目的探究对老年慢性心力衰竭合并2型糖尿病(Diabetes Mellitus Type 2,T2DM)及高尿酸血症患者采用达格列净和标准抗心衰及降糖方案结合治疗后效果。方法随机选取2021年6月—2022年6月广州市花都区人民医院收治的心力衰竭合并T2DM及高尿...目的探究对老年慢性心力衰竭合并2型糖尿病(Diabetes Mellitus Type 2,T2DM)及高尿酸血症患者采用达格列净和标准抗心衰及降糖方案结合治疗后效果。方法随机选取2021年6月—2022年6月广州市花都区人民医院收治的心力衰竭合并T2DM及高尿酸血症患者120例为研究对象,采用随机数表法分成对照组(60例)、观察组(60例)。对照组采取标准抗心衰及降糖方案,观察组在对照组基础上采取达格列净,对比临床效果。结果观察组氨基末端脑钠肽前体(N Terminal Pro B Type Natriuretic Peptide,NT-proBNP)为(519.36±107.52)ng/L、血尿酸为(346.17±42.15)μmol/L低于对照组,差异有统计学意义(t=2.020、4.245,P<0.05)。观察组血脂改善更好,左室舒张末容积、左室收缩末容积、舒张早期二尖瓣血流速度/二尖瓣环运动速度(the Ratio of Early Diastolic Transmitral Flow Velocity to Mitral Annular Velocity,E/e’)低于对照组,左室射血分数高于对照组,差异有统计学意义(P<0.05)。观察组主要终点事件、次要终点事件、痛风发作率低于对照组,差异有统计学意义(P<0.05)。两组药物不良反应率对比,差异无统计学意义(P>0.05)。结论针对老年慢性心力衰竭合并T2DM及高尿酸血症患者,采用达格列净联合标准抗心衰及降糖方案,能改善血脂、心功能等指标水平,预后效果以及安全性较高。展开更多
Post-exposure prophylaxis（PEP） has proved to be the most important measure for rabies prevention and control. There is little information regarding adverse reactions to the Essen and 2-1-1 regimens in preschool chil...Post-exposure prophylaxis（PEP） has proved to be the most important measure for rabies prevention and control. There is little information regarding adverse reactions to the Essen and 2-1-1 regimens in preschool children（aged 0-6）. We reexamined the outcomes of 1,109 preschool children who were vaccinated using SPEEDA under the Essen regimen between January 2011 and December 2012 and 1,267 preschool children under the 2-1-1 regimen between January 2013 and December 2014. We find that, in preschool children, the febrile reaction after the first 2-dose injection in the 2-1-1 regimen was significantly higher than that induced by the first 1-dose in the Essen procedure. Thus, we recommend that the Essen regimen should still be used for rabies PEP in preschool children.展开更多
AIM: To describe our experience using a low-acceleratingdose regimen(LADR) with pegylated interferon alpha-2a and ribavirin in treatment of hepatitis C virus(HCV) recurrence. METHODS: From 2003, a protocolized LADR st...AIM: To describe our experience using a low-acceleratingdose regimen(LADR) with pegylated interferon alpha-2a and ribavirin in treatment of hepatitis C virus(HCV) recurrence. METHODS: From 2003, a protocolized LADR strategy was employed to treat liver transplant(LT) recipients with recurrent HCV at our institution. Medical records of 182 adult patients with recurrent HCV treated with LADR between 1/2003 and 1/2011 were reviewed. Histopathology from all post-LT liver biopsies were reviewed in a blinded fashion. Paired recipient and donor IL28 B status were assessed. A novel technique was employed to ascertain recipient and donor IL28B(rs12979860) Gt data using DNA extracted from archival FFPE tissue from explanted native livers and donor gallbladders respectively. The primary endpoint was SVR; secondary endpoints examined include(1) patient and graft survival;(2) effect of anti-viral therapy on liver histology(fibrosis and inflammation);(3) incidence of on-treatment development of ACR, CDR, or PCH;(4) association of recipient and donor IL28 B genotype with SVR; and(5) incidence of antiviral therapy-associated adverse events(anemia, leukopenia, thrombocytopenia, depression) and hepatic decompensation.RESULTS: The overall SVR rate was 38%(29% Gt1, 67% Gt2, 86% Gt3 and 58% Gt4). HCV Gt(P < 0.0001), donor age(P = 0.003), cytomegalovirus mismatch(P = 0.001), baseline serum bilirubin(P = 0.002), and baseline viral load(P = 0.04) were independent predictors for SVR. SVR rates were significantly higher in the recipient-CC/donor-non CC pairs(P = 0.007). Neither baseline fibrosis nor change in fibrosis stage after anti-viral therapy were associated with SVR. Fibrosis progressed in 72% of patients despite SVR. Median graft survival was 91 mo. Five-year patient survival was superior in patients who achieved SVR(97% vs 82%, P = 0.001). Pre-treatment ALP ≥ 150 U/L(P = 0.01), total bilirubin ≥ 1.5 mg/d L(P = 0.001) and creatinine ≥ 2 mg/d L(P = 0.001) were independently associated with patient survival. Only 13% of patients achieving SVR died during the followup period. Treatment discontinuation and treatmentrelated mortality