吡格列酮对2型糖尿病患者胰岛素抵抗的影响

观察吡格列酮对2型糖尿病患者胰岛素抵抗的治疗作用,对30例2型糖尿患者予吡格列酮30mg／d口服,12周后发现餐后2小时血糖（PC2hPG）、糖化血红蛋白（GHbA1c）、空腹血糖（FPG）、胰岛素抵抗指数（Homa—IR）与用药前比较明显降低（P〈0．01）。提示吡格列酮可降低FPG、PC2hPG、GHbA1c及血浆胰岛素水平,明显减轻胰岛素抵抗。     

吡格列酮对新诊断2型糖尿病患者血清C反应蛋白的影响

目的探讨吡格列酮对新诊断2型糖尿病患者血清C反应蛋白的影响。方法将50例新诊断的2型糖尿病患者随机分成2组,治疗组26例予盐酸吡格列酮15mg／d,对照组24例予除噻唑烷二酮类和二甲双胍以外的其他降糖药物治疗6个月。结果治疗组治疗后的C反应蛋白、胰岛素抵抗指数和空腹胰岛素水平较对照组低（P〈0．01）,胰岛素敏感指数较对照组高（P〈0．01）。结论吡格列酮可以增加2型糖尿病患者的胰岛素敏感性,改善胰岛素抵抗,降低C反应蛋白,减轻炎症反应。     

吡格列酮辅助治疗2型糖尿病的疗效和安全性分析

目的探讨吡格列酮辅助治疗2型糖尿病的疗效和安全性分析。方法选取2013年3月—2014年3月于该院接受治疗的30患者,随机分成观察组和对照组。观察组服用吡格列酮30 mg(早饭前),对照组服用二甲双胍(早晚餐前)。比较两组患者服药后第2周后空腹血糖、饭后2 h血糖、糖化血红蛋白、空腹胰岛素含量及饭后2 h胰岛素含量变化情况。结果观察组及对照组用药2周后空腹血糖含量、饭后2 h血糖含量、糖化血红蛋白含量均呈现下降趋势、空腹胰岛素和饭后2 h胰岛素均呈现上升趋势,两组间比较有显著性差异。结论吡格列酮辅助治疗2型糖尿病疗效明显且安全性高,值得临床应用推广。     

吡格列酮辅助治疗2型糖尿病的疗效和安全性分析

目的探讨吡格列酮辅助治疗2型糖尿病的疗效和安全性分析。方法选取2013年3月—2014年3月于该院接受治疗的30患者,随机分成观察组和对照组。观察组服用吡格列酮30 mg(早饭前),对照组服用二甲双胍(早晚餐前)。比较两组患者服药后第2周后空腹血糖、饭后2 h血糖、糖化血红蛋白、空腹胰岛素含量及饭后2 h胰岛素含量变化情况。结果观察组及对照组用药2周后空腹血糖含量、饭后2 h血糖含量、糖化血红蛋白含量均呈现下降趋势、空腹胰岛素和饭后2 h胰岛素均呈现上升趋势,两组间比较有显著性差异。结论吡格列酮辅助治疗2型糖尿病疗效明显且安全性高,值得临床应用推广。     

随机、双盲、安慰剂对照评价盐酸吡格列酮并用磺酰脲类药物治疗2型糖尿病的有效性和安全性

目的 评价盐酸吡格列酮30 mg与磺酰脲类药物并用治疗2型糖尿病的有效性和安全性。方法 采用多中心、随机、双盲和安慰剂平行对照的研究方法。236例使用稳定剂量磺酰脲类药物治疗至少30 d而血糖控制不佳(空腹血糖7.5～ 13.0 mmol/L,糖化血红蛋白7.0％～12.0％)的2型糖尿病患者随机分入吡格列酮30 mg组与安慰剂组,磺酰脲类药物种类和剂量不变,治疗随访共16周。结果 16周时,吡格列酮组空腹血糖下降(1.48±2.08) mmol/L,安慰剂组则上升(0.17±1.92) mmol/L(P ＜0.05);吡格列酮组和安慰剂糖化血红蛋白分别下降(0.92±0.10)％和(0.28±0.11)％,空腹胰岛素下降(0.24±0.04) mU/L和(0.09±0.04) mU/L,稳态模型评价法计算的胰岛素抵抗指数下降1.42±2.90和0.46 ±3.52,TG平均下降0.36 mmol/L和0.14 mmol/L,HDL-C则平均上升0.17 mmol/L和0.05 mmol/L,两组间差异均有统计学意义(值均P＜0.05)。结论 为期16周的临床研究显示,2型糖尿病患者在单纯应用磺酰脲类血糖控制欠佳时加用吡格列酮30 mg/d,不仅可进一步改善血糖控制、增强胰岛素敏感性,还可降低TG、升高HDL-C水平,安全性和耐受性好。     

