吡格列酮联合二甲双胍治疗2型糖尿病肥胖疗效观察

目的观察吡格列酮联合二甲双胍治疗2型糖尿病肥胖疗效。方法治疗组给予吡格列酮30mg/d,一次口服,联合二甲双胍;对照组给予二甲双胍1 500mg/d,分三次服用,500mg/次,并进行为期16周的观察,分别检测体重、空腹血糖(FBG)、餐后2h血糖(2hBG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、餐后2h胰岛素(PINS)、肝功等指标。结果用药16周后,治疗组的FINS水平均明显低于治疗前(P<0.05),差异有统计学意义。对照组的FINS水平则差异无统计学意义(P>0.05),治疗组和对照组之间FINS比较差异有统计学意义(P<0.05)。结论说明吡格列酮联合二甲双胍即可发挥良好的降糖效果。吡格列酮除降低血糖外,亦能使FINS有所下降.     

吡格列酮联合二甲双胍治疗2型糖尿病肥胖疗效观察

目的观察吡格列酮联合二甲双胍治疗2型糖尿病肥胖疗效。方法治疗组给予吡格列酮30mg/d,一次口服,联合二甲双胍;对照组给予二甲双胍1 500mg/d,分三次服用,500mg/次,并进行为期16周的观察,分别检测体重、空腹血糖(FBG)、餐后2h血糖(2hBG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、餐后2h胰岛素(PINS)、肝功等指标。结果用药16周后,治疗组的FINS水平均明显低于治疗前(P<0.05),差异有统计学意义。对照组的FINS水平则差异无统计学意义(P>0.05),治疗组和对照组之间FINS比较差异有统计学意义(P<0.05)。结论说明吡格列酮联合二甲双胍即可发挥良好的降糖效果。吡格列酮除降低血糖外,亦能使FINS有所下降.     

二甲双胍、吡格列酮联合应用治疗肥胖2型糖尿病患者的疗效观察

目的 观察二甲双胍、吡格列酮联合应用治疗新诊断肥胖2型糖尿病(T2DM)的疗效.方法 选取71例新诊断肥胖T2DM患者随机分成两组,治疗组25例给予二甲双胍500mg、2次/d,吡格列酮30 mg、1次/d联合治疗;对照组包括二甲双胍组(M组)和吡格列酮组(P组),M组24例给予二甲双胍500mg、2次/d治疗;P组22例给予吡格列酮30mg、1次/d治疗患者.所有治疗疗程12周,观察空腹血糖(FPG)及餐后2 h血糖(2hPG)、空腹胰岛素(FINS)及餐后2 h胰岛素(P2hINS)和糖化血红蛋白(HbA1C)的变化情况.结果 三组患者在治疗后FPG、2hPG、HbA1C、FINS、T2hINS均明显下降.M组和P组疗效相似;治疗组在减低患者胰岛素水平、改善糖代谢紊乱方面均优于M组和P组.结论 联合应用二甲双胍和吡格列酮治疗,可作为经过单一使用二甲双胍或吡格列酮治疗血糖控制仍然不良的肥胖T2DM患者选用的治疗的方法之一.     

糖尿病合并肾病患者的临床治疗方法及效果

目的:探讨糖尿病合并肾病患者的临床治疗方法及效果。方法:抽取2014年1月-2015年12月间来我院治疗的糖尿病合并肾病患者100例,随机分为两组,每组50例,在胰岛素治疗的基础上分别给予吡格列酮治疗及吡格列酮联合二甲双胍治疗,对两组患者的治疗效果进行对比分析。结果:治疗4个月后,吡格列酮联合二甲双胍治疗组患者的LDL-C、UAER、FBG、Fib、HbA1c、Cr、ALT、ISI、HDL-C、空腹血糖及餐后2小时血糖变化明显优于吡格列酮治疗组。结论:吡格列酮联合二甲双胍治疗糖尿病合并肾病有较好的临床治疗效果,值得推广应用。     

二甲双胍、吡格列酮联合应用治疗肥胖2型糖尿病患者的疗效观察

目的观察二甲双胍、吡格列酮联合应用治疗新诊断肥胖2型糖尿病（T2DM）的疗效。方法选取71例新诊断肥胖他DM患者随机分成两组，治疗组25例给予二甲双胍500mg、2次／d，吡格列酮30mg、1次／d联合治疗；对照组包括二甲双胍组（M组）和吡格列酮组（P组），M组24例给予二甲双胍500mg、2次／d治疗；P组22例给予吡格列酮30mg、1次／d治疗患者。所有治疗疗程12周，观察空腹血糖（FPG）及餐后2h血糖（2hPG）、空腹胰岛素（FINS）及餐后2h胰岛素（P2hINS）和糖化血红蛋白（HbA1c）的变化情况。结果三组患者在治疗后FPG、2hPG、HbA1c、FINS、P2hINS均明显下降。M组和P组疗效相似；治疗组在减低患者胰岛素水平、改善糖代谢紊乱方面均优于M组和P组。结论联合应用二甲双胍和吡格列酮治疗，可作为经过单一使用二甲双胍或吡格列酮治疗血糖控制仍然不良的肥胖T2DM患者选用的治疗的方法之一。     

