The harmful use of alcohol is a worldwide problem. It has been estimated that alcohol abuse represents the world’s third largest risk factor for disease and disability; it is a causal factor of 60 types of...The harmful use of alcohol is a worldwide problem. It has been estimated that alcohol abuse represents the world’s third largest risk factor for disease and disability; it is a causal factor of 60 types of diseases and injuries and a concurrent cause of at least 200 others. Liver is the main organ responsible for metabolizing ethanol, thus it has been considered for long time the major victim of the harmful use of alcohol. Ethanol and its bioactive products, acetaldehyde-acetate, fatty acid ethanol esters, ethanol-protein adducts, have been regarded as hepatotoxins that directly and indirectly exert their toxic effect on the liver. A similar mechanism has been postulated for the alcohol-related pancreatic damage. Alcohol and its metabolites directly injure acinar cells and elicit stellate cells to produce and deposit extracellular matrix thus triggering the “necrosis-fibrosis” sequence that finally leads to atrophy and fibrosis, morphological hallmarks of alcoholic chronic pancreatitis. Even if less attention has been paid to the upper and lower gastrointestinal tract, ethanol produces harmful effects by inducing: (1) direct damaging of the mucosa of the esophagus and stomach; (2) modification of the sphincterial pressure and impairment of motility; and (3) alteration of gastric acid output. In the intestine, ethanol can damage the intestinal mucosa directly or indirectly by altering the resident microflora and impairing the mucosal immune system. Notably, disruption of the intestinal mucosal barrier of the small and large intestine contribute to liver damage. This review summarizes the most clinically relevant alcohol-related diseases of the digestive tract focusing on the pathogenic mechanisms by which ethanol damages liver, pancreas and gastrointestinal tract.展开更多
Objective: To perform meta-analyses evaluating the efficacy of adding Liuwei Dihuang Pills (六味地黄丸 LDP) to Western medicine in improving treatment outcomes for type 2 diabetes. Methods: Medline, PubMed, Cochra...Objective: To perform meta-analyses evaluating the efficacy of adding Liuwei Dihuang Pills (六味地黄丸 LDP) to Western medicine in improving treatment outcomes for type 2 diabetes. Methods: Medline, PubMed, Cochrane Library, and Chinese databases, including the Chinese National Knowledge Infrastructure were searched to identify eligible studies; i.e., if the study involved a randomized clinical trial in which the experimental group combined LDP with Western drugs and the control group used the corresponding Western drugs alone to treat type 2 diabetes. Outcomes were measured in terms of fasting blood glucose (FBG), postprandial blood glucose (2hPG) and HbAlc level. Efficacy was also measured by using control and response rates. The combined odds ratio (OR), mean difference (MD), and 95% confidence intervals (95% CI) were calculated. Results: Studies included in the analysis were less adequate than expected in terms of methodological qualify. A total of 1,609 patients from 18 studies were included. We found that adding LDP can lower patients' FBG (MD=0.54 mmol/L, 95% CI [0.15, 0.93], P=0.007), 2hPG (MD=1.05 mmol/L, 95% CI [0.29, 1.81], P〈0.01) and HbAlc (MD=0.23, 95% CI [0.02, 0.45], P=0.008). There were also improvements in treatment response rates (OR=3.41, 95% CI [2.38, 4.90], P〈0.01) and control rates (OR=2.47, 95% CI [1.91, 3.20], P〈0.01). Conclusion: Adding LDP to Western medicine might improve treatment outcomes of diabetes, including FBG, 2hPG, response rates and control rates.展开更多
弥漫性大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)作为最常见的侵袭性非霍奇金淋巴瘤具有较大的异质性。治疗前期及治疗过程中对患者进行有效的预后评估尤为重要。随着分子基因学及免疫治疗的迅速发展,传统的预后评估手段受...弥漫性大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)作为最常见的侵袭性非霍奇金淋巴瘤具有较大的异质性。治疗前期及治疗过程中对患者进行有效的预后评估尤为重要。随着分子基因学及免疫治疗的迅速发展,传统的预后评估手段受到了极大的挑战,综合多种方法对患者进行精准的预后评估至关重要。近年来,多种血清生物标志物在DLBCL的预后评估中受到关注。血清生物标志物以无创、便捷和灵敏度高等优点更易于被患者接受,其在DLBCL预后综合评估中的作用不可忽视。本文就血清生物标志物在DLBCL中的研究进展进行综述。展开更多
Objective To investigate the relationship between glycosylated hemoglobin A1 c (HbA1 c) and blood glucose levels of eight different points throughout the day in well-glycemic-controlled medical nutrition therapy (...Objective To investigate the relationship between glycosylated hemoglobin A1 c (HbA1 c) and blood glucose levels of eight different points throughout the day in well-glycemic-controlled medical nutrition therapy (MNT) alone type 2 diabetic pafients. Methods Data were collected as" capillary blood glucose value of eight different sample points among sixteen observing days in thirty MNT alone type 2 diabetic patients. The correlation between HbAI c and capillary blood glucose value was evaluated by Pearson's correlation method. Results The r-values between HbA1c and capillary blood glucose of 3:00, 6:00, and bedtime (22:00-23:00) were 0. 81,0. 79, and 0. 78, respectively(P 〈0. 001 ). The best correlation was found between the mean value of 8- point blood glucose value throughout the day and HbA1c ( r=0. 84, P 〈0. 001 ). Conclustion Fasting blood glucose and postabsorptive blood glucose have better correlations with HbAlc compared with other points in this group of well-glycemic-controlled MNT alone type 2 diabetic patients.展开更多
