Objective:To investigate the impacts of epalrestat in combination with alprostel on serum oxidative stress indices and fundus microcirculation in patients with early diabetic retinopathy (DR).Methods:A total of 123 individuals with early DR were chosen and categorized using the random number table approach in the Ophthalmology Department of Hebi People’s Hospital. Epalrestat was administered in combination with pancreatic kininogenase to 61 patients in the control group and alprodyl injection to 62 patients in the observation group. The indices of fundus microcirculation, serum oxidative stress, inflammatory factor levels, and adverse responses were evaluated.Results:Following treatment, the number of microhemangiomas( t=17.61, P<0.001), the area of hemorrhage( t=16.63, P<0.001) and the area of exudation( t=31.49, P<0.001) were fewer than those in the control group. Malondialdehyde( t=7.81, P<0.001), tumor necrosis factor-α( t=15.23, P<0.001) and interleukin-2( t=7.94, P<0.001) were lower than those in the control group, while the observation group’s levels of superoxide dismutase( t=7.15, P<0.001), total antioxidant capacity( t=5.81, P<0.001) and interleukin-10 ( t=6.27, P<0.001)were higher than those in the control group. The incidence of adverse responses was not significantly different between the two groups ( P>0.05). Conclusion:The use of ipalrestat and alproprol together can significantly enhance fundus microcirculation, lower oxidative stress, and reduce inflammation while posing little risks to individuals with early DR.

目的:探究高乙型肝炎病毒载量妊娠中晚期孕妇使用替比夫定阻断乙型肝炎病毒(Hepatitis B virus,HBV)母婴传播的效果.方法:选取我院2018年7月至2020年10月期间收治的97例高乙型肝炎病毒载量妊娠中晚期孕妇作为研究对象,根据随机数字表法分为DTF组(n=48)和LdT组(n=49).DTF组口服替诺福韦酯(Tenofovir Disoprox,DTF)治疗,LdT组口服替比夫定(Telbivudine,LdT)治疗,对比两组孕妇血清乙肝病毒基因(Hepatitis B virus-DNA,HBV DNA)水平、外周血Treg/Th17平衡状态、HBV母婴传播率及不良反应.结果:治疗前后两组孕妇HBV DNA水平、HBV DNA转阴率、乙型肝炎E抗原(Hepatitis Be antigen,HBeAg)转阴率、HbeAg血清学转换率、Treg细胞、Th17细胞百分比、Treg/Th17比值、新生儿HBV感染率、不良反应发生率均无统计学意义(P>0.05).结论:LdT与DTF两种药物对高乙型肝炎病毒载量妊娠中晚期孕妇治疗,均可有效阻断HBV母婴传播,调节免疫状态,降低HBV DNA水平,提升抗病毒效果,效果相当,安全性高,值得临床推广.

目的:探究原发性高血压合并动脉粥样硬化患者应用大剂量阿托伐他汀对血管微循环及颈动脉斑块进展的影响.方法:选取我院2019年8月至2020年8月期间收治的127例原发性高血压合并动脉粥样硬化患者,随机分为对照组和观察组.对照组63例患者口服常规剂量阿托伐他汀(20 mg Qd),观察组64例患者口服大剂量阿托伐他汀(40 mg Qd).3 m后采用氧化酶法检测总胆固醇(Total cholesterol,TC)、低密度脂蛋白胆固醇(Low density lipoprotein cholesterin,LDL-C)、高密度脂蛋白胆固醇(High-density lipoprotein cholesterol,HDL-C)、三酰甘油(Three acyl glycerin,TG)水平;采用比浊法检测纤维蛋白原(Fibrinogen,Fh)、血浆比黏度(Plasma specific viscosity,Np)、全血低切黏度(Whole blood has low shear viscosity,Nbl)、全血高切黏度(High shear viscosity of whole blood,Nbh)水平;采用彩色多普勒超声检测颈动脉血管内中膜厚度(Thickness of endomedia,IMT);同时观察不良反应发生情况.结果:观察组患者TC、TG、LDL-C水平均明显低于对照组,HDL-C水平高于对照组(P<0.05);观察组患者Fh、Np、Nbl、Nbh水平均低于对照组(P<0.05);观察组颈动脉IMT分级优于对照组(P<0.05);两组患者不良发生率比较无明显差异(P>0.05).结论:大剂量阿托伐他汀能够显著下调原发性高血压合并动脉粥样硬化患者血脂水平,改善血管微循环,缩小颈动脉斑块面积,安全性较高,其效果优于常规剂量阿托伐他汀治疗.

目的:观察加味升降散辅治糖尿病肾病的效果.方法:91例按掷币法分成对照组45例及观察组46例,两组均控制血糖、降低血压、健康教育、饮食干预等常规治疗,观察组加用加味升降散治疗.结果:治疗后观察组脘闷纳差、小便如脂膏、肢体浮肿中医征象评分低于对照组(P＜0.05).观察组Scr、BUN、FBG低于对照组(P＜0.05).观察组Alb高于对照组(P＜0.05),UAER、24h Upr低于对照组(P＜0.05).结论:加味升降散辅治DN效果较好.

Objective:To investigate the effects of sitagliptin phosphate on vascular endothelial function, renal function and bone metabolism in patients with type 2 diabetic nephropathy (T2DN).Methods:A total of 95 T2DN patients in the Department of Endocrinology of our hospital were enrolled in this study and divided into the conventional group and the combined group according to different treatment methods. Forty-seven cases in the conventional group were treated with insulin combined with benazepril, and 48 cases in the combined group were added with sitagliptin phosphate. The levels of vascular endothelium related factors, renal function, bone metabolism indexes and adverse reactions were compared between the two groups.Results:Three month after the treatment, the level of endothelin (ET) in both groups was lower than baseline, and the combined group was lower than the conventional group ( P<0.05). The level of nitric oxide (NO) in the combined group was higher than that in the conventional group ( P<0.05). The levels of serum creatinine (Scr), urea nitrogen (BUN) and urine β 2-microglobulin (β 2-MG) in two groups after treatment were decreased when compared with those before the treatment, and the combined group was lower than the conventional group ( P<0.05). Three month after the treatment, the level of 25-hydroxyvitamin D 3 (25-OH-D 3) in both two groups was higher than before the treatment, and the combined group was higher than the conventional group ( P<0.05). The levels of parathyroid hormone (PTH) and osteocalcin (BGP) in the combined group were lower than those in the conventional group ( P<0.05). The rate of adverse reactions in the combined group was 8.33% (4/48), which was higher than that in the conventional group (4.26% (2/47)), but there was no significant difference ( P>0.05). Conclusion:Sitagliptin phosphate treatment in T2DN patients can reduce the occurrence of renal microvascular lesions, regulate renal function and the level of vascular endothelium related factors, and improve the level of bone metabolism, with high safety and clinical efficacy.