目的 探讨芪蛭益肾胶囊联合八段锦治疗早期糖尿病肾病患者的临床疗效及对其24 h尿白蛋白排泄率的影响。方法 选取2023年1月—2023年12月在南京医科大学附属苏州医院就诊的260例早期糖尿病肾病患者作为研究对象,采用随机数字表法分为对...目的 探讨芪蛭益肾胶囊联合八段锦治疗早期糖尿病肾病患者的临床疗效及对其24 h尿白蛋白排泄率的影响。方法 选取2023年1月—2023年12月在南京医科大学附属苏州医院就诊的260例早期糖尿病肾病患者作为研究对象,采用随机数字表法分为对照组和观察组,每组130例。对照组在常规用药基础上进行八段锦锻炼,观察组在对照组治疗的基础上服用芪蛭益肾胶囊治疗。治疗6个月后,观察比较两组患者中医证候积分、临床疗效、不良反应情况,治疗前后血糖指标[空腹血糖(Fasting blood glucose,FBG)、餐后2 h血糖(2-hour postprandial blood glucose,2 h PBG)、糖化血红蛋白(Glycosylated hemoglobin,HbA1c)]、肾功能指标[24 h尿液总蛋白定量(24-hour urine total protein,24 h UTP)、血尿素氮(Blood urea nitrogen,BUN)浓度、24 h尿液蛋白排泄速率(24-hour urinary protein excretion rate,24 h UPER)]、血清炎症因子[C反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白细胞介素-6(Interleukin-6,IL-6)]水平。结果 治疗后两组患者中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组中医证候积分较对照组明显降低,差异有统计学意义(P<0.05)。两组患者治疗前后FBG、2 h PBG、HbA1c水平比较,差异无统计学意义(P>0.05)。治疗后两组患者24 h UTP、BUN、24 h UPER水平较治疗前降低,差异有统计学意义(P<0.05);且观察组24 h UTP、BUN、24 h UPER水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者CRP、TNF-α、IL-6水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组CRP、TNF-α、IL-6水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后观察组治疗总有效率74.62%(97/130)明显高于对照组60.77%(79/130),差异有统计学意义(P<0.05)。治疗期间,两组患者不良反应总发生率比较,差异无统计学意义(P>0.05)。结论 芪蛭益肾胶囊联合八段锦治疗早期糖尿病肾病,能有效控制血糖水平,改善肾功能和血清炎症指标,提高治疗效果,且安全性良好。展开更多
BACKGROUND Gastric cancer(GC)is one of the most common malignant tumors of the digestive system worldwide,the prognosis of patients with advanced GC remains poor.AIM To evaluate the combined expression characteristics...BACKGROUND Gastric cancer(GC)is one of the most common malignant tumors of the digestive system worldwide,the prognosis of patients with advanced GC remains poor.AIM To evaluate the combined expression characteristics of cancer stem cell markers CD24 and CD133 in GC pathological tissues,and to explore their association with patients’clinicopathological parameters and postoperative survival outcomes.METHODS A total of 304 GC patients who underwent surgical treatment in our hospital from January 2018 to January 2020 were retrospectively included.Immunohistochemistry was used to detect the protein expression of CD24 and CD133 in tumor tissues,adjacent tissues,and normal gastric mucosa tissues.Based on staining intensity and the proportion of positive cells,expression levels were classified into low and high expression,while clinicopathological parameters were recorded.χ2 test was used to evaluate the correlation between expression and categorical variables,Spearman rank correlation analysis was performed to assess the correlation between the expression intensities of the two markers,and multivariate regression models were applied to identify independent risk factors influencing co-expression.Kaplan-Meier survival curves and Log-rank test were used to compare survival differences among groups with different expression patterns.RESULTS Among the 304 patients,155 cases(50.99%)were CD24 positive,including 91 low-expression and 64 highexpression;133 cases(43.75%)were CD133 positive,including 81 low-expression and 52 high-expression.There were 74 cases(24.34%)with double positivity and 81 cases(26.64%)with double negativity.Compared with tumor tissues,the positive rates of CD24 and CD133 in normal gastric tissues and adjacent tissues were significantly lower(P<0.05).Univariate analysis showed that co-expression of CD24 and CD133 in GC tissues was significantly correlated with tumor size,Lauren classification,T stage,N stage,and vascular invasion(P<0.05),but not with patient age,gender,tumor site,World Health Organization histological classification,or M stage(P>0.05).Further multivariate regression analysis suggested that tumor size,T stage,N stage,and vascular invasion were independent risk factors promoting CD24 and CD133 double positivity.Spearman rank correlation analysis indicated a moderate positive correlation between their expression intensities(r=0.420,P<0.001).During follow-up,29 of 304 patients were lost(loss rate 9.54%);146 deaths occurred.According to expression combination,there were 89 cases of CD24 single positivity(39 deaths),68 cases of CD133 single positivity(31 deaths),81 cases of double negativity(25 deaths),and 66 cases of double positivity(51 deaths).Log-rank test showed significant differences in overall survival among the four groups(χ2=20.89,P<0.001),with CD24+/CD133+group showing the worst prognosis.CONCLUSION CD24 and CD133 exhibit high positive detection rates in GC tissues,and their co-positivity is closely associated with tumor stage progression and significantly indicates unfavorable survival outcomes.The co-expression of CD24/CD133 may reflect higher aggressiveness and metastatic potential of GC,serving as a potential prognostic marker and a direction for targeted therapeutic strategies.However,as this is a single-center retrospective study with limitations such as patient loss to follow-up and sample size,further prospective,multicenter,and mechanistic studies are required to validate its clinical applicability and biological role.展开更多
