Objective： To evaluate the long-term clinical effect of Tangyiping Granules（糖异平颗粒, TYP） on patients with impaired glucose tolerance（IGT） to achieve normal glucose tolerance（NGT） and hence preventing them f...Objective： To evaluate the long-term clinical effect of Tangyiping Granules（糖异平颗粒, TYP） on patients with impaired glucose tolerance（IGT） to achieve normal glucose tolerance（NGT） and hence preventing them from conversion to diabetes mellitus（DM）. Methods： In total, 127 participants with IGT were randomly assigned to the control（63 cases, 3 lost to follow-up） and treatment groups（64 cases, 4 lost to follow-up） according to the random number table. The control group received lifestyle intervention alone, while the patients in the treatment group took orally 10 g of TYP twice daily in addition to lifestyle intervention for 12 weeks. The rates of patients achieving NGT or experiencing conversion to DM as main outcome measure were observed at 3, 12, and 24 months after TYP treatment. The secondary outcome measures included fasting plasma glucose（FPG）, 2-h postprandial plasma glucose（2h PG）, glycosylated hemoglobin（Hb A1c）, fasting insulin（FINS）, 2-h insulin（2hI NS）, homeostatic model assessment of insulin resistance（HOMA-IR）, blood lipid and patients＇ complains of Chinese medicine（CM） symptoms before and after treatment. Results： A higher proportion of the treatment group achieved NGT compared with the control group after 3-, 12- and 24-month follow-up（75.00% vs. 43.33%, 58.33% vs. 35.00%, 46.67% vs. 26.67%, respectively, P〈0.05）. The IGT to DM conversion rate of the treatment group was significantly lower than that of the control group at the end of 24-month follow-up（16.67% vs. 31.67%, P〈0.05）. Before treatment, FPG, 2h PG, Hb A1 c, FINS, 2h INS, HOMA-IR, triglyceride（TG）, total cholesterol, low- and high-density lipoprotein cholesterol levels had no statistical difference between the two groups（P〉0.05）. After treatment, the 2hP G, HbA 1c, HOMA-IR, and TG levels of the treatment group decreased significantly compared with those of the control group（P〈0.05）. CM symptoms such as exhaustion, irritability, chest tightness and breathless, spontaneous sweating, constipation, and dark thick and greasy tongue were significantly improved in the treatment group as compared with the control group（P〈0.05）. No severe adverse events occurred. Conclusion： TYP administered at the IGT stage with a disciplined lifestyle delayed IGT developing into type 2 DM.展开更多
Background Although it is generally acknowledged that patients with ruptured abdominal aortic aneurysm （rAAA） obtain the greatest benefit from endovascular repair （EVAR）, convincing evidence on the medium-long ter...Background Although it is generally acknowledged that patients with ruptured abdominal aortic aneurysm （rAAA） obtain the greatest benefit from endovascular repair （EVAR）, convincing evidence on the medium-long term effect is lacking. The aim of this study was to compare and summarize published results of rAAA that underwent EVAR with open surgical repair （OSR）. Methods A search of publicly published literature was performed. Based on an inclusion and exclusion criteria, a systematic meta-analysis was undertaken to compare patient characteristics, complications, short term mortality and medium-long term outcomes. A random-effects model was used to pool the data and calculate pooled odds ratios and weighted mean differences. A quantitative method was used to analyze the differences between these two methods. Results A search of the published literature showed that fourteen English language papers comprising totally 1213 patients with rAAA （435 EVAR and 778 OSR） would be suitable for this study. Furthermore, 13 Chinese studies were included, including 267 patients with rAAA totally, among which 238 patients received operation. The endovascular method was associated with more respiratory diseases before treatment （OR=1.81, P=0.01）, while there are more patients with hemodynamic instability before treatment in OSR group （OR=1.53, P=0.031）. Mean blood transfusion was 1328 ml for EVAR and 2809 ml for OSR （weighted mean difference （WMD） 1500 ml, P=0.014）. The endovascular method was associated with a shorter stay in intensive care （WMD 2.34 days, P 〈0.001） and a shorter total post- operative stay （WMD 6.27 days, P 〈0.001）. The pooled post-operative complication rate of respiratory system and visceral ischemia seldom occurred in the EVAR group （OR=0.48, P 〈0.001 and OR=0.28, P=0.043, respectively）. The pooled 30-day mortality was 25.7% for EVAR and 39.6% for OSR, and the odds ratio was 0.53 （95% confidence interval （CI） 0.41-0.70, P 〈0.001）. There was not, however, any significant reduction in the medium-long all-cause mortality rate （HR=1.13, P=0.381） and re-intervention rate （OR= 2.19, ,~=-0.243） following EVAR. In EVAR group, nevertheless, incidence of type I endoleak was significantly lower than type II endoleak （OR=0.33, P=0.039） at late follow-up period. Conclusions On the basis of this systematic review, rAAA EVAR results in less blood use for transfusion, shorter operation time, shorter intensive care unit and hospital stays, and lower 30-day mortality. However, in the medium-long term, it is not associated with a reduction in all-cause mortality.展开更多
