桑枝颗粒联合达格列净片治疗2型糖尿病的临床研究

目的探讨桑枝颗粒联合达格列净片治疗2型糖尿病的临床疗效。方法选取2017年4月—2018年4月在驻马店市中心医院治疗的2型糖尿病患者94例,根据用药的差别分为对照组(47例)和治疗组(47例)。对照组口服达格列净片,起始剂量5 mg/次,1次/d,根据血糖可调整剂量至10 mg/次,1次/d;治疗组在对照组基础上口服桑枝颗粒,3 g/次,3次/d。两组均治疗4周。观察两组患者临床疗效,同时比较治疗前后两组患者血糖相关指标、HOMA-β和HOMA-IR及血清学指标。结果治疗后,对照组和治疗组临床有效率分别为82.98%和97.87%,两组比较差异具有统计学意义(P0.05)。治疗后,两组空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)和胰岛素(FINS)水平均显著降低(P0.05),且治疗后治疗组这些血糖相关指标明显低于对照组(P0.05)。治疗后,两组HOMA-β均显著增高(P0.05),HOMA-IR显著降低(P0.05),且治疗组HOMA-β和HOMA-IR水平明显好于对照组(P0.05)。治疗后,两组γ-谷氨酰转肽酶(γ-GT)、血管细胞黏附分子-1(VCAM-1)、单核细胞趋化蛋白-1(MCP-1)水平均显著降低(P0.05),分泌型卷曲相关蛋白-5(SFRP5)水平显著增加(P0.05),且治疗组这些血清学指标水平明显优于对照组(P0.05)。结论桑枝颗粒联合达格列净片治疗2型糖尿病可有效控制患者血糖水平,改善胰岛素抵抗及提高胰岛素敏感性,具有一定的临床推广应用价值。     

津力达颗粒联合格列吡嗪治疗2型糖尿病的临床研究

目的观察津力达颗粒联合格列吡嗪治疗2型糖尿病的临床疗效。方法选取2016年6月—2017年6月四川省科学城医院收治的2型糖尿病患者120例,随机分为对照组和治疗组,每组各60例。对照组口服格列吡嗪缓释片,5 mg/次,1次/d;治疗组在对照组治疗基础上口服津力达颗粒,1袋/次,3次/d。两组均连续治疗8周。观察两组的临床疗效,比较两组治疗前后空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、β细胞胰岛素分泌功能(HOMA-β)、胰岛素敏感指数(HOMA-IS)、高敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)的变化情况。结果治疗后,对照组和治疗组的总有效率分别为71.67%、88.33%,两组比较差异具有统计学意义(P0.05)。治疗后,两组FPG、2 h PG、糖化血红蛋白、TG、TC、LDL-C、hs-CRP、IL-6水平均较治疗前显著降低,但FINS、HOMA-β、HOMA-IS显著升高,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,治疗组FPG、2 h PG、糖化血红蛋白、TG、TC、LDL-C、hs-CRP、IL-6水平显著低于对照组,FINS、HOMA-β、HOMA-IS显著高于对照组,两组比较差异具有统计学意义(P0.05)。结论津力达颗粒联合格列吡嗪治疗2型糖尿病具有较好的临床疗效,可明显降低患者血糖、血脂水平,改善患者炎症状态,具有一定的临床推广应用价值。     

达格列净结合胰岛素治疗2型糖尿病的效果及其安全性观察

目的:观察评价达格列净结合胰岛素治疗2型糖尿病患者的临床效果及安全性.方法:选择2018年8月—2019年7月期间我院收治的2型糖尿病患者116例为研究对象,随机将其分成各有58例患者的两组.在常规治疗措施的基础上,对照组患者应用胰岛素治疗,治疗组患者应用达格列净结合胰岛素治疗.空腹血糖(FPG)、餐后2h血糖(2hPBG)及糖化血红蛋白(HbA1 c)、空腹胰岛素水平(FINS)、胰岛β细胞功能指数(HOMA-βF)水平,比较治疗期间药物不良反应发生情况.结果:在FBG、2hFBG以及HbAlC等血糖指标水平方面,治疗后两组均明显低于治疗前(P<0.05),治疗组治疗后血糖指标水平低于对照组(P<0.05).在FINS、HOMA-βF等胰岛β细胞功能指标水平方面,两组治疗后均明显低于治疗前,治疗组治疗后胰岛β细胞功能指标水平低于对照组(P<0.05).治疗组、对照组治疗期间不良反应发生率分别为5.17％、8.62％,两组之间比较,差异无显著性(P>0.05).结论:达格列净结合胰岛素可以有效控制2型糖尿病患者的血糖水平,改善胰岛β细胞功能,安全性较高,具有在临床推广的价值.     

