沙格列汀联合二甲双胍治疗2型糖尿病有效性和安全性的meta分析

目的评价沙格列汀联合二甲双胍治疗2型糖尿病的疗效和安全性。方法以"saxagliptin"和"metformin"为关键词检索PubMed和EMbase数据库,筛选出沙格列汀治疗2型糖尿病的所有随机对照试验(RCTs),根据纳入标准对文献进行筛选和评估,采用RevMan 5.1软件进行meta分析,比较沙格列汀联合二甲双胍(沙格列汀组)与安慰剂(安慰剂对照组)或其他降糖药物联合二甲双胍(阳性药物对照组)治疗对2型糖尿病患者糖化血红蛋白(HbA1c)和空腹血糖(FPG)水平的影响,并比较低血糖发生率,结果以平均差(MD)、相对危险系数(RR)及其95%置信区间(CI)表示。结果共纳入5项RCTs研究。meta分析结果显示,在降低患者HbA1c水平方面,沙格列汀组明显优于安慰剂对照组(MD=-0.59,95%CI为-0.87～-0.32,P=0.00),也优于阳性药物对照组(MD=-0.36,95%CI为-0.73～-0.54,P=0.00)。在降低患者FPG水平方面,沙格列汀组的治疗效果明显优于安慰剂对照组(MD=-16.27,95%CI为-21.64～-10.91,P=0.00),而与阳性药物对照组的治疗效果相比,差异无统计学意义(MD=-2.75,95%CI为-22.52～17.01,P=0.78)。沙格列汀组与安慰剂或阳性药物对照组患者的低血糖发生率差异无统计学意义(RR=0.55,95%CI为0.15～2.09,P=0.38)。结论沙格列汀联合二甲双胍治疗能有效降低2型糖尿病患者的HbA1c和FPG水平,且安全性较好。     

维格列汀联合二甲双胍治疗2型糖尿病的疗效与安全性的系统评价

目的:系统评价维格列汀联合二甲双胍治疗2型糖尿病的疗效和安全性。方法:计算机检索PubMed、Cochrane图书馆、EMBase、中国期刊全文数据库、万方数据库中关于维格列汀联合二甲双胍治疗2型糖尿病的随机对照试验(RCT),采用Cochrane协作网提供的Rev Man 5.2统计软件进行Meta分析。结果:共纳入6项RCT,合计10 730例患者。Meta分析结果显示,在降低患者糖化血红蛋白水平方面,试验组与对照组疗效相当,差异无统计学意义[WMD=0.02,95%CI(-0.05,0.09),P=0.56];在降低空腹血糖水平方面,试验组显著优于对照组,差异有统计学意义[WMD=0.35,95%CI(0.16,0.54),P<0.000)];在降低体质量方面,试验组显著优于对照组,差异有统计学意义[WMD=-1.52,95%CI(-1.90,-1.14),P<0.000];在低血糖发生率方面,试验组显著低于对照组,差异有统计学意义[RR=0.37,95%CI(0.15,0.90),P=0.03]。结论:维格列汀联合二甲双胍治疗2型糖尿病安全有效,其降糖疗效优于二甲双胍联合磺脲类或噻唑烷二酮类,且不出现二甲双胍联合磺脲类或噻唑烷二酮类引起的体质量增加,以及二甲双胍联合磺脲类易致的低血糖。由于纳入研究较少,该结论尚需大样本、多中心RCT进一步验证。     

利格列汀联合二甲双胍治疗2型糖尿病疗效与安全性初步研究

目的 探讨利格列汀与安慰剂作为二甲双胍的添加治疗对血糖控制不良的2型糖尿病患者的有效性、安全性。方法 15例2型糖尿病患者随机分为2组：5 mg利格列汀联合二甲双胍组(n=10)、安慰剂联合二甲双胍组(n=5),治疗24周,观察治疗前后2组糖化血红蛋白(HbAlc)、空腹血糖(FPG)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、血清肌酐(Scr)、尿白蛋白肌酐比(UACR)、肌酸激酶(CK)、体质指数(BMI)、腰围、收缩压(SBP)、舒张压(DBP),记录不良事件及低血糖事件。结果 2组HbA1c改变幅度分别为-14.9%,-7.3%(P<0.05);FPG改变幅度分别为-4.7%,-8.0%(P>0.05);SBP改变幅度分别为-1.6%,+9.0%(P<0.05);DBP改变幅度分别为+0.2%,+13.7%(P<0.05),UACR改变幅度分别为-33.3%,+91.1%(P<0.01)。2组间ALT、AST、ALP、Scr、BMI、腰围改变、不良事件差异均无统计学意义。2组均无低血糖事件。结论 利格列汀联合二甲双胍治疗较二甲双胍单药治疗,降低HbA1c更优,有相似的降低FPG疗效,能适当降低SBP,显著降低UACR。无体质量增加和低血糖风险,是一种安全有效的治疗方法。     