目的前瞻性长期观察人免疫缺陷病毒感染者和获得性免疫缺陷综合征(HIV/AIDS)患者的高效抗逆转录病毒治疗(highly active antiretroviral therapy,HAART)一线药物抗HIV及免疫重建效果和主要毒副反应,探索我国艾滋病长期抗病毒治疗的规律...目的前瞻性长期观察人免疫缺陷病毒感染者和获得性免疫缺陷综合征(HIV/AIDS)患者的高效抗逆转录病毒治疗(highly active antiretroviral therapy,HAART)一线药物抗HIV及免疫重建效果和主要毒副反应,探索我国艾滋病长期抗病毒治疗的规律。方法 437例HIV/AIDS患者先后启动HAART,一线方案为2个核苷类逆转录酶抑制剂(NRTI)加1个非核苷类逆转录酶抑制剂(NNRTI)。随访监测CD4+T细胞数量、HIV病毒载量,追踪血常规和主要生化指标的变化;观察发生的机会感染和药物毒副反应并及时处理,对出现病毒学失败或严重毒副反应者及时调整用药。结果对437例接受HAART的HIV/AIDS患者平均追踪了4.69年(3.15～7.34年),总病死率6.86%,大部分死亡发生在HAART启动的6个月内。启动HAART 12个月时,90.80%的患者HIV载量小于可检测下限;至治疗4、5、6、7年(±1个月)时,仍分别有63.46%、69.41%、70.00%和72.22%的患者病毒载量小于可检测下限。CD4+细胞数量在治疗的O、1、2、3、4、5、6、7年(±1个月)时分别为115、246、301、334、363、356、386和373个/μL。67.73%出现过各种可能与药物毒副作用相关的表现,主要有消化道症状、神经系统症状、肝功能损害、骨髓毒性、皮疹和血脂升高等,多发生于治疗启动12个月内;血脂分布异常和乳酸酸中毒较少见,多发生于启动2年以后;41例患者先后发生过Ⅲ/Ⅳ级毒副反应。因毒副反应而更换为其他一线药物者占19.22%,因病毒耐药或毒副反应而更换为二线药物者占11.67%。结论通过对HIV/AIDS患者HAART3～7年的多中心前瞻性观察,明确我国2个NRTI加1个NNRTI的HAART一线方案对大多数HIV/AIDS患者长期有效,病毒持续抑制,CD4+细胞增加;主要的毒副反应和死亡多发生在启动治疗12个月内。大多数HIV/AIDS患者可长期坚持一线药物治疗,少数因药物毒副反应或病毒耐药须换为二线药物治疗。展开更多
[目的]观察揿针结合耳穴治疗老年功能性消化不良(functional dyspepsia,FD)的临床疗效。[方法]选取我院符合纳入标准的90例老年FD患者,随机分为观察组与对照组,每组45例。对照组予采用枸橼酸莫沙必利分散片治疗,观察组在对照组基础上加...[目的]观察揿针结合耳穴治疗老年功能性消化不良(functional dyspepsia,FD)的临床疗效。[方法]选取我院符合纳入标准的90例老年FD患者,随机分为观察组与对照组,每组45例。对照组予采用枸橼酸莫沙必利分散片治疗,观察组在对照组基础上加揿针结合耳穴治疗,观察患者治疗前后的FD症状评分及功能性消化不良生存质量量表(functional digestive disorder quality of life questionnaire,FDDQL)评分,治疗结束后2个月进行随访并评价临床疗效。[结果]观察组的总有效率为91.1%,高于对照组的73.3%,差异有统计学意义(P<0.05);治疗结束后及随访时两组症状评分较治疗前降低,FDDQL评分较治疗前升高,差异均有统计学意义(P<0.05),组间治疗后同一时间点比较,观察组的改善优于对照组(P<0.05)。[结论]揿针联合莫沙必利治疗老年FD疗效确切,具有良好的近期及远期疗效。展开更多
基金Supported by Shandong Province Science and Technology Program for Public Wellbing(No.2014kjhm0106)Shandong Province Science and Technology Development Plan(No.2006GG3202011),China
文摘Objective： To evaluate the long-term clinical effect of Tangyiping Granules（糖异平颗粒, TYP） on patients with impaired glucose tolerance（IGT） to achieve normal glucose tolerance（NGT） and hence preventing them from conversion to diabetes mellitus（DM）. Methods： In total, 127 participants with IGT were randomly assigned to the control（63 cases, 3 lost to follow-up） and treatment groups（64 cases, 4 lost to follow-up） according to the random number table. The control group received lifestyle intervention alone, while the patients in the treatment group took orally 10 g of TYP twice daily in addition to lifestyle intervention for 12 weeks. The rates of patients achieving NGT or experiencing conversion to DM as main outcome measure were observed at 3, 12, and 24 months after TYP treatment. The secondary outcome measures included fasting plasma glucose（FPG）, 2-h postprandial plasma glucose（2h PG）, glycosylated hemoglobin（Hb A1c）, fasting insulin（FINS）, 2-h insulin（2hI NS）, homeostatic model assessment of insulin resistance（HOMA-IR）, blood lipid and patients＇ complains of Chinese medicine（CM） symptoms before and after treatment. Results： A higher proportion of the treatment group achieved NGT compared with the control group after 3-, 12- and 24-month follow-up（75.00% vs. 43.33%, 58.33% vs. 35.00%, 46.67% vs. 26.67%, respectively, P〈0.05）. The IGT to DM conversion rate of the treatment group was significantly lower than that of the control group at the end of 24-month follow-up（16.67% vs. 31.67%, P〈0.05）. Before treatment, FPG, 2h PG, Hb A1 c, FINS, 2h INS, HOMA-IR, triglyceride（TG）, total cholesterol, low- and high-density lipoprotein cholesterol levels had no statistical difference between the two groups（P〉0.05）. After treatment, the 2hP G, HbA 1c, HOMA-IR, and TG levels of the treatment group decreased significantly compared with those of the control group（P〈0.05）. CM symptoms such as exhaustion, irritability, chest tightness and breathless, spontaneous sweating, constipation, and dark thick and greasy tongue were significantly improved in the treatment group as compared with the control group（P〈0.05）. No severe adverse events occurred. Conclusion： TYP administered at the IGT stage with a disciplined lifestyle delayed IGT developing into type 2 DM.
