老年糖尿病患者并发肺结核66例临床分析

目的 探讨老年人糖尿病与结核病并存的临床特点。方法对66例老年糖尿病并发肺结核患者的临床资料进行分析。结果 先患糖尿病后患肺结核发病率高于先患肺结核后患糖尿病病人。糖尿病并发肺结核病变性质以干酪渗出为主占78％，痰结核菌阳性串高，短期内不易阴转；病变累及肺野多，空洞发生率高，占42．8％；血糖控制与病灶吸收关系密切，结论老年人糖尿病并发肺结核发病率高，早期检测、预防与规则治疗，对防止并发症的发生十分重要。     

肺结核合并糖尿病45例临床分析

目的：探讨肺结核合并糖尿病病人临床特征及治疗预后。方法：回顾性分析４５例肺结核合并糖尿病病人的临床表现、检查结果、合并症及治疗与转归。结果：肺结核合并糖尿病病人临床症状重，合并症多，Ｘ线表现复杂，病死率高。结论：对肺结核合并糖尿病病人要加以重视，首先防治糖尿病，同时进行正规抗结核治疗。     

浸润型肺结核合并糖尿病507例临床分析

目的 通过合并糖尿病的肺结核的临床分析，探讨二病并存时的临床特点及糖尿病控制对结核化疗疗效的影响。方法 对507例住院的肺结核合并糖尿病的患者的临床资料进行总结分析。结果 合并糖尿病的肺结核患者比单纯肺结核有病情较重、干酪病灶多、空洞多、排菌病例多及复治病例多的临床特点；在糖尿病稳定，血糖控制在8．4mmol／L以下，其痰菌阴转率、病灶显吸率与单纯性肺结核的疗效相似。结论 糖尿病与肺结核互有影响，以糖尿病对肺结核影响较大，合并糖尿病的肺结核化疗的疗效及预后与糖尿病控制情况有很大关系。     

119例肺结核合并糖尿病患者的临床回顾性研究

目的 探讨肺结核合并糖尿病患者的临床特点及诊疗转归.方法 针对2000年1月～2005年12月所收治的119例肺结核合并糖尿病患者进行回顾性分析.结果 肺结核合并糖尿病患者的病变范围广泛,并发症多,痰菌阳性率高,复诊率高.结论 肺结核合并糖尿病患者具有一定的临床特点,应积极控制血糖,早期抗痨治疗,预防并发症发生,改善其预后.     

肺结核病合并糖尿病134例临床特点分析

目的 探讨肺结核合并糖尿病患者的临床特点及诊疗转归.方法 对134例肺结核合并糖尿病患者的临床资料进行回顾性分析.结果 肺结核合并糖尿病患者以中老年人为多,病灶广泛,不典型,痰菌阳性率高,治疗难度大.结论 肺结核合并糖尿病有一定的临床特点,应积极控制血糖,同时遵循现代抗结核化疗的原则.其预后首先取决于糖尿病能否控制,其次为肺结核的严重程度.     

肺结核合并糖尿病98例临床分析

目的探讨肺结核合并糖尿病病人的临床特点及疗效。方法 对2004年6月至2010年2月在我院住院治疗的98例肺结核合并糖尿病病人临床特点及疗效等相关资料进行分析。结果 肺结核合并糖尿病病人比单纯肺结核病人有起病较急,病情较重,病灶范围广泛,干酪病灶多,多伴有空洞,痰菌阳性率高,复治病人多,疗效差等临床特点,其疗效与血糖控制水平密切相关。结论 肺结核合并糖尿病病人具有一定的临床特点,积极有效的控制血糖、早期合理的抗结核治疗可提高肺结核治愈率。     

胰岛素强化治疗糖尿病合并肺结核51例疗效观察

近几年来，糖尿病发病率急骤上升，糖尿病合并肺结核的患者明显增加，糖尿病与肺结核存在相互不利的影响，使病情复杂、治疗较困难。预后比单纯肺结核差。本文对2型糖尿病合并肺结核患者临床治疗效果进行观察。[第一段]     

118例糖尿病合并肺结核胸部X线表现特点分析

目的探讨糖尿病合并肺结核的胸部X线表现特点。方法将118例糖尿病肺结核Ⅰ组及120例单纯肺结核Ⅱ组患者进行治疗前、治疗中及治疗后胸部X线动态检查并对照比较。多，治疗中及治疗后病灶吸收Ⅰ组较Ⅱ组差，Ⅰ组病人血糖浓度高者治疗中及治疗后病灶吸收又较血糖浓度较低者为差。Ⅰ组病人空洞闭合程度较Ⅱ组病人缓慢。结论糖尿病肺结核病人病灶分布较广泛、干酪灶及融合病灶明显，空洞并发高，临床症状重，血糖浓度越高的糖尿病肺结核病人尤为严重，疗效慢、疗程长。单纯肺结核病人胸部X线病灶多局部，融合空洞相对较少，临床症状轻，疗效快，病程短。     

