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Objective To compare the effect of insulin or insulin secretagogues in the treatment of type 2 diabetes mellitus(T2DM) patients complicated with non -alcoholic fatty liver disease (NAFLD).Methods The study population consisted of 438 patients who were diagnosed T 2DM with B ultrasound checking screen fatty livers . According to different always used medications ,the patients were divided into insulin group and insulin secretagogous group.With the help of the B Doppler examination , the incidence rate of NAFLD was compared between the two groups .Further research chose respectively 113 patients from each group ,continued to use insulin for treatment ( group A);group B continued to use insulin secretagogous treatment (group B).After six months,when the patients visited to hospital again ,the impact of the two classes of drugs on the liver fat deposition was observed .Results There were 156 T2DM patients with NAFLD in group A(65.0％) and 131 T2DM patients with NAFLD in group B(66.2％).After six months of treatment ,TC,TG and LDL-C in group A and group B improved compared with before treatment [group A:TC decreased from (5.81 ±1.52)mmol/L to (4.14 ±1.82)mmol/L,t=3.575,P<0.05;TG decreased from (2.91 ±1.32) mmol/L to (2.14 ±1.40) mmol/L,t =0.770,P<0.05;LDL-C decreased from (3.67 ± 1.48)mmol/L to (3.11 ±1.21)mmol/L,t=2.120,P<0.05.Group B:TC decreased from (5.90 ±0.92)mmol/L to (4.37 ±1.22)mmol/L,t=4.016,P<0.05;TG decreased from (2.65 ±0.88)mmol/L to (2.21 ±1.02)mmol/L, t=0.554,P<0.05;LDL-C decreased from (3.91 ±1.38) mmol/L to (3.38 ±1.34) mmol/L,t=0.401,P<0.05].Changes of fatty liver with B ultrasound:the improvement rate was 10.7％in group A and 9.8％in group B, the difference between the two groups was not statistically significant (P>0.05).Conclusion In the T2DM popula-tion who used insulin or insulin secretagogues ,the prevalence of NAFLD is high .Exogenous insulin does not aggravate the liver lipid deposition .T2DM who used insulin or insulin secretagogues has different degrees of the improvement in blood sugar,lipid,Homa-IR and fatty liver.
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<p><b>BACKGROUND</b>Optic neuritis (ON) is often the first symptom of multiple sclerosis (MS) and neuromyelitis optica (NMO) while there has been very little research reported on ON combined with Sjögren's syndrome (SS). The aim of this study is to provide different treatments and services for and NMO patients combined with SS.</p><p><b>METHODS</b>Twenty-seven patients with ON combined SS were divided into two groups: corticosteroid group (C group, methylprednisolone sodium succinate, 14 patients) and corticosteroid+ immunosuppressant group (C+I group, leflunomide, 13 patients). ON relapse times in 1 year after treatment, number of patients who relapsed to NMO/MS in 1 years, visual acuity and retina nerve fiber layer (RNFL) thickness were measured. Mann Whitney-Wilcoxon test was used to compare continuous variables and Chi-square test or Fisher's exact test was to compare proportions.</p><p><b>RESULTS</b>ON combined with SS patients had higher incidence rates in middle-aged women who have binocular damage and heavier visual function damage or when there is an easy relapse, and the patients are often hormone dependent. The patients are more likely anti-aquaporin-4 IgG seropositive (70.4%). They are liable to form a centrocecal scotoma and tubular vision. The times of relapse decreased in patients who used immunosuppressant, and a significant difference was found between immunosuppressant and non-immunosuppressant groups in visual acuity recovery during 6-month follow-up period (P < 0.05); however, the RNFL thickness at the four quadrants was not significantly different.</p><p><b>CONCLUSIONS</b>The effect of immunosuppressant plus corticosteroid on the early onset of ON combined with SS was to provide ON remedy and to prevent recurrence in clinics. This study provides a significant reference for the prevention and treatment of ON on the basis of immunosuppressant and corticosteroid.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Adrenal Cortex Hormones , Therapeutic Uses , Immunosuppressive Agents , Therapeutic Uses , Magnetic Resonance Imaging , Methylprednisolone Hemisuccinate , Therapeutic Uses , Optic Neuritis , Drug Therapy , Sjogren's Syndrome , Drug Therapy , Visual AcuityABSTRACT
OBJECTIVE@#To evaluate the efficacy and safety of acupuncture for optic atrophy.@*METHODS@#All the randomized controlled trials (RCTs) on optic atrophy treatment with acupuncture were included after retrieving the PubMed, Embase, Cochrane Library, CBM, CNKI, VIP, Wanfang database from their establishment to November 2012. The bibliographies of the included studies were retrieved as well. The quality of RCTs meeting the inclusion criteria was evaluated and the data were extracted. Meta-analyses were performed with Stata 11.2 software.@*RESULTS@#Thirteen RCTs involving 1180 eyes were included. Meta-analyses showed that the effect of acupuncture or combined with medicine was superior to medicine alone in terms of total effectiveness [OR=3.281, 95% CI ( 2.517, 4.278)], visual acuity [3.287, 95% CI (2.193, 4.925)], and visual field [3.215, 95% CI (1.580, 6.543)]. The visual sensitivity and P-VEP test showed the similar results.@*CONCLUSION@#Acupuncture is superior to medicine in terms of improved visual acuity, visual field and P-VEP. However, large samples, and high-quality studies are needed for stronger evidence.