天芪降糖胶囊联合达格列净治疗2型糖尿病的临床研究

目的探讨天芪降糖胶囊联合达格列净片治疗2型糖尿病的临床疗效。方法回顾性分析2019年8月—2020年9月天津医科大学第二医院收治的134例2型糖尿病患者临床资料,采用随机数字表分成对照组和治疗组,每组各67例。对照组口服达格列净片,10 mg/次,1次/d;治疗组在对照组基础上口服天芪降糖胶囊,5粒/次,3次/d。两组患者治疗8周。观察两组患者临床疗效,比较治疗前后两组患者血糖指标空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbAlc)、胰岛素(FINS)、血糖标准差(SDBG)、平均血糖波动幅度(MAGE)、日内血糖波动次数(NGE)及日间血糖平均绝对差(MODD)水平,及血清肿瘤坏死因子相关蛋白6(CTRP6)、1-磷酸鞘氨醇(SIP)、白细胞介素-18(IL-18)、C1补体肿瘤坏死因子相关蛋白12(CTRP12)和血清脂蛋白-α(LP)水平。结果治疗后,在总有效率上治疗组显著高于对照组(98.51%vs 83.58%,P0.05)。治疗后,两组FPG、2 h PG、HbAlc、FINS水平均显著降低(P0.05),且治疗组最显著(P0.05)。治疗后,两组血清CTRP6、SIP、IL-18、LP水平均显著降低,而CTRP12水平显著升高(P0.05),且以治疗组改善最明显(P0.05)。治疗后,两组SDBG、MAGE、NGE和MODD均显著下降(P0.05),且以治疗组降低最明显(P0.05)。结论天芪降糖胶囊联合达格列净片治疗2型糖尿病可显著控制患者血糖,具有一定的临床推广应用价值。     

达格列净联合比格列酮治疗2型糖尿病的临床研究

目的探讨达格列净片联合吡格列酮片治疗2型糖尿病的临床疗效。方法选取2018年1月—2019年1月深圳市第二人民医院收治的86例2型糖尿病患者纳入本研究,根据用药方案之间的差异将患者分为对照组和治疗组,每组各43例。对照组于早饭前口服吡格列酮片,2片/次,1次/d。治疗组在对照组的基础上于早晨口服给予达格列净片,0.5片/次,1次/d。两组患者均治疗3个月。观察两组患者临床疗效,同时比较治疗前后两组患者血糖指标、氧化应激指标水平。结果治疗后,对照组、治疗组总有效率分别为72.1%、90.7%,两组总有效率比较差异具有统计学意义(P0.05)。治疗后,两组空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)水平均显著降低,胰高血糖素样肽1(GLP-1)水平显著升高,同组治疗前后比较差异具有统计学意义(P0.05);且治疗后治疗组血糖指标均明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组谷胱甘肽过氧化物酶(GSH-PX)、超氧化物歧化酶(SOD)、总抗氧化能力(T-Aoc)水平均显著升高,丙二醛(MDA)水平显著降低,同组治疗前后比较差异具有统计学意义(P0.05);且治疗后治疗组氧化应激指标均明显优于对照组,两组比较差异具有统计学意义(P0.05)。结论达格列净片联合吡格列酮片治疗2型糖尿病具有较好的临床疗效,可改善患者血糖水平,缓解氧化应激状态,具有一定的临床推广应用价值。     

达格列净对2型糖尿病合并冠心病患者血清hs-CRP、脂联素及胰岛素水平的影响观察

目的研究2型糖尿病合并冠心病患者使用达格列净对血清hs-CRP、脂联素及胰岛素水平的影响。方法选取2017年10月～2018年9月在我院就诊的2型糖尿病合并冠心病患者60例,随机分为观察组和对照组,各30例,观察组使用达格列净治疗,对照组使用二甲双胍治疗,两组患者均实施为期12周药物治疗。观察治疗前后两组患者血清超敏C-反应蛋白(hs-CRP)、脂联素、空腹血糖(FBG)、糖化血红蛋白(HbA1C)、胰岛素(FINS)水平,统计两组患者在治疗期间随访调查心血管事件发生情况,并记录药物不良反应。结果观察组治疗后血清hs-CRP水平明显低于对照组(P 0.05);治疗后,观察组血清脂联素水平明显高于对照组(P 0.05)。观察组治疗后FBG、HbA1C、FINS水平均低于对照组(P 0.05)。观察组治疗期间心血管事件发生率为6.67%,低于对照组30.00%(P 0.05)。结论 2型糖尿病合并冠心病患者使用达格列净能在一定程度上改善血清hs-CRP、脂联素及胰岛素水平,减少治疗期间心血管事件发生率。     

