摘要:目的: 观察瑞格列奈、阿卡波糖联合治疗老年性2型糖尿病患者的临床疗效及安全性。 方法 :观察58例2型糖尿病患者服用瑞格列奈及阿卡波糖,疗程12周,监测治疗前后空腹及餐后2 h血糖(FBG、PBG)、糖化血红蛋白(HbAlc)、肝功、肾功。 结果 :FBG、PBG及HbAlc较治疗前显著下降(Plt;005),尤其是餐后血糖更为明显(Plt;001)。无一例肝肾功能损害,也无严重低血糖及其它严重不良反应发生。 结论 :瑞格列奈联合阿卡波糖治疗2型糖尿病降糖作用确切,而且安全性、耐受性良好。Abstract: Objective: To observe the clinical efficacy and safety of combined treatment of repaglinide and acarbose in aged patients with diabetes type 2 Methods : After oral administration of repaglinide and acarbose for 12 weeks, 58 patients with type 2 diabetes were observed. The concentrations of fasting blood glucose (FBG), 2 h postprandial blood glucose (PBG), glycosylated hemoglobin (HbAlc), liver and kidney functions were monitored before and after treatment. Results : The levels of FBG, PBG and HbAlc were significantly decreased compared with pretreatment (Plt;005), especially PBG (Plt;001). No case of liver and kidney dysfunction was found, without serious hypoglycemia and other serious adverse events as well. Conclusion : Repaglinide and acarbose have the precise function in the treatment of type 2 diabetes, with good security and good tolerance.
ObjectiveTo evaluate the safety and efficacy of lenvatinib as targeted therapy for locally advanced thyroid cancer. MethodsThe data of 17 patients with locally advanced thyroid cancer who received targeted therapy in the Department of Head and Neck Surgery, Clinical Oncology School of Fujian Cancer Hospital from September 2021 to June 2023 were prospectively collected and analyzed. ResultsSeventeen patients received lenvatinib for a median of 8 weeks (4–32 weeks), 5 patients achieved partial response, 11 patients achieved stable disease, and 1 patient experienced progressive disease. The objective response and disease control rates were 29.4% (5/17) and 94.1% (16/17) respectively, the median tumor diameter of the target lesion decreased from 43 mm before treatment to 12 mm after treatment. Five patients did not undergo surgery because of tumor progression and their refusal; R0/1 resection was achieved in 11 of the 12 remaining patients (91.7%). All patients suffered from drug-related adverse events, and the commonest drug-related adverse events were hypertension (7/17, 41.2%), diarrhea (6/17, 35.3%), and proteinuria (5/17, 29.4%). There were no major drug-related adverse events. ConclusionPreliminary analysis indicates that lenvatinib is effective and safe for targeted therapy of locally advanced thyroid cancer, with a relatively high rate of R0/1 resection.
ObjectiveTo discuss the effect of synthesized physical nursing care on the treatment of meibomian gland dysfunction (MGD) patients. MethodWe collected 100 MGD patients between March and September 2014, and randomized them into conventional and synthesized physical nursing care groups with 50 patients in each. We evaluated the subjective symptoms, the break-up time of tear-film and the function of lacrimal gland secretion before and after treatment. We surveyed the satisfaction of these patients during the follow-up. ResultsCompared with the conventional nursing care group, the synthesized group had less clinical symptoms, longer break-up times of tear-film and better lacrimal gland secretion function. The results showed remarkable statistical significance (P<0.05). ConclusionsSynthesized nursing care has significant effect on the treatment efficacy of MGD outpatients.
