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Objective@#To evaluate the efficacy and safety of steroids-free immunosuppressive therapy including tacrolimus, cyclosporin A, tripterygium glycosides or intravenous cyclophosphamide in membranous nephropathy (MN) patients combined with type 2 diabetes mellitus (T2DM).@*Methods@#This study was a retrospective analysis of patients with T2DM complicated with biopsy proved MN in the First Affiliated Hospital, College of Medicine, Zhejiang University from January 2009 to January 2017. The patients were divided into steroids-free group and control group. The patients in steroids-free group were treated with one or two immunosuppressive agents except glucocorticoids. The patients in control group were treated with glucocorticoid combining with immunosuppressive agents.@*Results@#A total of 64 patients were enrolled in this study. There were 26 cases in steroids-free group and 38 cases in control group. The total remission rate was 69.24% in steroids-free group and 73.68% in control group at 12 months. In a median follow up of 33(12-106) months, two patients in control group entered hemodialysis and one of them died after 1 year of dialysis. One patient in steroids-free group died of accidental death and no patient entered dialysis. All patients in control group had elevated blood glucose level, whereas only 5 patients in steroids-free group had elevated blood glucose and all these 5 patients used tacrolimus.@*Conclusion@#Immunosuppressive regimen without glucocorticoid treatment can reduce side effects on blood glucose level in MN patients with type 2 diabetes, with a certain rate of treatment response.
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Objective To evaluate the efficacy and safety of steroids-free immunosuppressive therapy including tacrolimus, cyclosporin A, tripterygium glycosides or intravenous cyclophosphamide in membranous nephropathy (MN) patients combined with type 2 diabetes mellitus (T2DM). Methods This study was a retrospective analysis of patients with T2DM complicated with biopsy proved MN in the First Affiliated Hospital, College of Medicine, Zhejiang University from January 2009 to January 2017. The patients were divided into steroids-free group and control group. The patients in steroids-free group were treated with one or two immunosuppressive agents except glucocorticoids. The patients in control group were treated with glucocorticoid combining with immunosuppressive agents. Results A total of 64 patients were enrolled in this study. There were 26 cases in steroids-free group and 38 cases in control group. The total remission rate was 69.24％ in steroids-free group and 73.68％ in control group at 12 months. In a median follow up of 33(12-106) months, two patients in control group entered hemodialysis and one of them died after 1 year of dialysis. One patient in steroids-free group died of accidental death and no patient entered dialysis. All patients in control group had elevated blood glucose level, whereas only 5 patients in steroids-free group had elevated blood glucose and all these 5 patients used tacrolimus. Conclusion Immunosuppressive regimen without glucocorticoid treatment can reduce side effects on blood glucose level in MN patients with type 2 diabetes, with a certain rate of treatment response.
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Objective To investigate the clinical effect of mefformin tablets in the treatment of type 2 diabetes mellitus(T2DM) with atherosclerosis.Methods A total of 84 T2DM patients with atherosclerosis were divided into control group and treatment group according to the random number table method,42 cases in each group.All patients were given diet control,health education and exercise,etc..The control group was treated with gliclazide sustained-release tablets.The treatment group was treated with mefformin and treated for 6 months.The levels of fasting blood glucose(FBG) and 2 h postprandial blood glucose(2hPBG) were measured before and 6 months after treatment.The levels of intima-media thickness (cIMT),leptin (LP),adiponectin (TC),chitinase-3-like protein-1 (YKL-40),triglyceride (TG),low density lipoprotein cholesterol (HDL-C) and high-density lipoprotein cholesterol (HDL-C) were measured.The adverse reactions were observed in the two groups.Results After treatment for 6 months,the levels of FBG and 2hPBG in the treatment group were (6.71 ±0.41) mmol/L and (8.82 ±0.61) mmol/L,respectively,which were significantly lower than those in the control group [(6.96 ± 0.48) mmol/L,(9.58 ± 0.57) mmol/L,t =2.56,5.89,P =0.01,0.00].The levels of cIMT,TC,TG and LDL-C in the treatment group were significantly lower than those in the control group at 6 months after treatment (t =5.36,6.46,9.10,2.31,P =0.00,0.00,0.00,0.02).After 6 months of treatment,the HDL-C level of the treatment group was significantly higher than that of the control group (t =2.84,P =0.00).After treatment for 6 months,HDL-C level in the two groups was significantly higher than before treatment,the other indicators in the two groups were significantly lower than before treatment (all P ＜ 0.05).There were no adverse reactions in the two groups during treatment.Conclusion Metformin in the treatment of T2DM patients with atherosclerosis has significant effect,it can improve blood glucose levels and the clinical and biochemical indicators,and it is safe.
