二甲双胍对晚期非糖尿病肺癌患者的治疗价值研究

目的评价二甲双胍对晚期非糖尿病肺癌患者的诊治价值。方法选取初次确诊为肺癌晚期的非糖尿病患者100例,随机分为两组,其中常规化疗组(对照组)50例,加用二甲双胍治疗组(观察组)50例,评价其近期疗效、三年生存率、T淋巴细胞亚群分类计数、药物不良反应。用SPSS 17.0软件包采用卡方检验或t检验进行数据处理。结果观察组近期总有效率与对照组比较无显著差异(P0.05),观察组3年生存率明显高于对照组,差异有统计学意义(P0.05);两组患者治疗前各淋巴细胞亚群值差异无统计学意义(P0.05),治疗后两组患者CD_3~+、CD_4~+及CD_4~+/CD_8~+水平均有所降低,CD_8~+及NK细胞水平升高,差异有统计学意义,对照组更明显(P0.05);观察组及对照组不良反应比较差异无统计学意义(P0.05)。结论在常规化疗基础上加用二甲双胍治疗晚期非糖尿病肺癌患者,可减轻化疗对患者免疫功能损伤程度,提高生存率。     

二甲双胍治疗成年人非酒精性脂肪性肝病的荟萃分析

目的:评价二甲双胍治疗非酒精性脂肪性肝病(non alcoholic fatty liver disease.NAFLD)的疗效.方法:在Medline、Embase、OVID、Cochrane Library、Cinahl、CESJ、ASP、VIP和CNKI中国期刊全文数据库中检索已发表的关于二甲双胍联合饮食控制与单纯饮食控制比较治疗NAFLD的随机对照临床试验.利用Stata 9.0软件和Review Manager 5.0.14软件进行荟萃分析.结果:按入选标准,共纳入9个随机对照临床试验.荟萃分析表明:与单纯饮食控制相比,二甲双胍联合饮食控制可以明显降低NAFLD患者的ALT、AST和GGT,WMD值分别为-12.12 U/L(95%CI:-22.13,-2.12,P=0.02)、-11.38 U/L(95%CI:-22.86,0.11,P=0.05)和-19.91 U/,L(95%CI:-37.01,-2.82,P=0.02):二甲双胍联合饮食控制与单纯饮食控制相比,可以明显改善NAFLD患者的胰岛素抵抗,使HOMA-IR降低,WMD值为-0.67(95%CI:-0.80,-0.55,P＜0.00001);但二甲双胍联合饮食控制对NAFLD患者肝脏组织学的改善作用并不优于单纯饮食控制,并不能明显降低肝脏炎症评分和肝脏纤维化评分,SMD分别为-0.08(95%CI:-0.51,0.35,P=0.71)和-0.32(95%CI:-0.75,0.11,P=0.14).结论:二甲双胍可以加快NAFLD患者ALT、AST和GGT生化指标的恢复,并可以明显改善胰岛素抵抗,但对NAFLD患者肝脏组织学的改善作用并不明显.     

参芪扶正注射液联合化疗治疗非小细胞肺癌疗效系统评估

目的：从循证医学的角度综合分析参芪扶正注射液联合化疗对非小细胞肺癌患者疗效的系统评估。方法检索中国科技期刊数据库(维普资讯网)、中国学术期刊网全文数据库(CNKI),检索时间段设定为1990-2014年。可检索出关于参芪扶正注射液联合化疗对非小细胞肺癌患者疗效的文献165篇,最终6篇文献符合标准。对可纳入文献进行方法学质量评价,提取数据采用Meta分析专用软件 RevManager 5.2进行统计分析,对可以合并统计的数据合并OR 值并计算95%CI 。结果本分析共纳入6个研究。参芪扶正注射液可显著提高患者生存质量(OR =3.90,95%CI ：2.35~6.48,总体效应检验Z=5.25,P<0.00001),提高化疗的近期疗效(OR=1.94,95%CI ：1.30~2.90,总体效应检验Z =3.25,P =0.001),降低不良反应发生率(OR =0.38,95%CI ：0.23~0.64,总体效应检验Z=3.66,P=0.0002)。结论参芪扶正注射液联合化疗治疗非小细胞肺癌可显著提高患者生存质量,提高化疗的近期疗效,降低不良反应发生率。     

