Impact of Addition of Metformin to Abiraterone in Metastatic Castration-Resistant Prostate Cancer Patients With Disease Progressing While Receiving Abiraterone Treatment (MetAb-Pro): Phase 2 Pilot Study

Background

There is evidence linking metformin to improved prostate cancer–related outcomes.

中国5~18岁人群遗尿症患病率的横断面调查

目的 了解中国儿童和青少年遗尿症的患病情况。方法 横断面调查，以中国医师协会肾脏专委会中国儿童遗尿疾病管理协作组（简称：协作组）成员与所在省、自治区和直辖市有工作联系的区县为抽样单位。遗尿症诊断标准为年龄≥5岁，3个月内出现尿床事件≥1次；尿床指夜间睡眠中排尿于床上或尿湿衣裤。调查时间为2017年4月20日至2017年5月12日；调查人群为中国5~18岁儿童及青少年，分为幼儿园（5~6岁）、小学（~12岁），初中（~15岁）和高中（~18岁）。每个区县样本量需＞3 073人。自行设计遗尿症调查问卷，本文主要分析基本人口学信息和尿床事件。由儿童或青少年的家长或照护者在手机或其他安装有微信应用终端设备上填写问卷。结果 24个协作组成员所在省、自治区和直辖市中的34个区县中的225所幼儿园和学校参与了调查，其中幼儿园82所，小学61所，初中49所，高中33所。调查目标样本人群129 952人，进入本文分析的调查问卷100 071份（77.0%）。男52 074份，平均年龄（11.0±3.4）岁，汉族占92.5%，幼儿园、小学、初中、高中人数比例约为1∶5∶2∶1。中国儿童和青少年遗尿症患病率为4.8%（4 821/100 071）；幼儿园、小学、初中、高中遗尿患病率分别为12.1%、5.1%、1.1%和1.4%；各年龄男孩遗尿症患病率均高于同年龄的女孩；中国境内6大行政区（华北、东北、华东、中南、西南、西北）以样本人群年龄构成比进行标准化后，其患病率分别为4.2%，3.7%、4.6%、5.8%、5.1%和4.9%；4 821名遗尿症患儿中，轻、中、重度遗尿症患儿分别占81.4%、13.5%和5.1%；重度遗尿症幼儿园、小学、初中和高中组比例为6.9%、3.7%、5.3%和10.0%。结论 中国幼儿园、小学、初中、高中人群遗尿患病率分别为12.1%、5.1%、1.1%和1.4%，儿童遗尿症患病率总体为4.8%。幼儿园及高中组重度遗尿症的比例较高。     

义龈修复与牙周菌群变化相关性研究

目的 :通过对牙周菌群在两种义龈修复前后的种属变化探讨义龈修复对严重牙龈退缩患者修复治疗的远期效果及与牙周健康的关系。方法 :严重的牙龈退缩患者经过系统性牙周治疗后随机分为常规义龈修复组及弹性义龈修复组 ,分别提取修复治疗前后各观察时段内龈沟液 ,作细菌培养和分类计数观察。结果 :对细菌形态学的记数比较显示 ,弹性材料组的螺旋体及梭杆菌的改变较常用热凝塑料组慢 ,修复 6个月后才能检测出显著性差异 ,常规材料修复 1个月后即可发现显著性变化 ;对几种特异性的牙周厌氧菌的分类培养显示在常规材料组组内差异明显 ,随时间的延长 ,组间差异更加明显。结论 :弹性塑料由于材料组织相容性好等优点 ,制作的义龈对于患者牙周健康的保持更为有利 ,是一种较为满意的治疗严重牙龈退缩的修复方法     