基金This work was supported by Science Foundation of China grants from the National Natural （No. 304717076）, the Department of Education of Liaoning Province （Key Laboratory Project No. LS2010172）, and Ministry of Education of China （Key Research Project of Science and Technology No. 208028）.
文摘Background Although it is generally acknowledged that patients with ruptured abdominal aortic aneurysm （rAAA） obtain the greatest benefit from endovascular repair （EVAR）, convincing evidence on the medium-long term effect is lacking. The aim of this study was to compare and summarize published results of rAAA that underwent EVAR with open surgical repair （OSR）. Methods A search of publicly published literature was performed. Based on an inclusion and exclusion criteria, a systematic meta-analysis was undertaken to compare patient characteristics, complications, short term mortality and medium-long term outcomes. A random-effects model was used to pool the data and calculate pooled odds ratios and weighted mean differences. A quantitative method was used to analyze the differences between these two methods. Results A search of the published literature showed that fourteen English language papers comprising totally 1213 patients with rAAA （435 EVAR and 778 OSR） would be suitable for this study. Furthermore, 13 Chinese studies were included, including 267 patients with rAAA totally, among which 238 patients received operation. The endovascular method was associated with more respiratory diseases before treatment （OR=1.81, P=0.01）, while there are more patients with hemodynamic instability before treatment in OSR group （OR=1.53, P=0.031）. Mean blood transfusion was 1328 ml for EVAR and 2809 ml for OSR （weighted mean difference （WMD） 1500 ml, P=0.014）. The endovascular method was associated with a shorter stay in intensive care （WMD 2.34 days, P 〈0.001） and a shorter total post- operative stay （WMD 6.27 days, P 〈0.001）. The pooled post-operative complication rate of respiratory system and visceral ischemia seldom occurred in the EVAR group （OR=0.48, P 〈0.001 and OR=0.28, P=0.043, respectively）. The pooled 30-day mortality was 25.7% for EVAR and 39.6% for OSR, and the odds ratio was 0.53 （95% confidence interval （CI） 0.41-0.70, P 〈0.001）. There was not, however, any significant reduction in the medium-long all-cause mortality rate （HR=1.13, P=0.381） and re-intervention rate （OR= 2.19, ,~=-0.243） following EVAR. In EVAR group, nevertheless, incidence of type I endoleak was significantly lower than type II endoleak （OR=0.33, P=0.039） at late follow-up period. Conclusions On the basis of this systematic review, rAAA EVAR results in less blood use for transfusion, shorter operation time, shorter intensive care unit and hospital stays, and lower 30-day mortality. However, in the medium-long term, it is not associated with a reduction in all-cause mortality.
文摘[目的]观察揿针结合耳穴治疗老年功能性消化不良(functional dyspepsia,FD)的临床疗效。[方法]选取我院符合纳入标准的90例老年FD患者,随机分为观察组与对照组,每组45例。对照组予采用枸橼酸莫沙必利分散片治疗,观察组在对照组基础上加揿针结合耳穴治疗,观察患者治疗前后的FD症状评分及功能性消化不良生存质量量表(functional digestive disorder quality of life questionnaire,FDDQL)评分,治疗结束后2个月进行随访并评价临床疗效。[结果]观察组的总有效率为91.1%,高于对照组的73.3%,差异有统计学意义(P<0.05);治疗结束后及随访时两组症状评分较治疗前降低,FDDQL评分较治疗前升高,差异均有统计学意义(P<0.05),组间治疗后同一时间点比较,观察组的改善优于对照组(P<0.05)。[结论]揿针联合莫沙必利治疗老年FD疗效确切,具有良好的近期及远期疗效。
