西格列汀二甲双胍联合胰岛素治疗肥胖型2型糖尿病伴心力衰竭的疗效

目的探讨西格列汀二甲双胍(商品名为捷诺达)联合胰岛素治疗肥胖型2型糖尿病伴心力衰竭患者的疗效。方法收集我院收治的肥胖型2型糖尿病伴心力衰竭患者80例,随机分入仅给予胰岛素治疗的胰岛素组和给予胰岛素联合西格列汀二甲双胍治疗的联合治疗组,比较两组的血糖水平、胰岛素用量和心功能情况。结果联合治疗组治疗后12周时的空腹血糖、餐后2h血糖、糖化血红蛋白、单日胰岛素用量和舒张晚期充盈峰速度(A峰)均显著低于胰岛素组同时间(P0.05),血糖控制达标率、舒张早期充盈峰速度(E峰)、E/A比值、左心室舒张末期直径、左心室射血分数均显著高于胰岛素组同时间(P0.05)。结论西格列汀二甲双胍联合胰岛素治疗有助于控制肥胖型2型糖尿病伴心力衰竭患者的血糖水平,减少胰岛素用量,改善心功能,是肥胖型2型糖尿病伴心力衰竭患者理想的治疗方法。     

西格列汀联合二甲双胍治疗Ⅱ型糖尿病的疗效观察

目的：观察T2DM抑制剂西格列汀联合二甲双胍治疗Ⅱ型糖尿病在降低血糖、血脂以及减轻胰岛素抵抗、肥胖方面的作用,并观察其与单独使用胰岛素治疗Ⅱ型糖尿病（T2DM）的临床疗效。方法：选择120例符合T2DM标准的患者,所选患者均有口服降血糖药物史且无使用二甲双胍禁忌症。患者随机分为两组,实验组每天服用西格列汀和二甲双胍一次,对照组单纯使用胰岛素治疗。观察14周前后FBG、2hBG、FINS、HbAlC、TC、TG、LDL-C、HDL-C、HOMA-IR、BMI等指标的变化。结果：西格列汀联合二甲双胍实验组和单纯使用胰岛素的治疗组都能明显降低T2DM患者血糖、血脂,西格列汀联合二甲双胍治疗组可以显著降低胰岛素抵抗和控制体重,胰岛素组却无明显作用。结论：二肽基肽酶-4抑制剂西格列汀联合二甲双胍不仅能显著降低患者患者的血糖、血脂,而且能显著降低胰岛素抵抗及控制体重。     

西格列汀与二甲双胍联合治疗肥胖2型糖尿病的疗效分析

目的 分析西格列汀与二甲双胍联合治疗肥胖2型糖尿病的疗效.方法 选取我院2013年4月—2014年4月收治的肥胖2型糖尿病患者100例,随机分为对照组和治疗组各50例,对照组患者采用二甲双胍治疗,治疗组患者采用西格列汀与二甲双胍联合治疗.比较2组患者治疗前后空腹血糖、餐后2 h血糖和糖化血红蛋白的变化.结果 治疗6周后,2组患者的空腹血糖、餐后2 h血糖和糖化血红蛋白均显著下降(P<0.05),且治疗组的各项血糖指标下降程度优于对照组(P<0.05).结论 西格列汀与二甲双胍联合治疗肥胖2型糖尿病具有良好的降糖效果,且安全性较高.     

磷酸西格列汀与二甲双胍在初发性2型糖尿病治疗中的应用效果

目的:探究在初发性2型糖尿病临床治疗中,磷酸西格列汀与二甲双胍的应用效果。方法:选取我院2012年3月~2014年6月内分泌科收治的初发性2型糖尿病患者150例,并将其随机分为对照组与研究组。均给予两组常规治疗方法。在此基础上,给予研究组口服磷酸西格列汀片和二甲双胍片。观察两组患者的空腹血糖、糖化血红蛋白、餐后两小时血糖、空腹胰岛素、胰岛素抵抗指数。结果:在治疗后,与对照组相比,研究组患者的空腹血糖、餐后两小时血糖、胰岛素抵抗指数、空腹胰岛素明显较优。两组比较,差异具有统计学价值(p0.05)。结论:在初发性2型糖尿病的临床治疗中,磷酸西格列汀与二甲双胍的联合能够实现良好的治疗效果,且安全性较高,值得推广应用。     

胰岛素联合二甲双胍治疗2型糖尿病32例疗效观察

目的：探讨胰岛素联合二甲双胍治疗2型糖尿病的临床疗效。方法：将64例2型糖尿病患者随机分为2组：对照组和观察组,每组32人。对照组单纯采用胰岛素治疗,观察组采用胰岛素联合二甲双胍治疗,12周为1疗程,回顾性分析2组治疗前后胰岛素用量及血糖控制情况。结果：治疗后2组FBG、2hPG、HbAlc较治疗前均有所降低,但观察组与对照组比较血糖降低效果更明显,且胰岛素用量较对照组也有所减少,差异均有统计学意义（P＜0．05）。结论：在排除禁忌证的情况下,胰岛素联合二甲双胍治疗2型糖尿病,临床疗效更佳,值得临床推广应用。     

