[Summary] Considerable efforts have been made to understand the cellular and molecular mechanisms of metformin ,a potent antihyperglycemic agent now recommended as the first‐line treatment of patients with T2DM. The main effect of this drug is to reducethe hepatic glucose output ,primarily through inhibition of the mitochondrial respiratory chain complex Ⅰ and then activating AM P‐activated protein kinase (AMPK) ,which provide a generally acceptable mechanism for the action of metformin on hepatic gluconeogenesis. Beyond its effect on glucose metabolism ,metformin has been reported to improve ovarian function of patients with polycystic ovary syndrome (PCOS) and to reduce the risk of microvascular and macrovascular complications in patients with T2DM. In addition ,metfomin has also recently been suggested as an adjuvant treatment of cancer. Here we reviewed the progress of mechanism research and clinical application of metformin.

[Objective]To sturdy the biological responses of osteoblast-like cells in different maturation stages under shear flow.[Method]Flow chamber system was used to apply shear flow stimulation of 4.62dyn?s/cm~2 for 2 hours on osteoblast-like cell MC3T3-E1 of different maturation stage induced by osteogenic media,and then samples for dsDNA content and ALP activity analysis were collected.[Result]On 24 hours after simulation,there was not obvious change of ALP activity with non-osteogenic inducing group,an increase was observed in the group of 4 days of differentiation,while an decrease in the group of 8 days of differentiation.[Conclusion]Biological responses of osteoblast-like cells in different maturation stages under shear flow is quite different,and this may be an important role in bone growth and reconstruction.

Objective To construct the eukaryotic expression plasmid of recombinant human hypoxia-inducible factor-1?(HIF-1?) and get ready for the coloning and expressing of HIF-1? gene. Methods The total RNA was isolated from blood cells,and cDNA library was constructed by reverse transcription PCR method.PIREGFP containing EGFP fragment and cDNA were used as templet,the three designed primers (EGFP-linker,HIF-1? upstream and HIF-? downstream)were put into,after amplification the target gene fragment was inserted into the shuttle vector T,and transfected with E.coli DH5?,the bacterial colonies containing recombinant plasmids were identified by LB/KANA-agar plate,and the recombinant plasmids were extracted and purified.All sequences amplified by PCR were confirmed by complete sequencing.The correct sequences were cloned into the pVAX1 vector.Results The amplified fragments were about 870,1 199,672 bp by PCR,they were inserted into the shuttle vector T and sequenced. The result of sequencing was identical with that provided by GenBank.The final plasmid about 1 800 bp was obtained by the identification of enzyme digestion and it had same molecular size as expected.Conclusion The eukaryotic expression plasmid pVAX1-EGFP-linker-HIF-1? of recombinant human HIF-1? is successfully constructed.

Objective To study the relationship of free fatty acids and oxLDL-C with diabetic retinopathy(DR).Methods The 108 type 2 diabetes cases with(n=68)and without(n=40)DR were enrolled,and compared with 42 health control.FFA was determined by copper chromogenic method.oxLDL-C was determined by ELISA with kits provided.The correlation of risk factors with retinopathy was analyzed by logistic regression analysis.Results FFA and ox LDL-C levels were higher in DR group than in groups of DM and control.Logistic regression analysis showed that as the independent risk factors for DR pathogenesis,LDL-C,FFA,oxLDL-C and course of disease entered into regression equation.Conclusions FFA and oxLDL-C are the important risk factors for DR.

Oncocytic papilloma (OP) of nasal cavity and paranasal sinuses are uncommon. We report 3 cases of oncocytic papilloma arising in the nasal cavity and paranasal sinuses, and review the relevant literatures. Unilateral sinonasal lesions are the main clinical manifestation. Pathological feature is multiple layers of epithelial cells. The cytoplasm contains abundant eosinophilic granular and microcapsules filling with mucus. The neutrophils aggregate in the microcapsules which form microabscess. The tendence of recurrence and malignant transformation are the biological character. The best treatment choice is surgical excision completely, and long-term postoperative follow-up is necessary to prevent relapse.
Cell Transformation, Neoplastic ; Humans ; Nasal Cavity ; pathology ; Neoplasm Recurrence, Local ; Nose Neoplasms ; diagnosis ; Papilloma ; diagnosis ; Paranasal Sinuses ; pathology