miR-92b在非小细胞肺癌组织中的表达及临床意义

目的探讨miR-92b在非小细胞肺癌组织中的表达及临床意义。方法选取2012年4月至2014年4月在山东省立第三医院行手术切除的非小细胞肺癌患者103例,实时荧光定量PCR术检测非小细胞肺癌和癌旁组织中miR-92b表达,所有患者从术后第1d起随访至2019年4月30日,记录患者5年生存率及总生存时间,采用Kaplan-Meier法进行生存分析,采用Cox比例风险模型对影响预后的因素分析。结果miR-92b在非小细胞肺癌组织中表达量为(2.31±0.15),高于癌旁组织中的(1.01±0.10)(t=85.839,P<0.001);与TNM分期Ⅰ期和未发生淋巴结转移的患者相比,miR-92b在TNM分期Ⅱ~Ⅲ期和发生淋巴结转移患者组织中表达量升高(P<0.05);生存分析结果显示,低表达组5年累积生存率为57.69%,平均生存时间为(46.46±3.45)个月,均高于高表达组,分别为19.48%和(28.00±2.19)个月(χ²=13.395,P<0.001);影响非小细胞肺癌患者预后的风险因素包括TNM分期、淋巴结转移和miR-92b表达[HR=2.409(95%CI:1.294~4.486)、3.055(95%CI:1.620~5.759)和2.069(95%CI:1.045~4.096),P<0.05]。结论miR-92b在非小细胞肺癌组织中表达量升高,是患者5年生存率和生存时间的独立风险因素。     

探讨二甲双胍治疗糖尿病合并新发肝癌患者的远期疗效

目的:探讨二甲双胍治疗糖尿病合并新发肝癌患者的远期疗效.方法:选取我院2018年7月至2020年9月收治糖尿病合并新发肝癌患者64例,根据治疗方法差异将其分为二甲双胍组与非二甲双胍组,每组含患者32例,对比两组生存率及预后,分析二甲双胍治疗糖尿病合并新发肝癌的远期疗效.结果:两组患者一般临床资料对比无显著差异(P<0....     

二甲双胍联合顺铂对人肺癌裸鼠移植瘤治疗作用的研究

目的 研究二甲双胍联合常用的化疗药物顺铂对于人肺癌裸鼠移植瘤的抑瘤作用及对生存素(Survivin)、基质金属蛋白酶2(MMP-2)和Ki67分子表达的影响,致力于探索治疗肺癌的新的有效药物.方法 建立肺癌裸鼠移植瘤模型,将裸鼠随机分为二甲双胍组、顺铂组、二甲双胍联合顺铂组及对照组,给药42 d后,处死动物,留取肿瘤组织,免疫组织化学法及实时荧光定量PCR法检测肿瘤组织中Survivin、MMP-2和Ki67蛋白及mRNA的表达.结果 二甲双胍组、顺铂组和二甲双胍联合顺铂组抑瘤率分别为28.97％、35.34％和54.65％.与对照组比较,顺铂组及二甲双胍联合顺铂组Survivin、MMP-2和Ki67蛋白及mRNA表达水平均降低(P值均＜0.05),二甲双胍组MMP-2蛋白及mRNA表达水平降低(P值均＜0.05);与二甲双胍组、顺铂组比较,二甲双胍联合顺铂组Survivin、MMP-2和Ki67蛋白及mRNA表达水平均降低(P值均＜0.05).结论 二甲双胍组可抑制MMP-2的表达,顺铂组及二甲双胍联合顺铂组均可抑制Survivin、MMP-2和Ki67的表达,二甲双胍和顺铂联合应用可以增强抗肿瘤的疗效.     

西格列汀及西格列汀与二甲双胍联合治疗2型糖尿病的临床分析

目的 探讨西格列汀及西格列汀与二甲双胍联合治疗2型糖尿病(T2DM)的临床疗效.方法 将95例2型糖尿病患者随机分为西格列汀组(J组,30例)、二甲双胍组(M组,30例)、西格列汀和二甲双胍联合治疗组(U组,35例),J组服用西格列汀,M组服用二甲双胍,U组服用西格列汀与二甲双胍;治疗前、后检测患者空腹及餐后2小时血糖和胰岛素(FPG、2hPG、FIns、2hIns)、糖化血红蛋白(HbA1c),计算胰岛β细胞功能指数(HOMA-β).结果 3组患者血糖水平及HbA1c较治疗前降低(P均＜0.05),J组、U组患者HOMA-β较治疗前升高(P＜0.05);治疗后,J组和U组患者HOMA-β高于M组(P均＜0.05),M组HbA1c及FPG水平均低于J组,但高于U组(P＜0.05),J组2hPG水平低于M组,但高于U组(P＜0.05).结论 西格列汀降糖疗效显著,与二甲双胍联合应用能进一步增强对2型糖尿病患者的治疗效果.     

