ObjectiveTo explore the efficacy and safety of basal insulin plus oral antidiabetic drugs (OADs) treatment switched from premixed insulin therapy in type 2 diabetes patients. MethodsPatients with type 2 diabetes with glycosylated hemoglobin (A1C) lower than 10%, taking stable dose of premixed insulin twice daily for at least 12 weeks, and treated between February 2010 and August 2011 were identified from our outpatient service, and their treatment was switched to glargine plus OADs. After 24 weeks of treatment, we analyzed the changes of the patients' weight, fasting and postprandial blood glucose (FBG and PBG), A1C, hypoglycemic events and insulin dose. ResultsA total of 36 patients were followed up and received glargine plus OADs. After glargine treatment, the patients' weight[(63.77±10.34) vs. (62.31±9.98)kg, P=0.002] and total insulin dose[(23.56±6.15) vs. (10.28±4.04)kg, P=0.000] were declined obviously. The A1C level had further declined in the group of premixed insulin therapy with A1C approaching or reaching 7% from start to end point (6.70±0.81)% vs.(6.34±0.55)kg, P=0.007], and the insulin dose was (0.16±0.06) U/(kg·d). However, no significant difference of the incidence of hypoglycemic events was discovered compared with non-standard group (33.33% vs. 55.56%, P=0.267). Compared with premixed insulin group, glargine group usually had 1 or 2 kinds of OADs, and the most widely used drug was glucophage (17/36). ConclusionIn type 2 diabetes patients whose A1C level approaches or reaches 7%, switching premixed insulin therapy to glargine plus OADs is associated with significant improvement in glycemic control, as well as sound safety and other benefits.
ObjectiveTo systematically evaluate the efficacy, cosmetic outcome and adverse reaction of hypofractionation radiotherapy (HRT) versus conventional radiotherapy (CRT) for early stage breast cancer after breast conserving surgery. MethodsThe databases including CNKI, CBM, VIP, PubMed, EMbase and The Cochrane Library (Issue 1, 2015) were searched from the inception to May 2015 to collect the randomized controlled trials (RCTs) related to HRT versus CRT for early stage breast cancer after breast conserving surgery. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software. ResultsSix RCTs involving 8 240 patients were included. Meta-analyses results showed, there were no statistical differences between the HRT group and the CRT group in local-regional recurrence rate (5 year: RR=1.01, 95%CI 0.73 to 1.40, P=0.94; 10 year: RR=1.04, 95%CI 0.86 to 1.26, P=0.67), mortality (5 year: RR=0.95, 95%CI 0.85 to 1.08, P=0.45; 10 year: RR=0.97, 95%CI 0.86 o 1.09, P=0.61), photographic breast appearance (RR=0.98, 95%CI 0.91 to 1.05, P=0.56), the incidence of lung fibrosis (5 year: RR=1.07, 95%CI 0.66 to 1.72, P=0.78; 10 year: RR=1.05, 95%CI 0.62 to 1.77, P=0.86), the incidence of rib fracture (5 year: RR=1.00, 95%CI 0.60 to 1.68, P=0.99; 10 year: RR=1.19, 95%CI 0.70 to 2.00, P=0.52), and the incidence of ischemic of heart (5 year: RR=0.88, 95%CI 0.54 to 1.45, P=0.62; 10 year: RR=0.86, 95%CI 0.54 to 1.37, P=0.53). ConclusionHRT could provide similar tumor control as CRT without serious toxicity. Meanwhile HRT is superior to CRT in terms of patient convenience and costs, it should be promoted as adjuvant treatment for early stage breast cancer after breast conserving surgery.
ObjectiveTo assess the cosmetic outcomes and adverse events of MammoSite balloon brachytherapy for Accelerated Partial Breast Irradiation following breast-conserving surgery for patients with early stage breast cancer. MethodsWe searched PubMed, EMbase, Chinese Biomedical Database, Chinese Studies Online, China Journal Full-text Database up to March 2016, to collect clinical trials about MammoSite balloon brachytherapy following breast-conserving surgery for early stage breast cancer. And meta-analyses were performed by OpenMeta and Stata softwares. ResultsTwenty trials involving 3 796 patients were enrolled. The single arm meta-analysis results showed that:the cosmetic results were rated as excellent to good in 93% (95%CI 0.91 to 0.96), and the 5-year incidence of ipsilateral breast tumor recurrence (IBTR) was 3% (95%CI 0.020 to 0.040). ConclusionTo carry out the conclusion above, we still need controlled trials, especially randomized controlled trials (RCTs) to prompt further verification.