Efficacy and Safety of Mulberry Twig Alkaloids Tablet for the Treatment of Type 2 Diabetes: A Multicenter,Randomized, Double-Blind,Double-Dummy,and Parallel Controlled Clinical Trial

OBJECTIVEThis study aimed to evaluate the efficacy and safety of mulberry twig alkaloids (Sangzhi alkaloids [SZ-A]) in the treatment of type 2 diabetes (T2D).RESEARCH DESIGN AND METHODSThis was a multicenter, randomized, double-blind, double-dummy, and parallel controlled noninferiority clinical trial that was conducted for 24 weeks. A total of 600 patients were randomly allocated to the SZ-A group (n = 360) or acarbose group (n = 240). The primary efficacy end point was the change of glycosylated hemoglobin (HbA_1c) compared with baseline. In addition, adverse events (AEs), severe AEs (SAEs), treatment-related AEs (TAEs), and gastrointestinal disorders (GDs) were monitored.RESULTSAfter treatment for 24 weeks, the change in HbA_1c was –0.93% (95% CI –1.03 to –0.83) (–10.2 mmol/mol [–11.3 to –9.1]) and –0.87% (–0.99 to –0.76) (–9.5 mmol/mol [–10.8 to –8.3]) in the SZ-A and acarbose groups, respectively, and the least squares mean difference was –0.05% (95% CI –0.18 to 0.07) (–0.5 mmol/mol [–2.0 to 0.8]) between the two groups, with no significant difference on the basis of covariance analysis (P > 0.05). The incidence of TAEs and GDs was significantly lower in the SZ-A group than the acarbose group (P < 0.01), but no differences for AEs or SAEs between the two groups were observed (P > 0.05).CONCLUSIONSSZ-A exhibited equivalent hypoglycemic effects to acarbose in patients with T2D. Nevertheless, the incidence of TAEs and GDs was lower following SZ-A treatment than acarbose treatment, suggesting good safety.     

拉米夫定治疗乙肝合并抗结核药致肝功损害的临床研究

目的 探讨拉米夫定在HBVDNA阳性合并肺结核患者的治疗作用.方法 选择抗结核治疗及中药保肝后,肝功能再次异常30例,且HBVDNA阳性30例,予拉米夫定抗病毒治疗并中药保肝治疗,肝功能恢复正常后,恢复抗结核治疗,完成疗程.结论 HBVM且HBVDNA阳性,抗病毒治疗可以有效保护并恢复正常肝功能.     

脊柱淋巴瘤的MR表现——与病理结果对比研究

本文回顾性分析９例淋巴瘤中，椎体受累６例，２例有椎弓附件受累。脊柱信号异常形态４例呈弥漫性，２例呈斑片状信号异常，另２例呈轻度膨胀性改变，无１例呈压缩性改变。椎体周围及硬膜外间隙内软组织信号异常亦有３种，局灶梭形７个，在椎管内５例，其中２例环绕脊髓，２例于脊髓的后方，１例于脊髓前方，但均无椎弓附件的累及；弥漫长椭圆形１个；２例腰段椎管内呈弥漫性椎管铸型。淋巴瘤的信号８例Ｔ１加权图像呈等或低信号，Ｔ２加权为均匀等信号或不均匀略高、低信号改变，呈轻至中度增强；１例平扫时与前相同，但有明显增强。前者病理示血供欠丰富，后者示血供丰富。因此淋巴瘤的ＭＲＩ表现有多种形态，其信号改变亦多种多样，但仍有一定特征。与转移性病灶相比，椎旁及硬膜外病灶倾向呈梭形改变，硬膜外病灶轴位显示明显大于骨质累及病灶，椎体骨质压缩性改变较少。与脊柱结核及硬膜外脓肿区别在于受累部位的椎间盘形态、信号显示正常。     

居民水箱孳生摇蚊幼虫的原因分析

为居民水箱孳生摇蚊幼虫的原因，进行了现场调查及氯化消杀实验，结果表明，居民水箱摇蚊幼虫孳生率为５５．２６％，其他各类水体均未孳生；水箱水体游离氯浓度〈０．０５ｍｇ／Ｌ组的摇蚊幼虫孳生率明显高于游离氯≥０．０５ｍｇ／Ｌ组（Ｐ〈０．０５），水箱水面有死摇蚊的，孳生摇蚊幼虫；无死摇蚊的，未孳生摇蚊幼虫。氯化消杀实验游离氯浓度≥０．５ｍｇ／Ｌ对摇蚊幼虫及其卵均有杀灭作用，且其浓度越高，杀灭所需时间越短。居     

32P胶体致人胰腺癌Pc-3移植瘤细胞凋亡及其相关基因表达的研究

目的 观察低剂量^3-P胶体瘤体内注射诱导裸鼠人胰腺癌Pc-3移植瘤细胞凋亡的生物学效应、相关基因的表达及其可能的作用机理。方法建立：BALB／c裸鼠人胰腺癌Pc-3移植瘤动物模型，分别向30只荷瘤鼠瘤块中心注射不同剂量(0．37、0．74、1．48、2．96和5．92MBq)的^32P胶体溶液，对照组注射等体积冷胶体。于注射后24h取出瘤块；通过流式细胞仪、透射电镜及免疫组织化学检测等方法，研究肿瘤组织的细胞凋亡率、细胞坏死率、细胞超微结构改变及Apo2．7、Caspase-3、bcl-2、box相关基因的表达。结果 0．74、1．48和2．96MBq组瘤体内注射后电镜下可见典型的细胞凋亡表现，5．92MBq组细胞则以大量坏死为主。辐射诱导凋亡过程中，bcl-2／bax比值下调，Apoa2.7、Caspase-3蛋白表达均明显增加。结论 ^32P胶体瘤体注射可诱导荷瘤裸鼠人胰腺癌Pc-3肿瘤细胞凋亡；Aao2．7、Caspase-3、bcl-2及bax蛋白参与调控辐射诱导细胞凋亡过程。     