玉泉丸联合达格列净治疗2型糖尿病的临床研究

目的探讨玉泉丸联合达格列净片治疗2型糖尿病的临床疗效。方法选取2016年9月—2019年12月河南中医药大学第一附属医院收治的98例2型糖尿病患者,将所有患者随机分为对照组和治疗组,每组各49例。对照组早餐前口服达格列净片,5~10 mg/次,1次/d。治疗组在对照组基础上饭后服用玉泉丸,6 g/次,4次/d。两组患者均连续治疗3个月。观察两组的临床疗效,比较两组的血糖指标、胰岛素指标、炎症因子。结果治疗后,治疗组的总有效率(95.92%)较对照组(79.59%)高(P<0.05)。治疗后,两组白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平较治疗前降低(P<0.05);且治疗组炎症因子水平低于对照组(P<0.05)。治疗后,两组患者空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)较治疗前降低(P<0.05);且治疗组血糖指标低于对照组(P<0.05)。治疗后,两组胰岛素抵抗指数(HOMA-IR)较治疗前降低,胰岛素(FINS)、胰岛β细胞功能指数(HOMA-β)较治疗前升高(P<0.05);且治疗组HOMA-IR低于对照组,FINS、HOMA-β高于对照组(P<0.05)。结论玉泉丸联合达格列净片治疗2型糖尿病可改善患者血糖及胰岛素分泌,减轻炎症反应,且安全较好。     

达格列净结合胰岛素治疗2型糖尿病的有效性

目的分析达格列净结合胰岛素治疗2型糖尿病的有效性。方法选取我院2018年6月至2019年6月收治的94例2型糖尿病患者随机分为两组,均进行常规治疗,其中47例采用胰岛素治疗,记为对照组,47例采用达格列净结合胰岛素治疗,对比两组患者的空腹血糖水平和胰岛素用量情况,以及血糖达标时间。结果治疗开始时,两组患者的空腹血糖水平和胰岛素用量差异无统计学意义(P> 0.05),治疗一周后,观察组的空腹血糖水平和胰岛素用量均明显低于对照组(P <0.05),观察组的血糖达标时间优于对照组。结论对2型糖尿病患者使用达格列净结合胰岛素治疗,相比单纯使用胰岛素治疗,更能有效降低患者的血糖水平,减少胰岛素用量,帮助患者血糖更快达标,值得推广。     

达格列净联合利拉鲁肽强化治疗在二甲双胍抵抗2型糖尿病患者治疗中的效果研究

目的：探讨达格列净联合利拉鲁肽强化治疗在二甲双胍抵抗2型糖尿病(T2DM)患者治疗中的效果研究。方法：选取本院2020年2月至2022年2月收治的72例二甲双胍抵抗T2DM患者为研究对象，随机均分为治疗组(n=36)和对照组(n=36),对照组予以达格列净治疗，治疗组进行达格列净和利拉鲁肽的强化治疗。比较两组治疗后的临床疗效、治疗前后血糖指标[餐后2h血糖、空腹血糖(FPG)、糖化血红蛋白(HbA1c)]、血脂指标[血清高密度脂蛋白(HDL-C)、血清总胆固醇(TC)、血清低密度脂蛋白(LDL-C)、血清甘油三酯(TG)]及治疗期间用药安全性。结果：治疗后，治疗组临床疗效高于对照组(P<0.05);治疗后，两组HbA1c、FPG、LDL-C、餐后2h血糖、LDL-C、TC、TG水平低于治疗前，且治疗组低于对照组(P<0.05);两组HDL-C水平高于治疗前，且治疗组高于对照组(P<0.05);治疗期间两组不良反应发生率无明显差异(P>0.05)。结论：达格列净联合利拉鲁肽治疗可提高二甲双胍抵抗T2DM患者的临床疗效、改善血糖、血脂水平且具有临床用药安全性。     