肺结核合并糖尿病诊疗探讨

目的探讨肺结核合并糖尿病患者的临床特点、诊断、治疗及预后。方法回顾性分析80例肺结核合并糖尿病患者的临床资料。结果肺结核合并糖尿病临床常见,以2型糖尿病为主,老年病人多见(67.5%),具有病灶范围广泛,以干酪性病灶为主,多伴有空洞,痰菌阳性率高,临床症状复杂,合并症与并发症多(77.5%),复治病例多,血糖控制理想者(血糖<11.1mmol/L)抗痨治疗效果好,好转率75%,死亡1例。结论肺结核合并糖尿病两病相互影响,导致病情复杂化、严重化,临床上治疗相对困难,应采取两病同治、抗痨与降糖治疗兼顾的原则。     

肺结核合并糖尿病临床特征和预后的多因素分析

目的:研究肺结核合并糖尿病的临床特征和预后的相关因素。方法:选取我院肺结核合并糖尿病病例209例,查阅病例及2年随访资料,以189例肺结核不伴有糖尿病病人为参照,研究肺结核合并糖尿病病人的临床特征;采用Logistic回归方法进行肺结核合并糖尿病病人预后的多因素分析。结果:肺结核合并糖尿病和肺结核不伴有糖尿病病人组中,肺结核症状中、重度患者的比例分别为72.2%和62.9%,肺空洞发生率分别为74.1%和36.0%,痰菌的阳性率分别64.1%和53.4%,耐药率分别为31.1%和19.6%,肺结核合并糖尿病的中、重度患者比例、肺空洞发生率、痰菌阳性率和耐药率均高于肺结核不伴有糖尿病病人组的患者(P<0.05);与肺结核不伴糖尿病患者比较,血糖控制较差(P<0.01),不规则服药(P<0.01)和产生耐药(P<0.05)3个因素是影响肺结核合并糖尿病预后的主要因素。结论:肺结核合并糖尿病患者病情重,肺空洞率、菌阳性率较高,耐药明显;血糖控制情况、服药习惯和耐药是影响肺结核合并糖尿病预后的主要因素。     

益智健脑颗粒联合针灸对阿尔茨海默病大鼠学习记忆的影响

目的观察益智健脑颗粒联合针灸对阿尔茨海默病（Alzheimers disease,AD）大鼠学习记忆的影响。方法将大鼠随机分为假手术组（A组）、模型组（B组）、针灸组（C组）、益智＋针灸组（D组）各10只,B、C、D 3组分别以海马CA1区注射β淀粉样蛋白25-35（Aβ25-35）造模,A组注射等量的双蒸水,各组分别治疗20 d后行Morris水迷宫试验,观察大鼠学习记忆能力变化。结果B组较A组的平均潜伏期明显延长,差异具有统计学意义（P〈0.05）;与B组比较,C组、D组的平均潜伏期明显缩短,过台次数增多,差异具有统计学意义（P〈0.05,P〈0.01）;与C组比较,D组的潜伏期缩短,过台次数增多,差异具有统计学意义（P〈0.05）。结论益智健脑颗粒联合针灸能够提高Aβ25-35介导的AD模型大鼠的学习记忆能力。     

Effects of tacrolimus and cyclosporine treatment on metabolic syndrome and cardiovascular risk factors after renal transplantation: a meta-analysis

Background The therapeutic success of renal transplantation has been largely attributable to the development of effective and balanced immunosuppressive treatment regimens.This study provides a meta-analysis of a series of randomized controlled trials that compared the effects of tacrolimus and cyclosporine on metabolic syndrome （MetS） and cardiovascular risk factors after renal transplantation.Methods We searched various electronic databases and bibliographies,including MEDLINE,the Cochrane Central Register of Controlled Trials,and EMBASE,for relevant studies published prior to October 2012.Results Our meta-analysis included five randomized controlled trials that examined a total of 923 patients.The tacrolimus group and the cyclosporine group exhibited no significant differences in MetS incidence after renal transplantation; risk ratio （RR）：1.06,95％ confidence interval （C/）：0.73-1.55,P=0.76.Cyclosporine treatment was associated with a higher incidence of hyperlipidemia （RR：0.50,95％ CI：0.39-0.64,P ＜0.01）.Although there were no statistically significant differences,cyclosporine treatment was associated with a higher incidence of hypertension （RR：0.91,95％ CI：0.83-1.00,P=0.06） after renal transplantation compared to tacrolimus treatment,and tacrolimus treatment was associated with a higher incidence of diabetes after renal transplantation （RR：1.79,95％ CI：0.98-3.27,P=0.06） compared to cyclosporine treatment.Conclusions Compared to tacrolimus treatment,cyclosporine treatment was associated with a higher incidence of hyperlipidemia.Future large-scale studies are expected to be conducted to further confirm our findings.     