睡前加服吡格列酮/二甲双胍片可改善预混胰岛素治疗的2型糖尿病患者黎明现象

目的:比较吡格列酮/二甲双胍复方片剂与单药二甲双胍片对预混胰岛素治疗的2型糖尿病患者黎明现象的影响。方法:选择2019年1-12月在荆门市第二人民医院住院的使用预混胰岛素治疗后行末梢血糖监测仍存在黎明现象的2型糖尿病患者54例,随机分为2组:吡格列酮/二甲双胍组(A组) 28例、二甲双胍组(B组) 26例。A组睡前加服吡格列酮/二甲双胍(吡格列酮15 mg、二甲双胍500 mg),B组睡前仅加服二甲双胍500 mg,动态监测血糖,根据情况适时减少胰岛素用量,治疗1周,比较2组治疗前、后空腹血糖及黎明现象严重程度(Δ黎明)。结果:治疗1周后,2组空腹血糖和Δ黎明较治疗前下降(P均0. 05);且A组下降更显著(P均0. 05)。结论:使用预混胰岛素治疗的2型糖尿病患者,睡前加服吡格列酮/二甲双胍片较二甲双胍单药能更有效改善黎明现象。     

吡格列酮对2型糖尿病患者动脉粥样硬化相关因素的影响

目的探讨吡格列酮预防2型糖尿病动脉粥样硬化的可行性及机制。血清超敏C-反应蛋白（hs-CRP）、纤溶酶原激活物抑制剂-1（PAI-1）、P-选择素及胰岛素抵抗等动脉粥样硬化相关因素的影响。方法对30例2型糖尿病患者加用吡格列酮15mg／d,共12周。治疗前后测定血清超敏C-反应蛋白（hs—CRP）、纤溶酶原激活物抑制剂-1（PAI-1）、P-选择素及胰岛索抵抗指数、血脂等动脉粥样硬化相关指标。结果治疗后hs—CRP、PAI-1及P．选择素、胰岛素抵抗指数均显著下降（P〈0．05）,血脂各项指标均无显著变化。结论吡格列酮有助于预防2型糖尿病动脉粥样硬化;其机制为降低2型糖尿病患者血清hs—CRP、PAI-1及P-选择素水平及胰岛素抵抗程度。     

吡格列酮联合胰岛素治疗2型糖尿病疗效观察

40例大剂量胰岛素治疗的2型糖尿病患者，加服盐酸吡格列酮15mg／d，进行为期16周的用药观察。结果：与治疗前比较：空腹及餐后血糖均明显下降（P〈0．05），糖化血红蛋白也下降0．9％（P〈0．05），胰岛素用量减少12U（P〈0．05）。结论：2种药物联合应用可使高血糖得到满意控制，同时可以改善胰岛B细胞功能，降低胰岛素抵抗，增加胰岛素敏感性，减少胰岛素用量，二者起协同作用。     

糖耐量正常的日本人的β—细胞功能损害与胰岛素敏感性

作者旨在研究2型糖尿病患者应用吡格列酮(Pioglitazone)对血糖控制、胰岛素敏感性和胰岛素分泌的剂量.反应效应。方法 共58例采用饮食疗法的2型糖尿病患者,年龄(54±1)岁,男34例,女24例,体重指数(BMI)(31.5±0.6)kg·m-2,随机分为安慰剂组(11例)和吡格列酮7.5(13例)、15(12例)、30(11例)、45(11例),mg/d组,用药26周,用药前和用药26周后行口服葡萄糖(75 g)耐量试验(OGTT)。     

盐酸吡格列酮治疗2型糖尿病患者的临床研究

目的研究胰岛素增敏剂盐酸吡格列酮对2型糖尿病(T2DM)患者的胰岛素抵抗、血压、血脂的影响.方法对102例体质指数(BMI)≥25 kg/m2且使用磺脲类+双胍类药物后糖化血红蛋白(HbA1c)>7.0%的T2DM患者,在重新制定合理的饮食和运动的基础上,随机分为两组:治疗组使用盐酸吡格列酮15 mg/d连用12周,对照组使用原药物,观察两组患者治疗前后空腹血糖(FBG)、餐后两小时血糖(2hPG)、空腹胰岛素(FIns)、餐后2小时胰岛素(2hIns)HbA1c、甘油三酯(TG)、胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血压(BP)、胰岛素抵抗指数(HOMA-IR)等指标的变化.结果治疗12周后,治疗组FBG、HbA1c、Ins、BP、TG、LDL-C及HOMA-IR较较对照组均下降.结论盐酸吡格列酮能减轻胰岛素抵抗,降低血糖,改善脂代谢.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.