Subject(s)
Adolescent , Adult , Child , Female , Humans , Male , Middle Aged , Young Adult , Acupuncture Therapy , Optic Atrophy , Therapeutics , Randomized Controlled Trials as Topic , Treatment Outcome , Visual Acuity , Visual FieldsABSTRACT
Objective To learn the hotspots of study in ischemic optic neuropathy (ION).Methods Literature on ION published in January 2000 to July 2012 was identified in Pubmed database.MeSH terms that frequently appeared were identified and co-word analysis was carried out by cluster analysis.Then a network was drawn using social network analysis.Results A total of 1045 papers were included.The United States,England,Germany,France and Netherlands together accounted for 71.53％ (748) of the articles.There were 28 high-frequency MeSH terms and hot topics clustered into four fields.The appearance frequency of MeSH showed that most research focused on:(1)postoperative or arteritic ION;(2) epidemiology,pathology and diagnosis of ION ; (3) pathophysiology and therapy of ION ; (4) chemically induced ION.Conclusion The international main research focus of ION includes four fields,which may provide reference or scholars both in scientific research and clinical research.
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Objective To evaluate the correlation between antiphospholipid (APLA) antibodies and retinal vein occlusion (RVO).Methods A computerized search was conducted in the Pubmed,Chinese Biological Medicine Database,China National Knowledge Infrastructure,VIP database,Wanfang Database combined with manually searching of literature reference proceedings.The search time was ranged from establishment of each database to August 1st,2012.After the data extraction,quality of RCT was assessed.The meta analysis was performed by Stata 11.0.Results In total,12 case-control studies (1324subjects) that fulfilled the eligibility criteria were included in the meta-analysis involving 505 patients in RVO group and 819 subjects in control group.The odds ratio (OR) and 95％ confidence interval (CI) of APLA,anticardiolipin antibodies (ACA),lupus coagulation inhibitor and RVO were 5.01 and 3.33-7.53,4.38 and 2.38 8.05,1.72 and 0.73-4.04,respectively.The OR and 95％ CI of APLA,ACA and central RVO were 4.80 and 2.59-8.88,6.02 and 2.06-17.63,respectively.The OR and 95％ CI of APLA,ACA,lupus coagulation inhibitor and branch RVO were 4.22 and 1.67-10.63,3.69 and 1.32-10.32,2.07 and 0.79-5.41,respectively.Conclusions APLA may increase the rick of RVO,especially ACA has a prediction function to RVO.It is necessary to screening for APLA in RVO patients.
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<p><b>BACKGROUND</b>To evaluate the effect of combination chemotherapy with etoposide plus ifosfamide and cisplatin (VIP) for small cell lung cancer (SCLC).</p><p><b>METHODS</b>One-hundred and twenty patients with localized SCLC who never received chemotherapy were randomly divided into VIP regimen group and EP regimen group. The response and toxicity were evaluated after 3 cycle chemotherapy with VIP or EP respectively. In addition, salvage chemotherapy by VIP was given to 25 patients, who had progression or recurrence of the cancer after treatment with EP regimen, and the response was assessed after 3 cycles of the treatment.</p><p><b>RESULTS</b>In 118 evaluable patients, response rate was 89.6% for VIP regimen group and 78.3% for EP regimen group. There was no remarkable difference of response rates between the two groups. Toxicity of the two regimens was similar. However, complete response rate for VIP regimen group (43.1%) was significantly higher than that for EP regimen group (25.0%) (P < 0.05). In 23 patients who were progressive or relapsed after treatment with EP regimen, the complete response, partial response, progression and total response were 13.0%, 39.1%, 47.8% and 52.2% respectively.</p><p><b>CONCLUSIONS</b>VIP regimen may be used as the first-line chemotherapy for localized SCLC, its efficacy is superior to that of EP regimen. VIP can also be used as salvage chemotherapy regimen for patients with SCLC who failed to EP regimen chemotherapy.</p>
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AIM: To obtain a vaccine with sLAG-3 as immunoadjuvant and investigate its biologic activity in order to establish the safe and effective way for asthma as one of the specific immunotherapy.METHODS: The coding sequence of LAG-3 was amplified by polymerase chain reaction,the expression vector pcDNA-sLAG-3-Ig was constructed by inserting the PCR products of sLAG-3 and Fc sequence of IgG.With electroporation transfection,pcDNA-sLAG-3-Ig was transfected into COS-7 cells and its biologic activity was investigated by Western blotting analysis.RESULTS: By temperature induction,the LAG-3-Ig was highly expressed in E.coli DH5?.LAG-3-Ig fusion protein was observed by SDS-PAGE and Western blotting,the results showed that the LAG-3-Ig protein was an antagonist of the IL-4-induced synthesis of IgE in B cells.CONCLUSION: A new vaccine with sLAG-3 as immunoadjuvant was obtained.It could inhibit synthesis of IgE in B cells.Thus,LAG-3-Ig would be hopeful to establish the safe and effective way for asthma as one of the specific immunotherapy.