中国门诊2型糖尿病患者口服药降糖达标状况调查及格列齐特缓释片优化治疗效果分析

Objective To evaluate the current state of glycemie control in Chinese patients with type 2 diabetes mellitus who have received oral antidiabetic agents in the out-patient clinic,and the efficacy and safety of optimized regiments of gliclazide modified-release tablets (Diamicron MR, SERVIER, Tianjin) in patients with failed glycemic control (HbA1c 6.5%). Methods The patients with type 2 diabetes were enrolled from 54 hospitals in more than 20 cities and received long-term (more than 3 months) oral antidiabetic agents. HbA1c was measured and the success rate of HbA1c reduction was evaluated. The patients who failed to achieve glycemic control (HbA1c 6. 5%) and received daily multiple-dosing insulin secretagogues were provided with the optimized treatment regimen, consisting of replacing daily multiple-dosing insulin secretagogues with single-dosing gliclazide sustained-release tablets. Clinical efficacy and safety were evaluated after three months treatment. Results The survey of glycemic control revealed that the mean HbA1c of 5 586 patients with diabetes mellitus was (7.97±2.89)% ,and the success rate (HbA1c≤6.5%) was 14. 1%. Further more, HbA1c decreased from (8.23±4.00)% before optimization to (6.86±2.24)% after optimization with the average decrement of 1.37% (P<0. 001) and the success rate was raised to 34. 1%. The gliclazide modified-release tablets were well tolerated by most patients, only 2.6% of whom were reported to experience unconfirmed hypoglycemia. Conclusion The success rate of glycemic control was low in Chinese out-patients with type 2 diabetes mellitus receiving oral antidiabetic agents in the clinic. The optimized regimen of gliclazide modified-release tablets taken once daily can down-regulate glycemic levels and increase the success rate of HbA1c reduction,and thus plays efficiently and safely a key role in the optimized management of type 2 diabetes mellitus.     

中国门诊2型糖尿病患者口服药降糖达标状况调查及格列齐特缓释片优化治疗效果分析

Objective To evaluate the current state of glycemie control in Chinese patients with type 2 diabetes mellitus who have received oral antidiabetic agents in the out-patient clinic,and the efficacy and safety of optimized regiments of gliclazide modified-release tablets (Diamicron MR, SERVIER, Tianjin) in patients with failed glycemic control (HbA1c 6.5%). Methods The patients with type 2 diabetes were enrolled from 54 hospitals in more than 20 cities and received long-term (more than 3 months) oral antidiabetic agents. HbA1c was measured and the success rate of HbA1c reduction was evaluated. The patients who failed to achieve glycemic control (HbA1c 6. 5%) and received daily multiple-dosing insulin secretagogues were provided with the optimized treatment regimen, consisting of replacing daily multiple-dosing insulin secretagogues with single-dosing gliclazide sustained-release tablets. Clinical efficacy and safety were evaluated after three months treatment. Results The survey of glycemic control revealed that the mean HbA1c of 5 586 patients with diabetes mellitus was (7.97±2.89)% ,and the success rate (HbA1c≤6.5%) was 14. 1%. Further more, HbA1c decreased from (8.23±4.00)% before optimization to (6.86±2.24)% after optimization with the average decrement of 1.37% (P<0. 001) and the success rate was raised to 34. 1%. The gliclazide modified-release tablets were well tolerated by most patients, only 2.6% of whom were reported to experience unconfirmed hypoglycemia. Conclusion The success rate of glycemic control was low in Chinese out-patients with type 2 diabetes mellitus receiving oral antidiabetic agents in the clinic. The optimized regimen of gliclazide modified-release tablets taken once daily can down-regulate glycemic levels and increase the success rate of HbA1c reduction,and thus plays efficiently and safely a key role in the optimized management of type 2 diabetes mellitus.     

氨茶碱致心律失常36例分析

氨茶碱因其显著扩张支气管、增加心肌收缩力及利尿作用而广泛地在临床使用，用于治疗气管炎、支气管炎、哮喘、心力衰竭等，取得良好临床治疗效果和临床经济效益。     

甲状腺机能亢进性心脏病

甲状腺机能亢进(下称甲亢)时心脏的改变比较明显。由于甲状腺激素直接作用于心肌,可增加心肌组织中Na~+—K~+—ATP酶及肌球蛋白ATP酶活性,兴奋心肌腺苷环化酶,降低心脏对迷走神经刺激的敏感性,增加肾上腺素能交感活动,故可使心串加快,心肌收缩力加强,心搏出量增加,心脏指数常达5～7 L/(min·m~2),外周血管阻力下降。为适应上述代谢的需要,增加周围组织供氧,临床     