OBJECTIVE:To standardize hospital purchasing management for medicinal material. METHODS:The separation of the four powers,including plan,purchase,supply,and payment,was practiced on the basis of centralized purchasing medicinal material in our hospital. SWOT method was used to analyze the strengths,weaknesses,opportunities and threats of the model;im-provement measures were formulated;finally the effects of the model were evaluated. RESULTS:This model played an active role in the professional advantage of purchasing management,made up for the lack of management system and manpower shortage dis-advantage;adapted to policies to seize the opportunities for improvement,reduced the threat of standard deletion and purchasing cost,and promoted reasonable consumption of medicinal materials. And then the purchasing cost of our hospital was reduced after system procedure improvement,fine management of medicinal material and professional level improvement,medicine ratio fell from 42% in 2010 to 37% in 2014;logistics support became stable and standard,and the level of medicinal material supply was improved. CONCLUSIONS:The purchasing model for medicinal material under separation of the four powers provides the refer-ence for the correct course of the standardized,normalized and modernized hospital purchasing management.

Objective To explore the effects of childhood abuse on leptin level in blood plasma of adult depression patients.Methods 106 depression patients were included in this study.Children abuse status,severity of depression anxiety were assessed with the childhood trauma questionnaire (CTQ),Hamil-ton rating scale for depression ( HAMD) and Hamilton rating scale for anxiety ( HAMA) .According to CTQ score subjects were divided into abuse group ( n=38) and non-abuse group ( n=68) .Leptin levels were de-termined using the Enzyme Linked Immunosorbent Assay.Results Of 106 depression patients 35.85%( n=38) had been abused in childhood according to the result of CTQ score.There were significant differences between the abuse group and the non-abuse group in the age of first onset,sex ratio,the total score of the HAMD-24,the total score of HAMA.Leptin level of abuse group ((4.989±2.820)μg/L) was lower than that in non-abuse group((7.324±4.941)μg/L, P<0.05) and control group ((9.811±7.353)μg/L, P<0.01).Leptin level in non-abuse group was lower than that in control group ( P<0.01).Conclusion Childhood abuse obviously influences lep-tin levels of adult depression patients,which may be a risk factor of adult depression development.

Objective To discuss the diagnosis and treatment of acquired cystic kidney disease complicated by kidney cancer. Methods Clinical data of 11 patients with acquired cystic kidney disease complicated by kidney cancer were analyzed retrospectively. Eight patients were male and three were female. The mean age was 55 years old (range 37 to 68). The time of hemodialysis ranged from 2.8 to 7. 4 years, mean 4. 8 years. Results Follow-up ranged from 17- 83 months, mean 55 months. One patient died of cardiovascular disease. Lung metastasis was detected in one patient two years after surgery. Seven patients survived free of tumor recurrence and there was no follow-up on one patient. Conclusions Increased incidence of cancer was observed in patients with end-stage renal disease who have undergone long-term dialysis. In particular, renal cell carcinoma (RCC) showed an excess incidence in ACKD patients. RCC showed an increased prevalence compared with the general population. Patients with predialysis azotemia or a dialysis duration of longer than 3 years should be screened for ACKD. Sonegraphy or CT scanning are useful for early diagnosis of ACKD. We should pay close attention to complications, including ACKD malignant tendency, in patients who have been taking long-term dialysis and positive therapy.