occurred in 35% and 2.2% of patients, respectively. EPO, G-CSF and blood transfusion were needed in 89%, 40% and 23% of patients, respectively. Overall hospitalization rate for treatment-related serious adverse events was 21%. Forty-six(25%) of the patients were deceased; among those who died, 25(54%) were due to liver-related complications, and 4 deaths(9%) occurred while receiving therapy(2 patients experienced hepatic decompensation and 2 sepsis). CONCLUSION: LADR strategy remains relevant in managing post-LT recurrent HCV where access to DAAs is limited. SVR is associated with improved survival, but fibrosis progression still occurs.展开更多
Objective:To investigate the clinical effect of rituximab combined with CVAD regimen in patients with primary gastrointestinal B-cell lymphoma and serum vascular endothelial growth factor (VEGF) andβ2 microglobulin (...Objective:To investigate the clinical effect of rituximab combined with CVAD regimen in patients with primary gastrointestinal B-cell lymphoma and serum vascular endothelial growth factor (VEGF) andβ2 microglobulin (β2-MG) The impact of the level.Methods:Eighty-four patients with primary gastrointestinal B-cell lymphoma treated from May 2014 to December 2015 were enrolled. Based on the random number table, all the patients were divided into a control group (n=42) and an observation group (n=42). The control group was treated with CVAD. The observation group was treated with rituximab on the basis of the control group. The effect of the patients was evaluated after 3 courses of treatment. The patients were followed up for 3 years after treatment. US RECIST 1.1 was used to evaluate the short-term efficacy on the patients;VEGF, TNF receptor-associated factor 6 (TRAF6) and B-cell lymphoma factor-6 (Bcl-6) levels were measured by enzyme-linked immunosorbent assay;β2-MG level test was implemented to compare the short-term efficacy, biochemical indicators, incidence of toxic side effects and long-term survival rate of the two groups. Results: The short-term efficacy rate of the observation group was 76.19%, which was higher than that of the control group (50.00%) (P<0.05). The levels of VEGF, TRAF6, Bcl-6, andβ2-MG were lower in the observation group after 3 courses of treatment than that in the control group (P<0.05);there was no significant difference in the incidence of neutropenia, gastrointestinal reactions, sepsis, infection, infusion-related reactions and cardiovascular events between the observation group and the control group (P>0.05);The 1-year long-term survival rate after treatment was not statistically significant (P>0.05). The long-term survival rate of the observation group was higher than that of the control group at 2 and 3 years after treatment (P<0.05).Conclusion: The combination of rituximab and CVAD in patients with primary gastrointestinal B-cell lymphoma can improve short-term efficacy, lower VEGF andβ2-MG levels, and lower incidence of side effects. It can improve the long-term survival rate of patients and is worthy of promotion and application.展开更多
目的 分析西格列汀与胰岛素泵强化方案联合治疗初诊2型糖尿病的效果。方法 选取2022年6月—2023年5月南平市第一医院内分泌科收治的290例初诊2型糖尿病患者,按随机数表法分为研究组与对照组,各145例。对照组采取胰岛素泵治疗,研究组采...目的 分析西格列汀与胰岛素泵强化方案联合治疗初诊2型糖尿病的效果。方法 选取2022年6月—2023年5月南平市第一医院内分泌科收治的290例初诊2型糖尿病患者,按随机数表法分为研究组与对照组,各145例。对照组采取胰岛素泵治疗,研究组采取西格列汀与胰岛素泵强化方案联合治疗。针对两组血糖达标时间、胰岛素每日使用量、胰岛素抵抗指数(homeostatic model assessment of insulin resistance,HOMA-IR)、胰岛β细胞功能指数(homeostasis model assessment-β, HOMA-β),以及不良反应发生率进行比较。结果 研究组血糖达标时间短于对照组,差异有统计学意义(P<0.05),胰岛素每日使用量较对照组低,差异有统计学意义(P<0.05)。治疗8周后,研究组HOMA-IR指标较对照组低,差异有统计学意义(P<0.05);HOMA-β指标较对照组高,差异有统计学意义(P<0.05)。两组不良反应发生率对比,差异无统计学意义(P>0.05)。结论 西格列汀与胰岛素泵强化方案联合治疗能够促进初诊2型糖尿病患者血糖达标,减少胰岛素用量,改善其胰岛功能,安全性较佳,适于临床应用。展开更多
文摘目的探究对老年慢性心力衰竭合并2型糖尿病(Diabetes Mellitus Type 2,T2DM)及高尿酸血症患者采用达格列净和标准抗心衰及降糖方案结合治疗后效果。方法随机选取2021年6月—2022年6月广州市花都区人民医院收治的心力衰竭合并T2DM及高尿酸血症患者120例为研究对象,采用随机数表法分成对照组(60例)、观察组(60例)。对照组采取标准抗心衰及降糖方案,观察组在对照组基础上采取达格列净,对比临床效果。结果观察组氨基末端脑钠肽前体(N Terminal Pro B Type Natriuretic Peptide,NT-proBNP)为(519.36±107.52)ng/L、血尿酸为(346.17±42.15)μmol/L低于对照组,差异有统计学意义(t=2.020、4.245,P<0.05)。观察组血脂改善更好,左室舒张末容积、左室收缩末容积、舒张早期二尖瓣血流速度/二尖瓣环运动速度(the Ratio of Early Diastolic Transmitral Flow Velocity to Mitral Annular Velocity,E/e’)低于对照组,左室射血分数高于对照组,差异有统计学意义(P<0.05)。观察组主要终点事件、次要终点事件、痛风发作率低于对照组,差异有统计学意义(P<0.05)。两组药物不良反应率对比,差异无统计学意义(P>0.05)。结论针对老年慢性心力衰竭合并T2DM及高尿酸血症患者,采用达格列净联合标准抗心衰及降糖方案,能改善血脂、心功能等指标水平,预后效果以及安全性较高。