二甲双胍治疗老年2型糖尿病患者中联合利格列汀的临床观察

目的探讨二甲双胍治疗老年2型糖尿病(T2DM)患者中联合利格列汀的效果。方法 34例老年T2DM患者口服二甲双胍联合利格列汀5 mg,治疗3个月。观察治疗前后空腹血糖(FBG)、餐后血糖(PBG)、糖化血红蛋白(Hb A1c)、总胆固醇(TC)、三酰甘油(TG)、体质量指数(BMI)、空腹C肽(FCP)、餐后2 h C肽(PCP)及胰岛素抵抗指数(HOMA-IR)的差异。结果治疗后FBG、PBG、Hb A1c及TG下降,PCP较治疗前上升,HOMA-IR较前下降(P均<0.05)。结论二甲双胍联合利格列汀可有效降低老年T2DM患者血糖,改善胰岛素抵抗和血脂水平。     

西格列汀对初发2型糖尿病患者胰岛B细胞功能的影响

目的研究西格列汀对初发2型糖尿病患者胰岛B细胞功能的影响。方法选择我院门诊2型糖尿病患者69例,随机分为对照组和试验组,对照组35例,试验组34例,对照组予二甲双胍治疗,试验组予二甲双胍、西格列汀治疗,12周后比较治疗前后两组患者空腹血糖(FPG)、餐后2 h血糖(PPG)、糖化血红蛋白(Hb A1c)、体重指数(BMI)、空腹胰岛素(Fins)、餐后2 h胰岛素(Pins)。结果两组治疗前各项指标比较差异无统计学意义(P>0.05),治疗后,两组FPG、PPG、Hb A1c、BMI均较治疗前显著下降(P<0.05)。与对照组相比,试验组FPG、PPG、Hb A1c降低更明显(P<0.05),Fins、Pins水平升高更显著(P<0.05)。结论西格列汀能明显改善初发2型糖尿病患者的胰岛B细胞功能,在临床应用中安全有效。     

利格列汀联合二甲双胍治疗糖尿病的临床疗效研究

目的:探讨糖尿病患者采用二甲双胍联合利格列汀治疗的临床疗效。方法:将2017年6月~2018年6月治疗糖尿病的86例患者随机分为两组,A组采用格列齐特联合二甲双胍治疗,B组采用二甲双胍联合利格列汀治疗,比较两组的治疗效果。结果:两组患者治疗前HbAlc、2hPG、FPG水平比较差异不明显(P>0.05);B组患者治疗后以上血糖指标明显低于A组,治疗总有效率明显高于A组,对比差异有统计学意义(P<0.05)。结论:糖尿病患者采用利格列汀联合二甲双胍治疗,能有效降低患者的血糖水平,提高其治疗效果,适合在临床上应用。     

二甲双胍联合维格列汀治疗2型糖尿病临床疗效分析

目的 讨论二甲双胍联合维格列汀治疗2型糖尿病的临床疗效。方法 73例2型糖尿病患者,随机分为二甲双胍组(34例)和二甲双胍联合维格列汀组(39例),测定两组患者治疗前后空腹血糖(FBG)、口服葡萄糖耐量试验餐后2 h血糖(2 h FPG)、糖化血红蛋白(Hb A1c)、血脂、肾功、体质量指数(BMI)等生化指标。结果 组内比较二甲双胍组FBG、OGTT2 h、Hb A1c治疗后明显低于治疗前,差异有统计学意义(P<0.05),二甲双胍联合维格列汀组FBG、OGTT2 h、Hb A1c、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)治疗后明显低于治疗前,差异有统计学意义(P<0.05)。组间比较,治疗前二甲双胍组和二甲双胍联合维格列汀组各指标差异无统计学意义(P>0.05),治疗后二甲双胍联合维格列汀组BMI、LDL-C、TC明显低于二甲双胍组,差异有统计学意义(P<0.05)。结论 二甲双胍联合维格列汀具有良好降糖降血脂疗效。     

利格列汀辅助治疗老年糖尿病患者的疗效分析

目的 分析利格列汀治疗老年糖尿病患者的疗效及有效率.方法 100例老年糖尿病患者,随机分为对照组和观察组,每组50例.对照组患者采取二甲双胍口服治疗,观察组给予二甲双胍联合利格列汀治疗.比较两组治疗效果、不良反应以及治疗前后的血脂指标[甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆...     