ObjectiveTo investigate the effect of multidisciplinary team (MDT) on perioperative complications and clinical efficacy of patients who were receiver radical operation to treat lung cancer by video-assisted thoracoscopic surgery (VATS). MethodsEighty patients in the Thoracic Surgery Department of First Hospital of Lanzhou University from December 2017 to February 2019 who were diagnosed lung cancer were divided into two groups. Forty patients in the MDT group were treated with MDT discussion. The control group consisted of 40 patients who were treated without MDT discussion. The incidence of postoperative complications and clinical efficacy were compared between the two groups . ResultsThere was no statistical difference in incision infection, atelectasis, pleural effusion and pulmonary leakage between the two groups. However, the incidence of postoperative pulmonary infection (5% vs. 20%, P=0.043) and the overall postoperative complications (17.5% vs. 42.5%, P=0.015) in the MDT group was lower than that in the control group with a statistical difference. In the MDT group, the operative time (140.3±8.0 min vs. 148.8±6.8 min, P<0.001), intraoperative bleeding ( 207.8±19.4 mL vs. 222.0±28.3 mL, P=0.010), lymph node dissection number (25.1±6.2 vs. 20.1±7.0, P=0.001), postoperative drainage (273.0±33.5 mL vs. 24.0±52.5 mL, P<0.001), drainage duration (81.9±6.1 h vs. 85.3±8.1 h, P=0.039), pain on the first day after surgery (4.6±0.7 vs. 5.4±0.7), P<0.001), pain on the second day (2.5±0.7 vs. 3.0±0.8, P=0.002), pain on the third day (1.1±0.8 vs. 1.5±0.6, P=0.014), postoperative activity time (40.7±6.7 h vs. 35.3±7.1 h, P<0.001), postoperative recovery time (6.8±0.9 d vs. 7.4±0.7 d, P=0.003), patient satisfaction (8.1±1.4 vs. 7.2±2.0, P=0.020) were significantly better than those of the control group with statistical differences. But there was no statistical difference in the conversion to thoracotomy between the two group. ConclusionMDT discussion can reduce the surgical risk and postoperative complications, improve the clinical efficacy and accelerate the postoperative rehabilitation of patients, which has a good clinical significance.
ObjectiveTo explore the clinical curative effect of high flux hemodialysis on diabetic nephropathy (DN) and impact on patients' insulin resistance (IR). MethodsA total of 96 patients with DN meeting the inclusion criteria treated between January 2013 and January 2014 were selected. The patients were randomly divided in to the observation group and control group with 48 in each. The control group received low flux hemodialysis, while the observation group underwent high flux hemodialysis. Before the treatment and in the first half of the year after the treatment, the clinical renal function and inflammatory indexes, lipid metabolism, and glucose metabolism related markers were recorded, and IR index (HOMA-IR) were calculated and compared. ResultsBefore and after the treatment, the Kt/V showed no significant change in the two groups (P > 0.05). Serum creatinine levels was lower after the treatment compared with that before the treatment in both of the two groups; in the observation group, C-reactive protein, interleukin-6 and tumor necrosis factorαwere significantly lower than those before the treatment and than those in the control group after the treatment (P < 0.05). HOMA-IR and fasting insulin levels in the observation group after the treatment were significantly lower than those before the treatment and than those in the control group after the treatment (P < 0.05). No significant changes of fasting plasma glucose and glycosylated hemoglobin levels in the two groups before and after the treatment in patients were found (P > 0.05). ConclusionHigh flux hemodialysis therapy is effective on DN, which can effectively remove the body and large molecular type of inflammatory mediators, alleviate the micro inflammatory state, improve the IR status and correct the lipid metabolic abnormalities.
The method of evaluating clinical efficacy of traditional Chinese medicine is one of the hotspots in the field of traditional Chinese medicine in recent years. How to dynamically evaluate individual efficacy is one of the key scientific problems to explain the clinical efficacy of traditional Chinese medicine. At present, there are no recognized methods of evaluating individual efficacy of traditional Chinese medicine. In this study, we provided a method of dynamically evaluating individual efficacy of traditional Chinese medicine based on Bayesian N-of-1 trials after analyzing the current status of researches on methods of evaluating individual efficacy of traditional Chinese medicine. This method has the advantages of both N-of-1 trials and Bayesian multilevel models. It is feasible to evaluate individual efficacy of traditional Chinese medicine from the perspective of the design and analysis method. This study can provide an important basis for enriching and improving the methodology of evaluating individual efficacy of traditional Chinese medicine.
ObjectiveTo summarize controversy and progress of multi-slice spiral CT in efficacy evaluation of transformation therapy for advanced gastric cancer.MethodThe recent studies published at home and abroad on the spiral CT in evaluating the therapeutic effect of transformation therapy for the advanced gastric cancer were reviewed and analyzed.ResultsIn recent years, though the energy spectrum and dual-energy CT examinations had appeared, the most common tool in evaluating of the efficacy of transformation therapy for the advanced gastric cancer was the spiral CT. The most common evaluation standard was still the RECIST standard.ConclusionsSpiral CT has its outstanding diagnostic significance in therapeutic evaluation of transformation therapy for advanced gastric cancer. Although there is some controversy, with advancements of a large number of studies, it will greatly help diagnosis and treatment of advanced gastric cancer.