文摘The harmful use of alcohol is a worldwide problem. It has been estimated that alcohol abuse represents the world’s third largest risk factor for disease and disability; it is a causal factor of 60 types of diseases and injuries and a concurrent cause of at least 200 others. Liver is the main organ responsible for metabolizing ethanol, thus it has been considered for long time the major victim of the harmful use of alcohol. Ethanol and its bioactive products, acetaldehyde-acetate, fatty acid ethanol esters, ethanol-protein adducts, have been regarded as hepatotoxins that directly and indirectly exert their toxic effect on the liver. A similar mechanism has been postulated for the alcohol-related pancreatic damage. Alcohol and its metabolites directly injure acinar cells and elicit stellate cells to produce and deposit extracellular matrix thus triggering the “necrosis-fibrosis” sequence that finally leads to atrophy and fibrosis, morphological hallmarks of alcoholic chronic pancreatitis. Even if less attention has been paid to the upper and lower gastrointestinal tract, ethanol produces harmful effects by inducing: (1) direct damaging of the mucosa of the esophagus and stomach; (2) modification of the sphincterial pressure and impairment of motility; and (3) alteration of gastric acid output. In the intestine, ethanol can damage the intestinal mucosa directly or indirectly by altering the resident microflora and impairing the mucosal immune system. Notably, disruption of the intestinal mucosal barrier of the small and large intestine contribute to liver damage. This review summarizes the most clinically relevant alcohol-related diseases of the digestive tract focusing on the pathogenic mechanisms by which ethanol damages liver, pancreas and gastrointestinal tract.
基金Supported by the National Key Technology Research and Development Program of the People's Republic of China(No.2009BAI76B030900)
文摘Objective: To perform meta-analyses evaluating the efficacy of adding Liuwei Dihuang Pills (六味地黄丸 LDP) to Western medicine in improving treatment outcomes for type 2 diabetes. Methods: Medline, PubMed, Cochrane Library, and Chinese databases, including the Chinese National Knowledge Infrastructure were searched to identify eligible studies; i.e., if the study involved a randomized clinical trial in which the experimental group combined LDP with Western drugs and the control group used the corresponding Western drugs alone to treat type 2 diabetes. Outcomes were measured in terms of fasting blood glucose (FBG), postprandial blood glucose (2hPG) and HbAlc level. Efficacy was also measured by using control and response rates. The combined odds ratio (OR), mean difference (MD), and 95% confidence intervals (95% CI) were calculated. Results: Studies included in the analysis were less adequate than expected in terms of methodological qualify. A total of 1,609 patients from 18 studies were included. We found that adding LDP can lower patients' FBG (MD=0.54 mmol/L, 95% CI [0.15, 0.93], P=0.007), 2hPG (MD=1.05 mmol/L, 95% CI [0.29, 1.81], P〈0.01) and HbAlc (MD=0.23, 95% CI [0.02, 0.45], P=0.008). There were also improvements in treatment response rates (OR=3.41, 95% CI [2.38, 4.90], P〈0.01) and control rates (OR=2.47, 95% CI [1.91, 3.20], P〈0.01). Conclusion: Adding LDP to Western medicine might improve treatment outcomes of diabetes, including FBG, 2hPG, response rates and control rates.
文摘弥漫性大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)作为最常见的侵袭性非霍奇金淋巴瘤具有较大的异质性。治疗前期及治疗过程中对患者进行有效的预后评估尤为重要。随着分子基因学及免疫治疗的迅速发展,传统的预后评估手段受到了极大的挑战,综合多种方法对患者进行精准的预后评估至关重要。近年来,多种血清生物标志物在DLBCL的预后评估中受到关注。血清生物标志物以无创、便捷和灵敏度高等优点更易于被患者接受,其在DLBCL预后综合评估中的作用不可忽视。本文就血清生物标志物在DLBCL中的研究进展进行综述。
文摘Objective To investigate the relationship between glycosylated hemoglobin A1 c (HbA1 c) and blood glucose levels of eight different points throughout the day in well-glycemic-controlled medical nutrition therapy (MNT) alone type 2 diabetic pafients. Methods Data were collected as" capillary blood glucose value of eight different sample points among sixteen observing days in thirty MNT alone type 2 diabetic patients. The correlation between HbAI c and capillary blood glucose value was evaluated by Pearson's correlation method. Results The r-values between HbA1c and capillary blood glucose of 3:00, 6:00, and bedtime (22:00-23:00) were 0. 81,0. 79, and 0. 78, respectively(P 〈0. 001 ). The best correlation was found between the mean value of 8- point blood glucose value throughout the day and HbA1c ( r=0. 84, P 〈0. 001 ). Conclustion Fasting blood glucose and postabsorptive blood glucose have better correlations with HbAlc compared with other points in this group of well-glycemic-controlled MNT alone type 2 diabetic patients.