基金supported by the China Mega-Project for Infectious Disease(2014ZX10004002-004-001)National Natural Science Foundation of China(31500152)+1 种基金National Key Technology R&D Program(2014BAI13B04)National program on key research project of china(2016YFD0500400)
文摘Post-exposure prophylaxis（PEP） has proved to be the most important measure for rabies prevention and control. There is little information regarding adverse reactions to the Essen and 2-1-1 regimens in preschool children（aged 0-6）. We reexamined the outcomes of 1,109 preschool children who were vaccinated using SPEEDA under the Essen regimen between January 2011 and December 2012 and 1,267 preschool children under the 2-1-1 regimen between January 2013 and December 2014. We find that, in preschool children, the febrile reaction after the first 2-dose injection in the 2-1-1 regimen was significantly higher than that induced by the first 1-dose in the Essen procedure. Thus, we recommend that the Essen regimen should still be used for rabies PEP in preschool children.
基金Supported by JTD(an employee of Mount Sinai Medical Center)in part was provided by Genentech Pharmaceuticals
文摘AIM: To describe our experience using a low-acceleratingdose regimen(LADR) with pegylated interferon alpha-2a and ribavirin in treatment of hepatitis C virus(HCV) recurrence. METHODS: From 2003, a protocolized LADR strategy was employed to treat liver transplant(LT) recipients with recurrent HCV at our institution. Medical records of 182 adult patients with recurrent HCV treated with LADR between 1/2003 and 1/2011 were reviewed. Histopathology from all post-LT liver biopsies were reviewed in a blinded fashion. Paired recipient and donor IL28 B status were assessed. A novel technique was employed to ascertain recipient and donor IL28B(rs12979860) Gt data using DNA extracted from archival FFPE tissue from explanted native livers and donor gallbladders respectively. The primary endpoint was SVR; secondary endpoints examined include(1) patient and graft survival;(2) effect of anti-viral therapy on liver histology(fibrosis and inflammation);(3) incidence of on-treatment development of ACR, CDR, or PCH;(4) association of recipient and donor IL28 B genotype with SVR; and(5) incidence of antiviral therapy-associated adverse events(anemia, leukopenia, thrombocytopenia, depression) and hepatic decompensation.RESULTS: The overall SVR rate was 38%(29% Gt1, 67% Gt2, 86% Gt3 and 58% Gt4). HCV Gt(P < 0.0001), donor age(P = 0.003), cytomegalovirus mismatch(P = 0.001), baseline serum bilirubin(P = 0.002), and baseline viral load(P = 0.04) were independent predictors for SVR. SVR rates were significantly higher in the recipient-CC/donor-non CC pairs(P = 0.007). Neither baseline fibrosis nor change in fibrosis stage after anti-viral therapy were associated with SVR. Fibrosis progressed in 72% of patients despite SVR. Median graft survival was 91 mo. Five-year patient survival was superior in patients who achieved SVR(97% vs 82%, P = 0.001). Pre-treatment ALP ≥ 150 U/L(P = 0.01), total bilirubin ≥ 1.5 mg/d L(P = 0.001) and creatinine ≥ 2 mg/d L(P = 0.001) were independently associated with patient survival. Only 13% of patients achieving SVR died during the followup period. Treatment discontinuation and treatmentrelated mortality occurred in 35% and 2.2% of patients, respectively. EPO, G-CSF and blood transfusion were needed in 89%, 40% and 23% of patients, respectively. Overall hospitalization rate for treatment-related serious adverse events was 21%. Forty-six(25%) of the patients were deceased; among those who died, 25(54%) were due to liver-related complications, and 4 deaths(9%) occurred while receiving therapy(2 patients experienced hepatic decompensation and 2 sepsis). CONCLUSION: LADR strategy remains relevant in managing post-LT recurrent HCV where access to DAAs is limited. SVR is associated with improved survival, but fibrosis progression still occurs.
