目的评价度拉糖肽联合卡格列净对早期血糖控制不佳超重型2型糖尿病(T2DM)患者的临床治疗效果。方法研究对象为2021年7月至2022年12月在郑州人民医院内分泌代谢科收治的口服联合降糖方案血糖控制不好的超重型T2DM患者120例,随机分为试验...目的评价度拉糖肽联合卡格列净对早期血糖控制不佳超重型2型糖尿病(T2DM)患者的临床治疗效果。方法研究对象为2021年7月至2022年12月在郑州人民医院内分泌代谢科收治的口服联合降糖方案血糖控制不好的超重型T2DM患者120例,随机分为试验组和对照组,每组60例。试验组以周制剂度拉糖肽联合卡格列净治疗,对照组给予14 d胰岛素泵治疗至血糖稳定后,改用门冬胰岛素30注射液。经3个月治疗后,比较两种不同治疗策略的临床效果。包括临床疗效、血糖情况、胰岛功能、体格检查指标、血脂情况、血清因子[中性粒细胞与淋巴细胞比值(NLR)、C反应蛋白(CRP)、谷胱甘肽过氧化物酶(GSH-Px)及超氧化物歧化酶(SOD)]水平比较,分析GSH-Px、SOD分别与NLR及CRP间的相关性;并对比其诊疗过程中发生的不良反应。结果共剔除患者16例,最终纳入统计学分析病例包括试验组52例,对照组52例。两组空腹血糖(FPG)、餐后2 h血糖(2 h PG)及糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)、NLR及CRP水平与治疗前相比均降低,空腹胰岛素(FINS)、稳态模型胰岛β细胞功能指数(HOMA-β)、空腹C肽(FCP)、高密度脂蛋白(HDL-C)、GSH-Px及SOD水平与治疗前相比均增加,且试验组优于对照组,差异有统计学意义(P<0.05)。Pearson分析可知,GSH-Px与NLR、CRP及NLR与SOD均呈负相关。治疗过程中,试验组不良反应发生率为19.23%(10/52),对照组为36.54%(19/52),试验组低于对照组,差异有统计学意义(χ^(2)=3.873,P<0.05)。结论度拉糖肽联合卡格列净对于早期血糖控制不佳超重型T2DM患者较胰岛素表现出更好的临床治疗效果,值得临床推广应用。展开更多
Understanding the nature of parental melts for pyroxenite veins in supra-subduction zone(SSZ)ophiolites provides vibrant constraints on melt infiltration processes operating in subduction zones.The Zedang ophiolitic m...Understanding the nature of parental melts for pyroxenite veins in supra-subduction zone(SSZ)ophiolites provides vibrant constraints on melt infiltration processes operating in subduction zones.The Zedang ophiolitic massif in the eastern Yarlung–Zangbo suture zone in Tibet consists of mantle peridotites and a crustal section of gabbro,diabase,and basalt.Veins of two pyroxenite varieties cut the southern part of the Zedang massif.These pyroxenite rocks have different geochemical characteristics,where the first variety(type-I)has relatively higher contents of SiO_(2)(51.82–53.08 wt%),MgO(20.08–23.23 wt%),andΣPGE(3.42–13.97 ppb),and lower Al_(2)O_(3)(1.59–2.28 wt%)andΣREE(1.63–2.94 ppm).The second pyroxenite variety(type-II)is characterized by SiO_(2)(45.44–49.61 wt%),Mg O(16.68–19.78 wt%),Al_(2)O_(3)(4.24–8.77 wt%),ΣPGE(14.46–322.06 ppb),andΣREE(5.82–7.44 ppm).Pyroxenite type-I shows N-MORB-like chondritenormalized REE patterns.Zircon U-Pb ages of pyroxenite type-I(194±10 Ma),associated ophiolitic gabbro(135.3±2.0 Ma),and plagiogranite(124.2±2.3 Ma)evidently imply episodic evolution of the Zedang ophiolites.The mineralogical and geochemical characteristics of the investigated pyroxenites can be explained by subduction-initiated hydrous melting of metasomatized sub-arc mantle,later overprinted