西格列汀与吡格列酮联合二甲双胍在二甲双胍单药治疗控制不佳的2型糖尿病肥胖患者血糖的疗效观察

目的:研究分析西格列汀与吡格列酮联合二甲双胍在二甲双胍单药治疗控制不佳的2型糖尿病肥胖患者血糖的临床效果。方法:选取40例二甲双胍单药治疗控制不佳的2型糖尿病肥胖患者作为研究对象,将所有患者随机分为对照组和观察组各20例,对照组给予西格列汀+二甲双胍进行治疗,观察组给予吡格列酮+二甲双胍进行治疗,疗程均为12周。对比观察两组患者治疗前后的糖化血红蛋白、空腹血糖、餐后2 h血糖、体重指数变化情况以及低血糖发生情况。结果:两组患者的糖化血红蛋白、空腹血糖以及餐后2 h血糖等指标均明显低于治疗前,差异有统计学意义(P<0.05),对照组的餐后2 h血糖下降程度明显大于观察组,差异有统计学意义(P<0.05);而观察组的空腹血糖下降程度和体重质量增加程度均明显大于对照组,差异有统计学意义(P<0.05);两组患者的低血糖等不良反应发生情况相比,差异无统计学意义(P>0.05)。结论:采用西格列汀与吡格列酮联合二甲双胍在二甲双胍单药治疗控制不佳的2型糖尿病肥胖患者血糖中均有较高的临床应用价值,疗效显著,然而西格列汀在降低患者餐后2h血糖方面效果优于吡格列酮,吡格列酮在降低空腹血糖方面效果优于西格列汀。     

西格列汀联合二甲双胍治疗初发糖尿病的临床观察

目的探讨西格列汀联合二甲双胍治疗初发2型糖尿病的疗效。方法将80例初发肥胖2型糖尿病患者随机分为两组,治疗组40例,用西格列汀联合二甲双胍进行治疗,对照组40例应用二甲双胍治疗,观察12周。比较两组患者治疗前后空腹血糖（FBG）、餐后2小时血糖（2hPG）、糖化血红蛋白（HbA1C）、体重指数（BMI）的变化。结果治疗12周后,治疗组与对照组的FBG、2hPG、HbA1C、BMI均下降,但联合治疗组的各项指标更接近理想目标,消化道副作用更少。结论西格列汀联合二甲双胍治疗初发肥胖2型糖尿病疗效确切,具有很好的降糖效果和安全性。     

西格列汀联合二甲双胍治疗肥胖2型糖尿病患者的临床疗效及安全性

目的研究西格列汀联合二甲双胍治疗肥胖2型糖尿病患者的临床疗效及安全性。方法选取我院2014年2月至2015年12月收治的肥胖2型糖尿病患者88例为研究对象,将其随机分为观察与对照两组,对照组单独采用二甲双胍治疗,观察组除了采用二甲双胍进行治疗外,还要联合采用西格列汀进行治疗,对比两组治疗效果。结果观察组总有效率为90.91%,显著高于对照组的68.18%;治疗后,观察组患者的2h FPG、Hb Alc、BMI以及FPG显著优于对照组。结论西格列汀联合二甲双胍治疗肥胖2型糖尿病患者的临床疗效显著,在临床上值得广泛推广。     

西格列汀联合二甲双胍治疗2型糖尿病疗效观察

目的:探讨西格列汀联合二甲双胍治疗2型糖尿病的疗效。方法:选择2019年9-12月在佳木斯市中心医院诊断治疗的2型糖尿病患者98例为研究对象,根据治疗方法不同分为观察组与对照组,每组各49例。两组均给予二甲双胍治疗,在此基础上,观察组联合西格列汀片治疗,对照组联合阿卡波糖口服治疗。比较两组治疗后血糖相关指标、空腹胰岛素、胰岛素抵抗指数、胰岛素敏感指数,比较两组临床疗效及不良反应发生率。结果:治疗后,观察组的空腹血糖(FBG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数均显著低于对照组,胰岛素敏感指数高于对照组,差异均有统计学意义(P<0.05)。观察组临床疗效显著优于对照组,不良反应总发生率显著低于对照组(4.1%vs.20.4%),差异有统计学意义(P<0.05)。结论:西格列汀联合二甲双胍治疗2型糖尿病可显著改善临床疗效,降低血糖水平,改善胰岛素抵抗,提高胰岛素敏感,并且相对安全。     

甘精胰岛素联合二甲双胍治疗2型糖尿病患者对糖代谢的影响

目的:观察甘精胰岛素联合二甲双胍治疗2型糖尿病患者临床疗效、安全性及对糖代谢的影响。方法:选取2型糖尿病口服降糖药控制血糖较差患者100例,随机分为对照组和观察组,对照组给予中效低精蛋白胰岛素(NPH)联合二甲双胍治疗,观察组给予甘精胰岛素联合二甲双胍治疗,3个月后观察并对比两组空腹及餐后2 h血糖、糖化血红蛋白、空腹血糖达标时间、胰岛素用量、短效胰岛素用量及注射次数和低血糖发生率等情况。结果:观察组在空腹血糖、餐后2 h血糖、糖化血红蛋白、空腹血糖达标时间、短效胰岛素注射次数和低血糖发生率等方面均明显优于对照组,差异有统计学意义(P<0.05)。结论:甘精胰岛素联合二甲双胍治疗口服降糖药控制血糖较差的2型糖尿病患者具有糖代谢效果佳、临床效果显著及安全性高等优点,值得推广。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.