津力达颗粒联合二甲双胍治疗气阴两虚型2型糖尿病的效果观察

目的:观察津力达颗粒联合二甲双胍治疗气阴两虚型2型糖尿病的效果。方法:选取112例气阴两虚型2型糖尿病患者作为研究对象,采用随机数字表法将其分为研究组和对照组各56例;对照组单纯服用二甲双胍治疗,研究组在对照组基础上服用津力达颗粒治疗;比较两组临床疗效、胰岛β细胞功能、胰岛素抵抗指数及血糖指标水平。结果:研究组治疗有效率为87.50%(49/56),明显高于对照组的69.64%(39/56),差异具有统计学意义(P<0.05);治疗后研究组胰岛β细胞功能明显高于对照组,胰岛素抵抗指数明显低于对照组,差异均有统计学意义(P<0.05);治疗后研究组空腹血糖(FPG)、餐后2 h血糖(2h PG)及糖化血红蛋白(HbA1c)水平均明显低于对照组,差异有统计学意义(P<0.05);研究组不良反应发生率是5.36%(3/56),明显低于对照组的33.93%(19/56),差异有统计学意义(P<0.05)。结论:津力达颗粒联合二甲双胍治疗气阴两虚型2型糖尿病,临床疗效显著,可有效恢复患者的胰岛β细胞功能,改善胰岛素抵抗,降低血糖。     

津力达联合甘精胰岛素治疗初诊2型糖尿病患者的临床效果

目的观察津力达联合甘精胰岛素治疗初诊2型糖尿病患者(HbA1c9.0%)的临床疗效。方法选取我院2017年5月～2018年1月内分泌科收治的60例初诊2型糖尿病患者,按照随机数字表法分为治疗组(A组,30例)与对照组(B组,30例),A组患者给予津力达联合甘精胰岛素治疗,B组患者给予二甲双胍联合甘精胰岛素分别治疗24周。比较两组患者治疗前后血糖、糖化血红蛋白、体质指数、胰岛素抵抗的变化及甘精胰岛素的使用剂量及不良反应的发生情况。结果两组患者治疗后的空腹血糖、餐后2 h血糖、糖化血红蛋白、体质指数及胰岛素抵抗指数低于治疗前,而空腹胰岛素水平及胰岛功能高于治疗前水平,差异具有统计学意义(P0.05)。两组患者治疗后各指标比较,差异无统计学意义(P0.05),两组患者甘精胰岛素的使用剂量无显著差异(P0.05),且均未发生严重的不良反应。结论津力达联合甘精胰岛素可改善初诊2型糖尿病患者(HbA1c9.0%)的血糖控制、体重指数、胰岛素功能及敏感性,与二甲双胍联合甘精胰岛素的治疗具有相似的疗效及安全性,可以作为临床的治疗2型糖尿病的有效方案。     

津力达颗粒联合诺和龙治疗2型糖尿病

目的 观察津力达颗粒联合诺和龙治疗2型糖尿病的疗效.方法 选择2型糖尿病患者280例,观察津力达颗粒联合诺合龙为治疗组,诺合龙为对照组,治疗6个月评定疗效.结果 两组治疗后FPG、2hPG、HbA1c较治疗前均有显著下降(p＜0.05);治疗组治疗后空腹胰岛素(FINS)、餐后1h、2h(PINS1h、2h)血浆胰岛素水平均升高,但FINS1h、空腹C肽升高显著,与对照组比较有显著差异(P＜0.05).结论 津力达颗粒辅助降血糖效果明显,且能延缓胰岛β细胞功能衰退.     

