简述几种胰岛素类似物

胰岛素治疗的最终目标是使其进入人体后能够模拟生理胰岛素分泌,从而严格控制血糖,减少糖尿病各种并发症的发生。而胰岛素类似物与其他类型的胰岛素相比,作用更接近生理胰岛素[1]。本文就近年来这方面的发展综述如下。1速效胰岛素类似物1.1赖脯胰岛素(insulin lispro,IL)商品名     

OAD联合基础胰岛素类似物与门冬胰岛素30注射液治疗2型糖尿病的临床观察

目的观察口服降糖药物(OAD)联合基础胰岛素类似物与门冬胰岛素30注射液治疗2型糖尿病的临床疗效。方法观察对象为120例单纯口服降糖药物(至少服用一种胰岛素促泌剂,用量至少为最大推荐剂量的50%以上)未达标的2型糖尿病患者,诊断依据符合1999年WHO标准,按前瞻、随机、盲法、对照分为Det组、Gla组、Novomix组,测量身高、体质量,计算BMI,并测FBG、P2hBG、HBA1c、FC-P、2hC-P、Fins、2hIns,3组患者病程长短、血糖水平、并发症情况无统计学差别;Det组与Gla组原有口服降糖药物维持不变,分别睡前应用地特胰岛素和甘精胰岛素,起始剂量为0.2u/(kg d),每3天调整1次剂量2~4u,Novomix组停用所有降糖药物,采用门冬胰岛素30注射液早、午、晚餐前注射,起始剂量0.2~0.4u/(kg d),每3天调整1次剂量2~4u/餐,直至空腹血糖≤6.0mmol/L,餐后2h血糖≤8.0mmol/L,疗程3个月,观察3组患者BMI、FBG、P2hBG、HBA1c、FC-P、2hC-P、Fins、2hIns、低血糖发生率等指标。结果 3组治疗后FBG、P2hBG、HBA1c均有明显下降,差异有明显统计学意义(P<0.01),3组间血糖比较差异无统计学意义(P>0.05),Det组、Gla组血糖达标快,时间短,低血糖发生率低,差异有明显统计学意义(P<0.05)Det组比Gla组、Novomix组BMI下降明显,有明显统计学意义(P<0.05)。结论 3组治疗方案均可有效控制血糖达标,相比Novomix组,OAD联合基础胰岛素类似物,血糖达标率高,达标时间短,低血糖发生率显著减少,患者依从性高、耐受性好;同时对于超重或肥胖的2型糖尿病患者,Det相较Gla更具有减少体质量增加的优势。     

中效胰岛素联合口服降糖药物治疗2型糖尿病38例临床分析

对于部分长期服二甲双胍的2型糖尿病患者,无论如何调整服药剂量,血糖控制都不能达到较满意的结果。而近年来的临床研究及观察表明,2型糖尿病的胰岛素强化治疗优势日趋显著,它能有效控制血糖,且可以减少慢性并发症的发生与发展[1]。本文旨在观察对于口服二甲双胍血糖控制不佳的2     

胰岛素及其类似物

目的:对临床应用的胰岛素及其类似物加以回顾。方法:总结、归纳国、内外相关的文献。结果与结论:胰岛素及其类似物在临床的应用日趋成熟。     

胰岛素及胰岛素类似物的进展与应用

目的:介绍胰岛素及其类似物的进展和临床应用概况,并评价其疗效与安全性.方法:查阅近期国内外有关文献,进行分析、归纳与评价.结果与结论:大量的循证医学研究证实,胰岛素及其类似物进展迅速,因其可迅速降低餐后血糖,亦被称为"速效胰岛素"或"餐时胰岛素",保证了糖尿病患者高质量的生活,成为当前首选治疗药物,并在治疗糖尿病及其并发症方面显示了良好的临床和市场前景.     

胰岛素类似物临床应用研究进展

前言 自从1921年胰岛素应用于临床以来,经过多年的发展,胰岛素可以应用于临床各种类型糖尿病的治疗,是否需要使用取决于胰岛素抵抗和内源性胰岛素分泌之间的平衡,所有没有进行胰岛移植或者胰腺移植的1型糖尿病患者均需要胰岛素治疗;     

胰岛素及其类似物的研究进展

自胰岛素首次用于治疗糖尿病以来,随着对糖尿病病理生理和发病机制认识的深入,胰岛素的应用越来越广泛。综述近年来相关文献中有关胰岛素及其类似物制剂的分类、给药途径、体内吸收代谢、临床应用和不良反应等方面内容,为进一步研究、开发和合理利用胰岛素及其类似物提供参考。     

双时相胰岛素类似物在胰岛素强化治疗中的应用

传统胰岛素强化治疗能产生近似生理性的胰岛素分泌,但多次皮下注射给患者带来不便,依从性差.新的双时相胰岛素类似物因同时预混有速效胰岛素和鱼精蛋白化的部分,因此能够更好地控制空腹和餐后血糖,为胰岛素强化治疗提供了新方案.     