盐酸吡格列酮治疗2型糖尿病的疗效及安全性观察

目的:以二甲双胍为对照,评价盐酸吡格列酮治疗2型糖尿病的疗效和安全性。方法:将48例患者随机分为吡格列酮组24例(服用吡格列酮30 m g,1次/d))与二甲双胍组24例(服用二甲双胍250 m g,2次/d),治疗期12周。结果:吡格列酮组治疗8周空腹血糖较治疗前明显下降,治疗12周下降至(6.77±1.2)mm o l/L,二甲双胍组治疗12周才较治疗前下降(P均<0.01),餐后2 h血糖于治疗2周时2组均下降(P均<0.01),两组HbA 1c治疗后均较治疗前下降(P均<0.01),两组药物不良反应发生率相似。结论:吡格列酮有较好的降糖效果,且降糖效果出现早,不良反应低。     

吡格列酮联合二甲双胍治疗老年肥胖2型糖尿病48例

目的:观察吡格列酮联合二甲双胍对老年肥胖2型糖尿病患者降糖、降脂,改善体重指数的作用。方法:收治老年肥胖2型糖尿病患者48例,随机分组,观察组24例,用吡格列酮联合二甲双胍治疗,对照组24例,单用二甲双胍,疗程12周。治疗组血糖控制达标率88.5%,对照组达标率62.4%,治疗组显著高于对照组(P<0.05),治疗后BMI、TG、TC、LDL-C均显著降低,而HDL-C明显升高。结论:吡格列酮联合二甲双胍可以显著降低肥胖2型糖尿病血糖、血脂水平,降低BMI,联合应用于老年肥胖2型糖尿病有确切的治疗效果。     

二甲双胍和吡格列酮在2型糖尿病胰岛素抵抗中的应用比较

目的:观察二甲双胍和吡格列酮治疗对2型糖尿病患者胰岛素抵抗(IR)的影响。方法:将100例2型糖尿病患者随机分为二甲双胍组和吡格列酮组,治疗疗程为12周。结果:二甲双胍组和吡格列酮组在治疗后空腹和餐后C肽水平均较用药前有明显降低,IR稍有降低,β细胞功能明显改善,二甲双胍在降低餐后胰岛素、改善IR方面低于吡格列酮,两药治疗前后血游离脂肪酸水平比较差异无统计学意义。结论:二甲双胍和吡格列酮均有降低IR和改善β细胞功能,在降IR方面,二甲双胍低于吡格列酮。     

二甲双胍联合吡格列酮在临床治疗难治性2型糖尿病中的价值分析

目的:探讨使用二甲双胍联合吡格列酮治疗难治性2型糖尿病(T2DM)患者临床价值。方法:收集我院自2011年1月至2012年12月间收治的204例难治性2型糖尿病患者病例,随机分为观察组和对照组,每组102例。对照组患者单用二甲双胍进行治疗,观察组患者以二甲双胍联合吡格列酮进行治疗。两组患者治疗6个月后,对治疗有效率、不良反应以及空腹血糖(FBG)、餐后2h血糖(PBG)和糖化血红蛋白(HbA1C)水平的变化进行对比分析。结果:观察组患者治疗有效率93.1%(95/102),显著性高于对照组的76.4%(55/72),P<0.05。治疗6个月后,两组的FBG、2hPBG、HbA1C水平都显著性低于治疗前,治疗后观察组FBG、2hPBG、HbA1C水平都显著性低于对照组(P<0.05)。两组患者临床治疗中均出现轻微的不良反应,比较无显著性差异(P>0.05)。结论:二甲双胍联合吡格列酮在临床治疗中能有效改善难治性2型糖尿病患者的血糖水平,具有很好的治疗效果,值得推广。     

吡格列酮对老年2型糖尿病患者的作用

目的:观察吡格列酮对老年2型糖尿病(T2DM)患者血糖、血脂的作用。方法:将血糖控制不佳的64例T2DM患者按照年龄分为老年组(32例)和非老年组(32例),每组又按照随机区组设计分为安慰剂组、吡格列酮单药组、吡格列酮+磺脲类组、吡格列酮+二甲双胍组,每组8例,早餐前30 min口服实验药物,疗程为3月,分别于治疗前后检测空腹血糖(FBG)、糖化血红蛋白(HbA1C)、甘油三脂(TG)、高密度脂蛋白胆固醇(HDL-C)及肝功能、血常规。结果:治疗3月后,吡格列酮单药组和2个联合治疗组FBG、HbA1C、TG均显著降低,HDL-C升高,且2个年龄组间无显著性差异,2个联合治疗组分别有4例和3例减少了原磺脲类和二甲双胍的用量。无1例出现不良反应。结论:吡格列酮显著改善老年T2DM患者的血糖、血脂参数,是老年T2DM患者较理想的降糖药物。     

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.     

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.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.