重组甘精胰岛素联合盐酸二甲双胍缓释片治疗初诊2型糖尿病的效果分析

目的 探讨重组甘精胰岛素联合盐酸二甲双胍缓释片治疗初诊2型糖尿病的临床疗效及安全性.方法 将104例初诊2型糖尿病患者分为观察组和对照组,各52例.观察组给予重组甘精胰岛素联合盐酸二甲双胍缓释片治疗,对照组给予诺和灵30R治疗,观察两组患者治疗前后血糖变化及低血糖发生率.结果 两组患者治疗前空腹血糖(FPG)、餐后2 h血糖(2PG)及糖化血红蛋白(HbAlc)水平比较差异无统计学意义(P＞0.05);治疗12周后FPG、2PG及HbAlc水平均达到理想水平,且组间比较差异无统计学意义(P＞0.05);观察组低血糖发生率明显低于对照组(1.9%VS23.1%,P＜0.05).结论 重组甘精胰岛素联合盐酸二甲双胍缓释片治疗初诊2型糖尿病,不仅具有较好的降糖效果,且低血糖发生率更低,值得临床采用.     

甘精胰岛素联合瑞格列奈治疗2型糖尿病临床疗效观察

目的:研究并分析甘精胰岛素联合瑞格列奈治疗2型糖尿病的临床疗效。方法:选择本院收治的60例2型糖尿病患者为研究对象,分为观察组与对照组,观察组使用甘精胰岛素联合瑞格列奈进行治疗,对照组皮下注射预混胰岛素,观察两组患者治疗前后空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbAlc)的变化情况,比较两组治疗有效率。结果:观察组与对照组治疗后FPG、2 h PG、HbAlc均显著降低,观察组治疗效果更加显著,组间比较差异均有统计学意义(P0.05)。结论:甘精胰岛素联合瑞格列奈对于2型糖尿病患者能够达到良好的降糖效果,可以改善胰岛素的敏感性,该种治疗方式值得在临床中进行推广和使用。     

二甲双胍联合甘精胰岛素对初发肥胖型2型糖尿病患者血糖及血脂水平的影响

目的探讨二甲双胍联合甘精胰岛素对初发肥胖型2型糖尿病患者血糖及血脂水平的影响。方法选取商丘市第三人民医院83例初发肥胖型2型糖尿病患者,随机数表法分为两组。观察组42例,对照组41例,对照组予以单一甘精胰岛素治疗,观察组实施二甲双胍联合甘精胰岛素治疗,观察比较两组空腹血糖(FPG)、餐后2 h血糖(2 h PG)及甘油三酯(TG)、胆固醇(TC)水平。结果治疗后观察组FPG、2 h PG、TG、TC、LDL-C水平均低于对照组,差异有统计学意义(P<0.05)。结论二甲双胍配合甘精胰岛素治疗初发肥胖型2型糖尿病,可有效控制患者血糖、血脂水平。     

阿卡波糖与二甲双胍配合甘精胰岛素治疗2型糖尿病效果对比

目的探讨分别使用阿卡波糖与二甲双胍配合甘精胰岛素治疗2型糖尿病的临床效果。方法选择90例初发2型糖尿病确诊患者,随机分为观察组与对照组,各45例,均在每日睡前给予皮下注射甘精胰岛素1次,观察组给予二甲双胍,对照组给予阿卡波糖,持续治疗3个月后观察疗效。比较两组治疗前、治疗后空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(Hb A1c);血糖达标时间、胰岛素日用量、低血糖发生率及其他不良反应发生情况。结果治疗后不同时点各组指标均较治疗前明显下降(P<0.05),且治疗后1个月观察组FPG、Hb A1c水平明显低于对照组,而2 h PG高于对照组,两组治疗后2、3个月比较,差异无统计学意义(P>0.05)。两组患者血糖达标时间、胰岛素日用量比较,差异无统计学意义(P>0.05)。观察组不良反应发生率为6.67%,低于对照组的22.22%(P<0.05)。结论二甲双胍、阿卡波糖配合甘精胰岛素均能有效治疗初发2型糖尿病患者,临床治疗工作中可结合患者对药物耐受情况进行合理选择。     

二甲双胍与重组甘精胰岛素治疗2型糖尿病疗效分析

目的观察重组甘精胰岛素联合二甲双胍缓释片治疗2型糖尿病的疗效及安全性。方法选择我院治疗的2型糖尿病患者70例,随机分为对照组35例和治疗组34例（治疗组1例因不能耐受二甲双胍的胃肠反应,退出研究）。2组共观察12周,监测血糖控制情况。结果二甲双胍与重组甘精胰岛素与预混胰岛素30R空腹血糖（FPG）、餐后2 h血糖（2h PG）和糖化血红蛋白（HbA1c）的变化相同,但治疗组低血糖反应显著下降。结论重组甘精胰岛素联合二甲双胍缓释片治疗2型糖尿病能良好地控制血糖且低血糖反应少,患者依从性高。     