甲钴胺与马来酸桂哌齐特联合治疗糖尿病下肢神经病变的疗效观察

目的：探讨甲钴胺与马来酸桂哌齐特在2型糖尿病合并下肢周围神经病变治疗中的疗效及血管内皮功能的变化.方法：选择2型糖尿病合并下肢周围神经病变的病例60例,随机分甲钴胺治疗组（1组）和甲钴胺与马来酸桂哌齐特治疗组（2组）,每组30例,1组给予甲钴胺治疗,2组在甲钴胺治疗的基础上加用马来酸桂哌齐特治疗,疗程14天,治疗前后观察临床症状,测定血管内皮细胞功能和肌电图.结果：经过治疗,1组运动传导速度、感觉传导速度,以及临床症状有一定程度的改善,但差异无显著性意义（P＞0.05）,2组治疗后运动传导速度、感觉传导速度明显增快,同时临床症状改善明显（P＜0.01）;两组治疗前血内皮素、D-二聚体和C反应蛋白（CRP）均高于正常,治疗前后比较差异有显著性意义（P＜0.05）,而1组血内皮素、D-二聚体和CRP均有一定程度的下降但差异无显著性意义（P＞0.05）.结论：甲钴胺与马来酸桂哌齐特联合治疗在2型糖尿病合并下肢周围神经病变治疗中可改善血管内皮的功能和下肢周围神经病变,缓解临床症状,疗效显著.     

胃镜诊断十二指肠降部病变207例分析

目的：探讨十二指肠降部病变发病情况、主要临床表现及胃镜下改变。方法：分析本院近10年来胃镜诊断十二指肠降部病变207例，探讨其主要疾病及临床特点，胃镜诊断情况。结果：降部病变男多于女；以降部溃疡最常见(40．6％)，其次为降部息肉(16．9％)、降部癌(包括乳头癌)占14％、降部炎(11．6％)、降部憩室(4．8％)，还有降部乳头炎、黏膜下肿块、钩虫感染、蛔虫、结石、血管病变等；临床表现无明显特异性，胃镜 病理可以发现病变位置、大小、形状、性质等。结论：十二指肠降部病变多样，临床表现不典型，胃镜有重要诊断价值。     

Caloric beverage drinking patterns are differentially associated with diet quality and adiposity among Spanish girls and boys

The present study assesses the impact of beverage consumption pattern on diet quality and anthropometric proxy measures for abdominal adiposity in Spanish adolescents. Data were obtained from a representative national sample of 1,149 Spanish adolescents aged 10–18 years. Height, weight, and waist circumferences were measured. Dietary assessment was performed with a 24-h recall. Beverage patterns were identified by cluster analysis. Adherence to the Mediterranean diet was measured by the KIDMED index. Three beverage clusters were identified for boys—“whole milk” (62.5 %), “low-fat milk” (17.5 %) and “soft drinks” (20.1 %)—and for girls—^“whole milk” (57.8 %), “low-fat milk” (20.8 %) and juice (21.4 %), accounting for 8.3, 9.6, 13.9, 8.6, 11.5 and 12.9 % of total energy intake, respectively. Each unit of increase in the KIDMED index was associated with a 14.0 % higher (p?=?0.004) and 11.0 % lower (p?=?0.048) probability of membership in the “low-fat milk” and “soft drinks” cluster in girls and boys, respectively, compared with the “whole milk” cluster. Boys in the “soft drinks” cluster had a higher risk of 1-unit increase in BMI z score (29.0 %, p?=?0.040), 1-cm increase in waist circumference regressed on height and age (3.0 %, p?=?0.027) and 0.1-unit increase in waist/height ratio (21.4 %, p?=?0.031) compared with the “whole milk” cluster. Conclusion: A caloric beverage pattern dominated by intake of “soft drinks” is related to general and abdominal adiposity and diet quality in Spanish male adolescents.     

山 西 护 理 杂 志

对神经内科试行系统化整体护理，结果表明病人满意率上升，平均住院日缩短，并发症减少，护理人员业务水平、护理质量明显提高。     

Effects of rosuvastatin versus atorvastatin, simvastatin, and pravastatin on non-high-density lipoprotein cholesterol, apolipoproteins, and lipid ratios in patients with hypercholesterolemia: additional results from the STELLAR trial

