FFA levels 2 hours after OGTT were not significantly different among four groups, but they increased with the disease developing.Fasting FFA and FFA 2 hours after OGTT correlated with plasma glucose and plasma lipid, and negatively correlated with pancreatic beta-cell function indices.Serum FFA 2 hours after OGTT positively correlated with insulin resistance indices. Conclusion FFA influences both pancreatic beta-cell function and insulin resistance.
Objective To assess the long-time results of reconstruction of the extensor pollicis longus (EPL) function by transfer of the extensorindicis(EI). Methods From August 1978 to March 2003, 46 cases of loss of the EPL function were treatedby transfer of the extensor indicis. Of 46 cases, there were 32 males and 14 females, aged 16-51 years with an average of 36 years; there were 24 cases of oldtraumatic rupture and 22 cases of secondary rupture. The disease course was 2 days to 5 months, averaged 74 days. A specific EIEPL evaluation method (SEEM) wasused to measure the EPL function after transfer.Results Fortyone cases were followed up 9 years and 3 months on average (7 months to 23 years). Based on the SEEM, the results were excellent and good in 39 of 41 patients. The elevation deficit and combined flexion deficit were 0-2.2 cm (1.8 cm on average) and 0-3 cm (1.6 cm on average); the independent extension deficit was 0°-8° (5° on average). Conclusion Restoration of the extensor pollicis function by transfer of the extensor indicis is an effective and safe treatment option and the SEEM is a valid method for assessing EPL function.
The modified "seagull flap" for creating a new web in treated congenital syndactyly is deseribed. The technique is easy and this method can produce a web that is wide enough to allow adequate digital separation when fingers are abducted. The contour is satisfaction.