参苓健脾化湿汤加减治疗代谢综合征患者的临床疗效

目的分析参苓健脾化湿汤加减治疗代谢综合征的临床疗效。方法100例代谢综合征患者,采用随机数字表法分为对照组和观察组,各50例。对照组应用二甲双胍治疗,观察组应用参苓健脾化湿汤加减治疗。比较两组患者的临床疗效及治疗前后血糖(空腹血糖、餐后2 h血糖以及糖化血红蛋白)水平改善情况。结果对照组治疗总有效率为70.00%,观察组治疗总有效率为88.00%;观察组治疗总有效率明显高于对照组,差异有统计学意义(P<0.05)。治疗前,对照组空腹血糖、餐后2 h血糖以及糖化血红蛋白水平分别为(7.3±1.9)mmol/L、(10.4±2.8)mmol/L、(6.3±0.8)%,观察组分别为(7.3±1.7)mmol/L、(10.6±2.9)mmol/L、(6.3±0.9)%;治疗后,对照组空腹血糖、餐后2h血糖以及糖化血红蛋白水平分别为(6.2±0.8)mmol/L、(8.4±1.3)mmol/L、(5.8±0.6)%,观察组分别为(6.4±1.0)mmol/L、(8.7±1.4)mmol/L、(5.9±0.6)%;治疗前及治疗后,两组空腹血糖、餐后2 h血糖以及糖化血红蛋白水平比较,差异无统计学意义(P>0.05);治疗后,两组空腹血糖、餐后2 h血糖以及糖化血红蛋白水平均低于治疗前,差异有统计学意义(P<0.05)。结论代谢综合征患者采用参苓健脾化湿汤加减治疗的效果显著,且能够实现与二甲双胍治疗相同的血糖控制效果,值得推广应用。     

门冬胰岛素30联合二甲双胍治疗老年初诊2型糖尿病的临床疗效及安全性研究

目的探讨门冬胰岛素30联合二甲双胍治疗老年初诊2型糖尿病的治疗效果与安全性。方法随机将初诊为2型糖尿病的老年患者50例分为实验组与对照组,实验组运用门冬胰岛素30联合二甲双胍治疗,对照组单纯运用门冬胰岛素30治疗,对比观察两组治疗前后空腹血糖水平、餐后2小时血糖水平、糖化血红蛋白及相关不良反应。结果实验组在治疗前的空腹血糖、餐后2h血糖、糖化血红蛋白分别为(11.78±1.32)mmol/L、(18.43±1.56)mmol/L、(10.23±3.85)%,治疗后分别为(6.21±0.63)mmol/L、(8.56±1.04)mmol/L、(6.32±1.72)%。对照组在治疗前的空腹血糖、餐后2h血糖、糖化血红蛋白分别为(11.75±1.30)mmol/L、(18.37±1.62)mmol/L、(10.14±3.76)%,治疗后分别为(6.52±0.68)mmol/L、(9.45±1.34)mmol/L、(7.14±1.76)%。两组发生低血糖均为2例,胃肠道反应均为2例,不良反应发生率相同。结论门冬胰岛素30联合二甲双胍治疗老年初诊2型糖尿病中疗效好,安全性高,值得临床推广运用。     

二甲双胍治疗糖耐量降低的临床效果和机制

目的探究二甲双胍治疗糖耐量降低的临床效果及其作用机制。方法确诊为糖耐量降低的患者70例,随机分为二甲双胍组与对照组,各35例。指导对照组患者健康宣教、控制饮食及运动干预治疗等干预治疗方法 ,二甲双胍组患者在对照组基础上口服二甲双胍治疗。两组患者接受治疗时间均为12个月。观察两组患者治疗后的体质量指数、空腹血糖及餐后2 h血糖变化情况,并与治疗前比较;同时观察两组患者新发糖尿病情况并进行比较。结果治疗12个月后二甲双胍组患者体质量指数(20.12±2.63)kg/m2、空腹血糖(5.11±0.81)mmol/L、餐后2 h血糖(7.66±1.12)mmol/L均明显优于治疗前水平,差异具有统计学意义(P<0.05);对照组患者治疗前后体质量指数、空腹血糖及餐后2 h血糖对比差异无统计学意义(P>0.05)。治疗后二甲双胍组无新发糖尿病患者,对照组有7例新发糖尿病患者,差异具有统计学意义(P<0.05)。结论二甲双胍应用于糖耐量降低的治疗取得了良好的效果,同时还能够有效的预防或者延缓糖尿病的发生,值得临床推广。     