津力达颗粒联合二甲双胍治疗初发2型糖尿病患者的疗效观察

目的以2型糖尿病患者为观察对象,分析津力达颗粒联合二甲双胍联合治疗方法的临床应用价值。方法选取我院于2018年11月至2019年7月间收治的60例2型糖尿病患者,随机将其分为实验组、对照组。其中实验组患者30例,接受津力达颗粒联合二甲双胍治疗;对照组患者30例,单方面接受二甲双胍片治疗,评价联合治疗方法的先进性。结果比较两组患者治疗后的血糖指标情况,实验组优于对照组,P0.05;统计两组患者胰岛素功能情况情况,发现实验组患者的胰岛素分泌指数与胰岛素抵抗指数均优于对照组,P0.05。结论在初发2型糖尿病患者临床治疗期间,采用津力达颗粒联合二甲双胍的治疗方法可以取得满意效果,该疗法可以强化患者胰岛素功能,并改善血糖水平,对于疾病早期治疗具有重要意义,因此应该在临床上做进一步推广。     

优泌乐25治疗初诊2型糖尿病的临床体会

目的探讨优泌乐25治疗初诊2型糖尿病的临床疗效。方法选取初诊2型糖尿病患者80例,使用优泌乐25治疗12周,比较治疗前后空腹血糖、餐后2h血糖、糖化血红蛋白、空腹胰岛素、胰岛素分泌指数、胰岛素抵抗指数的变化。结果治疗后空腹血糖、餐后2h血糖、糖化血红蛋白、胰岛素抵抗指数较治疗前明显下降（P〈0.05）;空腹胰岛素、胰岛素分泌指数明显升高（P〈0.01）。结论用优泌乐25治疗能显著改善初诊2型糖尿病患者血糖和胰岛功能。     

玉液汤治疗气阴两虚型2型糖尿病临床研究

目的:观察胰岛素联合玉液汤治疗气阴两虚型2型糖尿病患者的临床疗效,并观察其对患者血糖、血脂及胰岛素分泌的影响。方法:120例气阴两虚型2型糖尿病患者随机分为对照组和观察组,每组各60例。对照组给予胰岛素治疗,观察组在对照组治疗基础上给予玉液汤。两组均治疗1个月。治疗后,比较两组患者临床疗效,血糖、血脂水平,并比较两组患者胰岛素分泌水平。结果:观察组有效率为95.0%,对照组为71.6%,两组比较,差异有统计学意义(P0.05)。对照组患者治疗前后空腹血糖分别为(10.07±3.59)mmol·L~(-1)、(7.34±1.96)mmol·L~(-1),餐后2小时血糖分别为(17.56±3.67)mmol·L~(-1)、(12.48±2.26)mmol·L~(-1);观察组患者治疗前后空腹血糖分别为(10.13±3.31)mmol·L~(-1)、(6.42±2.73)mmol·L~(-1),餐后2小时血糖分别为(17.59±3.94)mmol·L~(-1)、(11.05±2.10)mmol·L~(-1)。治疗前两组患者空腹血糖、餐后2小时血糖比较,差异无统计学意义(P0.05);治疗后,对照组和观察组患者空腹血糖、餐后2小时血糖均显著下降,差异均有统计学意义(P0.05);治疗后,观察组患者空腹血糖、餐后2小时血糖均显著低于对照组(P0.05)。治疗后,观察组患者胆固醇、三酰甘油、低密度脂蛋白胆固醇明显低于对照组,高密度脂蛋白胆固醇高于对照组,差异均有统计学意义(P0.05)。治疗后,观察组胰岛素分泌水平高于对照组,两组比较,差异有统计学意义(P0.05)。结论:玉液汤治疗气阴两虚型2型糖尿病疗效显著,可显著降低患者血糖、血脂水平,提高胰岛素分泌水平。     

津力达颗粒联合降糖药治疗2型糖尿病患者的临床研究

目的观察津力达颗粒联合降糖药治疗2型糖尿病的临床疗效。方法将确诊为2型糖尿病的患者88例随机分为A治疗组（46例）、B对照组（42例）。A组在使用降糖药的基础上口服津力达颗粒,B对照组单纯使用降糖药,治疗一月后观察两组的疗效。结果 A组治疗后空腹血糖、餐后2小时血糖、糖化血红蛋白均较治疗前明显降低（P〈0.01）,且A治疗组血糖达标时间、降糖药用量、低血糖发生率较B组明显下降（P〈0.01）,治疗组A在改善脂代谢方面胆固醇／甘油三酯明显优于对照组（P〈0.05）,治疗组A临床症状（多饮、多食、多尿、乏力、便秘）改善亦较对照组B明显（P〈0.05）。结论津力达颗粒联合降糖药治疗2型糖尿病能增加胰岛素敏感性,有效控制血糖,同时还可以减少胰岛素的用量,减少低血糖的发生,明显改善临床症状。     

