艾塞那肽治疗肥胖2型糖尿病疗效观察

目的:观察艾塞那肽治疗2型糖尿病的疗效。方法:将2型糖尿病患者100例随机分为治疗组50例和对照组50例。在常规服用二甲双胍基础上,治疗组予艾塞那肽皮下注射,对照组予胰岛素(诺和灵50R)皮下注射,观察疗效和不良反应。结果:艾塞那肽组的血糖控制和胰岛素组相比无显著差异,两组空腹血糖下降幅度相似,艾塞那肽对餐后血糖的控制更好;艾塞那肽对肥胖患者有控制体重增加,减轻体重作用,降低血脂,左心室内径缩小。两组均未发生严重不良反应。结论:艾塞那肽治疗2型糖尿病能有效控制血糖,并有效控制体重增加。

门冬胰岛素(IASP)治疗2型糖尿病的临床疗效观察

目的:观察门冬胰岛素(IASP)治疗2型糖尿病的临床疗效。方法:对治疗的50例2型糖尿病的患者随机分为两组,分别以IASP和诺和灵R治疗4周,观察两组餐后1h、2h血糖的变化。结果:IASP和诺和灵R均可有效降低血糖,但IASP餐后1h血糖下降幅度显著大于对照组,两组空腹血糖、餐后2h血糖的水平无显著差异性,IASP治疗组低血糖发生率明显低于对照组。结论:IASP治疗2型糖尿病具有显著效果、安全性及耐性好。

中西医结合治疗糖尿病合并脑梗塞的效果观察

目的探讨中西医结合治疗糖尿病合并脑梗塞的效果观察。方法选取2014年6月—2015年6月来该院治疗的糖尿病合并脑梗塞患者142例,随机分为两组,对照组71例患者采用西医治疗,实验组71例患者则在对照组的基础上加用补阳还五汤加味治疗,比较两组患者的临床疗效、神经功能缺损评分以及生活能力评分。结果治疗1个疗程后,实验组患者神经功能缺损评分为(4.26±2.4)分、日常生活质量评分为(76.5±16.7)分,对照组患者的评分为(9.76±2.65)分、(62.4±15.3)分。实验组患者的空腹血糖为(8.25±1.37)mmol/L,餐后2 h血糖为(9.74±2.95)mmol/L;对照组患者的空腹血糖为(10.96±3.89)mmol/L,餐后2 h血糖为(13.68±3.64)mmol/L。实验组基本痊愈12例,显效18例,有效35例,治疗的总有效率为91.5%,对照组基本痊愈6例,显效10例,有效24例,治疗的总有效率为70.4%,两组差异有统计学意义(P<0.05)。结论采用中西医结合治疗糖尿病合并脑梗塞具有较好的临床疗效,能明显降低神经功能缺损和提高生活质量,且能明显降低血糖,血脂和同型半胱氨酸,值得临床推广。

Analyses of therapeutic effects using rludarabine and cytarabine on acute myeloid leukemia at different stages during treatment

Objective: To evaluate the therapeutic effect of the fludarabine and cytarabine (FA) regimen on acute myeloid leukemia (AML) at different phases during treatment. Methods: A total of 185 patients with AML were divided into 4 groups based on the outcome of previous treatments. Patients in Group 1 had no remission after the first course of induction chemotherapy (n = 55). Patients in Group 2 had no remission after no less than two courses of induction chemotherapy (n = 41). Patients in Group 3 had early relapse (n = 40). Patients in Group 4 had late relapse (n = 49). Patients in groups 2, 3 and 4 had refractory AML or AML with relapse. We assessed the efficacy and toxicity of FA combination chemotherapy in each of these 4 groups. Results: The complete remission (CR) rates of Groups 1, 2, 3 and 4 were 74.5% (41/55), 45.9% (19/41), 17.5% (7/40) and 38.8% (19/49), respectively. The CR rate was higher in Group 1 than in the other 3 groups (34.6%, 45/130) (P = 0.000). A significant correlation was found between CR rate and the number of chemotherapeutic courses (P = 0.023). The main adverse reactions included bone marrow suppression and secondary infection. Conclusion: FA regimen is a good choice for patients with AML, especially those who have failed to achieve CR after the first course of induction chemotherapy.

溴酚化合物PTP1B抑制活性与松节藻提取物在糖尿病大鼠体内降血糖活性

蛋白酪氨酸磷酸酶1B(PTP1B)是胰岛素信号转导过程中的重要负调控因子,PTP1B是治疗2型糖尿病的有效靶点.来源于海洋红藻松节藻Rhodomela confervoides的4个溴酚类化合物,2,2′,3,3′-四溴-4,4′,5,5′-四羟基二苯甲烷(1),3-溴-4,5-双-(2,3-二溴-4,5-二羟基苄基)-邻苯二酚(2),双-(2,3-二溴-4,5-二羟基苄基)-醚(3)和2,2′,3-三溴-3′,4,4′,5-四羟基-6′-乙氧甲基二苯甲烷(4),表现出强烈的PTP1B抑制活性(IC50分别为2.4,1.7,1.5和0.84μmol/L),可能成为一类新型的2型糖尿病治疗药物.采用高脂饮食、链脲佐菌素诱导的2型糖尿病大鼠模型对松节藻的乙醇提取物进行了体内降血糖实验,结果表明,与糖尿病模型组相比,海藻醇提取物的中、高剂量组表现出显著的降血糖疗效.该研究表明,松节藻醇提取物体内良好的降血糖功效可能部分通过溴酚化合物对PTP1B酶活性抑制途径起作用,这对于2型糖尿病的治疗具有重要指导作用.