罗格列酮联合胰岛素治疗2型糖尿病26例临床观察

马来酸罗格列酮（太罗）是一种胰岛素增敏剂。为观察太罗联合胰岛素治疗效果，选择2004年10月～2005年7月对26例单纯胰岛素治疗血糖控制不佳的2型糖尿病给予太罗合并胰岛素治疗．观察其降糖效果及不良反应。     

注重综合治疗 合理应用胰岛素

糖尿病的治疗是综合性的,除饮食调节与运动治疗外,降糖药物治疗,尤其是胰岛素和口服降糖药物的应用是控制糖尿病病情的重要方法。本期我们邀请了国内一些资深专家和杰出的中青年专家,重点就糖尿病的药物治疗问题发表了他们的意见。这些见解既有文献综述,     

The Mechanism of Protraction of Insulin Detemir,a Long-Acting,Acylated Analog of Human Insulin

PURPOSE: Insulin detemir has been found in clinical trials to be absorbed with very low variability. A series of experiments were performed to elucidate the underlying mechanisms. METHODS: The disappearance from an injected subcutaneous depot and elimination studies in plasma were carried out in pigs. Size-exclusion chromatography was used to assess the self-association and albumin binding states of insulin detemir and analogs. RESULTS: Disappearance T50% from the injection depot was 10.2+/-1.2 h for insulin detemir and 2.0+/-0.1 h for a monomeric acylated insulin analog. Self-association of acylated insulin analogs with same albumin affinity in saline correlated with disappearance rate and addition of albumin to saline showed a combination of insulin detemir self association and albumin binding. Intravenous kinetic studies showed that the clearance and volume of distribution decreased with increasing albumin binding affinity of different acylated insulin analogs. CONCLUSIONS: The protracted action of detemir is primarily achieved through slow absorption into blood. Dihexamerization and albumin binding of hexameric and dimeric detemir prolongs residence time at the injection depot. Some further retention of detemir occurs in the circulation where albumin binding causes buffering of insulin concentration. Insulin detemir provides a novel principle of protraction, enabling increased predictability of basal insulin.     

临床上常见用药不当的分析

对临床上几种常见用药不当引起的问题进行了分析探讨 ,为临床用药者提供了参考。     

Effects of Phenol and meta-Cresol Depletion on Insulin Analog Stability at Physiological Temperature

The stability of three commercial “fast-acting” insulin analogs, insulin lispro, insulin aspart, and insulin glulisine, was studied at various concentrations of phenolic preservatives (phenol and/or meta-cresol) during 9 days of incubation at 37°C. The analysis by both size-exclusion and reversed-phase chromatography showed degradation of lispro and aspart that was inversely dependent on the concentration of phenolic preservatives. Insulin glulisine was much more stable than the other analogs and showed minimal degradation even in the absence of phenolic preservatives. With sedimentation velocity ultracentrifugation, we determined the preservatives' effect on the insulins' self-assembly. When depleted of preservatives, insulin glulisine dissociates from higher molecular weight species into a number of intermediate molecular weight species, in between monomer and hexamer, whereas insulin aspart and insulin lispro dissociate into monomers and dimers. Decreased stability of insulin lispro and insulin aspart seems to be because of the extent of dissociation when depleted of preservative. Insulin glulisine's dissociation to intermediate molecular weight species appears to help minimize its degradation during incubation at 37°C. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association J Pharm Sci 103:2255–2267, 2014     

抗生素对中枢神经系统感染的合理应用

目的：探讨抗生素对中枢神经系统感染的合理应用。方法：对药物分类与选择、联合用药问题、血脑屏障因素、鞘内给药途径、适应证等分别阐述。结果：使用抗生素有效控制了中枢神经系统感染。结论：合理使用抗生素治疗中枢神经系统感染，有利于减轻患者经济负担。     

