The proliferation of MG63 cells under high glucose intervened with metformin was measured by CCK-8 assay.The activity of intracellular alkaline phosphatase (ALP) was detected by SFBC assay.The expression of related genes was detected by RT-PCR.Metformin promoted the proliferation of MG63 cells (P＜0.01),the activity of ALP was increased (P＜0.05).The expressions of collagen Ⅰ and osteocalcin were up-regulated while the expressions of matrix metalloproteinase (MMP)-1,MMP-2,MMP-3,and MMP-8 were down-regulated (P＜0.05).The results indicate that metformin may protect osteoblast,via promoting osteoblast proliferation,differentiation and mineralization,as well as by inhibiting degradation of osteoblast extracellular collagen matrix.

Objective To evaluate the role of CT diagnosis of the benign or malignant mass in nasal cavity and sinus.Methods 100 cases of benign or malignant masses in nasal cavity and sinus were reviewed retrospectively,and their CT findings were analyzed in details.According to what the lesion involved,the masses were defined into three states : A、The mass only localized in nasal cavity;B、 The massinvolves nasal cavity and(or) nasal sinus;C、The mass involved the adjacent structure beyond the nasal cavity and(or) nasal sinus.Results In what the lesion involved,benign mass group: A,53 cases;B,1 case;C,6 cases;malignant mass group: A,3 cases;B,9cases;C,28 cases,the difference between the two groups had statistical significance(P

Objective To improve the differential diagnostic accuracy of abnormal image in the nasopharyngeal cavity and wall.Methods Sixty-five cases with abnormal image in the nasopharyngeal cavity and wall were collected.Twenty cases were proven by operation and pathology.Forty-five cases were proven by biopsy and pathology. All the patients were examined by using CT and (or) MRI. Their imaging features were analyzed in details.Results In 19 cases, polyp and inverted papilloma in the nasal cavity and choanal projected into the nasopharyngeal cavity. Small air bubbles or contact between the lesion and the nasopharyngeal wall were detected in 18 of them. The edge of the polyp was regular, while the margin of the inverted papilloma was irregular. In 11 cases, nasopharyngitis or adenoidal hypertrophy located in the posterosuperior wall. The anterior borders were almost straight or curve toward inside, and the contrast enhanced CT and MRI scans showed that the mucous membrane lines were continuous. Oropharyngitis in the right side spread to the right wall of the nasopharynx without clear borderline and the space occupying effect was little in 1 case. There were 33 cases of nasopharyngeal carcinoma (NPC) and 1 case of non-Hodgkin′s lymphoma (NHL), and the anterior borders of the masses were evaginated like a curve, and most of them were accompanied with shallowing or disappearing of pharyngeal recess and tumefaction of the levator muscle of palatine velum.Conclusion According to the imaging features, most of the abnormalities in the nasopharyngeal cavity and wall can be diagnosed correctly.

Objective To systematically evaluate the safety and efficacy of probiotics in the treatment of severe acute pancreatitis (SAP).Methods The randomized controlled trials (RCTs) for studying probiotics in the treatment of SAP were retrieved from databases,including PubMed,Embase,Cochrane Library,Medline,Chinese Biomedical Literature Database (CBM),Chinese science and technology journal full-text database (VIP),China journal full-text database (CNKI),Wanfang academic journal fulltext database.The methodological quality of included literatures was evaluated,and statistical analysis was performed via RevMan5.3 software.Results A total of 12 pieces of RCT literatures including 910 cases of patients with SAP were included.The results of meta analysis indicated that no statistically significant difference was found in the mortality [RR =0.97,95 ％ CI(0.63,1.49),P=0.88],the incidence rate of multiple organ dysfunction [RR =0.72,95 ％ CI(0.49,1.06),P=0.10] and the incidence rate of pancreas-related infections [RR=0.76,95 ％ CI(0.54,1.07),P=0.12] between the probiotics group and the control group;while there were statistically significant differences in the length of hospital stay [MD =-3.74,95 ％ CI(-6.37,-1.12),P=0.005] and the incidence rate of intestinal ischemia necrosis [RR=11.39,95 ％ CI(1.5,86.4),P =0.02],Conclusion Probiotics could not improve clinical outcomes of patients with SAP,and may increase risk for intestinal ischemic necrosis.However,it could shorten the length of hospital stay.

