二甲双胍对老年2型糖尿病患者的疗效及安全性

目的:观察二甲双胍对老年2型糖尿病患者的疗效与安全性。方法:42例老年2型糖尿病患者服用磺脲类降糖药物效果不佳时加服二甲双胍治疗,在随访24周的过程中,监测空腹血糖、糖化血红蛋白、胰岛素、血乳酸及血脂,并观察药物的副作用。结果:治疗后4周空腹血糖(7.6±1.9)mmol/Lvs(9.8±2.2)mmol/L,P<0.01、糖化血红蛋白(11.3±2.6)%vs(13.6±2.5)%,P<0.01显著下降;服药12周后LDL(2.3±0.8)mmol/Lvs(2.8±0.9)mmol/L,P<0.01、TG(3.0±1.1)mmol/Lvs(3.6±1.2)mmol/L,P<0.01显著下降;服药24周HDL升高(0.89±0.08)mmol/Lvs(0.85±0.08)mmol/L,P<0.01,但血胰岛素(16.7±3.6)mmol/Lvs(18.2±4.1)mmol/L,P>0.05、血乳酸(1.6±0.5)mmol/Lvs(1.4±0.5)mmol/L,P>0.05无显著变化。23.8%患者服用二甲双胍后出现恶心与腹泻,但症状轻微且短暂。结论:二甲双胍是治疗老年2型糖尿病患者安全、有效的药物。     

碳水化合物减肥法 拒绝复胖速效燃脂

碳水化合物减肥法的速效瘦身功效已经受到了很多MM的肯定,但也有些读者反映用此方法后容易反弹。怎样才能找到一条既快速燃脂又不复胖的瘦身之路,就让《瘦佳人》告诉你!     

超声诊断外伤性白内障并玻璃体积脓1例

患者女，19岁。因钢丝蹦右眼伤．疼痛、视物模糊．2h后来诊。检查：右眼睑轻度肿胀、羞明、混合性充血、角膜4点方位近lmm处可见一已自行闭合的小圆形穿孔伤．局部角膜混浊．前房内积血约7mm液平，内眼无法窥视。诊断：右眼角膜穿通伤，前房积血。人院后给予抗菌素、激素、止血等药物治疗。2     

膝OA关节镜术后补充玻璃酸钠效果评价

目的观察膝OA的关节镜治疗效果,进一步探讨玻璃酸钠对膝OA关节镜术后粘弹性补充治疗的疗效。方法按随机分组原则将113例病人分为用药组和对照组,分别于术后6周、3月、6月按Shahariarre标准进行疗效评定。结果术后6周、3月、6月用药组有效率分别为73%、88%、84%,对照组有效率分别为56%,60%、53%,术后6周两组间有效率无显著性差异,术后3月、6月两组间有显著性差异。结论关节镜下清理术治疗膝OA可缓解症状,改善功能,辅以SH腔内注射可明显提高疗效。     

Long-term application of diethylstilbestrol upregulates expressions of μ- and m-calpains in pituitary intermediate lobe of female Wistar rats

