简介：　　 [摘要 ] 目的 将门冬胰岛素、甘精胰岛素联合应用治疗小儿 I型糖尿病并对其疗效进行观察总结。方法 选取 2017年 6月— 2019年 5月期间该院录入接受治疗 90例小儿 I型糖尿病患者作为研究对象，随机分组，其中对照组 45例患儿给予单纯门冬胰岛素治疗，观察组 45例患儿给予门冬胰岛素、甘精胰岛素联合应用治疗。对患者临床糖尿病相关指标进行检测并加以记录。结果 两组患儿空腹、餐后 2 h血糖均显著低于治疗前（ P<0.05），观察组患儿空腹血糖、餐后 2 h血糖、糖化血红蛋白、甘油三酯、胆固醇以及低血糖临床发病率均显著低于对照组患儿，以上指标经比较均差异有统计学意义（ P<0.05）。 结论 门冬胰岛素、甘精胰岛素联合应用治疗小儿 I型糖尿病较单纯用药更具优势，能有效促进小儿 I型糖尿病临床症状消退，值得在临床治疗此类疾病时进一步推广。  　　 [关键词 ] 门冬胰岛素 ;甘精胰岛素 ;小儿 I型糖尿病 ;联合治疗 ;疗效观察  　 [Abstract] Objective To observe and summarize the curative effect of combination of insulin aspart and insulin glargine on type I diabetes in children. Methods from June 2017 to may 2019, 90 children with type I diabetes were randomly divided into two groups. 45 children in the control group were treated with simple aspartic insulin and 45 children in the observation group were treated with aspartic insulin and insulin glargine. The clinical diabetes related indexes were detected and recorded. Results fasting and postprandial 2 h blood glucose in two groups were significantly lower than before treatment (P<0.05). Fasting blood glucose, postprandial 2 h blood sugar, glycosylated hemoglobin, triglyceride, cholesterol and incidence rate of hypoglycemia in the observation group were significantly lower than those in the control group, and the above indexes were statistically significant (P<0.05). Conclusion the combination of insulin aspart and insulin glargine has more advantages in the treatment of children's type I diabetes than the single drug. It can effectively promote the clinical symptoms of children's type I diabetes, and it is worth further promoting in the clinical treatment of such diseases.

简介：摘要目的比较混合型肝癌(combined hepatocellular-cholangiocarcinoma，CHC)在超声造影(contrast enhanced ultrasonography，CEUS)和增强CT/磁共振成像(contrast enhanced computed tomography/magnetic resonance imaging，CECT/MRI)中增强模式的差异并探究影像学与影像学、影像学与肿瘤标志物以及肿瘤标志物之间的差异性表现对CHC检出的提示作用。方法回顾性分析2011年7月至2019年8月天津市第三中心医院35例病理确诊的CHC患者的临床资料，对病灶在CEUS和CECT/MRI中增强模式进行比较。联合病灶在CEUS和CECT/MRI中的差异性增强模式、影像增强模式与肿瘤标志物的差异性表现以及肿瘤标志物之间的差异性表现用于CHC检出。结果病灶在CEUS上表现为肝细胞癌(hepatocellular carcinoma，HCC)及肝内胆管细胞癌(intrahepatic cholangiocellular carcinoma，ICC)增强模式的比例为62.9%和37.1%；在CECT/MRI上表现为HCC、ICC及CHC增强模式的比例为48.6%、31.4%和20.0%。12例直径≤3.0 cm病灶在CEUS表现为HCC增强模式的比例为100%，在CECT/MRI表现为HCC和ICC增强模式的比例为91.7%和9.3%；23例直径>3 cm病灶在CEUS表现为HCC和ICC增强模式的比例为43.5%和56.5%，在CECT/MRI表现为HCC、ICC及CHC增强模式的比例为26.1%、43.5%和30.4%。以CEUS和CECT/MRI增强模式不一致、肿瘤标志物与影像学不一致、AFP和CA19-9同时升高作为提示性诊断信息，78.6%的患者至少符合上述3种差异性表现中的1种。结论CHC在CEUS及CECT/MRI中的增强模式具有差异性。随着病灶直径增加，CHC在增强影像中的表现均由类HCC转变为类ICC或CHC。联合CEUS和CECT/MRI差异性增强模式、影像学与肿瘤标志物之间的差异性表现以及肿瘤标志物的差异表现有助于提高CHC的检出率。