天芪降糖胶囊联合沙格列汀治疗2型糖尿病的临床研究

目的探讨天芪降糖胶囊联合沙格列汀治疗2型糖尿病的临床效果。方法选取2014年1月—2017年12月南阳市第一人民医院收治的2型糖尿病患者84例,随机分成对照组(42)和治疗组(42例)。对照组口服沙格列汀片,1片/次,1次/d。治疗组在对照组基础上口服天芪降糖胶囊,5粒/次,3次/d。两组均连续治疗8周。观察两组患者临床疗效,同时比较治疗前后两组患者症候积分、空腹血糖(FPG)、餐后2 h血糖(2 hPG)和糖化血红蛋白(HbA1c)血浆水平及胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数-β(HOMA-β)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)和中性粒细胞/淋巴细胞比值(NLR)水平。结果治疗后,对照组临床有效率为76.2%,显著低于治疗组的92.9%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者各项症候积分及总分均显著减少(P0.05),且治疗组明显低于对照组(P0.05)。治疗后,两组患者FPG、2 hPG和HbA1c血浆水平显著降低(P0.05),且治疗组上述血糖参数水平明显低于对照组(P0.05)。治疗后,两组患者HOMA-IR值和血清TNF-α、IL-6浓度及外周血NLR值均显著降低(P0.05),HOMA-β值显著升高(P0.05),且治疗组上述指标水平明显好于对照组(P0.05)。结论天芪降糖胶囊联合沙格列汀治疗2型糖尿病能明显减轻患者高血糖症状,维持血糖稳定,改善胰岛功能及体内微炎症状态,延缓病程进展。     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Lung disease and PKCs

The lung offers a rich opportunity for development of therapeutic strategies focused on isozymes of protein kinase C (PKCs). PKCs are important in many cellular responses in the lung, and existing therapies for pulmonary disorders are inadequate. The lung poses unique challenges as it interfaces with air and blood, contains a pulmonary and systemic circulation, and consists of many cell types. Key structures are bronchial and pulmonary vessels, branching airways, and distal air sacs defined by alveolar walls containing capillaries and interstitial space. The cellular composition of each vessel, airway, and alveolar wall is heterogeneous. Injurious environmental stimuli signal through PKCs and cause a variety of disorders. Edema formation and pulmonary hypertension (PHTN) result from derangements in endothelial, smooth muscle (SM), and/or adventitial fibroblast cell phenotype. Asthma, chronic obstructive pulmonary disease (COPD), and lung cancer are characterized by distinctive pathological changes in airway epithelial, SM, and mucous-generating cells. Acute and chronic pneumonitis and fibrosis occur in the alveolar space and interstitium with type 2 pneumocytes and interstitial fibroblasts/myofibroblasts playing a prominent role. At each site, inflammatory, immune, and vascular progenitor cells contribute to the injury and repair process. Many strategies have been used to investigate PKCs in lung injury. Isolated organ preparations and whole animal studies are powerful approaches especially when genetically engineered mice are used. More analysis of PKC isozymes in normal and diseased human lung tissue and cells is needed to complement this work. Since opposing or counter-regulatory effects of selected PKCs in the same cell or tissue have been found, it may be desirable to target more than one PKC isozyme and potentially in different directions. Because multiple signaling pathways contribute to the key cellular responses important in lung biology, therapeutic strategies targeting PKCs may be more effective if combined with inhibitors of other pathways for additive or synergistic effect. Mechanisms that regulate PKC activity, including phosphorylation and interaction with isozyme-specific binding proteins, are also potential therapeutic targets. Key isotypes of PKC involved in lung pathophysiology are summarized and current and evolving therapeutic approaches to target them are identified.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.     

Gender-related symptoms and correlates of alcohol dependence among men and women with a lifetime diagnosis of alcohol use disorders

This study explored gender-related symptoms and correlates of alcohol dependence in a crosssectional study of 150 men and 150 women with a lifetime diagnosis of alcohol use disorders (AUD). Participants were recruited in equal numbers from treatment settings, correctional centres and the general community. Standardized measures were used to determine participants' use of substances, history of psychiatric disorders and psychosocial stress, their sensation seeking and family history of substance use and mental health disorders. Multivariate analyses were used to detect patterns of variables associated with gender and the lifetime severity of AUD. Men had a longer history of severe AUD than women. Women had similar levels of alcohol dependence and medical and psychological sequelae as men, despite 6 fewer years of AUD. More women than men had a history of severe psychosocial stress, severe dependence on other substances and antecedent mental health problems, especially mood and anxiety disorders. There were differences in family history of alcohol-related problems approximating same-gender aggregation. The severity of a lifetime AUD was predicted by its earlier age at onset and the occurrence of other disorders, especially anxiety, among both men and women. The limitations in the generalizability of these findings due to sample idiosyncrasies are discussed.