CIK细胞联合二线化疗治疗晚期肺癌的临床效果观察

目的观察CIK(Cytokine-induced-killer)细胞联合二线化疗对一线化疗治疗失败的晚期肺癌患者的临床治疗效果。方法将2012年10月~2014年2月,40例经一线化疗无效的晚期肺癌患者随机分为两组:CIK细胞联合二线化疗药物组(n=21)和单用二线化疗药物组(n=19)。对两组的疾病控制率、缓解率、无疾病进展期和生存期进行观察比较。结果 CIK细胞联合化疗组的ORR(Objective response rate,客观缓解率)和DCR(Disease control rate,疾病控制率)分别达到33.3%和81.0%,而单用化疗药物治疗组ORR和DCR分别为15.8%和63.2%(PORR=0.361,PDCR=0.366)。CIK细胞联合化疗组的PFS(中位无疾病进展期)和OS(中位总生存期)分别为5.5个月(95%CI 3.71~7.29个月)及13.8个月(95%CI 10.75~16.85个月),相比而言,单用化疗药物组则分别为3.0个月(95%CI 2.68~3.32个月)及9.5个月(95%CI 8.38~10.62个月)。联合治疗组的患者有着明显更长的PFS和OS(PPFS=0.024,POS=0.042)。结论 CIK细胞联合二线化疗药物治疗一线化疗失败的晚期肺癌患者比单用二线化疗药物治疗可明显延长患者的PFS和平均存活时间。     

中国人群肺癌Napsin A蛋白表达的Meta分析

目的:探讨免疫组化检测Napsin A对非小细胞肺癌诊断的应用价值。方法:计算机检索Pubmed、中国学术期刊全文数据库、维普中文科技期刊数据库、万方数据库、中国生物医学文献数据库,末次检索日期为2017年2月27日。按照纳入与排除标准筛选文献,使用QUADAS对文献进行质量评价,以诊断比值比(DOR)为效应评价指标,采用Meta Disc1.4和Rev Man5.0诊断试验Meta分析方法检验各文献间的异质性,并根据异质性结果选择相应的效应模型进行加权定量合并,计算敏感度和特异度及其95%CI。绘制受试者工作特征曲线(SROC)并计算曲线下面积(AUC)。结果:免疫组化检测Napsin A在非小细胞肺癌诊断的汇总敏感度和特异度分别为0.87(95%CI:0.84~0.89)和0.89(95%CI:0.86~0.91),DOR为761.24(95%CI:51.77~11194.01),SROC的AUC为98.95%,Q*指数为0.939 7。结论:免疫组化检测Napsin A诊断非小细胞肺癌,特异度高,灵敏度较高,具有一定的临床应用价值。     

阿卡波糖联合二甲双胍治疗2型糖尿病临床探讨

目的探讨研究阿卡波糖联合二甲双胍治疗2型糖尿病的治疗效果。方法随机选取2013年3月—2014年3月门诊2型糖尿病患者40例作为治疗组,将2013年3月以前40例2型糖尿病治疗病历作为对照组,治疗组采取阿卡波糖联合二甲双胍治疗方案,对照组患者单纯使用二甲双胍治疗方案,对比研究阿卡波糖联合二甲双胍治疗2型糖尿病的治疗效果及不良反应和临床适用性。结果治疗3个月后,复查治疗组患者餐后2 h血糖及空腹血糖水平明显低于对照组,两组结果差异有统计学意义(P0.05),治疗组患者总有效率95%,对照组总有效率80%,治疗组效果明显优于对照组患者,差异有统计学意义(P0.05),且两组患者不良反应症状均不明显,安全性良好。结论阿卡波糖联合二甲双胍治疗2型糖尿病疗效确切,不良反应小,治疗总有效率优于单独用药方案,值得在临床上推广应用。     

Biliary microlithiasis,sludge,crystals,microcrystallization,and usefulness of assessment of nucleation time