苘麻子及常见近似品的鉴别

目的： 对苘麻子及近似品野葵子、冬葵子、蜀葵子、锦葵子和黄葵子进行鉴别,为苘麻子及近似品的鉴别提供实验依据。方法：运用性状鉴别和显微鉴别法,分析苘麻子及近似品的特征差异。结果：苘麻子及近似品在性状、显微上均有区别,可以将形状、大小、毛被情况及表面特征作为苘麻子的性状鉴别指标;毛茸的有无、下皮层有无分化、色素层细胞宽度以及子叶有无草酸钙簇晶作为苘麻子的显微鉴别指标。结论：以上结果可作为苘麻子及近似品野葵子、冬葵子、蜀葵子、锦葵子和黄葵子的主要鉴别依据。     

Interaction of Naproxen with Alpha-Cyclodextrin and Its Noncyclic Analog Maltohexaose

Purpose. To study the effect of mechanical grinding on crystallinity changes of naproxen (NAP) in mixtures with -cyclodextrin (Cd), amorphous Cd, and maltohexaose (M6); and the possible formation of a pseudo-inclusion complex between NAP and M6 in aqueous solution. Methods. NAP-additive physical mixtures at 0.30,0.18, and 0.10 mass fraction of drug were tested, after increasing grinding times, by differential scanning calorimetry (DSC) and X-ray powder diffractometry (XRD). Interaction in aqueous solution was examined by phase-solubility and fluorescence analyses supported by molecular modelling. Results. In the mixtures with each additive the fusion enthalpy per unit mass of NAP decreased and the half width at half maximum of selected X-ray diffraction peaks of NAP increased with the progress of grinding time following the loss of crystallinity of the samples. The mechanical treatment apparently did not affect the chemical integrity of the drug. Particularly active in the equimolar mixture was the best amorphizing agent, M6. Solution studies and molecular modelling confirmed M6 may have the feature of a supermolecule for NAP, which forms a 1:1 pseudo-inclusion complex that was as stable as the true inclusion complex with Cd. Conclusions. The intrinsically amorphous linear analog of Cd might be a potential amorphism-inducing agent and solubilizer for scarcely water soluble drugs.     

胰岛素超细化处理及其吸入给药系统的基础研究

综述胰岛素超细化处理方法及其吸入给药系统基础研究的最新进展，着重介绍超临界反溶剂过程用于胰岛素超细化处理的研究成果。     

多效胃镜乳的制备与临床应用

目的：研究多效胃镜乳的处方、制备工艺、质量标准及临床疗效。方法：用研磨乳化法将油相和水相混合制备成乳剂，并对其稳定性、主药含量进行测定。对506例胃镜检查患者进行疗效观察。用法：胃镜检查前30 min口服，每次10 mL。结果：一次性口服给药，同时达到局麻、解痉、消泡、减少分泌、润滑等多种效果，总有效率达100.0%。结论：多效胃镜乳处方合理、工艺成熟、质量稳定、疗效显著，值得推广使用。     

Changing the Subcellular Location of the Oncoprotein Bcr-Abl Using Rationally Designed Capture Motifs

Purpose  

Bcr-Abl, the causative agent of chronic myelogenous leukemia (CML), localizes in the cytoplasm where its oncogenic signaling leads to proliferation of cells. If forced into the nucleus Bcr-Abl causes apoptosis. To achieve nuclear translocation, binding domains for capture of Bcr-Abl were generated and attached to proteins with signals destined for the nucleus. These resulting proteins would be capable of binding and translocating endogenous Bcr-Abl to the nucleus.     

临床静脉输液配置常见问题及分析

目的:分析临床静脉输液配置过程中易出现的问题,为临床合理配置静脉输液提供参考。方法:以"输液"、"配伍"、"溶媒"、"配置"及各种药品的通用名称等为关键词检索《中国期刊全文数据库》1979年1月～2010年1月间静脉输液配置的相关文章,同时查阅2005年1月～2010年1月间我院门/急诊处方审核记录、住院药房医嘱审核记录、临床药师查房记录、药品不良反应报表等,对其中不合理的静脉输液配置情况进行统计、分析。结果:静脉注射药物在配置过程中,主要存在溶媒选择不当、药物配伍禁忌、药物配置浓度过高、药物配置后放置时间过长、输液配置器具选择不当、输液配置操作不规范等问题。结论:临床静脉输液配置应严格执行各项操作规范,严格遵照药品说明书、药物手册等法定文件的要求去做,现配现用,确保患者的用药安全。