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Objective To compare the influence of ziprasidone and paliperidone on PANSS scores,PRL and body weight of female patients with schizophrenia.Methods 140 female patients with schizophrenia were chosen,and they were randomly divided into group A (70 patients) with ziprasidone and group B (70 patients) with paliperidone.The clinical efficacy,PANSS score,PRL levels and body weight before and after treatment,and incidence of adverse effects were compared between the two groups.Results There was no significant difference in the clinical effects between the two groups (x2 =1.27,P ＞ 0.05).After treatment,the PANSS scores of both two groups were significantly better than those before treatment (t =2.78,3.31,3.06,3.50,2.90,3.38,3.17,3.62,all P ＜ 0.05).There was no significant difference in PANSS score after treatment between the two groups (t =1.08,1.20,0.97,0.88,all P ＞ 0.05).After treatment,the PRL level of group A was significantly higher than that before treatment (t =2.65,P ＜ 0.05).There was no significant difference in PRL level of group B between before and after treatment(t =1.24,P ＞ 0.05).There were no significant differences in the body weight between the two groups (t =1.10,0.97,0.88,all P ＞ 0.05).There was no significant difference in the incidence of adverse reactions between the two groups (x2 =1.03,P ＞ 0.05).Conclusion Ziprasidone and paliperidone in the treatment of female patients with schizophrenia has the same clinical effects and safety;but compared with paliperidone,ziprasidone in the treatment of female patients with schizo-phrenia can efficiently avoid the impact on the PRL levels of patients and reduce the risk of high serum PRL.
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Objective To investigate the influence of magnesium valproate and quetiapine separately combined with lithium carbonate on BRMS scores,PANSS scores and adverse effects of patients with manic episode of bipolar disorder in puberty. Methods 100 patients with manic episode of bipolar disorder in puberty were chosen and randomly divided into two groups according to the digital table. Group A ( 50 children ) was given magnesium valproate,and group B (50 children) was given quetiapine on the basis of lithium carbonate. The clinical efficacy,the BRMS score,PANSS score and WCST score before and after treatment and the incidence of adverse effects of the two groups were compared. Results There was no significant difference in clinical efficacy between the two groups (94. 00% vs. 90. 00%),(χ2 =1. 31,P>0. 05). After treatment for 2 weeks,the BRMS score,PANSS score and WCST score of group B were significantly better than those of group A and before treatment(t=2. 45,3. 16;2. 71,3. 26,2. 79, 3. 36,all P<0. 05). 6 weeksafter treatment,there were no significant differences in the BRMS score,PANSS score and WCST score between the two groups(t=1. 20,1. 08,1. 19,all P<0. 05). There was no significant difference in the incidence rate of adverse effects between the two groups(χ2 =1. 49,P>0. 05). Conclusion Two kinds of bigeminy drug therapy in the treatment of patients with manic episode of bipolar disorder in puberty possess the clinical effects and safety,and quetiapine combined with lithium can help to shorten the onset time and higher the compliance degree.
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Objective To investigate the influence of magnesium valproate and quetiapine separately combined with lithium carbonate on BRMS scores,PANSS scores and adverse effects of patients with manic episode of bipolar disorder in puberty. Methods 100 patients with manic episode of bipolar disorder in puberty were chosen and randomly divided into two groups according to the digital table. Group A ( 50 children ) was given magnesium valproate,and group B (50 children) was given quetiapine on the basis of lithium carbonate. The clinical efficacy,the BRMS score,PANSS score and WCST score before and after treatment and the incidence of adverse effects of the two groups were compared. Results There was no significant difference in clinical efficacy between the two groups (94. 00% vs. 90. 00%),(χ2 =1. 31,P>0. 05). After treatment for 2 weeks,the BRMS score,PANSS score and WCST score of group B were significantly better than those of group A and before treatment(t=2. 45,3. 16;2. 71,3. 26,2. 79, 3. 36,all P<0. 05). 6 weeksafter treatment,there were no significant differences in the BRMS score,PANSS score and WCST score between the two groups(t=1. 20,1. 08,1. 19,all P<0. 05). There was no significant difference in the incidence rate of adverse effects between the two groups(χ2 =1. 49,P>0. 05). Conclusion Two kinds of bigeminy drug therapy in the treatment of patients with manic episode of bipolar disorder in puberty possess the clinical effects and safety,and quetiapine combined with lithium can help to shorten the onset time and higher the compliance degree.
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Objective To investigate the efficacy and adverse reactions of risperidone orally disintegrating tablets joint oxazepam in the treatment of schizophrenia.Methods 63 patients with schizophrenia were selected and divided into two groups according to the order of admission Divided into the control group ( 31 cases ) and observation group ( 32 cases ) , were treated with chlorpromazine +alprazolam and risperidone orally disintegrating tablets+oxazepam.The two groups after treatment PANSS score, quality of life SF-36 health questionnaire score and ADL score before and after treatment, curative effect and adverse reactions were recorded and compared.Results The different PANSS score after treatment and compared, the observation group with different symptoms score and general psychopathology scores are significantly lower than the control group , the difference was statistically significant (P<0.05), the two groups after treatment ADL score compared with those before treatment were significantly increased, and the score of the observation group after treatment was significantly higher than the control group, the difference was statistically significant (P<0.05), the curative effect of observation group was 93.75%, significantly higher than the control group 77.42%, the difference was statistically significant ( P<0.05), quality of life questionnaire SF-36 score and one months after treatment, observation group scores were significantly higher than those in control group, the difference was statistically significant ( P <0.05), there were some adverse reactions in the two groups, the adverse reaction rate of observation group was 9.38%, significantly lower than 45.15%of the control group, the difference was statistically significant ( P <0.05 ) . Conclusion The implementation of schizophrenia risperidone orally disintegrating tablets oxazepam effect significantly , can better improve the clinical symptoms of patients, improve the patient's ability of daily life and quality of life.It can effectively reduce the occurrence of adverse reactions, and is a safe and effective treatment.