德谷门冬双胰岛素——理想的新一代基础餐时双胰岛素制剂

德谷门冬双胰岛素制剂由新一代超长效基础胰岛素类似物（德谷胰岛素）联合餐时胰岛素类似物（门冬胰岛素）组成。其能够更好地模拟生理性胰岛素分泌模式,更安全有效地控制空腹和餐后血糖,成为理想的新一代基础餐时双胰岛素制剂。     

比较地特胰岛素联合门冬胰岛素与中性精蛋白锌胰岛素联合可溶性人胰岛素对2型糖尿病住院患者疗效和安全性的随机对照研究

目的探讨使用1次/d基础胰岛素或2次/d预混胰岛素联合或未联合口服降糖药治疗但血糖控制欠佳的T2DM住院患者采用地特胰岛素+门冬胰岛素±二甲双胍方案(胰岛素类似物组)是否优效于中性精蛋白锌胰岛素+可溶性人胰岛素±二甲双胍方案(人胰岛素组)。方法两组住院治疗2周并进行有效性及安全性比较。结果两组治疗后8个时点血糖平均值较治疗前下降,两组间下降值比较差异无统计学意义(P=0.9157)。两组不良反应事件、低血糖事件发生率均较低,无严重药物不良反应和低血糖报告,胰岛素类似物组总体低血糖事件和日间低血糖发生率较人胰岛素组低(P=0.0056、0.0263)。结论胰岛素类似物和人胰岛素的基础-餐时胰岛素强化治疗方案均可改善T2DM住院患者血糖水平,但胰岛素类似物组总体低血糖和日间低血糖风险较人胰岛素组低。     

冬虫夏草繁育品质量控制和药理活性研究进展

冬虫夏草为传统的名贵中药材,在中国有悠久的药用历史,具有补肾、益肺、止血、化痰的功效。近年来,冬虫夏草繁育品的研究获得突破,实现了冬虫夏草的大规模产业化繁育。冬虫夏草繁育品基原符合中国药典规定,与野生冬虫夏草相比,冬虫夏草繁育品不仅具有相似的化学成分和药理活性,还具有较低的重金属含量,安全性更容易控制。     

携带胚系同源重组修复基因突变的卵巢上皮性癌临床特点

目的:探索携带胚系同源重组修复(HRR)基因突变的卵巢上皮性癌的临床特征、预后及家系特征。方法:选择2018年1月至2020年2月就诊于北京大学第三医院卵巢上皮性癌患者121例,采用二代测序技术对所有患者外周血HRR基因进行全外显子检测。分别对携带有害胚系HRR基因(致病性和可能致病性)突变的患者(有害突变组)和未携带HRR基因(包含良性、可能良性)突变的患者(未携带突变组)分析其临床特点、预后及个人/亲属肿瘤家族史。结果:121例卵巢上皮性癌患者HRR基因总突变率为29.8%(36/121),其中BRCA1占63%,RAD51D占13%,BRCA2占10%。有害突变组和未携带突变组的患者病理类型构成差异有统计学意义(P=0.018),有害突变组患者均为高级别浆液性癌(100%),未携带突变组高级别浆液性癌比例为72.2%(52/72)。有害突变组有5例(5/36)患者同时罹患其他原发恶性肿瘤,与未携带突变组(2/72)相比,差异有统计学意义(P=0.030)。有害突变组患者一级亲属罹患肿瘤阳性率69.4%(25/36)与未携带突变组31.9%(23/72)相比,差异有统计学意义(P<0.001)。有害突变组均为铂类敏感(100%),与未携带突变组(90.3%)铂类敏感相比差异无统计学意义(P=0.093)。有害突变组与未携带突变组发病年龄、分期、首发症状、无进展生存期比较差异均无统计学意义(P>0.05)。结论:卵巢上皮性癌患者特别是高级别浆液性癌患者应进行遗传咨询,重视个人及一级亲属肿瘤史采集。携带有害胚系HRR基因突变患者同时罹患其他恶性肿瘤风险高。对HRR基因的检测,有利于对患者进行精准治疗同时也有助于发现其亲属中的高危人群并早期干预、预防肿瘤发生。     

护理信息学专业发展与研究方向分析

本文回顾美国医学信息协会护理信息学工作组（AMIA-NIWG）护理信息学优先发展方向白皮书,2008-2018年的优先研究领域报告,并结合最近2届世界医学信息学大会（MEDINFO）和最近3届国际护理信息学会议（NI）的主题揭示国际上近几年以及未来护理信息学的重要研究议题。结合我国护理实践的需求和时代背景因素,从政策、技术、教育和科研角度提出我国护理信息学的专业发展和研究方向的思考与建议,以推动我国护理信息学学科的发展。