WHO西太区与“世界中医药学会联合会”中医名词术语国际标准比较研究：精、神、气、血、津、液部分

精、神、气、血、津、液是中医理论中6个非常重要的概念，有关术语在《WHO西太区传统医学国际标准名词术语》中一共收录了59条，“世界中医药学会联合会”（以下简称世中联）《中医基本名词术语中英对照国际标准》中收录了58条。血、津、液的内涵较为具体，有一定的物质基础，理解并不困难。翻译上虽有差异，但亦不难统一。精、神、     

Liuwei Dihuang,a traditional Chinese herbal formula,suppresses chronic inflammation and oxidative stress in obese rats

OBJECTIVE： To investigate the anti-inflammatory, anti-oxidative stress, and adipokine-ameliorating effects of Liuwei Dihuang （LWDH）, a traditional Chinese herbal formula, in obese rats. METHODS： After 2 weeks of acclimation with free access to regular rodent chow and water, obese-prone-caesarean-derived （OP-CD） rats were fed a modified AIN-93G diet containing 60% energy from fat. Treatment was performed twice daily by gavage feeding with 500, 1 500, or 3 500 mg/kg body weight LWDH suspended in water （n=12 rats per group）. Twelve obese-resistant-CD （OR-CD） rats were fed the atherogenic diet and gavaged with water, and served as the normal control. Blood biomarkers of inflammation, oxidative stress and adiponectin were measured post-sacrifice and used to determine the treatment effect of LWDH and assess the suitability of OR/OP-CD rats for studying these parameters. RESULTS： After 9 weeks of treatment, LWDH lowered serum C-reactive protein （CRP） and tumour necrosis factor-α （TNF-α） levels. Serum interleukin-6 （IL-6） levels showed a tendency towards reduction, but were not significantly different from the OP-CD control. Liver superoxide dismutase （SOD） activity was increased in response to all three doses of LWDH, while the levels of reduced （GSH） and oxidized glutathione （GSSG） and thiobarbituric acid reactive substances （TBARS） were unchanged. Serum adiponectin levels were increased in response to oral administration of LWDH at the dose of either 500 or 1 500 mg/kg body weight. In addition, comparisons between OR-CD and OP-CD rats revealed differential, and for some biomarkers, conflicting characteristics of high-fat diet-fed OP-CD rats in reference to obese human subjects in terms of inflammatory and oxidative stress biomarkers and circulating adiponectin levels. CONCLUSION： The results show, for the first time, the anti-inflammatory, anti-oxidative stress and adiponectin-ameliorating effects of LWDH in obese rats. The suitability of the OP-JOP-CD rat model as     

New Mechanism of Herb-herb Interaction between Ginseng and Trogopterus Based on CYPs in Rat Livers

The study was designed to investigate the potential mechanism of herb-herb interaction between ginseng and Trogopterus （Trg） based on Cytochrome P450 isozymes （CYPs） in rat livers. We estimated the influence on CYP1A2, CYP2E1, and CYP3A1/2 activity caused by ginseng and Trg used in combination. The CYP1A2 and CYP2E1 enzyme activity were induced by ginseng and Trg used in combination. And this induction effect was caused via inducing CYP1A2 and CYP2E1 protein expression which was supposed caused by inducing the gene expression of CYP1A2 and CYP2E1.     

表皮生长因子受体酪氨酸激酶抑制剂在非小细胞肺癌应用的瓶颈——获得性耐药

以表皮生长因子受体酪氨酸激酶抑制剂（epidermal growth factor receptor-tyrosine kinase inhibitor,EGFR-TKI）分子靶向治疗研究为肇始,转化性研究使基础实验和临床实践间的鸿沟迅速填平,改变着人们认识治疗肺癌的视角。无可否认,EGFR-TKI上市后极大地延伸了肿瘤学家治疗肺癌的手段,但不管从临床经验、临床研究数据、分子生物学层面还是文献计量学的角度,     

Bias in multiple-treatments meta-analysis: a case on comparative efficacy and tolerability of 15 antipsychotic drugs for schizophrenia

Multiple-treatments meta-analysis is thought to be a feasible method to compare the efficacy and safety among different treatments, especially when there was no head-to-head research among some treatments. But sometimes some conclusions are inconsistent with the clinical experience. Recently, we read a multiple-treatment meta-analysis finished by Stefen Leucht et al, which was published in Lancet） The authors summarized the results of the RCT studies on 15 antipsychotics commonly used in practice; they also horizontally compared the efficacy and safety profile by the recta-analysis. We believe that the results provide more solid evidence for the rational usage of antipsychotics to the psychiatrists, also for the government to distribute health resources in a more reasonable way.     

