格列本脲和二甲双胍复方制剂治疗2型糖尿病的疗效观察

目的：探讨格列本脲和二甲双胍复方制剂治疗2型糖尿病患者对糖化血红蛋白（GHbA1c）、空腹血糖（FPG）以及标准餐后2h血糖（2hPG）的影响。方法：把口服降糖药控制血糖效果不佳的患者86例随机分成治疗组、对照组,治疗观察12周,比较治疗组和对照组的疗效。结果：治疗组显效的病例有32例（71.11%）、总有效率为95.55%,对照组显效的病例有23例（56.10%）、总有效率为80.49%;两组比较具有显著性差异（P〈0.05）,说明格列本脲和盐酸二甲双胍复合片疗效优于达美康。结论：格列本脲和盐酸二甲双胍可以相互补充,协同发挥作用,从而改善2型糖尿病患者的代谢缺陷,最终改善人体对血糖的控制。该制剂尤其对单纯使用盐酸二甲双胍或格列本脲再次治疗无效的患者,具有良好的效果。     

盐酸二甲双胍联合吡格列酮治疗2型糖尿病的疗效观察

目的:探讨盐酸二甲双胍联合吡格列酮治疗2型糖尿病的临床疗效.方法:本组60例2型糖尿病患者均为2011年1月～2012年1月在我院治疗的患者,将其随机分为治疗组和对照组,各30例.治疗组(男性14例,女性16例)患者服用盐酸二甲双胍联合吡格列酮进行治疗;对照组(男性17例,女性1 3例)患者服用盐酸二甲双胍治疗.比较两组患者治疗前后空腹血糖(FBG)、餐后2h血糖(PBG)、糖化血红蛋白(HbA1c)的变化情况.结果:两组患者在治疗结束后,空腹血糖(FBG)、餐后2h血糖(PBG)及糖化血红蛋白(HbA1c)分别较治疗前均有显著下降,且治疗组上进指标较对照组降低更显著,差异有显著性(P＜0.05).结论:盐酸二甲双胍联合吡格列酮治疗2型糖尿病疗效确切,能明显控制血糖且安全性高,值得推广和应用.     

格列吡嗪治疗2型糖尿病的临床疗效

目的:探讨格列吡嗪治疗2型糖尿病的临床疗效。方法:224例2型糖尿病患者,随机分为2组。治疗组112例,采用格列吡嗪治疗。对照组112例,采用阿卡波糖治疗,比较两组疗效。结果:治疗组总有效率94.6%;对照组总有效率84.9%。治疗组明显高于对照组,有明显的统计学差异(P<0.05)。结论:格列吡嗪作用于胰岛β细胞,对餐前、餐后血糖都有明显的降低作用,使血糖得到有效控制,是治疗糖尿病的有效药物,值得在临床上推广。     

格列本脲联合知柏地黄丸治疗2型糖尿病30例疗效观察

目的:观察格列本脲联合知柏地黄丸治疗2型糖尿病的临床疗效。方法:将60例患者随机分为2组各30例。2组均给予基础治疗和格列本脲治疗,治疗组配合知柏地黄丸治疗。观察2组治疗前后空腹血糖(FBG)、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-胆固醇(HDL-C)等指标的变化。结果:治疗后2组FBG比较,差异有显著性意义(P<0.05)。治疗组治疗后TG、TC、LDL-C、HDL-C均得以改善,其中TC降低最为明显,与对照组治疗后比较,差异有显著性意义(P<0.05)。结论:格列本脲联合知柏地黄丸治疗2型糖尿病患者能改善临床症状,改善糖、脂代谢紊乱,其疗效明显优于单用西药。     

复方葛根格列本脲胶囊治疗2型糖尿病32例疗效观察

目的观察复方葛根格列本脲胶囊治疗2型糖尿病的疗效。方法将64例患者随机分为2组,治疗组32例,口服复方葛根格列本脲胶囊,对照组32例,口服格列本脲,4周为1个疗程。结果治疗组有效率90.62%,对照组有效率68.75%。2组有效率比较有显著性差异(P<0.05)。结论复方葛根格列本脲胶囊治疗2型糖尿病疗效显著。     