BACKGROUND:The process of microcrystallization,its sequel and the assessment of nucleation time is ignored.This systematic review aimed to highlight the importance of biliary microlithiasis,sludge,and crystals,and their association with gallstones,unexplained biliary pain,idiopathic pancreatitis, and sphincter of Oddi dysfunction.DATA SOURCES:Three reviewers performed a literature search of the PubMed database.Key words used were"biliary microlithiasis","biliary sludge","bile crystals","cholesterol crystallisation","bile microscopy","microcrystal formation of bile","cholesterol monohydrate crystals","nucleation time of cholesterol","gallstone formation","sphincter of Oddi dysfunction"and"idiopathic pancreatitis".Additional articles were sourced from references within the studies from the PubMed search.RESULTS:We found that biliary microcrystals account for almost all patients with gallstone disease,7%to 79%with idiopathic pancreatitis,83%with unexplained biliary pain, and 25%to 60%with altered biliary and pancreatic sphincter function.Overall,the detection of biliary microcrystals in gallstone disease has a sensitivity ranging from 55%to 87%and a specificity of 100%.In idiopathic pancreatitis,the presence of microcrystals ranges from 47%to 90%.A nucleation time less than 10 days in hepatic bile or ultra-filtered gallbladder bile has a specificity of 100%for cholesterol gallstone disease.CONCLUSIONS:Biliary crystals are associated with gallstone disease,idiopathic pancreatitis,sphincter of Oddi dysfunction, unexplained biliary pain,and post-cholecystectomy biliary pain.Pathways of cholesterol super-saturation,crystallisation, and gallstone formation have been described with scientificsupport.Bile microscopy is a useful method to detect microcrystals and the assessment of nucleation time is a good method of predicting the risk of cholesterol crystallisation.     

Antibacterial activity of cefpodoxime in comparison with cefixime,cefdinir, cefetamet,ceftibuten, loracarbef,cefprozil, BAY 3522, cefuroxime,cefaclor and cefadroxil

Summary The new oral cephalosporins cefpodoxime, cefixime, cefdinir, cefetamet and ceftibuten demonstrate enhanced activity against Enterobacteriaceae susceptible to the established compounds as well (e.g. cefuroxime, cefaclor, cefadroxil). In addition, cefpodoxime, cefixime, cefdinir, cefetamet and ceftibuten include in their spectrum species hitherto resistant to oral cephalosporins (Proteus vulgaris, Providencia spp.,Yersinia enterocolitica). Besides, the majority of these compounds demonstrate relevant activity (MIC₅₀ equal to or below 2 mg/l) againstEnterobacter spp.,Citrobacter freundii, Serratia spp. andMorganella morganii. Ceftibuten is the most potent oral cephalosporin against most of the Enterobacteriaceae. Non-fermentative bacilli (Acinetobacter spp.,Pseudomonas spp.) remain completely resistant to oral cephalosporins (except someAcinetobacter species against cefdinir andPseudomonas cepacia against ceftibuten). Antistaphylococcal activity for oral cephalosporins is highest for cefdinir followed by BAY 3522, cefprozil, cefuroxime and cefpodoxime. Loracarbef, cefaclor and cefadroxil are about equally active, while the other compounds are only weakly active (cefixime) or inactive (cefetamet, ceftibuten). Enterococci are insensitive to new generation oral cephalosporins as they have been to established compounds. The most active oral cephalosporins against hemolytic streptococci are cefdinir and cefprozil.Streptococcus pneumoniae, Streptococcus milleri andStreptococcus mitior are most susceptible to cefpodoxime, cefdinir, cefuroxime and BAY 3522. Penicillin resistant pneumococci have to be regarded as resistant to all oral cephalosporins. Fastidious pathogens likeHaemophilus spp.,Moraxella catarrhalis andNeisseria gonorrhoeae are more susceptible to cefpodoxime, cefixime, cefdinir, cefetamet and ceftibuten than to the other oral cephalosporins. The activity of oral cephalosporins is only weak againstListeria spp.,Helicobacter pylori and anaerobic pathogens (except BAY 3522).Bordetella pertussis remains resistant to all absorbable cephalosporins. Progress in antibacterial activity of oral cephalosporins was mainly achieved by cefpodoxime, cefixime, cefdinir, cefetamet and ceftibuten against Enterobacteriaceae and the fastidious pathogens and against staphylococci and the nonenterococcal streptococci by cefdinir, BAY 3522, cefprozil and cefpodoxime.

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Antibakterielle Aktivität von Cefpodoxim im Vergleich mit anderen oralen Cephalosporinen

