The aim of this study is to investigate the effects of the metformin on the formation of hepatic fibrosis in type 2 diabetic rats and discuss its mechanism of liver-protecting activity. After SD rats were fed with high-fat and high-sucrose diet for four weeks, low-dose streptozotocin (STZ) was injected intraperitoneally to make the animal mode of type 2 diabetes. Then, all diabetic rats was fed with the high-fat diet and metformin (ig, 100 mg x kg(-1)) was given orally to metformin group for four months. After the last administration, fasting blood glucose was determined. The livers were removed to calculate the hepatic coefficient and to make HE and Picro acid-Sirius red staining, immunohistochemistry (alpha-SMA and TGFbeta1) and TUNEL staining in order to evaluate the effect of metformin on the hepatic fibrosis. The animal model of type 2 diabetes with hepatic fibrosis was successfully made. Metformin can significantly alleviate the lesions of hepatic steatosis and fibrosis, markedly reduce the expressions of alpha-SMA and TGFbeta1 in liver tissue of type 2 diabetic rats. However, TUNEL staining result suggested that metformin could not reduce apoptosis of hepatocytes. The results suggest that metformin can inhibit the formation of hepatic fibrosis in type 2 diabetes.

Objective To summarize the experience in open surgery for huge adrenal tumors in order to improve its safety and efficiency of this complicated surgical procedure. Methods Fortyfour consecutive patients with huge adrenal tumors underwent open surgery with mean long tumor diameter of 13 cm (9-34 cm), and autologous blood transfusion was prepared in routine. It was analyzed retrospectively for clinical data, perioperative complications and the effective and safety results of this procedure. Results The incision was oblique in lumbar region in 5 cases, subcostal unilaterally in 32 cases and abdomino-thoracic joint in 7 cases. There were 27 malignant tumors (61.4%) in 44 cases, 3 with hepatic invasion, 6 with thrombi extending into inferior vena cava, among which 2 needed translocation of artificial blood vessels and 3 needed cardio-pulmonary bypass. The mean blood loss was 1309 ml (100-3000 ml) in 41 cases(93.2%)and the autologous blood transfusion was used in 20 case (45.5%). There were 1 diaphragmatic injury, 1 pleura injury, 3 hemorrhage in large amount more than 15 000 ml and 2 peritoneal cavity infection.There were no perioperative deaths and 42 tumors (95.5%) were curatively resected. Conclusions Open surgery for huge adrenal tumors is a complicated surgical technique with high risk and large amount of blood loss. The key points to success are proper selection of incision, routine autologous blood transfusion, perfect surgical skills and good cooperation between different specialties.