ObjectiveTo investigate the feasibility and safety of transcatheter aortic valve replacement (TAVR) through apical approach for aortic regurgitation of large annulus.MethodsFrom November 2019 to May 2020, 10 male patients aged 64.50±4.20 years with aortic valve insufficiency (AI) underwent TAVR in the Department of Cardiovascular Surgery, Xijing Hospital. The surgical instruments were 29# J-valveTM modified and the patients underwent TAVR under angiography. The preoperative and postoperative cardiac function, valve regurgitation, complications and left ventricular remodeling were summarized by ultrasound and CT before and after TAVR.ResultsA total of 10 valves were implanted in 10 patients. Among them, 1 patient was transferred to the aortic arch during the operation and was transferred to surgical aortic valve replacement; the other 9 patients were successfully implanted with J-valve, with 6 patients of cardiac function (NYHA) class Ⅱ, 4 patients of grade Ⅲ. And there was a significant difference between preoperation and postoperation in left ventricular ejection fraction (44.70%±8.78% vs. 39.80%±8.48%, P<0.05) or aortic regurgitation (1.75±0.72 mL vs. 16.51±8.71 mL, P<0.05). After 3 months, the patients' cardiac function was good.ConclusionTAVR is safe and effective in the treatment of severe valvular disease with AI using J-valve.
ObjectiveTo evaluate the efficacy of myomectomy via transumbilical laparoendompic single-site surgery (TU-LESS) and traditional multiport laparoscopy.MethodsThe study was conducted at Chengdu Western Hospital from June 2019 to June 2020. Fifty patients underwent TU-LESS myomectomy (TU-LESS group), while another 50 patients underwent traditional multiport laparoscopic myomectmy (multiport laparoscopy group). The conditions of operation, extra analgetic usage, VAS grade, and patients’ satisfaction degree were compared between two groups.ResultsPatients in both groups had similar age, BMI, fibroma volume, operative time, expelling gas day, blood loss, complication rate, and hospitalized costs (P>0.05). Compared with traditional multiport laparoscopy, the TU-LESS group resulted in significantly shorter hospitalization day, lower VAS score of the 1st/3nd/7th days after surgery, less use of analgetic after surgery, and higher satisfaction degree.ConclusionsTU-LESS is safe and feasible for myomectomy, and it is associated with less pain, shorter hospitalization day, and higher satisfaction degree.
ObjectiveTo compare the short-term efficacy of laparoscopic transanal pull through surgery and conventional laparoscopic surgery for rectal cancer.MethodsRelevant literatures were retrieved from databases including PubMed, Cochrane Library databases, Embase, CNKI, CBM, Wan-fang database, and VIP databases from Jan. 2009 to Jul. 2019, all the relevant trial documents ［included randomized controlled trial and non randomized controlled trial］ were collected for comparison of laparoscopic transanal pull through surgery and conventional laparoscopic surgery on the clinical efficacy of rectal cancer patients, the qualified literatures were screened in strict accordance with inclusion and exclusion criteria, and Stata12.0 software was used for statistical analysis.ResultsA total of 19 articles were included in the literature with 2 683 patients were included among them. Meta analysis results showed that, compared with the conventional laparoscopic surgery group, in laparoscopic transanal pull through surgery group, operation time [WMD=–6.78, 95% CI was (–11.96, –1.60), P<0.01], intraoperative blood loss [WMD=–14.94, 95% CI was (–23.48, –6.40),P<0.01], postoperative exhaust time [WMD=–13.55, 95% CI was (–18.24, –8.85), P<0.01], postoperative hospitalization time [WMD=–1.60, 95% CI was (–2.00, –1.21), P<0.01], incidence of postoperative overall complication [OR=0.50, 95% CI was (0.38, 0.67), P<0.01], and incidence of incision infection [OR=0.19, 95% CI was (0.08, 0.45), P<0.01] reduced. Those differences were not significant, such as intraoperative lymph node resection [WMD=–0.02, 95% CI was (–0.44, 0.40), P=0.92], incision margin distance of tumor [WMD=0.13, 95% CI was (–0.30, 0.55), P=0.56], and incidence of anastomotic fistula [OR=0.97, 95% CI was (0.62, 1.50), P=0.87].ConclusionsLaparoscopic transanal pull through surgery has more safe, effective, and reliable effects than conventional laparoscopic surgery for rectal cancer. It has further research value, but there may be inevitable bias and other effects in the included literatures, so more randomized controlled clinical trials are needed in the future.