Differential effect of calcium-activated potassium and chloride channels on rat basilar artery vasomotion

Spontaneous, rhythmical contractions, or vasomotion, can be recorded from cerebral vessels under both normal physiological and pathophysiological conditions. We investigated the cellular mechanisms underlying vasomotion in the cerebral basilar artery （BA） of Wistar rats. Pressure myograph video microscopy was used to study the changes in cerebral artery vessel diameter. The main results of this study were as follows： （1） The diameters of BA and middle cerebral artery （MCA） were 314.5±15.7 μm （n=15） and 233.3±10.1 μm （n=12） at 10 mmHg working pressure （P〈0.05）, respectively. Pressure-induced vasomotion occurred in BA （22/28, 78.6%）, but not in MCA （4/31, 12.9%） from 0 to 70 mmHg working pressure. As is typical for vasomotion, the contractile phase of the response was more rapid than the relaxation phase; （2） The frequency of vasomotion response and the diameter were gradually increased in BA from 0 to 70 mmHg working pressure. The amplitude of the rhythmic con- tractions was relatively constant once stable conditions were achieved. The frequency of contractions was variable and the highest value was 16.7±4.7 （n=13） per 10 min at 60 mmHg working pressure; （3） The pressure-induced vasomotion of the isolated BA was attenuated by nifedipine, NFA, 181]-GA, TEA or in Ca2＋-free medium. Nifedipine, NFA, 18~-GA or Ca2＋-free medium not only dampened vasomotion, but also kept BA in relaxation state. In contrasts, TEA kept BA in contraction state. These results sug- gest that the pressure-induced vasomotion of the isolated BA results from an interaction between Ca2＋-activated C1- channels （CaCCs） currents and Kca currents. We hypothesize that vasomotion of BA depends on the depolarizing of the vascular smooth muscle cells （VSMCs） to activate CaCCs. Depolarization in turn activates voltage-dependent Ca2＋ channels, synchronizing contractions of adjacent cells through influx of extracellular calcium and the flow of calcium through gap junctions. Subsequent calc     

Morphometric Analysis and Microsurgical Anatomy for Far-lateral Transcondylar Approach

Objective To provide basic microsurgical anatomy parameters for the far lateral transcondylar approach. Methods Thirty dry skulls were measured around foramen magnum. Twenty formalin fixed Chinese adult cadaveric heads were employed by microsurgical dissection and the vital anatomical structure was delineated and measured. The dissection was performed imitating the far-lateral transcondylar approach. In addition, among 20 formalin fixed cadaveric heads, 10 adult cadaveric heads were scanned with Spiral CT thin tomographic scanner. Some structures of foramen magnum were measured by CT thin tomographic scan. The 3D-CT （three dimensional computed tomography） reconstruction was performed in 4 adult cadaveric heads including preoperative and post-operative. Results Occipital condyle （OC） was an important sign in the far lateral transcondylar approach and its long axis was 24.47±3.32 （18.19-30.30）mm （left,L）; 25.16±2.39 （20.66-29.02）mm （right, R） （standard deviation）. The distance from the posterior midline of the foramen magnum （FM） to the medial border of the OC was 27.66±2.45 （23.00-31.48）mm （left）; 26.27±1.83 （23.68-29.64）mm （right）. Inferior occipital triangle was formed by three muscles, which was rectus capitis posterior major, superior oblique and inferior oblique. The distance of vertebral artery from lateral side of transverse foramen of atlas to its dural entry was 16.87±2.08 （12.64-20.1）mm （left）, 16.79±1.90 （12.44-20.22）mm （right）. Some vital bone structures such as jugular foramen, hypoglossal canal, condylar canal, transverse foramen of atlas could be showed clearly on the three-dimensional reconstruction CT image. Conclusion In this study, the authors provided some anatomic parameters for far lateral transcondylar approach. They documented the structures of inferior occipital triangle and the course of vertebral artery. Rare variation of VA should be paid more attention to. The thin tomographic scan and three-dimensional construction     

美国补充替代医学研究的主要机构（一）——美国癌症研究所和哈佛医学院

与对抗医学（allopathic medicine）的诊疗理念和实践有着重大区别的补充替代医学（complementary and alternative medicine.CAM）于20世纪70年代在美国达到第一个高峰。并且“替代医学”这个名词在此期间开始使用。此后．随着非常规医学在美国使用人数的迅速增多以及所治病种的不断增加．相关的基础研究和临床试验也相继展开，并且开始设立专门的CAM研究机构。