利格列汀联合二甲双胍治疗2型糖尿病的临床疗效观察

目的分析利格列汀与二甲双胍联合方案在2型糖尿病治疗中的有效性。方法回顾性比较我院应用联合药物治疗的97例2型糖尿病患者(即观察组,利格列汀+二甲双胍治疗)和单独应用二甲双胍治疗(即对照组)的94例2型糖尿病患者在空腹血糖、餐后血糖(即2h PG)、糖化血红蛋白(HbA1c)、药物不良反应等方面的差异性。结果规范治疗12周之后,两组患者的空腹血糖、2h PG、HbA1c均有明显改善,组内治疗前后数据具有显著差异(P<0.05);治疗后,观察组各项指标的改善效果均优于对照组,组间比较,P<0.05,具有显著性差异;组间不良反应相近(P>0.05)。结论利格列汀联合二甲双胍具有良好的降糖作用,且药物不良反应少,是2型糖尿病安全有效的治疗方案。     

消渴丸对比格列本脲治疗2型糖尿病疗效与安全性的系统评价

目的:系统评价消渴丸对比格列本脲治疗2型糖尿病的疗效和安全性,以为临床治疗提供循证参考。方法:计算机检索Medline、Pub Med、EMBase、Cochrane图书馆、中国生物医学文献数据库、中国期刊全文数据库、万方数据库和中文科技期刊数据库,纳入消渴丸(试验组)对比格列本脲(对照组)治疗2型糖尿病的随机对照试验(RCT),按Cochrane系统评价方法筛选文献、提取资料、评价质量后采用Rev Man 5.2统计软件对数据进行Meta分析。结果:共纳入15项RCT,合计3 319例患者。Meta分析结果显示,试验组患者糖化血红蛋白(Hb A1c)水平[MD=-0.39,95%CI(-0.75,-0.02),P=0.04]、空腹血糖(FPG)水平[MD=-0.70,95%CI(-1.27,-0.12),P=0.02]、餐后2 h血糖(2 h PG)水平[MD=-0.87,95%CI(-1.55,-0.20),P=0.01]、口渴喜饮治疗有效率[RR=3.35,95%CI(1.92,5.85),P<0.001]、倦怠乏力治疗有效率[RR=5.74,95%CI(3.52,9.36),P<0.001]均显著优于对照组,低血糖发生率[RR=0.67,95%CI(0.49,0.91),P=0.01]显著低于对照组,差异均有统计学意义。结论:消渴丸治疗2型糖尿病的疗效和安全性均优于格列本脲,可显著改善患者Hb A1c、FPG、2 h PG水平和中医症状。     

Satisfaction with information and its relationship with adherence in patients with chronic pain

□ Due to the nature of chronic pain it would be expected that patients are highly adherent to their pain medication. However, results from this study have shown that 23 per cent of patients often or always avoid using their pain medication, 13.4 per cent often or always alter dosages, and 10.3 per cent often or always stop taking their medication for a while. This suggests intentional non‐adherence to pain medication □ Less than 50 per cent of respondents were satisfied with information provided on side effects, what to do if side effects occur, and possible interactions with other medication □ Patients' satisfaction with information about their medication was related to self‐reported adherence; greater satisfaction was associated with higher self‐reported adherence     

Chlordiazepoxide antinociception: Cross-tolerance with opiates and with stress

Chlordiazepoxide (CDP) has been previously shown to possess antinociceptive properties that are resistant, except at high doses, to the opiate antagonist naloxone. The present study evaluated whether CDP's antinociceptive effects were subject to tolerance following repeated injections and whether cross-tolerance might develop between the antinociceptive action of CDP and that of either morphine or cold water swims. CDP increased flinch-jump thresholds following acute administration and exhibited tolerance following repeated injections. Neither morphine-tolerant nor cold water swim-adapted rats displayed an antinociceptive effect when tested with CDP. On the other hand, chronic pretreatment with CDP attenuated the antinociceptive effects of cold water swims, but did not produce any clear effect upon morphine analgesia.     

