阿托伐他汀钙片在人及Beagle犬体内药动学差异的对比

采用液相色谱-串联质谱法分别测定人和Beagle犬口服阿托伐他汀钙片后血浆中的阿托伐他汀(1)及其活性代谢物,包括邻位羟基化物(2)和对位羟基化物(3),计算并对比人和Beagle犬血浆中1、2、3的药动学参数.结果显示,药物在人体内主要以原型1的形式存在,检测不到代谢物3;而在Beagle犬体内主要以代谢物2的形式存在,另检测到原型药物占约30％,代谢物3约占5％.原型药物1在人体内的消除半衰期约为Beagle犬的3倍,而清除率仅约为Beagle犬的65％.可见,人与犬口服药物的药动学存在显著的种属间差异,Beagle犬对原型药物的代谢速度和程度均显著高于人体.     

持续皮下胰岛素输注和胰岛素每日多点注射治疗2型糖尿病的成本效果分析

Objective To observe the cost-effectiveness of using continuous subcutaneous insulin infusion (CS Ⅱ) and multi-point daily insulin injections (MDI) in controlling blood sugar in the newly hospitalized type 2 diabetes patients. Methods Retrospective analysis on 86 cases taking CS Ⅱ and 103 cases using MDI on a 'blood sugar control program' among the newly hospitalized patients with type 2 diabetes. The period for observation was 2 weeks, using cost-effectiveness analysis methods to evaluate the two treatment programs. Results After two weeks of treatment, the effectiveness in the control of blood sugar in CS Ⅱ group was similar to the MDI group, with no significant difference(P<0.05) and the adverse reactions were similar. Costs in the CS Ⅱ program (Yuan/person) was less than in the MDI program (1478.34 vs. 1620.46), with significant differences (P< 0.05). The cost-effectiveness ratios (C/E) were 15.07 in the CS Ⅱ group, and 16.34 in the MDI group, with no significant difference (P>0.05). In order to further reduce the cost of CS Ⅱ group as a reference, the incremental cost-effectiveness ratio (△C/ △E)ofthe MDI group was 129.20. Conclusion Costs-effective of the CS Ⅱ program was better than the MDI one in treating the newly hospitalized patients with type 2 diabetes, suggesting that CS Ⅱ program might be a better choice for hospitals to carry on an intensive insulin therapy program.     

神经营养性关节病1例

患者,女性,57岁。2008年4月以右肩及右肘肿胀、麻木、不能抬起来我院就诊。体格检查:患者右肩、右肘关节明显肿胀,自觉麻木,不能拿起任何东西,右肩及右肘关节不能活动,无压痛、无发热。患者曾于10多年前右肘关节受过外伤,之后当地医院诊断为右肘关节骨质增生。口服消炎药,不起1     

持续皮下胰岛素输注和胰岛素每日多点注射治疗2型糖尿病的成本效果分析

Objective To observe the cost-effectiveness of using continuous subcutaneous insulin infusion (CS Ⅱ) and multi-point daily insulin injections (MDI) in controlling blood sugar in the newly hospitalized type 2 diabetes patients. Methods Retrospective analysis on 86 cases taking CS Ⅱ and 103 cases using MDI on a 'blood sugar control program' among the newly hospitalized patients with type 2 diabetes. The period for observation was 2 weeks, using cost-effectiveness analysis methods to evaluate the two treatment programs. Results After two weeks of treatment, the effectiveness in the control of blood sugar in CS Ⅱ group was similar to the MDI group, with no significant difference(P<0.05) and the adverse reactions were similar. Costs in the CS Ⅱ program (Yuan/person) was less than in the MDI program (1478.34 vs. 1620.46), with significant differences (P< 0.05). The cost-effectiveness ratios (C/E) were 15.07 in the CS Ⅱ group, and 16.34 in the MDI group, with no significant difference (P>0.05). In order to further reduce the cost of CS Ⅱ group as a reference, the incremental cost-effectiveness ratio (△C/ △E)ofthe MDI group was 129.20. Conclusion Costs-effective of the CS Ⅱ program was better than the MDI one in treating the newly hospitalized patients with type 2 diabetes, suggesting that CS Ⅱ program might be a better choice for hospitals to carry on an intensive insulin therapy program.     

乳腺癌影像学检查方法比较

乳腺癌是危及女性健康的常见肿瘤之一,其发病率在欧美发达国家多居女性肿瘤的首位。该病近年来在全球有明显上升趋势,腺癌正迅速成为中国妇女主要死亡原因之一。在当前众多诊断乳腺癌的方法中,影像学诊断是最常用有效的诊断方法。随着计算机技术的飞速发展,与计算机技术有关的影像技术的发展日新月异,各种新技术包括乳腺钼靶计算机辅助诊断、彩色多普勒超声扫描、CT、MRI、红外热像图、正电子发射计算机体层（PET）以及PET／CT等相继出现,使乳腺癌的影像学诊断提高了一个新的水平。     

