二甲双胍联合炔雌醇环丙孕酮片对多囊卵巢综合征患者性激素和胰岛素水平的影响

目的:研究二甲双胍联合炔雌醇环丙孕酮片对多囊卵巢综合征(Polycystic ovarian syndrome,PCOS)患者性激素和胰岛素水平的影响。方法:选取2018年3月至2019年10月于我院就诊的PCOS患者135例,按照随机数字表法分为两组,对照组患者67例予以炔雌醇环丙孕酮片(每天1片)口服,研究组68例在对照组的基础上增加二甲双胍(每天0.85 g)口服。治疗3个疗程后,观察两组患者临床疗效、性激素水平、胰岛素水平、自然受孕率、不良反应。结果:研究组患者治疗后的临床有效率、受孕率明显高于对照组(P<0.05)。治疗后研究组黄体生成素(Luteinizing hrmone,LH)、睾酮(Testosterone,T)、卵泡刺激素(Follicle-stimulating Hormone,FSH)、胰岛素抵抗指数(Homeostasis model assessment insulin resistance,HOMA-IR)、空腹胰岛素(Fasting serum insulin,FINS)、空腹血清葡萄糖(Fasting plasma glucose,FPG)均显著低于对照组(P<0.05),雌二醇(Estradiol,E2)显著高于对照组(P<0.05)。两组患者不良反应发生率无显著差异(P>0.05)。结论:二甲双胍联合炔雌醇环丙孕酮片应用于PCOS患者可通过纠正性激素紊乱、改善胰岛素抵抗来提高临床疗效及自然受孕率,可临床推广。     

吡格列酮联合二甲双胍治疗2型糖尿病疗效探讨

目的 探讨吡格列酮联合二甲双胍治疗2型糖尿病的疗效.方法 在该院2019年4月—2020年3月收治的2型糖尿病患者中选取76例.按照入院编号分成两组:对照组38例,使用二甲双胍片治疗;试验组38例,联合使用吡格列酮片.观察两组的治疗效果和不良反应,比较治疗前后的血糖、血脂水平变化.结果 相比于对照组,试验组患者的治疗总...     

二甲双胍在结肠癌中通过抑制lncRNA-MALAT1的表达发挥抗肿瘤效应

目的 探讨二甲双胍（MET）对结肠癌细胞的抑制作用及其机制。方法 采用CCK-8、流式细胞术及Transwell检测MET对结肠癌细胞SW480和SW620增殖、凋亡及侵袭的影响,qRT-PCR检测5种lncRNA在结肠癌细胞中的表达,Western blotting检测MET和/或MALAT1基因敲减在体外对PI3K/AKT和ERK通路活性的影响。结果 MET在体外对SW480和SW620细胞具有抑制作用,且呈剂量和时间依赖性（P<0.05）。MET可促进SW480和SW620细胞凋亡（P<0.05）。在5种lncRNA中,lncRNA-MALAT1在SW480和SW620细胞中的表达水平最高（P<0.01）。siRNA可抑制lncRNA-MALAT1表达,并进一步增强MET介导的抗结肠癌作用（P<0.05）。MET可下调结肠癌细胞中lncRNA-MALAT1的表达（P<0.05）,并通过PI3K/AKT和ERK信号通路与lncRNAMALAT1敲减协同抑制结肠癌细胞的增殖和侵袭,并促进其凋亡（P<0.01）。结论 MET在结肠癌细胞中通过抑制ln...     

Evaluation of the metformin initiation rate in veterans with newly identified type 2 diabetes

BackgroundAn estimated 35 million individuals in the United States have diabetes. The American Diabetes Association recommends metformin as first-line pharmacologic treatment. The primary objective of this study was to evaluate the metformin initiation rate in veterans with recently identified type 2 diabetes.MethodsVeterans with new onset type 2 diabetes were identified using National Veterans Health Administration Data. Retrospective information was obtained from those with a first A1C ≥ 6.5% (48 mmol/mol) between 2013 and 2018. Veterans with at least one additional A1C < 6.5% (48 mmol/mol) documented in the three years prior to the A1C diagnostic for diabetes were included in the analysis.ResultsA total of 144,180 veterans were included. Of those, 45,776 (31.7%) were started on metformin within one year of diabetes diagnosis. The median time to metformin initiation was 12 days and median time to initiation of any anti-hyperglycemic was 11 days. Approximately 16,000 veterans were referred for lifestyle interventions within 90 days.ConclusionMetformin initiation occurred in fewer patients than expected given metformin is a generic, well-tolerated medication recommended as first-line pharmacologic treatment option regardless of A1C. Further studies are needed to assess the barriers of initiating metformin at time of diabetes diagnosis.     