氯吡格雷和沙格雷酯联用致血小板减少

1例74岁女性患者行人工血管旁路移植术,术后给予肝素,约8．33U·Kg^-1·min^-1静脉泵入;氯吡格雷50mg,1次／d口服;沙格雷酯100mg,3次／d口服;华法林3mg／d口服。手术次日停用肝素,改为达肝素钠0．4ml,1次／12h皮下注射。术后第7天血小板301×10^9／L,停用达肝素钠,同时加用辛伐他汀20mg／d,氯吡格雷、沙格雷酯及华法林按原剂量口服。术后6个月停用华法林,继续口服其他3种药物,此时复查血小板计数为240×10^9／L。术后9个月复查,血小板计数降至1×10^9／L,白细胞及血红蛋白水平正常。立即停用氯吡格雷和沙格雷酯,继续口服辛伐他汀。停药4周,血小板计数恢复至156×10^9／L。     

Interaction of streptonigrin with metals and with DNA.

The antitumor antibiotic, streptonigrin, interacted with zinc, copper, and manganese but not with calcium or magnesium, as indicated by spectral shifts and difference spectra. The titration data showed the formation of 1:1 complexes, and further titration continued to show spectral shifts until a molar ratio for zinc to streptonigrin of 5-10 to 1 was reached. Streptonigrin interacted with DNA only in the presence of a metal ion such as zinc. Streptonigrin titration with DNA at varying zinc molar equivalents revealed that one antibiotic molecule required 5-7 moles of zinc and 20-25 moles of DNA-phosphorus for complexation. Similar values were obtained from gel permeation chromatography.     

Implicit and explicit learning in schizophrenics treated with olanzapine and with classic neuroleptics

OBJECTIVE: Novel and classic neuroleptics differ in their effects on limbic striatal/nucleus accumbens (NA) and prefrontal cortex (PFC) dopamine turnover, suggesting differential effects on implicit and explicit learning as well as on anhedonia. The present study investigates whether such differences can be demonstrated in a naturalistic sample of schizophrenic patients. METHODS: Twenty-five inpatients diagnosed with DSM-IV schizophrenic psychosis and treated for at least 14 days with the novel neuroleptic olanzapine were compared with 25 schizophrenics taking classic neuroleptics and with 25 healthy controls, matched by age and education level. PFC/NA-dependent implicit learning was assessed by a serial reaction time task (SRTT) and compared with cerebellum-mediated classical eye-blink conditioning and explicit visuospatial memory. Anhedonia was measured with the Snaith-Hamilton-Pleasure Scale (SHAPS). RESULTS: Implicit (SRTT) and psychomotor speed, but not explicit (visuospatial) learning were superior in the olanzapine-treated group as compared to the patients on classic neuroleptics. Compared to healthy controls, olanzapine-treated schizophrenics showed similar implicit learning, but reduced explicit (visuospatial) memory performance. Acquisition of eyeblink conditioning was not different between the three groups. There was no difference with regard to anhedonia and SANS scores between the patients. CONCLUSION: Olanzapine seems to interfere less with unattended learning and motor speed than classical neuroleptics. In daily life, this may translate into better adaptation to a rapidly changing environment. The effects seem specific, as in explicit learning and eyeblink conditioning no difference to classic NL was found.     

他巴唑(MMI)与丙基硫氧嘧啶(PTU)治疗甲亢的比较和选择

目的 他巴唑(MMI)与丙基硫氧嘧啶(PTU)治疗甲亢的比较和选择.方法 选择我院2008年至2010年收治的甲亢患者52例,随机分为MMⅠ组和PTU组,治疗6月观察症状缓解,甲亢恢复情况、副作用等.结果 任何一个选择抗甲状腺药物(ATD)治疗甲亢的患者,均可使用MMI,但妊娠早期,甲亢危象,对.MMI治疗不敏感者都除外.     

Two Norwegian patients with melioidosis presenting with bacteraemia and splenic and prostatic abscesses

Infections caused by Burkholderia pseudomallei are rare in nonendemic areas, such as Scandinavia. We report the first two cases of melioidosis in Norway presenting with bacteraemia and splenic and prostatic abscesses, respectively.