Objective To probe into the effect of sitagliptin on blood glucose fluctuation of the patients with type 2 diabetes mellitus(T2DM) and poor control by insulin aspart 30.Methods Ninety cases of T2DM and poor control by insulin aspart 30 in affiliated Zhongshan hospital from January 1,2014 to December 31,2014 were selected and randomly divided into three groups:simply continuous subcutaneous insulin injection(CSII),acarbose combined CSII group(CSII + Aca) and sitagliptincombined CSII group (CSII + Sig),30 cases in each group.Three groups received the intensive treatment for 2 weeks,and72-h continuous glucose monitoring was performed on last 3 d.The 24 h mean blood glucose(24 hMBG),largest amplitude of glycemic fluctuation(LAGE),mean amplitude of glycemic excursion(MAGE) within 1 d,postprandial blood glucose spike(PGS),postprandial glucose peak time(△t),postprandial glucose excursion(PPGE) and total T were observed within 24 h.The difference of insulin dose(△ insulin),hypoglycemia incidence,glucose-target rate,blood glucose profiles were compared at the end of treatment.Results After two-week treatment,intraday blood glucose variation indicators(24 hMBG,LAGE and MAGE) and postprandial blood glucose variation indicators (PGS,△t,PPGE and total T) in the CSII+Sig and CSII+-Aca groups were significantly lower than those in the CSII group(P＜ 0.05),while the differences in blood glucose variation indicators between the CSII+Sig group and CSII+-Aca group were not statistical significant(P＞ 0.05).In the comparison after treatment,△ insulin,hypoglycemia incidence and glucose-target rate in the CSI + Sig group were lower(P＜0.05).Conclusion The combined application of short-term CSII and sitagliptin will achieve a better effect than the combination with acarbose,can smoothly and steadily reduces the blood glucose level,relieves the whole day glucose fluctuations,effectively reduces △ insulin,and has lower hypoglycemia occurrence rate.

Guangdong province assumes the task of pilot exploration and demonstration for building the preventive health service system of Chinese medicine. In the pilot process of preventive treatment of disease, a health pro-ject of Chinese medicine, sectoral agreements and policy studies are focusing issues. This paper explores the pre-ventive health service system building of Chinese medicine in G uangdong province , from following aspects such as access policy of service agencies, access policy of professional service staff, evaluation mechanism and verify sys-tem, the revision of existing medical subjects of medical institutions, health insurance policies and compensation policies, price policies, proactive technology policies and fiscal policies, incentive policies for the introduction of private capital .

On the basis of thermal stability of andrographolide and dehydroandrographolide,the influences of medicinal material factors(habitats,collecting time,storage time),thermal stability,production technology(solvent,temperature,heating time and storage condition)on the content of andrographolide and dehydroandrographolide in Andrographis Tablet(AT)were explored so as to increase the quality of AT.The results showed that the excellent medicinal material of Herba Andrographis,optimized production technology,shorter heating time and lower temperature are the effective measures for increasing the quality of AT.

OBJECTIVE To investigate the significance of expression of p53, Mdm2 and p21WAF/ CIP1 proteins and their relationships. METHODS Pathological specimens from thyroid carcinoma, adjacent non-tumor thyroid tissues and thyroid benign lesions were examined for p53, Mdm2 and p21WAF/CIP1 proteins by tissue microarray technique and immunohistochemistry method. RESULTS The positive expression rate of p53, Mdm2 and p21WAF/CIP1 in thyroid carcinoma was 50.6 %(37/73), 63.0 %(47/73) and 38.4 %(28/73) respectively. The expression of p53 and Mdm2 increased(P

Objective To analyze and summarize the efficacy and the experience in the application of type Ⅰ and type Ⅱ bundled pancreaticojejunostomy in pancreaticoduodenectomy. Methods Between Jan.2005 and Dec. 2009, a total of 38 patients who underwent bundled pancreaticojejunostomy was enrolled, and their clinical data were retrospectively analyzed. 20 patients received type Ⅰ bundled pancreaticojejunostomy and 18 patients received type Ⅱ bundled pancreaticojejunostomy. The operative time, postoperative hospital stay, mortality and complications were compared. Results The operative time of type Ⅰ bundled pancreaticojejunostomy was (91 ± 20) min, and it was (63 ± 21) min in type Ⅱ procedure, and the difference was statistically significant (P ＜ 0. 05). The mortality and complications, postoperative hospital stay were 10.0%(2/20), 45.0% (9/20) and (20 ±2)d in type Ⅰ procedure, while they were 5.6% (1/18),38.9% (7/18) and(23 ±2)d in type Ⅱ procedure, and the difference was not statistically significant.Conclusions There was no significant difference in the effects between type Ⅰ and type Ⅱ bundled pancreaticojejunostomy. Carefully selective application of type Ⅰ and type Ⅱ bundled pancreaticojejunostomy helps complete these procedures.