二肽基肽酶抑制剂联合二甲双胍对2型糖尿病合并代谢综合征患者血糖控制及HOMA-IR的影响

目的分析二肽基肽酶抑制剂联合二甲双胍对2型糖尿病合并代谢综合征患者血糖控制及胰岛素抵抗指数(HOMA-IR)的影响。方法选取某院2017年2月~2019年5月2型糖尿病合并代谢综合征患者76例,依照随机数字表法分组,各38例,对照组接受二甲双胍治疗,观察组接受二肽基肽酶抑制剂联合二甲双胍治疗,比较两组治疗前后血糖水平(空腹血糖、餐后2 h血糖)、血清炎性因子水平[白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)]、HOMA-IR。结果与对照组对比,观察组治疗后空腹血糖、餐后2 h血糖较低(P<0.05);治疗后,观察组血清IL-1、TNF-α、hs-CRP较对照组低(P<0.05);治疗后,与对照组对比,观察组HOMA-IR较低(P<0.05)。结论二肽基肽酶抑制剂联合二甲双胍治疗2型糖尿病合并代谢综合征,能有效降低患者血糖水平,减少胰岛素抵抗,降低炎性因子水平。     

利拉鲁肽联合二甲双胍治疗门诊2型糖尿病的效果观察

目的 分析利拉鲁肽联合二甲双胍对门诊2型糖尿病的治疗价值。方法 120例2型糖尿病患者,随机分为对照组与联合组,每组60例。对照组患者给予二甲双胍治疗,联合组患者给予利拉鲁肽联合二甲双胍治疗。比较两组血糖指标达标时间,治疗前后胰岛素抵抗指数-IR、空腹C肽、血糖指标,治疗效果,不良反应发生率。结果 联合组空腹血糖、餐后2 h血糖、糖化血红蛋白达标时间分别为(5.12±0.15)、(7.45±1.21)、(8.45±2.12)d,短于对照组的(7.91±0.34)、(8.24±2.54)、(10.31±3.12)d,差异有统计学意义(P<0.05)。治疗后,联合组胰岛素抵抗指数-IR、空腹C肽、空腹血糖、餐后2 h血糖、糖化血红蛋白分别为(3.01±0.25)、(0.52±0.21)nmol/L、(7.32±1.85)mmol/L、(9.18±2.75)mmol/L、(6.21±1.12)%,均低于对照组的(3.62±0.79)、(0.71±0.11)nmol/L、(9.24±2.41)mmol/L、(11.21±3.12)mmol/L、(8.45±1.92)%,差异有统计学意义(...     

阿卡波糖联合二甲双胍治疗初发2型糖尿病伴高脂血症的分析

目的探讨阿卡波糖联合二甲双胍治疗初发2型糖尿病伴高脂血症分析。方法从2017年3月至2018年5月来院接受治疗的初发2型糖尿病伴高脂血症患者中,随机选取102例,102例患者按照随机双盲法分为两组(n=51),所有患者均符合入组标准,医护人员给予对照组患者二甲双胍治疗,给予观察组患者阿卡波糖联合二甲双胍治疗,在实验研究结束后,观察两组患者的餐后2 h血糖值、空腹血糖值。结果观察组患者的空腹血糖为(6.17±2.85)mmol/L、餐后2 h血糖为(7.84±2.81)mmol/L,对照组患者的空腹血糖为(8.53±1.75)mmol/L、餐后2 h血糖为(9.51±2.91)mmol/L,观察组患者的治疗效果明显优于对照组患者,两组患者的实验数据具有统计学意义(P <0.05)。结论针对我院接受治疗的初发2型糖尿病伴高脂血症患者,让其接受阿卡波糖联合二甲双胍治疗,能有效的将患者的餐后2 h血糖以及空腹血糖值控制在合理水平,促进患者疾病的好转,具有临床治疗意义与应用价值。     