BACKGROUND: Non-high-density lipoprotein cholesterol (HDL-C), apolipoprotein (apo) B, and lipid and apolipoprotein ratios that include both atherogenic and antiatherogenic lipid components have been found to be strong predictors of coronary heart disease risk. OBJECTIVE: The goal of this study was to examine prospectively the effects of rosuvastatin, atorvastatin, simvastatin, and pravastatin across dose ranges on non-HDL-C, apo B, apo A-I, and total cholesterol (TC):HDL-C, low-density lipoprotein cholesterol (LDL-C):HDL-C, non-HDL-C:HDL-C, and apo B:apo A-I ratios in patients with hypercholesterolemia (LDL-C > or =160 mg/dL and <250 mg/dL and triglycerides <400 mg/dL) in the Statin Therapies for Elevated Lipid Levels compared Across doses to Rosuvastatin (STELLAR) trial. METHODS: In this randomized, Multicenter, parallel-group, open-label trial (4522IL/0065), patients > or =18 years of age received rosuvastatin 10, 20, 40, or 80 mg; atorvastatin 10, 20, 40, or 80 mg; simvastatin 10, 20, 40, or 80 mg; or pravastatin 10, 20, or 40 mg for 6 weeks. Pairwise comparisons were prospectively planned and performed between rosuvastatin 10, 20, and 40 mg and milligram-equivalent or higher doses of comparators. RESULTS: A total of 2268 patients were randomized to the rosuvastatin 10- to 40-mg, atorvastatin, simvastatin, and pravastatin groups. Fifty-one percent of patients were women, the mean (SD) age was 57 (12) years, and 19% had a documented history of atherosclerotic disease. Over 6 weeks, rosuvastatin significantly reduced non-HDL-C, apo B, and all lipid and apolipoprotein ratios assessed, compared with milligram-equivalent doses of atorvastatin and milligram-equivalent or higher doses of simvastatin and pravastatin (all, P < 0.002). Rosuvastatin reduced non-HDL-C by 42.0% to 50.9% compared with 34.4% to 48.1% with atorvastatin, 26.0% to 41.8% with simvastatin, and 18.6% to 27.4% with pravastatin. Rosuvastatin reduced apo B by 36.7% to 45.3% compared with 29.4% to 42.9% with atorvastatin, 22.2% to 34.7% with simvastatin, and 14.7% to 23.0% with pravastatin. The highest increase in apo A-I (8.8%) was observed in the rosuvastatin 20-mg group, and this increase was significantly greater than in the atorvastatin 40-mg and 80-mg groups (both, P < 0.002). CONCLUSION: Rosuvastatin 10 to 40 mg was more efficacious in improving the lipid profile of patients with hypercholesterolemia than milligram-equivalent doses of atorvastatin and milligram-equivalent or higher doses of simvastatin and pravastatin.     

急性心肌梗死患者血浆BNP、ET、CRP、ANP水平变化与临床观察分析

目的　观察急性心肌梗死 (AMI)患者血浆中B型钠尿肽 (BNP)、内皮素 (ET)、C 反应蛋白 (CRP)、A型钠尿肽 (ANP)水平变化 ,为治疗及预后判断提供依据。方法　应用酶联免疫法及免疫放射分析法对 4 6例AMI患者治疗前后和 30名正常对照者血浆中BNP、ET、CRP、ANP水平进行检测。结果　AMI患者血浆中BNP、ET、CRP、ANP治疗前后比较差异有显著性 (P <0 .0 0 1) ,正常对照组与AMI治疗前比较差异有显著性 (P<0 .0 0 1) ,BNP与CRP在AMI治疗前水平呈正相关 (r =0 .874 ) ,治疗后呈明显的下降趋势 (r =0 .6 5 4 ) ,AMI治疗前后ANP与ET呈正相关 ,但AMI经溶栓和相应的支持治疗后ANP基本恢复到正常水平 (P >0 .0 5 ) ,而BNP、ET、CRP水平虽然下降明显 ,但与正常组比较差异仍有显著性 (P <0 .0 5 )。结论　AMI患者血浆中BNP、ANP、ET、CRP水平的变化说明其参与了AMI的发生、发展 ,特别是冠状动脉粥样斑块的形成和 (或 )破裂及血栓形成 ,其炎症因子是主要因素。因此 ,4项指标的观察分析对AMI治疗、预后判断具有重要意义