胃原发性恶性淋巴瘤临床病理及免疫组化研究

作者应用细胞学、组织学及免疫组织化学标记技术研究了１２例胃原发性恶性淋巴瘤。结果表明其中无核裂细胞型４例，核裂细胞型３例，淋巴浆细胞样型５例。免疫组化标记证实１２例均系Ｂ细胞性淋巴瘤。本文讨论了原发性恶性淋巴瘤的诊断和鉴别诊断。     

硝苯吡啶合并巯甲丙脯酸治疗高血压病

报道４２０例高血压患者分别服用硝苯吡啶、巯甲丙脯酸及联合服用硝苯吡啶加巯甲丙脯酸治疗情况。观察结果３组的总有效率分别为７４．２％、７４．３％和９３．４％。两药并用疗效与前两组比较有非常显著性差异（Ｐ均＜０．０１）；而副作用明显少于前两组。作者认为两药合用可作为治疗高血压或高血压合并轻度心功能不全的第一线药物。     

中枢神经系统原发性恶性淋巴瘤临床与病理分析

通过对１４例中枢神经系统原发性恶性淋巴瘤临床资料分析及光镜，电镜和免疫组化研究，结果表明：临床上以颅内压增高为主要症状，肿瘤可发生于中枢系统的任何部位。组织学特点，瘤细胞单一，异形，早期常围血管呈袖套样排列，中晚期呈弥漫性分布，无滤波形成。ＬＣＡ，Ｌ２６，ＵＣＨＬ１，ＧＦＡＰ，ＥＭＡ免疫组织化学染色及电镜检查提示肿瘤多数为Ｂ细胞起源。并对其病间，发病机理，诊断和鉴别诊断作了讨论     

枸杞多糖对动脉粥样硬化模型兔血脂、脂质过氧化、NO和C-反应蛋白的影响

目的:探讨枸杞多糖对新西兰兔动脉粥样硬化的预防作用及其机制。方法:36只雄性新西兰兔随机分 为3组,每组12只。对照组喂普通饲料,模型组采用普通饲料加质量分数1.5%的胆固醇喂养,枸杞多糖(LBP)组 采用普通饲料加质量分数1.5%的胆固醇喂养,同时腹腔注射LBP(3.0mg/kg),10周后,测定各组空腹血清三酯酰 甘油(TG)、总胆固醇(TCh)、高密度脂蛋白胆固醇(HDL- C)、一氧化氮(NO)、丙二醛(MDA)、C -反应蛋白(CRP)含 量以及超氧化物歧化酶(SOD)活性,计算主动脉内膜粥样斑块面积并观察主动脉形态学变化。结果:模型组与对照 组比较,TG、TCh、NO、MDA、CRP升高(P<0.01),HDL- C/TCh、SOD活性下降(P<0.01),主动脉内膜粥样斑块面积 较大(P<0.01);LBP组与模型组比较,TG、NO、MDA、CRP下降(P<0.01或0.05),HDL -C/TCh、SOD活性升高 (P<0.01),主动脉内膜粥样斑块面积明显减少(P<0.05)。结论:枸杞多糖对动脉粥样硬化有明显的预防和治疗 作用,可能与其抗氧化、免疫调节、提高HDL- C/TCh有关。     

Extremely Low Frequency Magnetic Fields Do Not Induce DNA Damage in Human Lens Epithelial Cells In Vitro

Non‐ionizing radiations, e.g., radiofrequency electromagnetic fields, could induce DNA damage and oxidative stress in human lens epithelial cells (LECs) which can be early events in cataractogenesis. Extremely low frequency magnetic fields (ELF MF) as another common form of man‐made electromagnetic fields has been considered as suspected human carcinogen by International Agency for Research on Cancer (IARC) and become a focus that people play more and more attentions to. This study aimed to determine whether ELF MF can induce DNA damage in cultured human LECs at a relatively low intensity. Human LECs were exposed or sham‐exposed to a 50 Hz ELF MF which produced by a well‐designed exposure system at the intensity of 0.4 mT. DNA damage in human LECs was examined by the phosphorylated form of histone variant H2AX (γH2AX) foci formation assay and further explored with western blot, flow cytometry, and alkaline comet assay. Immunofluorescence analysis showed that 0.4 mT ELF MF did not significantly increase γH2AX foci formation in human LECs after 2, 6, 12, 24, or 48 hr exposure. No significant differences had been detected in γH2AX expression level between the ELF MF‐ and sham‐exposure groups, while no obvious chromosomal DNA fragmentation was detected by alkaline comet assay after ELF MF exposure. The results indicate an absence of genotoxicity in ELF MF‐exposed human epithelial cells and do not support the hypothesis that environmental ELF MF might be causally led to genomic instability via chromosomal damage response processes. Neither short nor long term continuous exposure to 50 Hz ELF MF at 0.4 mT could induce DNA damage in human lens epithelial cells in vitro. Anat Rec, 299:688–697, 2016. © 2016 Wiley Periodicals, Inc.