门冬胰岛素30联合二甲双胍治疗老年糖尿病患者100例

目的观察门冬胰岛素30联合二甲双胍治疗老年糖尿病的疗效。方法选取2010年1月至12月住院治疗的老年糖尿病患者200例,随机分为观察组和对照组,各100例。观察组采用门冬胰岛素30联合二甲双胍进行治疗,对照组仅采用门冬胰岛素30治疗。结果治疗12周后,观察组空腹血糖水平为(5.87±1.33)mmol/L,餐后2 h血糖水平(8.31±1.89)mmol/L,糖化血红蛋白水平为(6.69±1.57)%,均明显低于对照组的(6.35±1.48)mmol/L,(9.21±2.14)mmol/L和(7.43±1.48)%,差异均有统计学意义(P<0.05);观察组患者血糖控制情况明显优于对照组,差异有统计学意义(Z=4.035,P<0.001);观察组患者血糖控制达标时间明显短于对照组,差异有统计学意义(Z=2.082,P=0.037)。不良反应发生率观察组与对照组比较差异无统计学意义(6.00%比4.00%,χ2=0.421,P=0.516)。结论与单用门冬胰岛素30相比,联合应用门冬胰岛素30和二甲双胍治疗老年2型糖尿病可显著降低患者血糖水平、提高血糖控制达标率、缩短血糖达标时间,不良反应增加不明显,具有较高临床安全性。     

瑞格列奈片、二甲双胍联合步行锻炼对社区2型糖尿病患者血脂代谢的影响

目的 探讨瑞格列奈片、二甲双胍联合步行锻炼对社区2型糖尿病患者血脂代谢的影响.方法 以社区内82例2型糖尿病患者为研究对象,随机分为对照组(41例)和观察组(41例).对照组采用二甲双胍治疗;观察组同时给予瑞格列奈片.治疗期间,两组患者均遵医嘱进行步行锻炼.检测两组治疗前后空腹、餐后2h及睡前血糖水平.比较治疗前后两组血脂代谢水平变化,观察不良反应发生情况.结果 治疗后,观察组TG、TC、LDL-C、HDL-C水平分别为[(1.27±0.54)、(4.17±0.43)、(2.31±0.58)、(1.84±0.57)]mmol/L,与本组治疗前与对照组治疗后比较差异均有统计学意义(P＜0.05);观察组空腹、餐后2h及睡前血糖水平[(5.73±1.45)、(7.36±1.62)、(7.18±1.66) mmol/L]低于对照组,差异有统计学意义(P＜0.05).结论 瑞格列奈片、二甲双胍联合步行锻炼能有效控制患者血糖水平,改善患者血脂代谢,安全可靠.     

二甲双胍对冠心病患者代谢综合征的影响

目的探讨二甲双胍对冠心病患者代谢综合征的影响。方法52例冠心病合并代谢综合征（MS）患者随机分为对照组20例和观察组32冽,分别采用冠心病标准治疗以及在此基础上加用二甲双胍治疗,追踪时间为1年。对两组治疗前后的空腹血糖（FPG）、餐后2h血糖、空腹胰岛素（FINS）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白-胆固醇（HDL-C）、胰岛素抵抗指数（IRI）等指标进行比较,同时比较治疗后两组之间上述指标以及心血管事件发生率。结果与对照组比较,观察组患者治疗后FPG,餐后2h血糖、FINS、TG、IRI均明显下降（P〈0．05）,其心血管事件发生率也明显低于对照组（P〈0．05）。结论二甲双胍能降低冠心病合并MS患者的血糖、TG、BMI和FINS,改善胰岛素敏感度,全面控制心血管危险因素,保护心血管免受损害,减少心血管事件的发生率,使患者多方获益。     