甘精胰岛素联合二甲双胍治疗2型糖尿病临床疗效观察

目的：观察甘精胰岛素联合二甲双胍治疗2型糖尿病的临床疗效。方法：口服二甲双胍500mg,3次／日。甘精胰岛素睡前一次注射,初剂量从10U／日开始,以后根据空腹血糖调整,直至FBG≤7．0mmol／L或根据患者实际情况调整。结果：治疗12周后患者的FPG、2hPG以及HbA1c水平较治疗前明显降低,差异有统计学意义（P〈0．05）;BMI与治疗前比较无明显差异（P〉0．05）;发生低血糖2例,轻微,无严重低血糖发生。结论：甘精胰岛素联合二甲双胍治疗2型糖尿病患者有效,且低血糖危险低,体重增加少,值得推广。     

联合应用甘精胰岛素与二甲双胍缓释片治疗初诊2型糖尿病的系统性评价

目的:探讨联合应用甘精胰岛素与二甲双胍缓释片治疗初诊2型糖尿病的疗效。方法:病例资料来源于本社区2013年1月-12月诊治的初诊2型糖尿病患者65例。随机分成两组,对照组33例患者给予二甲双胍缓释片1片/d,同时每晚皮下注射诺和灵N;研究组32例患者给予二甲双胍缓释片1片/d,每晚皮下注射甘精胰岛素。对两组治疗前后空腹血糖(FBG),用餐2 h后血糖(PBG)及糖化血红蛋白(Hb A1C)含量进行分析比较。结果:研究组治疗总有效率为90.9%,明显高于对照组71.9%,两组比较差异具有统计学意义(P0.01);研究组治疗后各项指标均有明显改善,两组比较差异均有统计学意义(P0.05)。结论:联合应用甘精胰岛素与二甲双胍缓释片治疗初诊2型糖尿病疗效显著,有利于改善患者的症状,不但具有较好的降糖效果,且低血糖发生率更低,安全性好,值得推广及应用。     

甘精胰岛素联合二甲双胍和优泌林70/30治疗2型糖尿病的比较

目的探讨甘精胰岛素联合二甲双胍治疗2型糖尿病的疗效。方法选2型糖尿病患者50例,随机分为两组。治疗组,甘精胰岛素(n=25);对照组,(优泌林70/30胰岛素)(n=25)。分别采用每晚22:00注射甘精胰岛素加二甲双胍(早晚餐前半小时口服)和优泌林70/30胰岛素早晚餐前半小时皮下注射。根据血糖调整胰岛素剂量,12周后对观察两组糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2h血糖(2hPBG)、低血糖发生率。结果甘精胰岛素联合二甲双胍和优泌林70/30治疗2型糖尿病均可有效降低血糖,两组HbA1c、FPG、2hPBG差异无统计学意义(P>0.05),但甘精胰岛素组低血糖发生率明显低于优泌林70/30组(P<0.05)而且体重无明显增加(P>0.05)。结论甘精胰岛素联合二甲双胍治疗2型糖尿病,不仅能使血糖达标,而且能使体重有所减轻,并且减少了低血糖的发生风险,是治疗2型糖尿病尤其是体重指数较大患者较理想的选择。     

应用二甲双胍、甘精胰岛素联合治疗初诊肥胖2型糖尿病的效果

目的:探讨分析二甲双胍联合甘精胰岛素治疗初诊肥胖2型糖尿病的临床疗效。方法:将2015年4月~2016年6月我院78例初诊2型糖尿病伴肥胖患者随机分为对照组与试验组各39例。对照组单独应用甘精胰岛素治疗,试验组应用二甲双胍+甘精胰岛素治疗,比较两组临床疗效及低血糖发生情况。结果:治疗12周后,试验组血糖、血脂水平均显著优于对照组(p0.05);试验组低血糖发生率为12.82%,明显低于对照组28.21%(P0.05)。结论:二甲双胍联合甘精胰岛素是治疗初诊2型糖尿病伴肥胖的有效降糖方案,能够有效降低患者血糖及血脂水平,减少低血糖事件发生。     

甘精胰岛素联合瑞格列奈治疗2型糖尿病的临床效果和安全性

目的探讨甘精胰岛素联合瑞格列奈治疗2型糖尿病的临床效果和安全性。方法选取2014年11月至2015年11月淇县人民医院内分泌科收治的68例2型糖尿病患者作为研究对象,根据治疗方式的不同将其分为单用组和联合组,单用组患者予以皮下注射甘精胰岛素,联合组患者在单用组基础上加用瑞格列奈片口服治疗,比较两组患者治疗前后空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(Hb A1c)以及治疗后低血糖事件发生率。结果治疗后,两组患者FPG、2 h PG以及Hb A1c等指标较前明显改善,且联合组患者上述指标改善情况明显优于单用组,低血糖发生率明显低于单用组,差异具有统计学意义(P<0.05)。结论甘精胰岛素联合瑞格列奈治疗2型糖尿病临床效果显著,且低血糖事件发生率低,该方法安全可靠。     

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.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

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…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.