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。     

米格列奈治疗2型糖尿病临床分析

目的：观察比较米格列奈与格列本脲治疗2型糖尿病安全性及疗效。方法：收治2型糖尿病患者56例,均未经治疗,随机分为给予米格列奈的治疗组和给予格列本脲治疗的对照组,每组各28例,比较两组用药后疗效及安全性。结果：治疗组中4例出现不良反应,总发生率14.29%,明显低于对照组的42.86%,结果具有统计学意义（P〈0.05）。治疗组餐后2小时血糖治疗后降低2.7mmol/L,胰岛素升高12.2mIU/L,降糖效果显著,具有统计学意义（P〈0.05）。对照组用药后各项指标亦有降低好转,与治疗组比较无明显差异,结果不具有统计学意义（P〉0.05）。结论：米格列奈治疗2型糖尿病疗效确定,不良反应小。     

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。     

格列齐特缓释片治疗2型糖尿病的疗效观察

目的：探讨格列齐特缓释片治疗2型糖尿病患者后血糖、糖化血红蛋白及C肽（C-P）等指标的变化。方法：2005年2月-2006年12月在我院门诊及住院的2型糖尿病患者78例,随机分为两组,格列齐特缓释片治疗组48例和格列苯脲治疗组30例进行疗效观察。结果：经12周的治疗,格列齐特组与格列苯脲组两组之间的FBG、2hBG、HbA1c、FC-P、2hC-P没有显著差异（P〉0.05）,但低血糖发生率格列齐特组为4.17%,格列苯脲组为40.00%（P〈0.01）。结论：格列齐特缓释片与格列苯脲的降糖效果相似,但安全性更好。     

格列吡嗪控释片联合盐酸二甲双胍肠溶胶囊治疗糖尿病疗效研究

目的：旨在观察格列吡嗪控释片联合盐酸二甲双胍肠溶胶囊治疗糖尿病的临床疗效，为制定诊疗方案提供依据。方法：本研究选取了2012年2月－2016年2月期间，在我院进行糖尿病治疗的患者180例。将其随机分为观察组和对照组各90例。观察组患者给予格列吡嗪控释片联合盐酸二甲双胍肠溶胶囊进行治疗，对照组患者单用格列吡嗪控释片进行治疗，坚持治疗4周。待所有治疗完成后，将两组的血糖水平、血脂水平、不良反应发生情况进行对比。结果：两组患者接受诊治后，血糖水平、血脂水平均较前有所改善。然而，观察组所取得的临床疗效较对照组明显为优；同时，两组的不良反应情况没有显著统计性差异。结论：本实验使用格列吡嗪控释片联合盐酸二甲双胍肠溶胶囊治疗糖尿病，具有较好的临床疗效，可以有效改善血糖水平和血脂水平，且药物安全性较高，可以在临床上推广应用。     

盐酸二甲双胍缓释片治疗2型糖尿病疗效分析

目的 探讨盐酸二甲双胍缓释片治疗2型糖尿病的临床疗效。方法 将治疗组85例用盐酸二甲双胍缓释片治疗与对照组85例用中药治疗进行疗效比较观察。结果 治疗组显效率55.30%,总有效率90.59%;对照组显效率36.47%,总有效率69.41%。治疗组明显优于对照组,经统计学处理差异有显著性（P〈0.05）。结论 盐酸二甲双胍缓释片既能增强胰岛素敏感性,促进外周组织对血糖的利用,又能减少肝糖原的分解,减轻体重,是目前最常用的、有效的降糖药物,因此具有较强的临床推广价值。     

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。     

降糖止消方治疗2型糖尿病58例疗效观察

目的观察降糖止消方治疗2型糖尿病的临床疗效。方法将116例患者分为两组,均给予格列本脲片口服,2．5mg／次,2次,（1,盐酸二甲双胍片口服,0．25g／次,3次/d。治疗组同时服用中药降糖止消方。2组均以治疗3个月为1个疗程,治疗1个疗程后观察疗效。结果治疗组治愈率高于对照组,差异有统计学意义（P〈0．05）;治疗组总有效率高于对照组,差异统计学意义（P〈0．05）。治疗组血糖改善情况明显优于对照组,组间差异有显著性（P〈0．05）。结论降糖止消方治疗2型糖尿病临床疗效显著。     

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。     

格列本脲联合二甲双胍长期治疗对2型糖尿病患者胰岛素抵抗的影响

目的探讨格列本脲联合二甲双胍对2型糖尿病（T2DM）患者糖代谢和胰岛素功能的影响。方法选取我院门诊病人61例,分为格列本脲治疗（格列本脲组,n=32）和格列本脲＋二甲双胍治疗（格列本脲＋二甲双胍组,n=29）,格列本脲组为初诊病人;格列本脲＋二甲双胍组在保持平时服用二甲双胍的剂量不变的基础上加用格列本脲。随访24周,每4周根据空腹血糖（FBG）调整剂量,治疗前后做血脂、血糖、胰岛素、C肽测定,并计算胰岛素抵抗指数（HOMA-IR）。结果两组患者治疗后HbAlc较治疗前均显著降低（均P〈0.01）。格列本脲＋二甲双胍组治疗后FIns和HOMA-IR较治疗前均有显著降低（均P〈0.05）。结论格列本脲单用或与二甲双胍合用都能有效降低血糖,并没有明显的胰岛β细胞功能损害。但在改善胰岛素抵抗方面,两者联用效果更优。     

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.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

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.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.