大黄对老年Ⅱ型糖尿病尿蛋白排泄率的影响

目的 :观察大黄对老年Ⅱ型糖尿病尿白蛋白排泄率的改变。方法 :94例年龄≥ 60岁的NID DM患者伴微量白蛋白尿 ,分为三组 ,分别应用captopril、大黄及两药联合治疗 ,比较治疗前、治疗 2W和4W尿白蛋白排泄率。结果 :应用captopril 2W即发挥降低UAER作用 ( 95.1± 9.8比 82 .7± 8.8,P <0 .0 5) ,大黄治疗 2W对UAER无明显改变 ,4W与captopril效果相似 ( 72 .3± 9.6比 73.3± 9.2 ,P >0 .0 0 1 ) ,两药联合应用效果最佳 ( 4 2 .3± 1 1 .6,P <0 .0 0 1 )。结论 :大黄有降低老年NIDDM患者尿白蛋白排泄的作用 ,与aptopril联用效果最好。     

糖尿病合并脑梗塞患者血浆内皮素及降钙素基因相关肽的改变及其临床意义

观测了33例非胰岛素依赖型糖尿病(NIDDM)合并脑梗塞患者血浆内皮素(ET)及降钙素基因相关肽(CGRP)的变化.发现糖尿病合并脑梗塞组72h之内血浆ET高于脑梗塞组、糖尿病组及正常对照组,血浆CGRP低于单纯脑梗塞组,但高于糖尿病组.糖尿病伴有高血压和眼底、肾脏合并症者发生脑梗塞时比无合并症者ET升高明显,CGRP相对较低.糖尿病合并脑梗塞病人在72h内,病情危重者的ET高于轻中型者,CGRP低于轻、中型者.     

Cervical cancer – State of the science: From angiogenesis blockade to checkpoint inhibition

Vascular endothelial growth factor (VEGF) has emerged as a therapeutic target in several malignancies, including cervical cancer. Chemotherapy doublets combined with the fully humanized monoclonal antibody, bevacizumab, now constitute first-line therapy for women struggling with recurrent/metastatic cervical carcinoma. Regulatory approval for this indication was based on the phase III randomized trial, GOG 240, which demonstrated a statistically significant and clinically meaningful improvement in overall survival when bevacizumab was added to chemotherapy: 17.0 vs 13.3?months; HR 0.71; 98% CI, 0.54–0.95; p?=?.004. Incorporation of bevacizumab resulted in significant improvements in progression-free survival and response. These benefits were not accompanied by deterioration in quality of life. GOG 240 identified vaginal fistula as a new adverse event associated with bevacizumab use. All fistulas occurred in women who had received prior pelvic radiotherapy, and none resulted in emergency surgery, sepsis, or death. Final protocol-specified analysis demonstrated continued separation of the survival curves favoring VEGF inhibition: 16.8 vs 13.3?months; HR 0.77; 95% CI, 0.62–9.95; p?=?.007. Post-progression survival was not significantly different between the arms in GOG 240.Moving forward, immunotherapy has now entered the clinical trial arena to address the high unmet clinical need for effective and tolerable second line therapies in this patient population. Targeting the programmed cell death 1/programmed death ligand 1 (PD-1/PD-L1) pathway using checkpoint inhibitors to break immunologic tolerance is promising. The immunologic landscape involving human papillomavirus-positive head and neck carcinoma and cutaneous squamous cell carcinoma can be informative when considering feasibility of checkpoint blockade in advanced cervical cancer. Phase II studies using anti-PD-1 molecules, nivolumab and pembrolizumab are ongoing, and GOG 3016, the first phase III randomized trial of a checkpoint inhibitor (cemiplimab) in cervical cancer, recently activated. Important considerations in attempts to inhibit the inhibitors include pseudoprogression and post-progression survival, abscopal effects, and immune-related adverse events, including endocrinopathies.     

Antihyperglycemic,hypolipidemic and antioxidant activities of total saponins extracted from Aralia taibaiensis in experimental type 2 diabetic rats

Ethnopharmacological relevance

As a well-known traditional Chinese medicine the root bark of Aralia taibaiensis has multiple pharmacological activities, including relieving rheumatism, promoting blood circulation to arrest pain, inducing diuresis to reduce edema, and antidiabetic action. It has long been used as a folk medicine for the treatment of traumatic injury, rheumatic arthralgia, nephritis, edema, hepatitis and diabetes mellitus in China.

Aim of study

To evaluate the antihyperglycemic, hypolipidemic and antioxidant activities of total saponins extracted from Aralia taibaiensis (SAT) in experimental type 2 diabetic mellitus (T2DM) rats.

Materials and methods

Acute toxicity was studied in rats to determine the safe oral dose of SAT. Then, SAT was given orally to normal and streptozotocin–nicotinamide induced T2DM rats at 80, 160 and 320 mg/kg doses for a series of 28 days to determine the antihyperglycemic activity. Glibenclamide (600 μg/kg), a standard antidiabetic drug, was used as a positive control drug. At the end of treatment, biochemical parameters and antioxidant levels were measured to evaluate the hypolipidemic and antioxidant activities of SAT.