优泌乐50治疗初诊2型糖尿病的临床体会

目的探讨优泌乐50治疗初诊2型糖尿病的临床疗效。方法选取初诊2型糖尿病患者80例,使用优泌乐50治疗12周,比较治疗前后空腹血糖、餐后2h血糖、糖化血红蛋白、空腹胰岛素、胰岛素分泌指数、胰岛素抵抗指数的变化。结果治疗后空腹血糖、餐后2h血糖、糖化血红蛋白、胰岛素抵抗指数较治疗前明显下降（P〈0．05）;空腹胰岛素、胰岛素分泌指数明显升高（P〈0．01）。结论应用优泌乐50治疗能显著降低初诊2型糖尿病患者血糖和改善胰岛功能。     

利拉鲁肽对比甘精胰岛素治疗肥胖2型糖尿病的临床观察

目的探讨利拉鲁肽对比甘精胰岛素治疗肥胖2型糖尿病的临床疗效。方法纳入40例我院就诊的二甲双胍单药治疗效果不佳的肥胖2型糖尿病患者,随机分为实验组、对照组,实验组给予利拉鲁肽针,对照组给予甘精胰岛素针。观察两组治疗前及治疗12周后空腹血糖、餐后2 h血糖、糖化血红蛋白、总胆固醇、甘油三脂、体重指数、胰岛细胞功能指数(Homa-β)和胰岛素抵抗指数(Homa-IR)及记录不良反应事件。结果经12周治疗后,两组患者空腹血糖、餐后2 h血糖、糖化血红蛋白、胰岛素抵抗指数较治疗前明显下降,胰岛β细胞功能指数明显升高,与治疗前相比差异有统计学意义(P0.05),但组间比较差异无统计学意义(P0.05);治疗后实验组体重指数、胆固醇、甘油三脂与治疗前相比差异有统计学意义(P0.05),组间比较实验组较对照组明显下降,差异有统计学意义(P0.05),两组患者不良事件发生率差异无统计学意义(P0.05)。结论利拉鲁肽和甘精胰岛素均可有效改善肥胖2型糖尿病患者的血糖、糖化血红蛋白等指标,改善胰岛β细胞功能,低血糖发生率及胃肠道反应均较低,利拉鲁肽比甘精胰岛素更能有效地降低患者的体重,改善血脂,更适合肥胖的2型糖尿病患者。     

中西医结合治疗对新诊断2型糖尿病(气阴两虚证)炎症因子的影响

目的研究益气养阴中药方联合胰岛素皮下泵强化治疗新诊断2型糖尿病(气阴两虚证)患者的疗效及其对炎症因子的影响。方法将我院2010年12月~2016年10月收治的110例新诊断2型糖尿病患者(气阴两虚证)随机分为治疗组(n=54)和对照组(n=56),对照组予胰岛素泵强化治疗,治疗组在此基础上加用益气养阴中药方,疗程2周,评估患者的中医症候积分,血糖(包括空腹血糖及餐后2 h血糖)、空腹及餐后2 h血胰岛素水平、胰岛素敏感指数(ISI)、血脂、C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)等变化。结果经治疗后,与对照组比较,治疗组患者的中医证候明显改善;治疗组患者血糖、总胆固醇(TG)、甘油三酯(TC)、低密度脂蛋白胆固醇(LDL-C)及炎症因子(CRP、TNF-α、IL-6)较治疗前均有明显下降(P0.05);胰岛素敏感指数较治疗前改善。结论益气养阴中药方联合胰岛素皮下泵治疗可明显改善新诊断2型糖尿病(气阴两虚证)患者的临床症状,降低血糖血脂,改善胰岛素敏感性及降低体内炎症因子水平。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.