by sub-slab mantle melting triggered by upwelling asthenosphere during the Jurassic–Early Cretaceous times.The geochemical variations in pyroxenite vein composition,coupled with age differences amongst the other ophiolite units,may correspond to intermittent emplacement of pyroxenite dikes and isotropic gabbroic intrusions where the geodynamic setting progressed from arc maturation and slab rollback to slab tearing and delamination.展开更多
东波地幔橄榄岩是雅鲁藏布江缝合带内代表性超镁铁岩体,位于缝合带西段,面积超过400km2。为查明岩体成因,在岩体中实施了一口千米深的科学钻探(DSD-1)。除上部有约23m厚的第四系堆积物外,钻孔均钻进在地幔橄榄岩中,孔深1002.06m,岩心采...东波地幔橄榄岩是雅鲁藏布江缝合带内代表性超镁铁岩体,位于缝合带西段,面积超过400km2。为查明岩体成因,在岩体中实施了一口千米深的科学钻探(DSD-1)。除上部有约23m厚的第四系堆积物外,钻孔均钻进在地幔橄榄岩中,孔深1002.06m,岩心采取率96.62%。岩心编录结合显微镜下鉴定将岩心划分出44个岩性单元层,并进一步归并为上、下两套岩性:上部(23.1~340.17m)为含单辉方辉橄榄岩(斜方辉石含量为15~20%,单斜辉石含量不足5%);下部(340.17~1002.06m)为方辉橄榄岩(斜方辉石含量为10%~15%,几乎不含单斜辉石),其中发育薄层状纯橄岩和辉石岩以及辉绿岩脉。矿物学及全岩地球化学研究揭示:①东波地幔橄榄岩以方辉橄榄岩为主,其次为含单辉方辉橄榄岩,它们均具有亏损的全岩地球化学及矿物成分组成,指示它们为经历过中高程度部分熔融后的地幔残余岩石;经历过富水流体(熔体)交代作用,表现为角闪石呈柱状交代斜方辉石;②纯橄岩和辉石岩以透镜状或薄层状脉体发育于方辉橄榄岩中,具有岩浆成因的矿物组成,见交代矿物角闪石,指示它们可能为交代成因;③辉绿岩脉兼具N-MORB和弧玄武岩的化学属性,以低SiO2、高MgO和高Al2O3含量为特征,具有与Western Lau Basin玄武岩一致的REE配分型式,形成于较为成熟的弧后盆地环境。东波地幔橄榄岩(及其中的纯橄岩、辉石岩和辉绿岩脉)在成因上与俯冲带关系密切,都受到了与俯冲带相关地质作用的影响。展开更多
文摘目的评价度拉糖肽联合卡格列净对早期血糖控制不佳超重型2型糖尿病(T2DM)患者的临床治疗效果。方法研究对象为2021年7月至2022年12月在郑州人民医院内分泌代谢科收治的口服联合降糖方案血糖控制不好的超重型T2DM患者120例,随机分为试验组和对照组,每组60例。试验组以周制剂度拉糖肽联合卡格列净治疗,对照组给予14 d胰岛素泵治疗至血糖稳定后,改用门冬胰岛素30注射液。经3个月治疗后,比较两种不同治疗策略的临床效果。包括临床疗效、血糖情况、胰岛功能、体格检查指标、血脂情况、血清因子[中性粒细胞与淋巴细胞比值(NLR)、C反应蛋白(CRP)、谷胱甘肽过氧化物酶(GSH-Px)及超氧化物歧化酶(SOD)]水平比较,分析GSH-Px、SOD分别与NLR及CRP间的相关性;并对比其诊疗过程中发生的不良反应。结果共剔除患者16例,最终纳入统计学分析病例包括试验组52例,对照组52例。两组空腹血糖(FPG)、餐后2 h血糖(2 h PG)及糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)、NLR及CRP水平与治疗前相比均降低,空腹胰岛素(FINS)、稳态模型胰岛β细胞功能指数(HOMA-β)、空腹C肽(FCP)、高密度脂蛋白(HDL-C)、GSH-Px及SOD水平与治疗前相比均增加,且试验组优于对照组,差异有统计学意义(P<0.05)。Pearson分析可知,GSH-Px与NLR、CRP及NLR与SOD均呈负相关。治疗过程中,试验组不良反应发生率为19.23%(10/52),对照组为36.54%(19/52),试验组低于对照组,差异有统计学意义(χ^(2)=3.873,P<0.05)。结论度拉糖肽联合卡格列净对于早期血糖控制不佳超重型T2DM患者较胰岛素表现出更好的临床治疗效果,值得临床推广应用。
基金co-supported by Key Special Project for Introduced Talents Team of Southern Marine Science and Engineering Guangdong Laboratory(Guangzhou)(No.GML2019ZD0201)the Second Tibetan Plateau Scientific Expedition and Research Program(No.2019QZKK0801)+3 种基金the National Natural Science Foundation of China(NNSFCProject Nos.42272048,41720104009,42172069,92062215)the Key Laboratory of Deep-Earth Dynamics of Ministry of Natural Resources Fund(No.J1901-28)the China Geological Survey(CGS,Project Nos.DD20230340,DD20221630)。