Objective To study the technique condition for separating and purifying total flavones from Striga asiatica (L.) O. Ktze. by Polyamide. Methods Total flavones content, in the sample solution of Striga asiatica (L.)O. Ktze. , detected by UV spectrophotometry, is used as the index. Some technological parameters are observed by single factor observation. Results Polyamide has good absorbing effect on total flavones of Striga asiatica (L.) O. Ktze. The liquid concentration of its absorbing and separating technological condition is 1.12～2. 24 mg/mL and at the absorbing speed of 2BV/h. The elution effect of 95 % alcohol of 250 mL is the best. Conclusion This method is simple and feasi-ble, fit for separating and purifying total falvones from Striga asiatica (L.) O. Ktze.

Objective:To investigate whether idebenone can improve behavioral disorders in mice with Parkinson disease (PD) by increasing PHB2 mediated mitophagy.Methods:In the first small experiment, thirty mice were randomly divided into normal control group, model group and treatment group according to the random number table method, with 10 animals in each group.The aim of this study was to observe the effect of idebenone on the behavior of Parkinson disease model mice. In the second experiment, 20 mice were randomly divided into blank control group, MPTP group, shRNA-PHB2 group and shRNA-PHB2+ MPTP group, with 5 mice in each group. The changes of tyrosine dehydrogenase (TH) in brain tissue were detected by immunofluorescence assay. In the third experiment, 30 mice were randomly divided into blank control group, shRNA-PHB2 group, MPTP+ idebenone group, shRNA-PHB2+ MPTP group, shRNA-PHB2+ idebenone group and shRNA-PHB2+ MPTP+ idebenone group, with 5 animals in each group. The aim of this study was to investigate the effect of idebenone on mitochondrial autophagy in mouse brain.C57BL-6 mice were intraperitoneally injected with MPTP to establish the animal model of chronic PD. Then 200 mg / kg idebenone was given by gavage for 21 days. And the expression of PHB2 in brain was inhibited by microinjection of adeno-associated virus 9 (AAV9) shRNA inhibin 2(PHB2) into lateral ventricle. The behavioral changes of the PD mice were detected by Morris water maze, and the changes of tyrosine dehydrogenase (TH) induced by inhibiting PHB2 were detected by immunohistochemistry. The protein expression of LC3 and PHB2 in substantia nigra of midbrain was detected by Western blot.The data were analyzed by GraphPad 7.0 and SPSS 22.0.Results:(1) In the water maze test data of the first small experiment, the repeated measurement ANOVA showed that the group-time interaction effects of latency of mice from 1 to 7 days were significant ( Ftime×group=20.51, P<0.05). Simple effect analysis showed that on the 5th, 6th and 7th day, the incubation period of the treatment group was significantly shortened (all P<0.05). Univariate analysis of variance showed that on the 7th day of the test, the differences between the control group and the model group, the model group and the treatment group, the control group and the treatment group were all statistically significant( t=-49.95, -21.81, 28.14; all P<0.01). In the third small experiment, repeated measurement analysis of variance showed that the interaction between time and group was significant ( Ftime×group=42.11, P<0.01). Simple effect analysis showed that compared with MPTP+ idebenone group, the latency of shRNA-PHB2+ MPTP+ idebenone group was significantly prolonged (all P<0.05). There were no significant difference between shRNA-PHB2+ MPTP+ idebenone group and shRNA-PHB2+ MPTP group except the 4th day ( P<0.05). On the 7th day, compared with MPTP+ idebenone group, the residence time of shRNA-PHB2+ MPTP+ idebenone group was significantly increased ( t=-34.36, P<0.001), but there was no significant difference between shRNA-PHB2+ MPTP group and shRNA-PHB2+ MPTP+ idebenone group ( t=2.94, P>0.05). (2)The results of immunofluorescence experiment showed that the relative expression of TH in the control group, model group, shRNA-PHB2 group and shRNA-PHB2+ MPTP group were (41.03±3.01), (24.20±4.18), (38.39±3.31) and (13.12±2.65), respectively. Compared with the control group, the expression of TH in the midbrain of the MPTP group was significantly down-regulated, the difference was statistically significant( t=7.98, P<0.01). Compared with the MPTP group, the expression of TH in shRNA-PHB2 group was down regulated ( t=-6.73, P<0.05). (3) Western blot results showed that the relative expression of LC3 in midbrain tissue of control group, shRNA-PHB2 group, MPTP+ idebenone group, shRNA-PHB2+ MPTP group, shRNA-PHB2+ idebenone group and shRNA-PHB2+ MPTP+ idebenone group were (0.86±0.07), (0.77±0.08), (0.42±0.05), (0.21±0.05), (0.66±0.09) and (0.27±0.07). The relative expression of PHB2 were (1.13±0.14), (0.56±0.11), (1.08±0.14), (0.27±0.07), (0.68±0.14) and (0.24±0.10). Compared with MPTP+ idebenone group, the relative expression of LC3 and PHB2 in shRNA-PHB2+ MPTP+ idebenone group was significantly decreased ( F=1.96, P<0.01). Conclusion:Idebenone can increase the level of mitophagy in PD mice through PHB2, thus improving the behavioral disorder.