运动饮食疗法治疗妊娠期糖尿病疗效观察

探讨运动饮食疗法治疗妊娠期糖尿病的效果。方法:对2016年1月至2017年12月在我院产科门诊产检的60例患者妊娠期糖尿病患者作为研究对象,将这些患者分为两组,一组为运动饮食疗法治疗组30例,另一组为运动疗法治疗组30例,然后比较两组患者的空腹血糖水平及餐后2小时血糖水平、母儿并反症等。结果:经过治疗后,运动饮食疗法治疗组的空腹血糖、餐后两小时血糖水平平均明显低于运动疗法治疗组患者,发生早产儿、胎儿窘迫、胎膜早破、高胆红素血症等均明显低于运动疗法治疗组患者,差异显著,具有统计学意义(p<0.05)。结论:使用运动饮食疗法可有效降低患者血糖水平,降低母儿并发症的发生,值得在临床上推广应用。

Efficacy and safety of chiglitazar,a novel peroxisome proliferatoractivated receptor pan-agonist,in patients with type 2 diabetes:a randomized,double-blind,placebo-controlled,phase 3 trial(CMAP)

Chiglitazar(Carfloglitazar)is a novel non-thiazolidinedione(TZD)structured peroxisome proliferatoractivated receptor(PPAR)pan-agonist that has shown promising effects on glycemic control and lipid regulation in patients with type 2 diabetes in previous clinical studies.This randomized phase 3 trial aimed to compare the efficacy and safety of chiglitazar with placebo in patients with type 2 diabetes with insufficient glycemic control by strict diet and exercise alone.Eligible patients were randomly assigned to receive chiglitazar 32 mg(n=167),chiglitazar 48 mg(n=166),or placebo(n=202)once daily.The primary endpoint was the change in glycosylated hemoglobin A_(1c)(HbA_(1c))at week 24 with superiority of chiglitazar over placebo.The results showed that both chiglitazar 32 and 48 mg resulted in significant and clinically meaningful reductions in HbA_(1c),and placebo-adjusted estimated treatment differences at week 24 for chiglitazar 32 and 48 mg were-0.87%(95%confidential interval(CI):-1.10 to-0.65;P<0.0001)and-1.05%(95%CI:-1.29 to-0.81;P<0.0001),respectively.Secondary efficacy parameters including glycemic control,insulin sensitivity and triglyceride reduction were also significantly improved in the chiglitazar groups.The overall frequency of adverse events and study discontinuation attributable to adverse events were similar among the groups.Low incidences of mild edema and body weight gain were reported in the chiglitazar dose groups.The results from this phase 3 trial demonstrated that the PPAR pan-agonist chiglitazar possesses an overall good efficacy and safety profile in patients with type 2 diabetes inadequately controlled with lifestyle interventions,thereby providing adequate supporting evidence for using this PPAR pan-agonist as a treatment option for type 2 diabetes.

Chiglitazar monotherapy with sitagliptin as an active comparator in patients with type 2 diabetes:a randomized,double-blind,phase 3 trial(CMAS)

Chiglitazar(Carfloglitazar)is a novel peroxisome proliferator-activated receptor(PPAR)pan-agonist that has shown promising effects on glycemic control and lipid regulation in patients with type 2 diabetes.In this randomized phase 3 trial,we compared the efficacy and safety of chiglitazar with sitagliptin in patients with type 2 diabetes who had insufficient glycemic control despite a strict diet and exercise regimen.Eligible patients were randomized(1:1:1)to receive chiglitazar 32 mg(n=245),chiglitazar 48 mg(n=246),or sitagliptin 100 mg(n=248)once daily for 24 weeks.The primary endpoint was the change in glycosylated hemoglobin A_(1C)(HbA_(1c))from baseline at week 24 with the non-inferiority of chiglitazar over sitagliptin.Both chiglitazar and sitagliptin significantly reduced HbA1c at week 24 with values of-1.40%,-1.47%,and-1.39%for chiglitazar 32 mg,chiglitazar 48 mg,and sitagliptin 100 mg,respectively.Chiglitazar 32 and 48 mg were both non-inferior to sitagliptin 100 mg,with mean differences of-0.04%(95%confidential interval(Cl)-0.22 to 0.15)and-0.08%(95%Cl-0.27 to 0.10),respectively.Compared with sitagliptin,greater reduction in fasting and 2-h postprandial plasma glucose and fasting insulin was observed with chiglitazar.Overall adverse event rates were similar between the groups.A small increase in mild edema in the chiglitazar 48 mg group and slight weight gain in both chiglitazar groups were reported.The overall results demonstrated that chiglitazar possesses good efficacy and safety profile in patients with type 2 diabetes inadequately controlled with lifestyle interventions,thereby providing adequate supporting evidence for using this PPAR pan-agonist as a treatment option for type 2 diabetes.

Learning from berberine: Treating chronic diseases through multiple targets

Although advances have been made, chemotherapy for chronic, multifactorial diseases such as cancers, Alzheimer's disease, cardiovascular diseases and diabetes is far from satisfactory. Agents with different mechanisms of action are required. The botanic compound berberine(BBR) has been used as an over-the-counter antibacterial for diarrhea in China for many decades. Recent clinical studies have shown that BBR may be therapeutic in various types of chronic diseases. This review addresses BBR's molecular mechanisms of action and clinical efficacy and safety in patients with type 2 diabetes, hyperlipidemia, heart diseases, cancers and inflammation. One of the advantages of BBR is its multiple-target effects in each of these diseases. The therapeutic efficacy of BBR may reflect a synergistic regulation of these targets, resulting in a comprehensive effect against these various chronic disorders. The safety of BBR may be due to its harmonious distribution into those targets. Although the single-target concept is still the principle for drug discovery and research, this review emphasizes the concept of a multiple target strategy, which may be an important approach toward the successful treatment of multifactorial chronic diseases.