持续皮下胰岛素输注和胰岛素每日多点注射治疗2型糖尿病的成本效果分析

Objective To observe the cost-effectiveness of using continuous subcutaneous insulin infusion (CS Ⅱ) and multi-point daily insulin injections (MDI) in controlling blood sugar in the newly hospitalized type 2 diabetes patients. Methods Retrospective analysis on 86 cases taking CS Ⅱ and 103 cases using MDI on a 'blood sugar control program' among the newly hospitalized patients with type 2 diabetes. The period for observation was 2 weeks, using cost-effectiveness analysis methods to evaluate the two treatment programs. Results After two weeks of treatment, the effectiveness in the control of blood sugar in CS Ⅱ group was similar to the MDI group, with no significant difference(P<0.05) and the adverse reactions were similar. Costs in the CS Ⅱ program (Yuan/person) was less than in the MDI program (1478.34 vs. 1620.46), with significant differences (P< 0.05). The cost-effectiveness ratios (C/E) were 15.07 in the CS Ⅱ group, and 16.34 in the MDI group, with no significant difference (P>0.05). In order to further reduce the cost of CS Ⅱ group as a reference, the incremental cost-effectiveness ratio (△C/ △E)ofthe MDI group was 129.20. Conclusion Costs-effective of the CS Ⅱ program was better than the MDI one in treating the newly hospitalized patients with type 2 diabetes, suggesting that CS Ⅱ program might be a better choice for hospitals to carry on an intensive insulin therapy program.     

问题-讨论-指导结合小组讨论教学法在内分泌科教学中的研究

目的：研究问题-讨论-指导（PDG）结合小组讨论的教学方法在内分泌科教学中的作用。方法：选取60名2004级临床医学专业学生,随机分为两组进行问题-讨论-指导（PDG）结合小组讨论教学方法与传统单纯理论授课教学方法的对比研究,课程结束后采用统一试卷进行操作、理论考试以评价教学效果,并采用自行设计的调查问卷对学生进行问卷调查以评价教学的主观效果。结果：采用PDG结合小组讨论教学法的实验组操作、理论考试成绩显著优于传统授课教学法组,学生所取得的主观效果明显好于传统授课教学法组。结论：PDG结合小组讨论的教学方法在内分泌科教学中优于传统授课教学法,值得进一步研究和推广。     

急性缺血性脑卒中介入治疗及护理观察

目的 于急性缺血性脑卒中治疗中采用介入治疗手段,探究适配的护理方案.方法 以本院区神经内科收治的急性缺血性脑卒中患者为研究对象,共计85例,采用自拟数列分布分组法,42例仍采用常规护理指导为基础组,43例采用针对性护理指导为实验组.对比两组患者NIHSS评分.结果 治疗前两组NIHSS评分一致(P>0.05),治疗后,...     

新诊断2型糖尿病合并非酒精性脂肪肝患者 下肢动脉粥样硬化的临床分析

 【目的】 探讨新诊断2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)患者发生下肢动脉粥样硬化的临床特点及危险因素&#65377; 【方法】 对151例新诊断2型糖尿病住院患者进行回顾性研究&#65377;根据是否合并NAFLD分为A组(合并NAFLD,92例)和B组(无NAFLD,59例),比较两组患者胰岛素抵抗&#65380;脂代谢紊乱&#65380;下肢动脉粥样硬化程度的差异&#65377;【结果】 92例(60.93%)新诊断住院2型糖尿病患者伴NAFLD,A组有较高的体质量指数&#65380;甘油三酯&#65380;血尿酸&#65380;胰岛素抵抗指数&#65380;空腹胰岛素和C肽&#65380;餐后2 h胰岛素和C肽水平,及较低的高密度脂蛋白胆固醇和胰岛素敏感指数水平;与B组比较,差异有统计学意义(P < 0.05);两组血糖则无明显差别(P > 0.05)&#65377;101例(66.89%)新诊断住院2型糖尿病患者伴不同程度的下肢动脉血管病变,A组下肢动脉粥样硬化较B组明显增加&#65377;【结论】 新诊断2型糖尿病患者脂肪肝及下肢血管动脉硬化都较高,合并NAFLD的患者发生下肢动脉硬化比不合并NAFLD的患者明显升高,而且下肢动脉硬化病变也更严重&#65377;     

2型糖尿病视网膜病变患者血清炎症因子和脂联素水平的变化

目的:观察2型糖尿病合并视网膜病变(DR)患者血清炎症因子和脂联素的变化。方法:110例糖尿病患者分为3组:糖尿病无视网膜病变组(DM)35例、糖尿病伴非增殖期视网膜病变组(NPDR)45例和糖尿病伴增殖期视网膜病变组(PDR)30例,并与40名正常人对照(NC组)。观察患者的体检指标,并检测空腹血糖(FPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、餐后2h血糖(2hPG),总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、脂联素、血清细胞间黏附分子-1(ICAM-1)、肿瘤坏死因子-α(TNF-α)和高敏C-反应蛋白(hs-CRP)。计算稳态模型评估的胰岛素抵抗指数(HOMA-IR)。结果:DM组、NPDR组和PDR组患者的收缩压、体重指数、腰臀比、血清TG、LDL-C、FPG、2hPG、HbA1c、ICAM-1、TNF-α、hs-CRP水平和HOMA-IR均高于NC组(P<0.05),而NPDR组和PDR组的收缩压、血清ICAM-1、TNF-α、hs-CRP水平和HOMA-IR均高于DM组(P<0.05)。DM组、NPDR组及PDR组的患者血清脂联素水平均低于NC组(P<0.05),而NPDR组及PDR组的患者血清脂联素水平低于DM组患者(P<0.05)。血清脂联素水平与ICAM-1、TNF-α、hs-CRP和HOMA-IR之间呈负相关(r值分别为-0.735、-0.781、-0.768、-0.752,均P<0.01),HOMA-IR与ICAM-1、TNF-α和hs-CRP之间呈正相关(r值分别为0.857、0.906、0.888,均P<0.01)。结论:炎症因子和脂联素参与了DR的发生和发展,而脂联素可能通过拮抗炎症反应减轻胰岛素抵抗,对DR有一定的改善作用。