Dry eyes in patients with diabetes mellitus

Dry eyes may be caused by impairment in the tear production or excessive tear evaporation and are associated with photophobia, red eyes, vision impairment, local pain and pruritus. It has been described that patients with Diabetes Mellitus (DM) may have a higher prevalence of dry eyes than normal population.This is a case control study of 120 patients with Diabetes Mellitus (DM) and 120 paired controls aiming to compare their prevalence of dry eyes (by the Schirmer test) and its severity (measured by OSDI or Ocular Surface Disease Index) as well as their association with diseases’ clinical variables.We found that 38.3% of DM patients had dry eyes, a prevalence that was higher than controls (p = 0.02). At univariate analysis, they were found to be more common in older individuals (p = 0.001) with type 2 diabetes (p = 0.001) and in those using metformin (p = 0.001). A multivariate linear regression showed that metformin use was the only independent variable associated with dry eyes. When patients with dry eyes with and without DM were compared, no differences in the symptom’s intensity were found.     

利拉鲁肽治疗2型糖尿病合并多囊卵巢综合征的临床价值研究

目的 探讨利拉鲁肽治疗2型糖尿病合并多囊卵巢综合征的临床效果.方法 选择2018年1月—2019年6月收治的2型糖尿病合并多囊卵巢综合征患者60例为对象,随机数表法将其分成对照组(n=30)和观察组(n=30).对照组用二甲双胍治疗,观察组用二甲双胍联合利拉鲁肽治疗,治疗当天和治疗24周时,检测两组患者体内空腹血糖(F...     

补肾调冲方在多囊卵巢综合征中的辅助治疗作用及机制研究

目的 探讨补肾调冲方辅助促排卵法治疗多囊卵巢综合征（polycystic ovary syndrome,PCOS）的临床疗效及作用机制。方法 选取新乡医学院第一附属医院2016年1月—2018年12月符合PCOS诊断标准的病例100例,进行临床随机对照研究,以随机数表法分为观察组和对照组,每组50例。对照组采取炔雌醇环丙孕酮片+来曲唑进行治疗,观察组在对照组治疗方案的基础上给予补肾调冲方治疗,总疗程为6个月经周期,记录2组患者临床资料,检测治疗前后患者脂肪细胞因子、性激素、氧化应激等指标。结果 治疗后,观察组内脂素、瘦素、睾酮、促黄体生成激素（luteotropic hormone,LH）、卵泡刺激素（follicle-stimulating,FSH）、LH/FSH、丙二醛水平以及流产率显著低于对照组（P<0.05）;脂联素、雌二醇、超氧化物歧化酶、谷胱甘肽过氧化物酶水平,排卵率及妊娠率水平显著高于对照组（P<0.05）。结论 补肾调冲方对PCOS有较好的辅助治疗作用,可有效调节性激素水平,改善氧化应激状态,缓解胰岛素抵抗。     

来得时联合拜唐平治疗初发Ⅱ型糖尿病疗效观察

目的观察来得时联合拜唐平治疗初发Ⅱ型糖尿病的临床疗效，并作安全性评价。方法将符合初发Ⅱ型糖尿病纳入标准病例90例，按入院顺序随机分为治疗组45例与对照组45例，对照组予以诺和灵30R治疗，治疗组给予来得时联合拜唐平治疗，比较两组的疗效，以及两组治疗前后各项实验室指标的变化情况。结果治疗组总有效率明显优于对照组（P〈O．05），且治疗组在降低空服血糖、餐后2小时血糖及糖化血红蛋白水平方面均明显优于对照组（P〈0．05或P〈0．01）。治疗组低血糖发生率明显低于对照组，差异有统计学意义（P〈0．05）。结论来得时联合拜唐平治疗初发Ⅱ型糖尿病疗效确切，安全有效，低血糖发生率低，值得临床推广应用。