文摘目的 探讨芪蛭益肾胶囊联合八段锦治疗早期糖尿病肾病患者的临床疗效及对其24 h尿白蛋白排泄率的影响。方法 选取2023年1月—2023年12月在南京医科大学附属苏州医院就诊的260例早期糖尿病肾病患者作为研究对象,采用随机数字表法分为对照组和观察组,每组130例。对照组在常规用药基础上进行八段锦锻炼,观察组在对照组治疗的基础上服用芪蛭益肾胶囊治疗。治疗6个月后,观察比较两组患者中医证候积分、临床疗效、不良反应情况,治疗前后血糖指标[空腹血糖(Fasting blood glucose,FBG)、餐后2 h血糖(2-hour postprandial blood glucose,2 h PBG)、糖化血红蛋白(Glycosylated hemoglobin,HbA1c)]、肾功能指标[24 h尿液总蛋白定量(24-hour urine total protein,24 h UTP)、血尿素氮(Blood urea nitrogen,BUN)浓度、24 h尿液蛋白排泄速率(24-hour urinary protein excretion rate,24 h UPER)]、血清炎症因子[C反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白细胞介素-6(Interleukin-6,IL-6)]水平。结果 治疗后两组患者中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组中医证候积分较对照组明显降低,差异有统计学意义(P<0.05)。两组患者治疗前后FBG、2 h PBG、HbA1c水平比较,差异无统计学意义(P>0.05)。治疗后两组患者24 h UTP、BUN、24 h UPER水平较治疗前降低,差异有统计学意义(P<0.05);且观察组24 h UTP、BUN、24 h UPER水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者CRP、TNF-α、IL-6水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组CRP、TNF-α、IL-6水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后观察组治疗总有效率74.62%(97/130)明显高于对照组60.77%(79/130),差异有统计学意义(P<0.05)。治疗期间,两组患者不良反应总发生率比较,差异无统计学意义(P>0.05)。结论 芪蛭益肾胶囊联合八段锦治疗早期糖尿病肾病,能有效控制血糖水平,改善肾功能和血清炎症指标,提高治疗效果,且安全性良好。
基金National Natural Science Foundation of China,No.82003223and China Postdoctoral Science Foundation,No.2020M671398.
文摘BACKGROUND Gastric cancer(GC)is one of the most common malignant tumors of the digestive system worldwide,the prognosis of patients with advanced GC remains poor.AIM To evaluate the combined expression characteristics of cancer stem cell markers CD24 and CD133 in GC pathological tissues,and to explore their association with patients’clinicopathological parameters and postoperative survival outcomes.METHODS A total of 304 GC patients who underwent surgical treatment in our hospital from January 2018 to January 2020 were retrospectively included.Immunohistochemistry was used to detect the protein expression of CD24 and CD133 in tumor tissues,adjacent tissues,and normal gastric mucosa tissues.Based on staining intensity and the proportion of positive cells,expression levels were classified into low and high expression,while clinicopathological parameters were recorded.χ2 test was used to evaluate the correlation between expression and categorical variables,Spearman rank correlation analysis was performed to assess the correlation between the expression intensities of the two markers,and multivariate regression models were applied to identify independent risk factors influencing co-expression.Kaplan-Meier survival curves and Log-rank test were used to compare survival differences among groups with different expression patterns.RESULTS Among the 304 patients,155 cases(50.99%)were CD24 positive,including 91 low-expression and 64 highexpression;133 cases(43.75%)were CD133 positive,including 81 low-expression and 52 high-expression.There were 74 cases(24.34%)with double positivity and 81 cases(26.64%)with double negativity.Compared with tumor tissues,the positive rates of CD24 and CD133 in normal gastric tissues and adjacent tissues were significantly lower(P<0.05).Univariate analysis showed that co-expression of CD24 and CD133 in GC tissues was significantly correlated with tumor size,Lauren classification,T stage,N stage,and vascular invasion(P<0.05),but not with patient age,gender,tumor site,World Health Organization histological classification,or M stage(P>0.05).Further multivariate regression analysis suggested that tumor size,T stage,N stage,and vascular invasion were independent risk factors promoting CD24 and CD133 double positivity.Spearman rank correlation analysis indicated a moderate positive correlation between their expression intensities(r=0.420,P<0.001).During follow-up,29 of 304 patients were lost(loss rate 9.54%);146 deaths occurred.According to expression combination,there were 89 cases of CD24 single positivity(39 deaths),68 cases of CD133 single positivity(31 deaths),81 cases of double negativity(25 deaths),and 66 cases of double positivity(51 deaths).Log-rank test showed significant differences in overall survival among the four groups(χ2=20.89,P<0.001),with CD24+/CD133+group showing the worst prognosis.CONCLUSION CD24 and CD133 exhibit high positive detection rates in GC tissues,and their co-positivity is closely associated with tumor stage progression and significantly indicates unfavorable survival outcomes.The co-expression of CD24/CD133 may reflect higher aggressiveness and metastatic potential of GC,serving as a potential prognostic marker and a direction for targeted therapeutic strategies.However,as this is a single-center retrospective study with limitations such as patient loss to follow-up and sample size,further prospective,multicenter,and mechanistic studies are required to validate its clinical applicability and biological role.