文摘Understanding the nature of parental melts for pyroxenite veins in supra-subduction zone(SSZ)ophiolites provides vibrant constraints on melt infiltration processes operating in subduction zones.The Zedang ophiolitic massif in the eastern Yarlung–Zangbo suture zone in Tibet consists of mantle peridotites and a crustal section of gabbro,diabase,and basalt.Veins of two pyroxenite varieties cut the southern part of the Zedang massif.These pyroxenite rocks have different geochemical characteristics,where the first variety(type-I)has relatively higher contents of SiO_(2)(51.82–53.08 wt%),MgO(20.08–23.23 wt%),andΣPGE(3.42–13.97 ppb),and lower Al_(2)O_(3)(1.59–2.28 wt%)andΣREE(1.63–2.94 ppm).The second pyroxenite variety(type-II)is characterized by SiO_(2)(45.44–49.61 wt%),Mg O(16.68–19.78 wt%),Al_(2)O_(3)(4.24–8.77 wt%),ΣPGE(14.46–322.06 ppb),andΣREE(5.82–7.44 ppm).Pyroxenite type-I shows N-MORB-like chondritenormalized REE patterns.Zircon U-Pb ages of pyroxenite type-I(194±10 Ma),associated ophiolitic gabbro(135.3±2.0 Ma),and plagiogranite(124.2±2.3 Ma)evidently imply episodic evolution of the Zedang ophiolites.The mineralogical and geochemical characteristics of the investigated pyroxenites can be explained by subduction-initiated hydrous melting of metasomatized sub-arc mantle,later overprinted by sub-slab mantle melting triggered by upwelling asthenosphere during the Jurassic–Early Cretaceous times.The geochemical variations in pyroxenite vein composition,coupled with age differences amongst the other ophiolite units,may correspond to intermittent emplacement of pyroxenite dikes and isotropic gabbroic intrusions where the geodynamic setting progressed from arc maturation and slab rollback to slab tearing and delamination.
文摘东波地幔橄榄岩是雅鲁藏布江缝合带内代表性超镁铁岩体,位于缝合带西段,面积超过400km2。为查明岩体成因,在岩体中实施了一口千米深的科学钻探(DSD-1)。除上部有约23m厚的第四系堆积物外,钻孔均钻进在地幔橄榄岩中,孔深1002.06m,岩心采取率96.62%。岩心编录结合显微镜下鉴定将岩心划分出44个岩性单元层,并进一步归并为上、下两套岩性:上部(23.1~340.17m)为含单辉方辉橄榄岩(斜方辉石含量为15~20%,单斜辉石含量不足5%);下部(340.17~1002.06m)为方辉橄榄岩(斜方辉石含量为10%~15%,几乎不含单斜辉石),其中发育薄层状纯橄岩和辉石岩以及辉绿岩脉。矿物学及全岩地球化学研究揭示:①东波地幔橄榄岩以方辉橄榄岩为主,其次为含单辉方辉橄榄岩,它们均具有亏损的全岩地球化学及矿物成分组成,指示它们为经历过中高程度部分熔融后的地幔残余岩石;经历过富水流体(熔体)交代作用,表现为角闪石呈柱状交代斜方辉石;②纯橄岩和辉石岩以透镜状或薄层状脉体发育于方辉橄榄岩中,具有岩浆成因的矿物组成,见交代矿物角闪石,指示它们可能为交代成因;③辉绿岩脉兼具N-MORB和弧玄武岩的化学属性,以低SiO2、高MgO和高Al2O3含量为特征,具有与Western Lau Basin玄武岩一致的REE配分型式,形成于较为成熟的弧后盆地环境。东波地幔橄榄岩(及其中的纯橄岩、辉石岩和辉绿岩脉)在成因上与俯冲带关系密切,都受到了与俯冲带相关地质作用的影响。
