胰岛素强化降糖方案治疗2型糖尿病的应用及对患者胰岛功能影响分析

目的分析胰岛素强化降糖方案治疗2型糖尿病的应用及对患者胰岛功能影响。方法入组该院2018年8月—2020年4月收治的2型糖尿病患者共110例,随机分组,对照组的患者给予胰岛素多次皮下注射治疗,观察组给予早期胰岛素强化降糖方案治疗。比较两组血糖达标时间、使用胰岛素的用量、出现低血糖次数、血糖波动幅度、治疗前后患者空腹血糖、餐后2 h血糖和糖化血红蛋白、HOMA-β、HOMA-IR、治疗总有效率、不良反应。结果观察组血糖达标时间短于对照组,使用胰岛素的用量、出现低血糖次数、血糖波动幅度低于对照组相应的指标,差异有统计学意义(P<0.05)。治疗前两组空腹血糖、餐后2 h血糖和糖化血红蛋白、HOMA-β、HOMA-IR比较,差异无统计学意义(P>0.05),而治疗后两组的空腹血糖、餐后2 h血糖和糖化血红蛋白、HOMA-IR均降低,HOMA-β均显著升高,观察组空腹血糖、餐后2 h血糖和糖化血红蛋白、HOMA-IR显著低于对照组,而HOMA-β显著高于对照组,差异有统计学意义(P<0.05)。观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。观察组出现2例低血糖反应,对照组出现9例低血糖反应,差异有统计学意义(χ²=4.950,P=0.026<0.05)。结论给予早期胰岛素强化降糖方案治疗对血糖波动的临床效果确切,可更好控制血糖和减少胰岛素的用药量,促进患者胰岛功能的改善,并提高治疗的安全性。     

替诺福韦酯联合双重免疫方案阻断HBV携带孕妇母婴病毒传播效果研究

目的 观察应用替诺福韦酯联合双重免疫方案处理慢性乙型肝炎病毒(HBV)携带孕妇对母婴病毒传播阻断的效果。方法 2016年12月～2019年9月我院收治的HBV携带孕妇120例,采用随机数字表法分为对照组60例和观察组60例。对照组孕妇未进行抗病毒治疗,观察组孕妇在孕26～28个月时开始口服替诺福韦酯,治疗至分娩。所有新生儿出生后立即接种乙肝疫苗和乙型肝炎免疫球蛋白进行双重免疫。采用聚合酶链式反应法检测血清HBV DNA,采用胶体金法检测血清HBsAg和HBeAg。结果 在分娩时,观察组血清ALT水平为(23.2±3.6)IU/L,与对照组【(26.9±4.0)IU/L,P>0.05】比,无显著性差异,血清HBV DNA载量为(3.1±0.7) lg copies/mL,显著低于对照组【(5.9±0.8)lg copies/mL,P<0.05】;观察组新生儿Apgar评分为(9.7±0.3)分,与对照组【(9.9±0.5)分,P>0.05】比,无显著性差异,两组新生儿身高、体质量和头围比较,无显著性差异(P>0.05);在分娩时、出生后6个月和12个月,观察组婴儿HBV感染率为1.7%、1.7%和1.7%,与对照组(分别为11.7%、11.7%和13.3%,P>0.05)比,无显著性差异。结论 应用替诺福韦酯联合双重免疫方案处理HBV携带孕妇及其新生儿能显著降低孕妇血清HBV载量,可能降低婴儿HBV感染率,值得进一步扩大观察。     

Important factors improving outcome of young adults with acute lymphoblastic leukemia (ALL)

Four categories of important factors improving outcome of young adults and older adolescents with acute lymphoblastic leukemia (ALL) are biologic type, clinical trials, pediatric vs. adult treatment regimen, and psychosocial challenges. Overall, the outcome of ALL in the age group has improved and beginning to catch up with that in children, as exemplified by CALGB 10403, a pediatric treatment regimen. Each is dependent for optimum development, however, on progress in the others. Without adequate psychosocial support and improvement, progress in clinical trials, translational research, and pediatric regimen application is impaired. Without clinical trials, advances in translational research, optimal pediatric regimen application and adequate psychosocial research are restricted. Overall, we have improved the outcome and outlook of ALL in AYAs, as exemplified by CALGB 10403, but we and our current and future patients still have a long way to go.     

Bone marrow transplantation for acquired aplastic anemia: What's new

Bone marrow transplantation is a major therapeutic option for patients with acquired severe aplastic anaemia: improved survival has been achieved in younger patients, thanks to better donor selection, conditioning regimens and graft versus host disease prophylaxis, together with improved supportive care, including diagnosis and treatment of opportunistic infections. This has not been the case for older patients over the age of 40 years.We will discuss transplantation platforms as used for different donor types and we will analyse major breakthroughs of the last years: the combination of Fludarabine and cyclophosphamide as a conditioning regimen, the use of alternative donors including HLA haploidentical related donors and new strategies to prevent acute and chronic graft versus host disease, including post transplantation Cyclophosphamide. These changes extend the option of a bone marrow transplantation for patients who lack an HLA matched donor and appear to improve engraftment and reduce graft versus host disease: whether this will be true for all age groups is currently being investigated.     