文摘Objective:To investigate the clinical effect of rituximab combined with CVAD regimen in patients with primary gastrointestinal B-cell lymphoma and serum vascular endothelial growth factor (VEGF) andβ2 microglobulin (β2-MG) The impact of the level.Methods:Eighty-four patients with primary gastrointestinal B-cell lymphoma treated from May 2014 to December 2015 were enrolled. Based on the random number table, all the patients were divided into a control group (n=42) and an observation group (n=42). The control group was treated with CVAD. The observation group was treated with rituximab on the basis of the control group. The effect of the patients was evaluated after 3 courses of treatment. The patients were followed up for 3 years after treatment. US RECIST 1.1 was used to evaluate the short-term efficacy on the patients;VEGF, TNF receptor-associated factor 6 (TRAF6) and B-cell lymphoma factor-6 (Bcl-6) levels were measured by enzyme-linked immunosorbent assay;β2-MG level test was implemented to compare the short-term efficacy, biochemical indicators, incidence of toxic side effects and long-term survival rate of the two groups. Results: The short-term efficacy rate of the observation group was 76.19%, which was higher than that of the control group (50.00%) (P<0.05). The levels of VEGF, TRAF6, Bcl-6, andβ2-MG were lower in the observation group after 3 courses of treatment than that in the control group (P<0.05);there was no significant difference in the incidence of neutropenia, gastrointestinal reactions, sepsis, infection, infusion-related reactions and cardiovascular events between the observation group and the control group (P>0.05);The 1-year long-term survival rate after treatment was not statistically significant (P>0.05). The long-term survival rate of the observation group was higher than that of the control group at 2 and 3 years after treatment (P<0.05).Conclusion: The combination of rituximab and CVAD in patients with primary gastrointestinal B-cell lymphoma can improve short-term efficacy, lower VEGF andβ2-MG levels, and lower incidence of side effects. It can improve the long-term survival rate of patients and is worthy of promotion and application.
文摘目的 分析西格列汀与胰岛素泵强化方案联合治疗初诊2型糖尿病的效果。方法 选取2022年6月—2023年5月南平市第一医院内分泌科收治的290例初诊2型糖尿病患者,按随机数表法分为研究组与对照组,各145例。对照组采取胰岛素泵治疗,研究组采取西格列汀与胰岛素泵强化方案联合治疗。针对两组血糖达标时间、胰岛素每日使用量、胰岛素抵抗指数(homeostatic model assessment of insulin resistance,HOMA-IR)、胰岛β细胞功能指数(homeostasis model assessment-β, HOMA-β),以及不良反应发生率进行比较。结果 研究组血糖达标时间短于对照组,差异有统计学意义(P<0.05),胰岛素每日使用量较对照组低,差异有统计学意义(P<0.05)。治疗8周后,研究组HOMA-IR指标较对照组低,差异有统计学意义(P<0.05);HOMA-β指标较对照组高,差异有统计学意义(P<0.05)。两组不良反应发生率对比,差异无统计学意义(P>0.05)。结论 西格列汀与胰岛素泵强化方案联合治疗能够促进初诊2型糖尿病患者血糖达标,减少胰岛素用量,改善其胰岛功能,安全性较佳,适于临床应用。