Objective To compare the predictive value of the model for end-stage liver disease (MELD), MELD-Na and Child-Pugh (CP) for rebleeding in decompensated liver cirrhosis patients with esophageal varices within 3-month and 1-year. Methods A cohort of 365 decompensated liver cirrhotic patients with esophageal varices, who were admitted to hospital between Jan.2003 and Oct.2008, were retroseptively studied and followed up at least for one year. Patients were divided into hyponatremia group and normal group. MELD-Na, MELD and Child-Pugh scores were calculated for each patients on the first day of admission.Receiver operating characteristics curves (ROC) and the area under ROC (AUC) were used to determine the ability of three models for predicting rebleeding in 3-month and 1-year. Z-test was used to compare predictive ability of three models. Results At 3-month and 1 year of enrollment, AUC of MELD-Na was 0.825 and 0.842, respectively, whereas AUC of MELD was 0.779 and 0.802, respectively. MELD-Na and MELD were superior to Child-Pugh in rebleeding prediction (0.678 and 0.634, P＜0.05). But there was no significantly difference between MELD-Na and MELD in rebleeding prediction for 3-month and 1-year (P＞ 0.05). Conclusions MELD-Na and MELD are superior to Child-Pugh score in exactly predicting the rebleeding risk in decompensated liver cirrhosis patients with esophageal varices. MELD-Na compensates a deficiency of MELD.

Objective To observe the efficacy and safety of endoscopic variceal ligation (EVL) and esophageal variceal sclerotherapy (EVS) with different hardeners for esophageal variceal bleeding (EVB).Methods Clinical data of 314 patients with EVB were retrospectively reviewed.The patients were divided into 5 groups according to the endoscopic treatments they have received,i.e.,endoscopic variceal ligation (EVL) group (n =112),sodium morrhuate sclerotherapy (EVS1) group (n =48),lauromacrogol sclerotherapy (EVS2) group (n =40),EVL plus sodium morrhuate sclerotherapy (EVLS1) group (n =26) and EVL plus lauromacrogol sclerotherapy (EVLS2) group (n =88).The efficacy,variceal recurrence rate and complication rate were evaluated.Results There was no significant difference in efficacy of stop bleeding among 5 groups,which was 85.7％ (96/112) in EVL group,83.3％ (40/48) in EVS1 group,92.5％(37/40) in EVS2 group,92.3％ (24/26) in EVLS1 group and 94.3％ (83/88) in EVLS2 group (P ＞0.05).The complete cure rates in EVLS1 group (88.5％,23/26) and EVLS2 group (87.5％,77/88)were significantly higher than those in 3 other groups (P ＜ 0.05).Rebleeding rates in EVS1 group (18.8％,9/48) and EVL group (11.6％,13/112) were significantly higher than those in other 3 groups (P ＜0.05).The patients were followed up for 6-18 months,and the varices recurrence rate was highest in group EVL (23.2％,26/112) and lowest in EVLS2 (10.2％,9/88,P ＜0.05).The complication rate in group EVS1 (32.2％,49/152) was significantly higher than that in other 4 groups (P ＜0.05).Conclusion EVL plus EVS,either with sodium morrhuate or lauromacrogol EVS is safe and effective for EVB,especially EVL plus Lauromacrogol EVS,may become an optimal therapy to control esophageal variceal bleeding and rebleeding.

Objective Dieulafoy's lesion is a rare cause of upper gastrointestinal bleeding. The purpose of this study was to recognize the clinical characteristics of gastric Dieulafoy and to identify possible predictive factors of rebleeding. Methods Retrospective study of patients with gastrointestinal bleeding secondary to Dieulafoy's lesion from January 2009 to June 2016. We analyzed the clinical data and endoscopic findings and the correlated with rebleeding risk factors with Dieulafoy's lesion. Results 111 patients were included in the study, 97 (87.4%) patients were male; the most common location of the bleeding lesions were Proximal stomach of 53 cases (47.7%); According to the Forrest type, 46.8% of the cases were arterial (spurting), 52.3% of the cases were arterial (oozing), there were 101 (91.0%) patients treated by endoscopic combined drug therapy. The success rate of Endoscopic hemostatic treatment was 84.2%, endoscopic hemostatic treatment success rate was as follows: single endoscopic, 85.0%; two endoscopic, 84.8%; three endoscopic, 75.0%. The hemostatic treatment success rate of 101 patients with endoscopic combined drug was as follows: Proximal stomach, 83.7%; mid-stomach, 82.1%; and distal stomach, 88.9%. Age (P = 0.002) and blood transfusion (P = 0.004) were risk factors for rebleeding in the study. Blood transfusion was associated with a higher recurrence rate for bleeding (P = 0.018, OR=37.77, 95% CI = 1.86~766.47) for 101 patients with endoscopic in combination with drug. Conclusion Endoscopic therapy is effective for treating Dieulafoy's lesion. The blood transfusion was associated with a high rate of bleeding recurrence. There were no significant differences between the rebleeding and non-rebleeding groups with respect to bleeding location or hemostatic methods.