BACKGROUND: During formation of prolactin neoplasia, how cells and its structure in adenohypophysis affect prolactin cells should be further studied. Intermediate lobe can be regarded as a driving region to release prolactin (PRL) and may promote formation of prolactin neoplasia in pituitary anterior lobe. OBJECTIVE: To observe the effect of diethylstilbestrol (DES) on the expressions of μ and m-calpains in pituitary intermediate lobe of female Wistar rats. DESIGN: Observational contrast animal study. SETTING: Beijing Neurosurgical Institute. MATERIALS: A total of 21 female Wistar rats, 3 weeks old weighing 70–80 g were housed with free access to tap water and standard pellet food. They were kept in a CL-grade condition, at (24±1)℃ and a humidity of (55±5)%, and with a 12 hours day-night cycle. Caprine anti-μ- and m-calpains antibodies were provided by Santa Cruz Biotechnology, CA, USA; rabbit-anti-PRL antibodies by Dako, Denmark; rabbit-anti-ACTH antibody by Boster Company, Wuhan. METHODS: The experiment was carried out in Pathophysiological Department and Animal Laboratory, Beijing Neurosurgical Institute from August 2006 to January 2007. ① Rats were randomly divided into groups with 7 in each group, including vehicle control group, in which rats were injected intraperitoneally with sun-flower seed oil (1 mL/kg, twice a week) for 16 weeks; DES group, where animals were administered with DES (5 mg/kg, twice a week) for 16 weeks; DES + vehicle control group, in which DES was administered for 12 weeks at the same dose with those in DES group, and then was discontinued and replaced by sun-flower seed oil (1 mL/kg, twice a week) for the following 4 weeks. ② At 16 weeks later, pituitary tissue was dealt with HE staining and PRL immunohistochemical examination to observe evoke of tumor; meanwhile, immunohistochemical examination was used to observe expression of PRL of pituitary anterior lobe, expressions of μ- and m-calpains of pituitary intermediate lobe and distribution of adrenocorticotropin. MAIN OUTCOME MEASURES: ① Expression of PRL of pituitary anterior lobe, expressions of μ- and m-calpains of pituitary intermediate lobe and distribution of adrenocorticotropin. ② Morphological observation of pituitary tissue. RESULTS: All 21 rats were involved in the final analysis. ① Results of immunohistochemical examination: Morphological changes of neoplasia in DES group were strongly positive to PRL, and this suggested that formation of prolactin adenoma was observed in pituitary tissue. As compared with vehicle control group, expression of adrenoeorticotropic hormone (ACTH) was increased in both DES group and DES + vehicle control group. In addition, expressions of μ- and m-calpains in pituitary intermediate lobe were higher in DES group than that in vehicle control group. Otherwise, expressions of m-calpains in pituitary intermediate lobe was decreased in DES + vehicle control group, but expression of μ-calpains was still increased. ② Morphological observation of pituitary tissue: Gland tubes were orderly arranged in rats in vehicle control group. Anterior pituitary gland in rats of DES group demonstrated an apparent disappearance of gland tubes and a relatively large-scaled vasculature formation, namely the vascular lake lined by tightly arranged endothelial cells. Local integrated tumor cell arrangements were also detected. In addition, the border between the IL and the anterior lobe was locally blurred. The definite tumor-like changes in pituitary tissues were confirmed in 6 of 7 female Wistar rats in DES group, and one spontaneous occurrence of tumor formation was found in vehicle control group. In DES + vehicle control group, DES withdrawal led to the subtile emergence of gland tube cavity, although tumor-like cells still existed in 4 of 7 rats, suggesting occurrence of the tumor regression due to the withdrawal of DES. CONCLUSION: A long-term application of DES can enhance the expressions of ubiquitours neutral cysteine protease in pituitary intermediate lobe and this suggests that both of them play a key role in release of hormone and formation of prolactin neoplasia through directly promoting PRL expression and release of neighboring pituitary intermediate lobe.     

罗格列酮对心肌梗死和心血管病死亡的影响

作者首先表明进行本荟萃分析的目的。鉴于噻唑烷二酮类药物（TZDs）广泛用于治疗2型糖尿病（T2DM），罗格列酮（Rosiglitazone，ROS）是继曲格列酮（Troglitazone）因严重的肝毒性于1999年撤出市场后被美国食品、药品管理局（FDA）批准临床应用的降糖药物，2000年以来已广泛用于临床，包括单剂ROS和固定组方（ROS加二甲双胍或格列美脲）。但ROS在原始审批时重点是关注其降糖效果，而其对糖尿病大、小血管并发症的影响未给予充分的考虑，后来发现65％以上糖尿病人死于心血管病，     

锗（^132Ge）二酸口服液临床试用报告

报告了４４例晚期恶性肿瘤患者应用锗（＾１３２Ｇｅ）二酸治疗。结果表明该药抗肿瘤作用不明显，ＣＲ０例，ＰＲ２．３％，ＳＤ５４．５％，ＰＤ４３．２％。同时发现治疗后出现了ＢＵＮ升高。推测锗二酸可能对肾功能有损害作用，长期应用需提高警惕。     

盐酸二氢埃托啡与盐酸丁丙诺啡联合治疗海洛因依赖—附57例临床疗效分析

本文病例选择符合CCMD-Ⅱ精神活性物质所致精神障碍-阿片类物质依赖诊断标准，吸食或注射海洛因0．5a以上且目前仍在滥用的自愿戒毒患者。处理组57例，第1—2d每天用盐酸二氢埃托啡注射液(DHE)120—180μg加入10％葡萄糖注射液中缓慢静滴，第3d停用DHE，递减法im盐酸丁丙诺啡注射液(BUP)逐日剂量分别为1．2mg，     

解放军总医院门诊处方中苯二氮Zuo类药物使用调查

对苯二氮Ｚｕｏ类药物（ＢＺＤｓ）使用的调查分析，是监测精神药物滥用的重要依据，统计解放军总医院１９９６年６月份全月门诊处方，采用ＤＤＤ和ＤＵＩＯ的概念分析ＢＺＤｓ使用现况及合理性问题，并与国内其他医院的ＢＺＤｓ使用情况进行了比较，结果表明，（１）ＢＺＤｓ处方占门诊总处方的１．３２％，与其他地区和医院存在前显的地区差异；（２）ＢＺＤｓ各种药品的使用频率与国内其他医院相比也有较大差异，解放军总医院最常