格列吡嗪控释片治疗100例糖尿病患者的疗效分析

目的:就格列吡嗪控释片治疗100例糖尿病患者的疗效进行深入的分析。方法:选取治疗的糖尿病患者200例,男64例,女36例,平均年龄55岁。将200例患者随机分为治疗组(100例)和对照组(100例)。两组患者均予以严格控制饮食和糖尿病健康教育等基础治疗,对照组予以胰岛素强化治疗(普通胰岛素和诺和锐R),伴有并发症者,进行对症治疗。而治疗组在进行常规治疗的同时,还加用格列吡嗪控释片治疗。结果:100例治疗组患者经过上述治疗之后,显效(症状较治疗前明显减轻)85例(85%),有效(症状有所减轻)13例(13%),无效(治疗前后临床症状无改善)2例(2%),总有效率98%。而100例对照组患者经过上述治疗之后,显效73例(73%),有效12例(12%),无效15例(15%),总有效率85%,两组比较,差异有统计学意义(P<0.01)。结论:格列吡嗪控释片治疗糖尿病临床疗效较好,值得大力推广。     

格列本脲和胰岛素治疗妊娠期糖尿病的疗效比较观察及安全性评价

目的:探讨格列本脲和胰岛素治疗妊娠期糖尿病的疗效比较观察及安全性。方法:66例孕妇均为本院2014年5月-2016年10月期间收治的妊娠期糖尿病病例,按照双盲法将其分为两组。33例孕妇接受单纯胰岛素治疗作为对照组,33例孕妇给予格列本脲治疗作为观察组。至分娩结束时,比较两组患者的血糖控制效果,并就两组新生儿情况进行统计分析比较。结果:两组患者治疗后血糖指标均有明显改善,且观察组显著优于对照组,差异有统计学意义(p0.05)。两组新生儿发生窒息、低血糖、巨大儿的情况无明显差异(p0.05)。结论:相较于胰岛素来说,格列本脲控制血糖的效果较好,不会对孕妇和新生儿造成较大的影响,安全有效,值得推广。     

格列本脲与二甲双胍治疗2型糖尿病的效果比较

目的:观察格列本脲与二甲双胍治疗2型糖尿病的临床效果。方法:按照随机数字表法将124例2型糖尿病患者随机分为A组(42例)、B组(41例)和C组(41例),A组患者给予二甲双胍缓释片进行治疗,B组患者给予格列本脲片,C组患者给予二甲双胍与格列本脲联合治疗。结果:各组患者空腹血糖、餐后2h血糖及糖化血红蛋白均较治疗前有显著下降,P<0.05;C组患者空腹血糖达标率、餐后2h血糖达标率、糖化血红蛋白达标率显著高于A组及B组,P<0.05;3组患者不良反应发生率无显著性差异,P>0.05。结论:二甲双胍联合格列本脲治疗2型糖尿病可提高患者血糖达标率,且不增加不良反应风险,值得临床借鉴。     

降糖安胎方联合格列苯脲在妊娠期糖尿病患者中的应用

目的:探讨降糖安胎方联合格列苯脲对妊娠期糖尿病患者血糖控制及分娩结局的影响。方法:选取91例妊娠期糖尿病患者,按照随机数字表法分组,对照组45例予以格列苯脲治疗,观察组46例给予格列苯脲+降糖安胎方治疗,观察比较两组用药前后空腹血糖及餐后2 h血糖水平变化情况、血脂变化情况,并统计两组不良分娩结局发生率及不良反应发生率。结果:用药1个月后观察组空腹及餐后2 h血糖、TC、TG水平均明显低于对照组(P<0.05);观察组不良分娩结局发生率为4.35%(2/46),明显低于对照组20.00%(9/45)(P<0.05);观察组不良反应发生率为10.87%(5/46),对照组为11.11%(5/45),组间差异无统计学意义(P>0.05)。结论:对妊娠期糖尿病患者给予降糖安胎方与格列苯脲联合治疗,血糖、血脂控制效果显著,可改善分娩结局,用药安全性高。     

参地益阴胶囊治疗2型糖尿病疗效观察

目的：观察参地益阴胶囊治疗2型糖尿病的临床疗效。方法：选定气阴两虚的2型糖尿病患者63例，随机分为中西药治疗组（简称治疗组）43例和西药治疗对照组（简称对照组）20例。两组患者均给予常规治疗，对照组在常规治疗同时加服格列本脲2．5mg；治疗组在常规治疗与对照组基础上加服参地益阴胶囊。结果：治疗组显效35例，有效7例，总有效率97．5％；对照组显效8例，有效6例，总有效率70．0％；两组患者总有效率比较有极显著性差异（P〈0.01）。在血糖、血脂、糖化血红蛋白等指标方面，治疗组均有明显改善。结论：参地益阴胶囊对2型糖尿病的疗效确切．且未发现明显毒副作用，值得临床推广应用。     

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.