目的 觀察羅格列酮鈉對血糖控制未達標的2型糖尿病（T2DM）合并與不合并非酒精性脂肪肝（NAFL）患者的降糖療效和安全性。 方法 2009年1月－2011年1月60例僅用磺脲類和二甲雙胍治療血糖控制未達標的T2DM患者，按合并和不合并NAFL分為觀察組和對照組各30例，兩組均在原口服降糖藥基礎上聯合加用國產羅格列酮鈉4 mg 1次/d，治療共3個月，觀察治療前后的血糖、胰島素、糖化血紅蛋白（HbA1c）、體質量指數（BMI）、血脂、肝功、血壓水平以及藥物不良反應，并比較治療后的血糖達標率。 結果 兩組患者治療后的空腹血糖（FPG）、餐后2 h血糖（2hPG）、HbA1c、空腹胰島素、甘油三酯和極低密度脂蛋白膽固醇均較治療前下降，高密度脂蛋白膽固醇較治療前升高（P＜0.05），而丙氨酸轉氨酶、總膽固醇、低密度脂蛋白膽固醇及血壓無明顯變化（P＞0.05），但觀察組治療后的FPG和2hPG均較對照組下降更明顯（P＜0.01），且血糖達標率為73.3%，顯著高于對照組的46.7%（P＜0.05），同時觀察組餐后2 h胰島素（2hINS）水平在治療前后均明顯高于對照組而且治療后有顯著下降（P＜0.01），但對照組治療后2hINS雖然也有下降但無統計學意義（P＞0.05）。觀察組治療前后BMI無明顯變化，但對照組治療后BMI有明顯的升高（P＜0.05）。結論 國產羅格列酮鈉片對血糖控制未達標的T2DM合并和不合并NAFL患者均有進一步降低血糖、HbA1c以及改善血脂的作用，但對T2DM合并NAFL的患者的降糖療效更顯著，未見加重肝功能損壞，不良反應小，可作為此類患者聯合用藥的一種選擇。
Objective To explore effect of platelet-rich plasma (PRP) on rabbit BMSCs differentiation into SC in vitro and to detect secretory function of the differentiated cells. Methods BMSCs isolated from 5 mL bone marrow of 2-montholdNew Zealand white rabbit were cultured using density gradient centrifugation and adherence screening methods. A total of 5 mL femoral vein blood was obtained from rabbits to prepare PRP using modified Appel method. The BMSCs at passage 3 were divided into three groups: the combined induction group, in which the cells were cultured with complete medium containing PRP after β-mercaptoethanol and retinoic acid inductions; the simple induction group, in which the cells were cultured with L-DMEM complete medium without PRP afterβ-mercaptoethanol and retinoic acid induction; the control group, in which the cells were cultured with L-DMEM complete medium. Growth condition of the cells in each group was observed using inverted microscope. cell identification was conducted at 4, 7, 9, and 11 days after culture using immunofluorescence staining method, and NGF content was detected by ELISA method. NGF mRNA expression was assayed by RT-PCR 11 days after culture. Results Most cells in the combined induction and the simple induction group were out of BMSCs typical cell morphology 4 days after culture; cells in the combined induction group were out of BMSCs typical cell morphology and changed into cells resembl ing SC in terms of morphology and contour 9 days after culture. The cells in the control group showed no obvious morphological changes. S-100 protein expression in the cells was evident in the combined induction and the simple induction group at each time point after induced culture; the positive expression rate of cell in each group was increased over time, and significant differences were evident between the combined induction group and the simple induction group 7, 9, and 11 days after culture (P lt; 0.05). Control groupwas negative for the expression. There were significant differences when comparing the control group with the combined induction group or the simple induction group in terms of NGF content at each time point (P lt; 0.01). Significant difference was evident between the combined induction group and the simple induction group 7, 9, and 11 days after culture (P lt; 0.05), and no significant difference was noted 4 days after culture (P gt; 0.05). Relative intensity of NGF mRNA expression in the combined induction group was greater than that of the simple induction group 11 days after culture (P lt; 0.05). Conclusion Rabbit BMSCs can differentiate into SC excreting NGF under certain induction condition in vitro. PRP can remarkably promote BMSCs differentiation into SC.