VEGFR-1抗体对肺癌A549细胞顺铂药物敏感性的影响

目的观察血管内皮生长因子受体-1(VEGFR-1)抗体影响人肺腺癌A549细胞对顺铂(CDDP)的药物敏感性。方法将VEGFR-1抗体与顺铂单独及联合作用于A549细胞,72 h后用MTT法,克隆形成法检验化疗药物的敏感性。结果VEGFR-1抗体(30μmol/L)和顺铂(10μg/mL)联用组抑制A549细胞生长均显著强于VEGFR-1抗体与顺铂单独用药组。结论VEGFR-1抗体能显著增强顺铂抑制人肺癌细胞A549细胞生长的作用,可能是很有潜力化疗增敏剂。     

温和刺激方案在多囊卵巢综合征患者体外受精——胚胎移植中的应用研究

目的探讨温和刺激方案在多囊卵巢综合征(PCOS)患者体外受精-胚胎移植周期中的临床应用。方法选取2015年3月~2017年6月在我院接受体外受精-胚胎移植(IVF-ET)的PCOS患者共80例,将患者随机分为克罗米芬温和刺激方案(A组)40例和短效促性腺激素释放激素激动剂(Gn RHa)长方案(B组)40例,比较两组患者IVF周期的一般情况、促排卵参数、实验室指标及解冻胚胎移植(FET)临床妊娠率。结果 (1)两组患者年龄、不孕年限、基础FSH、基础LH、基础E2、体质量指数(BMI)均无统计学差异(P0.05);(2)A组使用促性腺激素(Gn)天数和Gn用量显著低于B组(P0.05);(3)两组注射人绒毛膜促性腺激素(HCG)日E2、P无显著性差异(P0.05);而HCG日LH水平A组显著高于B组,差异有统计学意义(P0.01);(4)两组获卵数、卵裂率、优质胚胎率差异均无统计学意义(P0.05),而A组正常受精率、冷冻胚胎数低于B组,差异有统计学意义(P0.05);(5)A组中度卵巢过度刺激综合征(OHSS)率明显低于B组,但差异无统计学意义(P0.05);(6)A组FET临床妊娠率高于B组,但差异无统计学意义(P0.05)。结论克罗米芬温和刺激方案在PCOS患者IVF-ET治疗中有较理想的促排效果,可明显减少Gn天数及Gn总量,从而减少患者周期治疗费用;OHSS并发症发生率较低,且能获得理想的临床妊娠率。     

茯苓抗衰、养生与美容作用诠析

茯苓是一味常用的抗衰老、养生与美容中药之一,就茯苓的相关作用机制进行了诠析。认为,茯苓通过健脾与渗湿作用达到抗衰老、养生与美容的目的。深入研究茯苓的抗衰老机制及其养生与美容作用,在当前关注养生与美容的今天,具有十分重要的意义。     

Long‐term efficacy and safety of ranibizumab administered pro re nata in Japanese patients with neovascular age‐related macular degeneration in the EXTEND‐I study

Purpose: To evaluate the long‐term efficacy and safety of ranibizumab administered pro re nata (PRN) in Japanese patients with choroidal neovascularization secondary to age‐related macular degeneration during the extension phase of the EXTEND‐I study. Methods: EXTEND‐I, an open‐label, multicenter, Phase I/II study comprised: a single‐injection (Group A); a multiple‐injection (Groups A and B; the latter consisted of patients who did not participate in the single‐injection phase); and an extension phase. In the extension phase, a PRN regimen of ranibizumab (0.3 or 0.5 mg) guided by monthly best‐corrected visual acuity (BCVA) score and other ophthalmic examinations was employed. The efficacy variables included the mean BCVA change from Month 12 to the last visit in Group B. Safety was assessed in all patients. Results: In the extension phase, efficacy was assessed only in Group B patients. The number of ranibizumab injections per year in the 0.3 and 0.5 mg Group B patients was 4.19 and 4.27, respectively. The mean BCVA change (SD) from Month 12 to the last visit was ?3.6 (14.82) letters for 0.3 mg (n = 28) and ?2.2 (7.92) letters for 0.5 mg groups (n = 33) in Group B. Conjunctival haemorrhage and nasopharyngitis were the most commonly reported adverse events. Of the 13 serious adverse events reported, cerebral infarction (two incidences) was suspected to be study‐drug related. Conclusions: Pro re nata regimen of ranibizumab guided by monthly BCVA and other ophthalmic examinations appears effective in sustaining the BCVA gained with 12 monthly injections while reducing the number of injections during the extension phase. Ranibizumab was well tolerated during the extension phase.     

潜在可切除胃癌新辅助化疗的临床疗效观察

目的探讨潜在可切除胃癌新辅助化疗的临床疗效。方法收集本科收治的进展期及局部晚期潜在可切除胃癌患者31例，予以改良DCF方案（mDCF）化疗2～4个周期，观察其临床疗效及不良反应。结果全组获CR1例，PR15例，SD10例，PD5例，临床有效率为51．61％，疾病控制率为83．86％。手术切除率为64．52％（20／31），其中R0切除率为45．16％（14／31），R1切除率为12．90％（4／31），R2切除率为6．45％（2／31）。姑息性手术7例（22．58％）。2例术后出现并发症，并发症发生率为10％（2／20）。主要不良反应为骨髓抑制、恶心呕吐及轻度肝功能损害，经对症处理后均可缓解及恢复。结论改良DCF方案应用于潜在可切除胃癌的新辅助化疗的临床疗效较好，该疗法可使肿瘤降期，增加手术切除的机会，化疗相关不良反应可耐受，安全性较高。