OBJECTIVE: To study the diagnosis and treatment of parotid Lymphoepithelioma-like carcinoma (LELC), and improve the rate of the diagnosis and treatment. METHOD: Eighteen cases with parotid LELC confirmed pathologically were collected in our department, and the clinical presentation, diagnosis, treatment and prognosis were retrospectively summarized and analyzed from 1982 to 2002. RESULT: All of these LELC patients were found in unilateral side. All cases received Epstein-Barr virus serological test except 2 cases because of refusing, and the testing result displayed: EBV-VCA-IGA positive rate in 93% (15/16); EBV-EA-IGA in 75% (12/ 16); EBV-DNA enzyme in 63% (10/16). Of 16 cases with facial nerve reserved, parotid superficial lobectomy were undertaken in 6 cases, resecting a majority of parotid in 5 cases, whole lobectomy in 5 cases. Facial never resection and whole lobectomy in 2 cases due to facial nerve trunk involved. Functional neck lymph dissection in superior and middle part was undertaken in 14 cases and radical neck lymph dissection in 4 cases, total neck lymph node metastasis rate was 67% (12/18). All of patients received radiotherapy to 50-70 Gy. The follow up were over 1 year, and local recurrence occurred in 2-4 years after operation for 4 cases and had to undergo reoperation. The 1, 3, 5 years survival rates of the 18 cases were 94% (17/18), 72% (13/18) and 50% (9/18), respectively. The chief Causes of death were distant metastasis and local recurrence. CONCLUSION There maybe be close relationship between occurrence of LELC and Epstein-Barr virus infection. Its histopathologic feature is similar to undifferentiated nasopharyngeal carcinoma and nasopharynx biopsy must be demanded before confirming diagnosis for eliminating metastasis focus. The neck lymph node metastasis rate of LELC is high and local invasion is strong. It is important to undergo enlarged local resection, neck lymph dissection and postoperative radiotherapy.
Adolescent ; Adult ; Aged ; Antigens, Viral ; analysis ; Carcinoma ; diagnosis ; surgery ; virology ; Female ; Herpesvirus 4, Human ; pathogenicity ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck Dissection ; Parotid Neoplasms ; diagnosis ; surgery ; virology ; Prognosis ; Retrospective Studies ; Young Adult

OBJECTIVE: To discuss a effective method of nasal septum deviation. METHOD: One hundred and sixteen subjects with nasal septum deviation were divided into treatment group (69 subjects) and control group (47 subjects) randomly. The combination therapy of correction of deviated nasal septum and plasma radiofrequency ablation were used in the treatment group. The combination therapy of deviated nasal septum and partial inferior turbinectomy were used in the control group. The data were analyzed by statistical method. RESULT: The effective rate of physical signs and symptoms of the treatment group was 100.0%, while the control group was 85.1%. There was significant difference of two effective rates (P < 0.05). Furthermore, hyperventilation and nasal adhesion were not happened in treatment group 6 months after treatments. CONCLUSION The correction of deviated nasal septum and plasma radiofrequency ablation combination therapy had the satisfied and safety treatment effect, which was and plasma radiofrequency ablation combination therapy had the satisfied and safety treatment effect, which was easy for observation as well as the minimal tissue damage. The combination therapy method was according with the principle of functional minimally invasive surgery.
Adult ; Catheter Ablation ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Nasal Septum ; abnormalities ; surgery ; Reconstructive Surgical Procedures ; Young Adult

Objective: To preliminarily investigate the difference of position fixation accuracy between polyurethane styrofoam and vacuum negative pressure pad in intensity-modulated radiation therapy (IMRT) after radical mastectomy for breast cancer. Methods: Forty breast cancer patients, who received breast-conserving surgery followed by hyper-fractionated IMRT of the whole breast (42.56 Gy for 16 times) in our hospital between 2017 and 2018 were recruited and randomly divided into the polyurethane styrofoam group and vacuum negative pressure pad group. Before IMRT treatment, the anterior and lateral films of patients were taken with kilovoltage digital radiographs (KVDRs) by Varian Trilogy machine-borne OBI KV image verification system. The KVDRs images were matched with the DRR images reconstructed by the planned system to obtain the setup errors in the left and right, head and foot, and ventral and back directions between two groups. Each patient was verified for 10 times to obtain 400 sets of data. The independent sample t-test was adopted to analyze the setup errors between two groups. The external expansion value of graded setup errors from clinical target volume (CTV) and planned target volume (PTV) was calculated. Results: The setup errors in the left and right, head and foot, ventral and back directions between the styrofoam fixation and vacuum pad groups were (1.63±1.29) mm and (1.83 ±1.61) mm (P=0.18), (1.46±1.51) mm and (2.26±2.03) mm (P=0.00), and (1.30±1.35) mm and (1.91±1.67) mm (P=0.00), respectively. The external expansion values of setup errors from CTV to PTV were 2.19 mm, 2.51 mm, 1.57 mm and 2.40 mm, 3.97 mm and 2.63 mm, respectively. Conclusion Both two fixation methods meet the clinical requirements. However, the setup accuracy and reproducibility in the polyurethane styrofoam group are better than those in the vacuum negative pressure pad group.