Objective To study the relationship between oxidative stress and endothelial progenitor cells(EPCs)count in the first-degree relatives of diabetes mellitus(FDRs).Methods Three groups were evaluated with 40 type 2 diabetes mellitus(T2DM)patients,38 FDRs and 30 healthy individuals as the control(NC).Fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),TG,TC and fasting plasma insulin concentrations were measured and homeostasis model assessment-insulin resistance(HOMAIR)was calculated.Quantity of EPCs and flow-mediated dilation(FMD)were evaluated.Malonaldehyde(MDA),glutathion peroxidase(GSH-Px),erythrocuprein(SOD)and total anti-oxidative capacity(TAO-C)were measured.Results In T2DM group FPG[(7.86 ±0.77)mmol/L]and HbA1c[(7.24 ±0.20)％]were significantly higher than those in NC[FPG(4.90 ± 0.35)mmol/L,HbA1 c(5.34 ± 0.37)％]and FDRsgroup[FPG(5.13±0.95)mmol/L,HbA1c(5.36 ±0.36)％](all P values ＜0.05).TC in T2DM group[(5.88 ±0.76)mmol/L]was higher than in NC[(4.66±0.90)mmol/L]and FDRs [(4.95 ± 0.76)mmol/L].HOMA-IR was 0.48 ± 0.25 in NC,0.81 ± 0.46 in FDRs and 1.47 ± 0.24 in T2DM group,P ＜ 0.01.In T2DM group,the plasma levels of SOD[(69.30 ± 2.21)U/ml],TAO-C [(7.30 ± 0.29)U/ml]and GSH-Px[(856.5 ± 9.01)U/ml]were significantly lower than those in NC [SOD(75.33 ±3.63)U/ml,TAO-C(8.17 ±0.58)U/ml and GSH-Px(938.1 ± 19.35)U/ml]and FDRs group[SOD(74.91 ±4.53)U/ml,TAO-C(8.24 ±0.46)U/ml and GSH-Px(936.9 ± 15.78)U/ml](all P values ＜ 0.01).Serum level of MDA was(2.87 ± 0.63)μmol/L in NC,(3.28 ± 0.71)μmol/L in FDRs and(3.69 ± 0.39)μmol/L in T2DM group(P ＜ 0.01).The quantity of EPCs and FMD％ were 96.75 ±8.11 and 8.36 ± 2.21 in NC,83.34 ± 12.43 and 6.78 ± 0.98 in FDRs and 58.45 ± 7.58 and 2.86 ± 0.35 in T2DM group with statistical differences between different groups(all P values ＜ 0.05).Pearson correlation analysis showed that lnHOMA-IR was positively correlated with MDA(r =0.486,P ＜0.05)and negatively correlated with SOD,TAO-C,GSH-Px(r =-0.426,-0.601,-0.524,all P values ＜ 0.05)in FDRs group.Conclusions Insulin resistance,oxidative stress,decreased quantity of EPCs and impairment of endovascular function have already occurred in the FDRs of T2DM with normal glucose tolerance and they are correlated with each other.

This study was aimed to make a systematic and comprehensive evaluation on clinical efficacy and safety of vertigo treatment with Tian-Ma Gou-Teng (TMGT) Decoction. Articles had been searched in the Chinese Journal Full-text Database, Chongqing VIP Chinese Scientific Journals Database, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database Online, Wanfang Data and Chinese Medicine Journal Literature Database for randomized controlled trials (RCT) on vertigo treatment with TMGT Decoction. The data retrieval time was from the establishment time of the database until present. Two investigators screened literatures, extracted data and assessed quality according to inclusion and exclusion criteria independently. RevMan5.0.2 was used in the meta-analysis. The results showed that a total of 33 trials were involved, which covered 2922 vertigo cases. The meta-analysis showed that from the aspect of clinical effectiveness, the comparison between Chinese medicine treatment group and modern medicine treatment group (OR = 3.67, 95% CI [2.66~5.07]), comparison between integrative medicine treatment group and modern medicine treatment group (OR = 3.28, 95% CI [2.33~4.62]), the comparison between Chinese medicine combined with other method (such as acupuncture, Tuina) treatment group and other Chinese medicine treatment group (OR = 2.29, 95% CI [1.34~3.91]), therapeutic effect in the experimental group was better than the control group. For the aspect of relapse rate, TMGT Decoction in the treatment of vertigo was better than the control group (OR = 0.27, 95% CI [0.12~0.65]). In the aspect of adverse reactions, TMGT Decoction in the treatment of vertigo was better than the control group (OR = 0.40, 95% CI [0.13~1.24]). For aspects of other indicators such as quality of life, no further analysis was conducted since there was no complete reported literature. It was concluded that the system evaluation results showed that compared with other methods, TMGT Decoction has better clinical efficacy and low recurrence rate, but safety needs to be further eualuated. However, due to the quality of included studies was not high, current evidences cannot be determined to be fully applicable in the clinical practice. But its efficacy advantages are worthy of further research. It especially requires high quality multi-center, large sample, double-blind, RCTs to verify.