二甲双胍联合胰岛素对比二甲双胍单独使用治疗糖尿病的临床分析

目的:探讨糖尿病采取二甲双胍联合胰岛素与单用二甲双胍治疗的临床效果.方法:选择我院收治的糖尿病患者80例作为研究对象,入组时间2014年5月～2017年5月,愿意配合本研究,以随机数字表法分为研究组与对照组,各40例.对照组单用二甲双胍治疗,研究组在对照组基础上联合胰岛素治疗,对两组治疗后空腹血糖、餐后2h血糖、血糖达标时间及低血糖发生率进行观察记录,实施统计学分析.结果:研究组治疗后空腹血糖与餐后2h血糖显著低于对照组,血糖达标时间明显短于对照组,两组差异有统计学意义(P<0.05);两组低血糖发生率比较无显著差异(P>0.05).结论:糖尿病采取二甲双胍联合胰岛素治疗相比单用二甲双胍治疗,可以更好地改善血糖指标,缩短血糖达标时间,且低血糖发生率低,值得借鉴.     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Lung disease and PKCs

The lung offers a rich opportunity for development of therapeutic strategies focused on isozymes of protein kinase C (PKCs). PKCs are important in many cellular responses in the lung, and existing therapies for pulmonary disorders are inadequate. The lung poses unique challenges as it interfaces with air and blood, contains a pulmonary and systemic circulation, and consists of many cell types. Key structures are bronchial and pulmonary vessels, branching airways, and distal air sacs defined by alveolar walls containing capillaries and interstitial space. The cellular composition of each vessel, airway, and alveolar wall is heterogeneous. Injurious environmental stimuli signal through PKCs and cause a variety of disorders. Edema formation and pulmonary hypertension (PHTN) result from derangements in endothelial, smooth muscle (SM), and/or adventitial fibroblast cell phenotype. Asthma, chronic obstructive pulmonary disease (COPD), and lung cancer are characterized by distinctive pathological changes in airway epithelial, SM, and mucous-generating cells. Acute and chronic pneumonitis and fibrosis occur in the alveolar space and interstitium with type 2 pneumocytes and interstitial fibroblasts/myofibroblasts playing a prominent role. At each site, inflammatory, immune, and vascular progenitor cells contribute to the injury and repair process. Many strategies have been used to investigate PKCs in lung injury. Isolated organ preparations and whole animal studies are powerful approaches especially when genetically engineered mice are used. More analysis of PKC isozymes in normal and diseased human lung tissue and cells is needed to complement this work. Since opposing or counter-regulatory effects of selected PKCs in the same cell or tissue have been found, it may be desirable to target more than one PKC isozyme and potentially in different directions. Because multiple signaling pathways contribute to the key cellular responses important in lung biology, therapeutic strategies targeting PKCs may be more effective if combined with inhibitors of other pathways for additive or synergistic effect. Mechanisms that regulate PKC activity, including phosphorylation and interaction with isozyme-specific binding proteins, are also potential therapeutic targets. Key isotypes of PKC involved in lung pathophysiology are summarized and current and evolving therapeutic approaches to target them are identified.     

Gender-related symptoms and correlates of alcohol dependence among men and women with a lifetime diagnosis of alcohol use disorders

This study explored gender-related symptoms and correlates of alcohol dependence in a crosssectional study of 150 men and 150 women with a lifetime diagnosis of alcohol use disorders (AUD). Participants were recruited in equal numbers from treatment settings, correctional centres and the general community. Standardized measures were used to determine participants' use of substances, history of psychiatric disorders and psychosocial stress, their sensation seeking and family history of substance use and mental health disorders. Multivariate analyses were used to detect patterns of variables associated with gender and the lifetime severity of AUD. Men had a longer history of severe AUD than women. Women had similar levels of alcohol dependence and medical and psychological sequelae as men, despite 6 fewer years of AUD. More women than men had a history of severe psychosocial stress, severe dependence on other substances and antecedent mental health problems, especially mood and anxiety disorders. There were differences in family history of alcohol-related problems approximating same-gender aggregation. The severity of a lifetime AUD was predicted by its earlier age at onset and the occurrence of other disorders, especially anxiety, among both men and women. The limitations in the generalizability of these findings due to sample idiosyncrasies are discussed.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.