Zusammenfassung Die neuen oralen Cephalosporine Cefpodoxim, Cefixim, Cefdinir, Cefetamet und Ceftibuten zeigen eine verstärkte Aktivität auch gegen solche Enterobacteriaceae, die gegen etablierte Substanzen empfindlich sind (z.B. Cefuroxim, Cefaclor, Cefadroxil). Zusätzlich schließt das Spektrum von Cefpodoxim, Cefixim, Cefdinir, Cefetamet und Ceftibuten Spezies ein, die gegen die bisherigen oralen Cephalosporine resistent waren (Proteus vulgaris, Providencia spp.,Yersinia enterocolitica). Daneben zeigt die Mehrheit der neuen Substanzen erhöhte Aktivität (MHK₅₀<2 mg/l) gegenEnterobacter spp.,Citrobacter freundii, Serratia spp. undMorganella morganii. Gegen die meisten Enterobacteriaceae ist Ceftibuten das wirksamste orale Cephalosporin. Non-Fermenter (Acinetobacter spp.,Pseudomonas spp.) bleiben gegenüber oralen Cephalosporinen vollständig resistent (mit Ausnahme einigerAcinetobacter-Spezies gegen Cefdinir undPseudomonas cepacia gegen Ceftibuten). Die Antistaphylokokken-Aktivität oraler Cephalosporine ist am höchsten bei Cefdinir, gefolgt von BAY 3522, Cefprozil, Cefuroxim und Cefpodoxim. Loracarbef, Cefaclor und Cefadroxil sind etwa gleich aktiv, während die anderen Substanzen nur schwach aktiv (Cefixim) oder inaktiv sind (Cefetamet, Ceftibuten). Enterokokken sind gegenüber der neuen Generation oraler Cephalosporine ebenso unempfindlich wie gegenüber den etablierten Substanzen. Die aktivsten oralen Cephalosporine gegen hämolysierende Streptokokken sind Cefdinir und Cefprozil.Streptococcus pneumoniae, Streptococcus milleri undStreptococcus mitior sind am empfindlichsten gegen Cefpodoxim, Cefdinir, Cefuroxim und BAY 3522. Penicillin-resistente Pneumokokken müssen als resistent gegenüber allen oralen Cephalosporinen betrachtet werden. Anspruchsvolle Erreger wieHaemophilus spp.,Moraxella catarrhalis undNeisseria gonorrhoeae sind gegen Cefpodoxim, Cefixim, Cefdinir, Cefetamet und Ceftibuten empfindlicher als gegen die anderen oralen Cephalosporine. Die Aktivität oraler Cephalosporine gegenListeria spp.,Helicobacter pylori und Anaerobier (Ausnahme BAY 3522) ist nur schwach.Bordetella pertussis bleibt gegen alle resorbierbaren Cephalosporine resistent. Der Fortschritt in der antibakteriellen Aktivität oraler Cephalosporine wurde gegen Enterobacteriaceae und anspruchsvolle Erreger hauptsächlich durch Cefpodoxim, Cefixim, Cefdinir, Cefetamet und Ceftibuten erlangt, gegen Staphylokokken und Streptokokken (außer Enterokokken) durch Cefdinir, BAY 3522, Cefprozil und Cefpodoxim.

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Supported by Luitpold-Werk, a company of the Sankyo group.     

Clinical trials update: highlights of the scientific sessions of The American College of Cardiology 2002: LIFE,DANAMI 2, MADIT-2, MIRACLE-ICD,OVERTURE, OCTAVE,ENABLE 1 & 2, CHRISTMAS,AFFIRM, RACE,WIZARD, AZACS,REMATCH, BNP trial and HARDBALL

This article continues a series of reports updating recent research developments of particular interest to personnel involved in the treatment and management of patients with heart failure. This is a summary of selected presentations made at the American College of Cardiology 51st Annual Scientific Session held in Atlanta on 17-20 March 2002. Reports of the following clinical studies are included: LIFE, DANAMI 2, MADIT-2, MIRACLE-ICD, OVERTURE, OCTAVE, ENABLE 1 & 2, CHRISTMAS, AFFIRM, RACE, WIZARD, AZACS, REMATCH, BNP trial and HARDBALL.     

Electrochemical Recovery and Behaviors of Rare Earth (La,Ce, Pr,Nd, Sm,Eu, Gd,Tb, Dy,Ho, Er,Tm, and Yb) Ions on Ni Sheets

The electrochemical behaviors of rare earth (RE) ions have extensively been studied because of their high potential applications to the reprocessing of used nuclear fuels and RE-containing materials. In the present study, we fully investigated the electrochemical behaviors of RE(III) (La, Ce, Pr, Nd, Sm, Eu, Gd, Tb, Dy, Ho, Er, Tm, and Yb) ions over a Ni sheet electrode in 0.1 M NaClO₄ electrolyte solution by cyclic voltammetry between +0.5 and −1.5 V (vs. Ag/AgCl). Amperometry electrodeposition experiments were performed between −1.2 and −0.9 V to recover RE elements over the Ni sheet. The successfully RE-recovered Ni sheets were fully characterized by scanning electron microscopy, energy dispersive X-ray spectroscopy, Fourier transform infrared spectroscopy, X-ray photoelectron spectroscopy, and photoluminescence spectroscopy. The newly reported recovery data for RE(III) ions over a metal electrode provide valuable information on the development of the treatment methods of RE elements.