Results

Oral administration of SAT did not exhibit toxicity and death at a dose not more than 2000 mg/kg. SAT dose-dependently improved the symptoms of polydipsia, polyuria, polyphagia and weight loss in diabetic rats. Compared with diabetic control group, administration of 320 mg/kg SAT resulted in significant (P<0.05) fall in the levels of fasting blood glucose, glycosylated hemoglobin, creatinine, urea, alanine transarninase, aspartate aminotransferase, total cholesterol, triglycerides, low density lipoprotein cholesterol and malondialdehyde, but significant (P<0.05) increase in the levels of serum insulin, superoxide dismutase and reduced glutathione. However, SAT did not have any effect on the normal rats.

Conclusions

SAT had excellent antihyperglycemic, hypolipidemic and antioxidant activities in T2DM rats and might be a promising drug in the therapy of diabetes mellitus and its complications.     

消渴汤方剂对Ⅱ型糖尿病大鼠GLP-1分泌的影响

目的　探讨消渴汤方剂对Ⅱ型糖尿病大鼠类胰高血糖素肽 1(GLP 1)水平和血糖分泌的影响, 为Ⅱ型糖尿病的治疗提供新的思路。方法　应用酶联免疫吸附(ELISA)方法测定正常组、Ⅱ型糖尿病模型组 和口服消渴汤大鼠组血浆GLP 1和血糖水平。结果　Ⅱ型糖尿病大鼠血糖水平明显高于正常大鼠,口服消渴 汤大鼠GLP 1水平明显高于Ⅱ型糖尿病大鼠、血糖水平低于Ⅱ型糖尿病大鼠,对正常组大鼠无影响。结论　 消渴汤使Ⅱ型糖尿病大鼠GLP 1水平升高、血糖水平降低。     

中西医结合治疗糖尿病Ⅱ型继发OHA失效的临床观察

以针刺配合黄连素、食母生治疗糖尿病 型继发 OHA(口服降糖药 )失效 80例 ,与对照 A组 40例和 B组 80例对照观察比较 ,结果分别为 P<0 .0 1、P>0 .0 5。说明针刺配合黄连素、食母生治疗糖尿病 型继发 OHA失效 ,具有明显疗效 ,是很好的补充疗法 ,并在一定程度上可替代胰岛素的应用。     

2型糖尿病患者血清肿瘤坏死因子和唾液酸检测的临床意义

分别应用放射免疫分析法和分光光度计法检测了 35名正常人和 82例 2型糖尿病患者血清中肿瘤坏死因子 (TNF)和唾液酸 (SA)含量。结果表明 :2型糖尿病患者无肾病组和伴有肾病组血清中TNF和SA含量均非常显著地高于正常人 ,尤以伴有肾病组为甚 (P <0 .0 0 1)。这说明 2型糖尿病患者血清中TNF和SA含量与疾病的发生和发展密切相关     

Evaluation of the Importance of Maternal History of Diabetes and of Mitochondrial Variation in the Development of NIDDM

In 79 South Indian nuclear pedigrees ascertained via probands with NIDDM and both parents living, parental diabetic status was established through previously diagnosed NIDDM (n = 97) or oral glucose tolerance testing (n = 61). There was no significant difference between diabetes prevalence in mothers and fathers (60 vs 53 (76 % vs 67 %), respectively, p = 0.22). ‘Age at diabetes diagnosis’ survival curves did differ according to parental gender (p = 0.02) but this may reflect gender differences in health provision rather than pathophysiology. No maternal excess effects of the magnitude evident in previous studies were detected, suggesting either ethnic differences or overestimation of the maternal effect when reported histories of parental diabetes have been used. The tRNA^Leu(UUR) gene region was studied for diabetes-associated variation given the role of mutations in this gene in some pedigrees displaying maternal transmission of NIDDM. None of 142 unrelated South Indian NIDDM subjects displayed the MELAS mutation at nt3243. However, sequencing identified two variants of potential importance: (a) at nt3290 in the tRNA^Leu(UUR) gene, seen in 7/142 diabetic and 1/85 control subjects (p = 0.11), (b) at nt3316 in the ND1 gene (4/142 vs 1/85 subjects, respectively (p = 0.51)). Further studies are needed to determine the relevance of these variants to the development of NIDDM.     

非胰岛素依赖型糖尿病患者红细胞膜ATP酶活力和细胞内离子水平变化

测定20例正常人及40例 NIDDM 患者红细胞膜 ATP 酶活力和红细胞内离子浓度。结果NIDDM 患者 Na~+-K~+-ATP 酶、Ca~(2+)-ATP 酶活力明显低于正常人(P 均<0.001),Mg~(2+)-ATT 酶活力无明显改变(P>0.05);NIDDM 患者红细胞内[Na~+]、[Ca~(2+)]明显高于正常人(P 分别<0.001和0.01),[Mg~(2+)]明显低于正常人(P<0.001),[K~+]无明显变化(P>0.05)。上述变化在无血管病者就已出现,有血管病者更加明显。     

糖尿病人群胰岛素受体基因变异的研究

动用聚合链反应及单链构型多态性技术分析５２例Ⅱ型糖尿病（ＮＩＤＤＭ）者及５４例正常对照组胰岛素受体基因第１７及２０外显子的变异。结果显示：外显子１７的１００８位ＧＧＣ－ＧＧＴ多态性频率在ＮＩＤＤＭ组为２９．４％，而在正常对照组为９．０７％（Ｘ＾２＝１０．０２，Ｐ〈０．００５）．外显子２０的１１６９位甘氨酸多态性ＧＧＴ→ＧＧＣ在ＮＩＤＤＭ与正常对照组的频率分别为１５．４％和３．７％（Ｘ＾２＝４．３７